Innovating the practice of medical speciality training.

Educational innovations are being introduced into medical speciality training. But how do people who participate in medical speciality training (residents, consultants, programme directors) deal with these innovations? And what effects do educational innovations have according to these people?By addressing these questions, this thesis contributes to the knowledge about the challenging process of innovating medical speciality training.

Cultural diversity: blind spot in medical curriculum documents, a document analysis.

Background: Cultural diversity among patients presents specific challenges to physicians. Therefore, cultural diversity training is needed in medical education. In cases where strategic curriculum documents form the basis of medical training it is expected that the topic of cultural diversity is included in these documents, especially if these have been recently updated.

Perceived effects of innovations in postgraduate medical education: a Q study focusing on workplace-based assessment.

Purpose: Anticipating users' perceptions of the effects an innovation will have in daily practice prior to implementation may lead to a more optimal innovation process. In this study, the authors aimed to identify the kinds of perceptions that exist concerning the effects of workplace-based assessment (WBA), an innovation that is widely used in medical education, among its users.

Method: In 2012, the authors used Q methodology to ascertain the principal user perceptions of effects of WBA in practice.

The CanMEDS framework: relevant but not quite the whole story.

Background: Despite acknowledgement that the Canadian Medical Educational Directives for Specialists (CanMEDS) framework covers the relevant competencies of physicians, many educators and medical professionals struggle to translate the CanMEDS roles into comprehensive training programmes for specific specialties.

Aim: To gain insight into the applicability of the CanMEDS framework to guide the design of educational programmes for specific specialties by exploring stakeholders' perceptions of specialty specific competencies and examining differences between those competencies and the CanMEDS framework.

Methods: This case study is a sequel to a study among ObsGyn specialists.

The transition to hospital consultant and the influence of preparedness, social support, and perception: A structural equation modelling approach.

Background: Insight into the transition from specialist registrar to hospital consultant is needed to better align specialty training with starting as a consultant and to facilitate this transition.

Aims: This study investigates whether preparedness regarding medical and generic competencies, perceived intensity, and social support are associated with burnout among new consultants.

Method: A population-based study among all 2643 new consultants in the Netherlands (all specialties) was conducted in June 2010.

New consultants mastering the role of on-call supervisor: a longitudinal qualitative study.

Context: The supervision of specialty registrars during on-call shifts is essential to ensure the quality of both health care and medical education, but has been identified as a major novelty and stressor for new consultants in the transition from specialty training. There is a paucity of research on how consultants deal with their new supervisory roles and which factors influence this process. These issues are addressed in a prospective study designed to gather insights that can inform measures to ensure the provision of high-quality supervision and specialty training.

The transition to hospital consultant: Denmark and the Netherlands compared on preparedness for practice, perceived intensity and contextual factors.

Introduction: Danish and Dutch new consultants' perceptions regarding the transition to consultant were compared to gain insight into this period, particularly the influence of contextual factors concerning the organisation of specialty training and health care therein. Preparation for medical and generic competencies, perceived intensity and burnout were compared. Additionally, effects of differences in working conditions and cultural dimensions were explored.

Clarifying students' feedback-seeking behaviour in clinical clerkships.

Context: Why and how do students seek feedback on their performance in the clinical workplace and which factors influence this? These questions have remained largely unanswered in research into workplace learning during clinical clerkships. Research on feedback has focused mainly on feedback providers. Whether and how feedback recipients actively seek feedback are under-examined issues.

Exploration of perceived effects of innovations in postgraduate medical education.

Context: Many studies have examined how educational innovations in postgraduate medical education (PGME) impact on teaching and learning, but little is known about effects in the clinical workplace outside the strictly education-related domain. Insights into the full scope of effects may facilitate the implementation and acceptance of innovations because expectations can be made more realistic, and difficulties and pitfalls anticipated. Using workplace-based assessment (WBA) as a reference case, this study aimed to determine which types of effect are perceived by users of innovations in PGME.

How lead consultants approach educational change in postgraduate medical education.

Context:   Consultants in charge of postgraduate medical education (PGME) in hospital departments ('lead consultants') are responsible for the implementation of educational change. Although difficulties in innovating in medical education are described in the literature, little is known about how lead consultants approach educational change.

Objectives:   This study was conducted to explore lead consultants' approaches to educational change in specialty training and factors influencing these approaches.

The curriculum for the doctor of the future: messages from the clinician's perspective.

Background: Medical curricula should focus on the future of health care. Contemporary competency frameworks for curriculum design such as Canadian Medical Education Directions for Specialists (CanMEDS), ACGME and Tomorrow's Doctors share this vision by stressing generic competencies.

Aim: The objective of this study was to investigate how well a contemporary competency framework fits in with clinicians' perspectives on future health care.