Communication skills assessment (CSA) is essential for ensuring competency, guiding educational practices and safeguarding regulatory compliance in health professions education (HPE). However, there appears to be heterogeneity in the reporting of validity evidence from CSA methods across the health profession that complicates our interpretation of the quality of assessment methods. Our objective was to map reliability and validity evidence from scores of CSA methods that have been reported in HPE.

Scoping review.

MEDLINE, Embase, PsycINFO, CINAHL, ERIC, CAB Abstracts and Scopus databases were searched up to March 2024.

We included studies, available in English, that reported validity evidence (content-related, internal structure, relationship with other variables, response processes and consequences) for CSA methods in HPE. There were no restrictions related to date of publication.

Two independent reviewers completed data extraction and assessed study quality using the Medical Education Research Study Quality Instrument. Data were reported using descriptive analysis (mean, median, range).

A total of 146 eligible studies were identified, including 98 394 participants. Most studies were conducted in human medicine (124 studies) and participants were mostly undergraduate students (85 studies). Performance-based, simulated, inperson CSA was most prevalent, comprising 115 studies, of which 68 studies were objective structured clinical examination-based. Other types of methods that were reported were workplace-based assessment; asynchronous, video-based assessment; knowledge-based assessment and performance-based, simulated, virtual assessment. Included studies used a diverse range of communications skills frameworks, rating scales and raters. Internal structure was the most reported source of validity evidence (130 studies (90%), followed by content-related (108 studies (74%), relationships with other variables (86 studies (59%), response processes (15 studies (10%) and consequences (16 studies (11%).

This scoping review identified gaps in the sources of validity evidence related to assessment method that have been used to support the use of CSA methods. These gaps could be addressed by studies explicitly defining the communication skill construct(s) assessed, clarifying the validity source(s) reported and defining the intended purpose and use of the scores (ie, for learning and feedback, for decision making purposes). Our review provides a map where targeted CSA development and support are needed. Limitations of the evidence come from score interpretation being constrained by the heterogeneity of the definition of communication skills across the health professions and the reporting quality of the studies.

The UK’s medical workforce is under increasing strain, and this is compounded by increasing numbers of resident doctors diverging from specialist training pathways, instead entering non-training roles, reducing clinical hours or leaving the profession or UK workforce entirely. These decisions are shaped by both individual motivations and wider structural conditions, including unsatisfactory working conditions, limited flexibility and a perceived lack of support or autonomy. While pursuing alternative career routes offers personal and professional benefits, they can also delay progression to senior clinical roles, contributing to workforce instability. There remains limited understanding of how best to support retention, particularly given the varied contexts, settings and career trajectories of resident doctors. This realist synthesis will examine how, why and in what contexts resident doctors leave the National Health Service, and what interventions might support their retention.

This realist synthesis will follow Realist And Meta-narrative Evidence Synthesis: Evolving Standards guidance and will be conducted in five iterative steps: (1) identifying existing theories to develop an initial programme theory; (2) undertaking formal and purposive searches to identify relevant UK-based literature; (3) selecting documents based on relevance and rigour; (4) extracting and coding data to support the development of explanatory insights; and (5) synthesising findings using a realist logic of analysis to develop and refine context-mechanism-outcome configurations. An advisory group will guide the review throughout. The final programme theory will inform the development of evidence-based recommendations and design principles to support resident doctor retention.

Ethical approval is not required for this synthesis of existing literature. Findings will be disseminated through academic publications, conference presentations and accessible formats, including infographics, plain English summaries and blog posts. Target audiences include resident doctors, medical educators, workforce planners and policymakers.

PROSPERO, CRD420251004453.

Patient blood management (PBM), an evidence-based, patient-centred approach for optimising blood health, faces significant implementation challenges despite regulatory support, and this study explores its adoption within a Portuguese hospital to enhance education, develop tailored protocols and address healthcare system complexities, thereby contributing a unique perspective to the global discourse on PBM in Portuguese-speaking countries. This study will evaluate the clinical outcomes and cost-effectiveness of implementing a PBM programme in elective surgical patients at a tertiary Portuguese hospital, with secondary objectives focusing on preoperative anaemia prevalence and aetiology, PBM protocol adherence, transfusion practices guided by viscoelastic tests and the impact of cell salvage techniques.

A baseline evaluation will be conducted in 2018, and postintervention assessments will follow from 2019 to 2024. The control group comprised patients who underwent selected elective surgeries—including cardiac, general, orthopaedic, urological and gynaecological procedures—during 2018 without exposure to targeted PBM interventions. The intervention group consisted of patients scheduled for the same elective surgeries, who were referred for preanaesthesia evaluation to identify the need for PBM interventions. These interventions, where indicated, were implemented during the preoperative phase and extended to the intraoperative and postoperative periods to ensure a comprehensive and standardised approach to PBM application. Data will be extracted from pseudoanonymised medical records, ensuring full compliance with ethical standards and data protection regulations. Statistical analyses will be performed using robust methods suitable for categorical and continuous variables, enabling the evaluation of temporal trends and the overall effectiveness of PBM interventions in improving clinical outcomes.

Our research has been ethically approved by the Vila Nova de Gaia/Espinho Hospital Centre’s Ethical Health Committee (approval number 196/2023–1). We plan to disseminate our findings through posters, lectures at conferences and in scientific journals.