Development of competencies related to care of older adults is necessary in pharmacy education. Skills laboratories as an essential part of the curriculum represent an important setting to teach geriatrics. The purpose of this research was to describe geriatrics cases in skills/simulation activities of an undergraduate pharmacy program.
A retrospective review of one academic year of skills laboratories from the pharmacy program at the Faculty of Pharmacy of University of Montreal was performed. Sessions including cases aged ≥65 years were selected. Content was extracted for characteristics relating to the patient, health, medications, and care context. A framework including geriatric considerations such as geriatric syndromes, frailty status, and potentially inappropriate medications was developed for data collection.
In total, 210 patient cases were extracted. Older adults (≥ 65 years) were represented in 51 cases (24%), with 8 cases (4%) aged ≥80 years. Geriatric syndromes were documented in 8%, functional status in 10%, and mobility in 12% of the cases. The median number of comorbidities and medications were 4 and 7, respectively. Regarding polypharmacy, only 10 cases had >10 medications, and none had >15 medications. Potentially inappropriate medications were found in 47% (n = 24) of the cases but were addressed in only 14% (n = 7) cases.
This mapping of skills laboratories highlights gaps in geriatrics content. Inclusion of the oldest patients and geriatrics issues were incorporated in a minority of cases and lacked many characteristics essential for geriatrics care.

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BACKGROUND: The organization and funding of health care delivery are undergoing rapid change. As a result, the need for effective and context relevant educational methods to teach physicians leadership skills is growing. The case-based discussion has been proven to be effective in teaching leadership skills. Therefore, we decided to explore the potential value of its application in leadership training programs for residents.
CONCLUSIONS: We performed a qualitative survey to investigate the views of residents and professionals on the use of case-based discussion for leadership skills development during residency training. The Results showed that there were differences in the quality and methods of teaching amongst teachers in different disciplines. More interactive educational strategies were recommended such as case-based discussion and practice-based education during protected teaching slots. Our findings reflected the challenges associated with finding the perfect moment to initiate formal leadership education in postgraduate medical education.
CONCLUSIONS: The case-based discussion is a potentially helpful method to teach residents leadership skills. In addition, establishing trust between stakeholders in the health system should be a focus of any leadership course. Still, determining the perfect timing to initiate leadership training during residency remains difficult.

BACKGROUND: In the last decade, nursing education has begun to reform to competency-based education worldwide, including in low-and middle-income countries. Case-Based Learning (CBL), an approach to delivering competency-based education, contributes to acquiring critical thinking competency, problem-solving, higher knowledge, professional value and attitude. However, it needs to be taught in a culturally appropriate manner. In Cambodia, CBL was initiated in a classroom and clinical practicum by faculty and preceptors who graduated from the upgrading course. This study examined the factors associated with the competency level of nursing students, explored the practice and perceptions of teaching-learning activities among students, faculty members and preceptors and assessed the coherence of qualitative and quantitative findings.
METHODS: This was a convergent, mixed methods study. Data were collected from eight educational institutions for quantitative and qualitative studies and seven hospitals for qualitative studies. From June to September 2019, a cross-sectional survey of nursing students in the third year of the three-year programme (n = 719), eight focus group discussions (FGDs; n = 55) with 6-8 members and 15 FGDs with faculty (n = 38) and clinical preceptors (n = 37) with 4-7 members were conducted to elicit the teaching-learning experience and perceptions. Multiple linear regression was performed to investigate the factors associated with student competency. Moreover, the study conducted thematic content analysis on the qualitative data. The integrated analysis was presented as side-by-side joint displays.
RESULTS: First, the quantitative and qualitative findings confirmed each other \'s CBL learning experiences. Students had higher levels of nursing competencies if they had CBL experiences, both in the classroom and clinical practicum, both in a group manner. Next, the quantitative and qualitative findings complemented students\' academic satisfaction with the teaching by faculty members and preceptors. Finally, the quantitative and qualitative findings were expanded to explain students\' academic satisfaction with the programme.
CONCLUSIONS: The finding of CBL experiences in a group and students\' satisfaction with faculty members\' and preceptors\' teaching improved nursing students\' competency development. Meanwhile, students\' satisfaction with the design and delivery of the educational programme provides implications for policy level to narrow the theory and practice gaps in low- and middle-income countries.

UNASSIGNED: Role extension into novel areas of ultrasound practice can be challenging for health care professionals. Expansion into existing areas of advanced practice typically occurs using established processes and accredited training; however, in areas where there is no formal training, there can be a lack of support for how to develop new and progressive clinical roles.
UNASSIGNED: This article presents how the use of a framework approach for establishing areas of advanced practice can support individuals and departments with safely and successfully developing new roles in ultrasound. The authors illustrate this via the example of a gastrointestinal ultrasound role, developed in an NHS department.
UNASSIGNED: The framework approach comprises three elements, each interdependent upon and inform each other: (A) Scope of practice, (B) Education and competency and (C) Governance. (A) Defines (and communicates) the role extension and area(s) of subsequent ultrasound imaging, interpretation and reporting. By identifying the why, how and what is required this informs (B) the education and assessment of competency for those taking on new roles or areas of expertise. (C) Is informed by (A) and is an ongoing process of quality assurance to safeguard high standards in clinical care. In supporting role extension, this approach can facilitate new workforce configurations, skill expansion and enable increasing service demands to be met.
UNASSIGNED: By defining and aligning the components of scope of practice, education/competency and governance, role development in ultrasound can be initiated and sustained. Role extension utilising this approach brings benefits for patients, clinicians and departments.

Although the National Institute of Medicine Social Security committee recommended that a person\'s financial capacity should be defined and assessed as real-world performance, there has been scant progress on creating methods to translate this idea into reliable methods. The current clinical comment focuses on analyzing actual financial management and decision-making in an evaluation to determine whether the older person needed a conservator.
A case study is used to illustrate how to take a feasible approach to analyzing financial management and decisions and applying those to financial capacity assessment.
By employing a person-centered analysis of checking and credit card statements and using a semi-structured interview, the clinician was able to assess the financial management and decision-making skills of an older adult.
Clinical gerontologists have an ethical prerogative to enhance autonomy where possible. Analyzing a person\'s actual financial management records as opposed to hypothetical and perhaps unfamiliar financial tasks may represent a step forward in person-centered assessment of financial management and capacity.
Clinical gerontologists are often asked to provide financial capacity assessments. Using a person-centered approach to assessing financial management and financial decision-making offers a new and reliable method of assessing financial capacity.

Reducing the global treatment gap for mental health conditions in low- and middle-income countries (LMICs) requires not only an expansion of clinical psychology training but also assuring that graduates of these programs have the competency to effectively and safely deliver psychological interventions. Clinical psychology training programs in LMICs require standardized tools and guidance to evaluate competency. The World Health Organization (WHO) and UNICEF developed the \"Ensuring Quality in Psychological Support\" (EQUIP) platform to facilitate competency-based training in psychosocial support, psychological treatments, and foundational helping skills, with an initial focus on in-service training for non-specialists. Our goal was to design the first application of EQUIP to implement competency-based training into pre-service education for clinical psychology trainees. With Makerere University in Uganda as a case study, we outline an approach to develop, implement, and evaluate a competency-based curriculum that includes seven steps: (1) Identify core clinical psychology competencies; (2) Identify evaluation methods appropriate to each competency; (3) Determine when competency evaluations will be integrated in the curriculum, who will evaluate competency, and how results will be used; (4) Train faculty in competency-based education including conducting competency assessments and giving competency-based feedback; (5) Pilot test and evaluate the competency-based education strategy with faculty and students; (6) Modify and implement the competency-based education strategy based on pilot results; and (7) Implement ongoing evaluation of the competency-based curriculum with continuous quality improvement. This approach will be formally evaluated and established as a foundation for pre-service training in other low-resource settings.

OBJECTIVE: The aim of this study was to develop Dental Public Health (DPH) competencies and to assess the self-perceived achievements of undergraduate students in regard to these competencies.
METHODS: In the first phase, by using the mixed method of the RAND-UCLA model, a list of the proposed competencies was developed and validated based on three-round expert consensus using both rating and group discussing method. In the second phase, 120 senior (final-year) dental students were asked to determine their achievements based on the finalised list of competency statements on a 0-10 numerical scale. Descriptive statistical analysis was then performed using SPSS (version 22) to determine the mean score of the items and domains. Some background factors were also tested for any relationship.
RESULTS: After three rounds of implementing the RAND-UCLA method, 31 statements in 10 domains were developed and validated. The mean total score of the self-reported competency was 176.87 ± 52.4 amongst the recruited dental students with a range of 37 to 304. The highest mean ± sd score (7.7 ± 1.8) was found for the preventive oral health services field, whilst the lowest one (4.5 ± 2.3) was reported for understanding the components and functions of the health system. The average self-reported scores of professional ethics and professionalism, evidence-based practice and oral health determinants were also acceptable amongst them.
CONCLUSIONS: The finalised competencies gained the consensus level of agreement and appropriateness by representatives of all DPH experts in the country. However, according to the dental students\' self-reports, they had moderate competencies in most cases. Therefore, content and applied methods of training and evaluation may need to be revised to support students\' development. Also, the complementary evaluation method at real work setting is highly suggested.

BACKGROUND: Nursing students\' practical training should begin when students can apply core knowledge, skills, and attitudes related to patient safety. This necessitates an integrated curriculum in nursing education that links practice to the theory concerning patient safety to enhance patient safety competencies and quality in nursing care. This study aimed to develop an integrated curriculum that incorporates patient safety factors in the existing curriculum to increase patient safety competencies in nursing students.
METHODS: A case study approach was adopted to explain the development processes of a new curriculum integrating patient safety in the existing outcome-based curriculum of a nursing college. Based on the existing outcome-based curriculum of a nursing college, a four-step process was performed to integrate patient safety component, including quality improvement, into the curriculum: 1) literature review, 2) analysis of course syllabus, 3) selection of courses related to patient safety topics, and 4) development of evaluation tool.
RESULTS: The integrated patient safety curriculum was based on six topics: patient safety principles, teamwork, communication, patient engagement, risk management and, quality improvement, and International Patient Safety Goals. Based on the characteristics of the course according to the level of students in each year, the curriculum was integrated to address patient safety topics in seven courses (four theoretical and three practical). A Patient safety Competency self-assessment checklist was developed for students to naturally acquire patient safety competencies in clinical settings.
CONCLUSIONS: This study demonstrated that patient safety topics should be addressed in both theoretical and practical settings across the entire nursing curriculum per the continuity and sequence of education principles.

Local health departments require assurance of competence of their workforce to prevent and mitigate outbreaks by supporting the implementation of evidence-based actions in clinical practice, medical procedures and infection control practices. Too often outdated policies or reduction in budgets prevent the appropriate training strategies or resources to recruit, retain or support this capability.
In this 2018 case study analysis, we coupled the Phillip\'s Return on Investment model with a standard financial proforma model to make a business case that investing in training, specifically the Certification in Infection Control (CIC), was worthwhile for cost reduction, improved knowledge, skills and abilities (KSA\'s) and improved employee retention.
Our model demonstrated that our initial investment (USD $1,840) was profitable based on the internal rate of return (IRR = 130%, Year. 5), payback period (0.71 years), Benefit Cost Ratio (BCR = 1.41) and Return of Investment (ROI = 41%), if an epidemiologist worked a minimum of 3 healthcare associated infection outbreaks per year. Data from 4 local epidemiologists demonstrated that the application of KSA\'s reduced investigation hours by 10%-25% for all types of outbreaks with payback periods of less than 6 months and positive ROIs for staff with retention greater than 1 year. Our model demonstrated that at the highest end of our investment costs (US $2940) with an investigation improve efficiency of 25%, the IRR was 85% after year 5 with a payback period of 1.13 years if the epidemiologist worked on 3 HAI outbreaks per year over the 5 years.
Our results validate the profitability of investment into the CIC for local epidemiologists if they could be retained longer than the payback period. The model provides a method for managers to leverage training opportunities for employee retention while ensuring competencies in the workforce.

OBJECTIVE: This study aimed to evaluate the effectiveness and efficiency of competency-oriented clinical laboratory teaching combined with case-based learning (CBL) and improve the examination of students\' competence of laboratory medicine.
METHODS: A total of 107 medical laboratory medicine interns at the Affiliated Hospital of Xuzhou Medical University from June 2017 to July 2019 volunteered to participate in the study and were randomly assigned into a control group with training of the traditional teacher-centered method, and an experimental group under a CBL teaching program. Student basic theory tests and skill assessment were designed to evaluate what the students gained from their internship when they completed their studies at the Affiliated Hospital of Xuzhou Medical University.
RESULTS: Compared to students in the control group taught with the teacher-centered method, those in the CBL teaching program had significantly higher theory test scores and skill assessment scores on average. Competencies with particularly significant improvement included identification and processing of instrument alarm information, analysis of test results, identification and solution of the problem, as well as identification and reporting of the critical value and clinical communication.
CONCLUSIONS: The competency-oriented teaching method combined with CBL is an effective method for improving students\' professional knowledge, increasing language expression, and enhancing interpersonal relationship and teamwork, which is worthy of being promoted in laboratory medicine teaching.