Developing a digital training tool to support oncologists in the skill of information-provision: a user centred approach.

Background: For patients with cancer, being well informed by their oncologist about treatment options and the implications thereof is highly relevant. Communication skills training (CST) programs have shown to be effective in improving clinicians' communication skills, yet CSTs are time-consuming, inconvenient to schedule, and costly. Online education enables new ways of accessible learning in a safe and personalised environment.

Terminal Bleeding in Angiosarcoma.

Terminal bleeding, a distressing symptom experience for patients, caregivers, and health professionals, occurs in a subset of patients in the palliative care setting. Terminal bleeding is often thought of as a large-volume catastrophically fatal event, but it can also occur for a longer period of time and still be the precipitating event for a patient's death. We present the case of terminal bleeding in an 87-year-old patient with angiosarcoma, a rare aggressive vascular neoplasm that can occur anywhere in the body but tend to occur more frequently in the head and neck.

Developing a digital communication training tool on information-provision in oncology: uncovering learning needs and training preferences.

Background: Adequate information-provision forms a crucial component of optimal cancer care. However, information-provision is particularly challenging in an oncology setting. It is therefore imperative to help oncological health care practitioners (HCP) optimise their information-giving skills.

Students' approaches to medical school choice: relationship with students' characteristics and motivation.

Objectives: The aim was to examine main reasons for students' medical school choice and their relationship with students' characteristics and motivation during the students' medical study.

Methods: In this multisite cross-sectional study, all Year-1 and Year-4 students who had participated in a selection procedure in one of the three Dutch medical schools included in the study were invited to complete an online survey comprising personal data, their main reason for medical school choice and standard, validated questionnaires to measure their strength of motivation (Strength of Motivation for Medical School-Revised) and autonomous and controlled type of motivation (Academic Self-regulation Questionnaire). Four hundred seventy-eight students participated.

A multi-site study on medical school selection, performance, motivation and engagement.

Medical schools seek ways to improve their admissions strategies, since the available methods prove to be suboptimal for selecting the best and most motivated students. In this multi-site cross-sectional questionnaire study, we examined the value of (different) selection procedures compared to a weighted lottery procedure, which includes direct admission based on top pre-university grade point averages (≥8 out of 10; top-pu-GPA). We also considered whether students had participated in selection, prior to being admitted through weighted lottery.

Self-evaluation and peer-feedback of medical students' communication skills using a web-based video annotation system. Exploring content and specificity.

Objective: Self-evaluation and peer-feedback are important strategies within the reflective practice paradigm for the development and maintenance of professional competencies like medical communication. Characteristics of the self-evaluation and peer-feedback annotations of medical students' video recorded communication skills were analyzed.

Method: Twenty-five year 4 medical students recorded history-taking consultations with a simulated patient, uploaded the video to a web-based platform, marked and annotated positive and negative events.

Peer-assessment of medical communication skills: the impact of students' personality, academic and social reputation on behavioural assessment.

Objective: Peer-assessment of communication skills may contribute to mastery of assessment criteria. When students develop the capacity to judge their peers' performance, they might improve their capacity to examine their own clinical performance. In this study peer-assessment ratings are compared to teacher-assessment ratings.

The psychophysiology of medical communication. Linking two worlds of research.

Objective: Medical communication is goal oriented behavior. As such, it can be modeled as a chain of decisions, resulting from cognitive and emotional processes each potentially associated with psychophysiological reactions. Psychophysiological may be helpful to detect small changes in affect or arousal in the course of a consultation that would be difficult to detect by other evaluations of the process, like self-reports.

How stressful is doctor-patient communication? Physiological and psychological stress of medical students in simulated history taking and bad-news consultations.

Introduction: Medical communication can be a stressful experience for both doctors and patients. In particular, inexperienced doctors facing the demanding task of a bad news consultation may experience high levels of distress. The aim of this exploratory study is to test students' differential cardiovascular reactivity to history taking and bad news consultations with a simulated patient, and to test the relation between the students' self-reported stressfulness of the consultation and their cardiovascular response.

Shifting goals in medical communication. Determinants of goal detection and response formation.

Objectives: Research and education of medical communication different perspective, making the extraction of clear recommendations from research that can be applied in education not always possible. In education, medical communication is encountered from a goal-oriented perspective, which is often lacking in quantitative research where the relationship between process variables and the content of medical practice is often ignored. The aim of this paper is to bring the worlds of research and education together by presenting a comprehensive model of determinants explaining the behavior of physicians in daily practice.

Reflective teaching of medical communication skills with DiViDU: assessing the level of student reflection on recorded consultations with simulated patients.

Objective: Acquisition of effective, goal-oriented communication skills requires both practicing skills and reflective thinking. Reflection is a cyclic process of perceiving and analysing communication behaviour in terms of goals and effects and designing improved actions. Based on Korthagen's ALACT reflection model, communication training on history taking was designed.

Effectiveness of selection in medical school admissions: evaluation of the outcomes among freshmen.

Context: In 2000 our medical school introduced a selection procedure (SP) for 10% of the otherwise randomly selected (RS) applicants. Students with excellent high school grade point averages (GPAs) were allowed direct access (DA) to our medical school. The selection procedure focused on medical comprehension, social and ethical understanding of health care, and communication and interpersonal skills.

Summative assessment of medical students' communication skills and professional attitudes through observation in clinical practice.

Unlabelled: To establish medical students' professional competence for the medical profession, we designed a standardized observation procedure and the Amsterdam Attitude and Communication Scale (AACS) with nine five-point scale items, for summative assessment of their communication skills and professional attitudes. This study examines the reliability of the AACS assessment in clinical practice. In the Academic Medical Centre, Amsterdam, The Netherlands, the performance of 442 fifth year clinical students was judged six times in two settings: behaviour in clinical practice was judged independently twice by a doctor and a nurse; one videotaped patient interview was judged independently by a doctor and by a psychologist.

Using standardized video cases for assessment of medical communication skills: reliability of an objective structured video examination by computer.

Objective: Using standardized video cases in a computerized objective structured video examination (OSVE) aims to measure cognitive scripts underlying overt communication behavior by questions on knowledge, understanding and performance. In this study the reliability of the OSVE assessment is analyzed using the generalizability theory.

Methods: Third year undergraduate medical students from the Academic Medical Center of the University of Amsterdam answered short-essay questions on three video cases, respectively about history taking, breaking bad news, and decision making.

Assessment of medical communication skills by computer: assessment method and student experiences.

Background: A computer-assisted assessment (CAA) program for communication skills designated ACT was developed using the objective structured video examination (OSVE) format. This method features assessment of cognitive scripts underlying communication behaviour, a broad range of communication problems covered in 1 assessment, highly standardised assessment and rating procedures, and large group assessments without complex organisation.

Setting: The Academic Medical Centre (AMC) at the University of Amsterdam, the Netherlands.

Communication patterns of primary care physicians in the United States and the Netherlands.

Background: While international comparisons of medical practice have noted differences in length of visit, few studies have addressed the dynamics of visit exchange.

Objectives: To compare the communication of Dutch and U.S.