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      <Title language="en">Evidence-oriented teaching of geriatric psychiatry: a narrative literature synthesis and pilot evaluation of a clerkship seminar</Title>
      <TitleTranslated language="de">Evidenz-orientierte Lehre in der Alterspsychiatrie &#8211; eine narrative Literatur&#252;bersicht und eine Pilotevaluation eines Blockpraktikumseminars</TitleTranslated>
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          <Lastname>Lenouvel</Lastname>
          <LastnameHeading>Lenouvel</LastnameHeading>
          <Firstname>Eric</Firstname>
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        <Address language="en">
          <Affiliation>University of Bern, University Hospital of Old Age Psychiatry and Psychotherapy, Bern, Switzerland</Affiliation>
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        <Address language="de">
          <Affiliation>Universit&#228;t Bern, Universit&#228;tsklinik f&#252;r Alterspsychiatrie und Psychotherapie, Bern, Schweiz</Affiliation>
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          <Lastname>Lornsen</Lastname>
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          <Firstname>Finn</Firstname>
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        <Address language="en">
          <Affiliation>University of Bern, University Hospital of Old Age Psychiatry and Psychotherapy, Bern, Switzerland</Affiliation>
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        <Address language="de">
          <Affiliation>Universit&#228;t Bern, Universit&#228;tsklinik f&#252;r Alterspsychiatrie und Psychotherapie, Bern, Schweiz</Affiliation>
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          <Firstname>Brigitte</Firstname>
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          <Affiliation>University of Bern, University Hospital of Old Age Psychiatry and Psychotherapy, Bern, Switzerland</Affiliation>
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          <Affiliation>Universit&#228;t Bern, Universit&#228;tsklinik f&#252;r Alterspsychiatrie und Psychotherapie, Bern, Schweiz</Affiliation>
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          <LastnameHeading>Mattson</LastnameHeading>
          <Firstname>Janet</Firstname>
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        <Address language="en">
          <Affiliation>Karolinska Institute, LIME, Department of Learning, Informatics, Management and Ethics, Solna, Sweden</Affiliation>
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        <Address language="de">
          <Affiliation>Karolinska Institute, LIME, Department of Learning, Informatics, Management and Ethics, Solna, Schweden</Affiliation>
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          <Lastname>Kl&#246;ppel</Lastname>
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          <Firstname>Stefan</Firstname>
          <Initials>S</Initials>
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        <Address language="en">
          <Affiliation>University of Bern, University Hospital of Old Age Psychiatry and Psychotherapy, Bern, Switzerland</Affiliation>
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        <Address language="de">
          <Affiliation>Universit&#228;t Bern, Universit&#228;tsklinik f&#252;r Alterspsychiatrie und Psychotherapie, Bern, Schweiz</Affiliation>
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          <Lastname>Pinilla</Lastname>
          <LastnameHeading>Pinilla</LastnameHeading>
          <Firstname>Severin</Firstname>
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          <AcademicTitle>Dr. med.</AcademicTitle>
          <AcademicTitleSuffix>M.Ed. PhD</AcademicTitleSuffix>
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        <Address language="en">University of Bern, University Hospital of Old Age Psychiatry and Psychotherapy, Bern, Switzerland<Affiliation>University of Bern, University Hospital of Old Age Psychiatry and Psychotherapy, Bern, Switzerland</Affiliation><Affiliation>University of Bern, Institute for Medical Education, Department for Assessment and Evaluation, Bern, Switzerland</Affiliation></Address>
        <Address language="de">Universit&#228;t Bern, Universit&#228;tsklinik f&#252;r Alterspsychiatrie und Psychotherapie, Bern, Schweiz<Affiliation>Universit&#228;t Bern, Universit&#228;tsklinik f&#252;r Alterspsychiatrie und Psychotherapie, Bern, Schweiz</Affiliation><Affiliation>Universit&#228;t Bern, Institut f&#252;r Medizinische Lehre, Abteilung f&#252;r Assessment und Evaluation, Bern, Schweiz</Affiliation></Address>
        <Email>severin.pinilla&#64;upd.unibe.ch</Email>
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          <Corporatename>German Medical Science GMS Publishing House</Corporatename>
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        <Address>D&#252;sseldorf</Address>
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    <SubjectGroup>
      <SubjectheadingDDB>610</SubjectheadingDDB>
      <Keyword language="en">geriatric psychiatry</Keyword>
      <Keyword language="en">teaching</Keyword>
      <Keyword language="en">learning activities</Keyword>
      <Keyword language="en">undergraduate medical education</Keyword>
      <Keyword language="de">Alterspsychiatrie</Keyword>
      <Keyword language="de">Lehre</Keyword>
      <Keyword language="de">Lernaktivit&#228;ten</Keyword>
      <Keyword language="de">medizinische Ausbildung im Grundstudium</Keyword>
      <SectionHeading language="en">psychiatry</SectionHeading>
      <SectionHeading language="de">Psychiatrie</SectionHeading>
    </SubjectGroup>
    <DateReceived>20210525</DateReceived>
    <DateRevised>20211122</DateRevised>
    <DateAccepted>20220209</DateAccepted>
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    <DatePublished>20220414</DatePublished></DatePublishedList>
    <Language>engl</Language>
    <LanguageTranslation>germ</LanguageTranslation>
    <License license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0/">
      <AltText language="en">This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License.</AltText>
      <AltText language="de">Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung).</AltText>
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    <SourceGroup>
      <Journal>
        <ISSN>2366-5017</ISSN>
        <Volume>39</Volume>
        <Issue>2</Issue>
        <JournalTitle>GMS Journal for Medical Education</JournalTitle>
        <JournalTitleAbbr>GMS J Med Educ</JournalTitleAbbr>
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    <ArticleNo>20</ArticleNo>
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    <Abstract language="de" linked="yes"><Pgraph><Mark1>Einleitung: </Mark1>Das Fachgebiet Alterspsychiatrie und Psychotherapie hat sich in den letzten Jahrzehnten zu einer eigenst&#228;ndigen Disziplin im Querschnittsgebiet Psychiatrie, Neurologie und Innere Medizin entwickelt. Angesichts der demographischen Entwicklungen gewinnt dieses auch an Bedeutung f&#252;r die Grundversorgung und medizinische Ausbildung. Bisher gibt es jedoch kaum medizindidaktische Empfehlungen zur Lehrgestaltung im Medizinstudium in diesem jungen Fachgebiet. </Pgraph><Pgraph><Mark1>Projektbeschreibung: </Mark1>Es wurde eine narrative Literatur&#252;bersicht zu medizindidaktischer Forschung im Fachgebiet Alterspsychiatrie erstellt. Weiterhin wurden bestehende Evaluationsdaten eines klinischen Seminars im Fachgebiet Alterspsychiatrie und -psychotherapie ausgewertet und eine Zielgruppenanalyse durchgef&#252;hrt. Darauf basierend wurde in mehrdimensionalen Evaluationszyklen ein neues medizindidaktisches Konzept entwickelt, implementiert und evaluiert. Lernmaterial wurde &#252;ber das Open-Source-Learning Management System ILIAS zur Verf&#252;gung gestellt. </Pgraph><Pgraph><Mark1>Ergebnisse:</Mark1> Insgesamt wurden 29 medizindidaktische Artikel und Projektberichte zum Fachgebiet Alterspsychiatrie identifiziert und ausgewertet. In der bestehenden Form wurde das Seminar zur Alterspsychiatrie an unserer Universit&#228;tsklinik bisher unterdurchschnittlich bewertet (Likert-Item Gesamtbewertung 4.3 von 6 im Vergleich zu anderen Seminaren mit einer durchschnittlichen Gesamtbewertung von 5.2, p&#60;0.001). Das Seminar wurde evidenz-orientiert in Bezug auf Inhalt und Rhythmisierung &#252;berarbeitet. F&#252;r die Lernendenaktivierung wurden in der Vortragssequenz der Selbstreferenz-Effekt und Publikumsbefragung genutzt. Weiterhin wurden zwei gerontopsychiatrische Fallszenarien f&#252;r die subjektive Auseinandersetzung adaptiert und f&#252;r eine Plenumsdiskussion genutzt. Die Evaluationsergebnisse zeigten nach der &#220;berarbeitung eine kontinuierliche Verbesserung und das Seminar wurde zuletzt mit 5.3 von 6 besser gesamtbewertet (p&#60;0.01, U&#61;135.5 Cohen&#8217;s d&#61;1.28). </Pgraph><Pgraph><Mark1>Schlussfolgerung: </Mark1>Ein systematisches Vorgehen mit an medizindidaktischer Evidenz orientierten Entwicklung eines Seminarkonzeptes f&#252;r Medizinstudierende war in unserem Kontext mit besseren Evaluationsergebnissen assoziiert. Die entwickelten Lehrmaterialien k&#246;nnten lokal adaptiert f&#252;r die alterspsychiatrische Lehre eingesetzt und entsprechend f&#252;r andere Standorte und in Bezug auf Lernzuwachs evaluiert werden.</Pgraph></Abstract>
    <Abstract language="en" linked="yes"><Pgraph><Mark1>Introduction: </Mark1>The field of geriatric psychiatry has in recent decades developed into an independent discipline, incorporating elements of psychiatry, neurology and internal medicine. In view of demographic changes, this field is becoming increasingly relevant for primary care and undergraduate medical training. So far, however, there is little educational guidance for instructional design of geriatric psychiatry in undergraduate medical education. </Pgraph><Pgraph><Mark1>Project description: </Mark1>A narrative literature review of medical education studies in the field of geriatric psychiatry was conducted. Student evaluations of a geriatric psychiatry clerkship seminar were analyzed, followed by a target group analysis. Results informed the iterative development of new clerkship seminar content and structure. This was implemented and evaluated over several academic cycles. Learning material was made available via the open-source learning management system &#8220;ILIAS&#8221;. </Pgraph><Pgraph><Mark1>Results:</Mark1> A total of 29 medical education articles were identified and evaluated. The previous seminar in geriatric psychiatry at our university hospital was rated below average (Likert item overall rating of 4.3&#47;6 compared to other seminars with an average overall rating of 5.2, p&#60;0.001). An evidence-oriented revision of the content and instructional design was implemented. Activation of learners, self-reference effect, and audience questioning were used during the lecture. Additionally, two geriatric psychiatry case scenarios were adapted for discussion. We saw continuous improvement of student evaluations of the revised course, reaching a rating improvement of 5.3 out of 6 (p&#60;0.01, U&#61;135.5 Cohen&#8217;s d&#61;1.28). </Pgraph><Pgraph><Mark1>Conclusion: </Mark1>A systematic approach was used to develop a geriatric psychiatry clerkship seminar, based on medical education evidence, for undergraduate medical students, resulting in better student evaluations. The teaching materials can be adapted for local implementation at other teaching hospitals. Future studies should also explore effects regarding higher learning outcomes. </Pgraph></Abstract>
    <TextBlock language="en" linked="yes" name="Introduction">
      <MainHeadline>Introduction</MainHeadline><Pgraph>The field of geriatric psychiatry is comparatively young. According to the World Health Organization (WHO) projected demographic trends, it is expected that by 2050 about 20&#37; of the population will be over 65 years of age, and 15&#37; of this age group will have psychiatric disorders <TextLink reference="1"></TextLink>. According to surveys by the Swiss Federal Statistical Office, the proportion of the population over 65 years of age is expected to increase the most in Switzerland <TextLink reference="2"></TextLink>. Corresponding predictions for 2050 show a doubling of the over 80-year-olds to more than one million persons in Switzerland. From an epidemiological point of view, neurocognitive disorders, delirium, and depression are among the most common psychiatric disorders in old age <TextLink reference="3"></TextLink>, <TextLink reference="4"></TextLink>, <TextLink reference="5"></TextLink>.</Pgraph><Pgraph>Surprisingly, there is a disproportionately low rate of psychiatric treatment considering the higher rate of suicide among older adults <TextLink reference="6"></TextLink>. Possible reasons are barriers to care, due to double stigmatization (age and mental illness), insufficiently qualified personnel, and lack of care structures <TextLink reference="7"></TextLink>, <TextLink reference="8"></TextLink>, <TextLink reference="9"></TextLink>. The diagnosis and treatment of old-age psychiatric patients requires specific abilities, skills, and attitudes to adequately classify psychiatric symptoms (e.g. major depression in old age), manage behavioral disturbances (e.g. due to neurocognitive disorders), navigate the complex clinical situations, involving multimorbidity and polypharmacy, as well as master communication and specific developmental tasks and conflicts in old age <TextLink reference="10"></TextLink>, <TextLink reference="11"></TextLink>.</Pgraph><Pgraph>Despite the changing demographics and the required competencies for geriatric psychiatry care, there are few professorships in gerontological psychiatry in German-speaking countries, only one chair in gerontological psychiatry <TextLink reference="12"></TextLink>, and hardly any medical education recommendations for corresponding graduate training. Due to the changing demographics alone, geriatric psychiatry should, in principle, become increasingly important in graduate medical training. However, its position in the medical school curriculum still does not reflect this.</Pgraph><Pgraph>High-quality education and training of medical staff, and other health professionals is needed to close the geriatric psychiatry care gap. For example, medical students often do not rotate through geriatric psychiatric wards <TextLink reference="13"></TextLink>, <TextLink reference="14"></TextLink>. Thus, clinical teaching in geriatric psychiatry, if taught at all, remains limited to lectures during undergraduate medical training. </Pgraph><Pgraph>The aim of this educational case report was to review medical school geriatric psychiatry medical education literature and to use it for the concept development of a clinical seminar during a clerkship rotation. For this purpose, a narrative literature review was conducted (subproject 1), an assessment of seminar evaluations of geriatric psychiatry teaching in geriatric psychiatry rotations at the University Hospital for Geriatric Psychiatry and Psychotherapy (UPD Bern) was carried out (subproject 2), an evidence-oriented new seminar concept was developed (subproject 3), and a multidimensional pilot evaluation was conducted (subproject 4). </Pgraph></TextBlock>
    <TextBlock language="de" linked="yes" name="Einleitung">
      <MainHeadline>Einleitung</MainHeadline><Pgraph>Das Fachgebiet Alterspsychiatrie und Psychotherapie ist vergleichsweise jung in der akademischen Medizin. Laut der prognostizierten demographischen Entwicklungen der Weltgesundheitsorganisation ist zu erwarten, dass bis 2050 etwa 20&#37; der Bev&#246;lkerung &#252;ber 65 Jahre alt sein und von diesen wiederum etwa 15&#37; psychiatrische Erkrankungen haben werden <TextLink reference="1"></TextLink>. Erhebungen des schweizerischen Bundesamtes f&#252;r Statistik nach ist f&#252;r die Schweiz zu erwarten, dass der Anteil der Bev&#246;lkerung &#252;ber 65 Jahre am st&#228;rksten wachsen wird <TextLink reference="2"></TextLink>. Entsprechende Szenarien f&#252;r 2050 ergeben eine Verdoppelung der &#252;ber 80-j&#228;hrigen auf mehr als eine Million Personen in der Schweiz. Aus epidemiologischer Sicht geh&#246;ren neurokognitive St&#246;rungen, delirante Syndrome und Depressionen zu den h&#228;ufigsten alterspsychiatrischen Krankheitsbildern <TextLink reference="3"></TextLink>, <TextLink reference="4"></TextLink>, <TextLink reference="5"></TextLink>. </Pgraph><Pgraph>In Bezug auf die psychische Gesundheit dieser Altersgruppe f&#228;llt ebenfalls auf, dass bei h&#246;heren Suizidzahlen im Alter die Inanspruchnahme psychologisch-psychiatrischer Behandlung vergleichsweise niedrig ist <TextLink reference="6"></TextLink>. M&#246;gliche Gr&#252;nde k&#246;nnten Versorgungsh&#252;rden durch doppelte Stigmatisierung (Alter und psychische Erkrankung) sowie nicht ausreichend qualifiziertes Personal oder fehlende Versorgungsstrukturen sein <TextLink reference="7"></TextLink>, <TextLink reference="8"></TextLink>, <TextLink reference="9"></TextLink>. Die Diagnostik und Behandlung alterspsychiatrischer Patient&#42;innen erfordert spezifische F&#228;higkeiten, Fertigkeiten und Haltungen in Bezug auf Einordnung der psychiatrischen Symptomatik (z.B. depressive Syndrome im Alter), Management alterspsychiatrischer Krankheitsbilder (z.B. neurokognitive St&#246;rungen), Komplexit&#228;t im Rahmen von Multimorbidit&#228;t und Polypharmazie, sowie Kommunikation und spezifische Entwicklungsaufgaben und -konflikte im Alter <TextLink reference="10"></TextLink>, <TextLink reference="11"></TextLink>. </Pgraph><Pgraph>Trotz der demographischen Entwicklungen und der spezifischen notwendigen Kompetenzen f&#252;r die gerontopsychiatrische Versorgung gibt es im deutschsprachigen Raum bisher wenige alterspsychiatrische Professuren, nur einen alterspsychiatrischen Lehrstuhl <TextLink reference="12"></TextLink> und kaum medizindidaktische Empfehlungen f&#252;r entsprechende Lehrveranstaltungen. Die Gerontopsychiatrie sollte allein aus demographischen Gr&#252;nden grunds&#228;tzlich in der Medizinausbildung zunehmend an Bedeutung gewinnen, ihre Stellung im Curriculum reflektiert dies jedoch nach wie vor nicht.</Pgraph><Pgraph>Um die alterspsychiatrische Versorgungsl&#252;cke zu schlie&#223;en ist eine qualitativ hochwertige Aus- und Weiterbildung von &#228;rztlichem Personal und anderen Gesundheitsberufen notwendig. In klinischen Blockpraktika beispielsweise rotieren Medizinstudierende h&#228;ufig nicht auf alterspsychiatrische Stationen <TextLink reference="13"></TextLink>, <TextLink reference="14"></TextLink>. Somit bleibt die klinische Lehre im Fach Alterspsychiatrie und Psychotherapie, wenn &#252;berhaupt, auf theoretische Vorlesungen im Studium beschr&#228;nkt. </Pgraph><Pgraph>Das Ziel des hier vorgestellten Lehrprojektes war es daher, die medizindidaktische Literatur in Bezug auf die alterspsychiatrische Lehre im Medizinstudium zu sichten und f&#252;r die Konzeptentwicklung eines klinischen Seminars im Kontext eines Blockpraktikums zu nutzen. Hierf&#252;r wurde eine narrative Literatur&#252;bersicht durchgef&#252;hrt (Teilprojekt 1), eine Standortbestimmung der Seminarevaluationen der alterspsychiatrischen Lehre im Blockpraktikum an der Universit&#228;tsklinik f&#252;r Alterspsychiatrie und Psychotherapie (UPD Bern) durchgef&#252;hrt (Teilprojekt 2), ein evidenz-orientiertes Seminarkonzept entwickelt (Teilprojekt 3) und eine mehrdimensionale Pilotevaluation durchgef&#252;hrt (Teilprojekt 4). </Pgraph></TextBlock>
    <TextBlock language="en" linked="yes" name="Project description">
      <MainHeadline>Project description</MainHeadline><SubHeadline2>Narrative literature review</SubHeadline2><Pgraph>The electronic database PubMed was searched using the following search terms and Boolean operators: (&#8220;geriatric psychiatry&#8221; AND &#8220;medical education&#8221; AND &#8220;students&#8221;). Furthermore, the individual digital archives of the journals &#8220;Academic Medicine&#8221;, &#8220;Medical Education&#8221;, &#8220;Medical Teacher&#8221;, &#8220;Academic Psychiatry&#8221; were searched with the search term (&#8220;geriatric psychiatry&#8221;) and &#8220;Der Nervenarzt&#8221; with the term (&#8220;teaching&#8221;). The term (&#8220;geriatric psychiatry&#8221;) was used for the search in the medical education database &#8220;MedEdPortal&#8221;. All identified articles were characterized and the educational focus and main findings were extracted (see attachment 1 <AttachmentLink attachmentNo="1"/>). The findings from the literature review were used to identify potential for instructional improvement. Changes in seminar evaluations were explored statistically in the context of a single academic context.</Pgraph><SubHeadline2>Assessment of student evaluations and context </SubHeadline2><Pgraph>Available evaluation data of the seminar &#8220;Mental Illness in Aging&#8221; from the 2019 geriatric psychiatry clinical rotation (n&#61;83 students) were analyzed thematically and compared to other psychiatric rotations during 2019: &#8220;Psychopathology&#8221;, &#8220;Sleep Disorders&#8221;, and &#8220;Psychiatric Interventions&#8221; (Wilcoxon signed-rank test for related samples, as the same students evaluated the different seminars). The clinical rotation begins in the 4th (six-year program) as part of the master&#8217;s degree in human medicine. Students rotate for one month (at full time) in internal medicine, surgery, gynecology, pediatrics, and psychiatry. The clinical rotation curricula are based on Entrustable Professional Activities (EPAs), which are defined in the PROFILES national learning objectives catalog <TextLink reference="15"></TextLink>.</Pgraph><Pgraph>For the target group analysis, a written survey of the perceived pros and cons of geriatric psychiatry was conducted (collected from n&#61;21 students) and comments were sorted thematically. Student demographics, a detailed description of our teaching context, and the embedding of clinical rotation in psychiatry have already been published as part of other studies <TextLink reference="16"></TextLink>, <TextLink reference="17"></TextLink>.</Pgraph><SubHeadline2>Revision of the instructional design of the seminar</SubHeadline2><Pgraph>The learning objectives for the clinical rotation are based on the learning objectives cataloged in PROFILES <TextLink reference="15"></TextLink>. For the revision of the seminar concept, a target group analysis was first conducted. Additional information was obtained from publications on geriatric psychiatry teaching, general medical education literature and current teaching recommendations of the  University of Bern were also used <TextLink reference="18"></TextLink>. Finally, expert advice from an instructional design course (&#8220;Best of Frontalunterricht&#8221; - Zentrum f&#252;r universit&#228;re Weiterbildung ZUW Hochschuldidaktik &#38; Lehrentwicklung, Universit&#228;t Bern) was obtained for optimising instructinal elements of the seminar <TextLink reference="19"></TextLink>. All materials and geriatric psychiatry textbook chapters were made available to students on the digital learning platform &#8220;ILIAS&#8221; for self-regulated learning following the seminar.</Pgraph><SubHeadline2>Multidimensional pilot evaluation</SubHeadline2><Pgraph>After revising the seminar concept and piloting it for three months in the 2021 geriatric psychiatry clinical rotation (n&#61;27 students, 6-point Likert item on global assessment), global assessment was evaluated in comparison to previous seminar evaluations from 2019 (clerkship seminar evaluations from eight months, n&#61;83 students) (Wilcoxon rank-sum test, unconnected sample because students were from different clerkship cohorts). Effect size was calculated using Cohen&#39;s d for nonparametric tests <TextLink reference="20"></TextLink>. For two implementations of the revised clinical rotations, an additional written multidimensional evaluation (5-point Likert items (n&#61;15 items), plus three open-ended questions) was conducted on learning climate, lecturing aspects, and media use, among others. The questions of the evaluation form are listed in table 1 <ImgLink imgNo="1" imgType="table"/> and in attachment 2 <AttachmentLink attachmentNo="2"/>.</Pgraph></TextBlock>
    <TextBlock language="de" linked="yes" name="Projektbeschreibung">
      <MainHeadline>Projektbeschreibung</MainHeadline><SubHeadline2>Narrative Literatur&#252;bersicht</SubHeadline2><Pgraph>Die Datenbank Pubmed wurde mit folgenden Suchtermini und Boolschen Operatoren durchsucht: (&#8222;geriatric psychiatry&#8220; AND &#8222;medical education&#8220; AND &#8222;students&#8220;). Weiterhin wurden die einzelnen digitalen Archive der Fachzeitschriften &#8222;Academic Medicine&#8220; &#8222;Medical Edcuation&#8220;, &#8222;Medical Teacher&#8220;, &#8222;Academic Psychiatry&#8220; mit jeweils dem Suchterminus (&#8222;geriatric psychiatry&#8220;) durchsucht und &#8222;Der Nervenarzt&#8220; mit dem Terminus (&#8222;Lehre&#8220;). F&#252;r die Suche in der medizindidaktischen Datenbank &#8222;MedEdPortal&#8220; wurde der Terminus (&#8222;geriatric psychiatry&#8220;) verwendet. Alle identifizierten Artikel wurden charakterisiert und der didaktische Fokus und die Hauptergebnisse extrahiert (siehe Anhang 1 <AttachmentLink attachmentNo="1"/>). Mit den Erkenntnissen aus der Literatur&#252;bersicht ist didaktisches Verbesserungspotenzial exemplarisch anhand eines einzelnen, konkreten universit&#228;ren Kontextes statistisch &#252;berpr&#252;ft worden.</Pgraph><SubHeadline2>Standortbestimmung studentischer Evaluationen und Kontext</SubHeadline2><Pgraph>Vorliegende Evaluationsdaten des Seminars &#8222;Psychische Erkrankungen im Alter&#8220; aus dem Blockpraktikumsjahr 2019 (n&#61;83 Studierende) wurden deskriptiv im Vergleich zu den anderen psychiatrischen Blockpraktikumsseminaren (ebenfalls im Blockpraktikumsjahr 2019) u.a. &#8222;Psychopathologie&#8220;, &#8222;Schlafst&#246;rungen&#8220;, &#8222;Psychiatrische Interventionen&#8220; analysiert (Wilcoxon-Vorzeichen-Rang-Test, verbundene Stichprobe da jeweils die gleichen Studierenden die unterschiedlichen Seminare bewerteten). Das Blockpraktikumsjahr beginnt im 4. Studienjahr (Teil des Masterstudiums Humanmedizin). Die Studierenden rotieren dabei jeweils einen Monat mit Vollzeitpr&#228;senz durch die F&#228;cher Innere Medizin, Chirurgie, Gyn&#228;kologie, P&#228;diatrie und Psychiatrie. Die Blockpraktikumscurricula basieren auf Entrustable Professional Activities (EPAs), die im nationalen Lernzielkatalog PROFILES definiert sind <TextLink reference="15"></TextLink>.</Pgraph><Pgraph>F&#252;r eine spezifische Zielgruppenanalyse erfolgte eine schriftliche Pro-Kontra-Befragung zur Wahrnehmung der Alterspsychiatrie allgemein (erhoben bei n&#61;21 Studierenden) und eine thematische Ordnung der Kommentare. Demographische Daten zu Blockpraktikumsstudierenden an unserer Universit&#228;tsklinik, eine detaillierte Beschreibung unseres Lehrkontextes und die Einbettung der klinischen Seminare in das Blockpraktikum Psychiatrie sind bereits im Rahmen anderer Studien publiziert <TextLink reference="16"></TextLink>, <TextLink reference="17"></TextLink>.</Pgraph><SubHeadline2>&#220;berarbeitung des Seminarkonzeptes</SubHeadline2><Pgraph>Die Lernziele f&#252;r das Seminar basieren auf dem Lernzielkatalog PROFILES <TextLink reference="15"></TextLink>. F&#252;r die &#220;berarbeitung des Seminarkonzeptes wurde zun&#228;chst eine Zielgruppenanalyse durchgef&#252;hrt. Neben den Publikationen zur alterspsychiatrischen Lehre f&#252;r die inhaltliche Gestaltung wurden auch allgemeine didaktische Literatur und aktuelle Lehrempfehlungen der Hochschuldidaktik an der Universit&#228;t Bern genutzt <TextLink reference="18"></TextLink>. Mittels kollegialem Feedback im Rahmen eines Hochschuldidaktik-Kurses (&#8222;Best of Frontalunterricht&#8220; &#8211; Zentrum f&#252;r universit&#228;re Weiterbildung ZUW Hochschuldidaktik &#38; Lehrentwicklung, Universit&#228;t Bern) konnten Teile der Lehreinheit optimiert werden <TextLink reference="19"></TextLink>. S&#228;mtliche Materialien und alterspsychiatrische Lehrbuchkapitel wurde den Studierenden auf der digitalen Lernplattform ILIAS f&#252;r vertiefendes Selbststudium im Anschluss an das Seminar zur Verf&#252;gung gestellt.</Pgraph><SubHeadline2>Mehrdimensionale Pilotevaluation</SubHeadline2><Pgraph>Nach &#220;berarbeitung des Seminarkonzepts und dreimonatiger Pilotierung im Blockpraktikumsjahr 2021 (n&#61;27 Blockstudierende, 6-Punkt-Likert-Item zu Globalbeurteilung) wurde die Globalbeurteilung im Vergleich zu den fr&#252;heren Seminarglobalbeurteilungen aus dem Blockpraktikumsjahr 2019 (acht Monate Blockpraktikum, n&#61;83 Studierende) ausgewertet (Wilcoxon Rangsummen-Test, unverbundene Stichprobe, da Studierende aus unterschiedlichen Blockpraktikumsjahren). Die Effektst&#228;rke wurde mittels Cohen&#8217;s d f&#252;r nicht-parametrische Tests berechnet <TextLink reference="20"></TextLink>. F&#252;r zwei Durchf&#252;hrungen des &#252;berarbeiteten Blockpraktikumsseminars erfolgte eine zus&#228;tzliche schriftliche mehrdimensionale Evaluation (5-Punkt-Likert-Items (n&#61;15 Items), zus&#228;tzlich 3 offene Fragen) u.a. zu Lernatmosph&#228;re, Vortragsaspekten und Medieneinsatz. Die Fragen des Evaluationsbogens sind in Tabelle 1 <ImgLink imgNo="1" imgType="table"/> und im Anhang 2 <AttachmentLink attachmentNo="2"/> aufgef&#252;hrt.</Pgraph></TextBlock>
    <TextBlock language="en" linked="yes" name="Results">
      <MainHeadline>Results</MainHeadline><SubHeadline2>Narrative literature review</SubHeadline2><Pgraph>A total of 659 articles and 15 MedEdPORTAL resources were found. Of these, 29 articles and 9 teaching project reports related to geriatric psychiatry teaching in medical school were retained. Table S1 (see attachment 1 <AttachmentLink attachmentNo="1"/>) shows the data extraction. The search term combination (&#8220;psychiatry&#8221; AND &#8220;GMS Journal for Medical Education&#8221;) yielded no hits. Most articles referred to geriatric psychiatry teaching in medical school in the United States and Canada (77&#37;) and about one-fifth (23&#37;) referred to the European educational context (Germany, UK, Portugal).</Pgraph><Pgraph>Thematically, the articles most frequently reported on geriatric psychiatry clinical teaching (e.g., clinical rotation curricula or participation in mobile geriatric psychiatric care in 21&#37; of the articles) <TextLink reference="21"></TextLink>, <TextLink reference="22"></TextLink>, <TextLink reference="23"></TextLink>, <TextLink reference="24"></TextLink>, <TextLink reference="25"></TextLink>, <TextLink reference="26"></TextLink>, followed by specific teaching methods (e.g., imagination exercise or immersion simulation) for geriatric psychiatry subject areas (also in 21&#37; of articles) <TextLink reference="27"></TextLink>, <TextLink reference="28"></TextLink>, <TextLink reference="29"></TextLink>, <TextLink reference="30"></TextLink>, <TextLink reference="31"></TextLink>, <TextLink reference="32"></TextLink>, teaching methods (e.g., courses or seminars) <TextLink reference="33"></TextLink>, <TextLink reference="34"></TextLink>, <TextLink reference="35"></TextLink>, <TextLink reference="36"></TextLink>, learning objectives for medical students <TextLink reference="27"></TextLink>, <TextLink reference="37"></TextLink>, <TextLink reference="38"></TextLink> and geriatric psychiatry teaching needs (each in 14&#37; of articles) <TextLink reference="12"></TextLink>, <TextLink reference="13"></TextLink>, <TextLink reference="14"></TextLink>, <TextLink reference="39"></TextLink>. Individual articles reported on problem-based curricula in the field of psychiatry related to life stages <TextLink reference="40"></TextLink>, digital geriatric psychiatry teaching and learning resources <TextLink reference="41"></TextLink>, specific examination formats for medical students&#8217; competencies in geriatric psychiatry <TextLink reference="42"></TextLink>, <TextLink reference="43"></TextLink>, <TextLink reference="44"></TextLink> and career path decisions of medical students in relation to geriatric psychiatry <TextLink reference="45"></TextLink>.</Pgraph><Pgraph>For empirical studies, scales measuring prejudice against geriatric psychiatry patients and interest in a professional career in geriatric psychiatry were frequently used <TextLink reference="23"></TextLink>, <TextLink reference="24"></TextLink>, <TextLink reference="29"></TextLink>, <TextLink reference="36"></TextLink>. Scales were found to measure the acquisition of knowledge, skills <TextLink reference="22"></TextLink>, <TextLink reference="26"></TextLink>, <TextLink reference="33"></TextLink> and prejudices of medical students <TextLink reference="26"></TextLink>, <TextLink reference="29"></TextLink>, with predominantly significant improvements after substantial clinical exposure. In one controlled-randomized trial however, no change in career decision-making was observed <TextLink reference="26"></TextLink>. </Pgraph><Pgraph>Furthermore, evaluated English-language teaching materials were identified for the following geriatric psychiatric topics: differential diagnostic considerations for dementia, depression, and delirium <TextLink reference="46"></TextLink>; Old age addiction <TextLink reference="47"></TextLink>; Recognizing psychological and behavioral disturbances of dementia <TextLink reference="48"></TextLink>; falls and fall prevention <TextLink reference="49"></TextLink>; introduction to geriatric psychiatry <TextLink reference="50"></TextLink>; cross-cultural communication strategies with older adults <TextLink reference="51"></TextLink>; recognition and treatment of depression in the elderly <TextLink reference="52"></TextLink>; and unintentional weight loss in old age <TextLink reference="53"></TextLink>. An overview of the didactic methods used is shown in Table S1 (see attachment 1 <AttachmentLink attachmentNo="1"/>).</Pgraph><SubHeadline2>Assessment of the status of student evaluations</SubHeadline2><Pgraph>Analysis of the 2019 geriatric psychiatry clerkship seminars (data available from n&#61;83 students, proportion female&#61;59&#37;, proportion male 41&#37;, corresponding to an evaluation response of 78&#37;, Likert-item overall rating average 4.3 out of 6, SD&#61;0.9, median&#61;4.3, skewness&#61;-0.47) compared to other seminars with an average overall rating of 5.2 out of 6 (SD&#61;0.8, median&#61;5.3, skewness&#61;-0.23, W&#61;97, p&#60;0.001) revealed evidence of a poorer average overall rating of the geriatric psychiatry seminar. The other clerkship seminars received lowest individual ratings ranging from 5.1 (SD&#61;0.7), for example, for the psychopathology seminar to a maximum of 5.6 (SD&#61;0.5) for the psychiatry clerkship introduction seminar. The overall evaluation of the clinical rotation on a 5-point Likert-item was 4.4 (SD&#61;0.5).</Pgraph><Pgraph>No specific evaluations were available from the 2020 clinical rotations due to the COVID-19-pandemic.</Pgraph><Pgraph>In the target group analysis medical students without clinical exposure to geriatric psychiatry most frequently mentioned diversity of geriatric psychiatric patients (3&#47;21), exposure to life experience (3&#47;21), and societal relevance (3&#47;21) as presumed positive aspects related to working in the field of geriatric psychiatry. In contrast, an expected one-sidedness of clinical activity (5&#47;21), challenges in communicating with geriatric psychiatric patients (5&#47;21), and a generally poorer prognosis (5&#47;21) were classified as unattractive aspects about the specialty. The complexity of geriatric psychiatric patients was rated as both positive and unattractive (3&#47;21 each). Of the students surveyed, the majority (62&#37;) indicated they were still undecided about a specialty. </Pgraph><SubHeadline2>Revision of the seminar concept</SubHeadline2><Pgraph>The seminar duration was about 60 minutes. Regarding the instructional design we considered research showing that the attention span dropping after around 25 to 30 minutes <TextLink reference="54"></TextLink>, theories on the influence of subjective theories, individually different prior knowledge, learning strategies, and learning motivation on the individual learning speed <TextLink reference="55"></TextLink>. Three overarching learning objectives with reference to the General Objectives for the Medical Expert and Professional and to EPAs 3, 4 and 7 from PROFILES were formulated for the seminar content design <TextLink reference="15"></TextLink>. In addition, ad hoc questions from the students were collected prior to each seminar.</Pgraph><Pgraph>For the cognitive activation during the lecture component of the seminar, the self-reference effect <TextLink reference="56"></TextLink> was used at the beginning (imagining one&#39;s own aging), followed by a theory input on demographic development, the need for geriatric psychiatric care, and an overview of geriatric psychiatric syndromes and their treatment with interspersed clinical audience questions. Content was also selected in consideration of target group analysis. Primarily visualized overview graphics were used for the necessary condensation of information.</Pgraph><Pgraph>For the second part of the seminar, a work assignment in small groups (2-3 students) (see attachment 3 <AttachmentLink attachmentNo="3"/> and attachment 4 <AttachmentLink attachmentNo="4"/>) was given of two short typical geriatric psychiatric case vignettes (major depressive episode and paranoid syndromes in neurocognitive disorder). Both case vignettes included questions about differential diagnoses and treatment recommendations, which were discussed afterwards. </Pgraph><SubHeadline2>Multidimensional pilot evaluation</SubHeadline2><Pgraph>The iteratively adjusted geriatric psychiatry seminar was rated 5.3 out of 6 (SD&#61;0.8, median&#61;5) in February through April 2021 (electronic evaluation response global rating: 67&#37;, data included from corresponding n&#61;18 clerkship students, proportion female&#61;61&#37;, proportion male&#61;39&#37;), with an average of 5.3 out of 6 (SD&#61;0.8, median&#61;5.0, skewness&#61;-0.19) evaluated better compared to the average of the geriatric psychiatry seminar global assessments from the 2019 cohort (n&#61;83 students, proportion female&#61;59&#37;, proportion male 41&#37;, overall average rating 4.3 out of 6, SD&#61;0.9, median&#61;4.3, skewness&#61;-0.47) (p&#60;0.01, U&#61;135.5, Cohen&#39;s d for non-parametric tests&#61;1.28). Results of the additional written multidimensional geriatric psychiatry seminar evaluation (n of two revised seminar evaluations&#61;21 clerkship students and elective year students) are summarized in <TextGroup><PlainText>table 1 </PlainText></TextGroup><ImgLink imgNo="1" imgType="table"/><TextGroup><PlainText>. </PlainText></TextGroup></Pgraph></TextBlock>
    <TextBlock language="de" linked="yes" name="Ergebnisse">
      <MainHeadline>Ergebnisse</MainHeadline><SubHeadline2>Narrative Literatur&#252;bersicht</SubHeadline2><Pgraph>Insgesamt wurden 659 Artikel und 15 MedEdPORTAL-Ressourcen gefunden. Von diesen bezogen sich 29 Artikel und 9 Lehrprojektberichte auf die alterspsychiatrische Lehre im Medizinstudium. In Tabelle S1 (siehe Anhang 1 <AttachmentLink attachmentNo="1"/>) sind die ausgewerteten Artikel dargestellt. Die Suchbegriffkombination (&#8222;psychiatry&#8220; AND &#8222;GMS Journal for Medical Education&#8220;) ergab keine Treffer. Der &#252;berwiegende Teil der Artikel bezog sich auf die alterspsychiatrische Lehre im Medizinstudium in den USA und Kanada (77&#37;) und etwa ein F&#252;nftel (23&#37;) auf den europ&#228;ischen Ausbildungskontext (Deutschland, UK, Portugal).</Pgraph><Pgraph>Thematisch am h&#228;ufigsten wurde in den Artikeln die alterspsychiatrische klinische Lehre untersucht (z.B. Blockpraktikumscurricula oder Teilnahme an mobiler alterspsychiatrischer Versorgung) in 21&#37; der Artikel) <TextLink reference="21"></TextLink>, <TextLink reference="22"></TextLink>, <TextLink reference="23"></TextLink>, <TextLink reference="24"></TextLink>, <TextLink reference="25"></TextLink>, <TextLink reference="26"></TextLink>, gefolgt von spezifischen Lehrmethoden (z.B. Imaginations&#252;bung oder Immersion-Simulation) f&#252;r alterspsychiatrische Themen (ebenfalls in 21&#37; der Artikel) <TextLink reference="27"></TextLink>, <TextLink reference="28"></TextLink>, <TextLink reference="29"></TextLink>, <TextLink reference="30"></TextLink>, <TextLink reference="31"></TextLink>, <TextLink reference="32"></TextLink> Lehrveranstaltungen (z.B. Kurse oder Seminare) <TextLink reference="33"></TextLink>, <TextLink reference="34"></TextLink>, <TextLink reference="35"></TextLink>, <TextLink reference="36"></TextLink>, Lernziele f&#252;r Medizinstudierende <TextLink reference="27"></TextLink>, <TextLink reference="37"></TextLink>, <TextLink reference="38"></TextLink> und dem alterspsychiatrischen Lehrbedarf (jeweils in 14&#37; der Artikel) <TextLink reference="12"></TextLink>, <TextLink reference="13"></TextLink>, <TextLink reference="14"></TextLink>, <TextLink reference="39"></TextLink>. Einzelne Artikel berichteten &#252;ber Problem-basierte Curricula im Fachgebiet Psychiatrie mit Bezug zu Lebensphasen <TextLink reference="40"></TextLink>, digitalen alterspsychiatrischen Lehr- und Lernressourcen <TextLink reference="41"></TextLink>, spezifischen Pr&#252;fungsformaten f&#252;r alterspsychiatrische Kompetenzen von Medizinstudierenden <TextLink reference="42"></TextLink>, <TextLink reference="43"></TextLink>, <TextLink reference="44"></TextLink> und Berufswegentscheidungen von Medizinstudierenden in Bezug auf die Alterspsychiatrie <TextLink reference="45"></TextLink>. </Pgraph><Pgraph>F&#252;r empirische Studien wurden h&#228;ufig Skalen zur Messung von Vorurteilen gegen&#252;ber alterspsychiatrischen Patient&#42;innen und das Interesse an einer beruflichen T&#228;tigkeit in der Alterspsychiatrie genutzt <TextLink reference="23"></TextLink>, <TextLink reference="24"></TextLink>, <TextLink reference="29"></TextLink>, <TextLink reference="36"></TextLink>. Es ergaben sich f&#252;r den Wissens- und Kompetenzerwerb <TextLink reference="22"></TextLink>, <TextLink reference="26"></TextLink>, <TextLink reference="33"></TextLink> und f&#252;r Vorurteile von Medizinstudierenden <TextLink reference="26"></TextLink>, <TextLink reference="29"></TextLink> &#252;berwiegend signifikante Verbesserungen nach l&#228;ngerer klinischer Exposition, jedoch in einer kontrolliert-randomisierten Studie keine &#196;nderung in Bezug auf die berufliche Laufbahnentscheidung <TextLink reference="26"></TextLink>. </Pgraph><Pgraph>Weiterhin konnten evaluierte, englischsprachige Lehrmaterialien f&#252;r folgende alterspsychiatrische Themen identifiziert werden: Differentialdiagnostische &#220;berlegungen f&#252;r Demenz, Depression und Delir, <TextLink reference="46"></TextLink>, Suchterkrankungen im Alter <TextLink reference="47"></TextLink>, Erkennen von psychischen und Verhaltenssymptomen bei Demenz <TextLink reference="48"></TextLink>, Sturz und Sturzpr&#228;vention <TextLink reference="49"></TextLink>, Einf&#252;hrung in die Alterspsychiatrie <TextLink reference="50"></TextLink>, kulturkompetente Gesundheitskommunikation mit &#228;lteren Patient&#42;innen <TextLink reference="51"></TextLink>, Erkennen und Behandeln einer Depression im Alter <TextLink reference="52"></TextLink> und ungewollter Gewichtsverlust im Alter <TextLink reference="53"></TextLink>. Eine &#220;bersicht der verwendeten didaktischen Methoden ist in Tabelle S1 (siehe Anhang 1 <AttachmentLink attachmentNo="1"/>) dargestellt.</Pgraph><SubHeadline2>Standortbestimmung studentischer Evaluationen</SubHeadline2><Pgraph>Die Analyse der alterspsychiatrischen Seminarevaluationen aus dem Blockpraktikumsjahr 2019 (Daten vorhanden von n&#61;83 Studierenden, Anteil weiblich&#61;59&#37;, Anteil m&#228;nnlich 41&#37;, entsprechend einem Evaluationsr&#252;cklauf von 78&#37;, Likert-Item Gesamtbewertung durchschnittlich 4.3 von 6, SD&#61;0.9, Median&#61;4.3, Schiefe&#61;-0.47) im Vergleich zu anderen Seminaren mit einer durchschnittlichen Gesamtbewertung von 5.2 von 6 (SD&#61;0.8, Median&#61;5.3, Schiefe&#61;-0.23, W&#61;97, p&#60;0.001) ergab Hinweise auf eine durchschnittlich schlechtere Gesamtbewertung des Seminars zur Alterspsychiatrie. Die anderen Blockpraktikumsseminare erhielten niedrigste Einzelbewertungen im Bereich von 5.1 (SD&#61;0.7) beispielsweise f&#252;r das Seminar Psychopathologie bis maximal 5.6 (SD&#61;0.5) f&#252;r das Einf&#252;hrungsseminar zum Blockpraktikum. Die Gesamtevaluation des Blockpraktikums auf einem 5-Punkte Likert-Item war 4.4 (SD&#61;0.5).</Pgraph><Pgraph>Aus dem Blockpraktikumsjahr 2020 lagen pandemiebedingt keine spezifischen Seminarevaluationen vor.</Pgraph><Pgraph>In der Zielgruppenanalyse nannten Medizinstudierende ohne alterspsychiatrische klinische Exposition am h&#228;ufigsten die Diversit&#228;t der alterspsychiatrischen Patient&#42;innen (3&#47;21), die Auseinandersetzung mit Lebenserfahrung (3&#47;21) und die gesellschaftliche Relevanz (3&#47;21) als vermutete positive Aspekte in Bezug auf eine T&#228;tigkeit im Fachgebiet Alterspsychiatrie. Im Gegensatz dazu wurden eine erwartete Einseitigkeit der klinischen T&#228;tigkeit (5&#47;21), Herausforderung bei der Kommunikation mit alterspsychiatrischen Patient&#42;innen (5&#47;21) und eine allgemein schlechtere Prognose (5&#47;21) als unattraktive Aspekte am Fachgebiet eingeordnet. Die Komplexit&#228;t alterspsychiatrischer Patient&#42;innen wurde sowohl als positiv als auch als unattraktiv eingeordnet (jeweils 3&#47;21). Von den befragten Studierenden gab die Mehrheit (62&#37;) an, noch unentschlossen in Bezug auf eine Fachrichtung zu sein. </Pgraph><SubHeadline2>&#220;berarbeitung des Seminarkonzeptes</SubHeadline2><Pgraph>F&#252;r die Rhythmisierung des 60-min&#252;tigen Seminars wurde insbesondere die Evidenz zur Aufmerksamkeitsspanne mit einem zu erwartenden starken Abfall nach den etwa ersten 25 bis 30 Minuten <TextLink reference="54"></TextLink> und Studien zum Einfluss subjektiver Theorien, individuell unterschiedlichen Vorwissens, Lernstrategien und Lernmotivation auf das individuelle Lerntempo ber&#252;cksichtigt <TextLink reference="55"></TextLink>. Es wurden drei &#252;bergeordnete Lernziele mit Bezug zu den General Objectives Medical Expert und Professional und zu den EPAs 3, 4 und 7 aus PROFILES f&#252;r die inhaltliche Seminargestaltung formuliert <TextLink reference="15"></TextLink>. Zus&#228;tzlich wurden ad hoc Fragen der Studierenden zu Beginn gesammelt.</Pgraph><Pgraph>F&#252;r die kognitive Aktivierung im Vortragsteil wurde in der Vorstellungsrunde der Selbstreferenz-Effekt <TextLink reference="56"></TextLink> zu Beginn genutzt (Imagination des eigenen Alterns), gefolgt von einem Theorie-Input zu demographischer Entwicklung, dem alterspsychiatrischen Versorgungsbedarf und einer &#220;bersicht zu alterspsychiatrischen Krankheitsbildern und deren Behandlung mit eingeschobenen klinischen Publikumsfragen. Die Inhalte wurden auch unter Ber&#252;cksichtigung der Zielgruppenanalyse ausgew&#228;hlt. F&#252;r die notwendige Stoffverdichtung wurden prim&#228;r visualisierte &#220;bersichtsgraphiken genutzt.</Pgraph><Pgraph>F&#252;r den zweiten Seminarteil wurde ein Arbeitsauftrag mit der selbst&#228;ndigen Bearbeitung von zwei kurzen typischen alterspsychiatrischen Fallvignetten (schwere depressive Episode und paranoides Syndrom bei Demenz) in Kleingruppen (2-3 Studierende) gestellt (siehe Anhang 3 <AttachmentLink attachmentNo="3"/> und Anhang 4 <AttachmentLink attachmentNo="4"/>). Beide Fallvignetten enthielten Fragen zur Differentialdiagnostik und Behandlungsempfehlung, die im Anschluss im Plenum diskutiert wurden. </Pgraph><SubHeadline2>Mehrdimensionale Pilotevaluation</SubHeadline2><Pgraph>Das iterativ angepasste alterspsychiatrische Seminar wurde im Zeitraum Februar bis April 2021 (elektronischer Evaluationsr&#252;cklauf Globalbewertung: 67&#37;, Daten eingeschlossen von entsprechend n&#61;18 Blockstudierenden, Anteil weiblich&#61;61&#37;, Anteil m&#228;nnlich&#61;39&#37;), mit zuletzt durchschnittlich 5.3 von 6 (SD&#61;0.8, Median&#61;5.0, Schiefe&#61;-0.19) besser im Vergleich zum Durchschnitt der alterspsychiatrischen Seminarglobalbewertungen aus dem Blockpraktikumsjahr 2019 (n&#61;83 Studierende, Anteil weiblich&#61;59&#37;, Anteil m&#228;nnlich 41&#37;, Gesamtbewertung durchschnittlich 4.3 von 6, SD&#61;0.9, Median&#61;4.3, Schiefe&#61;-0.47) evaluiert (p&#60;0.01, U&#61;135.5, Cohen&#8217;s d f&#252;r nicht-parametrische Tests&#61;1.28). Die Ergebnisse der zus&#228;tzlichen schriftlichen mehrdimensionalen alterspsychiatrischen Seminarevaluation (n von zwei &#252;berarbeiteten Seminardurchf&#252;hrungen&#61;21 Blockstudierende und Wahljahrstudierende) sind in Tabelle 1 <ImgLink imgNo="1" imgType="table"/> zusammengefasst. </Pgraph></TextBlock>
    <TextBlock language="en" linked="yes" name="Discussion">
      <MainHeadline>Discussion</MainHeadline><Pgraph>In the present work, we examined what evidence for instructional design is, to date, available for undergraduate teaching in the field of geriatric psychiatry. In addition, evidence-based general educational recommendations (including target group analysis, sequencing, and learner activation) were used to revise the instructional design of a geriatric psychiatry seminar in the clerkship year, that had previously been evaluated below average. The new seminar concept was evaluated significantly better by students. In this respect, the pilot evaluations presented here provide a first concrete indication that evidence-based improvements in instructional design can be statistically objectified by means of standardized evaluations.</Pgraph><Pgraph>In summary, the international literature on medical education shows that geriatric psychiatry instruction, its outcome assessment, and specific workplace-based teaching tend to be underrepresented in medical schools and do not adequately reflect societal needs <TextLink reference="13"></TextLink>, <TextLink reference="22"></TextLink>, <TextLink reference="41"></TextLink>. Whereas previous studies <TextLink reference="21"></TextLink>, <TextLink reference="28"></TextLink>, <TextLink reference="37"></TextLink> primarily examined geriatric psychiatry learning objectives and appropriate curricular structures, more recent research on geriatric psychiatry teaching has focused on the necessary human resource infrastructure <TextLink reference="14"></TextLink>, recruitment of junior faculty <TextLink reference="26"></TextLink>, digital teaching in geriatric psychiatry <TextLink reference="41"></TextLink> and teaching methods for specific disease entities such as neurocognitive disorders <TextLink reference="32"></TextLink>.</Pgraph><Pgraph>Lack of geriatric psychiatry clinical rotation experience in medical education may make it difficult for students to relate to everyday clinical practice and sabotage the necessary constructive alignment regarding competency-based learning objectives, theory and clinical practice, and their assessment <TextLink reference="57"></TextLink>. The quality of a workplace-based clinical learning experience in geriatric psychiatry care plays an important role for the individual acquisition of competencies <TextLink reference="22"></TextLink>. Educational research regarding professional interest in the specialty of geriatric psychiatry seems most likely to be inconclusive due to curricular structure differences <TextLink reference="25"></TextLink>, <TextLink reference="26"></TextLink>. In contrast, a meta-analysis of career interest in the specialty of general practice clearly concludes that early and systematic clinical learning experiences are associated with higher career interest in the specialty <TextLink reference="58"></TextLink>.</Pgraph><Pgraph>The prejudices and stereotypes mentioned by students (e.g., treatment options and outcomes) regarding geriatric psychiatry patients at our university hospital differ surprisingly little from those reported as early as the 1980s in the United States <TextLink reference="21"></TextLink>. Therefore, in addition to subject-relevant preclinical teaching, clinical exposure, structured discussion of geriatric psychiatry clinical cases and of the diversity of geriatric psychiatry patients, seem essential for the reduction of prejudices and high-quality care <TextLink reference="26"></TextLink>, <TextLink reference="29"></TextLink>. Clinical rotations in geriatric psychiatry also offer students the opportunity to engage with a conscious attitude towards age and aging from a bio-psycho-social perspective under appropriate supervision and to use this for future clinical work, regardless of specialty.</Pgraph><Pgraph>Seminars as reported in this pilot project should be seen as one element for teaching geriatric psychiatry and have to be complemented by theory and clinical experience. From a medical education point of view, it seems important to investigate the actual learning outcomes and attitude changes in an intervention-dependent manner. There is emerging evidence on the relevance of clinical rotations for changes in attitude, and career interest in this field in the context of medical students <TextLink reference="22"></TextLink>, <TextLink reference="25"></TextLink> as well as residents <TextLink reference="45"></TextLink>, <TextLink reference="59"></TextLink>. Accordingly, the various examination formats (knowledge tests, objective structured clinical examinations, and workplace-based assessments) should adequately reflect geriatric psychiatry learning objectives, in order to be able to assess the acquisition of competencies at higher levels.</Pgraph></TextBlock>
    <TextBlock language="de" linked="yes" name="Diskussion">
      <MainHeadline>Diskussion</MainHeadline><Pgraph>In der vorliegenden Arbeit wurde untersucht welche medizindidaktische Evidenz f&#252;r die Lehrgestaltung im Fachgebiet Alterspsychiatrie und -psychotherapie bisher vorliegt. Zudem wurden evidenz-basierte allgemeine didaktische Empfehlungen (u.a. Zielgruppenanalyse, Seminarrhythmisierung und Lernendenaktivierung) genutzt, um ein bisher unterdurchschnittlich evaluiertes studentisches Seminarkonzept im Blockpraktikum zu &#252;berarbeiten. Das neue Seminarkonzept wurde signifikant besser von Studierenden evaluiert. Insofern geben die vorgestellten Pilotevaluationen einen ersten konkreten Anhaltspunkt daf&#252;r, dass sich evidenz-orientierte Verbesserungen der Didaktik mittels standardisierter Evaluationen durchaus statistisch objektivieren lassen k&#246;nnen.</Pgraph><Pgraph>In der Zusammenschau zeigt sich in der internationalen medizindidaktischen Literatur, dass die alterspsychiatrische Wissensvermittlung, deren &#220;berpr&#252;fung und spezifische arbeitsplatz-basierte Lehre tendenziell an medizinischen Fakult&#228;ten unterrepr&#228;sentiert sind und den gesellschaftlichen Bedarf nicht ad&#228;quat abbilden <TextLink reference="13"></TextLink>, <TextLink reference="22"></TextLink>, <TextLink reference="41"></TextLink>. W&#228;hrend in fr&#252;heren Studien <TextLink reference="21"></TextLink>, <TextLink reference="28"></TextLink>, <TextLink reference="37"></TextLink> vor allem alterspsychiatrische Lernziele und geeignete curriculare Strukturen untersucht wurden, liegt der Fokus bei j&#252;ngeren Forschungsarbeiten zur alterspsychiatrischen Lehre auf der notwendigen Personalinfrastruktur <TextLink reference="14"></TextLink>, Nachwuchsrekrutierung <TextLink reference="26"></TextLink>, digitaler Lehre in der Alterspsychiatrie <TextLink reference="41"></TextLink> und Lehrmethoden f&#252;r spezifische Krankheitsentit&#228;ten wie den neurokognitiven St&#246;rungen <TextLink reference="32"></TextLink>.</Pgraph><Pgraph>Fehlende alterspsychiatrische klinische Arbeitserfahrung in der medizinischen Ausbildung erschwert es Studierenden m&#246;glicherweise einen Bezug zum klinischen Alltag herzustellen und verhindert die notwendige &#252;bergeordnete didaktische Koh&#228;renz durch Abstimmung kompetenz-basierter Lernziele mit Theorie und Praxis und deren Pr&#252;fung <TextLink reference="57"></TextLink>. Wesentlich erscheint uns, dass die Qualit&#228;t einer arbeitsplatz-basierten klinischen Lernerfahrung in der alterspsychiatrischen Versorgung f&#252;r den individuellen Kompetenzerwerb <TextLink reference="22"></TextLink> eine wichtige Rolle spielt. Die Studienlage in Bezug auf das berufliche Interesse am Fachgebiet Alterspsychiatrie erscheint am ehesten aufgrund curricularer Interventionsunterschiede nicht eindeutig <TextLink reference="25"></TextLink>, <TextLink reference="26"></TextLink>. Eine Metaanalyse zum Berufsinteresse am Fachgebiet Allgemeinmedizin hingegen kommt zu der klaren Schlussfolgerungen, dass fr&#252;he und systematische klinische Lernerfahrungen mit h&#246;herem beruflichen Interesse am Fachgebiet einhergehen <TextLink reference="58"></TextLink>.</Pgraph><Pgraph>Die von Studierenden genannten Vorurteile und Stereotypen (z.B. Behandlungsm&#246;glichkeiten und -erfolge) in Bezug auf alterspsychiatrische Patient&#42;innen an unserer Universit&#228;tsklinik unterscheiden sich erstaunlich wenig von den bereits in den 1980er Jahren in den USA berichteten Vorurteilen <TextLink reference="21"></TextLink>. Neben der entsprechenden Wissensvermittlung in der pr&#228;klinischen Lehre scheint daher die klinische Exposition und die strukturierte Auseinandersetzung mit alterspsychiatrischen Krankheitsbildern, der Diversit&#228;t alterspsychiatrischer Patient&#42;innen und der Abbau von Vorurteilen essenziell f&#252;r eine qualitativ hochwertige Versorgung <TextLink reference="26"></TextLink>, <TextLink reference="29"></TextLink>. Klinische Rotationen in der Alterspsychiatrie bieten Studierenden zudem die M&#246;glichkeit, sich unter entsprechender Supervision (und fallbasierter strukturierter Diskussion) mit einer bewussten Haltung zum Alter und Altern aus bio-psycho-sozialer Sicht auseinanderzusetzen und diese f&#252;r die zuk&#252;nftige klinische T&#228;tigkeit unabh&#228;ngig vom Fachgebiet zu nutzen.</Pgraph><Pgraph>Seminare wie in diesem Pilotprojekt berichtet sind nur als ein Baustein f&#252;r die alterspsychiatrische Lehre einzuordnen und m&#252;ssen durch theoretische Versorgungsgrundlagen und klinische Arbeitserfahrung komplementiert werden. Wichtig aus medizindidaktischer Sicht erscheint nun den tats&#228;chlichen Lernzuwachs und Einstellungs&#228;nderungen interventionsabh&#228;nig zu untersuchen. Erste empirische Hinweise auf die Wichtigkeit von klinischen Rotationen f&#252;r die Einstellungs&#228;nderung und das berufliche Interesse an diesem Fachgebiet gibt es bereits sowohl f&#252;r Medizinstudierende <TextLink reference="22"></TextLink>, <TextLink reference="25"></TextLink> als auch f&#252;r Weiterzubildende <TextLink reference="45"></TextLink>, <TextLink reference="59"></TextLink>. Entsprechend sollten auch die verschiedenen Pr&#252;fungsformate (Wissenstests, Objective structured clinical examinations und arbeitsplatz-basierte Assessments) gerontopsychiatrische Themen ad&#228;quat abbilden, um den Kompetenzerwerb auf h&#246;heren Ebenen &#252;berpr&#252;fen zu k&#246;nnen.</Pgraph></TextBlock>
    <TextBlock language="en" linked="yes" name="Conclusion">
      <MainHeadline>Conclusion</MainHeadline><Pgraph>To adequately prepare medical students for their clinical practice and societal care needs, high-quality teaching formats, including clinical rotations, must be implemented for geriatric psychiatry. Some resources for evidence-based teaching in geriatric psychiatry are already available and can be used by educators, such as the materials examined in this project report.</Pgraph></TextBlock>
    <TextBlock language="de" linked="yes" name="Schlussfolgerung">
      <MainHeadline>Schlussfolgerung</MainHeadline><Pgraph>Um Medizinstudierende ad&#228;quat auf ihre klinische T&#228;tigkeit und den gesellschaftlichen Versorgungsbedarf vorzubereiten, m&#252;ssen qualitativ hochwertige Lehrformate einschlie&#223;lich klinischer Rotationen f&#252;r die Alterspsychiatrie und Psychotherapie implementiert werden. F&#252;r die evidenz-orientiere Lehrgestaltung in der Alterspsychiatrie stehen bereits einige Ressourcen zur Verf&#252;gung und k&#246;nnen, wie das in diesem Projektbericht untersuchte Material, von Lehrenden genutzt werden.</Pgraph></TextBlock>
    <TextBlock language="en" linked="yes" name="Note">
      <MainHeadline>Note</MainHeadline><Pgraph>If interested in materials beyond the supplementary materials, the authors of this manuscript can be contacted.</Pgraph></TextBlock>
    <TextBlock language="de" linked="yes" name="Anmerkung">
      <MainHeadline>Anmerkung</MainHeadline><Pgraph>Bei Interesse an Materialien &#252;ber das Supplement hinaus k&#246;nnen die Autor&#42;innen dieses Manuskripts kontaktiert werden.</Pgraph></TextBlock>
    <TextBlock language="en" linked="yes" name="Competing interests">
      <MainHeadline>Competing interests</MainHeadline><Pgraph>The authors declare that they have no competing interests. </Pgraph></TextBlock>
    <TextBlock language="de" linked="yes" name="Interessenkonflikt">
      <MainHeadline>Interessenkonflikt</MainHeadline><Pgraph>Die Autor&#42;innen erkl&#228;ren, dass sie keinen Interessenkonflikt im Zusammenhang mit diesem Artikel haben.</Pgraph></TextBlock>
    <References linked="yes">
      <Reference refNo="1">
        <RefAuthor>World Health Organization</RefAuthor>
        <RefTitle></RefTitle>
        <RefYear>2015</RefYear>
        <RefBookTitle>Fact Sheet 381</RefBookTitle>
        <RefPage></RefPage>
        <RefTotal>World Health Organization. Fact Sheet 381. Geneva: World Health Organization; 2015. Zug&#228;nglich unter&#47;available from: http:&#47;&#47; www.who.int&#47;mediacentre&#47;factsheets&#47;fs381&#47;en&#47;</RefTotal>
        <RefLink>http:&#47;&#47; www.who.int&#47;mediacentre&#47;factsheets&#47;fs381&#47;en&#47;</RefLink>
      </Reference>
      <Reference refNo="2">
        <RefAuthor>Schweizer Eidgenossenschaft</RefAuthor>
        <RefAuthor>Bundesamt f&#252;r Statistik</RefAuthor>
        <RefTitle></RefTitle>
        <RefYear>2020</RefYear>
        <RefBookTitle>Zuk&#252;nftige Entwicklung</RefBookTitle>
        <RefPage></RefPage>
        <RefTotal>Schweizer Eidgenossenschaft, Bundesamt f&#252;r Statistik. Zuk&#252;nftige Entwicklung. Neuchatel: Bundesamt f&#252;r Statistik, Sektion Demografie und Migration; 2020. Zug&#228;nglich unter&#47;available from: https:&#47;&#47;www.bfs.admin.ch&#47;bfs&#47;de&#47;home&#47;statistiken&#47;bevoelkerung&#47;zukuenftige-entwicklung.html</RefTotal>
        <RefLink>https:&#47;&#47;www.bfs.admin.ch&#47;bfs&#47;de&#47;home&#47;statistiken&#47;bevoelkerung&#47;zukuenftige-entwicklung.html</RefLink>
      </Reference>
      <Reference refNo="3">
        <RefAuthor>Riedel-Heller SG</RefAuthor>
        <RefAuthor>Busse A</RefAuthor>
        <RefAuthor>Aurich C</RefAuthor>
        <RefAuthor>Matschinger H</RefAuthor>
        <RefAuthor>Angermeyer MC</RefAuthor>
        <RefTitle>Prevalence of dementia according to DSM-III-R and ICD-10: results of the Leipzig Longitudinal Study of the Aged (LEILA75&#43;) part 1</RefTitle>
        <RefYear>2001</RefYear>
        <RefJournal>Br J Psychiatry</RefJournal>
        <RefPage>250-254</RefPage>
        <RefTotal>Riedel-Heller SG, Busse A, Aurich C, Matschinger H, Angermeyer MC. Prevalence of dementia according to DSM-III-R and ICD-10: results of the Leipzig Longitudinal Study of the Aged (LEILA75&#43;) part 1. Br J Psychiatry. 2001;179(3):250-254. DOI: 10.1192&#47;bjp.179.3.250</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1192&#47;bjp.179.3.250</RefLink>
      </Reference>
      <Reference refNo="4">
        <RefAuthor>Siddiqi N</RefAuthor>
        <RefAuthor>House AO</RefAuthor>
        <RefAuthor>Holmes JD</RefAuthor>
        <RefTitle>Occurrence and outcome of delirium in medical in-patients: a systematic literature review</RefTitle>
        <RefYear>2006</RefYear>
        <RefJournal>Age Ageing</RefJournal>
        <RefPage>350-364</RefPage>
        <RefTotal>Siddiqi N, House AO, Holmes JD. Occurrence and outcome of delirium in medical in-patients: a systematic literature review. Age Ageing. 2006;35(4):350-364. DOI: 10.1093&#47;ageing&#47;afl005</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1093&#47;ageing&#47;afl005</RefLink>
      </Reference>
      <Reference refNo="5">
        <RefAuthor>Luppa M</RefAuthor>
        <RefAuthor>Sikorski C</RefAuthor>
        <RefAuthor>Luck T</RefAuthor>
        <RefAuthor>Ehreke L</RefAuthor>
        <RefAuthor>Konnopka A</RefAuthor>
        <RefAuthor>Wiese B</RefAuthor>
        <RefAuthor>Weyerer S</RefAuthor>
        <RefAuthor>K&#246;nig HH</RefAuthor>
        <RefAuthor>Riedel-Heller SG</RefAuthor>
        <RefTitle>Age-and gender-specific prevalence of depression in latest-life-systematic review and meta-analysis</RefTitle>
        <RefYear>2012</RefYear>
        <RefJournal>J Affect Disord</RefJournal>
        <RefPage>212-221</RefPage>
        <RefTotal>Luppa M, Sikorski C, Luck T, Ehreke L, Konnopka A, Wiese B, Weyerer S, K&#246;nig HH, Riedel-Heller SG. Age-and gender-specific prevalence of depression in latest-life-systematic review and meta-analysis. J Affect Disord. 2012;136(3):212-221. DOI: 10.1016&#47;j.jad.2010.11.033</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1016&#47;j.jad.2010.11.033</RefLink>
      </Reference>
      <Reference refNo="6">
        <RefAuthor>Schweizer Eidgenossenschaft</RefAuthor>
        <RefAuthor>Bundesamt f&#252;r Statistik</RefAuthor>
        <RefTitle></RefTitle>
        <RefYear>2020</RefYear>
        <RefBookTitle>Psychische Gesundheit</RefBookTitle>
        <RefPage></RefPage>
        <RefTotal>Schweizer Eidgenossenschaft, Bundesamt f&#252;r Statistik. Psychische Gesundheit. Neuchatel: Bundesamt f&#252;r Statistik, Sektionen Gesundheitsvorsorge, Gesundheit der Bev&#246;lkerung; 2020. Zug&#228;nglich unter&#47;available from: https:&#47;&#47;www.bfs.admin.ch&#47;bfs&#47;de&#47;home&#47;statistiken&#47;gesundheit&#47;gesundheitszustand&#47;psychische.html</RefTotal>
        <RefLink>https:&#47;&#47;www.bfs.admin.ch&#47;bfs&#47;de&#47;home&#47;statistiken&#47;gesundheit&#47;gesundheitszustand&#47;psychische.html</RefLink>
      </Reference>
      <Reference refNo="7">
        <RefAuthor>Gellert P</RefAuthor>
        <RefAuthor>Lech S</RefAuthor>
        <RefAuthor>Kessler EM</RefAuthor>
        <RefAuthor>Herrmann W</RefAuthor>
        <RefAuthor>D&#246;pfmer S</RefAuthor>
        <RefAuthor>Balke K</RefAuthor>
        <RefAuthor>Oedekoven M</RefAuthor>
        <RefAuthor>Kuhlmey A</RefAuthor>
        <RefAuthor>Schnitzer S</RefAuthor>
        <RefTitle>Perceived need for treatment and non-utilization of outpatient psychotherapy in old age: two cohorts of a nationwide survey</RefTitle>
        <RefYear>2021</RefYear>
        <RefJournal>BMC Health Serv Res</RefJournal>
        <RefPage>442</RefPage>
        <RefTotal>Gellert P, Lech S, Kessler EM, Herrmann W, D&#246;pfmer S, Balke K, Oedekoven M, Kuhlmey A, Schnitzer S. Perceived need for treatment and non-utilization of outpatient psychotherapy in old age: two cohorts of a nationwide survey. BMC Health Serv Res. 2021;21(1):442. DOI: 10.1186&#47;s12913-021-06384-6</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1186&#47;s12913-021-06384-6</RefLink>
      </Reference>
      <Reference refNo="8">
        <RefAuthor>Marques S</RefAuthor>
        <RefAuthor>Mariano J</RefAuthor>
        <RefAuthor>Mendoca J</RefAuthor>
        <RefAuthor>De Tavernier W</RefAuthor>
        <RefAuthor>Hess M</RefAuthor>
        <RefAuthor>Naegele L</RefAuthor>
        <RefAuthor>Peixeiro F</RefAuthor>
        <RefAuthor>Martins D</RefAuthor>
        <RefTitle>Determinants of ageism against older adults: a systematic review</RefTitle>
        <RefYear>2020</RefYear>
        <RefJournal>Int J Environ Res Public Health</RefJournal>
        <RefPage>2560</RefPage>
        <RefTotal>Marques S, Mariano J, Mendoca J, De Tavernier W, Hess M, Naegele L, Peixeiro F, Martins D. Determinants of ageism against older adults: a systematic review. Int J Environ Res Public Health. 2020;17(7):2560. DOI: 10.3390&#47;ijerph17072560</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.3390&#47;ijerph17072560</RefLink>
      </Reference>
      <Reference refNo="9">
        <RefAuthor>Temple JB</RefAuthor>
        <RefAuthor>Brijnath B</RefAuthor>
        <RefAuthor>Enticott J</RefAuthor>
        <RefAuthor>Utomo A</RefAuthor>
        <RefAuthor>Williams R</RefAuthor>
        <RefAuthor>Kelaher M</RefAuthor>
        <RefTitle>Discrimination reported by older adults living with mental health conditions: types, contexts and association with healthcare barriers</RefTitle>
        <RefYear>2020</RefYear>
        <RefJournal>Soc Psychiatry Psychiatr Epidemiol</RefJournal>
        <RefPage>1003-1014</RefPage>
        <RefTotal>Temple JB, Brijnath B, Enticott J, Utomo A, Williams R, Kelaher M. Discrimination reported by older adults living with mental health conditions: types, contexts and association with healthcare barriers. Soc Psychiatry Psychiatr Epidemiol. 2020;56(6):1003-1014. DOI: 10.1007&#47;s00127-020-01914-9</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1007&#47;s00127-020-01914-9</RefLink>
      </Reference>
      <Reference refNo="10">
        <RefAuthor>Kl&#246;ppel S</RefAuthor>
        <RefAuthor>Jessen F</RefAuthor>
        <RefTitle></RefTitle>
        <RefYear>2020</RefYear>
        <RefBookTitle>Praxishandbuch Gerontopsychiatrie und-psychotherapie</RefBookTitle>
        <RefPage></RefPage>
        <RefTotal>Kl&#246;ppel S, Jessen F. Praxishandbuch Gerontopsychiatrie und-psychotherapie. M&#252;nchen: Elsevier Health Sciences; 2020.</RefTotal>
      </Reference>
      <Reference refNo="11">
        <RefAuthor>Dening T</RefAuthor>
        <RefTitle></RefTitle>
        <RefYear>2021</RefYear>
        <RefBookTitle>Oxford textbook of old age psychiatry</RefBookTitle>
        <RefPage></RefPage>
        <RefTotal>Dening T. Oxford textbook of old age psychiatry. Third edition. New York, NY: Oxford University Press; 2021. DOI: 10.1093&#47;med&#47;9780198807292.001.0001</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1093&#47;med&#47;9780198807292.001.0001</RefLink>
      </Reference>
      <Reference refNo="12">
        <RefAuthor>Nikolaus T</RefAuthor>
        <RefTitle>Forschung und Lehre in der Geriatrie an deutschen Universit&#228;ten und Hochschulen</RefTitle>
        <RefYear>1998</RefYear>
        <RefJournal>Z Geront Geriatr</RefJournal>
        <RefPage>277-280</RefPage>
        <RefTotal>Nikolaus T. Forschung und Lehre in der Geriatrie an deutschen Universit&#228;ten und Hochschulen. Z Geront Geriatr. 1998;31(4):277-280. DOI: 10.1007&#47;s003910050045</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1007&#47;s003910050045</RefLink>
      </Reference>
      <Reference refNo="13">
        <RefAuthor>Lehmann SW</RefAuthor>
        <RefAuthor>Blazek MC</RefAuthor>
        <RefAuthor>Popeo DM</RefAuthor>
        <RefTitle>Geriatric psychiatry in the psychiatry clerkship: a survey of current education practices</RefTitle>
        <RefYear>2015</RefYear>
        <RefJournal>Acad Psychiatry</RefJournal>
        <RefPage>312-315</RefPage>
        <RefTotal>Lehmann SW, Blazek MC, Popeo DM. Geriatric psychiatry in the psychiatry clerkship: a survey of current education practices. Acad Psychiatry. 2015;39(3):312-315. DOI: 10.1007&#47;s40596-015-0316-y</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1007&#47;s40596-015-0316-y</RefLink>
      </Reference>
      <Reference refNo="14">
        <RefAuthor>Chun S</RefAuthor>
        <RefAuthor>Douglass AB</RefAuthor>
        <RefAuthor>Lehmann SW</RefAuthor>
        <RefAuthor>Hickey C</RefAuthor>
        <RefAuthor>Lee EK</RefAuthor>
        <RefTitle>Geriatric psychiatry teaching in Canadian medical schools: a cross-sectional study</RefTitle>
        <RefYear>2019</RefYear>
        <RefJournal>Acad Psychiatry</RefJournal>
        <RefPage>407-410</RefPage>
        <RefTotal>Chun S, Douglass AB, Lehmann SW, Hickey C, Lee EK. Geriatric psychiatry teaching in Canadian medical schools: a cross-sectional study. Acad Psychiatry. 2019;43(4):407-410. DOI: 10.1007&#47;s40596-019-01032-y</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1007&#47;s40596-019-01032-y</RefLink>
      </Reference>
      <Reference refNo="15">
        <RefAuthor>Michaud PA</RefAuthor>
        <RefAuthor>Jucker-Kupper P</RefAuthor>
        <RefAuthor> Members of the Profiles working group</RefAuthor>
        <RefTitle></RefTitle>
        <RefYear>2017</RefYear>
        <RefBookTitle>PROFILES: Principal Relevant Objectives and Framework for Integrated Learning and Education in Switzerland</RefBookTitle>
        <RefPage></RefPage>
        <RefTotal>Michaud PA, Jucker-Kupper P; Members of the Profiles working group. PROFILES: Principal Relevant Objectives and Framework for Integrated Learning and Education in Switzerland. Bern: Joint Commission of the Swiss Medical Schools; 2017. Zug&#228;nglich unter&#47;available from: https:&#47;&#47;www.profilesmed.ch&#47;</RefTotal>
        <RefLink>https:&#47;&#47;www.profilesmed.ch&#47;</RefLink>
      </Reference>
      <Reference refNo="16">
        <RefAuthor>Pinilla S</RefAuthor>
        <RefAuthor>Cantisani A</RefAuthor>
        <RefAuthor>Kl&#246;ppel S</RefAuthor>
        <RefAuthor>Strik W</RefAuthor>
        <RefAuthor>Nissen C</RefAuthor>
        <RefAuthor>Huwendiek S</RefAuthor>
        <RefTitle>Introducing a clerkship curriculum based on entrustable professional activities: a pilot study</RefTitle>
        <RefYear>2021</RefYear>
        <RefJournal>Acad Psychiatry</RefJournal>
        <RefPage>354-359</RefPage>
        <RefTotal>Pinilla S, Cantisani A, Kl&#246;ppel S, Strik W, Nissen C, Huwendiek S. Introducing a clerkship curriculum based on entrustable professional activities: a pilot study. Acad Psychiatry. 2021;45(3):354-359. DOI: 10.1007&#47;s40596-021-01417-y</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1007&#47;s40596-021-01417-y</RefLink>
      </Reference>
      <Reference refNo="17">
        <RefAuthor>Pinilla S</RefAuthor>
        <RefAuthor>Kyrou A</RefAuthor>
        <RefAuthor>Kl&#246;ppel S</RefAuthor>
        <RefAuthor>Strik W</RefAuthor>
        <RefAuthor>Nissen C</RefAuthor>
        <RefAuthor>Huwendiek S</RefAuthor>
        <RefTitle>Workplace-based assessments of entrustable professional activities in a psychiatry core clerkship: an observational study</RefTitle>
        <RefYear>2021</RefYear>
        <RefJournal>BMC Med Educ</RefJournal>
        <RefPage>223</RefPage>
        <RefTotal>Pinilla S, Kyrou A, Kl&#246;ppel S, Strik W, Nissen C, Huwendiek S. Workplace-based assessments of entrustable professional activities in a psychiatry core clerkship: an observational study. BMC Med Educ. 2021;21(1):223. DOI: 10.1186&#47;s12909-021-02637-4</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1186&#47;s12909-021-02637-4</RefLink>
      </Reference>
      <Reference refNo="18">
        <RefAuthor>Universit&#228;t Bern</RefAuthor>
        <RefTitle></RefTitle>
        <RefYear>2021</RefYear>
        <RefBookTitle>Gute Lehre an der Universit&#228;t Bern. 10 Lehrtipps aus der Lehr-Lern-Forschung</RefBookTitle>
        <RefPage></RefPage>
        <RefTotal>Universit&#228;t Bern. Gute Lehre an der Universit&#228;t Bern. 10 Lehrtipps aus der Lehr-Lern-Forschung. Bern: Universit&#228;t Bern; 2021. Zug&#228;nglich unter&#47;available from: https:&#47;&#47;www.gutelehre.unibe.ch&#47;lehrtipps&#47;</RefTotal>
        <RefLink>https:&#47;&#47;www.gutelehre.unibe.ch&#47;lehrtipps&#47;</RefLink>
      </Reference>
      <Reference refNo="19">
        <RefAuthor>Universit&#228;t Bern</RefAuthor>
        <RefTitle></RefTitle>
        <RefYear>2021</RefYear>
        <RefBookTitle>Kurse und Veranstaltungen Hochschuldidaktik &#38; Lehrentwicklung Universit&#228;t Bern</RefBookTitle>
        <RefPage></RefPage>
        <RefTotal>Universit&#228;t Bern. Kurse und Veranstaltungen Hochschuldidaktik &#38; Lehrentwicklung Universit&#228;t Bern. Bern: Universit&#228;t Bern; 2021. Zug&#228;nglich unter&#47;available from: https:&#47;&#47;zuw.me&#47;kurse&#47;index.php&#63;base&#61;hd</RefTotal>
        <RefLink>https:&#47;&#47;zuw.me&#47;kurse&#47;index.php&#63;base&#61;hd</RefLink>
      </Reference>
      <Reference refNo="20">
        <RefAuthor>Lenhard W</RefAuthor>
        <RefAuthor>Lenhard A</RefAuthor>
        <RefTitle></RefTitle>
        <RefYear>2016</RefYear>
        <RefBookTitle>Berechnung von Effektst&#228;rken</RefBookTitle>
        <RefPage></RefPage>
        <RefTotal>Lenhard W, Lenhard A. Berechnung von Effektst&#228;rken. Dettelbach: Psychometrica; 2016. DOI: 10.13140&#47;RG.2.2.17823.92329</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.13140&#47;RG.2.2.17823.92329</RefLink>
      </Reference>
      <Reference refNo="21">
        <RefAuthor>Molinari V</RefAuthor>
        <RefAuthor>Chacko RC</RefAuthor>
        <RefAuthor>Marmion J</RefAuthor>
        <RefAuthor>Adams GL</RefAuthor>
        <RefTitle>Geropsychiatry training of medical students in a community mental health center setting</RefTitle>
        <RefYear>1983</RefYear>
        <RefJournal>Gerontol Geriatr Educ</RefJournal>
        <RefPage>291-296</RefPage>
        <RefTotal>Molinari V, Chacko RC, Marmion J, Adams GL. Geropsychiatry training of medical students in a community mental health center setting. Gerontol Geriatr Educ. 1983;3(4):291-296. DOI: 10.1300&#47;J021v03n04&#95;07</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1300&#47;J021v03n04&#95;07</RefLink>
      </Reference>
      <Reference refNo="22">
        <RefAuthor>Diachun L</RefAuthor>
        <RefAuthor>Van Bussel L</RefAuthor>
        <RefAuthor>Hansen KT</RefAuthor>
        <RefAuthor>Charise A</RefAuthor>
        <RefAuthor>Rieder MJ</RefAuthor>
        <RefTitle>&#34;But I see old people everywhere&#34;: dispelling the myth that eldercare is learned in nongeriatric clerkships</RefTitle>
        <RefYear>2010</RefYear>
        <RefJournal>Acad Med</RefJournal>
        <RefPage>1221-1228</RefPage>
        <RefTotal>Diachun L, Van Bussel L, Hansen KT, Charise A, Rieder MJ. &#34;But I see old people everywhere&#34;: dispelling the myth that eldercare is learned in nongeriatric clerkships. Acad Med. 2010;85(7):1221-1228. DOI: 10.1097&#47;ACM.0b013e3181e0054f</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1097&#47;ACM.0b013e3181e0054f</RefLink>
      </Reference>
      <Reference refNo="23">
        <RefAuthor>Roane DM</RefAuthor>
        <RefAuthor>Tucker J</RefAuthor>
        <RefAuthor>Eisenstadt E</RefAuthor>
        <RefAuthor>Gomez M</RefAuthor>
        <RefAuthor>Kennedy GJ</RefAuthor>
        <RefTitle>Assessing the benefits of a geropsychiatric home-visit program for medical students</RefTitle>
        <RefYear>2012</RefYear>
        <RefJournal>Acad Psychiatry</RefJournal>
        <RefPage>216-218</RefPage>
        <RefTotal>Roane DM, Tucker J, Eisenstadt E, Gomez M, Kennedy GJ. Assessing the benefits of a geropsychiatric home-visit program for medical students. Acad Psychiatry. 2012;36(3):216-218. DOI: 10.1176&#47;appi.ap.09090156</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1176&#47;appi.ap.09090156</RefLink>
      </Reference>
      <Reference refNo="24">
        <RefAuthor>Blazek MC</RefAuthor>
        <RefAuthor>Struble L</RefAuthor>
        <RefAuthor>Cavalcante A</RefAuthor>
        <RefAuthor>Masse J</RefAuthor>
        <RefTitle>Medical Students in a Dementia Care Facility: an Enhanced Geriatric Psychiatry Experience</RefTitle>
        <RefYear>2016</RefYear>
        <RefJournal>Acad Psychiatry</RefJournal>
        <RefPage>932-934</RefPage>
        <RefTotal>Blazek MC, Struble L, Cavalcante A, Masse J. Medical Students in a Dementia Care Facility: an Enhanced Geriatric Psychiatry Experience. Acad Psychiatry. 2016;40(6):932-934. DOI: 10.1007&#47;s40596-015-0323-z</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1007&#47;s40596-015-0323-z</RefLink>
      </Reference>
      <Reference refNo="25">
        <RefAuthor>Ray-Griffith SL</RefAuthor>
        <RefAuthor>Krain L</RefAuthor>
        <RefAuthor>Messias E</RefAuthor>
        <RefAuthor>Wilkins KM</RefAuthor>
        <RefTitle>Fostering medical student interest in geriatrics and geriatric psychiatry</RefTitle>
        <RefYear>2016</RefYear>
        <RefJournal>Acad Psychiatry</RefJournal>
        <RefPage>960-961</RefPage>
        <RefTotal>Ray-Griffith SL, Krain L, Messias E, Wilkins KM. Fostering medical student interest in geriatrics and geriatric psychiatry. Acad Psychiatry. 2016;40(6):960-961. DOI: 10.1007&#47;s40596-015-0431-9</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1007&#47;s40596-015-0431-9</RefLink>
      </Reference>
      <Reference refNo="26">
        <RefAuthor>Pokrzywko K</RefAuthor>
        <RefAuthor>Torres-Platas SG</RefAuthor>
        <RefAuthor>Abdool PS</RefAuthor>
        <RefAuthor>Nassim M</RefAuthor>
        <RefAuthor>Semeniuk T</RefAuthor>
        <RefAuthor>Moussa Y</RefAuthor>
        <RefAuthor>Moussaoui G</RefAuthor>
        <RefAuthor>Leon C</RefAuthor>
        <RefAuthor>Baici W</RefAuthor>
        <RefAuthor>Wilkins-Ho M</RefAuthor>
        <RefAuthor>Blackburn P</RefAuthor>
        <RefAuthor>Friedland J</RefAuthor>
        <RefAuthor>Vasavan Nair NP</RefAuthor>
        <RefAuthor>Looper K</RefAuthor>
        <RefAuthor>Segal M</RefAuthor>
        <RefAuthor>Woo T</RefAuthor>
        <RefAuthor>Bruneau MA</RefAuthor>
        <RefAuthor>Rajji TK</RefAuthor>
        <RefAuthor>Rej S</RefAuthor>
        <RefTitle>Early clinical exposure to geriatric psychiatry and medical students&#39; interest in caring for older adults: a randomized controlled trial</RefTitle>
        <RefYear>2019</RefYear>
        <RefJournal>Am J Geriatr Psychiatry</RefJournal>
        <RefPage>745-751</RefPage>
        <RefTotal>Pokrzywko K, Torres-Platas SG, Abdool PS, Nassim M, Semeniuk T, Moussa Y, Moussaoui G, Leon C, Baici W, Wilkins-Ho M, Blackburn P, Friedland J, Vasavan Nair NP, Looper K, Segal M, Woo T, Bruneau MA, Rajji TK, Rej S. Early clinical exposure to geriatric psychiatry and medical students&#39; interest in caring for older adults: a randomized controlled trial. Am J Geriatr Psychiatry. 2019;27(7):745-751. DOI: 10.1016&#47;j.jagp.2019.03.004</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1016&#47;j.jagp.2019.03.004</RefLink>
      </Reference>
      <Reference refNo="27">
        <RefAuthor>Wilkins KM</RefAuthor>
        <RefAuthor>Blazek MC</RefAuthor>
        <RefAuthor>Brooks WB</RefAuthor>
        <RefAuthor>Lehmann SW</RefAuthor>
        <RefAuthor>Popeo D</RefAuthor>
        <RefAuthor>Wagenaar D</RefAuthor>
        <RefTitle>Six things all medical students need to know about geriatric psychiatry (and how to teach them)</RefTitle>
        <RefYear>2017</RefYear>
        <RefJournal>Acad Psychiatry</RefJournal>
        <RefPage>693-700</RefPage>
        <RefTotal>Wilkins KM, Blazek MC, Brooks WB, Lehmann SW, Popeo D, Wagenaar D. Six things all medical students need to know about geriatric psychiatry (and how to teach them). Acad Psychiatry. 2017;41(5):693-700. DOI: 10.1007&#47;s40596-017-0691-7</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1007&#47;s40596-017-0691-7</RefLink>
      </Reference>
      <Reference refNo="28">
        <RefAuthor>Isaacs B</RefAuthor>
        <RefAuthor>Nissenbaum H</RefAuthor>
        <RefTitle>Education in psychogeriatrics: the leap of the imagination</RefTitle>
        <RefYear>1989</RefYear>
        <RefJournal>Med Educ</RefJournal>
        <RefPage>453-456</RefPage>
        <RefTotal>Isaacs B, Nissenbaum H. Education in psychogeriatrics: the leap of the imagination. Med Educ. 1989;23(5):453-456. DOI: 10.1111&#47;j.1365-2923.1989.tb00901.x</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1111&#47;j.1365-2923.1989.tb00901.x</RefLink>
      </Reference>
      <Reference refNo="29">
        <RefAuthor>De Abreu ID</RefAuthor>
        <RefAuthor>Hinojosa-Lindsey M</RefAuthor>
        <RefAuthor>Asghar-Ali AA</RefAuthor>
        <RefTitle>A simulation exercise to raise learners&#39; awareness of the physical and cognitive changes in older adults</RefTitle>
        <RefYear>2017</RefYear>
        <RefJournal>Acad Psychiatry</RefJournal>
        <RefPage>684-687</RefPage>
        <RefTotal>De Abreu ID, Hinojosa-Lindsey M, Asghar-Ali AA. A simulation exercise to raise learners&#39; awareness of the physical and cognitive changes in older adults. Acad Psychiatry. 2017;41(5):684-687. DOI: 10.1007&#47;s40596-017-0775-4</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1007&#47;s40596-017-0775-4</RefLink>
      </Reference>
      <Reference refNo="30">
        <RefAuthor>Baessler F</RefAuthor>
        <RefAuthor>Ciprianidis A</RefAuthor>
        <RefAuthor>Rizvi AZ</RefAuthor>
        <RefAuthor>Weidlich J</RefAuthor>
        <RefAuthor>Wagner FL</RefAuthor>
        <RefAuthor>Klein SB</RefAuthor>
        <RefAuthor>Baumann TC</RefAuthor>
        <RefAuthor>Niken dei C</RefAuthor>
        <RefAuthor>Schultz JH</RefAuthor>
        <RefTitle>Delirium: medical students&#39; knowledge and effectiveness of different teaching methods</RefTitle>
        <RefYear>2019</RefYear>
        <RefJournal>Am J Geriatr Psychiatry</RefJournal>
        <RefPage>737-744</RefPage>
        <RefTotal>Baessler F, Ciprianidis A, Rizvi AZ, Weidlich J, Wagner FL, Klein SB, Baumann TC, Niken dei C, Schultz JH. Delirium: medical students&#39; knowledge and effectiveness of different teaching methods. Am J Geriatr Psychiatry. 2019;27(7):737-744. DOI: 10.1016&#47;j.jagp.2019.03.003</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1016&#47;j.jagp.2019.03.003</RefLink>
      </Reference>
      <Reference refNo="31">
        <RefAuthor>Besse M</RefAuthor>
        <RefAuthor>Wiltfang J</RefAuthor>
        <RefAuthor>Belz M</RefAuthor>
        <RefAuthor>Signerski-Krieger J</RefAuthor>
        <RefTitle>Einf&#252;hrung digitaler Lehre im Fach Psychiatrie als Reaktion auf COVID-19: eine vergleichende Evaluation zur Pr&#228;senzlehre.</RefTitle>
        <RefYear>2022</RefYear>
        <RefJournal>Nervenarzt</RefJournal>
        <RefPage>1-22</RefPage>
        <RefTotal>Besse M, Wiltfang J, Belz M, Signerski-Krieger J. Einf&#252;hrung digitaler Lehre im Fach Psychiatrie als Reaktion auf COVID-19: eine vergleichende Evaluation zur Pr&#228;senzlehre &#91;Implementation of digital teaching in psychiatry as cosequence of COVID-19: a comparative evaluation with classroom teaching&#93;. Nervenarzt. 2022;93:1-22. DOI: 10.1007&#47;s00115-021-01081-5</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1007&#47;s00115-021-01081-5</RefLink>
      </Reference>
      <Reference refNo="32">
        <RefAuthor>Hernandez CR</RefAuthor>
        <RefAuthor>Camp MM</RefAuthor>
        <RefTitle>Current Educational Practices for Major Neurocognitive Disorders in Psychiatry: a Scoping Review</RefTitle>
        <RefYear>2021</RefYear>
        <RefJournal>Acad Psychiatry</RefJournal>
        <RefPage>451-459</RefPage>
        <RefTotal>Hernandez CR, Camp MM. Current Educational Practices for Major Neurocognitive Disorders in Psychiatry: a Scoping Review. Acad Psychiatry. 2021;45:451-459. DOI: 10.1007&#47;s40596-021-01424-z</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1007&#47;s40596-021-01424-z</RefLink>
      </Reference>
      <Reference refNo="33">
        <RefAuthor>Goldstein MZ</RefAuthor>
        <RefAuthor>MaLossi RA</RefAuthor>
        <RefAuthor>Im K</RefAuthor>
        <RefAuthor>Young B</RefAuthor>
        <RefTitle>A course in dementia for third-year medical students</RefTitle>
        <RefYear>1999</RefYear>
        <RefJournal>Acad Psychiatry</RefJournal>
        <RefPage>142-150</RefPage>
        <RefTotal>Goldstein MZ, MaLossi RA, Im K, Young B. A course in dementia for third-year medical students. Acad Psychiatry. 1999;23(3):142-150. DOI: 10.1007&#47;BF03340042</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1007&#47;BF03340042</RefLink>
      </Reference>
      <Reference refNo="34">
        <RefAuthor>Halpain MC</RefAuthor>
        <RefAuthor>Jeste DV</RefAuthor>
        <RefAuthor>Trinidad GI</RefAuthor>
        <RefAuthor>Wetherell JL</RefAuthor>
        <RefAuthor>Lebowitz BD</RefAuthor>
        <RefTitle>Intensive short-term research training for undergraduate, graduate, and medical students: early experience with a new national-level approach in geriatric mental health</RefTitle>
        <RefYear>2005</RefYear>
        <RefJournal>Acad Psychiatry</RefJournal>
        <RefPage>58-65</RefPage>
        <RefTotal>Halpain MC, Jeste DV, Trinidad GI, Wetherell JL, Lebowitz BD. Intensive short-term research training for undergraduate, graduate, and medical students: early experience with a new national-level approach in geriatric mental health. Acad Psychiatry. 2005;29(1):58-65. DOI: 10.1176&#47;appi.ap.29.1.58</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1176&#47;appi.ap.29.1.58</RefLink>
      </Reference>
      <Reference refNo="35">
        <RefAuthor>McFarland K</RefAuthor>
        <RefAuthor>Rhoades D</RefAuthor>
        <RefAuthor>Roberts E</RefAuthor>
        <RefAuthor>Eleazer P</RefAuthor>
        <RefTitle>Teaching communication and listening skills to medical students using life review with older adults</RefTitle>
        <RefYear>2006</RefYear>
        <RefJournal>Gerontol Geriatr Educ</RefJournal>
        <RefPage>81-94</RefPage>
        <RefTotal>McFarland K, Rhoades D, Roberts E, Eleazer P. Teaching communication and listening skills to medical students using life review with older adults. Gerontol Geriatr Educ. 2006;27(1):81-94. DOI: 10.1300&#47;J021v27n01&#95;06</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1300&#47;J021v27n01&#95;06</RefLink>
      </Reference>
      <Reference refNo="36">
        <RefAuthor>Haque AF</RefAuthor>
        <RefAuthor>Soong DG</RefAuthor>
        <RefAuthor>Wong CL</RefAuthor>
        <RefTitle>Assessing the impact of a Geriatric Clinical Skills Day on medical students&#39; attitudes toward geriatrics</RefTitle>
        <RefYear>2014</RefYear>
        <RefJournal>Can Geriatr J</RefJournal>
        <RefPage>12-15</RefPage>
        <RefTotal>Haque AF, Soong DG, Wong CL. Assessing the impact of a Geriatric Clinical Skills Day on medical students&#39; attitudes toward geriatrics. Can Geriatr J. 2014;17(1):12-15. DOI: 10.5770&#47;cgj.17.74</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.5770&#47;cgj.17.74</RefLink>
      </Reference>
      <Reference refNo="37">
        <RefAuthor>Marin RS</RefAuthor>
        <RefAuthor>Forster JR</RefAuthor>
        <RefAuthor>Ford CV</RefAuthor>
        <RefAuthor>REifler BV</RefAuthor>
        <RefAuthor>Reisberg B</RefAuthor>
        <RefAuthor>Robinowitz CB</RefAuthor>
        <RefAuthor>Sledge WH</RefAuthor>
        <RefAuthor>Spar J</RefAuthor>
        <RefAuthor>Tighe PJ</RefAuthor>
        <RefTitle>A curriculum for education in geriatric psychiatry</RefTitle>
        <RefYear>1988</RefYear>
        <RefJournal>Am J Psychiatry</RefJournal>
        <RefPage>836-843</RefPage>
        <RefTotal>Marin RS, Forster JR, Ford CV, REifler BV, Reisberg B, Robinowitz CB, Sledge WH, Spar J, Tighe PJ. A curriculum for education in geriatric psychiatry. Am J Psychiatry. 1988;145(7):836-843. DOI: 10.1176&#47;ajp.145.7.836</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1176&#47;ajp.145.7.836</RefLink>
      </Reference>
      <Reference refNo="38">
        <RefAuthor>Zisook S</RefAuthor>
        <RefAuthor>Glick ID</RefAuthor>
        <RefAuthor>Jefferson JW</RefAuthor>
        <RefAuthor>Wagner KD</RefAuthor>
        <RefAuthor>Salzmann C</RefAuthor>
        <RefAuthor>Peselow ED</RefAuthor>
        <RefAuthor>Stahl S</RefAuthor>
        <RefTitle>Teaching psychopharmacology: what works and what doesn&#39;t</RefTitle>
        <RefYear>2008</RefYear>
        <RefJournal>J Clin Psychopharmacol</RefJournal>
        <RefPage>96-100</RefPage>
        <RefTotal>Zisook S, Glick ID, Jefferson JW, Wagner KD, Salzmann C, Peselow ED, Stahl S. Teaching psychopharmacology: what works and what doesn&#39;t. J Clin Psychopharmacol. 2008;28(1):96-100. DOI: 10.1097&#47;jcp.0b013e3181603f6b</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1097&#47;jcp.0b013e3181603f6b</RefLink>
      </Reference>
      <Reference refNo="39">
        <RefAuthor>Ribeiro O</RefAuthor>
        <RefAuthor>Fernandes L</RefAuthor>
        <RefAuthor>Firmino H</RefAuthor>
        <RefAuthor>Simoes MR</RefAuthor>
        <RefAuthor>Pa&#250;l C</RefAuthor>
        <RefTitle>Geropsychology and psychogeriatrics in Portugal: research, education and clinical training</RefTitle>
        <RefYear>2010</RefYear>
        <RefJournal>Int Psychogeriatr</RefJournal>
        <RefPage>854-863</RefPage>
        <RefTotal>Ribeiro O, Fernandes L, Firmino H, Simoes MR, Pa&#250;l C. Geropsychology and psychogeriatrics in Portugal: research, education and clinical training. Int Psychogeriatr. 2010;22(6):854-863. DOI: 10.1017&#47;S1041610210000347</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1017&#47;S1041610210000347</RefLink>
      </Reference>
      <Reference refNo="40">
        <RefAuthor>Sch&#228;fer M</RefAuthor>
        <RefAuthor>Georg W</RefAuthor>
        <RefAuthor>M&#252;hlinghaus I</RefAuthor>
        <RefAuthor>Fr&#246;hmel A</RefAuthor>
        <RefAuthor>Rolle D</RefAuthor>
        <RefAuthor>Pruskil S</RefAuthor>
        <RefAuthor>Heinz A</RefAuthor>
        <RefAuthor>Burger W</RefAuthor>
        <RefTitle>Neue Lehr-und Pr&#252;fungsformen im Fach Psychiatrie.</RefTitle>
        <RefYear>2007</RefYear>
        <RefJournal>Nervenarzt</RefJournal>
        <RefPage>283-293</RefPage>
        <RefTotal>Sch&#228;fer M, Georg W, M&#252;hlinghaus I, Fr&#246;hmel A, Rolle D, Pruskil S, Heinz A, Burger W. Neue Lehr-und Pr&#252;fungsformen im Fach Psychiatrie. &#91;Experience with new teaching methods and testing in psychiatric training&#93;. Nervenarzt. 2007;78(3):283-293. DOI: 10.1007&#47;s00115-005-2048-9</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1007&#47;s00115-005-2048-9</RefLink>
      </Reference>
      <Reference refNo="41">
        <RefAuthor>Blazek MC</RefAuthor>
        <RefAuthor>Wagenaar DB</RefAuthor>
        <RefAuthor>Brooks WB</RefAuthor>
        <RefAuthor>Lehmann SW</RefAuthor>
        <RefAuthor>Popeo DM</RefAuthor>
        <RefAuthor>Holland P</RefAuthor>
        <RefAuthor>Wilkins KM</RefAuthor>
        <RefTitle>Filling the Gap in Geriatric Psychiatry Education for Medical Students: Development of the ADMSEP Annotated Bibliography of Web-Based Resources on Geriatric Mental Health for Medical Student Education</RefTitle>
        <RefYear>2020</RefYear>
        <RefJournal>Acad Psychiatry</RefJournal>
        <RefPage>517-520</RefPage>
        <RefTotal>Blazek MC, Wagenaar DB, Brooks WB, Lehmann SW, Popeo DM, Holland P, Wilkins KM. Filling the Gap in Geriatric Psychiatry Education for Medical Students: Development of the ADMSEP Annotated Bibliography of Web-Based Resources on Geriatric Mental Health for Medical Student Education. Acad Psychiatry. 2020;45:517-520. DOI: 10.1007&#47;s40596-020-01263-4</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1007&#47;s40596-020-01263-4</RefLink>
      </Reference>
      <Reference refNo="42">
        <RefAuthor>Karel MJ</RefAuthor>
        <RefAuthor>Emery EE</RefAuthor>
        <RefAuthor>Molinari V</RefAuthor>
        <RefTitle>Development of a tool to evaluate geropsychology knowledge and skill competencies</RefTitle>
        <RefYear>2010</RefYear>
        <RefJournal>Int Psychogeriatr</RefJournal>
        <RefPage>886-896</RefPage>
        <RefTotal>Karel MJ, Emery EE, Molinari V. Development of a tool to evaluate geropsychology knowledge and skill competencies. Int Psychogeriatr. 2010;22(6):886-896. DOI: 10.1017&#47;S1041610209991736</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1017&#47;S1041610209991736</RefLink>
      </Reference>
      <Reference refNo="43">
        <RefAuthor>Diachun LL</RefAuthor>
        <RefAuthor>Klages KB</RefAuthor>
        <RefAuthor>Hansen KT</RefAuthor>
        <RefAuthor>Blake K</RefAuthor>
        <RefAuthor>Gordon J</RefAuthor>
        <RefTitle>The comprehensive geriatric assessment guide: An exploratory analysis of a medical trainee performance evaluation tool</RefTitle>
        <RefYear>2012</RefYear>
        <RefJournal>Acad Med</RefJournal>
        <RefPage>1679-1684</RefPage>
        <RefTotal>Diachun LL, Klages KB, Hansen KT, Blake K, Gordon J. The comprehensive geriatric assessment guide: An exploratory analysis of a medical trainee performance evaluation tool. Acad Med. 2012;87(12):1679-1684. DOI: 10.1097&#47;ACM.0b013e318271cad8</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1097&#47;ACM.0b013e318271cad8</RefLink>
      </Reference>
      <Reference refNo="44">
        <RefAuthor>Siegel B</RefAuthor>
        <RefAuthor>Kreuder T</RefAuthor>
        <RefAuthor>Ludwig M</RefAuthor>
        <RefAuthor>Anderson-Schmidt H</RefAuthor>
        <RefAuthor>Signerski-Krieger J</RefAuthor>
        <RefTitle>Staatsexamensanalyse hinsichtlich psychiatrisch relevanter Themen.</RefTitle>
        <RefYear>2017</RefYear>
        <RefJournal>Nervenarzt</RefJournal>
        <RefPage>1058-1064</RefPage>
        <RefTotal>Siegel B, Kreuder T, Ludwig M, Anderson-Schmidt H, Signerski-Krieger J. Staatsexamensanalyse hinsichtlich psychiatrisch relevanter Themen &#91;Analysis of the German state medical examination regarding psychiatrically relevant topics&#93;. Nervenarzt. 2017;88(9):1058-1064. DOI: 10.1007&#47;s00115-016-0151-8</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1007&#47;s00115-016-0151-8</RefLink>
      </Reference>
      <Reference refNo="45">
        <RefAuthor>Curran MA</RefAuthor>
        <RefAuthor>Black M</RefAuthor>
        <RefAuthor>Depp CA</RefAuthor>
        <RefAuthor>Iglewicz A</RefAuthor>
        <RefAuthor>Reichstadt J</RefAuthor>
        <RefAuthor>Palinkas L</RefAuthor>
        <RefAuthor>Jeste DV</RefAuthor>
        <RefTitle>Perceived barriers and facilitators for an academic career in geriatrics: Medical students&#39; perspectives</RefTitle>
        <RefYear>2015</RefYear>
        <RefJournal>Acad Psychiatry</RefJournal>
        <RefPage>253-258</RefPage>
        <RefTotal>Curran MA, Black M, Depp CA, Iglewicz A, Reichstadt J, Palinkas L, Jeste DV. Perceived barriers and facilitators for an academic career in geriatrics: Medical students&#39; perspectives. Acad Psychiatry. 2015;39(3):253-258. DOI: 10.1007&#47;s40596-014-0208-6</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1007&#47;s40596-014-0208-6</RefLink>
      </Reference>
      <Reference refNo="46">
        <RefAuthor>Paniagua M</RefAuthor>
        <RefAuthor>van Zuilen M</RefAuthor>
        <RefAuthor>Silver I</RefAuthor>
        <RefTitle>The &#34;Three D&#39;s&#34; of Cognitive Impairment: An Interactive Card-sorting Exercise</RefTitle>
        <RefYear>2006</RefYear>
        <RefJournal>MedEdPORTAL</RefJournal>
        <RefPage></RefPage>
        <RefTotal>Paniagua M, van Zuilen M, Silver I. The &#34;Three D&#39;s&#34; of Cognitive Impairment: An Interactive Card-sorting Exercise. MedEdPORTAL. 2006. DOI: 10.15766&#47;mep&#95;2374-8265.243</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.15766&#47;mep&#95;2374-8265.243</RefLink>
      </Reference>
      <Reference refNo="47">
        <RefAuthor>Bienenfeld D</RefAuthor>
        <RefTitle>Geriatric Psychiatry: Substance Abuse and Aging</RefTitle>
        <RefYear>20123</RefYear>
        <RefJournal>MedEdPORTAL</RefJournal>
        <RefPage></RefPage>
        <RefTotal>Bienenfeld D. Geriatric Psychiatry: Substance Abuse and Aging. MedEdPORTAL. 2012. DOI: 10.15766&#47;mep&#95;2374-8265.9258</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.15766&#47;mep&#95;2374-8265.9258</RefLink>
      </Reference>
      <Reference refNo="48">
        <RefAuthor>Rockefeller K</RefAuthor>
        <RefAuthor>Blazek M</RefAuthor>
        <RefAuthor>Kavanagh J</RefAuthor>
        <RefAuthor>Kales H</RefAuthor>
        <RefTitle>The University of Michigan Pocket Guide for Clinician-in-training Assessment of the Neuropsychiatric Symptoms of Dementia</RefTitle>
        <RefYear>2013</RefYear>
        <RefJournal>MedEdPORTAL</RefJournal>
        <RefPage></RefPage>
        <RefTotal>Rockefeller K, Blazek M, Kavanagh J, Kales H. The University of Michigan Pocket Guide for Clinician-in-training Assessment of the Neuropsychiatric Symptoms of Dementia. MedEdPORTAL. 2013. DOI: 10.15766&#47;mep&#95;2374-8265.9514</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.15766&#47;mep&#95;2374-8265.9514</RefLink>
      </Reference>
      <Reference refNo="49">
        <RefAuthor>Cheng H</RefAuthor>
        <RefTitle>Falls and Fall Prevention</RefTitle>
        <RefYear>2014</RefYear>
        <RefJournal>MedEdPORTAL</RefJournal>
        <RefPage></RefPage>
        <RefTotal>Cheng H. Falls and Fall Prevention. MedEdPORTAL. 2014. DOI: 10.15766&#47;mep&#95;2374-8265.9910</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.15766&#47;mep&#95;2374-8265.9910</RefLink>
      </Reference>
      <Reference refNo="50">
        <RefAuthor>Blazek M</RefAuthor>
        <RefTitle>Geriatric psychiatry: just so you know</RefTitle>
        <RefYear>2014</RefYear>
        <RefJournal>MedEdPORTAL</RefJournal>
        <RefPage></RefPage>
        <RefTotal>Blazek M. Geriatric psychiatry: just so you know. MedEdPORTAL. 2014. DOI: 10.15766&#47;mep&#95;2374-8265.9722</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.15766&#47;mep&#95;2374-8265.9722</RefLink>
      </Reference>
      <Reference refNo="51">
        <RefAuthor>Agness-Whittaker CF</RefAuthor>
        <RefAuthor>Macedo L</RefAuthor>
        <RefTitle>Aging, culture, and health communication: exploring personal cultural health beliefs and strategies to facilitate cross-cultural communication with older adults</RefTitle>
        <RefYear>2016</RefYear>
        <RefJournal>MedEdPORTAL</RefJournal>
        <RefPage></RefPage>
        <RefTotal>Agness-Whittaker CF, Macedo L. Aging, culture, and health communication: exploring personal cultural health beliefs and strategies to facilitate cross-cultural communication with older adults. MedEdPORTAL. 2016. DOI: 10.15766&#47;mep&#95;2374-8265.10374</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.15766&#47;mep&#95;2374-8265.10374</RefLink>
      </Reference>
      <Reference refNo="52">
        <RefAuthor>Lehmann SW</RefAuthor>
        <RefAuthor>Hemming P</RefAuthor>
        <RefAuthor>Rios R</RefAuthor>
        <RefAuthor>Meriden Z</RefAuthor>
        <RefTitle>Recognizing and managing geriatric depression: a two-part self-learning module set</RefTitle>
        <RefYear>2017</RefYear>
        <RefJournal>MedEdPORTAL</RefJournal>
        <RefPage></RefPage>
        <RefTotal>Lehmann SW, Hemming P, Rios R, Meriden Z. Recognizing and managing geriatric depression: a two-part self-learning module set. MedEdPORTAL. 2017. DOI: 10.15766&#47;mep&#95;2374-8265.10537</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.15766&#47;mep&#95;2374-8265.10537</RefLink>
      </Reference>
      <Reference refNo="53">
        <RefAuthor>Mulligan R</RefAuthor>
        <RefAuthor>Gilmer-Scott M</RefAuthor>
        <RefAuthor>Kouchel D</RefAuthor>
        <RefAuthor>Nickelson D</RefAuthor>
        <RefAuthor>Safavi A</RefAuthor>
        <RefAuthor>Drickamer M</RefAuthor>
        <RefAuthor>Roberts E</RefAuthor>
        <RefTitle>Unintentional weight loss in older adults: a geriatric interprofessional simulation case series for health care providers</RefTitle>
        <RefYear>2017</RefYear>
        <RefJournal>MedEdPORTAL</RefJournal>
        <RefPage></RefPage>
        <RefTotal>Mulligan R, Gilmer-Scott M, Kouchel D, Nickelson D, Safavi A, Drickamer M, Roberts E. Unintentional weight loss in older adults: a geriatric interprofessional simulation case series for health care providers. MedEdPORTAL. 2017. DOI: 10.15766&#47;mep&#95;2374-8265.10631</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.15766&#47;mep&#95;2374-8265.10631</RefLink>
      </Reference>
      <Reference refNo="54">
        <RefAuthor>Bligh DA</RefAuthor>
        <RefTitle></RefTitle>
        <RefYear>2000</RefYear>
        <RefBookTitle>What&#39;s the use of lectures&#63;</RefBookTitle>
        <RefPage></RefPage>
        <RefTotal>Bligh DA. What&#39;s the use of lectures&#63; 1st U.S. ed. San Francisco: Jossey-Bass; 2000.</RefTotal>
      </Reference>
      <Reference refNo="55">
        <RefAuthor>Wahl D</RefAuthor>
        <RefTitle></RefTitle>
        <RefYear>2013</RefYear>
        <RefBookTitle>Lernumgebungen erfolgreich gestalten: Vom tr&#228;gen Wissen zum kompetenten Handeln</RefBookTitle>
        <RefPage></RefPage>
        <RefTotal>Wahl D. Lernumgebungen erfolgreich gestalten: Vom tr&#228;gen Wissen zum kompetenten Handeln. Bad Heilbrunn: Julius Klinkhardt; 2013.</RefTotal>
      </Reference>
      <Reference refNo="56">
        <RefAuthor>Symons CS</RefAuthor>
        <RefAuthor>Johnson BT</RefAuthor>
        <RefTitle>The self-reference effect in memory: a meta-analysis</RefTitle>
        <RefYear>1997</RefYear>
        <RefJournal>Psychol Bull</RefJournal>
        <RefPage>371-394</RefPage>
        <RefTotal>Symons CS, Johnson BT. The self-reference effect in memory: a meta-analysis. Psychol Bull. 1997;121(3):371-394. DOI: 10.1037&#47;0033-2909.121.3.371</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1037&#47;0033-2909.121.3.371</RefLink>
      </Reference>
      <Reference refNo="57">
        <RefAuthor>Biggs J</RefAuthor>
        <RefAuthor>Tang C</RefAuthor>
        <RefTitle></RefTitle>
        <RefYear>2011</RefYear>
        <RefBookTitle>Teaching for quality learning at university: What the Student does</RefBookTitle>
        <RefPage></RefPage>
        <RefTotal>Biggs J, Tang C. Teaching for quality learning at university: What the Student does. 4th edition. New York, USA: Society for Research into Higher Education&#47;Open Univ. Press; 2011.</RefTotal>
      </Reference>
      <Reference refNo="58">
        <RefAuthor>Shah A</RefAuthor>
        <RefAuthor>Gasner A</RefAuthor>
        <RefAuthor>Bracken K</RefAuthor>
        <RefAuthor>Scott I</RefAuthor>
        <RefAuthor>Kelly MA</RefAuthor>
        <RefAuthor>Palombo A</RefAuthor>
        <RefTitle>Early generalist placements are associated with family medicine career choice: a systematic review and meta-analysis</RefTitle>
        <RefYear>2021</RefYear>
        <RefJournal>Med Educ</RefJournal>
        <RefPage>1242-1252</RefPage>
        <RefTotal>Shah A, Gasner A, Bracken K, Scott I, Kelly MA, Palombo A. Early generalist placements are associated with family medicine career choice: a systematic review and meta-analysis. Med Educ. 2021;55(11):1242-1252. DOI: 10.1111&#47;medu.14578</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1111&#47;medu.14578</RefLink>
      </Reference>
      <Reference refNo="59">
        <RefAuthor>Bartels SJ</RefAuthor>
        <RefAuthor>Lebowitz BD</RefAuthor>
        <RefAuthor>Reynolds 3rd CF</RefAuthor>
        <RefAuthor>Bruce ML</RefAuthor>
        <RefAuthor>Halpain M</RefAuthor>
        <RefAuthor>Faison WE</RefAuthor>
        <RefAuthor>Kirwin PD</RefAuthor>
        <RefTitle>Programs for developing the pipeline of early-career geriatric mental health researchers: Outcomes and implications for other fields</RefTitle>
        <RefYear>2010</RefYear>
        <RefJournal>Acad Med</RefJournal>
        <RefPage>26-35</RefPage>
        <RefTotal>Bartels SJ, Lebowitz BD, Reynolds 3rd CF, Bruce ML, Halpain M, Faison WE, Kirwin PD. Programs for developing the pipeline of early-career geriatric mental health researchers: Outcomes and implications for other fields. Acad Med. 2010;85(1):26-35. DOI: 10.1097&#47;ACM.0b013e3181c482cb</RefTotal>
        <RefLink>https:&#47;&#47;doi.org&#47;10.1097&#47;ACM.0b013e3181c482cb</RefLink>
      </Reference>
    </References>
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