Problem representation (PR) is a concise synthesis of clinical information that captures the core diagnostic problem in a single statement, often referred to as a 'one-liner'. Although central to diagnostic reasoning, this skill is frequently underdeveloped in medical training. Many trainees struggle to transform clinical data into meaningful representations, which can hinder communication, diagnostic reasoning and patient safety. The Assessment of Reasoning Tool-Reconstructed (ART-R) provides a structured framework that educators can adapt as a coaching rubric to strengthen PR during clinical teaching. Using the ART-R, faculty can guide trainees to refine their PR by focusing on three elements: (1) clarity of the synthesized clinical problem; (2) emphasis on diagnostically relevant positive and negative findings; (3) use of precise medical terminology. This micro-coaching approach can be naturally embedded into clinical rounds through brief prompts that encourage trainees to refine their one-liner summaries. Through repeated practice, trainees develop increasingly abstracted representations that activate illness scripts and support diagnostic hypothesis generation. Coaching PR in this way provides a practical, low-burden strategy for strengthening diagnostic reasoning during routine clinical teaching. Integrating this approach into patient presentations can help educators cultivate stronger diagnostic reasoning.

The way we teach physical diagnosis needs to be revitalized. Medical students now see patients in their first year, and the traditional head-to-toe physical exam (HTTE) can be overwhelming with its over 100 manoeuvres and does not give learners physical exam readiness for early clinical work. We have developed and implemented Core + Clusters (C + C). C + C begins with a streamlined Core Exam, with approximately 40 manoeuvres, that prepares learners for early clinical experiences. Diagnostic Clusters, the second component of C + C, are sets of history-taking questions and physical examination manoeuvres critical to discriminating among diagnoses in common clinical presentations. They build on prior education models by combining hypothesis-driven history-taking with hypothesis-driven physical examination to better resemble clinical practice. The C + C model is feasible, requires resources similar to those used in the HTTE curriculum and is flexible enough to adapt to the curricula of diverse institutions. In this paper we offer a C + C toolkit which describes the C + C components, gives examples of curricular implementation and shares lessons we have learned from over 10 years of experience with C + C.

Telephone triage services are widely used in many countries, reflecting a broader shift towards remote patient consultations. Acknowledging this trend, we introduced a programme that placed medical students within a telephone triage service. We present this novel teaching intervention alongside an evaluation of student experiences. Attendance at the 111 call centre was mandated for Year 5 medical students and was offered as an optional experience for Year 2 students. Students who had attended a call centre visit were invited to contribute to in-person focus groups. Three focus groups were conducted, involving 14 students. A semi-structured interview guide was employed and developed iteratively between focus groups. Data were analysed using thematic analysis. Findings were interpreted through the lens of cultural historical activity theory (CHAT). Students developed an understanding of how uncertainty and risk are managed in information-sparse environments. Applying CHAT helped identify tensions within the activity system. These tensions were linked to the tools mediating their learning-specifically, decision-making algorithms and telephone consultations. Additional tension emerged around the underlying rules of the educational experience and the division of labour within the call-centre community, which often conflicted with final-year students' expectations and hindered their learning. Students valued the opportunity to gain first-hand insight into telephone triage and its role within the health system. This setting may offer a useful perspective on managing uncertainty and risk in information-sparse environments. However, further research is needed to better understand how such placements can be optimised before wider educational adoption is recommended.

Electronic portfolios (e-portfolios) are increasingly used in healthcare professional education (HPE) to support learning, reflection and professional development. Despite their broad adoption, there is limited synthesis on how e-portfolios are structurally designed and pedagogically implemented across healthcare programmes and on the implications for clinical teachers. A narrative review was conducted following the Scale for the Assessment of Narrative Review Articles (SANRA). Literature search was conducted in PubMed, Web of Science, Scopus and CINAHL between January and February 2025. Twelve studies published between 2012 and 2024 were included. Data were analysed to explore e-portfolio structures, educational uses and reported effects on reflection and learning. E-portfolios were implemented in various educational and clinical settings, showing considerable variation in platform design, structural components and curricular integration. Common features included reflective writing, documentation of clinical experiences, feedback mechanisms and assessment rubrics. Studies reported that e-portfolios integrated into structured pedagogical frameworks and supported by training and mentoring promote reflective practice, student engagement and professional identity development. Conversely, inconsistent implementation, technological barriers or checklist-oriented designs were associated with superficial engagement and limited educational value. The educational value of e-portfolios in HPE lies less in the technology itself and more in how these tools are pedagogically designed, supported and contextualised within clinical education. For clinical educators, attention to flexibility, relevance to practice and ongoing guidance may be key to promoting meaningful reflection rather than procedural completion. Further research is needed to identify best practices and improve adaptability in different healthcare education contexts.

The authors declare no conflicts of interest. Data sharing not applicable to this article as no datasets were generated or analysed during the current study.

Patients increasingly encounter pain-related misinformation, requiring health professionals to effectively navigate the effects of misinformation to ensure appropriate patient care. This paper describes the implementation and evaluation of a simulation-based innovation to enhance physiotherapy students' self-efficacy to navigate pain misinformation in clinical settings, an integral concept of safe and effective practice. The Promoting Accurate Information Narratives (P.A.I.N) innovation was introduced as part of an undergraduate clinical simulation course and aimed to provide physiotherapy students with strategies for navigating pain misinformation during patient care. The innovation consisted of the following three key components: (1) a tutorial on identifying and addressing pain misinformation, (2) a simulated patient case and (3) postsimulation feedback and debriefing. Students' (N = 68) self-efficacy in identifying, evaluating and addressing pain misinformation was assessed before and after innovation using surveys, while student satisfaction was explored through surveys and focus groups. Post-innovation, self-efficacy significantly improved across all items (p < 0.001). Students had high overall satisfaction with all aspects (median score = 4/5, IQR 1.0) but reported needing repeated practice and additional strategies to address more challenging clinical situations. The P.A.I.N innovation provided an experiential simulation-based approach to improving physiotherapy students' self-efficacy to identify and address pain misinformation in clinical settings. Future applications should consider expanding the innovation to increase the number and complexity of clinical case scenarios and enabling and supporting students to integrate these skills into clinical practice.