Background: Adult learning theories play a pivotal role in the design and implementation of education programs, including healthcare professional programs. There is a variation in the use of theories in healthcare professional education programs and this is may be in part due to a lack of understanding of the range of learning theories available and paucity of specific, in-context examples, to help educators in considering alternative theories relevant to their teaching setting. This article seeks to synthesize key learning theories applicable in the learning and teaching of healthcare professionals and to provide examples of their use in context. Method and results: A literature review was conducted in 2015 and 2016 using PubMed, Scopus, Web of Science, and ERIC academic databases. Search terms used identified a range of relevant literature about learning theories, and their utilization in different healthcare professional education programs. The findings were synthesized and presented in a table format, illustrating the learning theory, specific examples from health and medical education, and a very brief critique of the theory. Outcome: The literature synthesis provides a quick and easy-to-use summary of key theories and examples of their use to help healthcare professional educators access a wider range of learning theories to inform their instructional strategies, learning objectives, and evaluation approaches. This will ultimately result in educational program enhancement and improvement in student learning experiences.

Reviews and elaborates on some of the major skills development barriers for small and medium‐sized enterprises (SMEs). The analysis reveals the influence of the prevalent SME culture to be significant. Other barriers that are identified refer to awareness, finance, access and provision of training and other skills development opportunities. By highlighting the difficulties that SMEs face in deciding to advance the skills of their workforce more formally, some government strategies are also discussed. The paper does this by reference to a number of recent qualitative and quantitative studies undertaken to investigate the attitude of Scottish SMEs towards learning and skills. The paper concludes by arguing that the continuous creation of new skills strategies, new initiatives, new (and at times misleading) names and labels in recent years has added to an apparent state of confusion among small and medium‐sized companies and their employees.

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BackgroundTo evaluate a Geriatric Emergency Department Intervention (GEDI) model of service delivery for adults aged 70 years and older.MethodsA pragmatic trial of the GEDI model using a pre-post design. GEDI is a nurse-led, physician-championed, Emergency Department (ED) intervention; developed to improve the care of frail older adults in the ED. The nurses had gerontology experience and education and provided targeted geriatric assessment and streamlining of care. The final format included 2.4 full time equivalent nurses working 7 days from 0700 h to 1730 h (1530 h at weekends). There were three implementations periods: pre-implementation (2012); a developmental phase from January 2013 to August 2015; and full implementation from September 2015 to August 2016. The outcomes measured were disposition (discharged home, admitted or died); ED length of stay; hospital length of stay; all cause in-hospital mortality within 28 days; time to ED re-presentation up to 28 days post-discharge; in-hospital costs.The setting was a tertiary hospital ED, with 385 beds, in Queensland, Australia. Approximately 53,000 patients presented to the ED annually with 20% aged 70 years and older. All patients over the age 70 who presented to the ED between January 2012 and August 2016 (n = 44,983) were included in the trial.ResultsOlder persons who presented to the ED when the GEDI team were working had increased likelihoods of discharge (Hazard ratio (HR) = 1.19; 95% CI: 1.13–1.24) and reduced ED length of stay (HR = 1.42; 95% CI: 1.33–1.52) compared with those who presented when GEDI were not working. There was no increase in the risk of mortality (HR = 1.01; 95% CI = 0.23–4.43) or risk of same cause re-presentation to 28 days (HR = 1.21; 95% CI: 0.99–1.49). The GEDI service resulted in average cost savings per ED presentation of $35 [95% CI, $21, $49] and savings of $1469 [95% CI, $1105, $1834] per hospital admission.ConclusionsImplementation of a nurse-led physician-championed model of ED care, focused on frail older adults, reduced ED length of stay, hospital admission and if admitted, hospital length of stay and cost, without increasing mortality or same cause re-presentation. These increases were sustained over time and after the initial implementation team had changed roles.Trial registrationAustralian Clinical Trials Registration Number ACTRN12615001157561 - retrospectively registered on 29/10/2015. Data were retrieved via retrospective access to clinical information systems. First data access was on 1/7/2015.

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Objective: To identify the body of knowledge exploring the subject of ADHD and African-Americans.Method: A systematic review of the literature was conducted through the Medline, Psychlit and Psychlnfo databases. Results: In contrast to thousands of articles on ADHD, only 16 articles were identified that dealt with ADHD in African-American youth. Additionally, only a handful of these articles had ethnicity as the primary focus of research. Studies that examined ADHD among African-Americans in a school context showed that race may affect how teachers diagnose hyperactivity . Treatment studies suggested that African-Americans may respond similarly to the same ADHD medications as do Caucasians. Studies evaluating ADHD assessment tools were so sparse that they were largely inconclusive. Discussion: The paucity of studies on the subject of ADHD and African-Americans suggests the urgent need for more research to be done in this area. Such studies should be based on culturally sensitive designs.

BackgroundEmergency departments are chaotic environments in which complex, frail older persons living in the community and residential aged care facilities are sometimes subjected to prolonged emergency department lengths of stay, excessive tests and iatrogenic complications. Given the ageing population, the importance of providing appropriate, quality health care in the emergency department for this cohort is paramount. One possible solution, a nurse-led, physician-championed, emergency department gerontological intervention team, which provides frontload assessment, early collateral communication and appropriate discharge planning, has been developed. The aim of this Geriatric Emergency Department Intervention is to maximise the quality of care for this vulnerable cohort in a cost effective manner.MethodsThe Geriatric Emergency Department Intervention research project consists of three interrelated studies within a program evaluation design. The research comprises of a structure, process and outcome framework to ascertain the overall utility of such a program. The first study is a pre-post comparison of the Geriatric Emergency Department Intervention in the emergency department, comparing the patient-level outcomes before and after service introduction using a quasi-experimental design with historical controls. The second study is a descriptive qualitative study of the structures and processes required for the operation of the Geriatric Emergency Department Intervention and clinician and patient satisfaction with service models. The third study is an economic evaluation of the Geriatric Emergency Department Intervention model of care.DiscussionThere is a paucity of evidence in the literature to support the implementation of nurse-led teams in emergency departments designed to target frail older persons living in the community and residential aged care facilities. This is despite the high economic and patient morbidity and mortality experienced in these vulnerable cohorts. This research project will provide guidance related to the optimal structures and processes required to implement the model of care and the associated cost related outcomes.Trial registrationAustralian New Zealand Clinical Trials Registration Number is 12615001157561. Date of registration 29 October 2015.