This dissertation concerns the adaptive ability by which workers meet new expertise needs throughout their careers. We aimed to increase our understanding of this adaptive ability through a series of four studies building upon the concept of flexpertise (Van der Heijden, 1998, 2000). These studies were designed to advance theorizing, specifically in scholarly research on expertise and expert performance (Ericsson et al., 2006) and sustainable careers (Van der Heijden & De Vos, 2015), and to increase our understanding of how flexpertise may be fostered among workers across expertise domains and working contexts.In this introduction chapter, we outline the key theoretical concepts regarding the flexpertise phenomenon that we will use throughout this dissertation, a description of the knowledge gap in the scholarly literature, and our research focus. This is followed by a summary of this PhD project that outlines the overall research objective, the research questions and research methods that we deployed, as well as an overview of the four flexpertise studies conducted (see Table 1.1). The subsequent chapters include the four (submitted) scientific publications on this matter. We conclude by reflecting on the theoretical, methodological and practical value of our research, and on the limitations of our research approach. We finish with recommendations for future research, ethical considerations on the usage of the flexpertise concept in labor market debates, and a personal reflection on this PhD program.Before explaining the key concept of flexpertise and related core concepts, we first outline what we mean by new expertise needs. These needs shaped the background of the four studies conducted.
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The generalist-plus-specialist palliative care model is endorsed worldwide. In the Netherlands, the competencies and profile of the generalist provider of palliative care has been described on all professional levels in nursing and medicine. However, there is no clear description of what specialized expertise in palliative care entails, whereas this is important in order for generalists to know who they can consult in complex palliative care situations and for timely referral of patients to palliative care specialists. Objective: To gain insight in the roles and competencies attributed to palliative care specialists as opposed to generalists. Methods: A scoping review was completed based on PRISMA-ScR guidelines to explore the international literature on the role and competence description of specialist and expert care professionals in palliative care. Databases Embase.com, Medline (Ovid), CINAHL (Ebsco) and Web of Science Core Collection were consulted. The thirty-nine included articles were independently screened, reviewed and charted. Thematic codes were attached based on two main outcomes roles and competencies. Results: Five roles were identified for the palliative care specialist: care provider, care consultant, educator, researcher and advocate. Leadership qualities are found to be pivotal for every role. The roles were further specified with competencies that emerged from the analysis. The title, roles and competencies attributed to the palliative care specialist can mostly be applied to both medical and nursing professionals. Discussion: The roles and competencies derived from this scoping review correspond well with the seven fields of competence for medical/nursing professionals in health care of the CanMEDS guide. A specialist is not only distinguished from a generalist on patient-related care activities but also on an encompassing level. Clarity on what it entails to be a specialist is important for improving education and training for specialists. Conclusion: This scoping review adds to our understanding of what roles and competencies define the palliative care specialist. This is important to strengthen the position of the specialist and their added value to generalists in a generalist-plus-specialist model
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In the Netherlands, palliative care is provided by generalist healthcare professionals (HCPs) if possible and by palliative care specialists if necessary. However, it still needs to be clarifed what specialist expertise entails, what specialized care consists of, and which training or work experience is needed to become a palliative care special‑ist. In addition to generalists and specialists, ‘experts’ in palliative care are recognized within the nursing and medical professions, but it is unclear how these three roles relate. This study aims to explore how HCPs working in palliative care describe themselves in terms of generalist, specialist, and expert and how this self-description is related to their work experience and education. Methods A cross-sectional open online survey with both pre-structured and open-ended questions among HCPs who provide palliative care. Analyses were done using descriptive statistics and by deductive thematic coding of open-ended questions. Results Eight hundred ffty-four HCPs flled out the survey; 74% received additional training, and 79% had more than fve years of working experience in palliative care. Based on working experience, 17% describe themselves as a generalist, 34% as a specialist, and 44% as an expert. Almost three out of four HCPs attributed their level of expertise on both their education and their working experience. Self-described specialists/experts had more working experience in palliative care, often had additional training, attended to more patients with palliative care needs, and were more often physicians as compared to generalists. A deductive analysis of the open questions revealed the similarities and dis‑ tinctions between the roles of a specialist and an expert. Seventy-six percent of the respondents mentioned the impor‑tance of having both specialists and experts and wished more clarity about what defnes a specialist or an expert, how to become one, and when you need them. In practice, both roles were used interchangeably. Competencies for the specialist/expert role consist of consulting, leadership, and understanding the importance of collaboration. Conclusions Although the grounds on which HCPs describe themselves as generalist, specialist, or experts difer, HCPs who describe themselves as specialists or experts mostly do so based on both their post-graduate education and their work experience. HCPs fnd it important to have specialists and experts in palliative care in addition to gen‑eralists and indicate more clarity about (the requirements for) these three roles is needed.
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Teacher education enables students to grow from ‘novice’ into ‘starting expert’ teachers. In this study, students’ textual peer feedback on video recordings of their teaching practice was analysed to determine the growth of their expertise in relation to blended curriculum design. The degree to which curriculum and literature influenced their feedback was assessed by semantic network analysis of prominent words from the literature that was studied, as well as the lexical richness andsemantic cohesion of students’ peer feedback and reflections. The lexical richness and the semantic cohesion increased significantly by the end of the semester. This means that students incorporated new vocabulary and maintained semantic consistency while using the new words. Regarding the semantic network analysis, we found stronger connections between the topics being discussed by the students at the end of the semester. Active use of video and peer feedback enhances students’ activeknowledge base, thus furthering effective teaching.
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Background: Deceptive movements occur when an actor seeks to fake, hide or delay kinematic information about their true movement outcomes. The purpose of deceptive movements is to impair the perception of opponents (the ‘observer’) to gain an advantage over them. We argue though that a lack of conceptual clarity has led to confusion about what deception is and in understanding the different approaches by which an actor can deceive their opponent. The aim of this article is to outline a conceptual framework for understanding deceptive movements in sport. Main body: Adopting Interpersonal Deception Theory from the field of communication, we define deception as when an actor deliberately alters their actions in an attempt to impair the ability of an observer to anticipate their true action outcomes. Further, deception can be achieved either by what we define as deceit, the act of providing false information, or disguise, the act of concealing the action outcome. Skilled athletes often have actions that are difficult to anticipate, but an action is only classified as containing deception if the actor has explicit intent to deceive an observer. Having outlined the conceptual framework, we then review existing empirical findings on the skilled perception of deceptive movements considering the framework. This approach includes a critical evaluation of the mechanisms known to facilitate the perceptual ability to prevent being deceived, including a consideration of visual search strategies, confidence, the contribution of visual and motor experiences, and the influence of response biases and action capabilities on perceptual performance. Conclusion: The distinction between deceit and disguise particularly helps to show that most research has examined deceit, with little known about how an actor can more effectively disguise their action, or about how an observer can improve their ability to anticipate the outcome of disguised actions. The insights help to identify fruitful areas for future research and outline implications for skill acquisition and performance enhancement.
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A special Women's Day edition of the podcast with the leading ladies of our Centre of Expertise on Global Governance. Your hosts Mendeltje and Ruud have a talk with Alanna O'Malley, Barbara Warwas en Sylvia Bergh on the international position of women and their research on the UN, alternative ways of conflict resolution and applied research worldwide. A conversation about experiences, education and change.
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Stakeholders must purposely reflect on the suitability of process models for designing tourism experience systems. Specific characteristics of these models relate to developing tourism experience systems as integral parts of wider socio-technical systems. Choices made in crafting such models need to address three reflexivity mechanisms: problem, stakeholder and method definition. We systematically evaluate application of these mechanisms in a living lab experiment, by developing evaluation episodes using the framework for evaluation in design science research. We outline (i) the development of these evaluation episodes and (ii) how executing them influenced the process and outcomes of co-crafting the process model. We highlight both the benefits of and an approach to incorporate reflexivity in developing process models for designing tourism experience systems.
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Background: A paradigm shift in health care from illness to wellbeing requires new assessment technologies and intervention strategies. Self-monitoring tools based on the Experience Sampling Method (ESM) might provide a solution. They enable patients to monitor both vulnerability and resilience in daily life. Although ESM solutions are extensively used in research, a translation from science into daily clinical practice is needed. Objective: To investigate the redesign process of an existing platform for ESM data collection for detailed functional analysis and disease management used by psychological assistants to the general practitioner (PAGPs) in family medicine. Methods: The experience-sampling platform was reconceptualized according to the design thinking framework in three phases. PAGPs were closely involved in co-creation sessions. In the ‘understand’ phase, knowledge about end-users’ characteristics and current eHealth use was collected (nominal group technique – 2 sessions with N = 15). In the ‘explore’ phase, the key needs concerning the platform content and functionalities were evaluated and prioritized (empathy mapping – 1 session with N = 5, moderated user testing – 1 session with N = 4). In the ‘materialize’ phase, the adjusted version of the platform was tested in daily clinical practice (4 months with N = 4). The whole process was extensively logged, analyzed using content analysis, and discussed with an interprofessional project group. Results: In the ‘understand’ phase, PAGPs emphasized the variability in symptoms reported by patients. Therefore, moment-to-moment assessment of mood and behavior in a daily life context could be valuable. In the ‘explore’ phase, (motivational) functionalities, technological performance and instructions turned out to be important user requirements and could be improved. In the ‘materialize’ phase, PAGPs encountered barriers to implement the experience-sampling platform. They were insufficiently facilitated by the regional primary care group and general practitioners. Conclusion: The redesign process in co-creation yielded meaningful insights into the needs, desires and daily routines in family medicine. Severe barriers were encountered related to the use and uptake of the experience-sampling platform in settings where health care professionals lack the time, knowledge and skills. Future research should focus on the applicability of this platform in family medicine and incorporate patient experiences.
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The concept of immersion has been widely used for the design and evaluation of user experiences. Augmented, virtual and mixed-reality environments have further sparked the discussion of immersive user experiences and underlying requirements. However, a clear definition and agreement on design criteria of immersive experiences remains debated, creating challenges to advancing our understanding of immersive experiences and how these can be designed. Based on a multidisciplinary Delphi approach, this study provides a uniform definition of immersive experiences and identifies key criteria for the design and staging thereof. Thematic analysis revealed five key themes – transition into/out of the environment, in-experience user control, environment design, user context relatedness, and user openness and motivation, that emphasise the coherency in the user-environment interaction in the immersive experience. The study proposes an immersive experience framework as a guideline for industry practitioners, outlining key design criteria for four distinct facilitators of immersive experiences–systems, spatial, empathic/social, and narrative/sequential immersion. Further research is proposed using the immersive experience framework to investigate the hierarchy of user senses to optimise experiences that blend physical and digital environments and to study triggered, desired and undesired effects on user attitude and behaviour.
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DOEL. Dit artikel beoogt een kritische analyse te geven van de manier waarop het begrip Evidence Based Practice in de literatuur doorgaans wordt ingevuld, waarna mogelijkheden worden geschetst de in het artikel geconstateerde bezwaren te ondervangen. METHODE. Er is literatuuronderzoek gedaan naar de manier waarop EBP in de literatuur wordt ingevuld. RESULTAAT. Hoewel in de literatuur met betrekking tot EBP wordt aangegeven dat het handelen van professionals gebaseerd zou moeten zijn op een integratie van wetenschappelijk onderzoek, klinische expertise en cliëntenvoorkeuren, krijgt de bron van het wetenschappelijk onderzoek de meeste nadruk. Binnen dit wetenschappelijk onderzoek wordt kwantitatief onderzoek bovendien doorgaans hoger gewaardeerd dan kwalitatief onderzoek. De andere kennisbronnen (deskundigheid van de cliënt en expertise van de verpleegkundige) die bij EBP worden onderscheiden, blijven veelal onderbelicht. DISCUSSIE EN CONCLUSIE. De manier waarop EBP meestal wordt ingevuld en geïmplementeerd brengt een aantal beperkingen met zich mee. Voorbeelden hiervan zijn de beperkte aandacht voor: de kern van het verplegen, de interactie tussen de cliënt en de verpleegkundige, de context of de cultuur waarin de zorgverlening plaatsvindt, het benutten van de ervaringsdeskundigheid van de cliënt en de expertise van de verpleegkundige zelf. In het artikel worden suggesties gegeven om deze beperkingen te ondervangen, zodat EBP inderdaad de integratie wordt van de verschillende kennisbronnen die in de literatuur worden onderscheiden en EBP met mogelijk meer succes kan worden geïmplementeerd.
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