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Introduction: Ventral hernia repair cost the U.S. healthcare system nearly 3 billion dollars annually. Surgical repair is a critical competency for residents yet hernia recurrence rates following mesh-based repair range from 0.8% to 24%. Improving surgical techniques using cadavers is often cost-prohibited for many education programs and limited research exists using simulation models with a corresponding hernia repair curriculum in the graduate medical education setting. This pilot project aimed to develop a low cost, easily reproducible novel abdominal wall reconstruction model and pilot-test the ventral hernia repair curriculum to inform further refinement prior to formal evaluation., Material and Methods: This descriptive study pilot-tested the newly refined Abdominal Wall Surgical Skills Operative Model (AWSSOM) simulator for ventral hernia repair with mesh and its corresponding 2-h training curriculum for use at all levels of general surgery graduate medical education. The AWSSOM is a 3D printed synthetic anatomically realistic abdominal wall model consisting of silicone cured layers of skin, fat, rectus abdominis and a posterior rectus sheath fascia, and silicone tubules to simulate lateral neurovascular bundles. The curriculum incorporated didactic content reflecting surgical practice guidelines, hands-on practice, and faculty guidance promoting interactive critical thinking development during task performance. A pre-/post-assessment included a 10-item knowledge test, a 19-item psychomotor assessment, and 4-items confidence survey to examine changes in performance, knowledge, and confidence in competently completing the ventral hernia repair technique. Descriptive statistics were used to report the limited results of six military surgical resident participants and inform further model and curriculum refinement prior to formal evaluation., Results: The five-layer AWSSOM model was manufactured in 65 h at a material cost of $87 per model frame, is reusable model, and secure base. Six surgical residents were recruited; only four completed both pre- and post-tests due to resident schedule conflicts. The average increase in knowledge was 25%, although variable changes in confidence were observed over the four program year participants. A larger sample size and a control group are needed to demonstrate curriculum effectiveness at improving knowledge, performance, and confidence in ventral hernia repair with mesh and better delineate if high scores translate to better operative skills. A key improvement requested by residents was a more secure model base for dissection and performance of the hernia repair., Conclusions: The novel abdominal wall surgical skills operative model fills an important proof of concept gap in simulation training. It is low cost with the potential to improve cognitive and psychomotor skills, as well as confidence to competently complete ventral hernia repair with mesh in the graduate medical education setting. Prior to formal effectiveness testing, our lessons learned should be addressed in both the model and curriculum. Future studies must include an adequately powered statistical evaluation with a larger sample across all levels of training., (Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2024. This work is written by (a) US Government employee(s) and is in the public domain in the US.)

Introduction: Health disparities in the Military Health System (MHS) have been consistently documented despite the system ensuring equal access to care for its beneficiaries. Research has shown that social, economic, and political factors (i.e., Social Determinants of Health) and health care-specific factors like provider bias and systemic discrimination are key drivers of health disparities in the general population. Medical education focused on introducing these concepts using case-based learning has led to effective learning of health equity terminology. However, a significant gap exists in identifying optimal teaching approaches to develop skills to recognize these factors in actual clinical cases. This begs the million-dollar question: can case-based learning help trainees acquire the skills needed to identify the main factors contributing to health disparities in the MHS?, Materials and Methods: A longitudinal case-based curriculum was developed in which clinical cases from the Internal Medicine Wards, Medical Intensive Care Unit, or General Internal Medicine Clinic at the National Capital Consortium were solicited from trainees and analyzed for evidence of health care provider bias and systemic forms of discrimination using small groups. The National Capital Consortium Internal Medicine Residency Program implemented this pilot study in November 2021. A retrospective pretest-posttest survey assessing trainee reactions to the curriculum and changes in self-reported confidence in skills was used for curriculum assessment. Survey data were analyzed using a paired samples t-test., Results: The survey was administered during the last session of the 2022-2023 academic year, with 14 of the 23 available trainees completing it: a 60.8% response rate. Overall, 93% reported that the cases selected that academic year were engaging; the skills they were taught were practice-changing, and the educational value of the curriculum was good, very good, or excellent. Confidence ratings, assessed via a 5-point Likert Scale, demonstrated a statistically significant increase in self-reported confidence in the following skill domains with large effect sizes: identification of bias and systemic discrimination in clinical cases-change in mean: 1.07 (Pre: 3.29, Post: 4.36), P < .001, g = 1.38; recognizing and mitigating personal biases-change in mean: 0.71 (Pre: 3.50, Post: 4.21), P <.001, g = 1.10; participating in a discussion about health care provider bias and systemic discrimination-change in mean: 0.79 (Pre: 3.57, Post: 4.36), P  = .001, g = 1.06; and leading a discussion about bias and systemic discrimination-change in mean: 1.00 (Pre: 2.93, Post: 3.93), P = .002, g = 0.98., Conclusions: As the need to address health disparities in the United States becomes more pressing, so does the need for military physicians to recognize the drivers of these disparities within the MHS. Results from this pilot study of Health Equity Rounds suggest that case-based learning may be an optimal teaching approach to improve the skills of military Internal Medicine trainees in identifying and recognizing the impact of health care provider bias and systemic discrimination on clinical cases from the MHS., (© The Association of Military Surgeons of the United States 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.)

Heart rhythm management is a continuously evolving sub-speciality of cardiology. Every year, many physicians and allied professionals (APs) start and complete their training in cardiac implantable electronic devices (CIEDs) or electrophysiology (EP) across the European Heart Rhythm Association (EHRA) member countries. While this training ideally ends with an EHRA certification, the description of the learning pathway (what, how, when, and where) through an EHRA core curriculum is also a prerequisite for a successful training. The first EHRA core curriculum for physicians was published in 2009. Due to the huge developments in the field of EP and device therapy, this document needed updating. In addition, a certification process for APs has been introduced, as well as a recertification process and accreditation of EHRA recognized training centres. Learning pathways are more individualized now, with Objective Structured Assessment of Technical Skills (OSATS) to monitor learning progression of trainees. The 2024 updated EHRA core curriculum for physicians and APs describes, for both CIED and EP, the syllabus, OSATS, training programme and certification, and recertification for physicians and APs and stresses the importance of continued medical education after certification. In addition, requirements for accreditation of training centres and trainers are given. Finally, suggested reading lists for CIED and EP are attached as online supplements., Competing Interests: Conflict of interest: none declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Purpose: Objective structured clinical examinations (OSCE) are a valuable assessment within healthcare education, as they provide the opportunity for students to demonstrate clinical competency, but can be resource intensive to provide faculty graders. The purpose of this study was to determine how overall OSCE scores compared between faculty, peer, and self-evaluations within a Doctor of Pharmacy (PharmD) curriculum., Methods: This study was conducted during the required nonprescription therapeutics course. Seventy-seven first-year PharmD students were included in the study, with 6 faculty members grading 10-15 students each. Students were evaluated by 3 graders: self, peer, and faculty. All evaluators utilized the same rubric. The primary endpoint of the study was to compare the overall scores between groups. Secondary endpoints included interrater reliability and quantification of feedback type based on the evaluator group., Results: The maximum possible score for the OSCE was 50 points; the mean scores for self, peer, and faculty evaluations were 43.3, 43.5, and 41.7 points, respectively. No statistically significant difference was found between the self and peer raters. However, statistical significance was found in the comparison of self versus faculty (p = 0.005) and in peer versus faculty (p < 0.001). When these scores were correlated to a letter grade (A, B, C or less), higher grades had greater similarity among raters compared to lower scores. Despite differences in scoring, the interrater reliability, or W score, on overall letter grade was 0.79, which is considered strong agreement., Conclusions: This study successfully demonstrated how peer and self-evaluation of an OSCE provides a comparable alternative to traditional faculty grading, especially in higher performing students. However, due to differences in overall grades, this strategy should be reserved for low-stakes assessments and basic skill evaluations., Competing Interests: Declaration of competing interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents, and royalties., (Copyright © 2024. Published by Elsevier Inc.)

Background and Purpose: Personal and professional development (PPD) is an essential focus of pharmacy school curriculum in developing future pharmacists. This manuscript describes the creation, implementation, and data collection of a PPD Activity Tracker in a pharmacy curriculum., Educational Activity and Setting: Previously, in "Standards 2016" and currently in "Standards 2025", colleges of pharmacy are tasked with documenting how students achieve PPD throughout their academic careers. Therefore, the PPD course directors developed a PPD Activities Tracker to provide student pharmacists a central location to document curriculum and co-curricular activities as they matriculate through the pharmacy program. The tracker was created using an electronic survey platform. Eleven activity categories were established, and students noted whether the activity was directed toward personal and/or professional development. The purpose of the tracker was to create a repository for student documentation of their PPD-promoting experiences and to provide a mechanism for individual and cohort reporting for assessment and accreditation., Findings: Student pharmacists from two class cohorts entered 3254 PPD activities into the tracker over a two-year period. All PPD categories were tracked with the highest attended activities, including personal development & self-care (19%) and self-reflection (19%); the next highest category was interprofessional education/collaboration (15%). Students noted that most PPD activities enhanced their personal and professional development (49%), while personal development only and professional development only were 31% and 19%, respectively. The students "highly recommended" (72%) most tracked PPD activities, while 26% of activities were "recommended." Individual student and class cohort data were also readily accessible., Summary: The PPD tracker created a central, easily accessible, and organized storehouse for successfully collecting curricular and co-curricular PPD activities throughout the student pharmacist's career. The data from this tracker could easily be collected and sorted individually as a class cohort or for an individual student pharmacist., Competing Interests: Declaration of competing interest None of the authors have any financial disclosures or conflicts of interest., (Copyright © 2024. Published by Elsevier Inc.)

Objective: To learn how students in an accredited PharmD program in the United States are using ChatGPT for personal, academic, and clinical reasons, and whether students think ChatGPT training should be incorporated into their program's curriculum., Methods: In August 2023, an 18-item survey was developed, pilot tested, and sent to all students who were enrolled during the Spring 2023 semester in the entry-level PharmD program at the University of Colorado. E-mail addresses were separated from survey responses to maintain anonymity. Responses were described using descriptive statistics., Results: 206 pharmacy students responded to the survey for a 49% response rate. Nearly one-half (48.5%) indicated they had used ChatGPT for personal reasons; 30.2% had used it for academic reasons; and 7.5% had used it for clinical reasons. The most common personal use for ChatGPT was answering questions and looking-up information (67.0%). The top academic reason for using ChatGPT was summarizing information or a body of text (42.6%), while the top clinical reason was simplifying a complex topic (53.3%). Most respondents (61.8%) indicated they would be interested in learning about how ChatGPT could help them in pharmacy school, and 28.1% thought ChatGPT training should be incorporated into their pharmacy curriculum., Conclusion: At the time of the survey, ChatGPT was being used by approximately one-half of our pharmacy student respondents for personal, academic, or clinical reasons. Overall, many students indicated they want to learn how to use ChatGPT to help them with their education and think ChatGPT training should be integrated into their curriculum., Competing Interests: Declaration of competing interest None of the authors have any conflicts of interest to disclose., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background and Need for Innovation: Teaching and learning approaches can support medical students in developing the research skills necessary to be adept consumers of scientific research. Despite various influencing factors, existing literature on effective strategies in undergraduate medical education remains limited., Goal of Innovation: Using a spiraled curriculum, we created and evaluated a longitudinal course to enhance medical students' research abilities., Steps Taken for Development and Implementation of Innovation: During a recent curriculum renewal at one medical school, a three-year longitudinal course on the principles of research was developed and implemented. The innovation of this course includes the sequential nature and deliberate redundancy of curriculum content, how new knowledge is linked to prior learning, and the progressive level of difficulty in knowledge application and skill development., Evaluation of Innovation: The authors analysed faculty members' and students' satisfaction and their perceptions of each session of the course using program evaluation data collected between 2019 and 2021. Both faculty members and students recognized the benefits of revisiting concepts and highlighted learning outcomes like improved synthesis of information, explaining findings to patients, and enhanced critical thinking., Critical Reflection: The adoption of a spiraled curriculum in undergraduate medical education offers a systematic approach for developing students' research skills. The positive reception of this innovation underscores its potential to help future health professionals form a professional identity as adept researchers. However, its implications demand careful consideration and ongoing evaluation to ensure that the desired outcomes are sustained., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2024 The Author(s).)

Purpose: This review article is the first comprehensive evaluation of the available literature surrounding the education of death and dying in pharmacy schools. The purpose of this review was to describe the available literature and methods utilized regarding the emotional preparation for patient death in pharmacy education., Procedures: Searches were performed in three pharmacy databases to identify articles that contained descriptions of activities related to death and dying education in pharmacy curriculums., Findings: Eleven journal articles were reviewed, detailing activities in pharmacy education including simulations, didactic sessions, and an innovative "death over dessert" model. Evaluation methods varied, with surveys being most common, followed by reflection. Didactic courses demonstrated increased empathy and knowledge, while simulations compared to case-based activities improved skills, knowledge, and comfort levels with providing end-of-life care. Simulations often involved interprofessional groups, with third-year pharmacy students most evaluated., Conclusion: Pharmacy students were mainly exposed to death and dying scenarios through didactic courses or simulations, with limited longitudinal exposure. Research suggests that students may lack preparation for handling death-related situations, leading to trauma and dysfunction. While existing studies focus on outward effects like empathy, internal factors such as coping methods receive less attention. Unlike nursing and medicine literature, pharmacy education lacks comprehensive coverage of coping and emotional support strategies for death and dying scenarios. Additional focus should be placed on intentional incorporation of these topics into pharmacy curriculums., Competing Interests: Declaration of competing interest None., (Copyright © 2023. Published by Elsevier Inc.)

The Competencies and Recommendations for Educating undergraduate Nursing Students (CARES) was originally designed for nursing students' palliative and end-of-life care education. The competencies were later revised to align with the 2021 American Association of Colleges of Nursing Essentials core competencies for baccalaureate nursing education. This project aimed to (1) review the courses in an accelerated baccalaureate nursing program for alignment with CARES, (2) determine any gaps, and (3) make program recommendations. The CARES competencies and Essentials were mapped according to the nursing program's 12 core curriculum courses and evaluated. Three CARES competencies were not met, and 12 were partially met. Areas of improvement were identified across the curriculum. Results of the mapping included palliative concepts needing earlier program introduction, reflective journaling was recommended for clinical practice courses, and incorporation of palliative care simulations was proposed to bridge the gaps., Competing Interests: The author has no conflicts of interest to disclose., (Copyright © 2024 by The Hospice and Palliative Nurses Association. All rights reserved.)

The overwhelming majority of states require pharmacists to pass the Multistate Pharmacy Jurisprudence Exam (MPJE) prior to licensure, and student performance in the pharmacy law course is the biggest predictor of success on the MPJE. However, wide variation exists regarding the structure and delivery of the pharmacy law course. Evidence-based learning strategies are well described in the literature, including: (1) practice testing, (2) distributed practice, (3) interleaved practice, (4) self-explanation, and (5) interrogative elaboration, and an opportunity may exist to implement them into the pharmacy law course. We translated these five evidence-based learning principles into practice for pharmacy law educators with specific examples. Faculty directing the pharmacy law course may consider implementing evidence-based teaching strategies into their pharmacy law course to further support student success., Competing Interests: Declaration of competing interest Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background and Purpose: Specifications grading is a mastery-based grading approach to unlock student potential and empower students to focus on learning goals while receiving and acting on meaningful feedback. Within specifications grading, bundles are created to group assignments and assessments. Based on student achievement within each bundle, overall course grade is determined. This article describes the development and implementation of a specifications grading schema in a required skills-based course series, along with lessons learned., Educational Activity and Setting: In a longitudinal course series with both a didactic and lab component, specifications grading was utilized for determination of the overall course grade. Key components of the specifications grading schema were defined by assignment bundles. Assignment bundles aligned with knowledge and skills taught and assessed in each course and also included summative capstone assessments. Each bundle was assigned a numeric grade linked to a letter grade which determined the students' final grade in the course., Findings: Following first course offerings, several changes to the specifications grading schema were made to improve tracking of assignments and activities, to improve consistency across courses, and to aid in final course grade determination. All quizzes were changed to optional, formative quizzes to encourage student accountability. Additional changes were made to the processes of capstone remediation and reassessment, which led to changes in language of the grading schema., Summary: Developing and implementing specifications grading was a crucial first step in building a required skills-based course series, which led to further refinement and improvement for future course offerings., Competing Interests: Declaration of competing interest The authors have no financial disclosures to declare and no conflicts of interest to report. The authors have no financial interests and have not received any funding for anything mentioned in this manuscript., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Across the healthcare continuum simulation is routinely integrated into the curriculum for nurses and other professionals. The amount of simulation experienced at different points in the clinical setting highly depends on the specialty and organizational investment. The use of simulation in nursing can be divided into five specific use cases. Required and specialty certification courses include the following: Nurse Onboarding, Nurse Continuing Education, Regulatory & Joint Commission, and Interprofessional Education. Although common elements exist for each of the abovementioned use cases, there are distinct advantages, disadvantages, and implementation challenges with each that need to be considered., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Training in palliative and end-of-life (EOL) care provision represents a critical topic in health professional curricula for ensuring a workforce prepared to provide safe and person-center care at the end of one's life. This manuscript describes the incorporation of a simulation-based learning experience (SBLE) and the evolution of a professional elective course for student pharmacists related to palliative and EOL care., Educational Activity: A SBLE was incorporated into a long-standing professional pharmacy elective course in palliative and EOL care. The decision to incorporate and utilize SBLE to introduce topics of deprescribing, communication, prioritization of quality of life, and establishing goals of care was utilized in recognition of a need to establish a psychologically safer environment to allow students to explore these topics prior to the advanced pharmacy practice experiences., Discussion: Incorporation of SBLE in this professional elective course resulted in a favorable effect on course enrollment. Observations from structured debriefing and anecdotal student feedback suggest that students had trouble tailoring care plans to the circumstances, particularly in focusing on de-escalating medication treatments, emphasizing the need for training in the care for this patient population which incorporate considerations for goals of care. Lessons related to the influence of environmental distractions, expressions of discomfort conveyed by body language, and challenges in prioritizing and focusing on tailoring care plans given evolving information at hand were identified., Implications: We describe the effective implementation and utilization of SBLE in a professional elective focused on palliative and EOL care for student pharmacists. Future directions include research initiatives designed to evaluate the impact of simulation on key competencies and areas developed through participation in such exercises. Systematic evaluation of outcomes and competencies related to team dynamics, sympathetic communication, professional identity formation and resiliency and preparation for dealing with death and dying in experiential learning are planned., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Nursing education at the undergraduate and graduate levels is undergoing a transformational curricular change that includes moving toward a competency-based curriculum. This opportunity holds promise to close the education-practice gap that has plagued nursing education for decades. A key teaching modality to achieve this outcome is simulation-based education. This article will explore the interaction between simulation and competency-based education., Competing Interests: Disclosure Dr C. Morse has no commercial or financial conflicts of interest to report. There are no funding sources to report; Dr S. Beroz has no commercial or financial conflicts of interest to report. There are no funding sources to report; Dr M.K. Fey has no commercial or financial conflicts of interest to report. There are no funding sources to report., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: Primary healthcare workers, including doctors and pharmacists, are well-positioned to detect and support women experiencing mental health disorders in the perinatal period. However, research exploring their education and training to fulfil these roles is limited. This study aimed to examine the perspectives of medical and pharmacy educational program representatives on perinatal mental health education in medical and pharmacy curricula at Australian and New Zealand universities., Methods: A web-based search (e.g., Australian Health Practitioner Regulation Agency) was used to identify potentially relevant medical and pharmacy educational program representatives. Eligible participants were invited to participate in audio-recorded semi-structured interviews which were transcribed verbatim. Data regarding perinatal mental health content within each program were extracted and tabulated for comparisons. Thematic analysis of participants' perspectives on perinatal mental health education was conducted., Results: Fifty medical and pharmacy educational program representatives were invited to participate (December 2022-March 2023), of which 13 participated representing 14 programs. The extent and content of perinatal mental health education varied considerably across programs. Thematic analysis resulted in four themes: How much perinatal mental health content is enough?; Reflections on perinatal mental health related content; Perinatal mental health education in and beyond the classroom; Challenges associated with delivering perinatal mental health content., Conclusions: Participants acknowledged the importance of perinatal mental health content for medical and pharmacy students; however, limited time and lack of opportunities for students to complete placements were key challenges to curricular integration., Competing Interests: Declaration of competing interest The authors have no conflict of interest to declare., (Copyright © 2023. Published by Elsevier Inc.)

Background: Integration of genomic content into nursing curricula and continuing education is limited., Purpose: This systematic review aimed to identify educational strategies to deliver genomics content., Methods: CINAHL Plus, ERIC, Ovid MEDLINE, and Scopus electronic databases were searched from January 1, 2003 through July 6, 2023. The three domains of learning: cognitive, affective, and psychomotor were used to categorize educational outcomes. A narrative approach was used to synthesize the data using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines., Discussion: Ten studies met inclusion criteria. Quality assessment for bias was conducted independently; study quality ranged from fair to poor. No study used a complete psychometrically tested instrument to measure genomic cognitive or affective knowledge; none measured the psychomotor domain., Conclusions: Effective strategies to deliver genomic education are a priority. Development of reliable and valid instruments for the assessment of educational interventions, including the psychomotor skills needed for practice., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Student nurses in the United Kingdom undertake field-specific pre-registration education. The implementation of the Nursing and Midwifery Council (2018) Future nurse: Standards of proficiency for registered nurses, has raised concerns that the increasingly generic component of pre-registration programmes is not adequately preparing newly qualified children's nurses to care for children safely., Objective: To investigate how the introduction of the Nursing and Midwifery Council standards in the United Kingdom has impacted the structure and field specific content of pre-registration children's nursing programmes., Settings: An online survey completed by 54 programmes, field, or professional leads linked to 76 pre-registration children's nursing programmes. This represents 80 % of higher education institutions with Nursing and Midwifery Council approved pre-registration children's nursing programmes across all four United Kingdom countries., Methods: A survey to capture the current content and changes to curricula since the introduction of the Nursing and Midwifery Council (2018) Future nurse standards. The survey included closed-ended and open-ended questions. Closed-ended questions were statistically analysed using SPSS v.28 for Windows. Open-ended questions were thematically analysed using Quircos v.2.1., Results: 50 % of respondents reported changes to theoretical content. In 27 programmes (35.5 %) there was a decrease in child-specific content. Child specific teaching methods accounted for less than 30 % of the content of all programmes whereas cross-field teaching methods (Adult, Mental Health, Learning Disability and Child learners together) accounted for over 70 % of the taught content. Analysis of qualitative data identified three themes: genericism as the focus, the challenge to achieve the standards' proficiencies, and dilution of child specific content., Conclusions: The survey responses show disparities in how United Kingdom higher education institutions have interpreted the Nursing and Midwifery Council standards highlighting academics concerns on the growing genericism within pre-registration children's nurse education nationally. These findings will inform the next stage of the project comparing the impact of greater or lesser degrees of genericism on the outcomes of the programme for newly qualified children's nurses., Competing Interests: Declaration of competing interest None., (Copyright © 2024. Published by Elsevier Ltd.)

Background and Purpose: Pharmacy robberies are a common occurrence. From 2010 to 2019, there were over 7500 prescription drug-related armed robbery incidents in the United States. A lecture on pharmacy robbery was added to the pharmacy curriculum in 2017 at Butler University. The primary objective of this study was to assess whether the pharmacy robbery lecture given during the first year of the pharmacy program is adequate, with a secondary objective comparing the results of this survey to one conducted prior to the curricular addition. This information provides an opportunity for schools of pharmacy to consider adding or enhancing drug diversion content into their curriculum., Educational Activity and Setting: A cross-sectional survey of all students enrolled in each professional year of the Doctor of Pharmacy program was conducted spring 2022 to collect information on pharmacy students' knowledge and experience regarding community pharmacy robberies and their perceptions of the pharmacy robbery education in the curriculum., Findings: A total of 285 of 407 students responded for a 70% response rate. More than half (53.5%) feel the pharmacy robbery education received is adequate and 63.9% feel prepared to properly manage a pharmacy robbery situation. The survey asked two pharmacy robbery knowledge-based questions and most students selected the correct response to both (89.9% and 97.8%). More than one-fourth (27.1%) of the respondents reported that the pharmacy they work/worked at had been robbed. When asked if students considered changing their career path because of pharmacy robberies, 9% responded yes., Summary: Pharmacy robbery still exists, and having proper education helps students prepare for and handle community pharmacy robbery situations., Competing Interests: Declaration of competing interest The authors declare no relevant conflicts of interest or financial relationships., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: To describe the validation and reliability assessment of a rubric designed to assess the participants' teaching portfolios and identify teaching excellence among teaching and learning curriculum (TLC) program participants., Methods: Following focus groups with program leadership at a single TLC program, an initial rubric was developed, consisting of criteria mapped to 5 domains, to be rated on a 4-point scale. The rubric was then redistributed to the TLC program leadership and external stakeholders for evaluation of face and content validity. The rubric was piloted using teaching portfolios from 3 cycles of the program. Cronbach αwas used to measure internal consistency and a 2-way random-effects model was used to assess the inter-rater reliability., Results: A total of 18 portfolios were independently evaluated by 4 raters. The overall mean Cronbach α for internal consistency was 0.90 and ranged from 0.65 to 0.84 by domain. The overall mean intraclass correlation coefficient for inter-rater reliability was 0.95 and ranged from 0.57 to 0.91 by domain., Conclusion: The rubric evaluates characteristics of teaching portfolios important to internal and external stakeholders and had good to excellent internal consistency and inter-rater reliability. It can be adapted and applied by TLC programs to identify teaching excellence., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 American Association of Colleges of Pharmacy. Published by Elsevier Inc. All rights reserved.)

Diagnosis education is explicitly included in the Draft Accreditation Standards 2025 and should be wholeheartedly supported. To address the staggering number of diagnostic errors in the US, the National Academy of Medicine advocates for diagnosis education for all health professions. Misperceptions of pharmacists' involvement in diagnosis are exacerbated by use of implicit language and euphemisms, and it's long overdue that we provide clarity. Pharmacists are engaged in diagnosis and diagnostic reasoning in everyday practice whether realized or not. Diagnosis education is implicitly included in US pharmacy curricula in the Pharmacists' Patient Care Process, and it is time to give students the language to engage in it responsibly to be practice-ready in all states. The explicit inclusion of diagnosis in the Draft Standards 2025 has positive implications for education, practice, and graduates., Competing Interests: Declaration of competing interest All authors certify that all authors have seen and approved the final version of the manuscript being submitted. They warrant that the article is the authors' original work, hasn't received prior publication and isn't under consideration for publication elsewhere. The authors declare no conflict of interest concerning primary interest, validity of research or financial gain. The authors declare that there's no financial/personal interest or belief that could affect their objectivity. Dr. Hookstra Danielson is an associate editor for the Journal of Interprofessional Education and Practice, another Elsevier publication. Other than that, we do not have any competing interests as far as we know., (Published by Elsevier Inc.)

Introduction: Medicinal chemistry instruction in PharmD programs at Canadian universities is considered an important foundational science. However, with few guidelines for the required content most programs have observed a decrease in hours of medicinal chemistry instruction. A Medicinal Chemistry Special Interest Group (SIG) was formed to address these issues nationally and initiated a pan-Canadian environmental scan to better understand the depth and breadth of medicinal chemistry instruction., Methods: The SIG carried out an environmental scan to identify medicinal chemistry content, delivery and assessments in PharmD programs in Canada., Results: Core medicinal chemistry concepts across the PharmD programs are in general agreement with those listed by the Accreditation Council for Pharmacy Education. Medicinal chemistry was typically taught as didactic lectures either as a standalone course or within a pharmacology course, although one program integrated some medicinal chemistry within therapeutics focused problem-based learning. There was no consistent time in program where medicinal chemistry occurred., Conclusions: The SIG found that similar medicinal chemistry content is taught across all Canadian PharmD programs, but incorporation of medicinal chemistry in therapeutics courses was minimal. Core concepts within six high-level overarching themes that guide our collective instruction were identified. The core concepts require developing high-level cognitive processes such as knowledge application and synthesis that practicing pharmacists are expected to possess for entry to practice. We the authors posit that in addition to providing a unique tool for pharmacists to employ in therapeutic decision-making, medicinal chemistry also provides early practice of important problem-solving and critical thinking skills., Competing Interests: Declaration of competing interest The authors listed above have no conflict of interest to declare and no affiliations with or involvement in any organization or entity with any financial interest in this submission., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The International Confederation of Midwives (ICM) defines and sets the Essential Competencies for Midwifery Practice and provides a framework for developing and reviewing midwifery curricula. This framework ensures that pre-service midwifery education designed for students leads to the demonstration of the required midwifery specific competencies. The development of the ICM competencies in 2024 confirms the timeliness of the effort of Rwanda to update its national curricula. This commentary showcases the blueprint followed by Rwanda to standardize and culturally adapt its midwifery curricula at diploma, bachelor and master's level to be competency-based and aligned with ICM. National ownership played a pivotal role in the standardization process, as the direction, priorities, and implementation of the curricula review initiative were driven by the country's own government, higher learning institutes, national midwifery association and other national organizations. Rwanda's experience in aligning its national curricula with international standards could serve as a model for south-south cooperation.

Background: Nurses and midwives are expected to provide inclusive care for LGBTQIA+ populations. However, there is a paucity of knowledge on how well-prepared nursing and midwifery graduates are for this aspect of their role., Aim: To explore LGBTQIA+ content in pre-registration nursing and midwifery curricula in Australia., Design: Cross-sectional study., Settings: Australian higher education institutions offering 86 pre-registration nursing and midwifery programs., Sample: Publicly available pre-registration nursing and midwifery course programs in Australia as presented in the online course handbooks of 25 randomly selected educational institutions., Methods: A LGBTQIA+ terminology matrix was developed to guide data extraction from subject titles, synopses, and learning outcomes. Explicit terms were those strongly associated with LGBTQIA+. Implicit terms were those indirectly associated with LGBTQIA+. Explicit and implicit LGBTQIA+ terms were analyzed for frequencies. Poisson regression was used to compare counts of LGBTQIA+ terms by course, subject, and university., Results: Among the 1093 subjects, no subject titles included explicit terms and 6 (0.55 %) titles included implicit LGBTQIA+ terminology. Explicit LGBTQIA+ terminology was identified in 54 (4.9 %) subject synopses and implicit terminology was found in 323 (29.6 %) subject synopses. Explicit LGBTQIA+ terms were identified in 14 (1.3 %) learning outcomes while implicit terms were found in 323 (29.6 %) learning outcomes. Group of Eight universities were more likely to use explicit and implicit LGBTQIA+ terminology than non-Group of Eight universities (p < 0.001; p = 0.035). Undergraduate programs included more LGBTQIA+ terminology than postgraduate programs (p = 0.019; p < 0.001). Core subjects were more likely to include LGBTQIA+ content than elective subjects (p < 0.001)., Conclusion: Explicit LGBTQIA+ terminology was minimal indicating limited overall content. The study results alert nursing and midwifery educators to take a targeted approach to teaching and learning with a LGBTQIA+ focus to support future nurses and midwives with quality knowledge and skills and ensure equitable and safe care for LGBTQIA+ people., Competing Interests: Declaration of competing interest The authors have no conflict of interest in this study., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The demand for palliative and end-of-life nursing is increasing with the aging US population. The American Association of Colleges of Nursing published recommendations for incorporating palliative and end-of-life care across nursing curriculum to prepare the future workforce. However, recommendations regarding teaching end-of-life content are limited. This project aimed to integrate and evaluate the outcomes of end-of-life education introduced in a prelicensure nursing program. Using a documentary created by the American Nurses Foundation, students had the opportunity to discuss common themes in end-of-life care, practice morgue care in the simulation laboratory, and practice reflective journaling. The students' preevaluations and postevaluations indicated that the educational program significantly increased their confidence in providing end-of-life care and support to patients and families, demonstrating the importance of end-of-life curricula in nursing school., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 by The Hospice and Palliative Nurses Association. All rights reserved.)

Introduction: Providing resilient Damage Control Resuscitation capabilities as close to the point of injury as possible is paramount to reducing mortality and improving patient outcomes for our nation's warfighters. Emergency Fresh Whole Blood Transfusions (EFWBT) play a critical role in supporting this capability, especially in future large-scale combat operations against peer adversaries with expected large patient volumes, restrictive operating environments, and unreliable logistical supply lines. Although there are service-specific training programs for whole blood transfusion, there is currently no dedicated EFWBT training for future military medical officers. To address this gap, we developed, implemented, and evaluated a training program to enhance EFWBT proficiency in third-year military medical students at the F. Edward Hebert School of Medicine at the USU., Materials and Methods: After reviewing both the 75th Ranger Regiment Ranger O-Low Titer program and the Marine Corps' Valkyrie program, along with the relevant Joint Trauma System Clinical Practice Guidelines, we created a streamlined and abbreviated training curriculum. The training consisted of both online preparatory materials as well as a 2-hour in-person training that included didactic and experiential learning components. Participants were 165 active duty third-year medical students at USU. Participants were assessed using a pre- and post-assessment self-reported questionnaire on their confidence in the practical application and administrative oversight requirements of an EFWBT program. Participants' performance was also assessed using a pre/post knowledge assessment consisting of 10 multiple choice questions identified as critical to understanding of the academic principles of EFWBT along with the baseline questionnaire., Results: Differences in the mean scores of the pre- and post-assessment self-reported questionnaire (increased from 2.32 to 3.95) were statistically significant (P < .001). Similarly, there was a statistically significant improvement in student test scores, with the mean score increasing by approximately 3 points or 30%. There was no significant difference in student confidence assessment or test scores based on branch of service. Students who had previously deployed did not show a statistically significant difference in scores compared to students who had not previously deployed., Conclusions: Our results suggest that the implementation of streamlined EFWBT training into the undergraduate medical education of future military medical officers offers an efficient way to improve their baseline proficiency in EFWBTs. Future research is needed to assess the impact of this training on real-world applications in forward-deployed environments., (© The Association of Military Surgeons of the United States 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.)

Introduction: Surgical cricothyroidotomy (SC) is a vital skill that combat first responders must master as airway obstruction is the third most preventable cause of death on the battlefield. Degradation of skills over time is a known problem, and there is inadequate knowledge regarding the rate of SC skill retention. Our prior study showed that simulation-based mastery learning was effective in training 89 novices how to reliably perform an en route SC to mastery performance standards. This study aims to assess the durability of this skill by bringing participants back in 3 separate cohorts at 6, 12, or 24 months following the initial training to perform SC in the same test environment., Materials and Methods: This was a randomized prospective trial. Random cohorts of equal subjects who previously underwent SC simulation-based mastery learning training were selected to return at 6, 12, and 24 months to retest in the same en route medical evacuation (MEDEVAC) helicopter scenario. A total of 22, 14, and 10 subjects returned at 6, 12, and 24 months, respectively, due to Coronavirus-19 impacts and travel limitations. Participants in the 24-month cohort received a refresher training prior to retesting. All attempts were recorded and blindly graded using the same 10 item standardized SC checklist used in initial training. Our previous work found that mastery criteria for performing a SC were ≤40 seconds and completion of 9/10 items on the checklist. Outcome measures in this study were time to complete the procedure and percent of subjects who completed at least 9/10 items on the SC checklist., Results: There was an increase in time required to complete the procedure compared to initial training in all three retesting cohorts (initial: median 27.50, interquartile range 25.38-31.07 seconds; 6 months: median 36.33, interquartile range 31.59-55.22 seconds; 12 months: median 49.50, interquartile range 41.75-60.75 seconds; 24 months: median 38.79, interquartile range 30.20-53.08 seconds; P < .0001, P < .0001, P = .0039). There was a decline in median value checklist scores compared to initial training in the 6- and 12-month retesting cohorts (initial: median 10.00/10, interquartile range 9.50-10.00; 6 months: median 8.00/10, interquartile range 6.75-9.00; 12 months: median 8.00/10, interquartile range 6.75-9.25; P < .0001, P < .001). There was no difference in median checklist scores between the initial and 24-month retesting scenario (initial: median 10.00/10, interquartile range 9.50-10.00; 24 months: 10.00/10, interquartile range 9.00-10.00; P= .125). There was a decrease in retention of skills as only 31.82% of subjects at 6 months and 14.29% at 12 months met the defined passing criteria of time to completion of ≤40 seconds and checklist score of ≥9/10. A brief refresher course several months prior to the 24-month cohort retesting greatly increased the retention of SC procedural skills, with 60% of subjects meeting the time and checklist criteria., Conclusions: This study showed that the skill required to perform a SC after initial mastery training does decay significantly. A brief refresher course can help increase retention of skills. Based on our findings SC skills should be refreshed at a minimum of every 6 months to assure optimal proficiency., (© The Association of Military Surgeons of the United States 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.)

Background: Perfused cadavers are viable training models for operating room surgical skills, increasing fidelity of vascular anatomy, dissection, and tissue handling. In addition, perfused cadavers may have benefits in military medical training environments with a focus on hemorrhage control and vascular access., Objectives: We created a large-scale training exercise with perfused cadavers in three different environments and aim to share the curricular design and feedback from the exercise., Methods: We conducted a 4-day simulation training exercise with 13 perfused cadavers in 3 different environments: hospital environment, the austere echelons of care environment, and a controlled-settings tent for hemorrhage control and needle decompression training. Through an anonymous online survey and an after-action review (AAR), we elicited feedback on advantages, disadvantages, costs, and comparison to models of porcine and fresh cadavers for procedures and existing courses., Results: A total of 324 participants were trained with 13 perfused cadavers for over 4 days from a variety of specialties and on different procedures and surgical skills. Based on 130 respondents to the survey and the AAR, perfused cadavers were rated to have realistic arterial bleeding and bleeding control training. In addition, perfused cadavers provided increased realism and fidelity for surgical skills. There were disadvantages of logistical requirements, cleanup, costs, and mobility., Conclusion: Perfused cadavers can be implemented effectively for hemorrhage control training, surgical and procedure skills, and even exercises in austere environments, but require significant logistical and planning considerations. The training value is maximized with a progressive curriculum from hemorrhage control iterations to more invasive surgical procedures, such as thoracotomy and exploratory laparotomy., (© The Association of Military Surgeons of the United States 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.)

Introduction: Suicide is a prevalent problem impacting the military community. The U.S. Army recognized the need to address this complex issue; one line of effort has been to provide suicide prevention and intervention education and training that is informed by current research, doctrine, and implementation best practices. The purpose of this article is to outline and present the genesis of the Army's new suicide prevention and intervention training-"Ask, Care, Escort (ACE) Base +1"-that aligns with the DoD newly published regulation-driven initiatives., Materials and Methods: The development of the "ACE Base +1" curriculum was a collaborative effort between two organizations within the Defense Health Agency: The Defense Centers for Public Health-Aberdeen and the WRAIR. A multidisciplinary team was formed by selecting specific operational and subject-matter experts from each organization based on educational qualifications and practical experiences expected to aid the development of curriculum content (e.g., subject-matter experts) and/or the training design. Revisions to the curriculum were informed by the Army's existing suicide prevention training module, current research in suicide prevention and public health, updated and relevant Army regulations, and current public health policy guidance from the CDC and the Department of Suicide Prevention Office. A detailed account of the systematic and iterative curriculum development process is provided., Results and Conclusions: The interagency collaborative efforts resulted in a suite of training products, "ACE Base +1" version 1.3 that is modernized in training content, delivery methods, and design. Four primary elements shaped the final products: (1) A modular framework allowing a tailored approach to mandatory training, (2) a public-health approach that focuses on earlier intervention opportunities while building trust and cohesion, (3) a training design centered on peer discussions and behavioral rehearsal, and (4) an expansion of the curriculum to be inclusive of the entire Army community. Practical implications for each element are discussed.As the program of record, "ACE Base +1" training satisfies the annual requirement for all Active Army, Army National Guard, U.S. Army Reserve, and Department of the Army (DA) civilians. Both the training content (e.g., public-health concepts) and design of "ACE Base +1" reflect a comprehensive approach, focused on developing concrete, applicable skills that support the shared responsibility to suicide prevention and intervention. Limitations, such as delayed interagency collaboration and time constraints, are discussed. Future directions include recommendations for future curriculum projects, specifically within military populations, such as interprofessional, interagency collaboration, and selecting a multidisciplinary team of subject-matter experts. Additionally, WRAIR plans to continue their support to Directorate of Prevention, Resilience and Readiness with the expansion of the +1 menu of trainings, ongoing program evaluation, and longitudinal analysis to inform future revisions and ensure the content and delivery methods remain modernized, relevant, and effective., (Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2024. This work is written by (a) US Government employee(s) and is in the public domain in the US.)

Reflection helps us learn from experiences, build good doctor-patient relationships and a professional identity. It also holds an important place in the competency-based curriculum as a tool for assessment, especially for competencies that cannot be assessed by conventional means. To embed reflection in the curriculum, we need to explicitly teach how to reflect, make it a habit by integrating it into the various curricular activities, assess reflections formatively, and provide an environment that allows guided reflections, taking care of ethical and emotional aspects. In the Indian scenario, reflection is taught in faculty development programs and as a part of short-term implementation projects. A more robust and nuanced effort is required to make reflection an inseparable component of the curriculum that will empower the graduates to be competent in the true sense.

Problem Description: Without externally validated tools to assess teaching and learning curriculum (TLC) programs, our program has undertaken continuous quality improvement (CQI) methods to make revisions in response to resident, programmatic, and accreditation demands., Quality Improvement Methods: Key stakeholders, including the college of pharmacy, the residents, and the executive committee, were engaged in discussion and feedback was solicited., Results of Cqi Inquiry: The demands identified prompted revision of the TLC teaching component, programming, and timeline. Major changes have included adding an application for the teaching track, limiting teaching track participation, altering the seminar format (to a mix of in person, virtual, and asynchronous), and starting the program earlier in the calendar year. Key stakeholders supported the proposed revisions., Interpretation and Discussion: The CQI method summarized here worked well for the TLC. Although simplistic in nature, it met the needs of the TLC and engaged several stakeholders. No major challenges were encountered during the process and stakeholders were amenable to the process and proposed revisions. Given the lack of externally validated tools for assessing TLC programs, any TLC program could perform a similar CQI method to assist with revisions., Conclusion: Continuous quality improvement of the TLC to address resident, programmatic, and accreditation demands has been vital to optimize and sustain the program. Assessment will be ongoing as future revisions are made., Competing Interests: Declaration of competing interest The authors have declared no potential conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The mission of the European Board of Physical and Rehabilitation Medicine (PRM) is to the ensure a consistent and high-level education for PRM physicians across Europe. An important action to accomplish this mission is the publication and continuous update of the European Training Requirements (ETRs) for the specialty of PRM. The first version of the ETRs for PRM was issued in 2017. The aim was to present the up-to-date training standards for trainees, trainers, and training institutions. The revision of the first ETRs, aiming to reflect the current standards in medical education and clinical advances in the field or PRM, started in 2022 and was completed in 2023. It was based on the Rehabilitation Competency Framework and the "Guide for using a contextualised competency framework to develop rehabilitation programmes and their curricula" published by the WHO in 2021. An important addition in the new version of the ETRs is the integration of Entrustable Professional Activities. In all endeavours of the creation of the ETRs, setting the highest standards of training in PRM was pursued.

The One Health concept focuses on the interconnections between human health, animal health, and the environment, stressing the need for interdisciplinary collaborations to address complex issues such as the health challenges posed by climate change and global pandemics. One Health is a central part of the curriculum of veterinary schools, however, it is rarely incorporated into medical school education. Nationally, there are limited examples of formal One Health education and training for medical students. To incorporate One Health into its curriculum, John A. Burns School of Medicine developed a Dean's Certificate of Distinction in One Health that consists of a One Health foundational course, a clinical One Health elective course, participation in the One Health Interest Group, engagement in One Health educational and outreach activities, and a One Health research or curriculum development project. To the authors' knowledge, this is the first One Health certificate program developed and implemented in any Association of American Medical Colleges accredited medical school. Although introducing similar programs into medical curricula will continue to be challenging, we hope it will serve as a framework for other academic institutions., Competing Interests: None of the authors identify a conflict of interest. Funding/Support: None; Other disclosures: None; Ethical Approval: Not applicable; Disclaimers: None; Previous presentations: None; Data: Not applicable, (©Copyright 2024 by University Health Partners of Hawai‘i (UHP Hawai‘i).)

Background and Purpose: Transitioning from the didactic to experiential setting is challenging for student pharmacists, perhaps due to lack of experiences providing "real-time" clinician interaction. We describe findings from a semester-long infectious diseases (ID) didactic elective that utilized a national cohort of preceptors and faculty across the United States to mimic clinician interaction and "real-time" ID management of various disease states. The mechanics of this elective provide a framework for others to implement to enhance advanced pharmacy practice experience (APPE) readiness., Education Activity and Setting: Students enrolled in an ID elective course at a school of pharmacy participated in "real-time" acute care scenarios. They assisted in multidisciplinary management of a patient's infection, mimicking "rounds" on an APPE, via interaction with external pharmacist volunteers (playing the roles of other healthcare personnel). Additionally, students formally presented and discussed their cases within the class, further promoting learning while optimizing presentation skills. Pharmacist volunteers were surveyed to assess student performances as measured by four entrustable professional activities (EPAs)., Findings: A total of 48 volunteer opportunities occurred during two course offerings. Results from 43 surveys were analyzed (90% response rate). Of those responses, 22/24 (92%) played the role of attending physician, and 19/24 (79%) played the role of technician. Volunteers agreed that students met the four EPAs evaluated (agreement was 85-100%)., Summary: This semester-long elective provided "real-time" experience and feedback for pre-APPE students to enhance APPE readiness and reinforce EPAs. Students are likely to benefit from mimicked intra-professional interaction and augmented critical thinking skills that could be adapted to various disease states within pharmacy curricula., (Published by Elsevier Inc.)

Nurses play a crucial role in reducing health disparities and advancing health equity for individuals and communities. The future nursing workforce relies on their nursing education to prepare them to promote health equity. Nursing educators prepare students through a variety of andragogical learning strategies in the classroom and in clinical experiences and by intentionally updating and revising curricular content to address knowledge and competency gaps. This critical review aimed to determine the extent to which health equity concepts are explicitly present in prelicensure undergraduate nursing curricula globally. Of 434 articles screened, 22 articles describing 20 studies met inclusion criteria. Frequency and quantity of health equity content, concepts and topics, teaching strategies, evaluation strategies, and the overall extent of integration varied widely. Notably, only two articles described overall well-integrated explicit health equity content, and there was little attention to whether students transfer this learning into practice. A focus on individualism rather than population and community was noted, highlighting the presence of whiteness in nursing. Results from this review confirm that nursing education has room to improve with respect to health equity in the curricula., (© 2024 The Authors. Nursing Inquiry published by John Wiley & Sons Ltd.)

Introduction: In the last decade, significant changes in pharmaceutical sciences have influenced the delivery of pharmacy education in Pharmacy programs. Integrated curriculum is one such method considered. We aimed to describe the perceived level of integrated curriculum among PharmD programs in the US., Methods: From October 26th, 2021, until January 18th, 2022, faculty administrators across 138 US pharmacy colleges were surveyed. Data was collected regarding each program's perceived curriculum integration and assessment integration. Characteristics of each college, including region and the type of school (public/private), were obtained from the PharmCAS website. Programs were categorized into high-integration and low-integration groups for analysis purposes. Descriptive and comparative analysis by the level of curriculum integration was performed., Results: Overall, 60 colleges completed surveys (participation rate = 43.48%). Most schools were from the South region (38.33%) and public colleges (53.33%). The average perceived curriculum integration was 45% (SD = 23.69), while the average perceived assessment integration was 36% (SD = 25.52). Pharmacy practice [clinical sciences] (76.67%) was the most common discipline considered for integration, and the social and administrative sciences (21.67%) was the discipline least commonly considered for integration. Case-based learning (95%) was the most common pedagogy strategy to integrate knowledge from different disciplines., Conclusions: Integrated curriculum implementation in the US PharmD programs varied across colleges. While most programs integrated their clinical practice courses, social and administrative sciences was the course least commonly integrated. Very limited progress in assessment integration was perceived., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background and Purpose: Little is known about nutrition education in pharmacy programs. This study reports on the outcomes assessment of pharmacy students' knowledge, perceptions, and satisfaction in a clinical nutrition course., Educational Activity and Setting: A 2-credit required course in clinical nutrition and diet therapy provides third-year professional pharmacy students with knowledge on various diet and nutrition topics. These relate to nutrition concepts in health and disease, the prevention and treatment of diet- and nutrition-related health conditions, and enteral and parenteral nutrition., Findings: Between the academic years 2012 and 2021, 720 students were enrolled in the course. Direct assessment data were collected from 227 students, and indirect assessment data from 173 students. On average, 85.7% of students acquired the necessary knowledge on all 23 course learning objectives. Average course evaluation ratings by students on a 5-point Likert scale (strongly disagree = 1; disagree = 2; somewhat agree = 3; agree = 4; strongly agree = 5) were high (4.43). High ratings were also recorded for students' satisfaction with the course structure (4.46) and teaching effectiveness (4.39). Students appreciated the clear presentation of the course learning objectives, requirements, and teaching effectiveness. They also acknowledged the quality of the learning experience and the course's relevance to pharmacy., Discussion: Students highly rated the course in achieving its learning objectives in addition to their satisfaction with its content, structure, delivery, and relevance to pharmacy education and practice. Furthermore, the course content addressed the accreditation requirements for nutrition education and covered the topics listed in the American College of Clinical Pharmacy (ACCP) Pharmacotherapy Didactic Curriculum Toolkits., Summary: The clinical nutrition and diet therapy course was well received. Educating pharmacy students on diet and nutrition prepares graduates for expanding their role in these domains in the community, hospital and clinical practice settings., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Emergency physicians and trainees provide the initial care for critically ill patients. In times of emergency department boarding, this care may extend beyond the first few hours. To meet the needs of this population, a standardized novel critical care curriculum targeting third- and fourth-year medical students was developed., Objectives: We hypothesized that the institution of such a curriculum is feasible and will provide an increased understanding of the underlying critical care principles within this learner population., Methods: We developed a 2-month-long critical care curriculum (February-April) and carried out the course twice from 2022-2023. Our pilot study deployed this curriculum to medical students interested in critical care through the American Academy of Emergency Medicine/Resident and Student Association. The primary outcome included was the overall composite score comparison of the pre- and post-course evaluations, with a higher score indicating that the student improved their comprehension. Secondary outcomes included the individual factors of the pre- and post-course surveys., Results: Fifty-one trainees completed the pilot course, including 11/51 (21.6%) third-year medical students and 40/51 (78.4%) fourth-year medical students. Overall, 39 had "no experience" in critical care and 12 indicated that they had "previous experience." The students' baseline pre-course from the pooled 2022 and 2023 Introduction to Critical Care in Emergency Medicine (ICCEM) curriculum data was 3 (interquartile range 4-3) and their post-course score was 9 (interquartile range 9-9), p-value 0.015 for the 51/54 students who completed the course., Conclusions: The novel curriculum was found to be effective during its implementation in third- and fourth-year medical students. As such, it indicated that a critical care fundamentals course improves confidence in these topics for students with and without prior experience. Further work is necessary to understand the generalizability and knowledge retention of the proposed pilot curriculum., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Problem & Background: Medical education has acknowledged the impact of structural societal factors on health, prompting the need for curricula seeking to eliminate health inequities upstream while simultaneously caring for downstream effects of existing inequities. The Keck School of Medicine of USC (KSOM) implemented one such comprehensive curriculum, Health Justice and Systems of Care (HJSC), integrating health systems science, structural competency, and service-learning in a required course spanning the pre-clerkship and clerkship phases with an optional post clerkship elective., Approach: The HJSC course addresses topics including racism in medicine, health inequities, and health systems science. Using transformative learning theory, it fosters critical consciousness and structural competency. Assessments include case analyses, reflections, team-based learning sessions, and group projects related to social justice in healthcare. The program aims to instill cultural humility and practical application, fostering a holistic approach to medical education that implores physicians to become advocates for health justice., Outcomes of the Innovation: Feedback from students indicated generally positive perceptions of the curriculum. Students provided overall positive comments about discussions with guest speakers. However, students expressed a desire for more concrete examples of how health inequities can be remedied. Some found small-group activities less engaging. Other challenges included providing students of different readiness levels with tailored experiences and seamlessly integrating HJSC content within basic and clinical sciences courses., Critical Reflection: Next steps include continuing to integrate content into the science curriculum and clerkships, improving opportunities for meaningful student interactions, and enhancing faculty development to address health justice concerns in clinical settings., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2024 The Author(s).)

The current situation in Germany is characterised by significant differences between the two types of higher education institutions offering bachelor's degree programmes in midwifery at both universities of applied sciences and universities. These differences are noticeable in admission procedures, resource allocation, content focus and competence assessment at the respective institutions, which in turn result in heterogeneous study experiences. This article highlights the challenges currently facing bachelor degree programmes and the academic qualification of midwives, and identifies future requirements for the development of degree programmes in theory and practice as well as theory-practice transfer, and assessment formats. Furthermore, this article covers the content-related and structural-organisational requirements to develop in-depth academic skills grounded in theory teaching, the facilitation of clinical placements at an academic level, the training of qualified practical instructors and the development of applicable competence-based assessment formats, especially for the state exam. The development of a standardised, high-quality academic education for midwives in Germany requires networking of the different academic sites/locations to exchange experiences in teaching/learning and assessment formats. Furthermore, it can facilitate the development of a standardised competence-oriented model and core curriculum as well as the definition of quality criteria and standards for study programmes of midwifery science. The Midwifery Science Committee (AHW) in the DACH Assoviation for Medical Education (GMA) offers an optimal platform for cooperation between the different universities. The existing challenges for the further professional development of midwives can only be overcome by collaboration and pooled expertise., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2024 Plappert et al.)

Background: The number of people suffering from chronic diseases requiring palliative care (PC) is increasing rapidly. Therefore, PC teaching in undergraduate health science programs is necessary to improve primary PC based on international recommendations and available scientific evidence., Methods: A descriptive cross-sectional study was conducted. Active undergraduate medical and nursing programs that were approved by the Colombian Ministry of Education and integrated PC teaching into their curricula were included in the study. The total sample consisted of 48 programs: 31 nursing and 17 medical programs., Results: PC competencies are distributed throughout the curriculum in 41.67% of programs, in elective courses in 31.25%, and in mandatory courses in 27.08% of the programs. The average PC teaching hours is 81 for nursing and 57.6 for medicine. PC clinical rotations are not offered in 75% of the programs. For undergraduate nursing programs, the most frequent competencies taught are the definition and history of PC and identifying common symptoms associated with advanced disease. In undergraduate medicine, the most common competencies are pharmacological and non-pharmacological pain management and identification of PC needs., Conclusions: PC teaching in undergraduate health science programs mainly addresses the conceptual and theoretical aspects of PC, which are part of the competencies present throughout the programs' curricula. Low availability of PC clinical rotations was identified. Future studies should assess whether the low availability of clinical rotations in PC limits the ability of students to develop the practical competencies necessary to provide quality PC., Trial Registration: Not applicable., (© 2024. The Author(s).)

We describe the Life Experiences Curriculum (LEC), which attempts to integrate medical student well-being with trauma-informed medical education. The long-term goal of LEC is to help medical students flourish with adversity and trauma, where flourishing refers to having a sense of purpose that arises from awareness of one's strengths and limitations, shaped by life experiences. The short-term goal of LEC is to develop students' relational capacities, such as acceptance and awareness of self and others, while building and maintaining students' psychological safety. We describe the conceptual rationale for these goals and the curriculum's development, implementation, evaluation, and limitations. The curriculum extends over four years and involves a preclinical seminar and students' individual and group reflection sessions with LEC faculty. The seminar addresses the coexistence of trauma and flourishing across life experiences, as well as how safety in relationships is impaired by traumatic experiences and must be restored for healing and growth. The physician faculty have no role in student evaluation and co-lead all LEC activities. LEC is intended to provide students with new language for understanding the process of trauma and flourishing in both individuals and systems and to build and sustain students' relational capacities. There are ongoing efforts to re-imagine self-care as communal-care in which care and support are given and received in a community of students and faculty. Such a model may help build the relational capacities needed to deliver trauma-informed care and also promote flourishing with adversity in healers and in those seeking to be healed., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2024 The Author(s).)

Objectives: We aimed to define and map subcompetencies required for pediatric cardiac critical care (PCCC) fellowship education and training under the auspices of the Pediatric Cardiac Intensive Care Society (PCICS). We used the 2022 frameworks for PCCC fellowship learning objectives by Tabbutt et al and for entrustable professional activities (EPAs) by Werho et al and integrated new subcompetencies to the EPAs. This complementary update serves to provide a foundation for standardized trainee assessment tools for PCCC., Design: A volunteer panel of ten PCICS members who are fellowship education program directors in cardiac critical care used a modified Delphi method to develop the update and additions to the EPA-based curriculum. In this process, the experts rated information independently, and repetitively after feedback, before reaching consensus. The agreed new EPAs were later reviewed and unanimously accepted by all PCICS program directors in PCCC in the United States and Canada and were endorsed by the PCICS in 2023., Procedure and Main Results: The procedure for defining new subcompetencies to the established EPAs comprised six consecutive steps: 1) literature search; 2) selection of key subcompetencies and curricular components; 3) written questionnaire; 4) consensus meeting and critical evaluation; 5) approval by curriculum developers; and 6) PCICS presentation and endorsement. Overall, 110 subcompetencies from six core-competency domains were mapped to nine EPAs with defined levels of entrustment and examples of simple and complex cases. To facilitate clarity and develop a future assessment tool, three EPAs were subcategorized with subcompetencies mapped to the appropriate subcategory. The latter covering common procedures in the cardiac ICU., Conclusions: This represents the 2023 update to the PCCC fellowship education and training EPAs with the defining and mapping of 110 subcompetencies to the nine established 2022 EPAs. This goal of this update is to serve as the next step in the integration of EPAs into a standardized competency-based assessment framework for trainees in PCCC., Competing Interests: The authors have disclosed that they do not have any potential conflicts of interest., (Copyright © 2024 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.)

Background and Purpose: To investigate final-year student pharmacists' experiences of a new module for North American Pharmacist Licensure Examination® (NAPLEX®) preparation at one college of pharmacy in the United States., Educational Activity and Setting: All student pharmacists enrolled in a new Spring 2023 module for NAPLEX preparation (n = 118) were invited to complete an electronic questionnaire and participate in a semi-structured interview. The questionnaire investigated the perceived helpfulness, grading, importance, prioritization, structure, and timing of the module in the curriculum, as well as assignment choices, confidence building, and time management using a six-point Likert scale. Semi-structured interviews investigated experiences with NAPLEX modules, time management, and course format. Questionnaire data were descriptively analyzed; interview data were thematically analyzed., Findings: Forty-one completed questionnaires and seven interviews were analyzed. Median scores for questionnaire items were six (denoting strongly agree) for three items, five (denoting agree) for seven items, and four (denoting somewhat agree) for two items. Twenty-three (56%) students desired an online self-directed (asynchronous) course structure. Seventeen (42%) students desired a mixture of short and long course assignments with a greater proportion of short course assignments while another 17 (42%) desired only short course assignments. Two themes were constructed from interviews: timing (when to study for NAPLEX) and structure (how to study for NAPLEX)., Summary: Study findings indicated typically positive perceptions of a module for NAPLEX preparation among final-year student pharmacists at a college of pharmacy in the United States. Recommendations from students can be used to improve the module in future years., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background and Purpose: Effective communication skills are essential for all pharmacists, regardless of practice setting. An implicit need in pharmacy education is to emphasize direct application of these skills to future healthcare practice prior to experiential rotations. The aim of this article is to describe how we revised a required first professional year (P1) doctor of pharmacy course to achieve two main goals: 1) improve the course relevance by connecting content to real-world skills; and 2) qualify all pharmacy students at our institution as certified National Diabetes Prevention Program (DPP) lifestyle coaches upon course completion., Educational Activity and Setting: Lifestyle coach training approved by the Centers for Disease Control and Prevention (CDC) was integrated into a P1 communications course consisting of 14 modules that include: review of diabetes pathophysiology, group facilitation skills, social determinants of health, food tracking, action planning, participant retention and program administration. This content serves as a direct application of pre-existing course objectives related to knowledge (evidence-based theory) and skills (technical and counseling) required for effective communication with patients, families, and health professionals., Findings: Between 2019 and 2022, the redesigned course was offered to 373 P1 students. Course evaluations during this time were consistently positive. The average evaluation score since DPP activities were integrated into the course was 3.41 (on a 4-point scale). Based upon course evaluations, students appreciated three main benefits of incorporating lifestyle coach certification into the pharmacy curriculum: 1) a certified skill that can differentiate them in the job market; 2) practice of skills on real patients under faculty supervision in the community setting; 3) early exposure to pharmacy patient care topics, thus contributing to professional identity., Summary: Integration of lifestyle coach training into an existing core P1 pharmacy course increased application and assessment of communications skills and allowed wider availability of trained coaches to deliver DPP in the community., Competing Interests: Declaration of competing interest All authors declare that they have no conflicts of interest related to preparation of this manuscript., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Global surgery and anesthesia is an emerging field in global health and academic medicine. Promoting the education of global surgery and anesthesia among uniformed medical students is imperative and will prepare the next generation of uniformed physicians for global surgical missions through both the DoD and civilian opportunities., (Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2023. This work is written by (a) US Government employee(s) and is in the public domain in the US.)

Introduction: Previous conflicts have demonstrated the impact of physician readiness on early battlefield mortality rates. To prepare for the lethal nature of today's threat environment and the rapid speed with which conflict develops, our medical force needs to sustain a high level of readiness in order to be ready to "fight tonight." Previous approaches that have relied on on-the-job training, just-in-time predeployment training, or follow-on courses after residency are unlikely to satisfy these readiness requirements. Sustaining the successes in battlefield care achieved in Iraq and Afghanistan requires the introduction of effective combat casualty care earlier and more often in physician training. This needs assessment seeks to better understand the requirements, challenges, and opportunities to include the Military Unique Curriculum (MUC) during graduate medical education., Materials and Methods: This needs assessment used a multifaceted methodology. First, a literature review was performed to assess how Military Unique Curricula have evolved since their initial conception in 1988. Next, to determine their current state, a needs-based assessment survey was designed for trainees and program directors (PDs), each consisting of 18 questions with a mixture of multiple choice, ranking, Likert scale, and free-text questions. Cognitive interviewing and expert review were employed to refine the survey before distribution. The Housestaff Survey was administered using an online format and deployed to Internal Medicine trainees at the Walter Reed National Military Medical Center (WRNMMC). The Program Director Survey was sent to all Army and Navy Internal Medicine Program Directors. This project was deemed to not meet the definition of research in accordance with 32 Code of Federal Regulation 219.102 and Department of Defense Instruction 3216.02 and was therefore registered with the WRNMMC Quality Management Division., Results: Out of 64 Walter Reed Internal Medicine trainees who received the survey, 32 responses were received. Seven of nine PDs completed their survey. Only 12.5% of trainees felt significantly confident that they would be adequately prepared for a combat deployment upon graduation from residency with the current curriculum. Similarly, only 14.29% of PDs felt that no additional training was needed. A majority of trainees were not satisfied with the amount of training being received on any MUC topic. When incorporating additional training on MUC topics, respondents largely agreed that simulation and small group exercises were the most effective modalities to employ, with greater than 50% of both trainees and PDs rating these as most or second most preferred among seven options. Additionally, there was a consensus that training should be integrated into the existing curriculum/rotations as much as possible., Conclusions: Current Military Unique Curricula do not meet the expected requirements of future battlefields. Several solutions to incorporate more robust military unique training without creating any significant additional time burdens for trainees do exist. Despite the limitation of these results being limited to a single institution, this needs assessment provides a starting point for improvement to help ensure that we limit the impact of any "peacetime effect.", (Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2023. This work is written by (a) US Government employee(s) and is in the public domain in the US.)

The success of deep-learning algorithms in analyzing complex structured and unstructured multidimensional data has caused an exponential increase in the amount of research devoted to the applications of artificial intelligence (AI) in medicine in the past decade. Public release of large language models like ChatGPT the past year has generated an unprecedented storm of excitement and rumors of machine intelligence finally reaching or even surpassing human capability in detecting meaningful signals in complex multivariate data. Such enthusiasm, however, is met with an equal degree of both skepticism and fear over the social, legal, and moral implications of such powerful technology with relatively little safeguards or regulations on its development. The question remains in medicine of how to harness the power of AI to improve patient outcomes by increasing the diagnostic accuracy and treatment precision provided by medical professionals. Military medicine, given its unique mission and resource constraints,can benefit immensely from such technology. However, reaping such benefits hinges on the ability of the rising generations of military medical professionals to understand AI algorithms and their applications. Additionally, they should strongly consider working with them as an adjunct decision-maker and view them as a colleague to access and harness relevant information as opposed to something to be feared. Ideas expressed in this commentary were formulated by a military medical student during a two-month research elective working on a multidisciplinary team of computer scientists and clinicians at the National Library of Medicine advancing the state of the art of AI in medicine. A motivation to incorporate AI in the Military Health System is provided, including examples of applications in military medicine. Rationale is then given for inclusion of AI in education starting in medical school as well as a prudent implementation of these algorithms in a clinical workflow during graduate medical education. Finally, barriers to implementation are addressed along with potential solutions. The end state is not that rising military physicians are technical experts in AI; but rather that they understand how they can leverage its rapidly evolving capabilities to prepare for a future where AI will have a significant role in clinical care. The overall goal is to develop trained clinicians that can leverage these technologies to improve the Military Health System., (Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2023. This work is written by (a) US Government employee(s) and is in the public domain in the US.)

India introduced competency-based medical education (CBME) in the year 2019. There is often confusion between terms like ability, skill, and competency. The provided curriculum encourages teaching and assessing skills rather than competencies. Though competency includes skill, it is more than a mere skill, and ignoring the other aspects like communication, ethics, and professionalism can compromise the teaching of competencies as well as their intended benefits to the patient and the society. The focus on skills also undermines the assessment of relevant knowledge. This paper clarifies the differences between ability, skill, and competency, and re-emphasizes the role of relevant knowledge and its assessment throughout clinical training. It is also emphasized that competency assessment is not a one-shot process; rather, it must be a longitudinal process where the assessment should bring out the achievement level of the student. Many of the components of competencies are not assessable by purely objective methods and there is a need to use expert subjective judgments, especially for the formative and classroom assessments. A mentor adds to the success of a competency-based curriculum.

Purpose: Given the increasing significance and potential impact of artificial intelligence (AI) technology on health care delivery, there is an increasing demand to integrate AI into medical school curricula. This study aimed to define medical AI competencies and identify the essential competencies for medical graduates in South Korea., Method: An initial Delphi survey conducted in 2022 involving 4 groups of medical AI experts (n = 28) yielded 42 competency items. Subsequently, an online questionnaire survey was carried out with 1,955 participants (1,174 students and 781 professors) from medical schools across South Korea, utilizing the list of 42 competencies developed from the first Delphi round. A subsequent Delphi survey was conducted with 33 medical educators from 21 medical schools to differentiate the essential AI competencies from the optional ones., Results: The study identified 6 domains encompassing 36 AI competencies essential for medical graduates: (1) understanding digital health and changes driven by AI; (2) fundamental knowledge and skills in medical AI; (3) ethics and legal aspects in the use of medical AI; (4) medical AI application in clinical practice; (5) processing, analyzing, and evaluating medical data; and (6) research and development of medical AI, as well as subcompetencies within each domain. While numerous competencies within the first 4 domains were deemed essential, a higher percentage of experts indicated responses in the last 2 domains, data science and medical AI research and development, were optional., Conclusions: This medical AI framework of 6 competencies and their subcompetencies for medical graduates exhibits promising potential for guiding the integration of AI into medical curricula. Further studies conducted in diverse contexts and countries are necessary to validate and confirm the applicability of these findings. Additional research is imperative for developing specific and feasible educational models to integrate these proposed competencies into pre-existing curricula., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Association of American Medical Colleges.)