To identify ethical issues that interns encounter in their clinical education and thus build a more empirical basis for the required contents of the clinical ethics curriculum. The authors analyzed a total of 522 required case reports on ethical dilemmas experienced by interns from September 1995 to May 1999 at the medical school of Vrije Universiteit in Amsterdam. They identified four regularly described and numerous less frequently described topics. The interns addressed a wide range of ethical themes. In 45% of the cases, they mentioned disclosure or non-disclosure of information and informed consent; in 37%, medical decisions at the end of life; in 16%, medical failures; and in 9%, problems transferring patients from one caregiver to another. The interns also identified 27 themes linked to their unique position as interns and 19 themes related to specific types of patients. Based on self-reported experiences, the authors conclude that clinical ethics teachers should reflect on a multitude of dilemmas. Special expertise is required with respect to end-of-life decisions, truth telling, medical failures, and transferring patients from one caregiver to another. The clinical ethics curriculum should encourage students to voice their opinions and deal with values, responsibilities, and the uncertainty and failings of medical interventions.
The Research Group International Cooperation investigates the acquisition of international competencies by internships or study abroad, the international competencies of lecturers, the needs and demands for international competencies of alumni and employers and which factors are important to attract international students to stay and work in the Netherlands. Sending students abroad is, by itself, not enough to develop international competencies, just as bringing students of different nationalities together in an international classroom is, by itself, not enough. The Research Group International Cooperation has therefore developed a training module to prepare students for the purposeful acquisition of international competencies (PREFLEX, Preparation for your Foreign Learning Experience). The Hague University of Applied Sciences wishes to be and to present itself as an international institute of higher education. That requires both a whole package of interventions to strengthen its international character and a clear message to Dutch and foreign partners and to prospective international and Dutch students. In order to bring policy, implementation, profiling and research together, The Hague University of Applied Sciences organized on 15 March 2013 an international conference for team leaders and directors, for internationalization and internship coordinators, for researchers and foreign partners and for international Dutch and foreign students. The aim was to sharpen the vision and the profile of The Hague University of Applied Sciences and to equip the participants with the ideas and the tools to engage all lecturers and students in international cooperation. After the introduction by Susana Menéndez and the keynote lecture by Lisa Childress, the workshops gave the participants an opportunity to go deeper into various aspects of internationalization and to engage actively in discussions with the workshop chairs, who introduced the topics. I hope that these proceedings will give all participants an insight in all workshops and also that non-participants can taste the fruits of this most inspiring and informative gathering.
INTRODUCTION: To facilitate various transitions of medical residents, healthcare team members and departments may employ various organizational socialization strategies, including formal and informal onboarding methods. However, residents' preferences for these organizational socialization strategies to ease their transition can vary. This study identifies patterns (viewpoints) in these preferences.METHODS: Using Q-methodology, we asked a purposeful sample of early-career residents to rank a set of statements into a quasi-normal distributed grid. Statements were based on previous qualitative interviews and organizational socialization theory. Participants responded to the question, 'What are your preferences regarding strategies other health care professionals, departments, or hospitals should use to optimize your next transition?' Participants then explained their sorting choices in a post-sort questionnaire. We identified different viewpoints based on by-person (inverted) factor analysis and Varimax rotation. We interpreted the viewpoints using distinguishing and consensus statements, enriched by residents' comments.RESULTS: Fifty-one residents ranked 42 statements, among whom 36 residents displayed four distinct viewpoints: Dependent residents (n = 10) favored a task-oriented approach, clear guidance, and formal colleague relationships; Social Capitalizing residents (n = 9) preferred structure in the onboarding period and informal workplace social interactions; Autonomous residents (n = 12) prioritized a loosely structured onboarding period, independence, responsibility, and informal social interactions; and Development-oriented residents (n = 5) desired a balanced onboarding period that allowed independence, exploration, and development.DISCUSSION: This identification of four viewpoints highlights the inadequacy of one-size-fits-all approaches to resident transition. Healthcare professionals and departments should tailor their socialization strategies to residents' preferences for support, structure, and formal/informal social interaction.
