https://www.selleckchem.com/products/bms-935177.html Health professional education is transitioning to online platforms to meet students' need for flexibility and international access. However, there is a necessity for authentic presentation of educational material particularly in regard to clinical skills development. There has been major growth in the delivery of virtual simulated-based learning and assessment to provide clinical skill acquisition in an online platform. The aim of this review was to explore the use of virtual simulation to assess clinical competence in health education. Integrative review. Peer reviewed studies published between 2008 to March 2020 were searched across PubMed, Embase, Cochrane Library, CINAHL Medline, Scopus, and PsycINFO. The Preferred Reporting Items for Systematic reviews and Meta-Analyses was followed. Twenty-three studies, which met the inclusion criteria, were downloaded, and a quality appraisal and analysis was completed by the research team. A thematic analysis identified four themes; pedagogy differences acromes. Virtual simulation is a feasible strategy to assess students' clinical competency and support their learning in both medical and nursing programs, however simulation should be authentic and incorporate reflection.The rare earth element (REE) group is widely used for geochemical prospection and the hydrochemical differentiation of waters. Most of the currently applied methods use normalized REE patterns to determine enrichments or depletions of certain REE in comparison to standard materials, which are caused by specific environmental conditions. Contrast agents containing Gadolinium (Gd), which are used for magnetic resonance imaging (MRI), have been emitted into surface waters since the 1980s. Patients excrete these contrast agents shortly after ambulant medication in hospitals or at home. Sewage treatment is currently unable to hold back Gd from this anthropogenic source. Therefore, the Gd concentration in the r