Literature Collection

Background: Little is known about the implication of launching virtual-first primary care (VPC) in a health system. Our experience and survey can guide others to establish their virtual-first programs. This study examines implementation, patient perspectives, and satisfaction with VPC at University of Pittsburgh Medical Center (UPMC). Methods: We conducted a Web-based survey to examine factors associated with the likelihood of early adoption and continued use of VPC. We used bivariate comparisons and cluster analysis to evaluate the results. The survey was sent to 1,420 patients seen between August 2022 and January 2023. Responses related to demographics, doctor-patient relations, savings, experience, and future preferences of use were aggregated. To evaluate the relationship between demographics and survey responses, we conducted univariate analysis. Results: Females and patients between 40 and 50 years of age were the primary users and indicated the most interest in continued use. Health insurance status seems not to be a significant predictor in the selection and use of VPC. Most (78%) felt that the physician-patient relationship was unimpaired. The survey showed that 90% of patients saved time by using VPC, and 66% reported saving money on tolls, childcare, or gasoline. Only 13% reported not wanting to continue VPC. Discussion: A majority of surveyed patients felt the doctor-patient relationship was not negatively affected in VPC. VPC programs can be implemented with high patient satisfaction in an integrated health system. VPC is acceptable to most patients, and further expansion of the model is warranted.

This study, using a mixed-methods approach, explored pharmacy students' perceptions and experiences of formative and summative OSCEs and their use of AI tools in OSCE preparation. Formative and summative OSCE marks were compared. Further quantitative data were collected from 82 students (89.13 %) via a post-OSCE questionnaire. Qualitative data were collected from 20 face-to-face semi-structured interviews that were audio-recorded, transcribed verbatim and thematically analyzed. Results showed improvement in marks from formative to summative OSCE, with mean marks increasing from 44.2 % to 56.0 %. Students generally perceived the OSCE process positively, with the majority rating their overall experience as excellent (65 %). The formative OSCE was viewed as particularly helpful in preparing for the summative. The integration of AI tools in OSCE preparation was well-received, with 58.5 % of students finding them helpful. However, challenges such as "lack of humanization" and occasional inaccuracies were noted. Themes generated from qualitative data endorsed the quantitative findings and were categorized into facilitators (briefing session, formative OSCE, feedback from role players and evaluators, AI tools) and barriers (challenges with the use of AI tools, anxiety, time management). The study highlights the importance of formative assessments prior to summative and the potential of AI tools in enhancing OSCE preparation, but emphasizes the need for structured training and guidance.

BACKGROUND: Young people often face significant challenges accessing effective mental health support as they navigate through complex healthcare systems, education pathways, and social pressures. Understanding the service-level barriers they encounter is critical to improving mental health system design and delivery. While previous studies have examined individual barriers to mental healthcare access, few have adopted a cross-sectorial, youth-informed approach which captures the interrelated structural, institutional, and socio-cultural factors influencing young people’s mental health experiences. METHODS: Seventeen participants aged 18–24 years with lived experience of depression and/or anxiety participated in nine in-person focus groups and interviews in Perth. Reflexive thematic analysis was used to identify systemic barriers and facilitators to mental healthcare, with a particular focus on access, care coordination, therapeutic engagement, and service responsiveness. RESULTS: Key themes included fragmented care pathways, inadequate provider follow-up, prolonged wait times, financial constraints, lack of youth-specific mental health training among clinicians, and limited therapeutic rapport. Participants also described inadequate mental health literacy within schools and persistent stigma in social and familial settings. These intersecting barriers hindered access, disrupted continuity of care, and undermined trust in the mental health system. CONCLUSIONS: Findings highlight critical inefficiencies in mental health service delivery for young Australians. Policy responses should prioritise integrated care models, investment in multidisciplinary youth mental health hubs, improved school-based mental health literacy, and culturally inclusive anti-stigma initiatives to promote access, trust, and continuity of care.