Aims: Prescribing errors among junior doctors are common in clinical practice because many lack prescribing competence after graduation. This is in part due to inadequate education in clinical pharmacology and therapeutics (CP&T) in the undergraduate medical curriculum. To support CP&T education, it is important to determine which drugs medical undergraduates should be able to prescribe safely and effectively without direct supervision by the time they graduate. Currently, there is no such list with broad-based consensus. Therefore, the aim was to reach consensus on a list of essential drugs for undergraduate medical education in the Netherlands. Methods: A two-round modified Delphi study was conducted among pharmacists, medical specialists, junior doctors and pharmacotherapy teachers from all eight Dutch academic hospitals. Participants were asked to indicate whether it was essential that medical graduates could prescribe specific drugs included on a preliminary list. Drugs for which ≥80% of all respondents agreed or strongly agreed were included in the final list. Results: In all, 42 (65%) participants completed the two Delphi rounds. A total of 132 drugs (39%) from the preliminary list and two (3%) newly proposed drugs were included. Conclusions: This is the first Delphi consensus study to identify the drugs that Dutch junior doctors should be able to prescribe safely and effectively without direct supervision. This list can be used to harmonize and support the teaching and assessment of CP&T. Moreover, this study shows that a Delphi method is suitable to reach consensus on such a list, and could be used for a European list.
MULTIFILE
This survey is about recognizing patterns in the way Small and Medium Enterprises (SMEs) organize their procurement activities. The scope of the survey is limited to the key commodities of the SME.A key commodity is defined as the purchased product or service group which is essential for realizing the value proposition for the customers of the SME.Prior outcome of our research indicated the existence of four procurement oriented patterns in SMEs. 4 Procurement Oriented Patterns where part of the study: Pattern 1 Focal company: ICT turn-key designerValue proposition of the focal company: ICT Design and assembly of offices on a high quality level at a reasonable price. Operational excellence: standardization in commodities, low transaction costs internally and externallyPurchased key commodity: Standard ICT software and hardwarePattern 2 Focal company: Horse shoes manufacturerValue proposition of the focal company: Standard horse shoes assortment at reasonable prices in a competitive environmentPurchased key commodity: Standard quality iron, reliable deliveryPattern 3 Focal company: IT innovation driven companyValue proposition of the focal company: Developing innovative software made applicable for practical usage in devices at a reasonable pricePurchased key commodity: Delivering applicable solutions on the bases of regular soft- and hardware, to enable the companies’ innovative software function in practicePattern 4 Focal company: designer and manufacturer of trailersValue proposition of the focal company: Designing and manufacturing trailers tailor made for specific requirements of customersPurchased key commodity: Designing and manufacturing axles which align to the specific trailer wishes of the customer of the focal companyFINDINGS Pattern recognitionAbout 50 % of the respondents recognized the four presented patterns from own experience and/or read literature. Respondents also suggested pattern variants. It is concluded that this Delphi study strengthens the view that these patterns exist in SMEs. Further research may include further empirical testing of these patterns and their variants. Perceived strengths or weaknesses. Respondents mentioned a wide variety of strengths and weaknesses of the patterns. No clear conclusions can be drawn from this data. Adequacy of the pattern descriptions. One of the outcomes of this Delphi study is an improved conceptual framework for describing procurement activity patterns. This framework can be used for collecting SME data in future research, for example by modifying the existing survey questions which are used in the WIM research program to describe SME procurement activities. The improved model includes more variables and values than the initial model. Thus future research may lead to more detailed patterns descriptions. Missing patterns and pattern variantsApart from the suggested pattern variants, respondents do not miss patterns which are quite different from the four patterns suggested by the research team. Methodological remarksThe Delphi study method did not allow for fast feedback on panel member contributions and fast group think processes. For the future it is advised to consider other methods in similar cases, for example the World Cafe method.
Background: For most women, participation in decision-making during maternity care has a positive impact on their childbirth experiences. Shared decision-making (SDM) is widely advocated as a way to support people in their healthcare choices. The aim of this study was to identify quality criteria and professional competencies for applying shared decision-making in maternity care. We focused on decision-making in everyday maternity care practice for healthy women. Methods: An international three-round web-based Delphi study was conducted. The Delphi panel included international experts in SDM and in maternity care: mostly midwives, and additionally obstetricians, educators, researchers, policy makers and representatives of care users. Round 1 contained open-ended questions to explore relevant ingredients for SDM in maternity care and to identify the competencies needed for this. In rounds 2 and 3, experts rated statements on quality criteria and competencies on a 1 to 7 Likert-scale. A priori, positive consensus was defined as 70% or more of the experts scoring ≥6 (70% panel agreement). Results: Consensus was reached on 45 quality criteria statements and 4 competency statements. SDM in maternity care is a dynamic process that starts in antenatal care and ends after birth. Experts agreed that the regular visits during pregnancy offer opportunities to build a relationship, anticipate situations and revisit complex decisions. Professionals need to prepare women antenatally for unexpected, urgent decisions in birth and revisit these decisions postnatally. Open and respectful communication between women and care professionals is essential; information needs to be accurate, evidence-based and understandable to women. Experts were divided about the contribution of professional advice in shared decision-making and about the partner’s role. Conclusions: SDM in maternity care is a dynamic process that takes into consideration women’s individual needs and the context of the pregnancy or birth. The identified ingredients for good quality SDM will help practitioners to apply SDM in practice and educators to prepare (future) professionals for SDM, contributing to women’s positive birth experience and satisfaction with care.
MULTIFILE
The results will be consensus between departments of physiotherapy universities of allied health care about learning outcomes CommunicationThere is no consensus between Dutch Physiotherapy departments on learning outcome of bachelors
Meestal is er geen specifieke oorzaak te vinden voor nekpijn. Fysiotherapie richt zich daarom op algemene zaken, zoals spierkracht en beweeglijkheid. We onderzoeken of er effectieve behandelingen zijn voor subgroepen met niet-specifieke nekpijn. Met deze inzichten kunnen we fysiotherapie verbeteren.Doel We willen inzicht krijgen in effectieve behandelingen bij subgroepen patiënten met niet-specifieke nekpijn. Dit leidt uiteindelijk tot kostenvermindering voor de maatschappij en een sneller en beter herstel van de patiënten. Resultaten Dit onderzoek loopt nog. Na afronding vind je hier een samenvatting van alle resultaten. Tot nu toe is duidelijk geworden dat de volgende behandelingen effectief kunnen zijn bij patiënten met niet-specifieke nekpijn: Behandelingen gericht op kracht en uithoudingsvermogen. Behandelingen gericht op coördinatie met gebruik van visuele feedback. Een voorbeeld hiervan is patiënten met een laserlamp een parcours laten uitvoeren op een scherm. De resultaten van het onderzoek worden verwerkt in het bachelor- en masteronderwijs en cursussen binnen het werkveld. Looptijd 01 december 2015 - 01 december 2020 Aanpak Dit onderzoek bestaat uit verschillende delen: We onderzoeken wat er vanuit wetenschappelijk onderzoek al bekend is over de relatie tussen beperking in activiteit en een passende behandeling. We voeren een Delphi-studie uit onder deskundigen naar het behandelen van mensen met niet-specifieke nekpijn. We vragen ze naar een overeenstemming over de relatie tussen beperking in activiteit en een algemene behandeling, zoals het trainen van spierkracht. We onderzoeken of beweegoefeningen en/of manipulaties, als meest onderzochte behandelingen bij mensen met nekpijn, zo zijn beschreven dat we het kunnen hergebruiken. In de laatste studie onderzoeken we of beweegoefeningen en/of manipulaties effectief zijn in het herstellen van de beweeglijkheid. Het gaat hierbij om een subgroep van mensen met nekpijn die ook beperkt zijn in hun beweeglijkheid. Rapporten tot nu toe: The clinical reasoning process in randomized clinical trials with patients with non-specific neck pain is incomplete: A systematic review. Maissan F, Pool J, de Raaij E, Mollema J, Ostelo R, Wittink H. Musculoskelet Sci Pract. 2018 Jun;35:8-17 Clinical reasoning in unimodal interventions in patients with non-specific neck pain in daily physiotherapy practice, a Delphi study. Maissan F, Pool J, Stutterheim E, Wittink H, Ostelo R., Musculoskelet Sci Pract. 2018 Oct;37:8-16
The increasing concentration of people in urban environments in an era of globalisation means that social, economic, and environmental resources for living and working are under pressure. Urban communities experience increased stress levels due to inadequate and overburdened infrastructure and services, challenges due to ethnic and cultural diversity, socio-economic inequalities as well as the impact of environmental degradation. For these communities to build resilience under these circumstances therefore requires a multipronged approach. The underlying question this project will answer is: “What are the key characteristics of experiencescapes that contribute to resilience-building in communities?” The project will dive into the identification of building blocks of experiencescapes and roles of relevant actors that can support communities in building resilience. Within the context of a multidisciplinary approach, this project applies a range of qualitative research methods, such as in-depth interviews, focus groups, participant observation, storytelling techniques, life stories, as well as various biometric quantitative methods, available through the experience lab of BUas. The outcome of the project will enable practitioners and researchers alike in various sectors to understand what and how they can contribute to creating an environment in which people can meaningfully interact in a way that builds resilience in communities. This outcome is communicated not only through academic publications and conference contributions, but also through public reports and a handbook for practitioners and students. These reports and handbooks support identification and application of building blocks of experiencescapes that support building resilience in communities. Finally, the knowledge generated in the project will contribute to the development of curricula of various educational programmes at Breda University of Applied Sciences by expanding the scope of experience design into the area of people-to-people relationships.
