Background: Pharmacists' clinical decision-making is a core process in pharmaceutical care. However, the practical aspects and effective teaching methods of this process remain largely unexplored.... Show moreBackground: Pharmacists' clinical decision-making is a core process in pharmaceutical care. However, the practical aspects and effective teaching methods of this process remain largely unexplored. Objective: To examine the cognitive processes involved in pharmacists' perceptions of how they make clinical decisions in pharmacy practice. Methods: Semi-structured, face-to-face interviews were conducted with pharmacists working in community, outpatient, and hospital care in the Netherlands between August and December 2021. Participants were explicitly asked for examples when asked how they make clinical decisions in practice and how they teach this to others. After transcribing audio-recorded interviews, an inductive thematic analysis was conducted to identify cognitive processes. A theoretical model of clinical decision-making was then used and adapted to structure the identified processes. Results: In total, 21 cognitive processes were identified from interviews with 16 pharmacists working in community (n = 5), outpatient (n = 2), and hospital care (n = 9). These cognitive processes were organized into 8 steps of the adapted theoretical model, i.e. problem and demand for care consideration, information collection, clinical reasoning, clinical judgment, shared decision-making, implementation, outcomes evaluation, and reflection. Pharmacists struggled to articulate their clinical decision-making and went back-and-forth in their explanations of this process. All pharmacists emphasized the importance of identifying the problem and described how they collect information through reviewing, gathering, recalling, and investigating. Clinical reasoning entailed various cognitive processes, of which comprehending the problem in the patient's context was deemed challenging at times. Pharmacists seemed least active in evaluating patient outcomes and reflecting on these outcomes. Conclusions: Pharmacists use multiple cognitive processes when making clinical decisions in pharmacy practice, and their back-and-forth explanations emphasize its dynamic nature. This study adds to a greater understanding of how pharmacists make clinical decisions and to the development of a theoretical model that describes this process, which can be used in pharmacy practice and education. Show less
This paper follows the analysis of Vansina in analyzing colonization as an attempt to destroy and replace Africa’s autonomous cultural systems. It shows that in Botswana, this has been only... Show moreThis paper follows the analysis of Vansina in analyzing colonization as an attempt to destroy and replace Africa’s autonomous cultural systems. It shows that in Botswana, this has been only partially successful. Due to clever forms of resistance,Botswana has been able to keep part of its autonomy intact. This helps to explain the relative success the country has had. However, in the educational field, the country is now also one of the first to be confronted with the limitations that are inherent in the colonial education system. The paperargues that a gradual transition to using indigenous languages as a medium of instruction is practically possible and will become inescapable if the country wishes to reach the goals it has set for itself. In this, special attentionis needed for the speakers of Khoisan languages. Show less
BackgroundA good educational climate is essential for delivering high-quality training for medical trainees, professional development, and patient care. The aim of this study was to (1) validate... Show moreBackgroundA good educational climate is essential for delivering high-quality training for medical trainees, professional development, and patient care. The aim of this study was to (1) validate the Dutch Residency Educational Climate Test (D-RECT) in a Danish setting and (2) describe and evaluate the educational climate among medical trainees.MethodsD-RECT was adopted in a three-step process: translation of D-RECT into Danish (DK-RECT), psychometric validation, and evaluation of educational climate. Trainees from 31 medical specialties at Copenhagen University Hospital - Rigshospitalet, Denmark were asked to complete an online survey in a cross-sectional study.ResultsWe performed a forward-backward translation from Dutch to Danish. Confirmatory factor analysis showed that DK-RECT was robust and valid. The reliability analysis showed that only seven trainees from one specialty were needed for a reliable result. With 304 trainees completing DK-RECT, the response rate was 68%. The subsequent analysis indicated a positive overall educational climate, with a median score of 4.0 (interquartile range (IQR): 3.0-5.0) on a five-point Likert scale. Analysis of the subscales showed that the subscale Feedback received the lowest ratings, while Supervision and Peer collaboration were evaluated highest.ConclusionsPsychometric validation of D-RECT in a Danish context demonstrated valid results on the educational climate in specialist training. DK-RECT can be used to evaluate the effectiveness of interventions in the future and can facilitate the conversation on the educational climate. Show less
Interest is key to learning. Video is a promising tool for interest development in education, but professionals in education are in need of more theory-grounded guidance for production, selection,... Show moreInterest is key to learning. Video is a promising tool for interest development in education, but professionals in education are in need of more theory-grounded guidance for production, selection, and use of videos. In previous studies, we developed and validated a model on film’s interest raising mechanisms in educational contexts, called the FIRM model. In the qualitative study reported here, we used the model to explain how pupils’ appraisals of video characteristics relate to their interest in the video. We evaluated the use of five videos in seven 12th-grade science and mathematics classrooms (177 pupils). We measured interest at scene level and grouped pupils on general interest. We performed video analyses, case studies (N = 5), and a cross-case analysis. Our findings resulted in three relationships between appraisals and interest, regarding the video’s complexity level and the pupils’ knowledge level, pupils’ recognition of video categories, and pupils’ expectations of videos. Show less
Research shows that teachers and education are often represented negatively or stereotypically in popular and literary culture, both in the Dutch language area and in Anglophone contexts. Regarding... Show moreResearch shows that teachers and education are often represented negatively or stereotypically in popular and literary culture, both in the Dutch language area and in Anglophone contexts. Regarding contemporary Dutch literature, though, research on educational representations has until now focussed on small corpora of novels that explicitly deal with education. In this article, we explore the representations of teachers and education in a much larger and broader corpus: the 170 submissions to the bulk list of the prestigious Dutch Libris Literatuurprijs of 2013. We provide a Keyword in Context Analysis of 292 educational representations in this corpus and offer a demographic analysis of the 71 teachers who inhabit the novels under analysis. In doing so, we show that educational representations and teacher characters are relatively common in contemporary Dutch language novels. Our analysis also reveals that literary representations of teachers are predominantly negative in nature, especially regarding their behaviour towards students, their external presentation, and their pedagogical skills. Representations of education in general tend to be even more negative. In that sense, literary representations of education appear to converge with the negative public appeal of the educational sector in the contemporary Low Countries. Show less
Sanon-Ouattara, F.E.G.; Pinxteren, L.M.C. van 2022
Experiments with indigenous languages as medium of instruction have been ongoing in francophone Africa. These experiments have not been generalized to all schools by educational authorities and... Show moreExperiments with indigenous languages as medium of instruction have been ongoing in francophone Africa. These experiments have not been generalized to all schools by educational authorities and have been limited to the first few years of primary education. A more generalized approach to using indigenous languages as medium of instruction can contribute to improve the outcomes of education. However, when is such a development likely to occur and which languages should be chosen? This article explores these questions using the case of Burkina Faso as an example. We show that it will be practically possible to use a limited number of indigenous languages as medium of instruction, rather than all languages spoken in the country. In order to do so, we introduce an approximate assessment of which languages are easy to learn and to teach, for speakers of which other languages. We demonstrate that a gradual transition towards indigenous languages will become a necessity if the present trend of increased participation in education continues into the future. In order for this to happen, careful planning and preparation will be essential; we conclude with a brief examination of what such planning and preparation might consist of. Show less
BackgroundTo support family caregivers of people with dementia in end-of-life decision making, a family booklet on comfort care has been adapted and adopted by several European jurisdictions since... Show moreBackgroundTo support family caregivers of people with dementia in end-of-life decision making, a family booklet on comfort care has been adapted and adopted by several European jurisdictions since the original publication in Canada in 2005.MethodsWe analyzed and compared the adaptations to the family booklets used in Canada, the Czech Republic, Italy, the Netherlands, the UK and Ireland that were made up to 2021. Qualitative content analysis was used to create a typology of changes to the original booklet. Interviews with the teams that adapted the booklets contributed to methodological triangulation. Further, using an established framework, we assessed whether the contents of the booklets addressed all domains relevant to optimal palliative dementia care.ResultsThe booklets differed in the types of treatment addressed, in particular tube feeding, euthanasia, and spiritual care. There was also variability in the extent to which medical details were provided, an emphasis on previously expressed wishes in medical decision making, addressing of treatment dilemmas at the end of life, the tone of the messages (indirect or explicit) and the discussion of prognosis (as more or less positive), and the involvement of various healthcare professionals and family caregivers in care. All booklets addressed all domains of palliative dementia care.ConclusionsWe identified core elements in providing information on end-of-life care to family caregivers of people with dementia as related to optimal palliative care in dementia. Additionally, local adaptations and updates are required to account for socio-cultural, clinical, and legal differences which may also change over time. These results may inform development of educational and advance care planning materials for different contexts. Show less
Education is important for fostering research integrity (RI). Although RI training is increasingly provided, there is little knowledge on how research stakeholders view institutional RI education... Show moreEducation is important for fostering research integrity (RI). Although RI training is increasingly provided, there is little knowledge on how research stakeholders view institutional RI education and training policies. Following a constructivist approach, we present insights about research stakeholders’ views and experiences regarding how research institutions can develop and implement RI education and training policies. We conducted thirty focus groups, engaging 147 participants in eight European countries. Using a mixed deductive-inductive thematic analysis, we identified five themes: (1) RI education should be available to all; (2) education and training approaches and goals should be tailored; (3) motivating trainees is essential; (4) both formal and informal educational formats are necessary; and (5) institutions should take into account various individual, institutional, and system-of-science factors when implementing RI education. Our findings suggest that institutions should make RI education attractive for all and tailor training to disciplinary-specific contexts. Show less
Zhao, S.S.; Nikiphorou, E.; Boonen, A.; Lopez-Medina, C.; Dougados, M.; Ramiro, S. 2021
Objective: To examine whether associations between socioeconomic factors and work outcomes in spondyloarthritis (SpA) differ across axial (axSpA), peripheral SpA (pSpA) and psoriatic arthritis (PsA... Show moreObjective: To examine whether associations between socioeconomic factors and work outcomes in spondyloarthritis (SpA) differ across axial (axSpA), peripheral SpA (pSpA) and psoriatic arthritis (PsA), and whether associations for individual-level socioeconomic factors are modified by country-level factors. Methods: Patients with a physician diagnosis of SpA within working age (18-65 years) were included. Associations between individual-(age, gender, education, marital status) and country-level factors (Human Development Index, Health Care Expenditure (HCE), Gross Domestic Product, percentage unemployed) with work outcomes (employment status, absenteeism, presenteeism) were assessed using multivariable mixed-effects models. Associations between individual factors and outcomes were compared according to SpA phenotypes and country-level factors using interaction terms. Results: A total of 3835 patients (mean age 42 years, 61% males) from 23 countries worldwide were included (66% axSpA, 10% pSpA, 23% PsA). Being employed was associated with gender (male vs. female OR 2.5; 95%CI 1.9-3.2), education (university vs. primary OR 3.7; 2.9-4.7), marital status (married vs. single OR 1.3; 1.04-1.6), and age in a non-linear manner. University (vs primary) education was associated with lower odds of absenteeism (OR 0.7; 0.5-0.96) and presenteeism (OR 0.5; 0.3-0.7). Associations were similar across SpA phenotypes. Higher HCE was associated with more favourable work outcomes, e.g., higher odds of employment (OR 2.5; 1.5-4.1). Gender discrepancy in odds of employment was greater in countries with lower socioeconomic development. Conclusion: Higher educational attainment and higher HCE were associated with more favourable work outcomes, independently of SpA phenotype. The disadvantageous effect of female gender on employment is particularly strong in countries with lower socioeconomic development. (c) 2021 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/) Show less
Film has been used for education ever since educators recognized its powerful potential for learning. But its educational application has been criticized throughout the decades for underuse of the... Show moreFilm has been used for education ever since educators recognized its powerful potential for learning. But its educational application has been criticized throughout the decades for underuse of the distinctive potential of film: to raise interest. To understand more fully film's potential for learning, we propose a dynamic model of viewer interest and its underlying cognitive and emotional mechanisms (film's interest raising mechanisms or FIRM model). In addition, we present an analysis method for assessing the interestingness of films in learning contexts. Our model marries interest theories from cognitive film theory and educational psychology and captures the dynamics of interestingness across a film as depending on a balance between challenge posed and coping potential provided. Show less
Iotova, V.; Schalin-Jantti, C.; Bruegmann, P.; Broesamle, M.; Graaf, J. de; Bratina, N.; ... ; Hiort, O. 2021
Aim To perform a baseline survey on condition-specific information access among patients/parents/caregivers with rare endocrine disorders (RD) in Europe. Methods Electronic invitation to... Show moreAim To perform a baseline survey on condition-specific information access among patients/parents/caregivers with rare endocrine disorders (RD) in Europe. Methods Electronic invitation to participate in a survey (19 questions) was sent to 120 patient advocacy groups (PAGs), and further distributed to 32 European countries. Results A total of 1138 respondents from 22 countries (74% women), aged between 1 year (parents) and 70 years, participated. The Netherlands, France, Germany, Italy and France had highest participation rates. All Main Thematic Groups (MTGs) were represented; the adrenal (32%), pituitary (26%) and thyroid (22%) were the most common. The majority of the respondents got information from their endocrinologist (75%), PAGs (37%) and expert reference centre (22%); 95% received information in their mother tongue. Leaflets (70%), infographics (65%), webinars (60%) and Internet films (55%) were preferred ways of learning. Respondents relied mostly on materials by PAGs and alliances (79%), rather than from specific international RD sites (15%). Fifty-six percent used Facebook, and 37% other social media, with a significant age difference (40 years) among non-users, 19% vs. 36%, p < 0.0001. Of all, 685 answered questions on informational materials for children-79% wanted materials that can be used by the children themselves. There was significant age difference (40 years) in the willingness to help create new educational materials; 49% vs. 34%, p < 0.001. Conclusions Our current patient information access survey provides a sound basis for further planning and execution of educational and teaching activities by Endo-ERN. Show less
Advanced endoscopic imaging is an emerging field in endoscopy practice, especially in optical diagnosis. Current technologies like virtual chromoendoscopy and small-field technologies allow... Show moreAdvanced endoscopic imaging is an emerging field in endoscopy practice, especially in optical diagnosis. Current technologies like virtual chromoendoscopy and small-field technologies allow visualization of subtle changes in mucosal and vascular patterns that are predictive of histology. The limiting factor in broadly utilizing these techniques is training and the need for reliable detection of these subtleties. This review provides the current evidence and limitations of training in advanced endoscopic imaging, and future directions of learning. A literature search was performed on PubMed and Medline through March 2020 with relevant keywords as advanced endoscopic imaging, training, and learning. References of relevant articles were screened for additional literature. Several didactic and web-based education programs are developed for training in virtual chromoendoscopy, autofluorescence imaging, confocal laser endomicroscopy, and volumetric laser endomicroscopy. Studies and post-hoc analysis on learning curves showed relatively steep learning curves after training, and web-based education seems to be as valuable as in-person didactic training for most techniques. However, consistent performance on expert level after training has not yet been demonstrated. Most advanced endoscopic imaging techniques are learned within a reasonable timeframe. Future efforts to enhance training and implementation of these techniques should focus on developing standardized and broadly incorporated training programs. The future role of artificial intelligence-assistance in advanced endoscopy and training has to be elucidated. Show less
WHO ARE WE? OR A PROFILE OF THE ARCHAEOLOGICAL PROFESSIONAL COMMUNITY IN BRAZIL: FIRST APPROACHESIn the last twenty years, archeological academic-scientific training has grown exponen-tially in... Show moreWHO ARE WE? OR A PROFILE OF THE ARCHAEOLOGICAL PROFESSIONAL COMMUNITY IN BRAZIL: FIRST APPROACHESIn the last twenty years, archeological academic-scientific training has grown exponen-tially in Brazil, culminating in the recognition of the profession in 2018. However, little is known about the demographic profiles of people working in the area, as well as of students in the process of training, in undergraduate and graduate levels. By updating some data from previous studies, in this manuscript we present the results of an initial survey on the professional profile in Brazilian archeology, which includes information on the trajectory of education, gender, nationality and re-search themes. This initiative allows us to outline the challenges of inclusion and representativeness in the exercise of the profession, whose reflections will assist us in the conceiving of practical measures for a change in this situation in the future. Show less
Purpose Sexual health is an important quality-of-life concern for cancer patients and survivors, but a difficult discussion topic for patients and healthcare professionals. The most important... Show morePurpose Sexual health is an important quality-of-life concern for cancer patients and survivors, but a difficult discussion topic for patients and healthcare professionals. The most important barriers causing healthcare professionals to avoid the topic are lack of education and lack of knowledge. How effective education about sexual health is for oncology healthcare professionals is not clear. The aim of this review is to examine the effectiveness of interventions in improving the provision of sexual healthcare for cancer patients. Methods A systematic literature review was conducted according to PRISMA guidelines using the following data sources: PubMed, PsychInfo, Embase and Emcare. Quantitative research was included which contained pre-intervention and post-intervention outcomes. The assessment of the studies was conducted independently by two reviewers. A third reviewer was involved if there was no consensus. Results Seven studies were included. In total, 572 oncology healthcare professionals participated, including physicians, nurses and allied healthcare professionals. Interventions consisted of 6 face-to-face sessions and one online program. Primary objectives of the studies were the assessment of improvement in knowledge about sexual health, improvement of practice, frequency of discussing sexual health and comfort level and the decline of perceived barriers to discussing sexual health. Studies showed that interventions resulted in improved realization of the objectives. Conclusions Although improvement in the knowledge of healthcare professionals was achieved, it was not possible to give an overall recommendation for the development of interventions due to the limited number of studies and heterogeneity of the data. Implications for Cancer Survivors Sexual health is an important area of survivorship that is often neglected. Many oncology healthcare professionals lack training and knowledge to provide such care. More evidence-based practices are needed to improve sexual healthcare for cancer survivors. Show less
Claassen, A.A.O.M.; Schers, H.J.; Busch, V.J.J.F.; Heesterbeek, P.J.C.; Hoogen, F.H.J. van den; Vlieland, T.P.M.V.; Ende, C.H.M. van den 2020
Background To evaluate the effect of a stand-alone mobile and web-based educational intervention (eHealth tool) compared to usual preparation of a first orthopedic consultation of patients with hip... Show moreBackground To evaluate the effect of a stand-alone mobile and web-based educational intervention (eHealth tool) compared to usual preparation of a first orthopedic consultation of patients with hip or knee osteoarthritis (OA) on patients' satisfaction. Methods A two-armed randomized controlled trial involving 286 patients with (suspicion of) hip or knee OA, randomly allocated to either receiving an educational eHealth tool to prepare their upcoming consultation (n = 144) or usual care (n = 142). Satisfaction with the consultation on three subscales (range 1-4) of the Consumer Quality Index (CQI - primary outcome) and knowledge (assessed using 22 statements on OA, range 0-22), treatment beliefs (assessed by the Treatment beliefs in OsteoArthritis questionnaire, range 1-5), assessment of patient's involvement in consultation by the surgeon (assessed on a 5-point Likert scale) and patient satisfaction with the outcome of the consultation (numeric rating scale), were assessed. Results No differences between groups were observed on the 3 subscales of the CQI (group difference (95% CI): communication 0.009 (- 0.10, 0.12), conduct - 0.02 (- 0.12, 0.07) and information provision 0.02 (- 0.18, 0.21)). Between group differences (95% CI) were in favor of the intervention group for knowledge (1.4 (0.6, 2.2)), negative beliefs regarding physical activities (- 0.19 (- 0.37, - 0.002) and pain medication (- 0.30 (- 0.49, - 0.01)). We found no differences on other secondary outcomes. Conclusions An educational eHealth tool to prepare a first orthopedic consultation for hip or knee OA does not result in higher patient satisfaction with the consultation, but it does influence cognitions about osteoarthritis. Show less
Jonge, L.P.J.W.M. de; Mesters, I.; Govaerts, M.J.B.; Timmerman, A.A.; Muris, J.W.M.; Kramer, A.W.M.; Vleuten, C.P.M. van der 2020
Background Direct observation of clinical task performance plays a pivotal role in competency-based medical education. Although formal guidelines require supervisors to engage in direct... Show moreBackground Direct observation of clinical task performance plays a pivotal role in competency-based medical education. Although formal guidelines require supervisors to engage in direct observations, research demonstrates that trainees are infrequently observed. Supervisors may not only experience practical and socio-cultural barriers to direct observations in healthcare settings, they may also question usefulness or have low perceived self-efficacy in performing direct observations. A better understanding of how these multiple factors interact to influence supervisors' intention to perform direct observations may help us to more effectively implement the aforementioned guidelines and increase the frequency of direct observations. Methods We conducted an exploratory quantitative study, using the Theory of Planned Behaviour (TPB) as our theoretical framework. In applying the TPB, we transfer a psychological theory to medical education to get insight in the influence of cognitive and emotional processes on intentions to use direct observations in workplace based learning and assessment. We developed an instrument to investigate supervisors intention to perform direct observations. The relationships between the TPB measures of our questionnaire were explored by computing bivariate correlations using Pearson's R tests. Hierarchical regression analysis was performed in order to assess the impact of the respective TPB measures as predictors on the intention to perform direct observations. Results In our study 82 GP supervisors completed our TPB questionnaire. We found that supervisors had a positive attitude towards direct observations. Our TPB model explained 45% of the variance in supervisors' intentions to perform them. Normative beliefs and past behaviour were significant determinants of this intention. Conclusion Our study suggests that supervisors use their past experiences to form intentions to perform direct observations in a careful, thoughtful manner and, in doing so, also take the preferences of the learner and other stakeholders potentially engaged in direct observations into consideration. These findings have potential implications for research into work-based assessments and the development of training interventions to foster a shared mental model on the use of direct observations. Show less
Grimmon, A.S.; Cramer, J.; Yazilitas, D.; Smeets, I.; De Bruyckere, P. 2020
