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Background and purpose Design-based research (DBR) processes aim to connect educational research with instructional techniques by focusing on the development and evaluation of multiple iterations of learning activities for systematic improvement within learning environments. Desirable difficulties (DD) are purposeful challenges introduced to facilitate deeper learning of material. The purpose of this work was to evaluate a second iteration of a sterile compounding DD study in the context of DBR in order to allow for the identification and refinement of the educational methods. Educational activity and setting In this second iteration, doctor of pharmacy students in their second professional year were exposed to both a mechanical and mathematical difficulty in sterile compounding training. Afterwards, students completed a questionnaire to rate their change in confidence and reflect on the activity. Findings An increase in confidence in sterile compounding skills was seen by the majority (97.9%) of students. Students' reflections highlighted gains in strategic knowledge, split between internal and external strategies. Summary Course instructors saw value in the refinement of a DD sterile compounding activity and plan to continue incorporating DBR processes in order to allow for the further improvement of this educational method. Faculty at other institutions could apply these processes to further refine a variety of educational activities.

Summary Lipoblastomatosis and lipoblastomas are rare benign tumours arising from fetal–embryonal adipocytes. These tumours occur predominately in young children on their extremities. Chung and Ezinger (E.B. Chung, F.M. Ezinger, Benign lipoblastomatosis. An analysis of 35 cases. Cancer 32 (1973) 82–92) differentiated between the two types and described a lipoblastoma to be localised, and well-circumscribed arising from superficial fat tissue, and a lipoblastamatosis to be an unencapsulated, diffuse-type lesion that grows from deeply situated adipose tissue. A case of a lipoblastomatosis in a 6-month-old infant is described. There are no reported cases of this tumour occurring in the facial–buccal region. Although these tumours are rare they should be included in differential diagnoses of soft tissue lesions in infants.