Designing a Workplace-Based Learning Environment for Learning Health Promotion: A Design-Based Research.

Introduction: The healthcare landscape has a growing emphasis on health promotion (HP), which makes HP important in the training of future physicians. This study employed design-based research to develop a clerkship focused on HP and to outline design principles for shaping workplace learning environments to promote HP learning.

Methods: We evaluated a nursing-home clerkship designed at Radboud University Medical Center in the Netherlands, and refined it over three rounds.

Exploring workplace-based learning in distributed healthcare settings: a qualitative study.

Background: Distributed healthcare settings such as district hospitals, primary care, and public health facilities are becoming the real-life settings for workplace-based learning required to educate the future healthcare workforce. Therefore, a major focus should be on designing and developing workplace-based learning in these learning environments. Healthcare professionals and educational policymakers play a significant role in these settings as role models in workplace-based learning, and as leaders in integrating learning into their work environments.

Workplace-based learning about health promotion in individual patient care: a scoping review.

Objective: To outline current knowledge regarding workplace-based learning about health promotion in individual patient care.

Design: Scoping review.

Data Sources: PubMed, ERIC, CINAHL and Web of Science from January 2000 to August 2023.

An Innovative Undergraduate Medical Curriculum Using Entrustable Professional Activities.

The need to educate medical professionals in changing medical organizations has led to a revision of the Radboudumc's undergraduate medical curriculum. Entrustable professional activities (EPAs) were used as a learning tool to support participation and encourage feedback-seeking behavior, in order to offer students the best opportunities for growth. This paper describes the development of the Radboudumc's EPA-based Master's curriculum and how EPAs can facilitate continuity in learning in the clerkships.

How an EPA-based curriculum supports professional identity formation.

Background: Entrustable professional activities (EPAs) are widely used in medical education, and they might be an important incentive to stimulate professional identity formation (PIF) of medical students, by actively encouraging participation in the workplace. The goal of this study was to explore the effects of an EPA-based curriculum on the PIF of medical students in undergraduate curricula.

Methods: In this study at the Radboud University Medical Center in Nijmegen, the Netherlands, the authors interviewed twenty-one medical students in three focus group interviews (November 2019), and conducted a thematic analysis based on both the synthesizing concepts PIF, communities of practice and EPAs, and newly defined themes.

Exploring the views of successful applicants for medical school about gender medicine using a gender-sensitive video assignment.

Background: Sex and gender influence health and disease outcomes, therefore, doctors should be able to deliver gender-sensitive care. To train gender-sensitive doctors, relevant sex and gender differences have to be included in medical education. In order to develop appealing, relevant, and effective education for undergraduate medical students, education should be tailored to students' level and anticipated on their ideas and assumptions.

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.

Implementing medical teaching policy in university hospitals.

Within the unique and complex settings of university hospitals, it is difficult to implement policy initiatives aimed at developing careers in and improving the quality of academic medical teaching because of the competing domains of medical research and patient care. Factors that influence faculty in making use of teaching policy incentives have remained underexplored. Knowledge of these factors is needed to develop theory on the successful implementation of medical teaching policy in university hospitals.

An investigation of anatomical competence in junior medical doctors.

Because of a decrease of the time available for anatomy education, decisions need to be made to reduce the relevant content of the anatomy curriculum. Several expert consensus initiatives resulted in lists of structures, lacking analysis of anatomical competence. This study aims to explore the use of anatomical knowledge by medical doctors in an attempt to delineate the nature of anatomical competence.

Relations between policy for medical teaching and basic need satisfaction in teaching.

Policy initiatives that aim to elevate the position of medical teaching to that of medical research could influence the satisfaction of three basic psychological needs related to motivation for medical teaching. To explore relations between the satisfaction of three basic psychological needs towards medical teaching and two policy initiatives for medical teaching: (Junior) Principal Lecturer positions [(J)PL positions] and Subsidized Innovation and Research Projects in Medical Education (SIRPMEs). An online questionnaire was used to collect data about medical teaching in the setting of a university hospital.

Exploring the validity of assessment in anatomy: do images influence cognitive processes used in answering extended matching questions?

Assessment is an important aspect of medical education because it tests students' competence and motivates them to study. Various assessment methods, with and without images, are used in the study of anatomy. In this study, we investigated the use of extended matching questions (EMQs).

Learning anatomy enhances spatial ability.

Spatial ability is an important factor in learning anatomy. Students with high scores on a mental rotation test (MRT) systematically score higher on anatomy examinations. This study aims to investigate if learning anatomy also oppositely improves the MRT-score.

Do images influence assessment in anatomy? Exploring the effect of images on item difficulty and item discrimination.

Anatomists often use images in assessments and examinations. This study aims to investigate the influence of different types of images on item difficulty and item discrimination in written assessments. A total of 210 of 460 students volunteered for an extra assessment in a gross anatomy course.

[The physician as teacher. Ways to measure the quality of medical training].

Ninety percent of medical students' training is comprised of working and learning in the clinical setting. Good training is the responsibility of the physicians who also work in that setting. It is important that these physicians are aware of what is expected of them in this role.

A clinical classification system for rheumatoid forefoot deformity.

Background And Purpose: In the present study a classification system for the rheumatoid forefoot is reported with its intra- and interobserver reliability and clinical relevance. The classification is based on the sequence of anatomical changes resulting from the loss of integrity of the MTP joints, loss of motion and changes regarding the quality and position of the plantar soft tissues. It is hypothesized that with progression of the amount of deformity of the MTP joint(s), patients have more pain and functional loss.

Effects of naproxen and sulphasalazine or methotrexate on hypothalamic-pituitary-adrenal axis activity in patients with rheumatoid arthritis.

Objectives: To study the effects of antirheumatic drugs on hypothalamic-pituitary-adrenal (HPA) axis activity in patients with rheumatoid arthritis (RA).

Methods: Twenty patients with recent-onset active RA were studied before antirheumatic treatment, after 2 weeks of naproxen, and after 5½ months of additional treatment with sulphasalazine or methotrexate. The results before treatment were compared with those obtained in 20 age and sex-matched healthy controls (HC).

The 2009 framework for undergraduate medical education in the Netherlands.

The 2009 Framework defines the joint Dutch national learning outcomes to be attained by medical students after completing their three-year master programme in medicine. The Framework thus helps to guarantee to society at large and to patients in particular that medical graduates who are starting out as practitioners have attained a certain professional level. This level is the aggregate of the physicians' target profile, physicians' (sub-) competencies to be achieved and the list of issues relating to illness and health.

[Internship 'Care of the elderly' should be obligatory in all medical schools].

This internship in care of the elderly should become an obligatory course at all 8 medical schools in the Netherlands. The most important reasons for making it obligatory are increased aging of the population and the current lack of knowledge and skills that leads to insufficient quality and safety of healthcare for the frail elderly. In this article we describe the possible structure of such an internship in care of the elderly, based on the experiences at the Radboud University Nijmegen Medical Centre.

Tumour necrosis factor-alpha antagonists in the management of rheumatoid arthritis in the elderly: a review of their efficacy and safety.

Rheumatoid arthritis (RA) is a chronic inflammatory disease that frequently affects people aged >or=65 years, causing significant impairment with pain and functional disability. Elderly RA patients have specific problems, including co-morbid diseases, numerous concomitant medications, greater number of damaged joints as a result of longer disease duration and often a more severe disease presentation in elderly-onset RA. These factors, together with an age-related decline in the immune defence mechanisms, make elderly patients more vulnerable.

Missed opportunities in the treatment of elderly patients with rheumatoid arthritis.

Objective: To investigate whether there is a difference in waiting time between indication and start of anti-TNF-alpha therapy in younger and older RA patients.

Methods: The study was carried out in the Nijmegen inception cohort of early RA. All patients meeting indications for anti-TNF-alpha therapy according to the Dutch reimbursement criteria were included in the analysis.

The initial validation of a Markov model for the economic evaluation of (new) treatments for rheumatoid arthritis.

Objective: Markov models are increasingly used in economic evaluations of (new) treatments for chronic diseases. In this study we propose a Markov model with health states defined by the disease activity score (DAS) to be used to extrapolate efficacy data from short-term clinical trials in rheumatoid arthritis to longer term cost-effectiveness results. Moreover, we perform an initial validation of this model.

Quality of life and costs for different treatment strategies for rheumatoid arthritis.

Rheumatoid arthritis is a chronic, inflammatory, systemic disease. In the past, treatment (strategy) for this disease has changed dramatically, becoming more aggressive and new drugs have become available. Furthermore, closely monitoring the disease and treatment has been advocated.

Modeling the 5-year cost effectiveness of treatment strategies including tumor necrosis factor-blocking agents and leflunomide for treating rheumatoid arthritis in the Netherlands.

Objective: To determine the cost effectiveness of treatment strategies for rheumatoid arthritis patients satisfying the indication for tumor necrosis factor (TNF)-blocking treatment.

Methods: A Markov model study was performed. The following treatment strategies were considered: 1) usual treatment; 2) treatment with leflunomide, in the case of nonresponse after 3 months, switch to usual treatment; 3) TNF-blocking treatment, in the case of nonresponse after 3 months, switch to usual treatment; 4) treatment with leflunomide, in the case of nonresponse, switch to TNF-blocking treatment, in the case of nonresponse to TNF-blocking treatment, switch to usual treatment; 5) TNF-blocking treatment, in the case of nonresponse, switch to leflunomide treatment, in the case of nonresponse to leflunomide, switch to usual treatment.

Economic evaluation of folate supplementation during methotrexate treatment in rheumatoid arthritis.

Objective: To determine cost-effectiveness of folic or folinic acid supplementation in patients with rheumatoid arthritis (RA) who started methotrexate (MTX) treatment.

Methods: An economic evaluation, performed alongside a randomized, double blind, placebo controlled trial with followup of 48 weeks. Patients started MTX with placebo (n = 137), folic acid (n = 133), or folinic acid (n = 141).