School of Health Professions Education
Faculty of Health, Medicine and Life Sciences
Annual Report 2013
Contents
Introduction
02
Mission and Management of SHE
03
SHE Programmes and Courses
Short and Advanced Courses
Master of Health Professions Education
Research in Education Programme
PhD Programme
06
International Activities and Collaboration
14
Appointments
15
Distinctive Academic Items
15
SHEILA: SHE International League of Alumni
16
08
Introduction
In front of you is the Annual Report 2013 of the SHE Graduate School
(School of Health Professions Education) of the Faculty of Health,
Medicine and Life Sciences. The pursuit of excellence in training
health professionals in education and in educational research
captures the mission of SHE in a nutshell. We have a strong international orientation in realising our mission. This report provides a
short overview of the main activities of SHE and is deliberately kept
brief. SHE’s main activities were the training programmes, the special
projects and contracts that SHE engaged in and the scientific in and
output from the research that is being done.
As you will note, 2013 has been an active and productive year. We are
rapidly growing and professionalising. We thank all our affiliates who
contributed to the successful activities in 2013. We are open to readers’
suggestions and to any other queries that you might have about the
activities of SHE. Please send your response to
[email protected]
Very best wishes,
Cees P.M. van der Vleuten
Scientific Director Graduate School of Health Professions Education
Annual Report 2013 | School of Health Professions Education | Faculty of Health, Medicine and Life Sciences
02
Mission and Management of SHE
The mission of the SHE Graduate School is to provide opportunities for professional development to health care workers
involved in health professional education all around the world
and to generate new knowledge about education. Through
integrated programmes of excellence in education and
research we aim to contribute to innovation in health
professions education and ultimately to improve health for all.
The vision of SHE is to professionalise health professions
education through evidence-based knowledge of how
learning environments can be made effective to produce
competent health care workers who are able to provide the
best of health care. As education specialists we value the
interplay between professionals in the health care domain
responsible for teaching and learning and specialists in the
parental disciplines (education, psychology, sociology, etc.),
who provide the knowledge to improve learning environments. We place high value on providing scientific education
to these professionals to enable them to improve their
education practices based on evidence and tailored to the
needs of the health care domain. We aim to educate leaders of
educational innovation around the globe and regardless of the
wealth of their home countries. We aspire to educate new
researchers who are able to contribute to more evidence in
education. We are dedicated to excellence in our own teaching
and learning programmes as well as in our research. We aim to
practice what we preach. We value personal relationships and
a supportive learning and working climate in our school and
with all the people that are affiliated with it.
Societal Impact of SHE
Universities in the Netherlands attach increasingly more value
to the societal impact and valorization of their work. Starting in
2016, all Dutch universities need to have a set of indicators for
the societal impact and valorization of their work. In this
context, SHE also started to develop its own set of indicators.
Many of these indicators are already available for the different
programs of SHE. For our research program, professional
publications, textbooks and policy documents are already
included in the output reports, showing that many publications from SHE are targeting a non-scientific audience.
Publications for Practitioners
In addition to scientific articles, SHE regularly publishes
how-to articles aimed at practitioners in medical education.
Good examples are the Twelve Tips articles in the journal
Medical Teacher. In 2013, three Twelve Tips articles were
published: Twelve tips on how to set up postgraduate
training via remote clinical supervision (by Susan Wearne,
Tim Dornan, Pim Teunissen and Timothy Skinner); Twelve
tips for implementing whole-task curricula: How to make it
work (by Diana Dolmans, Ineke Wolfhagen and Jeroen van
Merrienboer), and Twelve tips for making the best use of
feedback (by Renee van der Leeuw and Irene Slootweg).
New indicators may relate to interviews and other media
presentations for a broad public as well as the practical use
of research-based software applications (e.g., E-Pass) and
methodologies (e.g., 4C/ID). For our educational program (short
courses, MHPE, PhD), contributions to educating professionals
in the health professions domain (in contrast to educating
undergraduates) are an important indication of societal impact.
All educational programs of SHE serve professionals in the
domain, thus societal impact is not merely an effect but the
actual reason for existence of these programs. New indicators
may relate, for example, to the position of alumni, demonstrating
that they drive educational innovations and renewal in their
home institutions.
Finally, SHE Collaborates runs a consultancy program that is
exclusively concerned with societal impact and valorization.
Their projects make directly visible how research and educational
efforts are transformed into innovation and implementation
projects. New indicators may, for example, list SHE involvement
in national and international policy and advisory committees.
We are fully confident that the societal impact of SHE is high,
and indicators for impact and valorization are discussed in this
report.
Annual Report 2013 | School of Health Professions Education | Faculty of Health, Medicine and Life Sciences
03
Management Team SHE
Cees van der Vleuten, PhD
Geraldine van Kasteren, MD, MHPE
Role: Scientific Director SHE Graduate School
Department: Department of Educational Development and
Research, Faculty of Health, Medicine and Life Sciences, Maastricht University
Role: Project Manager SHE Collaborates
Department: Department of Educational Development and
Research, Faculty of Health, Medicine and Life Sciences, Maastricht University
Cees van der Vleuten was trained as a psychologist and earned
his PhD in education. In 1982 he came to Maastricht University
to become involved in medical education. In 1996 he was
appointed Professor of Education at the Faculty of Health,
Medicine and Life Sciences and Chair of the Department of
Educational Development and Research. In 2005 he was
appointed as the Scientific Director of the SHE Graduate
School. His area of expertise is evaluation and assessment. His
particular expertise concerns assessment of professional
competence, including modern methods of assessment and
strategies for designing assessment programmes. He has
published widely on these topics, holds several academic
awards for this work, and has mentored more than 60 PhD
students. He has frequently served as a consultant internationally. He has held honorary appointments to a number of
universities throughout the world.
Geraldine van Kasteren studied Medicine at the Medical
Faculty of Maastricht University and thus trained as a medical
professional in an innovative educational manner (e.g. by
Problem Based Learning and Early Clinical Exposure). After
graduation she worked a few years in regional health centres
and hospitals, getting experience in medical practice.
Subsequently, she turned to medical education in the context
of developing countries. She assists universities as a consultant for longer and shorter durations to change into innovative
ways of health professional education. In her capacity as
project manager she coordinates projects resulting from the
match between the demand of a university together with the
expertise available within SHE and Maastricht University and
if required the (financial) support of other (inter)national
organisations and consultants. At the skills lab she taught
medical students applied professional skills that are necessary
in encounters with patients: physical examination skills,
procedural skills and communication skills. She is mentor,
tutor, lecturer and coordinator in several international courses
at the FHML.
Annual Report 2013 | School of Health Professions Education | Faculty of Health, Medicine and Life Sciences
04
Renée Stalmeijer, PhD
Role: Programme Director Master of Health Professions
Education
Department: Department of Educational Development and
Research, Faculty of Health, Medicine and Life Sciences,
Maastricht University
Renée Stalmeijer is trained as an educational scientist and holds
a PhD in medical education obtained from Maastricht University.
Since 2013 she is the director of the Master of Health Professions
Education of the SHE Graduate School. Besides that she is
responsible for the programme-evaluation of the Master phase
of the medical curriculum at the Faculty of Health, Medicine and
Life Sciences. Her research focuses on supervision, learning and
collaboration in the workplace, and quality assurance of curricula.
She co-supervises several PhD projects both nationally and
internationally. She is Associate Editor of Perspectives on Medical
Education. Furthermore she provides training in qualitative
research methodology and quality assurance and has given
several international consultations on those topics.
Jeroen J. G. van Merriënboer, PhD
Role: Programme Director Research in Education,
School of Health Professions Education.
Department: Department of Educational Development
and Research, Faculty of Health, Medicine and Life Sciences,
Maastricht University.
Jeroen van Merriënboer was trained as an experimental
psychologist at the VU University Amsterdam and earned his
PhD in Educational Sciences at the University of Twente (1990).
He was an assistant and associate professor at the University of
Twente and at Maastricht University before moving to the Open University of the Netherlands as a full research professor. In 2009 he joined the Faculty of Health, Medicine and Life Sciences
of Maastricht University. He is currently programme director of
Research in Education (RiE), the research and PhD programme of the SHE Graduate School of Health Professions Education. He is also vice-chair of the Netherlands Initiative for Education
Research, which is the funding organisation for educational
research within the Netherlands Organisation for Scientific
Research NWO. His main area of expertise is learning and
instruction, in particular instructional design and the use of new
media in innovative learning environments. He has published
widely on four component instructional design, cognitive load
theory, and lifelong learning. He holds several academic awards
for his research and has been a supervisor of over 35 PhD students.
Mascha Verheggen, PhD
Role: Programme Director Competence Development Programme
Department: Department of Educational Development and Research,
Faculty of Health, Medicine and Life Sciences, Maastricht University
Mascha Verheggen was trained as a medical biologist and
earned a PhD in immunology. In 1997 she came to Maastricht
University to become involved in medical education at the
Faculty of Health, Medicine and Life Sciences. In 2006 she was
appointed programme director of the Competence Development
Programme of the SHE Graduate School of Health Professions
Education. In 2009 she was appointed programme director of the first and second year of the international track in medicine at the Faculty of Health, Medicine and Life Sciences. Her areas of expertise are assessment and curriculum development. She is internationally involved as a consultant in several projects.
Annual Report 2013 | School of Health Professions Education | Faculty of Health, Medicine and Life Sciences
05
SHE Programmes and Courses
Short and Advanced Courses
The SHE Graduate School offers a variety of courses:
• Advanced Courses (one week course in April)
- Curriculum and Course Design
- Master Class in Qualitative Research Analysis
- Simulated and Standardized Patient
- Writing a PhD Research Proposal (in October)
• Advanced Courses taught in Dutch
- Assessment in Medical Education
- Research in Medical Education
• Summer Course (two week course in June)
• Visitors Workshop (two-day programme in September)
Summer Course 2013 week 2
Visitors
Course
Summer
Course
Advanced
Course
‘Curriculum
and Course
Design in
Medical
Education’
Advanced
Course
Masterclass
in
Qualitative
Research
Analysis
Advanced
Course
Simulated
and
Standardized
Patients
Advanced
Course
‘Writing
a PhD
Research
Proposal’
Poland,
Brazil,
Scotland
Brazil,
Estonia,
Ethiopia,
Ghana,
Indonesia,
Oman,
Poland,
Republic of
Georgia, and
Saudi Arabia
Indonesia,
Kenya,
Malaysia,
the
Netherlands,
Rwanda,
Saudi Arabia,
Zambia
UK, USA,
Belgium,
Canada,
Denmark,
Ireland,
Italy, the
Netherlands
Belgium,
Germany,
Indonesia,
Italy,
Republic of
Kazakhstan,
Saudi Arabia,
Sweden,
Switzerland,
Turkey, UK
Philippines,
Ethiopia,
Ireland, USA, Germany,
Ghana,
Indonesia
Thailand,
Switzerland,
Indonesia,
Saudi-Arabia,
Australia,
Mexico, the
Netherlands
Belgium, the
Netherlands
the
Netherlands
18
19
18
11
8
Total number of participants
5
82
15
Tailor-Made
programme
Offered in
Maastricht
24
Toetsing van
Onderzoek
van Medisch Medische
Competentie
Onderwijs
The table summarises the number of participants in the Short and Advanced Courses offered in 2013 and lists their countries of origin.
Master of Health Professions Education
Collaborating International Master of Health Professions Education
In 2013 a total of 54 students were attending the Master of Health Professions Education programme of the SHE Graduate School in Maastricht
• MHPE Cohort 2012: 2nd year students of the MHPE programme
• MHPE Cohort 2013: 1st year students of the MHPE programme
In 2013 a total of 63 students were attending the collaborating
Master of Health Professions Education programmes in Egypt, Brazil
and Canada
The MHPE of the SHE Graduate School in Maastricht is collaborating
with various countries in the world in offering the MHPE programme
in diverse collaboration models.
• In Egypt: the (JMHPE) programme is a distance learning programme of
Maastricht University (UM) jointly with Suez Canal University (SCU), Egypt.
• In Brazil: the (BMPHE) International Master in Health Professions
Education Programme (MHPE) in Brasilia, Brazil.
• In Canada: the (CMHPE) Master of Health Professions Education
program in Canada delivered from Vancouver, British Columbia and
London, Ontario.
MHPE Cohort 2013
In Maastricht 27:
Australia, Brazil, Canada,
Ghana, Indonesia, Japan,
Kenya, The Netherlands,
Oman, Pakistan, Peru, Saudi
Arabia, Singapore, South
Africa, Thailand, United
States, Vietnam, Zambia
In Egypt
46 participants
In Brazil
10 participants
In Canada MHPE
7 participants
Total number of participants
90
Annual Report 2013 | School of Health Professions Education | Faculty of Health, Medicine and Life Sciences
MHPE Cohort 2012
In Maastricht 27:
Brazil, Canada, Colombia,
Kuwait, The Netherlands,
Pakistan, Saudi Arabia,
Tanzania, USA
In Egypt 49 participants
In Brazil
19 participants
In Canada MHPE started 2012
12 participants
107
06
Presenters and Graduates topics of the Master’s Theses 2013
Student
Title Master Thesis
Andreas Herrler
Perceptions on anatomical knowledge and transfer
Beatriz Manuel Training Health Professionals on HIV/AIDS in Medium and Higher Education Institutions in Mozambique:
National Policies related to HIV/AIDS Curriculum
Emanuelle Pessa Valente How do obstetrics and gynaecology residents perceive assessment practices during their specialty training
Ivan Solarte
Perceived educational consequences of the use of electronic medical records for medical students
Jascha de Nooijer
The systematic design and evaluation of a training in a 3D-virtual learning environment for health sciences
students
Luke Devine Effectiveness of Directed Self-Regulated Mastery Learning of Advanced Cardiac Life Support Skills - A Randomized Trial
Marleen Schultz-Vugs
Does an internationalization program with internship contributes to intercultural competence development?
Marlies Schillings
Scientific writing: Do students understand written feedback?
Melike Sahiner Evaluation of the medical professional outcomes of Clinical medicine and professional skills’ program;
From the view of students and clinical teachers
Mirjam oude Egbrink
Student selection as a first step in assessment for Learning
Thálita Menezes How to improve the performance of tutors by understanding their perspectives about tutors evaluation
Verena Wessel
The multiple mini-interviews in the selection process for medical school admission: An empirical analysis of
its acceptability
Viktor Riklefs
Progress test and learning styles inventory as indicators of curriculum efficiency
MHPE Graduates
Annual Report 2013 | School of Health Professions Education | Faculty of Health, Medicine and Life Sciences
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Master Thesis topics of the MHPE students who were presenting their thesis in their home country in 2013
Student
Title Master Thesis
Curt Bodkyun
Self-directed learning, intrinsic motivation and student performance
Henal Shah Empathy and patient centeredness in medical & dental post graduate students
Telma Kremer Negative emotions triggered in students by medical school routine situations
Fathiku Asmara Unie
The Implementation of Multi-Source Feedback (MSF) Assessment to Assess Professional Behaviour of
Nursing Students: An Evaluation Study
Robert Opika Opoka
Perceptions of postgraduate trainees at Makerere University on the impact of objective structured clinical
examination on their study behaviour and clinical practice
Xandra Janssen-Brandt
Item relevance can make it difficult; the use of a template for progress tests to rate item relevance and
the relation of this relevance to item difficulty
Keiko Hasegawa
The impact of the introduction of multi-layered, competence-based staff training on respiratory management workshop for physicians in Japan
Rafael Batista
Tutors’ and students’ perceptions regarding tutors’ de Oliveira performance and behaviour in PBL tutorial
groups of a Brazilian medical school: A Mixed-Method Study
Tereza R. de Melo Casta The undergraduate medical students’ perceptions on the implementation of post-ward round sessions
in the routine of a pediatric ward: a focus group study
Annual Report 2013 | School of Health Professions Education | Faculty of Health, Medicine and Life Sciences
08
Research in Education Programme
Researchers within the Research
in Education Programme
Full time equivalents of Scientific Staff and
PhD candidates
Reseachers
Nick Broers
Anique de Bruin
Jamiu Busari
Jan van Dalen Joost Dijkstra
Diana Dolmans
Jeroen Donkers
Tim Dornan
Erik Driessen
Kevin Eva Janneke Frambach Anton de Goeij
Marjan Govaerts
Willem de Grave
Ide Heyligers Karen Konings
Richard Koopmans Bas de Leng
Jimmie Leppink Jeroen van Merrienboer
Job Metsemakers Arno Muijtjens Miriam Oude Egbrink
Jan Joost Rethans Charlotte Ringsted Albert Scherpbier
Henk Schmidt
Lambert Schuwirth Dominique Sluijsmans Luc Snoeckx Ingrid Spanjers Renee Stalmeijer
Fred Stevens Frans Tan Pim Teunissen
Mascha Verheggen Danielle Verstegen
Cees van der Vleuten
Jill Wittingham Ineke Wolfhagen
Assistant Professor
Assistant Professor
Associate Professor
Assistant Professor
Researcher
Professor
Assistant Professor
Professor
Associate Professor
Associate Professor
Assistant Professor
Professor
Assistant Professor
Senior Lecturer
Affiliated Professor
Researcher
Professor
Assistant Professor
Postdoc Researcher
Professor
Professor
Associate Professor
Professor
Associate Professor
Honorary Professor
Professor
Honorary Professor
Honorary Professor
Associate professor
Associate Professor
Assistant Professor
Assistant Professor
Associate Professor
Assistant Professor
Assistant Professor
Assistant Professor
Assistant Professor
Professor
Assistant Professor
Associate Professor
In 2013 99 staff members and PhD candidates were active in
the Research in Education Programme; three employees were
active in a detachment position. Overview of the staff of the
Research in Education Programme in 2013:
Scientific staff:
7.95 fte (2.33 fte externally funded)
Support staff:
3.87 fte (1.87 fte externally funded)
PhD candidates: 7.27 fte (3.00 fte externally funded) Total:19.10 fte
Support staff
Ron Hoogenboom Rafael Losada Lilian Swaen
Nicky Verleng
Danielle Vogt Research assistant
Administrator
Secretary
Secretary
Communications & PR
External Funding
Overview of external funding for the Research in Education
Programme in 2013:
€ 88.758,2nd € 356.058,3rd Other € 218.743,Total € 663.559,-
SHE Academy
In March 2013, the first SHE Academy was organized for all
SHE PhD students and staff, by Dr. Anique de Bruin, Dr. Karen
Könings, Ellen Kok en Nicky Verleng. The goal of the SHE
Academy was twofold. It contributed to building a community
of SHE researchers, and also gave external and internal PhD
students possibilities to further develop their research skills.
46 PhD students and staff attended the conference. Most of
them presented their research during the poster session.
Furthermore, participants could attend two workshops from a
total of six different workshops. Other activities were a journal
club, a keynote lecture by Kevin Eva, a speed date session
during which participants created research ideas together, and a reflection-session. During the reflection session, PhD students wrote a personal action plan for the upcoming
months. These action plans were e-mailed to them several
months after the SHE Academy as a reminder, which was
much appreciated by the PhD students.
In general, the SHE Academy was positively evaluated.
Participant particularly liked the working atmosphere during
the SHE Academy, and they felt that they had ample opportunity to get to know the fellow SHE PhD students as well as the staff members, which was one of the main goals of the
conference. Therefore the next SHE Academy, to be held in
March 2015, will be 4 days, with more slots for intervision and presentation of own research.
Annual Report 2013 | School of Health Professions Education | Faculty of Health, Medicine and Life Sciences
09
PhD Programme
PhD dissertations completed in 2013
at Maastricht University
PhD dissertations defended in 2013
at other university than Maastricht University
M. Jippes
E. Taminiau, Open University, Heerlen
8
5
Culture matters in medical schools:
How values shape a successful curriculum change
Date of defence: 01-02-2013
Supervisors: C.P.M. van der Vleuten, E.W. Driessen en G.D. Majoor
Advisory models for on-demand learning
Date of defence: May 24, 2013
Maastricht supervisor: Jeroen van Merriënboer
Z. Ladhani
Visual problem solving and self-regulation in training air traffic control
Date of defence: September 6, 2013
Maastricht supervisor: Jeroen van Merriënboer
Competency based education and professional competencies:
A study of institutional structures, perspectives and practices in Pakistan.
Date of defence: 05-07-2013
Supervisors: A.J.J.A. Scherpbier en F.C.J. Stevens
M. Sibbald
Is that your final answer? How doctors should check decisions
Date of defence: 09-10-2013
Supervisors: J.J.G. van Merriënboer en A.B.H. de Bruin
A. Alves de Lima
Assessment of clinical competence: Reliability, Validity, Feasibility and Educational Impact of the mini-CEX
Date of defence: 23-10-2013
Supervisor: C.P.M. van der Vleuten
N. Junod Perron
Towards a learner-centered approach to postgraduate communications skills teaching
Date of defence: 24-10-2013
Supervisors: D.H.J.M. Dolmans, C.P.M. van der Vleuten en M.R. Nendaz, Geneva, Switzerland
A. Pratidina Susilo
L. W. van Meeuwen, Open University, Heerlen
E. Pelgrim, Radboud University, Nijmegen
Clarifying observation and assessment feedback in workplace-based
learning.
Date of defence: September 2013.
Maastricht supervisor: Cees van der Vleuten
I. Houwink, Free University of Amsterdam
Training in genetics and genomics for primary health care workers.
Date of defence: December 2013.
Maastricht supervisor: Cees van der Vleuten
T. van Roermund, Radboud University Nijmegen
How do postgraduate medical teachers develop their teaching skills?
Date of defence: 8 January 2013
Maastricht supervisor: Albert Scherpbier
PhD projects started in 2013
Abdul Sattarkhan,Saudi Arabia
How to foster the effectiveness of receiving peer feedback in small groups
Learning to be the Patient Advocate
The Development of a Communication Skills Course to Enhance
Nurses,
Contribution to the Informed Consent Process
Date of defence: 24-10-2013
Supervisors: A.J.J.A. Scherpbier en J. van Dalen
Rahila Yasmeen, Pakistan
R.J.A. Kamp
Towards a Deeper Understanding of Evaluator Subjectivity: An In-Depth Exploration of the Language Used in Assessments
Peer Feedback to Enhance Learning in Problem-Based Tutorial
Groups
Date of defence: 28-11-2013
Supervisors: D.H.J.M. Dolmans, H.G. Schmidt en H.J.M. van Berkel
K. Winston
Remediation Theory and Practice:
Transforming At-Risk Medical Students
Date of defence: 12-12-2013
Supervisors: A.J.J.A. Scherpbier en C.P.M. van der Vleuten
Workplace Based Learning a Legitimate Forum for Faculty Development
Marjolein Oerlemans, the Netherland
Profiles in Daily Performance in Trainees During Patient Encounters
Shiphra Ginsburg, Canada
Lucy Mc Lellan, United Kingdom
A study of Expertise Development in Prescribing
Anthony Amalba, Ghana
Influence of PBL with COBES as an Integral Part of the Undergraduate
Curriculum on Specialty and Rural Workplace Choices
Annual Report 2013 | School of Health Professions Education | Faculty of Health, Medicine and Life Sciences
10
Ahmed Al Rumayyan, Saudi Arabia
Professionalism in Medical Curricula: From A Cross Cultural
Perspective
Hiroshi Nishigori, Japan
Why Do Doctors Work for Patients? From Altruism to Prosociality,
with the Perspective of Bushido
Rahila Yasmeen, Pakistan
‘Workplace Based Learning’; a Legitimate Forum for Faculty
Development
Hisham Mirghani, Sudan
Training and Skill Acquisition for Basic Obstetrical Ultrasound Skills
Heba Mohtady, Egypt
Informal Mentorship and how it is Perceived and Developed in
Postgraduate Medical Education
Claudia Behrens, Chili
An Innovate Simulated Setting to Improve Decision Making Skills in
an Emergency Department in Undergraduate Medical Students
Abdul Sattar Khan, Saudi Arabia
How to Foster the Effectiveness of Receiving Peer Feedback in Small
Groups
Harumi Gomi, Japan
Art of Adaptive Questioning: Quality, Factors for improvement, and
Outcomes in Learning.
Chew Keng Shenk, Malaysia
Exploring Educational Strategies on Debiasing Search Satisficing in
Clinical Decision Making in Undergraduate Medical Curriculum.
Publication Output
Top 5 SHE Publications
Durning, S. J., Artino, A. R., Schuwirth, L., & van der Vleuten, C. (2013).
Clarifying assumptions to enhance our understanding and
assessment of clinical reasoning. Academic Medicine, 88, 442-448.
Deciding on a diagnosis and treatment is essential to the practice
of medicine. Developing competence in these clinical reasoning
processes, commonly referred to as diagnostic and therapeutic
reasoning, respectively, is required for physician success. Clinical
reasoning has been a topic of research for several decades, and
much has been learned. However, there still exists no clear
consensus regarding what clinical reasoning entails, let alone
how it might best be taught, how it should be assessed, and the
research and practice implications therein. In this article, the
authors first discuss two contrasting epistemological views of
clinical reasoning and related conceptual frameworks. They then
outline four different theoretical frameworks held by medical
educators that the authors believe guide educators’ views on the topic, knowingly or not. Within each theoretical framework,
the authors begin with a definition of clinical reasoning (from
that viewpoint) and then discuss learning, assessment, and
research implications. The authors believe these epistemologies
and four theoretical frameworks also apply to other concepts (or
“competencies”) in medical education. The authors conclude by
outlining practical implications and potential future areas for
research.
Sibbald, M., de Bruin, A. B. H., & van Merrienboer, J. J. G. (2013).
Checklists improve experts’ diagnostic decisions. Medical
Education, 47, 301-308.
Fifteen experts interpreted 18 electrocardiograms (ECGs) in four
different conditions: undirected interpretation; verification without
a checklist; verification with a checklist, and interpretation combined
with verification with a checklist. Outcomes included the number
of errors, cognitive load, interpretation time and interpretation
length. Standardised scores for each outcome were used to calculate
the efficiency of a checklist and to weigh its relative benefit against
its relative cost in terms of cognitive load imposed, interpretation
time and interpretation length. Checklist use was found to reduce
error (more errors were corrected in verification conditions with
checklists and fewer net errors occurred in all conditions with
checklists. Checklists were not associated with increased cognitive
load. Checklists resulted in greater interpretation times and lengths.
However, checklists were efficient in terms of the cognitive load
invested, interpretation time and interpretation length. Among
ECG interpretation experts, checklist use during the verification
stage of diagnostic decisions did not increase cognitive load or
cause expertise reversal, but did reduce diagnostic error.
Stalmeijer, R. E., Dolmans, D., Snellen-Balendong, H. A. M., van SantenHoefufft, M., Wolfhagen, I., & Scherpbier, A. (2013). Clinical teaching based
on principles of cognitive apprenticeship: Views of experienced clinical
teachers. Academic Medicine, 88, 861-865.
To explore (1) whether an instructional model based on principles
of cognitive apprenticeship fits with the practice of experienced
clinical teachers and (2) which factors influence clinical teaching
during clerkships from an environmental, teacher, and student level
as perceived by the clinical teachers themselves. The model was
designed to apply directly to teaching behaviors of clinical teachers
and consists of three phases, advocating teaching behaviors such
as modeling, creating a safe learning environment, coaching,
knowledge articulation, and exploration. A purposive sample of 17
experienced clinical teachers from five different disciplines and four
different teaching hospitals took part in semistructured individual
interviews. All participants recognized the theoretical model as a
structured picture of the practice of teaching activities during both
regular and senior clerkships. According to participants, modeling
and creating a safe learning environment were fundamental to the
learning process of both regular and senior clerkship students.
Division of teaching responsibilities, longer rotations, and proactive behavior of teachers and students ensured that teachers
were able to apply all steps in the model. The theoretical model
can offer valuable guidance in structuring clinical teaching activities and offers suggestions for the design of effective clerkships.
Annual Report 2013 | School of Health Professions Education | Faculty of Health, Medicine and Life Sciences
11
Van Loon, M. H., Kok, E. M., Kamp, R. J. A., Carbonell, K. B., Beckers,
J., Frambach, J. M., & de Bruin, A. B. H. (2013). AM last page:
Avoiding five common pitfalls of experimental research in medical
education. Academic Medicine, 88, 1588.
Experimental research is a scientific method that aims to
provide evidence for cause-and-effect relations. One or more
independent variables are systematically manipulated to
determine the effect(s) on a dependent variable while
controlling other relevant factors. Often, the goal is to gain
insight into underlying factors of an educational intervention.
However, pitfalls are numerous in medical education experiments.
Five common pitfalls are presented: (1) using an inappropriate
control condition, (2) failing to align your outcome measures
to your research questions, (3) ignoring possible reactive
effects of a pretest, (4) not taking time-on-task into account,
and (5) confusing ecological and external validity. For each pitfall,
examples of the pitfalls and ways to avoid them are discussed.
Watling, C., Driessen, E., van der Vleuten, C. P. M., Vanstone,
M., & Lingard, L. (2013). Music lessons: Revealing medicine’s
learning culture through a comparison with that of music.
Medical Education, 47, 842-850.
In this study, we undertook a comparative examination of
two learning cultures - those of music and medicine - in order
to unearth assumptions about learning that are taken for
granted within the medical culture. We used a constructivist
grounded theory approach to explore experiences of learning
within the two cultures. We conducted nine focus groups (two
with medical students, three with residents, four with music
students) and four individual interviews (with one clinicianeducator, one music educator and two doctor-musicians),
for a total of 37 participants. Cultural perspectives diverged in
terms of where learning should occur, what learning outcomes
are desired, and how learning is best facilitated. Whereas
medicine valued learning by doing, music valued learning
by lesson. Whereas medical learners aimed for competence,
music students aimed instead for ever-better performance.
Whereas medical learners valued their teachers for their
clinical skills more than for their teaching abilities, the
opposite was true in music, in which teachers’ instructional
skills were paramount. Self-assessment challenged learners
in both cultures, but medical learners viewed self-assessment
as a skill they could develop, whereas music students recognised
that external feedback would always be required.
Annual Report 2013 | School of Health Professions Education | Faculty of Health, Medicine and Life Sciences
12
Overview Publications
For an overview of all the publications in 2013, visit our website: www.maastrichtuniversity.nl/she
Publication Output 2013
Publication category
Dissertations
2005 2006
5
4
International S(S)CI journal articles
50
55
National journal articles
12
10
Total
82
93
International journal articles
9
Book publications
6
15
9
2007 2008
5
2
63
79
15
6
16
105
9
5
12
107
2009
2010
90
90
3
2011 2012 2013
0
18
23
14
8
88
125
114
5
45
148
11
13
11
23
13
8
169
127
35
12
8
1
10
10
189
145
The Thomson Reuters list of 2009 is used to determine the category of the articles.
Publication Output Research of Education
(Number of publications)
2009
2010
2011
2012
2013
120
110
100
90
80
70
60
50
40
30
20
10
0
Di
Dissertations
Wi-1
International S(S)CI
journal articles
Wi-2
International
journal articles
Wn
National
journal articles
Wb(c)
Book
publications
Direct funding staff: 5.62 FTE (mean 2013)
Wi-1 output per FTE: 20.28
Annual Report 2013 | School of Health Professions Education | Faculty of Health, Medicine and Life Sciences
13
International Activities and Collaboration
SHE Collaborates - a newly structured initiative by SHE
New projects in 2013
SHE started in 2012 with a new branch of international
activities and collaborations. A constant strength of the SHE
approach became “SHE Collaborates” including the tasks and
missions associated. SHE Collaborates aims to improve healthcare
globally, by facilitating higher educational institutes in realizing
educational innovation. The aim is to maintain long-term
collaborations with institutes for Higher Education in countries
all over the world by way of a Demand and Dialogue approach.
In Ethiopia we conducted 4 Tailor Made Training projects granted by
Nuffic in different areas: Intervention Mapping (Samara University),
Effective Teaching methods (Samara Health College) Regional Health
Management (Afar Regional State Bureau of Health) and Innovative
Medical Education (Aksum University, Health Science College). The first three projects we implemented with staff from SHE and
Health Promotion, in a mix of tailor-made courses in Ethiopia and
courses in Maastricht, the latter we executed in collaboration with
Erasmus University, Rotterdam.
Examples of current SHE Collaborates projects
We are in the finalization of the collaboration with Oman Medical
Specialty Board to start early 2014 Certificate Courses Leading to
MHPE and Faculty Development Workshops in Muscat.
Al Rahji University, Qassim, Kingdom of Saudi Arabia
Project period: 2008-2019. Project manager: Dominique Waterval
The already existing projects in the Qassim Region of Saudi
Arabia were continued in 2012 under the umbrella of SHE
Collaborates. The college of Al Rahji College franchises the
Maastricht medical curriculum. Part of the contract is the
delivery of training programmes by SHE for staff from Al Rahji
College and other colleges in Saudi Arabia. The SHE summer
Course has been given as a Winter Course in Qassim in
February 2012 and was a great success.
Qassim University, Qassim, Kingdom of Saudi Arabia
Project period: 2012-2013. Project manager: Carlos Collares,
supported by Dominique Waterval
Another project with the University of Qassim was started in
the Qassim region of Saudi Arabia and continued in 2012 for the
development of progress tests in Saudi Arabia, together with a
few other medical schools in the kingdom as partners. This
initiative will provide an opportunity to further develop FHML’s
ambition to international progress testing and benchmarking
University for Development Studies, Tamale, Ghana
‘Strengthening the capacity of midwifes and nurses at university
level to improve the quality of health care in Northern Ghana’
Also in cooperation with the Hogeschool Zuyd (Faculty of
Midwifery Education and Studies and Faculty of Nursing)
and with Management for Development Foundation (MDF)
Project period: September 2012-September 2015
Project manager: Mike Robertson
We are equally proud of our collaboration with Jazan University in the
most Southern part of The Kingdom of Saudi Arabia. This started as a
student exchange in the field of clinical nutrition, but has extended
to the areas of capacity building of staff in Jazan in physical therapy,
medicine and health promotion.
New building Jazan University, Jazan, KSA
In Mozambique we were supporting the Training of trainers in
Family and Community Therapy also in a Nuffic TMT project,
with input from consultants in Portugal and Germany.
University for Development Studies, Tamale, Ghana
‘Strengthening Quality Performance standards of paramedics health
professions. Support for the further development of the problembased learning medical curriculum at the medical school of the
University for Development Studies, Tamale, Ghana. Also in cooperation with the Management for Development Foundation (MDF)’
Project period: 2012-2015. Project manager: Geraldine van Kasteren
Sana’a High Institute of Health Sciences, Sana’a, Yemen
‘Strengthening quality performance standards for paramedics
health professionals at Sana’a High Institute of Health Sciences’
Also in cooperation with Hogeschool Zuyd Project period:
2012-2014. Project manager: Geraldine van Kasteren
Course Participants in Eduardo Mondlane University in Maputo, Mozambique
Annual Report 2013 | School of Health Professions Education | Faculty of Health, Medicine and Life Sciences
14
Appointments
In 2013 the following staff members were appointed:
Carlos Collares, SHE Collaborates
Janneke Frambach, SHE Staff
Jimmie Leppink, SHE Staff
Ingrid Spanjers, SHE Staff
Distinctive Academic Items
Jan-Joost Rethans
Received the first Howard S. Barrows Invited Presenter award;
installed in 2013 by the Association of Simulated Patients in
Education (ASPE) in memory of the late Professor Howard
Barrows.
Kitty Cleutjens, Hetty Snellen and
Mirjam Oude Egbrink
Received the best paper award during the NVMO conference
2013 for their contribution: Decentralized Selection Bachelor
Medicine Maastricht University: First Experiences and Effects.
Pim Teunissen
Won the Medical Education’s Critics Choice Award 2013 of the Journal of Medical Education, honoring exceptional
contributions by peer reviewers. Annual Report 2013 | School of Health Professions Education | Faculty of Health, Medicine and Life Sciences
15
SHEILA: SHE International League of Alumni
The School of Health Professions Education International
League of Alumni (SHEILA) builds on a lively international
network of alumni and students of the SHE programmes that
include a PhD, Master’s and Joint Master’s Programme in
Health Professions Education. Since 2008, the AMEE and the
Network: TUFH conferences have been SHEILA’s international
meeting points and SHEILA likes this! Why? International
friendships and collaborations between people engaged in
health professions education are made and consolidated
offering supportive opportunities to our challenges at home.
SHEILA learns @ AMEE, the interactive workshop
2013 heralded the transferal of the sceptre of SHEILA chair.
After five years of breaking ground, building the network and
organizing innovative workshops as the first SHEILA chair,
Jolien van den Houten (MHPE alum 2005-2007) was succeeded
by Ruud Wong Chung (MHPE alum 2010-2012). And he did a
great job by organizing the yearly SHEILA@AMEE workshop,
this time in Prague, Czech Republic.
Three MHPE/PhD alumni from Argentina (Alberto Alves de
Lima, Eduardo Durante, Marcelo Garcia Dieguez) put the
participants to work on defining criteria for mini clinical
evaluation exercises (mini-cex). This created a lively discussion
on the strengths and limitations of the instrument and the
difficulty of gaining consensus within multidisciplinary teams.
After that role play was used to practice our feedback skills which
led to the discussion around principles of constructive feedback
(even in situations when it seems impossible). Participants valued
the workshop for helping them formulate suggestions for
improvement for their own assessment practices.
SHEILA teamed with Rogano
This year SHEILA @ AMEE pre-conference workshop was
teamed with the preceding Rogano-meeting. The workshop
was open for Rogano participants. The teaming of the two
initiatives (Rogano and SHEILA) proved successful in widening
the horizon for all participants.
Rogano
An initiative has been taken in 2010 to exchange research
across a few prominent research groups in health professions
education around the world (University of Toronto, University
of British Columbia, University of Helsinki, Peninsula Medical
School, Karolinska, University of Copenhagen, Maastricht
University). Under the name of ROGANO, a first successful
activity has been held in conjunction to the AMEE conference
in 2011. After a successful continuation in 2012, 2013 saw
Rogano being strengthened even further by the addition of
several new, leading research groups in health professions
education. The meeting was again characterized by the
exchange of information, projects and ideas by both Postdocs
and PhD students within a stimulating and constructive
learning environment. Rogano also stimulates the exchange
of researchers and SHE and the Department of Educational
Development and Research hosted several foreign guests, who gave presentations on their research. In 2013 Rogano
members and SHE alumni joined together the SHEILA
workshop@AMEE in Prague.
SHEILA rendez-vous in Prague
The yearly informal SHEILA get together on the Monday
evening at the AMEE conference brought us to the steps of a
historical fort, called Vyšehrad, in the historically rich city of
Prague. Over 70 SHEILA participants and SHE relations and
friends joined us. Many old friends found each other again and
many new friends were found, across continents and language
barriers. As a special treat the SHEILA rendez-vous became the
venue of the graduation of Ayad Al-Moslih, one of our MHPE
students.
Finally next year’s workshop SHEILA@AMEE 2014 comes up in
Milan, Italy and will be organized by several SHEILA members
from Japan. The workshop will focus on “Change management
in health professions education. “Lessons from Japan”. Annual Report 2013 | School of Health Professions Education | Faculty of Health, Medicine and Life Sciences
16
www.maastrichtuniversity.nl/she
Contact information
Maastricht University
School of Health Professions Education
Faculty of Health, Medicine and Life Sciences
P.O. Box 616, 6200 MD Maastricht, The Netherlands
Email: [email protected]
Based in Europe, focused on the world. Maastricht University is
a stimulating environment. Where research and teaching are
complementary. Where innovation is our focus. Where talent
can flourish. A truly student oriented research university.