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
Abstract Purpose: The pharmacology and clinical pharmacology and therapeutics (CPT) education during the undergraduate medical curriculum of NOVA Medical School, Lisbon, Portugal, was changed from a traditional programme (i.e. discipline-based, lectures) to a problem-based learning (PBL) programme (i.e. integrated, case-based discussions) without an increase in teaching hours. The aim of this study was to investigate whether this change improved the prescribing competencies of final-year medical students. Methods: Final-year students from both programmes (2015 and 2019) were invited to complete a validated prescribing assessment and questionnaire. The assessment comprised 24 multiple-choice questions in three subdomains (working mechanism, side-effects and interactions/contraindications), and five clinical case scenarios of common diseases. The questionnaire focused on self-reported prescribing confidence, preparedness for future prescribing task and education received. Results: In total, 36 (22%) final-year medical students from the traditional programme and 54 (23%) from the PBL programme participated. Overall, students in the PBL programme had significantly higher knowledge scores than students in the traditional programme (76% (SD 9) vs 67% (SD 15); p = 0.002). Additionally, students in the PBL programme made significantly fewer inappropriate therapy choices (p = 0.023) and fewer erroneous prescriptions than did students in the traditional programme (p = 0.27). Students in the PBL programme felt more confident in prescribing, felt better prepared for prescribing as junior doctor and completed more drug prescriptions during their medical training. Conclusion: Changing from a traditional programme to an integrated PBL programme in pharmacology and CPT during the undergraduate medical curriculum may improve the prescribing competencies of final-year students.
LINK
This thesis presents an exploration of ‘how entrepreneurship education pedagogy can enhance undergraduate business students’ autonomous motivation for self-directed learning’. It has twin, equally valuable, purposes: to make an original theoretical contribution and to improve professional practice in this area. The work addresses the lack of pedagogical research in entrepreneurship education that focuses on learner development, with a specific aim at development of self-directed learning skills for lifelong learning. The research is approached with a concurrent, mixed methods design, comparing pre- and a post-EE, self-assessment survey results from 245 students, enrolled in a Young Enterprise venture creation programme, and a control group at a Dutch university. With the use of open-question surveys among the same population, during and after the EE modules, as well as from focus group discussions with a selection of participating students and teachers, explanation was sought for the observations drawn from the quantitative study. Significant relationships were found between students’ self-reported maturity of autonomy, self-efficacy, and motivation for learning, and in how these relate to self-directed learning readiness. Entrepreneurship education was found to significantly moderate the relationship between the learning characteristics and self-directed learning, and to strengthen of the students’ perceived readiness for self-directed learning. Explanation for the impact of EE were found to be related to the stage-wise, mixed pedagogy approach to learning, that combines authentic learning with a hierarchical approach to competence development, and supportive team dynamics. The research contributes to practice with a proposed conceptual framework for understanding how to prepare for self-directed learning readiness and a teaching-learning framework for its development in formal educational settings. It contributes to knowledge with its deeper understanding of how students experience learning in EE and how that affects their willingness to pursue learning opportunities.
MULTIFILE
BACKGROUND: Access to pain education for healthcare professionals is an International Association for the Study of Pain's key recommendation to improve pain care. The content of preregistration and undergraduate physical therapy pain curricula, however, is highly variable.OBJECTIVE: This study aimed to develop a list, by consensus, of essential pain-related topics for the undergraduate physical therapy curriculum.METHODS: A modified Delphi study was conducted in four rounds, including a Delphi Panel (N = 22) consisting of in pain experienced lecturers of preregistration undergraduate physical therapy of Universities of Applied Sciences in the Netherlands, and five Validation Panels. Round 1: topics were provided by the Delphi Panel, postgraduate pain educators, and a literature search. Rounds 2-4: the Delphi Panel rated the topics and commented. All topics were analyzed in terms of importance and degree of consensus. Validation Panels rated the outcome of Round 2.RESULTS: The Delphi Panel rated 257, 146, and 90 topics in Rounds 2, 3, and 4, respectively. This resulted in 71 topics judged as "not important," 97 as "important," and 89 as "highly important." In total, 63 topics were rated as "highly important" by the Delphi Panel and Validation Panels.CONCLUSION: A list was developed and can serve as a foundation for the development of comprehensive physical therapy pain curricula.
DOCUMENT
BACKGROUND: Intensive Care Units (ICUs) are daunting environments for physiotherapy (PT) students performing clinical rotations. To prepare students for this environment, a newly developed, evidence-based e-learning module was designed and implemented in the undergraduate curriculum. The aim of this study was to investigate whether e-learning is a feasible method in preparing PT students for clinical work in complex ICU environments, as perceived by students and experts.METHODS: A mixed methods proof of concept study was undertaken. Participants were final-year students of an international curriculum, and experts from didactic and clinical fields. An e-learning module consisting of 7 separate chapters based on the latest scientific evidence and clinical expertise was developed, piloted and incorporated into the undergraduate curriculum as a compulsory course to be completed prior to clinical ICU rotations. Data were collected through 3 focus group meetings and 5 semi-structured interviews; these meetings and interviews were audio recorded, transcribed verbatim and analyzed.RESULTS: The study sample comprised of 14 students and 5 experts. Thematic analysis revealed three themes: expected competencies of PT students in ICU, feeling prepared for ICU clinical work and dealing with local variety. The e-learning module enabled students to anticipate clinical situations and PT tasks in the ICU. Higher level clinical reasoning skills, handling of lines and wires and dealing with out-of-textbook situations could not be achieved with the e-learning module alone.CONCLUSIONS: An e-learning module can sufficiently prepare PT students for their clinical tasks in the ICU, as long as it is integrated with, or closely connected to, the students' clinical placement.
DOCUMENT
Background Interprofessional education is promoted as a means of enhancing future collaborative practice in healthcare. We developed a learning activity in which undergraduate medical, nursing and allied healthcare students practice interprofessional collaboration during a student-led interprofessional team meeting. Design and delivery During their clinical rotation at a family physician’s practice, each medical student visits a frail elderly patient and prepares a care plan for the patient. At a student-led interprofessional team meeting, medical, nursing and allied healthcare students jointly review these care plans. Subsequently, participating students reflect on their interprofessional collaboration during the team meeting, both collectively and individually. Every 4 weeks, six interprofessional team meetings take place. Each team comprises 9–10 students from various healthcare professions, and meets once. To date an average of 360 medical and 360 nursing and allied healthcare students have participated in this course annually. Evaluation Students mostly reported positive experiences, including the opportunity to learn with, from and about other healthcare professions in the course of jointly reviewing care plans, and feeling collectively responsible for the care of the patients involved. Additionally, students reported a better understanding of the contextual factors at hand. The variety of patient cases, diversity of participating health professions, and the course material need improvement. Conclusion Students from participating institutions confirmed that attending a student-led interprofessional team meeting had enabled them to learn with, from and about other health professions in an active role. The use of real-life cases and the educational design contributed to the positive outcome of this interprofessional learning activity.
DOCUMENT
Students in higher professional education are prepared for high level professional practice. To be able to fulfil their future roles, their educational programs aid them in developing their professionalism. This paper presents the conceptual and empirical search for a measurement model on professionalism. Professionalism is a multifaceted construct which is at best vaguely described in previous research. It is here conceptualized through the conceptual model by Griffioen (2019) as a personal integration of professional identity, professional knowledge and professional action that transforms over time through accommodation and assimilation practices. These practices imply the development of the (future) professional. Additionally, initial findings of the development of professionalism in students during their 4 year undergraduate degree are discussed.
DOCUMENT
Background: Clinical reasoning skills are considered to be among the key competencies a physiotherapist should possess. Yet, we know little about how physiotherapy students actually learn these skills in the workplace. A better understanding will benefit physiotherapy education.Objectives: To explore how undergraduate physiotherapy students learn clinical reasoning skills during placements.Design: A qualitative research design using focus groups and semi-structured interviews.Setting: European School of Physiotherapy, Amsterdam, the Netherlands.Participants: Twenty-two undergraduate physiotherapy students and eight clinical teachers participated in this study.Main outcome measures: Thematic analysis of focus groups and semi-structured interviews.Results: Three overarching factors appeared to influence the process of learning clinical reasoning skills: the learning environment, the clinical teacher and the student. Preclinical training failed to adequately prepare students for clinical practice, which expected them to integrate physiotherapeutic knowledge and skills into a cyclic reasoning process. Students’ basic knowledge and assessment structure therefore required further development during the placements. Clinical teachers expected a holistic, multifactorial problem-solving approach from their students. Both students and teachers considered feedback and reflection essential to clinical learning. Barriers to learning experienced by students included time constraints, limited patient exposure and patient communication.Conclusions: Undergraduate physiotherapy students develop clinical reasoning skills through comparison of and reflection on different reasoning approaches observed in professional therapists. Over time, students learn to synthesise these different approaches into their own individual approach. Physiotherapy programme developers should aim to include a wide variety of multidisciplinary settings and patient categories in their clinical placements.
DOCUMENT
This presentation compares the two main gifted education programmes for undergraduate students in the Netherlands and Germany. The programmes were evaluated and will be compared in terms of the institutions involved, the educational objectives pursued, the nature of support provided to the students, and the anticipated effects (Netherlands), respectively the achieved effects (Germany). The Dutch study focuses on the Sirius Program established by the Dutch government which invited universities to submit their own plans for the promotion of student excellence. The successful applications are analysed with respect to the above mentioned criteria. The German study focuses on the ideational support means, which is a varied enrichment programme provided by several national foundations that is supported with money and guidelines by the German government. The scholarship recipients were interviewed in large online surveys ( N1 = 2379 and N2 = 1614). Both programmes are endowed with public funding and thus are shaped by political objectives. Also, both programmes are conducted by non-governmental institutions: universities in the Netherlands, and basically political, religious and social foundations in Germany. Thus, the presentation provides insights in theory and practice of gifted undergraduate education in both countries. The discussion will address the impact of political objectives and organizational structures on the reality of gifted education. Strategies for educators to accumulate scientific knowledge about gifted education, about evidence-based goals and about real life limitations will be provided. The different evaluation methods will be discussed in order to find out the best practice for research.
DOCUMENT
Diagnosing teachers are teachers who perceive diagnostic information about students’ learning process, interpret these aspects, decide how to respond, and act based on this diagnostic decision. During supervision meetings about the undergraduate thesis supervisors make in-the-moment decisions while interacting with their students. We regarded research supervision as a teaching process for the supervisor and a learning process for the student. We tried to grasp supervisors’ in-the-moment decisions and students’ perceptions of supervisors’ actions. Supervisor decisions and student perceptions were measured with video-stimulated recall interviews and coded using a content analysis approach. The results showed that the in-the-moment decisions our supervisors made had a strong focus on student learning. Supervisors often asked questions to empower students or to increase student understanding. These supervising strategies seemed to be adapted to students’ needs, as the latter had positive perceptions when their control increased or when they received stimuli to think for themselves.
MULTIFILE
