How to evaluate lifelong learning skills of healthcare professionals: a systematic review on content and quality of instruments for measuring lifelong learning.

Background: Having lifelong learning skills is a necessity for healthcare professionals. To evaluate these skills, sound instruments are needed. Those working in healthcare of medical educating looking for a suitable instrument to evaluate lifelong learning (LLL) skills in healthcare professionals are faced with a multitude of definitions and operationalizations of the concept of LLL.

Tracking response flexibility in high-stakes summative assessments: A longitudinal student perspective.

Purpose: The ability to perceive assessments as learning instruments calls upon flexible perspective taking and flexible responding. We investigated the maturation of the student perspective on assessment as learning and explored the (in)flexibility of student responses during their development towards graduation.

Methods: In a longitudinal study with an extensive 6-year timeframe, we tracked the development of 12 medical students.

Design and Validation of a Questionnaire to Measure Interprofessional Collaborative Practice for Auditing Integrated Hospital Care: Empirical Research.

Introduction: Interprofessional teamwork is the key issue of delivering integrated hospital care; however, measuring interprofessional collaboration for auditing is fragmented. In this study, a questionnaire to measure InterProfessional collaborative Practice for Integrated Hospital care (IPPIH) has been developed and validated.

Methods: A four-step iterative process was conducted: (1) literature search to find suitable questionnaires; (2) semistructured stakeholder interviews (individual and in focus groups) to discuss the topics and questions (face validity), (3) pretesting the prototype of the questionnaire in two different integrated care pathways for feasibility, usability, and internal consistency, and (4) testing (content and construct validity and responsiveness) of the revised questionnaire in eight integrated care pathways; the validation and responsiveness was tested by means of exploratory factor analysis, calculation of Cronbach alpha, item analysis, and linear mixed model analysis.

Co-learning and co-teaching in a newly introduced research learning community.

Background: Research clerkships are usually designed as individual learning projects focusing on research skills training, such as research design, data analysis and reporting. When the COVID-19 pandemic triggered an urgent need for digital education, we redesigned a research clerkship with the challenging aim to maintain original quality for more students than usual with limited teaching staff.

Approach: We introduced the concept of a research learning community (RLC) with co-teaching and co-learning to a group of 14 students and seven teaching faculty using digital platforms.

An innovative assessment tool for evaluating narrative feedback quality among Medicine and Biomedical Sciences students.

Objectives: To develop a reliable instrument to objectively assess feedback quality, to use it for assessment of the quality of students' narrative feedback and to be used as a self-assessment instrument for students in their learning process.

Methods: In a retrospective cohort study, 635 feedback narratives, provided by small groups of Medicine and Biomedical Sciences undergraduate students, have been extracted from available quarterly curriculum evaluation surveys. A rubric was developed based on literature and contents of our feedback education.

How to coach student professional development during times of challenges and uncertainties.

Background: What we teach our (bio)medical students today may differ from the future context under which they will operate as health professionals. This shifting and highly demanding profession requires that we equip these students with adaptive competencies for their future careers. We aimed to develop a framework to promote and facilitate professional development from day one, guided by self-awareness and self-directed learning.

The teacher as coach: An innovative, longitudinal training for (bio)medical educators.

Background: In order to be impactful, to support students to become resilient, adaptive, and collaborative lifelong learning professionals in an ever-changing environment requires the teachers to have a specific set of skills and abilities. Teachers who are not taught these competencies struggle empirically and cannot coach students effectively in the modern professional world.

Approach: We developed a longitudinal programme for teachers, combining theory and skills training, and performed nine half-day hands-on training modules on campus.

Twelve tips for patient involvement in health professions education.

Moving towards person-centered care, with equal partnership between healthcare professionals and patients, requires a solid role for the patient in the education of students and professionals. Patients can be involved as teachers, assessors, curriculum developers, and policy-makers. Yet, many of the initiatives with patients are isolated, small events for targeted groups and there is a lack of patient involvement at the institutional level.

Development of a tool for identifying and addressing prioritised determinants of quality improvement initiatives led by healthcare professionals: a mixed-methods study.

Background: Several frameworks have been developed to identify essential determinants for healthcare improvement. These frameworks aim to be comprehensive, leading to the creation of long lists of determinants that are not prioritised based on being experienced as most important. Furthermore, most existing frameworks do not describe the methods or actions used to identify and address the determinants, limiting their practical value.

Validity, reliability and feasibility of a new observation rating tool and a post encounter rating tool for the assessment of clinical reasoning skills of medical students during their internal medicine clerkship: a pilot study.

Background: Systematic assessment of clinical reasoning skills of medical students in clinical practice is very difficult. This is partly caused by the lack of understanding of the fundamental mechanisms underlying the process of clinical reasoning.

Methods: We previously developed an observation tool to assess the clinical reasoning skills of medical students during clinical practice.

Does a Long-Term Quality and Safety Curriculum for Health Care Professionals Improve Clinical Practice? An Evaluation of Quality Improvement Projects.

Introduction: Little is known about the effects on clinical practice of continuing education quality and safety curricula. The aim of this study is to gain insight into learning outcomes on the fourth level of the Kirkpatrick evaluation model for systematically deployed quality improvement projects performed by health care professionals during a Masters in Healthcare Quality and Safety in the Netherlands.

Methods: The researchers reviewed 35 projects led by health care professionals in 16 different hospitals to determine their scopes and effects.

Process evaluation of the effects of patient safety auditing in hospital care (part 2).

Objective: To identify factors that explain the observed effects of internal auditing on improving patient safety.

Design Setting And Participants: A process evaluation study within eight departments of a university medical centre in the Netherlands.

Intervention(s): Internal auditing and feedback for improving patient safety in hospital care.

Effects of patient safety auditing in hospital care: results of a mixed-method evaluation (part 1).

Objective: To evaluate the effectiveness of internal auditing in hospital care focussed on improving patient safety.

Design, Setting And Participants: A before-and-after mixed-method evaluation study was carried out in eight departments of a university medical center in the Netherlands.

Intervention(s): Internal auditing and feedback focussed on improving patient safety.

Observable phenomena that reveal medical students' clinical reasoning ability during expert assessment of their history taking: a qualitative study.

Background: During their clerkships, medical students are meant to expand their clinical reasoning skills during their patient encounters. Observation of these encounters could reveal important information on the students' clinical reasoning abilities, especially during history taking.

Methods: A grounded theory approach was used to analyze what expert physicians apply as indicators in their assessment of medical students' diagnostic reasoning abilities during history taking.

Reactive Rather than Proactive Diabetes Management in the Perioperative Period.

As perioperative hyperglycemia is associated with poor postoperative patient outcomes, clinical guidelines provide recommendations for optimal perioperative glucose control. It is unclear to what extent recommended glucose levels are met in daily practice, and little is known about factors that influence these levels. We describe blood glucose levels throughout the hospital care pathway in 375 non-critically ill patients with diabetes who underwent major surgery (abdominal, cardiac, or orthopedic) in 6 hospitals, examine determinants of these levels including adherence to 9 quality indicators for optimal perioperative diabetes care, and perform qualitative interviews to identify barriers for optimal care.

Measurement of patient safety: a systematic review of the reliability and validity of adverse event detection with record review.

Objectives: Record review is the most used method to quantify patient safety. We systematically reviewed the reliability and validity of adverse event detection with record review.

Design: A systematic review of the literature.

Perioperative diabetes care: development and validation of quality indicators throughout the entire hospital care pathway.

Background: In this study, we aim to develop a set of quality indicators for optimal perioperative diabetes care throughout the hospital care pathway and to gain insight into the feasibility of the indicator set in daily clinical practice by assessing the clinimetric properties of the indicators in a practice test.

Methods: A literature-based modified Delphi method was used to develop a set of quality indicators. To assess clinimetric properties of each indicator (measurability, applicability, reliability, improvement potential and case-mix stability), a practice test was performed in six Dutch hospitals using a sample of 389 major surgery patients with diabetes who underwent abdominal, cardiac or large joint orthopaedic surgery.

Effects of auditing patient safety in hospital care: design of a mixed-method evaluation.

Background: Auditing of patient safety aims at early detection of risks of adverse events and is intended to encourage the continuous improvement of patient safety. The auditing should be an independent, objective assurance and consulting system. Auditing helps an organisation accomplish its objectives by bringing a systematic, disciplined approach to evaluating and improving the effectiveness of risk management, control, and governance.

[Regular discussion of serious complications during admission to an internal medicine department].

Three patients, two women aged 54 and 84 years, and a man aged 76 years, had serious complications during a stay in an internal medicine ward. The complications were discussed at monthly multidisciplinary complication meetings, which we organise from 2007 and which are aimed at improving care processes. The first patient developed urinary tract infection, fever and delirium and an arm fracture as a result of a fall after she had been given a routine urinary catheter in order to monitor her fluid balance.

Transport within the interstitial space, rather than membrane permeability, determines norepinephrine recovery in microdialysis.

Microdialysis is a sampling method that permits measurement of hormones, drugs, and other lower molecular weight compounds present in interstitial fluid. We developed a straightforward mathematical model that predicts a linear relationship between the reciprocal dialysate concentration of the analyte from the interstitium and perfusion rate, permitting estimation of the interstitial concentration by extrapolation to zero perfusion rate. Conversely, linearity between the reciprocal dialysate concentration of internal standard added to the perfusion medium (retrodialysis), and the reciprocal perfusion rate, is predicted.

Sympathetic nervous system function in HIV-associated adipose redistribution syndrome.

It was recently suggested that HIV-associated adipose redistribution syndrome (HARS) results from an autonomic dysbalance. We investigated the local and global sympathetic nervous system function of patients with HIV-1 infection and HARS. Interstitial noradrenaline concentrations in skeletal muscle and subcutaneous adipose tissue were increased in the absence of changes in global sympathetic nerve activity, consistent with locally increased sympathetic activity.

Local sympathetic denervation in painful diabetic neuropathy.

This study assessed whether painful diabetic neuropathy is associated with abnormal sympathetic nervous function in the affected limbs. Nine patients with diabetes (four men, five women; age 61 +/- 7 years) and painful peripheral neuropathy of the feet, but without evidence of generalized autonomic neuropathy, underwent intravenous infusion of tritiated norepinephrine (NE) and sampling of arterial and venous blood in both feet and in one arm to quantify the rate of entry of NE into the local venous plasma (NE spillover). In the same patients, positron emission tomography (PET) scanning after intravenous injection of the sympathoneural imaging agent 6-[(18)F]fluorodopamine was used to visualize sympathetic innervation and after intravenous [(13)N]ammonia to visualize local perfusion.