Human papillomavirus (HPV) is a major preventable cause of cervical cancer, yet awareness and uptake of HPV vaccination remain suboptimal in many settings. Evidence regarding women's HPV-related awareness, factual knowledge, and vaccine acceptability in Palestine remains limited. This study assessed awareness, factual knowledge, attitudes, self-reported uptake, willingness, and perceived barriers related to HPV infection and HPV vaccination among adult women in Palestine. A cross-sectional online survey was conducted between October 2025 and February 2026 among women aged ≥18 years residing in Palestine. The questionnaire assessed sociodemographic characteristics, HPV and HPV vaccine awareness, factual knowledge, attitudes, vaccine uptake, willingness to receive or recommend vaccination, and perceived barriers. A 12-item factual knowledge score was calculated, and higher factual knowledge was defined as ≥7 correct responses. Descriptive statistics, subgroup analyses, and multivariable logistic regression were performed. Among 424 adult women included in the final analysis, 220 (51.9%) had heard of HPV and 146 (34.4%) had heard of the HPV vaccine. The mean factual knowledge score was 4.03 ± 2.72 out of 12, and 90 participants (21.2%) had higher factual knowledge. Self-reported HPV vaccine uptake was low (13.0%), whereas willingness to receive the vaccine was higher (55.2%). Lack of awareness (55.8%) and concern about vaccine safety (22.8%) were the most frequently reported barriers among unvaccinated women. In expanded adjusted analyses, prior HPV awareness, prior HPV vaccine awareness, and more supportive HPV-vaccination attitudes were independently associated with higher factual knowledge. Higher factual knowledge and supportive attitudes were associated with self-reported vaccine uptake, while willingness among unvaccinated women was most strongly associated with supportive vaccination attitudes. Adult women in Palestine demonstrated limited HPV-related awareness and low factual knowledge, together with low self-reported HPV vaccine uptake. The gap between willingness and uptake, combined with the predominance of awareness and safety concerns as reported barriers, suggests a need for culturally appropriate education, provider-led counseling, and improved access to reliable HPV vaccine information. Findings should be interpreted cautiously given the cross-sectional design and online convenience sampling.
ARF is a major public health issue among children with increased morbidity and mortality. This study aims to ascertain the level of awareness and knowledge of the college adolescent children on acute ARF. This was a cross-sectional study carried out among 553 adolescents from ten secondary schools in Enugu metropolis over a 4-month period. A total of 553 adolescents were studied, with a mean age of 14.4 ± 2.7 years and a female predominance (64.9%). Overall, awareness of rheumatic fever was good (63.3%), with health workers, peers, and social media as the major information sources. Knowledge of key symptoms such as joint pain (95.3%), sore throat (94.2%), and shortness of breath (81.7%) was high, and most respondents correctly identified preventive measures (87.5%) and treatment options (89.3%). The mean knowledge score was 23.1 ± 5.8. Significantly higher knowledge was observed among respondents aged <15 years, those in junior secondary school, those with parents having tertiary education, and those from a higher socio-economic class. Junior secondary school status remained an independent predictor of good knowledge. This study demonstrates that although awareness of rheumatic fever among adolescents is relatively high, comprehensive knowledge, particularly regarding disease burden, is inadequate. Significant socio-demographic disparities in knowledge exist, influenced by age, educational level, parental education, and socio-economic status. Bridging the gap between awareness and accurate knowledge is essential to improving early recognition, prevention, and control of rheumatic fever and its long-term complications.
Background  Foodborne illnesses remain a major global public health concern, often linked to poor hygiene and unsafe food handling. Dormitory students are particularly vulnerable due to shared kitchen facilities and varying levels of food safety awareness. This study aims to assess knowledge, attitudes, and practices (KAPs) regarding food safety among dormitory students at the University of Sharjah. Materials and methods  A cross-sectional study was conducted at the University of Sharjah during 2024-2025. The sample was selected using convenience sampling, targeting at least 385 students. A self-administered questionnaire adapted from validated studies was distributed among university dormitories. It included demographic data, multiple-choice questions (MCQs) assessing knowledge and practices, and a Likert-scale section assessing attitudes toward food safety. Data were analyzed using SPSS version 29. The chi-square test was used to assess the association between categorical variables, with statistical significance set at p < 0.05. Results  A total of 399 dormitory students participated. Of these, 249 (62.4%) were female. Most students were aged 20 years or older. A total of 238 (59.6%) were enrolled in medical-related majors. The sample included students from women's dormitories (150, 37.6%), men's dormitories (150, 37.6%), and medical/nursing dormitories (99, 24.8%). Age and gender were significantly associated with practice level (p = 0.048 and p < 0.001, respectively), with students aged ≥20 years and female students demonstrating better practices. More than half of the medicine and health sciences students had good knowledge (130, 54.6%) compared with non-medical students (p = 0.004). Students in the medical/nursing dormitory reported higher levels of good knowledge (63, 63.6%) and good practice (55, 55.6%) (p = 0.001 and p < 0.001, respectively). Higher knowledge was associated with better attitudes and better practices, and a higher attitude level was associated with a better practice level. Conclusions Dormitory students at the University of Sharjah demonstrated poor attitudes and moderate levels of food safety knowledge and practices. The observed knowledge-attitude gap represents a public health concern. Universities should implement targeted educational interventions to improve food safety awareness and promote the translation of knowledge into appropriate attitudes and practices.
Acute stroke commonly causes dysphagia, which can delay recovery and worsen nutrition. Nurses detect and treat dysphagia and maintain oral hygiene, but their knowledge, attitudes, and practices (KAP) vary. This study aimed to assess nurses' knowledge, attitudes, and practices regarding dysphagia screening and oral care among stroke patients and to identify factors associated with good attitudes and practices. Cross-sectional research comprised 650 tertiary stroke and neurology nurses. Data were collected using a validated self-administered dysphagia screening and oral care knowledge, attitude, and practice questionnaire. Data analysis included descriptive statistics, Pearson's correlation, and multivariate logistic regression. Overall, nurses demonstrated good knowledge (mean score = 15.6 ± 3.1), positive attitudes (77.4 ± 9.8), and moderate-to-good practices (73.2 ± 10.5) toward dysphagia management. Though documentation, caregiver education, and formal training were lacking, routine screening and oral care were strongly supported. Knowledge, attitude, and practice showed significant positive associations (r = 0.46-0.57, p < 0.001). Higher qualifications, career experience, stroke unit experience, dysphagia training, and knowledge were significantly associated with more positive attitudes and practices (p < 0.05). Nurses were knowledgeable and supportive of dysphagia screening and oral care, but inadequate training and institutional support were associated with practical challenges. Improving nursing competency and stroke may benefit from in-service education, standardized screening techniques, and interprofessional teamwork.
The COVID-19 pandemic substantially disrupted surgical education, primarily by limiting in-person rotations, prompting the development of virtual learning platforms. The University of California Davis Vascular Surgery Department piloted a two-week virtual vascular surgery rotation to evaluate its effectiveness in improving surgical skills and knowledge retention among fourth-year medical students nationwide. Five medical students from across the United States enrolled and participated in the virtual rotation. Baseline assessments were obtained, including a 37-question multiple-choice examination covering core vascular topics and timed evaluations of one-handed and two-handed knot-tying skills. The virtual curriculum included interactive sessions, such as case conferences, virtual rounding, faculty- and resident-led didactics, and journal clubs, as well as non-interactive components (readings, recorded surgical videos, and written assignments). Students were reassessed post-rotation and at six months. Statistical analysis was performed using mean comparisons and Fisher's exact testing, with significance set at p<0.05. Students demonstrated statistically significant improvements in both one-handed and two-handed knot-tying skills at the two-week and six-month time points compared to baseline (p<0.05). Knowledge scores improved at two weeks (p=0.012) but declined by six months; there was no significant difference from baseline (p=0.32). All students remained above baseline in both skills and knowledge at six months despite measurable regression from the two-week assessment. Interactive sessions were rated more favorably than non-interactive activities (p=0.003). All participants reported that the rotation met expectations. Virtual education has become an integral part of modern education, including the surgical realm. A virtual surgical rotation can produce sustained progress and improvement in surgical skills and knowledge base. While knowledge retention may decline over time with the virtual format alone, this only reinforces the need for multimodal education elements and long-term learning that may incorporate reading and continued clinical/surgical exposure. Interactive components appear to be critical to the perceived educational value of virtual surgical rotations as well.
Needlestick injuries (NSIs) remain a major occupational hazard among healthcare workers (HCWs), increasing the risk of exposure to blood-borne infections such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). Although largely preventable, NSIs continue to occur frequently in fragile and resource-limited health systems, including Somalia. This study assessed healthcare workers' knowledge, attitudes, and practices regarding NSIs in Mogadishu, Somalia, to identify existing gaps and inform occupational safety interventions. A facility-based cross-sectional study was conducted in Mogadishu, Somalia, from July 2024 to January 2025. A total of 422 healthcare workers from public and private health facilities were selected using stratified random sampling. Data were collected through a validated self-administered electronic questionnaire covering sociodemographic characteristics and knowledge, attitudes, and practices related to NSIs. Scores for knowledge, attitude, and practice were categorized using Bloom's cut-off criteria. Data were analyzed using descriptive statistics and multivariable logistic regression in SPSS version 20, with statistical significance set at p ≤ 0.05. Overall, 82.94% of participants demonstrated good knowledge of needlestick injuries (NSIs), with a mean score of 8.15 ± 2.23. However, gaps remained in awareness of post-exposure prophylaxis (PEP) and the recommended timing of follow-up viral testing. Attitudes toward NSI prevention were generally positive, with 96.21% of participants classified as having a positive attitude. Nevertheless, some respondents continued to prioritize patient care over healthcare worker safety. Preventive practices were less satisfactory, with only 44.79% of participants reporting good practice. Underreporting of injuries and delayed uptake of PEP were also notable concerns. In the adjusted analysis, healthcare workers aged 18-30 years were less likely to report good preventive practices than those aged over 40 years (AOR = 0.30, p = 0.001). In contrast, nurses (AOR = 3.29, p = 0.002) and specialists (AOR = 2.67, p = 0.048) were more likely to report good preventive practices than laboratory technicians. Estimates from the attitude model were unstable because of sparse outcome data and should therefore be interpreted cautiously. Despite relatively high knowledge and generally positive attitudes toward NSI prevention, important gaps in preventive practice remain among healthcare workers in Mogadishu. Underreporting of injuries and inadequate post-exposure management highlight a persistent gap between awareness and action. Targeted interventions aimed at younger healthcare workers, improved reporting systems, better access to PEP, and stronger institutional safety practices are needed to reduce the burden of NSIs in resource-limited settings.
Healthcare professionals' knowledge, attitudes, and beliefs toward adults living with obesity influence clinical engagement, communication, and quality of care. However, existing outcome measurement instruments used to assess these constructs have demonstrated limitations in development quality, contextual relevance, and content validity, particularly within the United Kingdom (UK) healthcare system. To conduct a qualitative concept elicitation study aligned with the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) recommendations to identify key themes shaping UK healthcare professionals' knowledge, attitudes, and beliefs regarding adults living with obesity in order to inform the development of an outcome measurement instrument. Qualitative descriptive study using semi-structured group and individual interviews. 35 UK healthcare professionals from multiple disciplines participated in semi-structured individual and group interviews. Data were analysed using inductive reflexive thematic analysis in accordance with COSMIN recommendations for content validity and item generation. Four interrelated themes were identified: (1) clinical working environment, (2) knowledge of obesity, (3) attitudes to obesity, and (4) beliefs about professional roles. The clinical working environment was identified as a primary contextual determinant influencing how knowledge is constructed, how attitudes are expressed, and how beliefs about professional roles are enacted in practice. Structural constraints, organizational culture, role ambiguity, and service limitations influenced clinicians' confidence, communication, and perceived legitimacy in adult obesity care. Healthcare professionals' knowledge, attitudes, and beliefs regarding adult obesity are not solely individual attributes but are embedded within organizational and service contexts. These findings provide a strong empirical foundation for COSMIN-aligned item development and support the creation of a context-sensitive outcome measurement instrument to inform research, workforce development, and service improvement in UK adult obesity care. Patient and Public Involvement (PPI) contributors reviewed the interview guide to ensure clarity and relevance prior to data collection.
Biostatistics is a vital component of healthcare, enabling nursing students to interpret and analyze health-related data effectively. However, gaps in statistical knowledge persist, making it essential to address these deficiencies to ensure professional competence and uphold ethical standards. The aim of this study was to assess the impact of hands-on biostatistics training on postgraduate nursing students' knowledge and attitude at a tertiary care institution in Rishikesh, located in the sub-Himalayan region. A quasi-experimental design was adopted for this study. Total enumerative sampling was used to recruit 38 postgraduate nursing students from a tertiary care institution in Rishikesh, located in the sub-Himalayan region. The intervention comprised 16 hours of expert-led hands-on training. The variables assessed were knowledge of and attitude toward biostatistics. The mean age of the participants was 25.21 ± 3.54 years. The majority were female (89.5%, n = 34). Most participants (76.3%, n = 29) had not received prior statistical training. Significant improvements were observed in overall biostatistics knowledge scores across all domains (p = 0.001), overall attitude scores (p < 0.001), and the perceived difficulty domain (p = 0.006). The study indicates that hands-on biostatistics training improved postgraduate nursing students' knowledge and positively influenced their attitudes toward biostatistics. However, the findings are exploratory and context-specific and may be influenced by potential biases. Integrating such training into nursing curricula could enhance statistical literacy and support research participation and evidence-based practice. This will serve as a foundation for advancing the nursing discipline.
Comprehensive sexuality education is fundamental for the healthy development of children and adolescents, as it promotes essential knowledge, values, and skills for responsible emotional and sexual lives. Early and integrated implementation within the school curriculum contributes to the prevention of risks such as sexually transmitted infections (STIs), unintended pregnancies, and exposure to pornography. This study aimed to explore short-term changes following a school-based sexual health education intervention among primary school students. A quantitative pre-post approach was employed using a quasi-experimental design with a single intervention group. Participants were assessed through pre- and post-tests using non probabilistic sampling. The educational intervention addressed topics including sexuality, puberty, consent, anatomical knowledge, and critical understanding of sexual content. The intervention was associated with increased understanding of sexuality, puberty, and consent among students. Improvements were observed in anatomical knowledge as well as in students' comfort and openness when discussing sexual health topics. Levels of exposure to sexual content were identified, highlighting the relevance of early and age-appropriate education. Prior to the intervention, students reported limited knowledge about sexuality and puberty and relied primarily on family as their main source of information. Educational interventions may help normalize discussions about sexuality and improve communication among primary school students. However, insufficient responses to abuse situations and increasing exposure to pornography emphasize the need for comprehensive, critical, and age-appropriate sexuality education from early educational stages.
Yoga is beneficial for mental, physical stress and noncommunicable diseases (NCDs). Due to long and hectic working hours, nursing officers experience stress and NCDs. Awareness of yoga helps adopt yoga practice and healthy lifestyle. Our objective was to assess the knowledge, attitude, and beliefs regarding yoga and examine their association with its practice among nursing officers. This was a cross-sectional analysis of baseline data of an intervention study on in-service nursing officers employed at workplace for at least 1 year. Those who were under treatment for any psychiatric disorder and any condition preventing practice yoga were excluded. After taking informed written consent, a pretested, semi-structured questionnaire was administered. Data were extracted in Microsoft Excel and analyzed by statistical software STATA V12. A total of 105 participants completed the questionnaire, 78% were female, and the mean age was 33 years. Majority (79.0%) of them were aware of yoga as a way of healthy life and beneficial practice. A proportion of ever practiced participants were 53.3% and currently practicing were 12.4%. The level of knowledge, attitude, and belief score was positively correlated among themselves. The belief score had a significant association with current practice of yoga (odds ratio of 1.9, 95% confidence interval: 1.4-2.7, P < 0.001). Knowledge, attitude, and belief were higher among most of the participants though the level of practice was low. The score of knowledge, attitude, and belief was higher among those who had a history of either current or past practice. Belief score was significantly associated with current yoga practice. A larger study is recommended at workplace setting with further exploration.
Peripheral nerve blocks offer numerous advantages, including reduced postoperative pain, decreased opioid use, and faster recovery. Despite their benefits, patients' understanding of peripheral nerve blocks remains poorly characterized. This survey study aimed to assess patient knowledge of peripheral nerve blocks among individuals undergoing outpatient orthopedic surgery. Adult patients scheduled for outpatient orthopedic surgery and awaiting consent for peripheral nerve blocks between February 18, 2025 and July 3, 2025 at a single academic institution were eligible for inclusion. Pediatric and non-English-speaking patients were excluded. After providing written consent, participants completed a one-time written survey in the preoperative area on the day of surgery. The survey included 10 "true/false" statements assessing knowledge of peripheral nerve block mechanisms, applications, outcomes, and comparisons with general anesthesia. Participants also ranked concerns regarding potential complications, including neurological, vascular, and infectious ones, allergic/autoimmune reactions to anesthetic, and pain during the procedure. Most patients reported limited prior understanding, with only 4.0% identifying as "very knowledgeable." Only 27.7% reported receiving prior explanations about peripheral nerve blocks from a non-anesthesiologist physician. Neurological and infectious complications were ranked as the most concerning. This study identified significant knowledge gaps, particularly regarding continuous peripheral nerve blocks and distinctions between peripheral nerve blocks and general anesthesia. These findings highlight the need for targeted preoperative educational initiatives to support informed decision-making and improve patient-centered outcomes.
Cervical cancer is expected to become the second leading cause of female cancer mortality in low- and middle-income countries, with the majority of critical cases projected to occur in these regions by 2050. This study aimed to identify the prevalence and determinants of knowledge and attitudes toward cervical cancer prevention, including Pap smear uptake and human papillomavirus (HPV) vaccination, while highlighting actionable gaps for intervention. A cross-sectional study was conducted using an online structured questionnaire, administered to Lebanese women aged 18-50 years. A knowledge score (KS) was calculated from true-or-false questions on risk factors, symptoms, and prevention. An attitude score (AS) assessed the proportion of women with a positive attitude toward cervical cancer prevention. Participants had a mean age of 28.5 years. The prevalence of women who had ever had a Pap smear was 18.6%, and HPV vaccination coverage was 17.9%. Bivariate analysis showed that HPV vaccination was significantly associated with younger age, being single, having a graduate degree, being a health care student/professional, perceiving income as sufficient, and never smoking. Binary logistic regression analysis indicated that only a KS above the mean and an AS above the mean remained significant predictors after adjustment. Physicians were the most influential incentive for vaccination, while lack of knowledge was the primary barrier. To improve HPV vaccination rates and reduce cervical cancer incidence in developing countries, strategies should focus on enhancing health care access and physician-patient communication. Targeted awareness campaigns addressing misconceptions and negative attitudes toward HPV vaccination are warranted to improve preventive practices and reduce disease burden.
Despite increasing e-cigarette use among young adults, data on medical students' knowledge, attitudes, and practices (KAP) remain limited. This study assessed KAP regarding e-cigarettes and examined the influence of sociodemographic factors on their use. A cross-sectional study was conducted among 311 MBBS students at RUHS College of Medical Sciences, Jaipur. A validated 37-item questionnaire assessed sociodemographic details and KAP. Responses were recorded on a 5-point Likert scale. Data were analyzed using SPSS version 26 with descriptive statistics, independent t-tests, ANOVA, and chi-square tests. Subgroup analysis compared ever-users and never-users. Among ever-users, the majority were male (74%) and aged 19-23 years (78%). Knowledge gaps were evident, with 23% unaware of e-cigarette types and 63% perceiving them as less harmful than conventional cigarettes. While most participants recognized nicotine-related harms (91%), awareness of regulatory measures was lower, including the national ban (61.6%) and prior taxation (57.5%). Over half (58.9%) considered e-cigarettes not cost-effective. Ever-users demonstrated relatively more favorable attitudes (43.8%); however, most rejected perceived social benefits (75.3%) and supported regulatory bans (56.2%). Overall use was low, with 76.5% reporting no lifetime use; among ever-users, occasional use predominated (43%). Medical students displayed partial awareness and permissive attitudes, but ever-users showed inconsistent cessation behaviors. These findings underscore the need for targeted education and structured cessation support to address rising e-cigarette use in this vulnerable group.
Globally, malaria cases increased from 228 million in 2018 to 282 million in 2024, with the African region accounting for 95% of the cases. Nigeria bears the highest malaria burden in the world, and pregnant women carry a significant number of the cases. Malaria in pregnancy (MiP) may have negative implications for maternal and neonatal health. The WHO-recommended intermittent preventive treatment using sulphadoxine-pyrimethamine (IPTp-SP) helps to prevent MiP, but its uptake is low in Nigeria. Using the theory of reasoned action (TRA), this study investigated the attitudes and intentions of pregnant women in Bayelsa State towards the use of IPTp-SP. The study adopted qualitative methods, including focus group discussions with pregnant women and key informant interviews with relevant community stakeholders. Six focus group discussions and seventeen key informant interviews were conducted with pregnant women and stakeholders, respectively. Data were managed using NVivo (version 12) and analysed thematically and deductively in line with the TRA. Pregnant women had limited knowledge of preventing MiP and specifically IPTp-SP use. This resulted in a negative attitude towards the preventive technique. Interestingly, while the role of significant others, such as traditional birth attendants (TBAs), husbands and mothers-in-law, was acknowledged, many pregnant women did not succumb to the social pressure to use IPTp-SP when they did not think it was best for them. Many women intended to use IPTp-SP but had not done so at the time of the study due to structural barriers, poor access to facilities, and the unavailability of IPTp-SP. The use of IPTp-SP is poor among pregnant women in the sample. These women have their own will and are not necessarily pressured by social norms. Intentions may not translate to actual practice or use if structural barriers are not eliminated.
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To identify the barriers to timely access to palliative care from the perspective of Australian inpatients and their families. A co-designed mixed methods study with an equal status explanatory design (QUAN ➔ QUAL). Quantitative data were collected in Phase 1 via surveys to assess participants' knowledge and experience of palliative care. In the second phase, qualitative data were obtained via semi-structured interviews to explore participants' perceptions of palliative care and to identify barriers to palliative care. A total of 194 complete patient survey responses and 52 family/visitor responses were received. Mean self-rated knowledge of palliative care was slightly higher than self-rated knowledge of end-of-life care in both groups. Patient respondents scored a mean of 9.3 out of 13 on the Palliative Care Knowledge Scale and family visitor respondents had a mean score of 9.7. Statistically significant differences in the mean Palliative Care Knowledge scores were found when patient and family respondents reported being familiar with palliative care. A total of 11 patients and nine family members participated in an interview in Phase 2. Three main themes and nine subthemes were identified. The three main barriers were Communication, Knowledge and Perceptions, and Accessibility. Patients and family members perceived a range of barriers to palliative care at the individual, health professional, and system level. These findings highlight areas where targeted interventions should be developed to improve timely access to palliative care. While the perspectives of health professionals are well known, the perceptions of patients and families on the barriers to palliative care are underreported. A wide variety of complex issues that could impede timely access to palliative care were identified at the individual, health professional and system level. Health consumer perspectives are essential to fully understanding the barriers to palliative care access. The findings of this research can be used to inform future interventions to improve access to palliative care. Good Reporting of A Mixed Methods Study (GRAMMS) checklist (Data S2) (O'Cathain et al., 2008). The study was guided by a steering group of health consumers and health professionals working in partnership with the research team through all stages of the research process.
Simulation-based learning (SBL) is an emerging educational methodology that actively engages students and helps bridge the gap between theoretical knowledge and practical clinical skills. It allows students to learn in realistic clinical scenarios using manikins and trained actors (standardized patients) in a controlled learning environment. Well-designed simulation exercises can enhance both technical and non-technical competencies among medical students. This study aimed to assess the knowledge, attitudes, and perceptions of clinical medical students toward simulation-based learning at Ahmadu Bello University, Zaria, North-Western Nigeria. A descriptive cross-sectional study design was employed. Data were collected using a pretested, structured, closed-ended, self-administered questionnaire. A total of 138 clinical medical students of Ahmadu Bello University, Zaria, were selected using a stratified random sampling technique. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 25.0, and results were presented using tables and charts. Associations between categorical variables were assessed using the Chi-square test, with statistical significance set at p < 0.05. The mean age of the respondents was 24.76 ± 1.93 years. More than two-thirds (70.3%) of the respondents had good knowledge of SBL, while the majority demonstrated positive perceptions (90.6%) and positive attitudes (92.7%) toward simulation-based learning. A statistically significant association was observed between attitude and perception toward simulation-based learning as a method of clinical training. The findings indicate that most respondents possessed good knowledge of simulation-based learning and expressed positive attitudes and perceptions toward its use. The majority were satisfied with SBL as a teaching method. Therefore, simulation-based learning should be incorporated into the medical school curriculum to enhance clinical training.
Healthcare professionals in intensive care units face substantial psychological stress, yet structured educational approaches to promote mental health during early training remain underdeveloped. While current recommendations advocate early integration of psychosocial support into onboarding, they have not been translated into competency-based educational frameworks aligned with modern health professions education. To develop a competency-based educational framework for ICU onboarding that integrates mental health promotion into structured learning objectives across knowledge, reflection, and action domains. A mixed-methods design was applied, combining a structured consensus process with competency-based curricular mapping. Guiding questions were iteratively refined using a two-stage rapid consensus process involving a multidisciplinary panel of clinicians, educators, and external experts in psychology and occupational health. Consensus was defined as the absence of substantial disagreement. The resulting content was mapped to competency dimensions informed by competency-based medical education principles and aligned with Miller's Pyramid, a hierarchical model of clinical competence ranging from knowledge to action. The process resulted in a competency-based framework comprising eight educational domains: relevance of mental health, ICU-specific stressors, conceptual understanding of stress, resilience and coping, the second victim phenomenon (the psychological impact on healthcare professionals following adverse events), structural support systems, professional self-reflection, and shared responsibility. Each domain was operationalized into competency levels (knowledge to evaluation), enabling constructive alignment between learning objectives, teaching formats, and potential assessment strategies. The framework integrates individual, team, and organizational perspectives and provides a structured basis for embedding psychosocial competencies into onboarding curricula. This study may contribute to advancing health professions education and supports constructive alignment among learning objectives, teaching formats, and assessment strategies. It operationalizes existing recommendations into actionable educational components and supports constructive alignment in curriculum design. Implementation and evaluation studies are warranted to assess its impact on learning outcomes, behavioral change, and clinical practice.