Patients with acute psychiatric symptoms are often referred to the emergency department (ED) for medical evaluation to exclude medical causes before psychiatric admission. The absence of a prospectively validated medical screening tool leads to wide practice variation. This study aims to develop a new, evidence-based and consensus-based medical screening tool through a collaborative, interdisciplinary, international Delphi approach.

This modified Delphi study will include representatives from emergency medicine and psychiatry societies across four continents, as well as patient representatives with prior experience of medical screening in the ED. A minimum sample size of 24 participants is planned to account for potential dropouts. The Delphi procedure consists of four rounds. Round 1 will present current evidence and identify key items for the new medical screening tool. Round 2 will evaluate and refine statements from Round 1. Round 3 will seek consensus on the variables to be included in a medical screening tool. In Round 4, hypothetical clinical vignettes will be used to assess the agreement on the recommendations of the newly developed medical screening tool in order to test for content and construct validity. Surveys will be conducted via Research Electronic Data Capture (REDCap), with participants rating statements on a 6-point Likert scale. Response stability will be evaluated using the intraclass correlation coefficient, and consensus defined as ≥80% agreement. Results will be reported according to the ACcurate COnsensus Reporting Document guidelines and the Guidance for Reporting Involvement of Patients and the Public 2 short form.

The Ethics Committee of Northwestern and Central Switzerland exempted the project from committee approval under the Human Research Act on 11 September 2024. Written consent will be obtained from all participants. Results of this study will be summarised as a medical screening tool which will be validated in a prospective, multicentre study in a second step.

NCT06936826.

This qualitative study explores the experiences of medical students involved in clinical work and learning under distant supervision, aiming to understand their adaptation, challenges and learning processes in the context of clinical uncertainty and reduced oversight.

This study employed a constructivist grounded theory (CGT). CGT was chosen for its strength in examining complex social interactions and uncovering emergent themes that are not fully explained by existing theoretical frameworks. Data were collected through 13 semi-structured, in-depth interviews with medical students who actively participated in clinical care under conditions of limited supervision and high responsibility.

Faculty of Medicine, Switzerland.

We conducted interviews with 13 medical students who worked in Mobile SWAB Teams during the COVID-19 pandemic.

Students described a shift from observation to actively taking on a professional role. This experience provided a unique opportunity for medical students to apply their knowledge and skills in real-world settings, develop a sense of autonomy and foster personal growth. Acknowledging the importance of effective communication, teamwork and decision-making in providing patient care, they embraced the concept of self-regulated learning (SRL).

Creating a supportive learning environment that promotes SRL encourages collaboration and enables medical students to take on clinical tasks with increasing autonomy. In our study, working under distant supervision promoted reflection, strengthened communication and supported both clinical development and identity formation. This approach highlights the value of integrating supported responsibility and guided reflection into future models of clinical education.