Advances and challenges in endoscopy training: A mixed methods study among endoscopy trainers in the Netherlands.

Variation between trainers in providing traditional gastrointestinal endoscopy training, in which residents learn endoscopy by doing under the supervision of endoscopy trainers, may cause differences in endoscopy competence between residents. In this study, we explored endoscopy trainers' views on the current status and desired future best practices regarding endoscopy training. This mixed-methods study comprised quantitative survey data collected from 158 endoscopy trainers working in 26 gastroenterology teaching hospitals in the Netherlands and semi-structured interviews with 15 gastroenterology residency (associate) program directors (PDs).

Associations between physicians' SDM behaviour and participation of older patients and family members in triadic decision-making: An observational study.

Background: Medical consultations with older patients often include triadic conversations and decision-making processes involving physicians, patients, and family members. The presence of family members may change the communication dynamics and therefore increase the complexity of the consultation and decision-making process.

Objective: This study explored associations between physicians' shared decision-making (SDM) behaviour and patients' and family members' participation in the decision-making process.

The reliability of the College of Intensive Care Medicine of Australia and New Zealand "Hot Case" examination.

Background: High stakes examinations used to credential trainees for independent specialist practice should be evaluated periodically to ensure defensible decisions are made. This study aims to quantify the College of Intensive Care Medicine of Australia and New Zealand (CICM) Hot Case reliability coefficient and evaluate contributions to variance from candidates, cases and examiners.

Methods: This retrospective, de-identified analysis of CICM examination data used descriptive statistics and generalisability theory to evaluate the reliability of the Hot Case examination component.

Child participation during outpatient consultations: a mixed methods study.

Unlabelled: Although children wish to be included in their own healthcare, they recognize a gap between their right to be heard and their ability to become involved. Despite adaptation of medical consultation styles which suit a more patient-centered approach, data on the current state of child participation in clinical encounters are missing. We aimed to assess actual child participation in a Dutch pediatric clinic.

Observational study on the timing and method of interruption by hospital consultants during the opening statement in outpatient consultations.

Objective: To analyse verbal interruptions by Dutch hospital consultants during the patient's opening statement in medical encounters.

Design: Cross-sectional descriptive study.

Setting: Isala teaching hospital in Zwolle, the Netherlands.

Simulation-based bronchoscopy training: Randomized trial comparing worked example to video introduction.

Introduction: Learning the complex skill of bronchoscopy involves the integration of cognitive domains and motor skills. The development of simulators has opened up new possibilities in bronchoscopy training. This study aimed at evaluating how effective the modeling example methodology is in training this skill and assessed its effect on cognitive load in learning.

Child participation in triadic medical consultations: A scoping review and summary of promotive interventions.

Objectives: To promote patient centered care, children with health issues should be supported to participate in consultations with health care professionals. We aimed to summarize, in a scoping review, the evidence on child participation in triadic encounters and its promotive interventions.

Methods: Two researchers systematically searched four major databases, and included studies on child participation in medical consultations.

A framework to improve quality of hospital-based physiotherapy: a design-based research study.

Background: A quality framework for hospital-based physiotherapy is lacking. This study aims to design a framework, building on the currently available literature, to improve the quality of hospital-based physiotherapy.

Methods: A multidisciplinary panel of six representatives of hospital-based physiotherapy and their key stakeholders (patients, medical specialists, hospital management and professional association) was set up.

Endoscopy training in the Netherlands: a national survey among gastroenterology residents.

Training in endoscopy is a key objective of gastroenterology residency. There is currently no standardized or systematic training approach. This study evaluated and compared the current status of gastrointestinal endoscopy training programs in all teaching hospitals in the Netherlands from a resident perspective.

[Feedback in medical education - separate coaching for improvement from summative assessment].

A supervisor's feedback can change a medical learner's behaviour consistently if the learner views the supervisor as a credible role model. A learner's trust in the supervisor is a prerequisite for feedback to contribute to effective learning. In current educational practice, coaching for improvement and summative assessment are frequently mixed, which leads medical learners to experience workplace based assessments as tests and makes them unresponsive to formative feedback.

Hypoallergenicity assessment of an extensively hydrolyzed whey-protein formula in cow's milk allergic infants.

Background: Extensively hydrolyzed formulas are recommended for the dietary management of infants with cow's milk allergy (CMA).

Objectives: Hypoallergenicity, growth, and gastrointestinal (GI) tolerability of a new extensively hydrolyzed whey-protein formula (eHWF) in CMA children were assessed.

Methods: In this prospective, randomized, international, multi-center study (Trial NL3889), 34 children with confirmed CMA (74% IgE-mediated) underwent a double-blind, placebo-controlled food challenge (DBPCFC) with an eHWF developed with non-porcine enzymes, supplemented with prebiotic short-chain galacto- and long-chain fructo-oligosaccharides (0.

Patient coaching: What do patients want? A mixed methods study in waiting rooms of outpatient clinics.

Introduction: Effective communication in specialist consultations is difficult for some patients. These patients could benefit from support from a coach who accompanies them to and during medical specialist consultations to improve communication in the consultation room. This study aims to investigate patients' perspective on interest in support from a patient coach, what kind of support they would like to receive and what characterizes an ideal patient coach.

Shared decision-making in the Netherlands: Progress is made, but not for all. Time to become inclusive to patients.

Dutch initiatives targeting shared decision-making (SDM) are still growing, supported by the government, the Federation of Patients' Organisations, professional bodies and healthcare insurers. The large majority of patients prefers the SDM model. The Dutch are working hard to realise improvement in the application of SDM in daily clinical practice, resulting in glimpses of success with objectified improvement on observed behavior.

[Observing a resident doing a consultation with a patient: goal determines form].

Observation of residents by supervisors is a highly recommended, but underused educational tool in postgraduate medical education. Observation can be performed indirectly (using video recordings of residents performing clinical tasks) or directly (supervisor is present when the resident performs the task). The choice of the observation method depends on aim and context of the observation.

[Development and validation of a uniform QUality Instrument for ClerKship (QUICK)].

Objective: Because both clerks and medical faculty quality management workers expressed the need for it, we aimed to develop a compact, valid and uniform instrument to assess the quality of Dutch clinical clerkships across all medical faculties in the Netherlands.

Method: We divided all 249 items from existing published and unpublished clerkship quality instruments into the three essential learning environment domains: content, atmosphere and organisation. In a 3-stage Delphi procedure, the 45 most relevant items from this list were selected that comprehensively covered the three domains.

Patients' preferred and perceived decision-making roles, and observed patient involvement in videotaped encounters with medical specialists.

Objective: To assess how patients prefer and perceive medical decision making, which factors are associated with their preferred and perceived decision-making roles, and whether observed involvement reflects patients' perceived role.

Methods: We asked 781 patients visiting a medical specialist from 18 different disciplines to indicate their preferred and perceived decision-making roles. Patient involvement in videotaped consultations was assessed with the OPTION5 instrument.

Effectiveness of Individual Feedback and Coaching on Shared Decision-making Consultations in Oncology Care: Protocol for a Randomized Clinical Trial.

Background: Shared decision-making (SDM) is particularly important in oncology as many treatments involve serious side effects, and treatment decisions involve a trade-off between benefits and risks. However, the implementation of SDM in oncology care is challenging, and clinicians state that it is difficult to apply SDM in their actual workplace. Training clinicians is known to be an effective means of improving SDM but is considered time consuming.

Shared decision making, patient-centered communication and patient satisfaction - A cross-sectional analysis.

Objectives: The integration of shared decision making (SDM) and patient-centered communication (PCC) is needed to actively involve patients in decision making. This study examined the relationship between shared decision making and patient-centered communication.

Methods: In 82 videotaped hospital outpatient consultations by 41 medical specialists from 18 disciplines, we assessed the extent of shared decision making by the OPTION score and patient-centered communication by the Four Habits Coding Scheme (4HCS), and analyzed the occurrence of a high versus low degree (above or below median) of SDM and/or PCC, and its relation to patient satisfaction scores.

Why do medical residents prefer paternalistic decision making? An interview study.

Background: Although shared decision making is championed as the preferred model for patient care by patient organizations, researchers and medical professionals, its application in daily practice remains limited. We previously showed that residents more often prefer paternalistic decision making than their supervisors. Because both the views of residents on the decision-making process in medical consultations and the reasons for their 'paternalism preference' are unknown, this study explored residents' views on the decision-making process in medical encounters and the factors affecting it.

Association between allergen component sensitisation and clinical allergic disease in children.

Background: Allergen component sensitisation testing is becoming increasingly important in the diagnosis of peanut allergy. The aim of the present study was to evaluate the relationship between sensitisation and symptoms of allergic disease in children by testing a large panel of inhalants, food allergens, and allergen components.

Methods: For 287 children visiting our laboratory for allergy testing, symptoms of allergic disease were recorded by standardised validated questionnaires.

Shared Decision-making in Different Types of Decisions in Medical Specialist Consultations.

Backgrounds: Research on shared decision-making (SDM) has mainly focused on decisions about treatment (e.g., medication or surgical procedures).

Do consultants do what they say they do? Observational study of the extent to which clinicians involve their patients in the decision-making process.

Objectives: To assess whether consultants do what they say they do in reaching decisions with their patients.

Design: Cross-sectional analysis of hospital outpatient encounters, comparing consultants' self-reported usual decision-making style to their actual observed decision-making behaviour in video-recorded encounters.

Setting: Large secondary care teaching hospital in the Netherlands.

Why are children with asthma bullied? A risk factor analysis.

The links between bullying and asthma have not been explored in children. We wanted to determine the child/parent factors and attitudes associated with asthma-related bullying. Individual child/parent responses of children with asthma (N=943) from the Room to Breathe survey were analysed.