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One of the most prominent trends in contemporary health professions education (HPE) is the design of teaching and learning processes that are learner-centered, clinically relevant, and capable of f...

Background: Reflection is fundamental to medical education, supporting clinical reasoning, professional identity formation, and lifelong learning. Although generative artificial intelligence (AI) chatbots have emerged as tools to facilitate reflection, little is known about how AI-supported reflection differs from independent reflective writing. This study compared the characteristics and educational contributions of independent reflective writing and AI-supported reflection among medical interns. Methods: A comparative qualitative quasi-experimental study was conducted with medical interns during an emergency medicine rotation. The control group was instructed to perform reflective writing independently, while the intervention group was tasked to use AI-supported reflections using a purpose-built chatbot to complete reflective writing. Data were analyzed using qualitative content analysis and compared in terms of themes, reflective depth, clinical reasoning, emotional awareness, and professional learning. Results: Twenty-one interns completed independent reflective writing, while eighteen engaged in AI-supported reflection using a chatbot. Although both approaches supported reflective learning, they facilitated distinct dimensions of the reflective process. Independent reflective writing was characterized by greater autonomous meaning-making, critical reflection, ethical reasoning, and systems-level thinking. In contrast, AI-supported reflection was characterized by greater emotional articulation, structured reflective dialogue, and future learning planning, but showed more limited exploration of contextual, ethical, and systems-level issues. Participants’ comments embedded within the chatbot interactions suggested that some found the interaction supportive, while repetitive prompting and limited critical exploration emerged as limitations. Conclusions: Independent reflective writing and AI-supported reflections represent complementary rather than interchangeable educational approaches. While independent reflective writing fosters deeper critical reflection, AI primarily functions as a reflective scaffold that supports emotional engagement and structures reflective learning. Integrating AI-assisted reflections with independent writing and faculty-guided debriefing may optimize reflective learning in medical education.

Introduction Although evidence supporting peer-assisted learning in clinical skills education is growing, qualitative insights into stakeholder perceptions remain limited. Informed by sociocultural learning perspectives, peer-assisted clinical skills training may be pedagogically effective while simultaneously challenging established educational authority and faculty role boundaries. This study aimed to explore multi-stakeholder perceptions of peer-assisted clinical skills training in the preclinical phase of medical education. Methods This qualitative study employed a thematic analysis approach. Semi-structured in-depth or focus group interviews were conducted with medical students, peer educators, and faculty members following their initial exposure to peer-led clinical skills sessions. Data were analyzed iteratively to capture shared and divergent perspectives across stakeholder groups. Results Peer-assisted training was perceived to enhance psychological safety and promote active learner participation. Peer educators were viewed as technically competent and effective facilitators of learning. However, faculty members expressed tensions related to educational authority, professional identity, and hierarchical norms. These concerns were not primarily linked to the perceived educational quality of peer-assisted training but rather to challenges associated with shifting instructional roles. Conclusion The findings suggest that barriers to the integration of peer-assisted clinical skills training are predominantly cultural and institutional rather than pedagogical. Conceptualized through sociocultural and professional identity lenses, faculty resistance appears to reflect role-related tensions rather than opposition to peer learning itself. A supervised hybrid model, integrating peer educators with visible faculty oversight, emerged across stakeholder groups as the most sustainable and acceptable approach for implementing peer-assisted clinical skills training.

The quality of the clinical learning environment plays a critical role in shaping medical students’ educational outcomes. The Undergraduate Clinical

Intern physicians, in the final stage of medical training, face increasing clinical responsibility and workload, which may heighten vulnerability to errors and second victim experiences. This study aimed to explore interns’ second victim experiences using an escape-room–based educational intervention and to examine the emotional and systemic dimensions underlying these experiences. A mixed-methods design was employed. Sixty-six Year 6 medical students in the Emergency Medicine rotation at XXX University Faculty of Medicine participated. Interns who voluntarily attended the escape-room activity and structured reflection session (n = 33) were compared with those who did not participate but completed the quantitative assessment (n = 33). Quantitative data were collected using the Second Victim Experience and Support Tool–Revised (T-SVEST-R), and qualitative data were derived from reflection transcripts. A statistically significant difference was observed in perceived organizational support, with higher scores in the intervention group compared with the comparison group (p < 0.05). Although psychological distress scores were lower among interns who participated in the escape-room activity, this difference did not reach statistical significance. Qualitative findings indicated that the gamified and reflective process made emotional experiences more visible and shareable, strengthened team identity, and increased awareness of systemic and interpersonal dimensions of second victimization. Themes included emotional confrontation, peer support, coping through reflection, and recognition of structural challenges within clinical training. The integration of experiential learning and structured reflection through an escape-room approach can effectively address second victimization by fostering resilience, emotional awareness, and compassionate teamwork among medical interns. The online version contains supplementary material available at 10.1186/s12909-026-09033-w.

This scoping review aimed to map the current literature on how drama methods are used in simulation-based training (SBT) across health professions education. Drama-based methods are increasingly recognised as valuable tools in health professions education, particularly for fostering affective, interpersonal and ethical competencies. When integrated into SBT, these methods may enhance learner engagement and humanistic skill development. However, the extent and nature of their use within SBT remain unclear. The review followed Arksey and O’Malley’s methodological framework and adhered to Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews reporting guidelines. A comprehensive search was conducted in PubMed using keywords related to ‘drama’, ‘role play’, ‘simulation’ and ‘health professions education’. Inclusion criteria focused on empirical studies involving undergraduate health professions learners, SBT and identifiable drama techniques. Ten studies met the criteria and were analysed. Three main drama approaches were identified: structured role-play, improvisational techniques and forum theatre. These approaches were primarily applied in low-fidelity to mid-fidelity simulations targeting skills such as empathy, communication, ethical reasoning and professional identity formation. Across studies, terminology was inconsistent, theoretical underpinnings were rarely articulated and outcome evaluations relied mainly on subjective measures. Disciplinary diversity was also limited. Although references to drama are common in the literature, true pedagogical integration of drama into simulation-based education remains limited. More theory-informed, rigorously evaluated and inclusive research is needed to explore the full potential of drama methods in enriching SBT and promoting humanistic learning outcomes.