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Cees van der Vleuten

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https://www.readbyqxmd.com/read/29215378/developing-resident-sensitive-quality-measures-a-model-from-pediatric-emergency-medicine
#1
Daniel J Schumacher, Eric S Holmboe, Cees van der Vleuten, Jamiu O Busari, Carol Carraccio
PURPOSE: To begin closing the gap with respect to quality measures available for use among residents, the authors sought to identify and develop resident-sensitive quality measures (RSQMs) for use in the pediatric emergency department (PED) setting. METHOD: In May 2016, the authors reviewed National Quality Measures Clearinghouse (NQMC) measures to identify resident-sensitive measures. To create additional measures focused on common, acute illnesses (acute asthma exacerbation, bronchiolitis, closed head injury [CHI]) in the PED, the authors used a nominal group technique (NGT) and Delphi process from September to December 2016...
December 5, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29189494/rethinking-remediation-a-model-to-support-the-detailed-diagnosis-of-clinicians-performance-problems-and-the-development-of-effective-remediation-plans
#2
Linda Prescott-Clements, Vicky Voller, Mark Bell, Natasha Nestors, Cees P M van der Vleuten
The successful remediation of clinicians demonstrating poor performance in the workplace is essential to ensure the provision of safe patient care. Clinicians may develop performance problems for numerous reasons, including health, personal factors, the workplace environment, or outdated knowledge/skills. Performance problems are often complex involving multifactorial issues, encompassing knowledge, skills, and professional behaviors. It is important that (where possible and appropriate) clinicians are supported through effective remediation to return them to safe clinical practice...
November 16, 2017: Journal of Continuing Education in the Health Professions
https://www.readbyqxmd.com/read/29172856/contextual-attributes-promote-or-hinder-self-regulated-learning-a-qualitative-study-contrasting-rural-physicians-with-undergraduate-learners-in-japan
#3
Yasushi Matsuyama, Motoyuki Nakaya, Hitoaki Okazaki, Jimmie Leppink, Cees van der Vleuten
BACKGROUND AND OBJECTIVES: Previous studies support the notion that East Asian medical students do not possess sufficient self-regulation for postgraduate clinical training. However, some East Asian physicians who are employed in geographically isolated and educationally underserved rural settings can self-regulate their study during the early phase of their postgraduate career. To explore the contextual attributes that contribute to self-regulated learning (SRL), we examined the differences in self-regulation between learning as an undergraduate and in a rural context in East Asia...
November 26, 2017: Medical Teacher
https://www.readbyqxmd.com/read/29141616/contextual-factors-and-clinical-reasoning-differences-in-diagnostic-and-therapeutic-reasoning-in-board-certified-versus-resident-physicians
#4
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
#5
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
#6
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/28984375/context-matters-when-striving-to-promote-active-and-lifelong-learning-in-medical-education
#7
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
#8
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
#9
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/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/28557945/how-entrustment-is-informed-by-holistic-judgments-across-time-in-a-family-medicine-residency-program-an-ethnographic-nonparticipant-observational-study
#12
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/28521573/students-motivation-toward-feedback-seeking-in-the-clinical-workplace
#13
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
#14
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
#15
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)...
July 2017: Medical Education
https://www.readbyqxmd.com/read/28403004/the-hidden-value-of-narrative-comments-for-assessment-a-quantitative-reliability-analysis-of-qualitative-data
#16
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/28281369/electronic-assessment-of-clinical-reasoning-in-clerkships-a-mixed-methods-comparison-of-long-menu-key-feature-problems-with-context-rich-single-best-answer-questions
#17
Sören Huwendiek, Friedrich Reichert, Cecilia Duncker, Bas A de Leng, Cees P M van der Vleuten, Arno M M Muijtjens, Hans-Martin Bosse, Martin Haag, Georg F Hoffmann, Burkhard Tönshoff, Diana Dolmans
BACKGROUND: It remains unclear which item format would best suit the assessment of clinical reasoning: context-rich single best answer questions (crSBAs) or key-feature problems (KFPs). This study compared KFPs and crSBAs with respect to students' acceptance, their educational impact, and psychometric characteristics when used in a summative end-of-clinical-clerkship pediatric exam. METHODS: Fifth-year medical students (n = 377) took a computer-based exam that included 6-9 KFPs and 9-20 crSBAs which assessed their clinical reasoning skills, in addition to an objective structured clinical exam (OSCE) that assessed their clinical skills...
March 10, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28220333/developing-skilled-doctor-patient-communication-in-the-workplace-a-qualitative-study-of-the-experiences-of-trainees-and-clinical-supervisors
#18
Esther Giroldi, Wemke Veldhuijzen, Kristel Geelen, Jean Muris, Frits Bareman, Herman Bueving, Trudy van der Weijden, Cees van der Vleuten
To inform the development of recommendations to facilitate learning of skilled doctor-patient communication in the workplace, this qualitative study explores experiences of trainees and supervisors regarding how trainees learn communication and how supervisors support trainees' learning in the workplace. We conducted a qualitative study in a general practice training setting, triangulating various sources of data to obtain a rich understanding of trainees and supervisors' experiences: three focus group discussions, five discussions during training sessions and five individual interviews...
December 2017: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/28218984/closing-the-patient-experience-chasm-a-two-level-validation-of-the-consumer-quality-index-inpatient-hospital-care
#19
Alina Smirnova, Kiki M J M H Lombarts, Onyebuchi A Arah, Cees P M van der Vleuten
BACKGROUND: Evaluation of patients' health care experiences is central to measuring patient-centred care. However, different instruments tend to be used at the hospital or departmental level but rarely both, leading to a lack of standardization of patient experience measures. OBJECTIVE: To validate the Consumer Quality Index (CQI) Inpatient Hospital Care for use on both department and hospital levels. DESIGN: Using cross-sectional observational data, we investigated the internal validity of the questionnaire using confirmatory factor analyses (CFA), and the generalizability of the questionnaire for use at the department and hospital levels using generalizability theory...
October 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28212117/validation-of-the-incept-a-multisource-feedback-tool-for-capturing-different-perspectives-on-physicians-professional-performance
#20
Mirja W van der Meulen, Benjamin C M Boerebach, Alina Smirnova, Sylvia Heeneman, Mirjam G A Oude Egbrink, Cees P M van der Vleuten, Onyebuchi A Arah, Kiki M J M H Lombarts
INTRODUCTION: Multisource feedback (MSF) instruments are used to and must feasibly provide reliable and valid data on physicians' performance from multiple perspectives. The "INviting Co-workers to Evaluate Physicians Tool" (INCEPT) is a multisource feedback instrument used to evaluate physicians' professional performance as perceived by peers, residents, and coworkers. In this study, we report on the validity, reliability, and feasibility of the INCEPT. METHODS: The performance of 218 physicians was assessed by 597 peers, 344 residents, and 822 coworkers...
February 15, 2017: Journal of Continuing Education in the Health Professions
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