BackgroundWhile night shifts are crucial for patient care, they threaten doctors' well-being and performance. Knowledge of how the impact of night shifts differs for doctors is needed to attenuate... Show moreBackgroundWhile night shifts are crucial for patient care, they threaten doctors' well-being and performance. Knowledge of how the impact of night shifts differs for doctors is needed to attenuate the adverse effects of night shifts. This study aimed to obtain more precise insight into doctors' feelings surrounding night shift by: identifying profiles based on doctors' alertness, contentedness and calmness scores before and after night shifts (research question (RQ) 1); assessing how doctors' pre- and post-shift profiles change (RQ2); and determining associations of doctors' demographics and shift circumstances with alertness, contentedness and calmness change (RQ3).MethodsLatent Profile Analysis using doctors' pre- and post-shift self-rated alertness, contentedness and calmness scores was employed to identify pre- and post-shift profiles (RQ1). A cross-tabulation revealed pre- and post-shift profile changes (RQ2). Multiple regressions determined associations of demographics (i.e. age, sex, specialty) and night shift circumstances (i.e. hours worked pre-call, hours awake pre-call, shift duration, number of consecutive shifts, total hours of sleep) with alertness, contentedness and calmness change (RQ3).ResultsIn total, 211 doctors participated with a mean age of 39.8 & PLUSMN; 10 years; 47.4% was male. The participants included consultants (46.4%) and trainees (53.6%) of the specialties surgery (64.5%) and obstetrics/gynaecology (35.5%). Three pre-shift (Indifferent, Ready, Engaged) and four post-shift profiles (Lethargic, Tired but satisfied, Excited, Mindful) were found. Most doctors changed from Ready to Tired but satisfied, with alertness reducing most. Age, specialty, sleep, shift duration and the number of consecutive shifts associated with alertness, contentedness and calmness changes.ConclusionsThe results provided nuanced insight into doctors' feelings before and after night shifts. Future research may assess whether specific subgroups benefit from tailored interventions. Show less
Beulens, J.W.J.; Yauw, J.S.; Elders, P.J.M.; Feenstra, T.; Herings, R.; Slieker, R.C.; ... ; Heijden, A.A. van der 2021
Aims/hypothesis Approximately 25% of people with type 2 diabetes experience a foot ulcer and their risk of amputation is 10-20 times higher than that of people without type 2 diabetes. Prognostic... Show moreAims/hypothesis Approximately 25% of people with type 2 diabetes experience a foot ulcer and their risk of amputation is 10-20 times higher than that of people without type 2 diabetes. Prognostic models can aid in targeted monitoring but an overview of their performance is lacking. This study aimed to systematically review prognostic models for the risk of foot ulcer or amputation and quantify their predictive performance in an independent cohort.Methods A systematic review identified studies developing prognostic models for foot ulcer or amputation over minimal 1 year follow-up applicable to people with type 2 diabetes. After data extraction and risk of bias assessment (both in duplicate), selected models were externally validated in a prospective cohort with a 5 year follow-up in terms of discrimination (C statistics) and calibration (calibration plots).Results We identified 21 studies with 34 models predicting polyneuropathy, foot ulcer or amputation. Eleven models were validated in 7624 participants, of whom 485 developed an ulcer and 70 underwent amputation. The models for foot ulcer showed C statistics (95% CI) ranging from 0.54 (0.54, 0.54) to 0.81 (0.75, 0.86) and models for amputation showed C statistics (95% CI) ranging from 0.63 (0.55, 0.71) to 0.86 (0.78, 0.94). Most models underestimated the ulcer or amputation risk in the highest risk quintiles. Three models performed well to predict a combined endpoint of amputation and foot ulcer (C statistics >0.75).Conclusions/interpretation Thirty-four prognostic models for the risk of foot ulcer or amputation were identified. Although the performance of the models varied considerably, three models performed well to predict foot ulcer or amputation and may be applicable to clinical practice. Show less
Huizinga, C.R.H.; Tummers, F.H.M.P.; Marang-van de Mheen, P.J.; Cohen, A.E.; Bogt, K.E.A. van der 2019
The need for data to study the relationship between fatigued healthcare professionals and performance outcomes is evident, however, it is unclear which methodology is most appropriate to provide... Show moreThe need for data to study the relationship between fatigued healthcare professionals and performance outcomes is evident, however, it is unclear which methodology is most appropriate to provide these insights. To address this issue, we performed a systematic review of relevant articles by searching the MEDLINE, EMBASE, Cochrane, Web of Science, and CINAHL databases. The literature search identified 2960 unique references, of which 82 were identified eligible. The impact on performance was studied on clinical outcomes, medical simulation, neurocognitive performance, sleep quantification and subjective assessment. In general results on performance are conflicting; impairment, no effect, and improvement were found. This review outlines the various methods currently available for assessing fatigue-impaired performance. The contrasting outcomes can be attributed to three main factors: differences in the operationalisation of fatigue, incomplete control data, and the wide variety in the methods used. We recommend the implementation of a clinically applicable tool that can provide uniform data. Until these data become available, caution should be used when developing regulations that can have implications for physicians, education, manpower planning, and - ultimately - patient care. (C) 2019 Elsevier Ltd. All rights reserved. Show less
Within the higher education context, peer feedback is frequently applied as an instructional method. Research on the learning mechanisms involved in the peer feedback process has covered aspects of... Show moreWithin the higher education context, peer feedback is frequently applied as an instructional method. Research on the learning mechanisms involved in the peer feedback process has covered aspects of both providing and receiving feedback. However, a direct comparison of the impact that providing and receiving peer feedback has on students’ writing performance is still lacking. The current study compared the writing performance of undergraduate students (N = 83) who either provided or received anonymous written peer feedback in the context of an authentic academic writing task. In addition, we investigated whether students’ peer feedback perceptions were related to the nature of the peer feedback they received and to writing performance. Results showed that both providing and receiving feedback led to similar improvements of writing performance. The presence of explanatory comments positively related both to how adequate students perceived the peer feedback to be, as well as to students’ willingness to improve based upon it. However, no direct relation was found between these peer feedback perceptions and students’ writing performance increase. Show less
Students in secondary education inevitably favour some subjects more than other subjects. This appraisal may affect how motivation relates to performance in these subjects. Whereas autonomous... Show moreStudents in secondary education inevitably favour some subjects more than other subjects. This appraisal may affect how motivation relates to performance in these subjects. Whereas autonomous motivation is generally linked to positive school outcomes, the effect of controlled motivation is less clear. This study specifically focused on the associations of controlled motivation with performance in the context of favoured and disfavoured subjects. In the present study, secondary school students (N = 918) identified 2 favoured and 2 disfavoured subjects. Hierarchical linear modelling was performed to investigate the relationship of autonomous and controlled motivation with performance in these subjects. Results showed that autonomous motivation positively related to performance in both types of subjects. The association of controlled motivation with performance was negative in both contexts, and more negative in disfavoured subjects. For teaching practice, this means that teachers should always stimulate autonomous motivation, even for negatively appraised subjects. Show less
Bautista-Molano, W.; Landewe, R.B.M.; Londono, J.; Romero-Sanchez, C.; Valle-Onate, R.; Heijde, D. van der 2016
