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Search Results: 1 - 10 of 4091 matches for " Albert JJA Scherpbier "
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Students' perceptions about the transition to the clinical phase of a medical curriculum with preclinical patient contacts; a focus group study
Merijn B Godefrooij, Agnes D Diemers, Albert JJA Scherpbier
BMC Medical Education , 2010, DOI: 10.1186/1472-6920-10-28
Abstract: A purposive sample of 21 students participated in three focus groups which met twice during their first weeks of clinical clerkships. The interviews were recorded and transcribed literally. Qualitative content analysis of the transcriptions was performed.According to the students, working in clinical practice was enjoyable, motivated them to study and helped them to develop non-analytical reasoning skills. The students experienced stress due to increased working hours and work load, uncertainty as to what was expected of them and self-perceived lack of knowledge. They did not experience a major gap between the preclinical and clinical phase and felt well prepared for the clerkships. The preclinical patient contacts were considered to be instrumental in this.Early patient contacts seem to ameliorate the shock of practice and prepare students for clinical work. The problems mentioned by the students in this study are mainly related to the socialisation process. The results of this study have to be validated by quantitative research.The transition between the theoretical and the clinical phase of undergraduate medical education has often been characterised as the most stressful period of undergraduate medical education [1-3]. The first clinical year has been described as a period where medical students go through intense emotional experiences [4] and students have described entering the clinical arena as though they were being "thrown in at the deep end" [5]. Boshuizen [6] highlighted that the "shock of practice", a crisis experienced by many medical students on first entering the clinical workplace, is marked by a temporary decrease in their ability to properly use biomedical knowledge in clinical reasoning.The ability to use theoretical knowledge to solve clinical problems is claimed to be enhanced by Problem-Based Learning (PBL) [7]. It has been suggested that the transition from theory to practice is less problematic for students in a PBL curriculum. However, both
Teachers' ideas versus experts' descriptions of 'the good teacher' in postgraduate medical education: implications for implementation. A qualitative study
Thea CM van Roermund, Fred Tromp, Albert JJA Scherpbier, Ben JAM Bottema, Herman J Bueving
BMC Medical Education , 2011, DOI: 10.1186/1472-6920-11-42
Abstract: Recently, a new competency-based description of the good teacher was developed and introduced in all the Departments of Postgraduate Medical Education for Family Physicians in the Netherlands. We compared the views reflected in the new description with the views of teachers who were required to adopt the new framework.Qualitative study. We interviewed teachers in two Departments of Postgraduate Medical Education for Family Physicians in the Netherlands. The transcripts of the interviews were analysed independently by two researchers, who coded and categorised relevant fragments until consensus was reached on six themes. We investigated to what extent these themes matched the new description.Comparing the teachers' views with the concepts described in the new competency-based framework is like looking into two mirrors that reflect clearly dissimilar images. At least two of the themes we found are important in relation to the implementation of new educational methods: the teachers' identification and organisational culture. The latter plays an important role in the development of teachers' ideas about good teaching.The main finding of this study is the key role played by the teachers' feelings regarding their professional identity and by the local teaching culture in shaping teachers' views and expectations regarding their work. This suggests that in implementing a new teaching framework and in faculty development programmes, careful attention should be paid to teachers' existing identification model and the culture that fostered it.In times of change in medical education, teachers are often asked to adapt to a new concept of what being a good teacher includes [1,2]. These new concepts represent what is considered to be best educational practice and are often developed by experts outside the departments where the changes are to be implemented. The concepts are based on an analysis of the teachers' tasks and/or educational theory and operationalized in competency profi
Reducing errors in health care: cost-effectiveness of multidisciplinary team training in obstetric emergencies (TOSTI study); a randomised controlled trial
Joost van de Ven, Saskia Houterman, Rob AJQ Steinweg, Albert JJA Scherpbier, Willy Wijers, Ben Mol, S Guid Oei, the TOSTI-trial group
BMC Pregnancy and Childbirth , 2010, DOI: 10.1186/1471-2393-10-59
Abstract: It is attractive to belief that multidisciplinary team training will reduce the number of errors in obstetrics. The other side of the medal is that many hospitals are buying expensive patient simulators without proper evaluation of the training method. In the Netherlands many hospitals have 1,000 or less annual deliveries. In our small country it might therefore be more cost-effective to train obstetric teams in medical simulation centres with well trained personnel, high fidelity patient simulators, and well defined training programmes.The aim of the present study is to evaluate the cost-effectiveness of multidisciplinary team training in a medical simulation centre in the Netherlands to reduce the number of medical errors in obstetric emergency situations. We plan a multicentre randomised study with the centre as unit of analysis. Obstetric departments will be randomly assigned to receive multidisciplinary team training in a medical simulation centre or to a control arm without any team training.The composite measure of poor perinatal and maternal outcome in the non training group was thought to be 15%, on the basis of data obtained from the National Dutch Perinatal Registry and the guidelines of the Dutch Society of Obstetrics and Gynaecology (NVOG). We anticipated that multidisciplinary team training would reduce this risk to 5%. A sample size of 24 centres with a cluster size of each at least 200 deliveries, each 12 centres per group, was needed for 80% power and a 5% type 1 error probability (two-sided). We assumed an Intraclass Correlation Coefficient (ICC) value of maximum 0.08.The analysis will be performed according to the intention-to-treat principle and stratified for teaching or non-teaching hospitals.Primary outcome is the number of obstetric complications throughout the first year period after the intervention. If multidisciplinary team training appears to be effective a cost-effective analysis will be performed.If multidisciplinary team training appe
The role of deliberate practice in the acquisition of clinical skills
Robbert J Duvivier, Jan van Dalen, Arno M Muijtjens, Véronique RMP Moulaert, Cees PM van der Vleuten, Albert JJA Scherpbier
BMC Medical Education , 2011, DOI: 10.1186/1472-6920-11-101
Abstract: Students in years 1-3 completed 34 Likert type items, adapted from a questionnaire about the use of deliberate practice in cognitive learning. Exploratory factor analysis and reliability analysis were used to validate the questionnaire. Analysis of variance examined differences between years and regression analysis the relationship between deliberate practice and skill test results.875 students participated (90%). Factor analysis yielded four factors: planning, concentration/dedication, repetition/revision, study style/self reflection. Student scores on 'Planning' increased over time, score on sub-scale 'repetition/revision' decreased. Student results on the clinical skill test correlated positively with scores on subscales 'planning' and 'concentration/dedication' in years 1 and 3, and with scores on subscale 'repetition/revision' in year 1.The positive effects on test results suggest that the role of deliberate practice in medical education merits further study. The cross-sectional design is a limitation, the large representative sample a strength of the study. The vanishing effect of repetition/revision may be attributable to inadequate feedback. Deliberate practice advocates sustained practice to address weaknesses, identified by (self-)assessment and stimulated by feedback. Further studies should use a longitudinal prospective design and extend the scope to expertise development during residency and beyond.The ultimate goal of medical education is to prepare students to become clinically competent doctors. During their years in medical school and the hospital undergraduate students begin the gradual transition from novice to expert, a process that is by no means an easy one [1-3]. Research in other domains has shown that it requires hard work to become very good in a particular area of expertise. Chase and Simon, for example, argued that it takes ten years of intensive practice to reach expert level in a particular field [4].Ericsson made a distinction between
Why residents should teach: A literature review
Busari J,Scherpbier Albert
Journal of Postgraduate Medicine , 2004,
Abstract: Resident doctors contribute significantly to the quality of undergraduate medical training and it is assumed that by participating in the process, they also improve their own professional competency. We decided to investigate whether there is evidence to support this assumption. Our hypothesis, the physician-as-teacher rule, stated that 'A skilled teacher has an increased likelihood of becoming a competent clinician, than a skilled clinician has of becoming a competent teacher' . We conducted a literature review to search for evidence to confirm or refute this assumption. Twenty-four articles written after 1990 were identified as relevant from 132 references we generated by searching Medline. The identified articles were qualitatively reviewed to identify key research conclusions and/or main discussion points. The findings from the review were collated and discussed. None of the studies showed specific evidence of how teaching results in improved professional competence. However, there was evidence that teaching ability correlated positively with the perception of clinical competency. There was also need for improved supervision and training programmes for residents in teaching skills. The review provided evidence that teaching influenced the perceived professional competency of physicians positively. Physicians who were perceived as competent were those who taught effectively, and who had a basic understanding of teaching and learning. The review shows that training in teaching is essential for physicians, and that further research is still needed to demonstrate the effect of good teaching on professional competency.
Preclinical students’ experiences in early clerkships after skills training partly offered in primary health care centers: a qualitative study from Indonesia
Doni Widyandana, Gerard Majoor, Albert Scherpbier
BMC Medical Education , 2012, DOI: 10.1186/1472-6920-12-35
Abstract: Thirty pre-clinical students trained clinical skills exclusively in a skills laboratory; 30 peers received part of their skills training in PHC centers. Within half a year after commencing their clerkships all 60 students shared their experiences in focus group discussions (FGDs). Verbatim transcripts of FGDs were analyzed using Atlas-Ti software.Clerkship students who had participated in ECE in PHC centers felt better prepared to perform their clinical skills during the first clerkships than peers who had only practiced in a skills laboratory. ECE in PHC centers impacted positively in particular on students’ confidence, clinical reasoning, and interpersonal communication.In the Indonesian setting ECE in PHC centers reduce difficulties commonly encountered by medical students in the first clerkships.
Shortage in general practice despite the feminisation of the medical workforce: a seeming paradox? A cohort study
Tanja Maiorova, Fred Stevens, Jouke Zee, Beppie Boode, Albert Scherpbier
BMC Health Services Research , 2008, DOI: 10.1186/1472-6963-8-262
Abstract: A cohort of 206 final year medical students at the Maastricht University, the Netherlands were asked to complete a questionnaire focusing on career preferences before and after a 12-week general practice clerkship and at graduation, a couple of months later.Gender was significantly related to willingness to become a GP in bivariate analysis. Adding variables in multivariate analysis made this effect disappear. While females expressed overall higher preference for general practice than males, after the GP clerkship likelihood of choosing general practice increased with 38% among male and 22% among female students. After graduation, interest in general practice had dropped, mainly among females. Attitudes predicting a GP career choice were: extrinsic career motivation before the clerkship, and the content of GP work (patient contacts, treatments) and motivation to work with chronic and palliative patients after the clerkship.Gender 'as such' appeared not to be a distinctive predictor of specialty choice. It is students' attitudes towards GP work and preferred patient category that determine the career choice in general practice. However, more male students were positively influenced by the GP clerkship than female students. The motivating effect of the clerkship is not long lasting. Especially female graduates change their interest in favour of other specialties, which may explain why eventually few students choose general practice. It might be worthwhile to reinforce an initial preference for general practice by motivational guidance throughout the whole period of clerkships.All over the world a steady feminisation of medicine is taking place [1-7]. Formerly male-dominated specialties are nowadays overrepresented by women [8]. In the Netherlands in 2008 65% of medical students were female [9]. Since 1970 the percentage of women doctors in the UK has risen by over 40% [5]. In the US in 2007 49% of medical students are female, compared to only 13% female medical studen
Educational climate seems unrelated to leadership skills of clinical consultants responsible of postgraduate medical education in clinical departments
Bente Malling, Lene S Mortensen, Albert JJ Scherpbier, Charlotte Ringsted
BMC Medical Education , 2010, DOI: 10.1186/1472-6920-10-62
Abstract: The study was a trans-sectional correlation study. The educational climate was investigated by a survey among all doctors (specialists and trainees) in the departments. Leadership skills of the consultants responsible for education were measured by multi-source feedback scores from heads of departments, peer consultants, and trainees.Doctors from 42 clinical departments representing 21 specialties participated. The response rate of the educational climate investigation was moderate 52% (420/811), Response rate was high in the multisource-feedback process 84.3% (420/498). The educational climate was scored quite high mean 3.9 (SD 0.3) on a five-point Likert scale. Likewise the leadership skills of the clinical consultants responsible for education were considered good, mean 5.4 (SD 0.6) on a seven-point Likert scale. There was no significant correlation between the scores concerning the educational climate and the scores on leadership skills, r = 0.17 (p = 0.29).This study found no relation between the educational climate and the leadership skills of the clinical consultants responsible for postgraduate medical education in clinical departments with the instruments used. Our results indicate that consultants responsible for education are in a weak position to influence the educational climate in the clinical department. Further studies are needed to explore, how heads of departments and other factors related to the clinical organisation could influence the educational climate.Postgraduate medical education (PGME) is a work-based education where learning and teaching takes place in a clinical context. On the one hand the young doctor (trainee) is under education and on the other hand he is a member of the staff in the clinical department. The clinical departments face the challenge of creating an educational environment that is supportive and learning-oriented [1] and at the same time meeting the demands from society to deliver efficient clinical services and research
Combining a leadership course and multi-source feedback has no effect on leadership skills of leaders in postgraduate medical education. An intervention study with a control group
Bente Malling, Lene Mortensen, Thomas Bonderup, Albert Scherpbier, Charlotte Ringsted
BMC Medical Education , 2009, DOI: 10.1186/1472-6920-9-72
Abstract: Study participants were consultants responsible for postgraduate medical education at clinical departments. Study design: pre-post measures with an intervention and control group. The intervention was participation in a seven-day leadership course. Scores of multi-source feedback from the consultants responsible for education and respondents (heads of department, consultants and doctors in specialist training) were collected before and one year after the intervention and analysed using Mann-Whitney's U-test and Multivariate analysis of variances.There were no differences in multi-source feedback scores at one year follow up compared to baseline measurements, either in the intervention or in the control group (p = 0.149).The study indicates that a leadership course following a MSF procedure compared to MSF alone does not improve leadership skills of consultants responsible for education in clinical departments. Developing leadership skills takes time and the time frame of one year might have been too short to show improvement in leadership skills of consultants responsible for education. Further studies are needed to investigate if other combination of initiatives to develop leadership might have more impact in the clinical setting.Postgraduate medical education (PGME) usually takes place at many clinical departments in both university and non-university hospitals [1-3]. The increasing demands to PGME in the clinical departments at hospitals have made it necessary to appoint leaders of PGME at every training site [1,3].The expectations of the leader of PGME in the clinical departments are high and they vary across stakeholders according to their position in the department [3]. Although the various stakeholders have only limited knowledge of the role of leaders in PGME, they suggest formal leadership education to meet the expectations [3].Although it has recently been questioned it is still the general opinion that education of leaders results in improvement of leader
Does reflection have an effect upon case-solving abilities of undergraduate medical students?
Koole Sebastiaan,Dornan Tim,Aper Leen,Scherpbier Albert
BMC Medical Education , 2012, DOI: 10.1186/1472-6920-12-75
Abstract: Background Reflection on professional experience is increasingly accepted as a critical attribute for health care practice; however, evidence that it has a positive impact on performance remains scarce. This study investigated whether, after allowing for the effects of knowledge and consultation skills, reflection had an independent effect on students’ ability to solve problem cases. Methods Data was collected from 362 undergraduate medical students at Ghent University solving video cases and reflected on the experience of doing so. For knowledge and consultation skills results on a progress test and a course teaching consultation skills were used respectively. Stepwise multiple linear regression analysis was used to test the relationship between the quality of case-solving (dependent variable) and reflection skills, knowledge, and consultation skills (dependent variables). Results Only students with data on all variables available (n = 270) were included for analysis. The model was significant (Anova F(3,269) = 11.00, p < 0.001, adjusted R square 0.10) with all variables significantly contributing. Conclusion Medical students’ reflection had a small but significant effect on case-solving, which supports reflection as an attribute for performance. These findings suggest that it would be worthwhile testing the effect of reflection skills training on clinical competence.
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