Professional identity formation in health professions education is often conceptualised as socialisation into established professional norms and values. For neurodivergent learners, however, these norms may reflect assumptions that privilege neurotypical ways of thinking, communicating, and behaving. While professional identity formation has been explored among other minoritised learners, less is known about how neurodivergent learners navigate this process. This study explored how neurodivergent graduates of Australian health professions programs constructed professional identities. Twelve neurodivergent health professionals participated in semi-structured interviews or provided written responses. Data were analysed using reflexive thematic analysis, informed by Baxter Magolda’s theory of self-authorship. Participants initially encountered narrow archetypes of the “ideal health professional” that were shaped by assumptions about capability, professionalism, and neurotypical behaviour. These expectations generated identity dissonance, concerns about disclosure, and pressure to mask neurodivergent traits. Over time, participants developed greater self-recognition of their strengths, needs, and preferred ways of practising. This enabled them to critically question dominant constructions of professionalism and to rework professional identities in ways that were more authentic, sustainable, and aligned with their values. Rather than simply assimilating into existing norms, participants actively expanded and reshaped understandings of what competent and compassionate healthcare practice can look like. Viewed through the lens of self-authorship, these findings highlight how professional identity formation for neurodivergent learners involves negotiating, resisting, and reconstructing professional norms. In response, educators could move beyond supporting learners to conform to dominant professional archetypes and instead create educational environments that recognise diverse ways of being, foster self-authorship, and broaden understandings of professionalism within the health professions.
Social accountability (SA) is a defining institutional mandate in health professions education (HPE), yet how educational approaches associated with SA are experienced in practice remains insufficiently understood. Rather than examining what these approaches aim to achieve, this study explores how they are encountered, interpreted, and made meaningful by those directly involved. We conducted an interpretive descriptive study using rich picture interviews combined with semi-structured interviews with 46 participants, including learners, clinical teachers, community organization members, patient partners, and leaders in SA. Participants depicted and discussed their experiences with educational approaches related to SA. Data were analyzed using reflexive thematic analysis. Five interrelated themes were identified. Participants described (a) an evolving reorientation in how they understood and positioned themselves in relation to responsibility, (b) the limits of abstraction, where experiential encounters revealed dissonance between lived realities and curricular representations, (c) reflexivity as uneven and pedagogically mediated, requiring dialogue, continuity, and psychological safety, (d) institutional conditions as shaping what can be questioned or enacted, including hierarchy, role modeling, and competing priorities, and (e) social accountability as a collective and relational practice, in which participation, reciprocity, and whose perspectives shape educational processes mattered. Across these themes, the presence of an educational approach did not itself determine how socially accountable education was experienced or made meaningful. Meaning was shaped through the interplay between what encounters made visible, opportunities to interpret and question those experiences, the institutional conditions in which they occurred, and whose perspectives were able to shape the educational process. Advancing SA in HPE therefore requires attention not only to which educational approaches are included, but to how they are experienced, facilitated, and negotiated within educational and community relationships.
Limited evidence exists regarding dental students’ intentions to treat People Living with HIV/AIDS (PLWHA). This study aimed to examine the factors associated with intentions to treat PLWHA among students at the Tel Aviv University School of Dental Medicine using an Extended Theory of Planned Behavior (E-TPB) framework. A cross-sectional survey was conducted between September 2024 and January 2025 among a convenience sample of 302 dental students. The questionnaire assessed TPB variables (attitudes, subjective norms, and perceived behavioral control) as well as extended constructs, including self-efficacy, moral norms, altruism, HIV-related knowledge, risk perceptions, and protective perceptions. Data were analyzed using Confirmatory Factor Analysis (CFA) and Structural Equation Modeling (SEM). Participants reported moderate intentions to treat PLWHA. The final SEM demonstrated good fit to the data and explained 51
We respond to Chen’s commentary on our recent article, “Personality and emotional intelligence among health professions students: the roles of perceived group cohesion, perceived team emotional intelligence, and attitudes toward interprofessional education.” We address methodological and interpretive questions concerning covariate coding, variable centering, the Group Cohesion (GC) × Attitudes Toward Interprofessional Education (ATIPE) interaction, and the perceived team emotional intelligence (TEI)-only indirect pathway. Sensitivity analyses supported the main findings of the original article, including the serial mediation effects, the negative GC × ATIPE interaction, and the moderated mediation effects. We further clarify that the interaction reflects attenuation rather than amplification, and that the TEI-only pathway attenuated after attitudes toward interprofessional education were included as a predictor. Overall, this reply reinforces the robustness of the original findings while refining their interpretation.
Objective Structured Clinical Examinations (OSCEs) remain central to the assessment of clinical competence, yet the integration of artificial intelligence (AI) into assessment design, delivery, and scoring raises a fundamental question: what evidence of competence are OSCEs intended to generate? This paper argues that AI should be evaluated through the lens of OSCE validity, with particular attention to how it may strengthen or weaken the interpretive chain linking observed performance to assessment decisions. Drawing on Messick’s unitary conception of validity and Kane’s argument-based framework, we examine how AI may introduce distinct threats across the scoring, generalisation, extrapolation, and implication inferences that underpin OSCE interpretation. We argue that generative AI (genAI) creates a particular risk of construct drift, whereby plausible assessment materials or scoring processes gradually reward observable proxies rather than the underlying clinical capabilities they are intended to assess. To translate this validity perspective into practice, we propose a framework that maps AI applications across the OSCE workflow according to their proximity to candidate consequences and the evidential burden required to justify their use. Lower-risk applications, such as design support and post-hoc analytics, may strengthen assessment when accompanied by construct-focused review and human oversight, whereas higher-risk uses, including AI-mediated candidate encounters and automated summative scoring, require substantially stronger validity evidence. We conclude that AI should be adopted according to the principle of concept before capability: assessment communities must first establish what clinical competence means and what evidence should count before deciding where AI has a legitimate role in high-stakes assessment.
