NHS Education for Scotland

There is a need for competency-based assessment of pharmacy students during experiential learning (EL). Entrustable Professional Activities (EPAs) originated in Medical Education and have been adopted by other health professions globally. This research sought consensus on entrustment levels, EPAs and competencies for use in assessing student pharmacists during EL. Six EPAs with competencies were developed based on previous research: NHS England entrustment levels were adopted. A Delphi questionnaire was distributed to EL facilitators (n=1685), final year student pharmacists at the University of Strathclyde and Robert Gordon University (n=240), and academic and National Health Education Scotland (NES) pharmacists involved in initial education and training of pharmacists (n=58). Participants could agree or disagree with the appropriateness of entrustment levels and competencies using yes/no responses. "No" responders could suggest alternative wording/comment/explain their answer. There was also space for general comments. Consensus was set at 75%. For primary analysis response percentages were calculated with respondent subgroups as secondary analysis. Comments were analyzed for themes. Response rate was 15.8% (313/1983) and consensus was achieved on all EPA competencies and Entrustment Levels on the first round. Secondary analysis showed one entrustment level and two EPA competencies in the Academic/NES subgroup, and one other EPA competency where both Hospital Facilitator and Academic/NES subgroups did not reach consensus. Themes identified were student knowledge, placement duration, guidance required, supervision/checking of work, missing EPAs/competencies and overlap of EPAs. Consensus was reached on entrustment levels and EPA competencies for use in student pharmacist EL.

Introduction Healthcare organisations worldwide are expected to investigate or review incidents that unintentionally harm or could cause harm. Investigation findings are presented in a written report, which is arguably a proxy measure for the quality of investigations. The report is an important document to be read and acted upon. The aims of this study were: (1) to design a tool to support the writing and review of healthcare safety investigation reports, and (2) to validate the content of the tool. Methods The study was conducted in two phases. Phase 1: The initial content of the tool was developed using relevant published literature and building consensus with 25 specialist participants from the UK and Australia. Phase 2: Content validity of the tool was assessed for relevance and clarity in two e-Delphi survey rounds with users of the tool. Using a 4-point scale, a median of 3 or 4 and an interquartile range of less than or equal to 1.5 were used to determine consensus. Results Phase 1: A tool containing eight areas of review with accompanying descriptors was developed. For each area of review, a three-point ordinal rating scale along with a comments box for formative self-assessment was included. Phase 2: At the end of the round 1 survey, there was consensus on all but one area of review in the tool. By the end of the round 2 survey, consensus was reached on all areas of review. No additional areas of review were added and none were removed. Some descriptors were amended to improve clarity. Conclusion We co-designed and validated the content of a tool that can be used to inform the quality of safety investigation reports and learning in terms of a systems-based approach. The tool has multiple uses ranging from self-assessment for report writers to facilitating oversight of the quality of healthcare safety investigation reports. Future work could focus on building further evidence of the tool's overall utility.

Rural surgical training attachments are an important means to improve rural-urban workforce equity. Recent evidence from the USA indicates that the educational benefits of rural surgical attachments are much broader than just developing a rural workforce pipeline. In our own context rural attachments have been offered for many years, but the quality and gains from rural training have not been studied previously. Thus, the study aim was to explore UK core surgical trainees' experiences of a remote and rural rotation and the value they placed on this experience in terms of positioning them for their next career surgical steps. This was a qualitative study using semi-structured interviews to gather the views and experiences of core surgical trainees (CSTs) who had undertaken a placement in a Scottish rural hospital. Interview questions were developed from the wider literature. Data were analysed using an inductive, thematic approach. Four themes were identified from interviews with 10 trainees. First, rural surgical training is a unique and valuable learning experience, ideal for early surgical training, offering useful experiences for personal and professional growth. Second, rural training is a positive and personalised experience: a community experience both within and outside the hospital. Third, rural training is an opportunity to gain a broad understanding of healthcare delivery, and the impact of context on healthcare delivery. Fourth, there was a perceived misalignment between rural surgical training and core training requirements, and a view that rural training was not for everyone. Rural surgical attachments in Scotland are high-quality educational experiences which effectively facilitate the development of both technical and non-technical skills and deliver self-learning as well as an understanding of the wider context of surgical care delivery. These placements integrate well into many surgical careers and their uniqueness could be better recognised in the training system.

Background: To help address ongoing recruitment and retention issues in the adult social care workforce, the Scottish Government commissioned the development of a National Induction Framework (NIF) for adult social care. This was to include a portable learning record to allow workers to move employers without having to duplicate induction learning. Effective induction has been shown to positively influence workforce turnover, job satisfaction, organisational commitment, task performance, and employee wellbeing. Approach: Development of the NIF, a collaborative project between NHS Education for Scotland (NES) and the Scottish Social Services Council (SSSC), involved extensive stakeholder engagement including a Delphi technique, to define essential induction training content. Stakeholder involvement was essential to facilitate employer adoption of the NIF. Key development stages included: 1.Establishing sector appetite for a NIF and potential challenges. Stakeholder discussions identified strong interest along with a need for robust quality assurance of and easy access to learning materials; a set of standards to reduce variation in implementation; completion tracking; a portable learning record. 2.Identifying essential induction content through a) initial stakeholder engagement reviewing current practices b) analysis of UK-wide induction frameworks c) a Delphi technique collaborating with stakeholders to gain consensus on essential NIF topics. This approach allowed wide engagement with stakeholders in a time efficient manner, essential for this time poor workforce. 3.Selecting the most suitable platform to host the NIF, considering resource housing and learning record integration. 4.The development of a portable learning record enabling workers to demonstrate prior learning with new employers. This involved innovating an Application Programmer Interface allowing the NES Learning Management Platform to share leaner data with the SSSC MyLearning app. 5.Developing the landing site, induction standards, learning outcomes and high-quality resources. 6.Piloting the framework. 7.Official launch. Impact and Outcomes :Social care employers from 30 of Scotland’s 32 local authority areas participated in the Delphi technique achieving consensus regarding inclusion of 68 of 71 topics. These were structured into 30 hours of learning and aligned to the SSSC Continuous Professional Learning framework. Since the May 2025 launch, 1437 learners have started and 111 completed the NIF. The quality of learning resources is rated highly (mean score 4.65/5). Initial survey findings (n=44) show 88% of workers would recommend the NIF and 80% reported increased knowledge and a positive impact on practice. Additionally, 92% found it easy to share completion certificates for learning, indicating strong potential for the learning record to be portable across employers. Implications: Scotland now has a standardised, data-informed induction process for adult social care providers to use with their workforce. This initiative has the potential to reduce workforce turnover due to improved induction learning resulting in increased job satisfaction and organisational commitment. If workers leave and take up a new role, the portable record of learning prevents duplication of learning and combined impact allows more time to provide direct, high-quality care and support for individuals.

Background: Recruiting and retaining healthcare professionals in rural and island areas remains one of Scotland’s greatest challenges, directly impacting access, equity, and the sustainability of services. The NHS National Centre for Remote and Rural Health and Care (established in 2023) leads a coordinated national response to these challenges through research, evaluation, and innovation programmes focused on strengthening the rural health and care workforce. One such initiative—the Skye Community-Engaged Recruitment Group—has pioneered a model of locally driven, system-supported recruitment and retention that integrates community engagement into workforce planning. This work aligns with the Sustainable Development Goals (SDGs), particularly those addressing reduced inequalities and improved health and wellbeing. Approach: The National Centre has developed a Menu of Options for Improved Recruitment and Retention, mapping evidence-informed, contextually adaptable strategies for workforce attraction, induction, and retention across Scotland’s rural, remote, and island (RRI) settings. This includes mechanisms for community participation, such as the “Living Library” (developed in collaboration with the University of Aberdeen and rural communities), which documents practical tools and examples of community-enhanced recruitment. The Skye model, evaluated through co-designed qualitative and developmental approaches, provides a transferable framework underpinned by five evaluation dimensions: Effectiveness, Impact, Relevance, Efficiency, and Sustainability (EIRES). Results: Findings: indicate that structured community involvement strengthens the visibility and attractiveness of rural posts, supports early integration of new staff, and enhances professional belonging. The evaluation framework developed through this collaboration provides a replicable tool for assessing the effectiveness and sustainability of community-engaged workforce initiatives. Early insights from testing the framework suggest improved coordination between communities and health boards, greater local ownership, and enhanced workforce resilience. Implications:Embedding community insight within workforce policy and practice can transform recruitment from a transactional to a relational process. The National Centre’s programmes illustrate how community-engaged models can contribute to achieving equitable, sustainable rural health systems by addressing workforce gaps at both structural and human levels. The next phase involves scaling and adapting the framework across diverse rural contexts in Scotland, offering an evidence-based, SDG-aligned model for regions worldwide seeking to strengthen integrated rural health and care systems.

The rapid evolution of phishing methods has long been a threat to cybersecurity that demands adaptive and intelligent detection techniques. This current work envisions an improved phishing detection system that involves the integration of machine learning (ML) with feature selection for improving the performance of real-time classification. A comprehensive dataset was optimized and preprocessed through Chi-square (CHI) feature selection to reduce dimensionality while preserving the most discriminative features. Random forest (RF) algorithm, selected for its robustness, interpretability, and high computational efficiency for binary classification, was employed and achieved an accuracy of 96.25%, effectively identifying sophisticated phishing attacks. The architecture is designed to operate on large datasets with minimal computational overhead but with high precision and scalability. Experimental results also indicate the dependability of the system with an area under the curve (AUC)-receiver operating characteristic (ROC) score of 1.0, indicating perfect separation of phishing from normal cases. In addition, an adaptive classification model was used to accommodate unknown data sets with a 100% accuracy score. The results above identify the potential of adaptive, feature-optimized ML systems in the ability to handle dynamic phishing attacks and enable proactive cybersecurity defense.

Background/Objectives: Adenosine monophosphate deaminase deficiency has been implicated in impaired exercise capacity. We examined whether the AMPD1 C34T (rs17602729) genotype was associated with athlete status and performance in distance runners (DRs) and rugby union (RU) athletes. Methods: Participants included 621 elite male RU athletes, 666 elite/sub-elite male and female DRs, and 1029 male and female non-athletes (NA), all of European ancestry. Genotyping was performed using real-time PCR with TaqMan reagents. Genotype and allele frequencies were compared using χ2 tests, while performance data were analysed using Kruskal–Wallis H, Mann–Whitney U, one-way ANOVA, and t-tests, with Benjamini–Hochberg correction applied for multiple comparisons. Results: Genotype and allele frequencies did not differ between athletes and NA or between athlete groups. In all DRs, run times did not differ between genotypes, although participants with the CT genotype in the elite and elite male subgroups were up to 5% faster than CC and TT homozygotes. In RU, participants with the CC genotype played 13% longer per appearance than those with the CT genotype, while forwards and front five participants with the CC genotype played 13% and 26% longer per appearance than T-allele carriers, respectively. Front five T-allele carriers made 75% more clean breaks than the front five with the CC genotype despite playing for a shorter time, although this finding should be interpreted cautiously. Conclusions: In summary, while the AMPD1 C34T genotype was not associated with athlete status, the CC genotype was associated with greater RU playing time per appearance in forwards, and the CT genotype was associated with superior performance in elite DRs.