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https://www.readbyqxmd.com/read/29141616/contextual-factors-and-clinical-reasoning-differences-in-diagnostic-and-therapeutic-reasoning-in-board-certified-versus-resident-physicians
#1
Elexis McBee, Temple Ratcliffe, Katherine Picho, Lambert Schuwirth, Anthony R Artino, Ana Monica Yepes-Rios, Jennifer Masel, Cees van der Vleuten, Steven J Durning
BACKGROUND: The impact of context on the complex process of clinical reasoning is not well understood. Using situated cognition as the theoretical framework and videos to provide the same contextual "stimulus" to all participants, we examined the relationship between specific contextual factors on diagnostic and therapeutic reasoning accuracy in board certified internists versus resident physicians. METHODS: Each participant viewed three videotaped clinical encounters portraying common diagnoses in internal medicine...
November 15, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29129176/composite-reliability-of-workplace-based-assessment-of-international-medical-graduates
#2
Balakrishnan Kichu R Nair, Joyce Mw Moonen-van Loon, Mulavana Parvathy, Brian C Jolly, Cees Pm van der Vleuten
OBJECTIVE: The fitness to practise of international medical graduates (IMGs) is usually evaluated with standardised assessment tests. The performance rather than the competency of practising doctors should, however, be assessed, for which reason workplace-based assessment (WBA) has gained increasing attention. Our aim was to assess the composite reliability of WBA instruments for assessing IMGs. DESIGN AND SETTING: Between June 2010 and April 2015, 142 IMGs were assessed by 99 calibrated assessors; each was assessed in the workplace over 6 months...
November 20, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/29068817/broadening-the-scope-of-feedback-to-promote-its-relevance-to-workplace-learning
#3
Renée M van der Leeuw, Pim W Teunissen, Cees P M van der Vleuten
The common goal in medical education is to support the health care workforce, both present and future, in becoming and remaining competent professionals. Both during and after medical training, learning takes place in the clinical workplace. Yet, how feedback is defined in medical education and how it is practiced in clinical training situations, combined with a research focus on "what works," limits its potential for learning. This article explores the theoretical background of learning in interaction and current trends in medical education to broaden the scope of feedback and promote its relevance to workplace learning...
October 24, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29050008/response-of-the-endothelium-to-the-epicutaneous-application-of-leukotriene-b4
#4
Sabina C A Hanssen, Anke G M Hendriks, Romy M C Keijsers, Piet E J van Erp, Carine J M van der Vleuten, Marieke M B Seyger, Peter C M van de Kerkhof
BACKGROUND: Vascular changes, both endothelial and functional, are crucial events in inflammatory responses. OBJECTIVES: To investigate the dynamics of endothelial cell (EC) and functional changes during acute inflammation in an in vivo model of the skin using leukotriene B4. METHODS: EC proliferation, vascular network size, vessel diameter (VD), and hypoxia-inducible factor (HIF)-1α were studied by immunohistochemical CD31/Ki67 double staining and single staining of HIF-1α...
October 20, 2017: Skin Pharmacology and Physiology
https://www.readbyqxmd.com/read/28986976/development-of-an-international-core-outcome-set-for-peripheral-vascular-malformations-ovama-project
#5
S E R Horbach, C M A M van der Horst, F Blei, C J M van der Vleuten, I J Frieden, G T Richter, S T Tan, T Muir, A Penington, L M Boon, P I Spuls
BACKGROUND: An important limitation in vascular malformation research is the heterogeneity in outcome measures used for the evaluation of treatment outcome. OBJECTIVE: The Outcome measures for VAscular MAlformations (OVAMA) project aimed to reach international consensus on a core outcome set (COS) for clinical research on peripheral vascular malformations: lymphatic (LM), venous (VM) and arteriovenous malformations (AVM). In this consensus study, we determined what domains should constitute the COS...
October 7, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28984375/context-matters-when-striving-to-promote-active-and-lifelong-learning-in-medical-education
#6
Joris J Berkhout, Esther Helmich, Pim W Teunissen, Cees P M van der Vleuten, A Debbie C Jaarsma
WHERE DO WE STAND NOW?: In the 30 years that have passed since The Edinburgh Declaration on Medical Education, we have made tremendous progress in research on fostering 'self-directed and independent study' as propagated in this declaration, of which one prime example is research carried out on problem-based learning. However, a large portion of medical education happens outside of classrooms, in authentic clinical contexts. Therefore, this article discusses recent developments in research regarding fostering active learning in clinical contexts...
October 6, 2017: Medical Education
https://www.readbyqxmd.com/read/28953570/the-association-between-learning-climate-and-adverse-obstetrical-outcomes-in-16-nontertiary-obstetrics-gynecology-departments-in-the-netherlands
#7
Alina Smirnova, Anita C J Ravelli, Renée E Stalmeijer, Onyebuchi A Arah, Maas Jan Heineman, Cees P M van der Vleuten, Joris A M van der Post, Kiki M J M H Lombarts
PURPOSE: To investigate the association between learning climate and adverse perinatal and maternal outcomes in obstetrics-gynecology departments. METHOD: The authors analyzed 23,629 births and 103 learning climate evaluations from 16 nontertiary obstetrics-gynecology departments in the Netherlands in 2013. Multilevel logistic regressions were used to calculate the odds of adverse perinatal and maternal outcomes, by learning climate score tertile, adjusting for maternal and department characteristics...
September 26, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28936900/a-collaborative-comparison-of-objective-structured-clinical-examination-osce-standard-setting-methods-at-australian-medical-schools
#8
Bunmi Sherifat Malau-Aduli, Peta-Ann Teague, Karen D'Souza, Clare Heal, Richard Turner, David L Garne, Cees van der Vleuten
BACKGROUND: A key issue underpinning the usefulness of the OSCE assessment to medical education is standard setting, but the majority of standard-setting methods remain challenging for performance assessment because they produce varying passing marks. Several studies have compared standard-setting methods; however, most of these studies are limited by their experimental scope, or use data on examinee performance at a single OSCE station or from a single medical school. This collaborative study between 10 Australian medical schools investigated the effect of standard-setting methods on OSCE cut scores and failure rates...
September 22, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28818436/use-of-the-hemangioma-severity-scale-to-facilitate-treatment-decisions-for-infantile-hemangiomas
#9
COMPARATIVE STUDY
Andre Vadimovich Moyakine, Bjorn Herwegen, Catharina Joanna Maria van der Vleuten
BACKGROUND: The Hemangioma Severity Scale (HSS) assesses the severity of an infantile hemangioma (IH). OBJECTIVE: First, to compare HSS scores between patients with IH for whom propranolol treatment was indicated at their first visit and those who were not treated. Second, to assess suitable cutoff values for the need for propranolol treatment. METHOD: All patients with IH who attended our tertiary referral center since 2008 and were 0 to 6 months of age at their first visit were included...
November 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28741446/uncovering-the-unknown-a-grounded-theory-study-exploring-the-impact-of-self-awareness-on-the-culture-of-feedback-in-residency-education
#10
Subha Ramani, Karen Könings, Karen V Mann, Cees van der Vleuten
AIM: Self-assessment and reflection are essential for meaningful feedback. We aimed to explore whether the well-known Johari window model of self-awareness could guide feedback conversations between faculty and residents and enhance the institutional feedback culture. METHODS: We had previously explored perceptions of residents and faculty regarding sociocultural factors impacting feedback. We re-analyzed data targeting themes related to self-assessment, reflection, feedback seeking and acceptance, aiming to generate individual and institutional feedback strategies applicable to each quadrant of the window...
July 25, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28707630/how-innovative-and-conventional-curricula-prepare-medical-students-for-practice-in-sub-saharan-africa-a-comparative-study-from-mozambique
#11
Janneke M Frambach, Beatriz A F Manuel, Afonso M T Fumo, Bernard Groosjohan, Cees P M Van Der Vleuten, Erik W Driessen
BACKGROUND: Medical education in Sub-Saharan Africa is in need of reform to promote the number and quality of physicians trained. Curriculum change and innovation in this region, however, face a challenging context that may affect curriculum outcomes. Research on outcomes of curriculum innovation in Sub-Saharan Africa is scarce. We investigated curriculum outcomes in a Sub-Saharan African context by comparing students' perceived preparedness for practice within three curricula in Mozambique: a conventional curriculum and two innovative curricula...
January 2017: Education for Health: Change in Training & Practice
https://www.readbyqxmd.com/read/28688352/inter-comparison-of-personal-monitors-for-nanoparticles-exposure-at-workplaces-and-in-the-environment
#12
Ana Maria Todea, Stefanie Beckmann, Heinz Kaminski, Delphine Bard, Sébastien Bau, Simon Clavaguera, Dirk Dahmann, Hélène Dozol, Nico Dziurowitz, Karine Elihn, Martin Fierz, Göran Lidén, Asmus Meyer-Plath, Christian Monz, Volker Neumann, Johannes Pelzer, Barbara Katrin Simonow, Patrick Thali, Ilse Tuinman, Arjan van der Vleuten, Huub Vroomen, Christof Asbach
Personal monitors based on unipolar diffusion charging (miniDiSC/DiSCmini, NanoTracer, Partector) can be used to assess the individual exposure to nanoparticles in different environments. The charge acquired by the aerosol particles is nearly proportional to the particle diameter and, by coincidence, also nearly proportional to the alveolar lung-deposited surface area (LDSA), the metric reported by all three instruments. In addition, the miniDiSC/DiSCmini and the NanoTracer report particle number concentration and mean particle size...
December 15, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28578320/utility-of-an-app-based-system-to-improve-feedback-following-workplace-based-assessment
#13
Janet Lefroy, Nicola Roberts, Adrian Molyneux, Maggie Bartlett, Simon Gay, Robert McKinley
Objectives: To determine whether an app-based software system to support production and storage of assessment feedback summaries makes workplace-based assessment easier for clinical tutors and enhances the educational impact on medical students. Methods: We monitored our workplace assessor app's usage by Year 3 to 5 medical students in 2014-15 and conducted focus groups with Year 4 medical students and interviews with clinical tutors who had used the apps. Analysis was by constant comparison using a framework based on elements of van der Vleuten's utility index...
May 31, 2017: International Journal of Medical Education
https://www.readbyqxmd.com/read/28557945/how-entrustment-is-informed-by-holistic-judgments-across-time-in-a-family-medicine-residency-program-an-ethnographic-nonparticipant-observational-study
#14
Margaretha H Sagasser, Cornelia R M G Fluit, Chris van Weel, Cees P M van der Vleuten, Anneke W M Kramer
PURPOSE: Entrustment has mainly been conceptualized as delegating discrete professional tasks. Because residents provide most of their patient care independently, not all resident performance is visible to supervisors; the entrustment process involves more than granting discrete tasks. This study explored how supervisors made entrustment decisions based on residents' performance in a long-term family medicine training program. METHOD: A qualitative nonparticipant observational study was conducted in 2014-2015 at competency-based family medicine residency programs in the Netherlands...
June 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28552538/the-utility-of-glut1-as-a-diagnostic-marker-in-cutaneous-vascular-anomalies-a-review-of-literature-and-recommendations-for-daily-practice
#15
REVIEW
Lieke J van Vugt, Carine J M van der Vleuten, Uta Flucke, Willeke A M Blokx
OBJECTIVE: To assess the utility of GLUT1 as an immunohistochemical marker in the diagnostics of cutaneous vascular anomalies. METHODS: A systematic literature search was conducted for studies on GLUT1 staining patterns in cutaneous vascular lesions. Data was grouped according to the latest ISSVA classification for vascular anomalies. RESULTS: Vascular tumors: GLUT1 staining was positive in 368/386 (95%) of infantile hemangiomas. Congenital hemangiomas (16 cases) and kaposiform hemangioendotheliomas (62 cases) were all negative for GLUT1...
June 2017: Pathology, Research and Practice
https://www.readbyqxmd.com/read/28521573/students-motivation-toward-feedback-seeking-in-the-clinical-workplace
#16
Lubberta H de Jong, Robert P Favier, Cees P M van der Vleuten, Harold G J Bok
In medical education, students are increasingly regarded as active seekers of feedback rather than passive recipients. Previous research showed that in the intentions of students to seek feedback, a learning and performance goal can be distinguished. In this study, we investigated the intentions (defined as level and orientation of motivation) of different performing students (low, average, and high performing students) to seek feedback in the clinical workplace using Self-Determination Theory. We conducted a quantitative study with students in their clinical clerkships and grouped them based on their performance...
September 2017: Medical Teacher
https://www.readbyqxmd.com/read/28454581/changing-the-culture-of-assessment-the-dominance-of-the-summative-assessment-paradigm
#17
Christopher J Harrison, Karen D Könings, Lambert W T Schuwirth, Valerie Wass, Cees P M van der Vleuten
BACKGROUND: Despite growing evidence of the benefits of including assessment for learning strategies within programmes of assessment, practical implementation of these approaches is often problematical. Organisational culture change is often hindered by personal and collective beliefs which encourage adherence to the existing organisational paradigm. We aimed to explore how these beliefs influenced proposals to redesign a summative assessment culture in order to improve students' use of assessment-related feedback...
April 28, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28418162/exploring-the-institutional-logics-of-health-professions-education-scholarship-units
#18
Lara Varpio, Bridget O'Brien, Wendy Hu, Olle Ten Cate, Steven J Durning, Cees van der Vleuten, Larry Gruppen, David Irby, Susan Humphrey-Murto, Stanley J Hamstra
CONTEXT: Although health professions education scholarship units (HPESUs) share a commitment to the production and dissemination of rigorous educational practices and research, they are situated in many different contexts and have a wide range of structures and functions. OBJECTIVES: In this study, the authors explore the institutional logics common across HPESUs, and how these logics influence the organisation and activities of HPESUs. METHODS: The authors analysed interviews with HPESU leaders in Canada (n = 12), Australia (n = 21), New Zealand (n = 3) and the USA (n = 11)...
April 18, 2017: Medical Education
https://www.readbyqxmd.com/read/28403004/the-hidden-value-of-narrative-comments-for-assessment-a-quantitative-reliability-analysis-of-qualitative-data
#19
Shiphra Ginsburg, Cees P M van der Vleuten, Kevin W Eva
PURPOSE: In-training evaluation reports (ITERs) are ubiquitous in internal medicine (IM) residency. Written comments can provide a rich data source, yet are often overlooked. This study determined the reliability of using variable amounts of commentary to discriminate between residents. METHOD: ITER comments from two cohorts of PGY-1s in IM at the University of Toronto (graduating 2010 and 2011; n = 46-48) were put into sets containing 15 to 16 residents. Parallel sets were created: one with comments from the full year and one with comments from only the first three assessments...
November 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28397009/what-programmatic-assessment-in-medical-education-can-learn-from-healthcare
#20
L Schuwirth, C van der Vleuten, S J Durning
No abstract text is available yet for this article.
August 2017: Perspectives on Medical Education
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