BACKGROUND

Internationalization in medical education aims to align programs with global standards, foster intercultural competence, and expand academic collaboration. In private medical schools in Northern Luzon, clarifying how internationalization is conceptualized and enacted can enhance the medical curriculum.

OBJECTIVE

To explore how private medical schools in Northern Luzon conceptualize and implement internationalization, identify associated challenges, and propose curriculum inputs to enhance delivery of the medical curriculum.

METHODS

The qualitative study utilized a multiple case study design. The study was approved by the Saint Louis University Research Ethics Committee. Using purposive sampling, 45 participants from private institutions in Northern Luzon Philippines consented to engage in focus group discussions and in-depth interviews from February to April 2025. Data were analyzed through inductive content and thematic techniques.

RESULTS

Participants conceptualized internationalization as (1) alignment with international quality and practice standards; (2) global engagement and exchange encompassing knowledge, skills, culture, institutional networking, and collaboration; (3) inclusivity and multicultural responsiveness; and (4) pursuit of global recognition and accreditation. Implementation occurred via “internationalization at home” (embedding global perspectives in local learning environments), “internationalization abroad” (student/faculty mobility and external exposure), and alignment of philosophical and curricular frameworks. Reported challenges included institutional and curricular constraints, language and cultural barriers, sociocultural and financial limitations, and external/contextual pressures.

CONCLUSION

Addressing the identified barriers and scaling the documented practices can enhance the delivery of the medical curriculum. The study offers actionable curricular revisions that private institutions may adopt to strengthen internationalization in medical education.

Schools, Medical ; Reference Standards ; Mental Competency ; Education, Medical ; Case Reports ; Education ; Curriculum ; International Cooperation ; Cultural Competency

BACKGROUND

Internationalization in medical education aims to align programs with global standards, foster intercultural competence, and expand academic collaboration. In private medical schools in Northern Luzon, clarifying how internationalization is conceptualized and enacted can enhance the medical curriculum.

OBJECTIVE

To explore how private medical schools in Northern Luzon conceptualize and implement internationalization, identify associated challenges, and propose curriculum inputs to enhance delivery of the medical curriculum.

METHODS

The qualitative study utilized a multiple case study design. The study was approved by the Saint Louis University Research Ethics Committee. Using purposive sampling, 45 participants from private institutions in Northern Luzon Philippines consented to engage in focus group discussions and in-depth interviews from February to April 2025. Data were analyzed through inductive content and thematic techniques.

RESULTS

Participants conceptualized internationalization as (1) alignment with international quality and practice standards; (2) global engagement and exchange encompassing knowledge, skills, culture, institutional networking, and collaboration; (3) inclusivity and multicultural responsiveness; and (4) pursuit of global recognition and accreditation. Implementation occurred via “internationalization at home” (embedding global perspectives in local learning environments), “internationalization abroad” (student/faculty mobility and external exposure), and alignment of philosophical and curricular frameworks. Reported challenges included institutional and curricular constraints, language and cultural barriers, sociocultural and financial limitations, and external/contextual pressures.

CONCLUSION

Addressing the identified barriers and scaling the documented practices can enhance the delivery of the medical curriculum. The study offers actionable curricular revisions that private institutions may adopt to strengthen internationalization in medical education.

Schools, Medical ; Reference Standards ; Mental Competency ; Education, Medical ; Case Reports ; Education ; Curriculum ; International Cooperation ; Cultural Competency

INTRODUCTIONThe Short Portable Mental Status Questionnaire (SPMSQ) is a brief cognitive screening instrument, which is easy to use by a healthcare worker with little training. However, the validity of this instrument has not been established in Singapore. Thus, the primary aim of this study was to determine the diagnostic performance of SPMSQ for screening dementia among patients attending outpatient cognitive assessment clinics and to assess whether the appropriate cut-off score varies by patient's age and education. A secondary aim of the study was to map the SPMSQ scores with Mini-Mental State Examination (MMSE) scores.

MATERIALS AND METHODSSPMSQ and MMSE were administered by a trained interviewer to 127 patients visiting outpatient cognitive assessment clinics at the Singapore General Hospital, Changi General Hospital and Tan Tock Seng Hospital. The geriatricians at these clinics then diagnosed these patients with dementia or no dementia (reference standard). Sensitivity and specificity of SPMSQ with different cut-off points (number of errors) were calculated and compared to the reference standard using the Receiver Operator Characteristic (ROC) analysis. Correlation coefficient was also calculated between MMSE and SPMSQ scores.

RESULTSBased on the ROC analysis and a balance of sensitivity and specificity, the appropriate cut-off for SPMSQ was found to be 5 or more errors (sensitivity 78%, specificity 75%). The cut-off varied by education, but not by patient's age. There was a high correlation between SPMSQ and MMSE scores (r = 0.814, P <0.0001).

CONCLUSIONDespite the advantage of being a brief screening instrument for dementia, the use of SPMSQ is limited by its low sensitivity and specificity, especially among patients with less than 6 years of education.

Age Factors ; Aged ; Aged, 80 and over ; Ambulatory Care Facilities ; statistics & numerical data ; Comparative Effectiveness Research ; Dementia ; diagnosis ; epidemiology ; psychology ; Educational Status ; Female ; Geriatric Assessment ; methods ; statistics & numerical data ; Humans ; Intelligence Tests ; standards ; statistics & numerical data ; Male ; Mass Screening ; methods ; standards ; Mental Competency ; Middle Aged ; ROC Curve ; Reference Standards ; Reproducibility of Results ; Singapore ; epidemiology

Competency to stand trial relates directly to legal rights of the appraised individual as well as whether criminal procedure can be carried out smoothly. Foreign scholars have conducted a large number of theoretical researches, and developed a series of standardized evaluation tools. However, the assessment on competency to stand trial has mainly focused on medical criteria in China for a long time, and most cases were judged by forensic psychiatrists' experience. Recently, Chinese scholars have started the initial research on standardized evaluation. This paper reviews the notion of competency to stand trial, the evaluation criteria, and the assessment tools domestically and abroad. The main focus is on foreign assessment tools, which included three categories. First category includes checklist, self-report questionnaires and sentence-completion tasks. Second category is the interview-based instruments without criterion-based scoring. Last category is the interview-based instruments with criterion-based scoring. This literature may be helpful for further research and standardization on assessment tools of competency to stand trial of mentally disordered offenders.
Crime/psychology* ; Criminal Law/legislation & jurisprudence* ; Criminals/psychology* ; Forensic Psychiatry/standards* ; Humans ; Insanity Defense ; Mental Competency/psychology* ; Mental Disorders/psychology* ; Psychiatric Status Rating Scales ; Psychological Tests ; Reference Standards ; Reproducibility of Results ; Surveys and Questionnaires

Testamentary capacity is one of the civil competences, it means that a natural person enjoys the capacity or qualification to establish testament and deal with his property. Recently, the cases of testamentary capacity assessment of the mentally disordered are increasing. This article firstly introduces the concepts of the testament as well as the testamentary capacity, and then summarizes the assessment standard of the testamentary capacity, by using the Banks v. Goodfellow case as a basis to make the standard criteria including: the understanding of the nature of a will and codicil, the knowledge of the general extent of one's assets, the knowledge of the natural object of one's bounty, the understanding of the impact of the distribution of the assets of the estate, and the absence of a delusion specifically affecting the distribution of the estate. The impact factors of the testamentary capacity, including dementia, mood disorder, schizophrenia, alcohol, drug, and undue influence, etc., are summarized. Lastly, the related assessment tools such as the Mini-Mental State Examination, the Clock-Drawing Test, and the Testament Definition Scale are introduced briefly.
Alcoholism/psychology* ; Dementia/psychology* ; Expert Testimony/standards* ; Forensic Psychiatry ; Humans ; Mental Competency/standards* ; Mental Disorders/psychology* ; Mental Status Schedule ; Wills/legislation & jurisprudence*

Schizophrenia is the most common in forensic psychiatry. The motive, the style and the consequence of any schizophrene's misdeed have its own particularity. So schizophrenia is significant in the forensic practice. The characteristics of schizophrene's misdeed and the peace breaker's responsibility, competence to stand trial and to serve a sentence werereviewed.
Crime/psychology* ; Expert Testimony/standards* ; Forensic Psychiatry/standards* ; Humans ; Liability, Legal ; Mental Competency/legislation & jurisprudence* ; Schizophrenia

OBJECTIVETo test the reliability and validity of two mental workload assessment scales, i.e. subjective workload assessment technique (SWAT) and NASA task load index (NASA-TLX).

METHODSOne thousand two hundred and sixty-eight mental workers were sampled from various kinds of occupations, such as scientific research, education, administration and medicine, etc, with randomized cluster sampling. The re-test reliability, split-half reliability, Cronbach's alpha coefficient and correlation coefficients between item score and total score were adopted to test the reliability. The test of validity included structure validity.

RESULTSThe re-test reliability coefficients of these two scales and their items were ranged from 0.516 to 0.753 (P < 0.01), indicating the two scales had good re-test reliability; the split-half reliability of SWAT was 0.645, and its Cronbach's alpha coefficient was more than 0.80, all the correlation coefficients between its items score and total score were more than 0.70; as for NASA-TLX, both the split-half reliability and Cronbach's alpha coefficient were more than 0.80, the correlation coefficients between its items score and total score were all more than 0.60 (P < 0.01) except the item of performance. Both scales had good inner consistency. The Pearson correlation coefficient between the two scales was 0.492 (P < 0.01), implying the results of the two scales had good consistency. Factor analysis showed that the two scales had good structure validity.

CONCLUSIONBoth SWAT and NASA-TLX have good reliability and validity and may be used as a valid tool to assess mental workload in China after being revised properly.

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Mental Competency ; Middle Aged ; Occupational Health ; Reproducibility of Results ; Sampling Studies ; Self-Assessment ; Surveys and Questionnaires ; standards ; Task Performance and Analysis ; Workload

PURPOSE: With a sample of cognitively impaired nursing home residents and nursing staff, the following were examined 1) the proportion and nature of aggressive behavior, 2) the frequency and types of aggressive behavior, 3) the difference between the residents who demonstrate aggressive behavior and those who do not demonstrate aggressive behavior (age, mental status, functional status, and pain, length of nursing home stay), and 4) nursing staff responses to aggressive behavior by residents. METHODS: A cross-sectional descriptive study design was used. Data were collected from cognitively impaired nursing home residents (N=205) and nursing staff (N=60) at two nursing homes using Ryden Aggression Scale I and II, Mini-Mental State Exam, Modified Barthel Index, Verbal Descriptor Scale, and aggressive behavior management questionnaire. Data were analyzed using descriptive statistics including t-test. RESULTS: About 62.9% residents were found to be aggressive and 38.5% were both physically and verbally aggressive. Pushing, making threatening gestures, hitting, slapping, cursing/obscene/vulgar languages, making verbal threats were occurred frequently. Aggressive residents were significantly older, had more cognitive impairment, had more pain, and stayed longer in the nursing home when compared with non-aggressive residents. Considerable proportion of nursing staff responded to aggressive behaviors inadequately. CONCLUSION: Aggressive behavior among cognitively impaired nursing home residents is prevalent thus needs to be prevented and reduced. Along with environmental modification, educational programs for nursing staff and family caregivers need to be developed and implemented so that they can have extensive knowledge and skills to manage aggressive behaviors.
Aged ; Aged, 80 and over ; *Aggression/psychology ; Attitude of Health Personnel ; Case-Control Studies ; Clinical Competence/standards ; Cognition Disorders/*complications/nursing ; Cross-Sectional Studies ; Education, Nursing, Continuing ; Female ; Geriatric Assessment ; Geriatric Nursing/education/organization & administration ; Health Services Needs and Demand ; Humans ; Inservice Training ; Korea/epidemiology ; Male ; Mental Competency ; *Nursing Homes ; Nursing Staff/education/psychology ; Prevalence ; Psychomotor Agitation/epidemiology/*etiology/prevention & control/psychology ; Questionnaires ; Risk Factors

OBJECTIVE: To create an instrument to determine the mental disorder offenders' competency to stand trial, which is according with the Chinese legal system. METHODS: Integrating the foreign instruments and the Chinese criminal jurisprudence, and combing the authors' forensic psychiatric experience, the research team created an instrument which was called Competency to stand trial Determining Instrument firstly, then used the instrument in practice, in the end the validity and reliability of the instrument were inspected, and through an diagnostic test, the feasibility of the instrument was evaluated. RESULTS: Split-half and homogeneity reliability of the instrument is 0.9366 and 0.9213 respectively, the correspondence of the conclusion between the instrument and the expertise is 0.704. Except the sensitivity is 0.6097, all the other diagnostic index are over 0.80. CONCLUSION The Competency to stand trial Determining Instrument is feasible.
Expert Testimony ; Forensic Psychiatry/methods* ; Humans ; Mental Competency/standards* ; Mental Disorders/psychology* ; Psychiatric Status Rating Scales ; Reproducibility of Results ; Surveys and Questionnaires

OBJECTIVE: Explore the affecting factors of mentally prisoner's competency to serve a sentence (CSS), establish the base of quantitative study of CSS. METHODS: Firstly, the researchers compile a questionnaire named legal-psycho ability of competency to serve a sentence questionnaire, then the researchers scaling the object with RTHD, and ask all object complete the questionnaire. there a hypothesis, that the object who are cured in cured ward is incompetent to serve a sentence (ISS), and the other who are stay in rehabilitated ward is competent to serve a sentence (CSS). RESULTS: There are 185 object admitted the study, the ISS group the CSS group have significance between psychiatric and legal aspects. CONCLUSION At the influence of psychiatric symptoms, the mentally prisoner's competency to serve a sentence had been impaired, and they should been transferred from prison to hospital.
Adult ; Expert Testimony/standards* ; Female ; Forensic Psychiatry ; Humans ; Male ; Mental Competency ; Mental Disorders/psychology* ; Mentally Ill Persons/psychology* ; Middle Aged ; Prisoners/psychology* ; Surveys and Questionnaires