Seeking consensus on physician leadership development in rural and remote Indonesian primary care settings: a Delphi study.

Purpose: This study aims to formulate a consensus on primary care physicians' leadership competencies tailored to Indonesia's rural and remote health systems using the LEADS framework. Effective physician leaders are essential in these settings; however, many physicians lack the necessary leadership qualifications due to insufficient training. From a medical education perspective, this issue is further compounded by the lack of consensus on leadership course content.

Self-management support from health care providers in Shared Medical Appointments: Didactic techniques, peer learning, group dynamics and motivation.

Objective: We investigated the support of self-management by health care providers (HCP) in prenatal Shared Medical Appointments (SMA).

Methods: on an topic list, semi-structured interviews were conducted. HCP who provided prenatal care in SMA in the last five years were recruited.

The impact of an educational intervention on physician leadership competencies among rural and remote primary care doctors in Aceh, Indonesia.

Purpose: This study aims to examine how an educational intervention, using the lens of the LEADS framework, can influence the development of primary care doctors' leadership skills in Aceh, Indonesia. In order to persevere in the face of inadequate resources and infrastructure, particularly in rural and remote settings of low- and middle-income countries, physicians require strong leadership skills. However, there is a lack of information on leadership development in these settings.

Investigating physician leadership competencies in rural and remote areas of the province of Aceh, Indonesia.

Backgrounds: Globally, the most rural healthcare systems are lagging behind those of urban healthcare systems. Especially in rural and remote areas, the essential resources to provide principal health services are inadequate. It is purported that physicians have an important role in healthcare systems.

Patients' experiences with an obstetric telephone triage system: A qualitative study.

Background: Telephone Triage Systems aim to provide a uniform and practical system for healthcare professionals in order to prioritize urgency of care. A disadvantage of telephone triage system could be that the conversations are experienced as less personal, as it uses a uniform procedure for every patient. Therefore, aside from the clinical relevance, patient expectations, experiences and satisfaction were studied.

A phenomenology of direct observation in residency: Is Miller's 'does' level observable?

Introduction: Guidelines on direct observation (DO) present DO as an assessment of Miller's 'does' level, that is, the learner's ability to function independently in clinical situations. The literature, however, indicates that residents may behave 'inauthentically' when observed. To minimise this 'observer effect', learners are encouraged to 'do what they would normally do' so that they can receive feedback on their actual work behaviour.

Self-management support by health care providers in prenatal Shared Medical Appointments (CenteringPregnancy©) and prenatal individual appointments.

Objective: This cross-sectional questionnaire study investigates if there a difference in the extent to which health care providers in prenatal Shared Medical Appointments (CenteringPregnancy©) and in prenatal individual appointments support self-management in patient education. It also investigates if there is a difference in the extent to which health care providers in CenteringPregnancy@ and in individual appointments pay attention to the factors of the Integrated Model for Behavioral Change (I-Change) in supporting self-management.

Methods: Dutch health care providers in prenatal care were invited to fill out a questionnaire.

Evaluation of Normalization After Implementation of the Digital Dutch Obstetric Telephone Triage System: Mixed Methods Study With a Questionnaire Survey and Focus Group Discussion.

Background: The Dutch Obstetric Telephone Triage System (DOTTS) was developed to improve the quality of acute obstetric care. To achieve optimal effect, the DOTTS should be adopted in the daily care process by triage staff.

Objective: The primary aim was to evaluate the degree of implementation (ie, normalization) of the DOTTS, and the secondary aim was to evaluate which lessons can be learned from its current implementation in Dutch hospitals.

Reliability of Dutch Obstetric Telephone Triage.

Background: Safety and efficiency of emergency care can be optimized with a triage system which uses urgency to prioritize care. The Dutch Obstetric Telephone Triage System (DOTTS) was developed to provide a basis for assessing urgency of unplanned obstetric care requests by telephone. Reliability and validity are important components in evaluating such (obstetric) triage systems.

Evaluating the effect of interventions for strengthening non-physician anesthetists' education in Ethiopia: a pre- and post-evaluation study.

Background: Access to safe surgery has been recognized as an indispensable component of universal health coverage. A competent anesthesia workforce is a prerequisite for safe surgical care. In Ethiopia, non-physician anesthetists are the main anesthesia service providers.

Clinicians' perspectives on quality: do they match accreditation standards?

Background: Quality of training is determined through programs' compliance with accreditation standards, often set for a number of years. However, perspectives on quality of training within these standards may differ from the clinicians' perspectives on quality of training. Knowledge on how standards relate to clinicians' perspectives on quality of training is currently lacking yet is expected to lead to improved accreditation design.

Roses and Balances: A Paradigm for Constructive Ethical Review of Health Professions Education Research.

Recently, the balance between value and necessity of ethical review of health professions education research has been debated. At present, there are large differences in how ethical review of research proposals for health professions education is organized. We present a framework that describes the organization of ethical review in health professions education research, based on the interpersonal circumplex model, also known as Leary's Rose.

Validation of Dutch Obstetric Telephone Triage System: A Prospective Validation Study.

Objective And Purpose: A triage system that prioritizes care according to medical urgency has a favorable effect on safety and efficiency of emergency care. The Dutch obstetric telephone triage system is comparable to physical triage systems. It consists of five urgency levels: resuscitation and life threatening (U1), emergency (U2), urgent (U3), non-urgent (U4) and self-care advice (U5).

What happens under the flag of direct observation, and how that matters: A qualitative study in general practice residency.

Introduction: In competency-based medical education, direct observation (DO) of residents' skills is scarce, notwithstanding its undisputed importance for credible feedback and assessment. A growing body of research is investigating this discrepancy. Strikingly, in this research, DO as a concrete educational activity tends to remain vague.

A phenomenological investigation of patients' experiences during direct observation in residency: busting the myth of the fly on the wall.

Direct observation (DO) of residents by supervisors is a highly recommended educational tool in postgraduate medical education, yet its uptake is poor. Residents and supervisors report various reasons for not engaging in DO. Some of these relate to their interaction with patients during DO.

Effective accreditation in postgraduate medical education: from process to outcomes and back.

Background: The accreditation of medical educational programs is thought to be important in supporting program improvement, ensuring the quality of the education, and promoting diversity, equity, and population health. It has long been recognized that accreditation systems will need to shift their focus from processes to outcomes, particularly those related to the end goals of medical education: the creation of broadly competent, confident professionals and the improvement of health for individuals and populations. An international group of experts in accreditation convened in 2013 to discuss this shift.

The role of accreditation in 21st century health professions education: report of an International Consensus Group.

Background: Accreditation is considered an essential ingredient for an effective system of health professions education (HPE) globally. While accreditation systems exist in various forms worldwide, there has been little written about the contemporary enterprise of accreditation and even less about its role in improving health care outcomes. We set out to 1) identify a global, contemporary definition of accreditation in the health professions, 2) describe the relationship of educational accreditation to health care outcomes, 3) identify important questions and recurring issues in twenty-first century HPE accreditation, and 4) propose a framework of essential ingredients in present-day HPE accreditation.

Evaluation of continuous quality improvement in accreditation for medical education.

Background: Accreditation systems are based on a number of principles and purposes that vary across jurisdictions. Decision making about accreditation governance suffers from a paucity of evidence. This paper evaluates the pros and cons of continuous quality improvement (CQI) within educational institutions that have traditionally been accredited based on episodic evaluation by external reviewers.

An international study on teachers' conceptions of learning and teaching and corresponding teacher profiles.

Teachers' conceptions of learning and teaching (COLT) affect their teaching behaviour. The 18 item COLT instrument has been developed in the Netherlands and comprises three scales, 'teacher centredness', 'appreciation of active learning' and 'orientation to professional practice'. Previously we found five teacher profiles.

Factors influencing patient education in shared medical appointments: Integrative literature review.

Objective: This integrative literature review investigates the factors influencing patient education in Shared Medical Appointments.

Methods: Following template analysis method, we used key concepts of the Social Cognitive Theory (SCT) and Social Constructivism as a priori themes. After detailed analysis of the included studies, we deduced subthemes, forming a final template.

How To Get Your Clinical Teaching Team Ready For Curriculum Change: A Practical Guide.

Our health care system is constantly adapting to change at an increasingly rapid pace. Unavoidably, this also applies to the field of medical education. As a result, clinical teaching teams face the challenging task of successfully implementing the proposed changes in daily practice.

How clinical teaching teams deal with educational change: 'we just do it'.

Background: In postgraduate medical education, program directors are in the lead of educational change within clinical teaching teams. As change is part of a social process, it is important to not only focus on the program director but take their other team members into account. The purpose of this study is to provide an in-depth insight into how clinical teaching teams manage and organize curriculum change processes, and implement curriculum change in daily practice.

Social Interactions of Clerks: The Role of Engagement, Imagination, and Alignment as Sources for Professional Identity Formation.

Purpose: Participating in clinical practice shapes students' identities, but it is unclear how students build meaningful relationships while "dipping into" various social contexts. This study explored with whom students interacted, which social relationships they built, and how these relationships contributed to the formation of a professional identity.

Method: In this longitudinal study at University Medical Center Groningen, University of Groningen, the Netherlands, 9 undergraduate medical students recorded experiences of thinking about themselves as future professionals (September 2015 to March 2017).