BackgroundTo support professional development of medical students faced with challenges of the clinical phase, collaborative reflection sessions (CRSs) are used to share and reflect on workplace... Show moreBackgroundTo support professional development of medical students faced with challenges of the clinical phase, collaborative reflection sessions (CRSs) are used to share and reflect on workplace experiences. Facilitation of CRSs seems essential to optimise learning and to provide important skills for lifelong learning as a professional. However, little is known about which workplace experiences students share in CRSs without advance guidance on specific topics, and how reflecting on these experiences contributes to students’ professional development. Therefore, we explored which workplace experiences students shared, what they learned from reflection on these experiences, and how they perceived the value of CRSs.MethodsWe conducted an exploratory study among medical students (N = 99) during their General Practice placement. Students were invited to openly share workplace experiences, without pre-imposed instruction. A thematic analysis was performed on shared experiences and student learning gains. Students’ perceptions of CRSs were analysed using descriptive statistics.ResultsAll 99 students volunteered to fill out the questionnaire. We found four themes relating to students’ shared experiences: interactions with patients, complex patient care, diagnostic or therapeutic considerations, and dealing with collegial issues. Regarding students’ learning gains, we found 6 themes: learning from others or learning from sharing with others, learning about learning, communication skills, self-regulation, determination of position within the healthcare team, and importance of good documentation. Students indicated that they learned from reflection on their own and peer’s workplace experiences. Students valued the CRSs as a safe environment in which to share workplace experiences and helpful for their professional development.ConclusionsIn the challenging General Practice placement, open-topic, guided CRSs provide a helpful and valued learning environment relevant to professional development and offer opportunities for vicarious learning among peers. CRSs may also be a valuable tool to incorporate into other placements. Show less
BackgroundAs there is a need to prepare doctors to minimize errors, we wanted to determine how doctors go about reflecting upon their medical errors.MethodsWe conducted a thematic analysis of the... Show moreBackgroundAs there is a need to prepare doctors to minimize errors, we wanted to determine how doctors go about reflecting upon their medical errors.MethodsWe conducted a thematic analysis of the published reflection reports of 12 Dutch doctors about the errors they had made. Three questions guided our analysis: What triggers doctors to become aware of their errors? What topics do they reflect upon to explain what happened? What lessons do doctors learn after reflecting on their error?ResultsWe found that the triggers which made doctors aware of their errors were mostly death and/or a complication. This suggests that the trigger to recognize that something might be wrong came too late. The 12 doctors cited 20 topics’ themes that explained the error and 16 lessons-learnt themes. The majority of the topics and lessons learnt were related more to the doctors’ inner worlds (personal features) than to the outer world (environment).ConclusionTo minimize errors, doctors should be trained to become earlier and in time aware of distracting and misleading features that might interfere with their clinical reasoning. This training should focus on reflection in action and on discovering more about doctors’ personal inner world to identify vulnerabilities. Show less
Aimed to gain insight into patients’ expectations regarding the professionalism of GPs, we first studied unsolicited patient complaints. It appeared that a substantial proportion of unsolicited... Show moreAimed to gain insight into patients’ expectations regarding the professionalism of GPs, we first studied unsolicited patient complaints. It appeared that a substantial proportion of unsolicited complaints concern professionalism issues. This dissertation provides insight into how patients experience unprofessional behaviour of physicians.Further, it provides educators with appropriate language to describe the unprofessional behaviour of residents, which matches that of the 4 I’s model. This language can contribute to the early identification of professionalism issues and the remediation of lapses in professionalism.This dissertation also provides insights into the PIF of GP residents from the perspectives of both supervisors and residents. According to residents, identity formation occurs primarily in the workplace as they move from doing the work of to becoming a GP and negotiate perceived norms. Residents feel that a tapestry of interrelated influencing factors – most prominently clinical experiences, clinical supervisors, and self-assessments – which changes over time, is felt to exert its influence predominantly in the workplace. Their supervisors have an image of the professional identity they are supporting and work toward that goal through role-modeling and mentoring. Supervisors believe that a bond of trust between supervisor and resident is a prerequisite to properly support residents’ PIF. Show less
