Hostname: page-component-cd4964975-pf4mj Total loading time: 0 Render date: 2023-03-29T17:52:00.114Z Has data issue: true Feature Flags: { "useRatesEcommerce": false } hasContentIssue true

Piloting the global capacity education e-tool: can capacity be taught to health care professionals across different international jurisdictions?

Published online by Cambridge University Press:  16 July 2019

Carmelle Peisah*
School of Psychiatry, Faculty of Medicine, University of New South Wales Sydney, Sydney, NSW, Australia Discipline of Psychiatry, Sydney University Medical School, Sydney, NSW, Australia Capacity Australia, Kensington, NSW, Australia
Yaffa Lerman
Geriatric Department, Tel Aviv Medical Centre, Tel Aviv, Israel Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
Nathan Herrmann
Department of Psychiatry, Sunnybrook Health Sciences Centre, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
Jeremy Rezmovitz
Department of Family & Community Medicine, Sunnybrook Health Sciences Centre, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
Kenneth Shulman
Department of Psychiatry, Sunnybrook Health Sciences Centre, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
Correspondence should be addressed to: Carmelle Peisah, University of NSW, Randwick, Sydney, New South Wales, 2031, Australia. Email:


Determining decision-making capacity is part of everyday business for health care professionals working with older adults. We used a modified Delphi approach to develop an inclusive curriculum for a capacity education e-tool with global application and clinical relevance to a range of disciplines. The tool comprised: (i) 25 questions forming a “pre-test” for the adaptive and personalized e-Learning platform; (ii) a learning module based on the participant’s response to the “pre-test”; (iii) a “post-test” (the same baseline 25 questions) to test knowledge translation. The tool was tested on 31 health care professionals across Israel (8), Canada (15), and Australia (8) from the following disciplines: General Practitioners (GP) (19), Internal Medicine (1), Palliative Care GP (2); Palliative Care Physician (2), Geriatrician (2); and one of each: Psychologist, Occupational Therapist, Psychiatrist, Aged Care Researcher, and Aged Care Pharmacist. The mean baseline pre-test score was 19.1/25 (S.D. =1.61; range 15–22) and post-test score 21.7/25 (S.D.= 1.42; range 18–24); with a highly significant improvement in test scores (paired t-test P < 0.0001; t=10.81 on 30 df). This is the first such pilot study to demonstrate that generic capacity principles can be taught to health care professionals from different disciplines regardless of jurisdiction.

Brief Report
© International Psychogeriatric Association 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Appelbaum, P. S. (2007) Assessment of patients’ competence to consent to treatment. The New England Journal of Medicine, 357, 18341840.CrossRefGoogle ScholarPubMed
Gurian, B. S., Baker, E. H., Jacobson, S., Lagerbom, B. and Watts, P. (1990) Informed consent for neuroleptics with elderly patients in two settings. Journal of the American Geriatrics Society, 38, 3744.CrossRefGoogle ScholarPubMed
Kim, S. Y. et al. (2011). Variability of judgments of capacity: experience of capacity evaluators in a study of research consent capacity. Psychosomatics, 52, 346353.CrossRefGoogle Scholar
Marcus, N., Ben-Naim, D. and Bain, M. (2011). Instructional support for teachers and guided feedback for students in an adaptive elearning environment. In: Latifi, S. (Ed.), 2011 Eighth International Conference on Information Technology: New Generations (pp. 626-631). Los Alamitos, CA: IEEE.Google Scholar
Markson, L. J., Kern, D. C., Annas, G. J. and Glantz, L. H. (1994) Physician assessment of patient competence. Journal of the American Geriatrics Society, 42, 107480.CrossRefGoogle ScholarPubMed
Marson, D. C., McInturff, B., Hawkins, L., Bartolucci, A. and Harrell, L. E. (1997) Consistency of physician judgments of capacity to consent in mild Alzheimer’s disease. Journal of the American Geriatrics Society, 45, 453457.CrossRefGoogle ScholarPubMed
Moye, J., Marson, D. C. and Edelstein, B. (2013) Assessment of capacity in an aging society. American Psychologist, 68, 5871.CrossRefGoogle Scholar
O’Neill, N. and Peisah, C. (2018) Capacity and the Law. Third edition. Accessed 26 March 2018.Google Scholar
Preston-Shoot, M. and McKimm, J. (2013) Exploring UK medical and social work students’ legal literacy: comparisons, contrasts and implications. Health & Social Care in the Community, 21, 271282.CrossRefGoogle ScholarPubMed
Peisah, C. (2017). Capacity assessment. In Chiu, H. and Shulman, K. (eds.), Mental Health and Illness Worldwide: Mental Health and Illness of the Elderly. New York, NY: Springer HbMIE.Google Scholar
Rendina, N., Brodaty, H., Draper, B., Peisah, C. and Brugue, E. (2009). Substitute consent for nursing home residents prescribed psychotropic medication. International Journal of Geriatric Psychiatry, 24, 226231.CrossRefGoogle ScholarPubMed
Skulmoski, G., Hartman, F. T. and Krahn, J. (2007). The Delphi method for graduate research. Journal of information Technology Education, 6, 112.CrossRefGoogle Scholar
UNCRPD, United Nations Convention on the Rights of Persons with Disabilities. Available at: Accessed March 2018.Google Scholar
Widera, E., Steenpass, V., Marson, D. and Sudore, R. (2011). Finances in the older patient with cognitive impairment: “He didn’t want me to take over”. Journal of the American Medical Association, 305, 698706.CrossRefGoogle Scholar
Young, G., Douglas, A. and Davison, L. (2018). What do doctors know about assessing decision-making capacity? New Zealand Medical Journal, 131, 5871.Google ScholarPubMed
Supplementary material: File

Peisah et al. supplementary material

Appendix S1

Download Peisah et al. supplementary material(File)
File 17 KB