How Do Trainees Use EPAs to Regulate Their Learning in the Clinical Environment? A Grounded Theory Study.

Introduction: Entrustable Professional Activities (EPAs) can potentially support self-regulated learning in the clinical environment. However, critics of EPAs express doubts as they see potential harms, like checkbox behaviour. This study explores how GP-trainees use EPAs in the clinical environment through the lens of self-regulated learning theory and addresses the question of whether EPAs help or hinder trainees' learning in a clinical environment.

[Education about primary-secondary care collaboration deserves more attention].

Effective primary-secondary care collaboration is crucial for patient care. However, this collaboration does not come naturally and requires specific attention during education and training. This article outlines what needs to be learned, how to approach it, and provides examples.

Intraprofessional boundary crossing in acute paediatric care: A rich journey for general practice and paediatric residents.

Background: Achieving optimal collaboration between general practitioners and hospital-based critical care doctors is vital yet challenging, necessitating targeted collaborative training during residency. Despite apparent benefits, implementing intraprofessional learning faces constraints. Understanding its occurrence is crucial for engaging and educating residents.

How does portfolio use support self-regulated learning during general practitioner specialty training? A qualitative focus group study.

Objectives: Portfolios are used to support self-regulated learning (SRL), but the research literature is still inconclusive on their effectiveness. This study explored experiences with portfolio use among different stakeholders, to answer the research question: How does portfolio use support SRL during general practitioner (GP) specialty training?

Design: We used a qualitative research design, based on phenomenology.

Setting: Three of the eight training institutes of Dutch GP specialty training participated in this study.

How does portfolio use affect self-regulated learning in clinical workplace learning: What works, for whom, and in what contexts?

Introduction: Portfolio use to support self-regulated learning (SRL) during clinical workplace learning is widespread, but much is still unknown regarding its effectiveness. This review aimed to gain insight in the extent to which portfolio use supports SRL and under what circumstances.

Methods: A realist review was conducted in two phases.

Reaching consensus on GP interprofessional competencies: a nominal group study.

Background: As the requirements for collaboration in primary care increase, effective interprofessional teamwork between GPs and other primary care professionals is crucial. The need for more training in interprofessional collaborative competencies is widely recognised. However, existing competency frameworks do not sufficiently specify interprofessional collaboration to guide interprofessional competency development.

Referring patients with stable moderate-to-advanced chronic kidney disease back to primary care: a feasibility study.

Background: Care for patients with chronic kidney disease (CKD) necessitates tailored pathways between primary and secondary care. It is unknown if back referring patients with CKD is safe and effective.

Aim: To study the feasibility of discharging patients with stable moderate-to-advanced CKD from secondary to primary care, and to evaluate quality of care (QoC) and patients' and GPs' experiences.

Exploring power dynamics and their impact on intraprofessional learning.

Background: During postgraduate training, considerable efforts for intraprofessional education are in place to prepare primary care residents (PC residents) and medical specialty residents (MS residents) for intraprofessional collaboration (intraPC). Power dynamics are inherently present in such hierarchical medical contexts. This affects intraPC (learning).

Intraprofessional workplace learning in postgraduate medical education: a scoping review.

Background: Residents need to be trained across the boundaries of their own specialty to prepare them for collaborative practice. Intraprofessional learning (i.e.

General practitioners' views on the influence of long-term care reforms on integrated elderly care in the Netherlands: a qualitative interview study.

This study explores the long-term care (LTC) reform in the Netherlands and its relation to the day-to-day integrated care for frail elderly people, from the perspective of general practitioners (GPs). We assessed GP perspectives regarding which elements of the LTC reform have promoted and hindered the provision of person-centred, integrated care for elderly people in the Netherlands. We performed case studies conducted by semi-structured interviews, using the Healthy Alliances (HALL) framework as a framework for thematic analysis.

Competencies for collaboration between general practitioners and medical specialists: a qualitative study of the patient perspective.

Objectives: To explore the patient view of competencies essential for doctors to provide good collaboration at the primary-secondary care interface.

Design: We used a qualitative research approach. Focus groups with patients were conducted to explore their opinions of doctors' competencies to provide good collaboration between primary and secondary care doctors.

Chances for learning intraprofessional collaboration between residents in hospitals.

Context: Intraprofessional collaboration (intraPC) between primary care (PC) doctors and medical specialists (MSs) is becoming increasingly important. Patient safety issues are often related to intraPC. In order to equip doctors well for their task of providing good quality and continuity of care, intraPC needs explicit attention, starting in postgraduate training.

What Patients with Mild-to-Moderate Kidney Disease Know, Think, and Feel about Their Disease: An In-Depth Interview Study.

Introduction: It is unknown what patients in primary care with mild-to-moderate chronic kidney disease (CKD) know, think, and feel about their diagnoses and how they value the information provided. The aim of the study was to explore their knowledge, thoughts, and experiences concerning their CKD and the information given to them.

Method: Qualitative interview study with patients with mild-to-moderate CKD who know their diagnoses and are treated mainly by family physicians.

General practitioners' perspectives on management of early-stage chronic kidney disease: a focus group study.

Background: Guideline adherence in chronic kidney disease management is low, despite guideline implementation initiatives. Knowing general practitioners' (GPs') perspectives of management of early-stage chronic kidney disease (CKD) and the applicability of the national interdisciplinary guideline could support strategies to improve quality of care.

Method: Qualitative focus group study with 27 GPs in the Netherlands.

Learning intraprofessional collaboration by participating in a consultation programme: what and how did primary and secondary care trainees learn?

Background: A growing number of patients require overview and management in both primary and secondary care. This situation requires that primary and secondary care professionals have well developed collaborative skills. While knowledge about interprofessional collaboration and education is rising, little is known about intraprofessional collaboration and education between physicians of various disciplines.

Adherence to chronic kidney disease guidelines in primary care patients is associated with comorbidity.

Background: GPs insufficiently follow guidelines regarding consultation and referral for chronic kidney disease (CKD).

Objective: To identify patient characteristics and quality of care (QoC) in CKD patients with whom consultation and referral recommendations were not followed.

Method: A 14 month prospective observational cohort study of primary care patients with CKD stage 3-5.

Web-based consultation between general practitioners and nephrologists: a cluster randomized controlled trial.

Background: Consultation of a nephrologist is important in aligning care for patients with chronic kidney disease (CKD) at the primary-secondary care interface. However, current consultation methods come with practical difficulties that can lead to postponed consultation or patient referral instead.

Objective: This study aimed to investigate whether a web-based consultation platform, telenephrology, led to a lower referral rate of indicated patients.

Communities of practice: A means to support occupational therapists' continuing professional development. A literature review.

Background: This literature review investigates what research reports about the contribution that communities of practice (CoPs) can make in the continuing professional development (CPD) of qualified occupational therapists.

Methods: Academic databases (CINAHL, MEDLINE and ERIC) were searched and articles were included based on pre-determined criteria. Five articles were included in the review.

What is the relationship between renal function and visit-to-visit blood pressure variability in primary care? Retrospective cohort study from routinely collected healthcare data.

Objective: To determine the relationship between renal function and visit-to-visit blood pressure (BP) variability in a cohort of primary care patients.

Design: Retrospective cohort study from routinely collected healthcare data.

Setting: Primary care in Nijmegen, the Netherlands, from 2007 to 2012.

Quality of chronic kidney disease management in primary care: a retrospective study.

Background: Early detection and appropriate management of chronic kidney disease (CKD) in primary care are essential to reduce morbidity and mortality.

Aim: To assess the quality of care (QoC) of CKD in primary healthcare in relation to patient and practice characteristics in order to tailor improvement strategies.

Design And Setting: Retrospective study using data between 2008 and 2011 from 47 general practices (207 469 patients of whom 162 562 were adults).

[Timely referral for predialysis; multiple players in the field].

Timely referral is essential in patients with end-stage renal disease. Time is needed to inform the patient on the options of dialysis or kidney transplantation and for the placement of arteriovenous fistulae if haemodialysis is indicated; early referral is associated with lower morbidity and mortality. A prerequisite for timely referral is that patients with chronic kidney disease are recognised, which involves the following factors: chronic kidney disease should be mentioned in the patient's history; the patient should be informed of the diagnosis; and patients, general practitioners, pharmacists and specialists should have knowledge of the risk factors for acute-on-chronic kidney disease.

Effect of shared care on blood pressure in patients with chronic kidney disease: a cluster randomised controlled trial.

Background: Chronic kidney disease (CKD) is highly prevalent in patients with diabetes or hypertension in primary care. A shared care model could improve quality of care in these patients

Aim: To assess the effect of a shared care model in managing patients with CKD who also have diabetes or hypertension. Design and setting A cluster randomised controlled trial in nine general practices in The Netherlands.