Education, relationships, and place: life choices in the narratives of university master students.

Choice is one of the most roughly defined concepts in contemporary social sciences. Previous studies have elucidated the factors that influence young people's choices in different life situations. However, it is still unclear how young people evaluate these choices and how they integrate them into their biographies. In this study, we examine the narratives of 30 first-year master's students at HSE University with regard to two categories of life choices: those that they perceive as fortunate and those that they perceive as unfortunate. Using a written online survey, the data was collected in the spring of 2022. To categorize the different decision kinds, thematic analysis was applied. Overall, we discovered that narratives about the life choices made by master students concentrated on education, relationships and place.

Visual Perceptions Skills and its Association with Written Mathematical Communication Skills among Learning Disabilities Students in Jordan.

Aim: The present research sought at investigating the association between visual perception skills and written mathematical communication skills among a sample of students with learning disabilities in mathematics in Jordan. Method: This was a cross-sectional correlational study that included a sample of 90 primary-stage students who were diagnosed as having learning disabilities in mathematics. To collect data, the researchers developed two data collection tools; the visual perception skills test (50 items) and the written mathematical communication skills test (6 items). The tests were validated and ensured for reliability before implementation on the original study sample. The data gathered in this study was analyzed using the Statistical Package of Social Sciences (SPSS). Results: The results showed that there was a significant statistical association between visual discrimination and Written mathematical communication skills test (r=0.218), visual closing test and Written mathematical communication skills test (r=0.411), shape relationship perception test and Written mathematical communication skills test (r=0.438), Visual Integration and Spatial Relationship Perception Test and Written mathematical communication skills test (r=0.614), Visual information recall test and Written mathematical communication skills test (r=0.154). The results showed that there was a significant positive association between visual perception skills and written mathematical communication skills (r=0.509). Conclusion: The study ended up with that there is a significant positive association between visual perception skills and written mathematical communication skills among students with learning disabilities in mathematics. The study recommends developing mathematical educational material based on the visual approach and improving these skills among students with learning disabilities to develop their written mathematical communication skills.

How to communicate with patients in written asynchronous online conversations: an intervention study with undergraduate medical students in a cross-over design.

Introduction: The patient-physician encounter is the core element in the treatment of patients and the diagnosis of disease. In these times of digitalization, patient-physician communication is increasingly taking place online: patients embrace new possibilities offered digitally, and physicians are encouraged to adapt accordingly. Since a huge part of online communication is written, this study aims to investigate how medical students communicate with patients online by focusing on their written competencies and whether an intervention might improve their competencies. Methods: This study was performed in an explanatory cross-sectional manner with a cross-over design. Second-year medical students participated. An intervention was developed on how to formulate an appropriate written response to a patient's request and integrated a longitudinal communication class. The intervention consists of education on general set-up (e.g., greetings), syntax, spelling, content and kind of communication (e.g., appreciative attitude). After meeting a patient in a simulated role play medical students received the patient's request via a digital platform. The control group had the same simulated role play and the same task but they received the intervention on communication afterwards. Intervention and control group were statistically compared based on a checklist. Results: Twenty-nine medical students took part in the study. The results showed that the medical students had basic competencies in dealing with written communication independent if they received the intervention (CG: M = 3.86 ± 1.23 vs. IG: M = 4.07 ± 1.03; p = 0.625). Similar results were also for the emotional competency ratings (MCG = 3.36 ± 1.08; MIG = 3.67 ± 0.98; p = 0.425).The intervention was able to lead to a more appreciative response toward patient. Discussion: Intervention on basic competencies such as simple language and clear presentation might not be needed as an integral part in medical education. However, medical students should learn how to present empathic and authentic behavior in written online communication.

Evaluation of the effectiveness of written communication training of a public higher education institution using the Kirkpatrick model

BACKGROUND@#This study aims to evaluate the effectiveness of the “Effective Written Communication Training” provided among 16 UP Manila administrative employees following Kirkpatrick's training evaluation model.@*OBJECTIVES@#This study specifically examines the reaction of the employees to the training program (Level 1), changes in the level of learning (Level 2), and transfer of training in the workplace or behavioral changes (Level 3).@*METHODOLOGY@#The study used a cross-sectional design, and the primary data was collected through survey questionnaires, a pretest, and a posttest. For the Level 1 evaluation, a training assessment survey was given to the participants. For the Level 2 evaluation, tests were given to the participants before and after the conduct of the training program. For the Level 3 evaluation, a survey questionnaire was given to the participants and their immediate supervisor five months after the end of the training.@*RESULTS@#The Level 1 results showed that the participants' overall reaction to the training was Excellent in terms of training design, facilitation, resource speaker/facilitator, and overall experience. For the Level 2 evaluation, results showed that there is a significant change (t(15)=11.32, ρ<0.05) in the participants' learning about written communication, as shown in the difference between the pretest (M=16.56, SD=3.01) and posttest scores (M=20.25, SD=2.49). Results of the Level 3 evaluation showed that written communication competencies have been applied to the workplace. Employees confidently compose written correspondences, construct formal and official letters, and relay queries using a more appropriate choice of words, which the participants' supervisors also observed.@*CONCLUSION@#Overall, the training program was found to be effective in improving the participants' written communication skills, following Kirkpatrick's training evaluation model.

Global pen pal education intervention among student pharmacists: A pilot project.

INTRODUCTION: Global health, a practice that prioritizes improving health and achieving health equity for all people worldwide, is a priority for pharmacists, schools, and pharmacy colleges. Several initiatives aim to enhance faculty and student exchanges while promoting projects and initiatives among thriving universities and under-resourced countries and institutions. While many organizations recognize the benefit of global collaboration, as demonstrated by the adoption of the 2012 American Association of Colleges of Pharmacy Strategic Plan, which calls for increased global experiences for faculty and students, the COVID-19 pandemic created a demand for international engagement within pharmacy practice. The objective of this study was to evaluate students' perceptions and attitudes toward incorporating a global pharmacy pen pal (PPP) exchange within the pharmacy curricula at two schools/colleges of pharmacy. METHODS: This mixed-method study included assigned engagement within a required or elective didactic course, followed by a post-experience survey. Each student was pre-assigned a pen pal from a cohort of pharmacy students residing in 11 countries for the assignment. RESULTS: In total, 184 students completed the learning experience, and across both sites, 63 students completed the post-experience survey. The students' impressions of the PPP varied by site, yet most participants reported an improved awareness of pharmacy practice in other countries.

Teaching Neuroimmunology to Undergraduate Students: Resource for Full Course or Modular Implementation.

This paper describes a course I designed to teach neuroimmunology to undergraduate students. In this course I incorporated many active learning strategies to help make it a student-centered class, where they developed communication skills, while reading and analyzing primary literature articles. As the field of neuroimmunology is relatively new, most textbooks in the field approached the subject from the perspective of neurology and autoimmune diseases. Therefore, I used reading, analysis, and student-led presentation of primary papers in the classroom to not only develop critical thinking and application of the scientific method, but also oral communication skills. Other activities such as writing New York Times-style articles and literature review papers were employed to develop written communications skills. The goal of this article is to provide a reference tool for instructors trained in neuroscience to deploy an entire course on neuroimmunology or select a module or a single paper to incorporate into their existing course to offer students a taste for neuroimmunology.

Teaching plain language to medical students: improving communication with disadvantaged patients.

BACKGROUND: Low health literacy underpins health inequality and leads to poor adherence to medical care and higher risk of adverse events and rehospitalization. Communication in plain language, therefore, is an essential skill for health professionals to acquire. Most medical education communication skill programs focus on verbal communication, while written communication training is scarce. ETGAR is a student delivered service for vulnerable patients after hospital discharge in which, amongst other duties, students 'translate' the medical discharge letters into plain language and share them with patients at a home visit. This study ascertains how this plain language training impacted on students' written communication skills using a tool designed for purpose. METHODS: Students, in pairs, wrote three plain language discharge letters over the course of a year for patients whom they encountered in hospital. The students handed over and shared the letters with the patients during a post-discharge home visit. Structured feedback from course instructors was given for each letter. An assessment tool was developed to evaluate students' ability to tell the hospitalization narrative using plain and clear language. First and last letters were blindly evaluated for the entire cohort (74 letters; 87 students). RESULTS: Students scored higher in all assessment categories in the third letters, with significant improvement in overall score 3.5 ± 0.8 vs 4.1 ± 0.6 Z = -3.43, p = 0.001. The assessment tool's reliability was high α = 0.797, it successfully differentiated between plain language categories, and its score was not affected by letter length or patient's medical condition. CONCLUSIONS: Plain language discharge letters written for real patients in the context of experience-based learning improved in quality, providing students with skills to work effectively in an environment where poor health literacy is prevalent. ETGAR may serve as a model for learning written communication skills during clinical years, using the assessment tool for formative or summative evaluation.

Construcción de una escala de autoeficacia para comunicación oral y escrita dentro de entornos laborales en futuros egresados / Construction of a self-efficacy scale for oral and written communication in work environments in future graduates

Resumen El mercado laboral requiere de futuros trabajadores con buen desarrollo de competencias transversales como la Comunicación Oral y Escrita para el trabajo. Relacionado con esto, la categoría de auto-eficacia es relevante, pues constituye un factor decisivo para que un individuo logre sus metas, siendo entonces necesario evaluarla para dicha competencia en futuros egresados. Con este fin se diseñó, validó y evaluó la confiabilidad de una escala (n=443). Para la de validez de contenido se utilizó el método CVI y para la consistencia interna el método de división por mitades así como el coeficiente alfa de Cronbach. Finalmente se aplicó un análisis factorial para la validez de constructo. Se obtuvieron niveles altos de CVI (0.87) y consistencia interna (R=0.97, α=0.95) así como cuatro factores que explican el 66 % de la varianza total. Concluyendo que el instrumento es válido y confiable para medir auto-eficacia para la comunicación oral y escrita en entornos laborales en futuros egresados.

Abstract The labor market needs future workers with adequate levels of transversal skills such as Oral and Written Communication for the job. In this regard, the category of self-efficacy becomes relevant, since it constitutes a decisive factor for an individual to achieve his goals, being then necessary to evaluate this competence in future graduates. To this end, a scale was designed, validated and evaluated for reliability (n=443). For content validity the CVI method was used and for internal consistency the method of division by halves was used as well as Cronbach's alpha coefficient. Finally, a factor analysis was applied for construct validity. High levels of CVI (0.87) and internal consistency (R=0.97, α=0.95) were obtained, as well as four factors that explain 66% of the total variance. We conclude that the instrument is valid and reliable to measure self-efficacy for oral and written communication in work environments in future graduates.

Exploring parents' perceptions of the value of pediatric genetic counseling patient letters: A qualitative study presenting lessons learned.

Genetic counseling patient letters are a valuable supplement to genetic counseling practice. As the demand for genetic services increases, improving efficiency in daily tasks such as letter writing could improve genetic counselor workflow. Additionally, understanding the value recipients place on the content of these letters prior to creating efficiencies is essential toward ensuring that the utility of these letters is not lost. To better understand parents' perceptions of the letter's value in the pediatric genetic counseling setting, we employed a qualitative design involving thirteen parents of children who received a patient letter following their diagnosis. Parents participated in a semi-structured focus group, interview, or phone interview, and the data were analyzed using thematic analysis. In addition to gathering perceptions of their child's letter, we sought to learn preferences for letter length, formatting, and level of detail by asking for verbal and written feedback on three different letter formats created for a fictional patient. We used self-determination theory (SDT) framework to create the sample letters, which states that an individual's experience of autonomy, competence, and relatedness can impact their ability to engage in activities. This includes caring for a child with special medical needs. While the findings from this work reinforced the importance of written communication for patients as seen in previous research, this work uncovered three major themes about the letter's value: (a) elements such as readability and content impact parent feelings of autonomy and improve competence moving forward with their child's care; (b) parents value written acknowledgment of the emotional impact of the diagnosis; and (c) parents use the letter as a tool to communicate their child's diagnosis with others. These results can be used for creating comprehensible patient letters that support autonomy, competence, and relatedness.

Non-Medical Radiography Staff Experiences in Inter-Professional Communication: A Swedish Qualitative Focus Group Interview Study.

PURPOSE: To describe the experiences of non-medical discipline staff of difficulties and possibilities in inter-professional communication within the radiology department and remitting departments. MATERIALS AND METHODS: Three focus group interviews were conducted with 16 non-medical discipline staff in a radiology department at a university hospital in Sweden. Data were analysed using qualitative content analysis. RESULTS: The experiences of inter-professional communication by non-medical discipline staff within the radiology department and with remitting departments can be described in three categories, and six sub categories. The informants experienced difficulties in both oral and written inter-professional communication. Inadequate structures, incorrect information and unclear language in the referral forms, lack of feedback from clinicians and radiologists, and reduced face-to-face communication were described as factors that negatively influenced communication. Other difficulties were time shortage, inadequate routines and economy issues. The possibilities described were use of face-to-face communication, interpreters, and clear and well-structured referral forms. CONCLUSION: Non-medical staff experience that quality in inter-professional communication has a significant impact on health outcomes and patient safety. They expressed a number of difficulties in both written and oral inter-professional communication. For example inadequate written and oral communication, as well as practical issues such as routine could negatively influence the quality of the outcome of inter-professional communication. Lack of feedback from clinicians and radiologists and reduced face-to-face communication were also mentioned as factors that influence oral communication. Possibilities described to improve inter-professional communication quality and thus patient safety were professional contact on both professional and personal levels, use of interpreters, and clear and well-structured referral forms. The results of this study add to our knowledge of the difficulties and possibilities in non-medical inter-professional communication, which may enhance both safety and health outcomes for patients if implemented. Future studies in interprofessional communication is needed.

Understanding the Return of Genomic Sequencing Results Process: Content Review of Participant Summary Letters in the eMERGE Research Network.

A challenge in returning genomic test results to research participants is how best to communicate complex and clinically nuanced findings to participants in a manner that is scalable to the large numbers of participants enrolled. The purpose of this study was to examine the features of genetic results letters produced at each Electronic Medical Records and Genomics (eMERGE3) Network site to assess their readability and content. Letters were collected from each site, and a qualitative analysis of letter content and a quantitative analysis of readability statistics were performed. Because letters were produced independently at each eMERGE site, significant heterogeneity in readability and content was found. The content of letters varied widely from a baseline of notifying participants that results existed to more detailed information about positive or negative results, as well as materials for sharing with family members. Most letters were significantly above the Centers for Disease Control-suggested reading level for health communication. While continued effort should be applied to make letters easier to understand, the ongoing challenge of explaining complex genomic information, the implications of negative test results, and the uncertainty that comes with some types of test and result makes simplifying letter text challenging.

Gist Inference Scores predict gist memory for authentic patient education cancer texts.

OBJECTIVES: Develop a tool to evaluate and improve written medical communication to patients. Determine how effectively Gist Inference Scores (GIS) predict comprehension of patient education texts independently of health literacy. Explicate the text characteristics and psychological mechanism underlying GIS. METHODS: For study 1, a nationally representative sample of older women (N = 61) completed a fill-in-the-blank comprehension task on authentic National Cancer Institute (NCI) texts of varying GIS levels. In study 2, participants (N = 198) read NCI texts (high or low GIS) then recalled what they read. RESULTS: Study 1 showed that a higher percentage of different words yielding semantically similar sentence meaning were used to correctly fill-the-blanks on high GIS texts and there was no significant interaction with health literacy. In study 2, a greater proportion of decision-relevant information was recalled for high GIS texts. CONCLUSIONS: GIS predicts the likelihood that readers will form gist representations of medical texts on free recall and fill-in-the-blank tasks. High GIS texts allow for more semantic flexibility to mentally represent the same meaning, and more strongly emphasizes gist rather than verbatim representations. PRACTICAL IMPLICATIONS: GIS provides medical communicators with an automated and user-friendly method to evaluate medical texts for their ability to convey the bottom-line meaning.

Written interprofessional communication in the context of home healthcare: A qualitative exploration of Swiss perceptions and practices.

The aim of this study was to explore the practices and perceptions of Swiss home care professionals with regards to written interprofessional communication. We analyzed 11 home care notebooks and conducted six focus groups with home health-care professionals in 2015-2016. Interprofessional written communication was rarely explicit. Health professionals reported a lack of clarity about what to document and for whom. They felt unsure how to reconcile the need for confidential information-sharing among health professionals and the desire for patient/families' active involvement. An ideal (electronic) tool should allow patients to formulate goals and use the platform while allowing health professionals to communicate confidentially among themselves in order to avoid information retention.

Fortalezas y debilidades presentes en el desarrollo de las habilidades en comunicación escrita en español, en alumnos de pregrado de Enfermería, desde la perspectiva del estudiante / Strengths and Weaknesses Present in the Improvement of Writing Expression Skills in Spanish, in Undergraduate Nursing Students, from the Students' Perspective

Introducción: La enseñanza y aprendizaje de la escritura requiere un esfuerzo coordinado entre directivos, docentes y estudiantes. No obstante, la disposición a participar de este último dependerá de si es capaz de identificar sus fortalezas y debilidades en escritura, lo que incidiría en su interés por mejorar o no dicha habilidad. Objetivos: Conocer las fortalezas y debilidades que los estudiantes de pregrado de enfermería identifican en sí mismos para el desarrollo de las habilidades de comunicación escrita en español. Métodos: Estudio descriptivo transversal. Se aplicó encuesta semiestructurada a 261 estudiantes de pregrado de enfermería. Los datos fueron analizados utilizando tablas de frecuencia y contingencia, mediante el software STATAv.14. Resultados: La principal fortaleza que los estudiantes identificaron tener en sí mismos fue la buena ortografía (76,7 por ciento), mientras que la principal debilidad fue la mala organización en la expresión de ideas (45,3 por ciento). Surgió como dificultad importante la falta de tiempo; mientras que, como estrategia de mejora, la revisión de guías. Si bien existió consenso en que la escritura es una habilidad primordial a desarrollar en el individuo, dicha habilidad estuvo condicionada por la capacidad de éste para hacer suya la necesidad de su desarrollo, y, asimismo, se identificó las falencias a mejorar. Si el estudiante confió demasiado en su capacidad para escribir de una forma correcta, difícilmente sintió la necesidad de capacitarse para perfeccionar este saber. Conclusiones: Considerar las fortalezas y debilidades con las que cuenta el estudiante al momento de escribir, permitiría la implementación de un programa de mejora con mejor y mayor impacto(AU)

Introduction: The teaching and learning of writing requires a coordinated effort between managers, teachers and students. However, the willingness to participate in the latter will depend on whether it is able to identify their strengths and weaknesses in writing, which would affect their interest in improving or not improving said ability. Objectives: To know the strengths and weaknesses that undergraduate nursing students identify in themselves for the development of written communication skills in Spanish. Methods: Cross-sectional descriptive study. Semi-structured survey was applied to 261 undergraduate nursing students. The data were analyzed using frequency and contingency tables, using the software STATAv.14. Results: The main strength that students identified in themselves was good spelling (76.7 percent), while the main weakness was poor organization in the expression of ideas (45.3 percent). Lack of time emerged as a major difficulty; while, as an improvement strategy, the revision of guides. Although there was a consensus that writing is a fundamental skill to be developed in the individual, this ability was conditioned by the ability of the individual to make the need for its development his own, and also, the weaknesses to be improved were identified. If the student was too confident in his ability to write correctly, he hardly felt the need to train himself to perfect this knowledge. Conclusions: Considering the strengths and weaknesses that the student has at the time of writing, would allow the implementation of an improvement program with better and greater impact(AU)

What you "see" is how you communicate: Medical students' meaning making of a patient's vignette.

OBJECTIVES: To examine how medical students notice issues in a vignette and construct their meaning, and how this construction influences their plan to communicate with the patient. METHODS: Following a breaking bad news course for 112 senior medical students, we qualitatively analyzed the participants' written descriptions of the issues they noticed as requiring special attention, using an Immersion/Crystallization iterative consensus process. RESULTS: Different students noticed different issues, but no-one noticed all 19 planted issues (Mean of issues noticed by students = 6.77; SD = 2.29). The students wrote about the issues in 46 different ways, representing the diverse meanings they ascribed, ranging from identifying, through inferring, to interpreting while jumping to conclusions. Moreover, for some issues, some students focused on the patient whereas others focused on the physician or the physician-patient relationship. Noticing issues led to preparing for communication with the patient. CONCLUSIONS: Noticing the issues and the subsequent meaning-making process facilitated the preparation to address them in the envisioned encounter. PRACTICE IMPLICATIONS: When teaching communication skills, it would be helpful to focus on increasing students' awareness of the issues they notice or fail to notice and their personal meaning-making process. This might reduce bias and enhance their preparation for effective patient-centered communication.

Attention and written expression in school-age, high-functioning children with autism spectrum disorders.

High-functioning children with autism spectrum disorders often find writing challenging. These writing difficulties may be specific to autism spectrum disorder or to a more general clinical effect of attention disturbance, as these children are often comorbid for attention-deficit/hyperactivity disorder (ADHD) symptomatology (and children with attention-deficit/hyperactivity disorder often also find writing challenging). To examine this issue, this study investigated the role of attention disturbance on writing in 155 school-age children across four diagnostic groups: high-functioning autism spectrum disorder (HFASD) with lower ADHD symptoms (HFASD-L), HFASD with higher ADHD symptoms (HFASD-H), ADHD symptoms but no autism spectrum disorder symptoms, and typical development. Both HFASD subgroups and the ADHD group displayed lower word production writing scores than the typical development group, but the clinical groups did not differ. The HFASD-H and ADHD groups had significantly lower theme development and text organization writing scores than the typical development group, but the HFASD-L and typical development groups were not significantly different. The findings support prior research reporting writing problems in children with autism spectrum disorder but also suggest that children with HFASD-H may be at greater risk for writing difficulties than children with HFASD-L. Better understanding the role of attention in writing development could advance methods for assessment and intervention for children with high-functioning autism spectrum disorder at risk for writing difficulties.

Assessment of Current Genetic Counselor Practices in Post-Visit Written Communications to Patients.

Providing patients with post-visit written communication (PVWC) is a long-standing component of genetic counseling. However the depiction of this practice in today's clinical landscape is limited. To better describe this practice, we surveyed practicing clinical genetic counselors to ask if they send post-visit communications to patients and if so, what are the types, the average length, and the average time spent writing. They were also asked the perceived purpose of providing PVWC, if/how the practice has changed over time, and factors influencing the practice. Eighty three percent (233/280) of participants reported sending patients PVWC. Of those, 93% sent at least one communication written in patient-friendly language. The type of communication varied by specialty. Prenatal genetic counselors were less likely to send patient-specific letters and hybrid letters (defined as letters with content intended for both a physician and a patient) than those in cancer genetics (p = 0.010, p = 0.001, respectively) or pediatric genetics (p = 0.001, p = 0.004, respectively). Prenatal genetic counselors spent less time on average writing post-visit communications (19.0 min) relative to those in cancer and pediatric genetics (30.6 min, p = 0.027 and 37.7 min, p = 0.001, respectively). The most commonly cited purpose for sending PVWC was to provide patients a formal account of what happened during the appointment. These data suggest PWVC are still regularly sent to patients but the practice is variable and is influenced by numerous factors including specialty, years of experience, and time constraints.

The use of writing assignments to help students synthesize content in upper-level undergraduate biology courses.

Biology education is undergoing a transformation toward a more student-centered, inquiry-driven classroom. Many educators have designed engaging assignments that are designed to help undergraduate students gain exposure to the scientific process and data analysis. One of these types of assignments is use of a grant proposal assignment. Many instructors have used these assignments in lecture-based courses to help students process information in the literature and apply that information to a novel problem such as design of an antiviral drug or a vaccine. These assignments have been helpful in engaging students in the scientific process in the absence of an inquiry-driven laboratory. This commentary discusses the application of these grant proposal writing assignments to undergraduate biology courses.

Self-Directed Rater Training for Pediatric History and Physical Exam Evaluation (P-HAPEE) Rubric, a Validated Written H&P Assessment Tool.

INTRODUCTION: We developed, revised, and implemented self-directed rater training materials in the course of a validity study for a written Pediatric History and Physical Exam Evaluation (P-HAPEE) rubric. METHODS: Core training materials consist of a single-page instruction sheet, sample written history and physical (H&P), and detailed answer key. We iteratively revised the materials based on reviewer comments and pilot testing. Eighteen attending physicians and five senior residents underwent self-directed training, scored 10 H&Ps, and completed a rubric utility survey in the course of the validity study. We have since implemented the P-HAPEE rubric and self-directed rater training in a pediatric clerkship. Based on input from reviewers, study raters, faculty members, and medical student users, we have also developed and implemented additional optional supplemental training materials. RESULTS: Pilot testing indicated that training takes approximately 1 hour. While reviewers endorsed the training format, several suggested having optional supplemental materials available. Nineteen out of 23 volunteer study raters completed the rubric utility survey. All described the rubric as good or very good and indicated strong to very strong interest in continued use. DISCUSSION: The P-HAPEE rubric offers a novel, practical, reliable, and valid method for supervising physicians to assess pediatric written H&Ps and can be implemented using brief, self-directed rater training.