Background Poor communication skills can potentially compromise patient care. However, as communication skills training (CST) programs are not seen as a priority to many clinical departments, there is a discernible absence of a standardised, recommended framework for these programs to be built upon. This systematic scoping review (SSR) aims to gather prevailing data on existing CSTs to identify key factors in teaching and assessing communication skills in the postgraduate medical setting. Methods Independent searches across seven bibliographic databases (PubMed, PsycINFO, EMBASE, ERIC, CINAHL, Scopus and Google Scholar) were carried out. Krishna’s Systematic Evidence-Based Approach (SEBA) was used to guide concurrent thematic and content analysis of the data. The themes and categories identified were compared and combined where possible in keeping with this approach and then compared with the tabulated summaries of the included articles. Results Twenty-five thousand eight hundred ninety-four abstracts were identified, and 151 articles were included and analysed. The Split Approach revealed similar categories and themes: curriculum design, teaching methods, curriculum content, assessment methods, integration into curriculum, and facilitators and barriers to CST. Amidst a wide variety of curricula designs, efforts to develop the requisite knowledge, skills and attitudes set out by the ACGME current teaching and assessment methods in CST maybe categorised into didactic and interactive methods and assessed along Kirkpatrick’s Four Levels of Learning Evaluation. Conclusions A major flaw in existing CSTs is a lack of curriculum structure, focus and standardisation. Based upon the findings and current design principles identified in this SSR in SEBA, we forward a stepwise approach to designing CST programs. These involve 1) defining goals and learning objectives, 2) identifying target population and ideal characteristics, 3) determining curriculum structure, 4) ensuring adequate resources and mitigating barriers, 5) determining curriculum content, and 6) assessing learners and adopting quality improvement processes.

Multiple three-dimensional (3D) tumour organoid models assisted by multi-omics and Artificial Intelligence (AI) have contributed greatly to preclinical drug development and precision medicine. The intrinsic ability to maintain genetic and phenotypic heterogeneity of tumours allows for the reconciliation of shortcomings in traditional cancer models. While their utility in preclinical studies have been well established, little progress has been made in translational research and clinical trials. In this review, we identify the major bottlenecks preventing patient-derived tumour organoids (PDTOs) from being used in clinical setting. Unsuitable methods of tissue acquisition, disparities in establishment rates and a lengthy timeline are the limiting factors for use of PDTOs in clinical application. Potential strategies to overcome this include liquid biopsies via circulating tumour cells (CTCs), an automated organoid platform and optical metabolic imaging (OMI). These proposed solutions accelerate and optimize the workflow of a clinical organoid drug screening. As such, PDTOs have the potential for potential applications in clinical oncology to improve patient outcomes. If remarkable progress is made, cancer patients can finally benefit from this revolutionary technology.

Purpose: Urological training in Singapore has seen a reduction in length of training and shortened working hours to fit requirements of the residency model. Virtual reality(VR) simulators may contribute as an adjunct to shorten the learning curve and acquire surgical skills. This study assesses the construct validity of a transurethral resection of prostate(TURP) simulator and its pilot study in urological residents. Methods: The study first assessed the construct validity of the VirtaMed UroS™️ simulator with 12 novices and 12 experts. A pilot study involving 12 junior(JR) and 15 senior urology residents(SR) was then conducted. Participants were given 2 attempts to complete the same task. Performance indicators include: Percentage of prostate resected(PR), Completion time, the time that loop diathermy was active without tissue contact(TAWC), percentage of capsule resection(CR). Results: Construct validity was demonstrated: experts had significantly greater PR (40.6% vs 11.9%, p<0.05) and less TAWC than novices (0.13s vs 13.9s, p<0.05). JR demonstrated an increase in PR (13.3% vs 26.7%, p=0.0005) and a decrease in TAWC when comparing attempts (4.5s vs 1.3s, p= 0.003). Although statistically insignificant, increased PR (30.2 vs 40.5, p=0.1) and decreased TAWC (1.1 vs 0.9, p=0.84) was demonstrated when comparing attempts by SR. In the 2nd attempt, both groups demonstrated a decrease in TAWC with JR showing a greater decrease (2.9 vs 0.4, p<0.05). Conclusion: This pilot experience shows that the TURP simulator may provide time-efficient learning to supplement urological training. Further research and incorporation of VR simulation is needed to develop more robust and comprehensive training programmes.