1
|
Alsem MW, Berkhout JJ, Buizer AI. Therapy needs and possibilities in paediatric rehabilitation during the COVID-19 lockdown in the Netherlands. Child Care Health Dev 2020; 46:749-750. [PMID: 32692426 PMCID: PMC7404530 DOI: 10.1111/cch.12797] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/15/2020] [Accepted: 07/15/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Mattijs W. Alsem
- Department of Rehabilitation, Amsterdam Movement SciencesAmsterdam UMC, University of AmsterdamMeibergdreef 9AmsterdamThe Netherlands,Emma Children's HospitalAmsterdam UMCAmsterdamThe Netherlands
| | - Joris J. Berkhout
- Department of Rehabilitation Medicine, Amsterdam Movement SciencesVrije Universiteit Amsterdam, University of AmsterdamAmsterdamThe Netherlands,Emma Children's HospitalAmsterdam UMCAmsterdamThe Netherlands
| | - Annemieke I. Buizer
- Department of Rehabilitation Medicine, Amsterdam Movement SciencesVrije Universiteit Amsterdam, University of AmsterdamAmsterdamThe Netherlands,Emma Children's HospitalAmsterdam UMCAmsterdamThe Netherlands
| |
Collapse
|
2
|
van Houten‐Schat MA, Berkhout JJ, van Dijk N, Endedijk MD, Jaarsma ADC, Diemers AD. Self-regulated learning in the clinical context: a systematic review. Med Educ 2018; 52:1008-1015. [PMID: 29943415 PMCID: PMC6175376 DOI: 10.1111/medu.13615] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 01/29/2018] [Accepted: 04/05/2018] [Indexed: 05/09/2023]
Abstract
OBJECTIVES Research has suggested beneficial effects of self-regulated learning (SRL) for medical students' and residents' workplace-based learning. Ideally, learners go through a cyclic process of setting learning goals, choosing learning strategies and assessing progress towards goals. A clear overview of medical students' and residents' successful key strategies, influential factors and effective interventions to stimulate SRL in the workplace is missing. This systematic review aims to provide an overview of and a theoretical base for effective SRL strategies of medical students and residents for their learning in the clinical context. METHODS This systematic review was conducted according to the guidelines of the Association for Medical Education in Europe. We systematically searched PubMed, EMBASE, Web of Science, PsycINFO, ERIC and the Cochrane Library from January 1992 to July 2016. Qualitative and quantitative studies were included. Two reviewers independently performed the review process and assessed the methodological quality of included studies. A total of 3341 publications were initially identified and 18 were included in the review. RESULTS We found diversity in the use of SRL strategies by medical students and residents, which is linked to individual (goal setting), contextual (time pressure, patient care and supervision) and social (supervisors and peers) factors. Three types of intervention were identified (coaching, learning plans and supportive tools). However, all interventions focused on goal setting and monitoring and none on supporting self-evaluation. CONCLUSIONS Self-regulated learning in the clinical environment is a complex process that results from an interaction between person and context. Future research should focus on unravelling the process of SRL in the clinical context and specifically on how medical students and residents assess their progress towards goals.
Collapse
Affiliation(s)
- Maaike A van Houten‐Schat
- Department of General Practice and Elderly Care MedicineUniversity Medical Centre GroningenUniversity of GroningenGroningenthe Netherlands
- Centre for Research and Innovation in Medical EducationUniversity Medical Centre GroningenUniversity of GroningenGroningenthe Netherlands
| | - Joris J Berkhout
- Centre for Evidence‐Based EducationAcademic Medical CentreUniversity of AmsterdamAmsterdamthe Netherlands
| | - Nynke van Dijk
- Department of General PracticeAcademic Medical CentreUniversity of AmsterdamAmsterdamthe Netherlands
| | - Maaike D Endedijk
- Department of Educational SciencesFaculty of Behavioural, Management and Social SciencesUniversity of TwenteEnschedethe Netherlands
| | - A Debbie C Jaarsma
- Centre for Research and Innovation in Medical EducationUniversity Medical Centre GroningenUniversity of GroningenGroningenthe Netherlands
| | - Agnes D Diemers
- Department of General Practice and Elderly Care MedicineUniversity Medical Centre GroningenUniversity of GroningenGroningenthe Netherlands
| |
Collapse
|
3
|
Berkhout JJ, Helmich E, Teunissen PW, van der Vleuten CPM, Jaarsma ADC. Context matters when striving to promote active and lifelong learning in medical education. Med Educ 2018; 52:34-44. [PMID: 28984375 DOI: 10.1111/medu.13463] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 04/05/2017] [Accepted: 08/14/2017] [Indexed: 05/11/2023]
Abstract
UNLABELLED WHERE DO WE STAND NOW?: In the 30 years that have passed since The Edinburgh Declaration on Medical Education, we have made tremendous progress in research on fostering 'self-directed and independent study' as propagated in this declaration, of which one prime example is research carried out on problem-based learning. However, a large portion of medical education happens outside of classrooms, in authentic clinical contexts. Therefore, this article discusses recent developments in research regarding fostering active learning in clinical contexts. SELF-REGULATED, LIFELONG LEARNING IN MEDICAL EDUCATION Clinical contexts are much more complex and flexible than classrooms, and therefore require a modified approach when fostering active learning. Recent efforts have been increasingly focused on understanding the more complex subject of supporting active learning in clinical contexts. One way of doing this is by using theory regarding self-regulated learning (SRL), as well as situated learning, workplace affordances, self-determination theory and achievement goal theory. Combining these different perspectives provides a holistic view of active learning in clinical contexts. ENTRY TO PRACTICE, VOCATIONAL TRAINING AND CONTINUING PROFESSIONAL DEVELOPMENT: Research on SRL in clinical contexts has mostly focused on the undergraduate setting, showing that active learning in clinical contexts requires not only proficiency in metacognition and SRL, but also in reactive, opportunistic learning. These studies have also made us aware of the large influence one's social environment has on SRL, the importance of professional relationships for learners, and the role of identity development in learning in clinical contexts. Additionally, research regarding postgraduate lifelong learning also highlights the importance of learners interacting about learning in clinical contexts, as well as the difficulties that clinical contexts may pose for lifelong learning. However, stimulating self-regulated learning in undergraduate medical education may also make postgraduate lifelong learning easier for learners in clinical contexts.
Collapse
Affiliation(s)
- Joris J Berkhout
- Center for Evidence-Based Education, Academic Medical Center (AMC-UvA), University of Amsterdam, Amsterdam, The Netherlands
| | - Esther Helmich
- Center for Research and Innovation in Medical Education, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Pim W Teunissen
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Obstetrics and Gynecology, VU University Medical Center, VU University Amsterdam, Amsterdam, The Netherlands
| | - Cees P M van der Vleuten
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - A Debbie C Jaarsma
- Center for Research and Innovation in Medical Education, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
4
|
Berkhout JJ, Slootweg IA, Helmich E, Teunissen PW, van der Vleuten CPM, Jaarsma ADC. How characteristic routines of clinical departments influence students' self-regulated learning: A grounded theory study. Med Teach 2017; 39:1174-1181. [PMID: 28784026 DOI: 10.1080/0142159x.2017.1360472] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND In clerkships, students are expected to self-regulate their learning. How clinical departments and their routine approach on clerkships influences students' self-regulated learning (SRL) is unknown. AIM This study explores how characteristic routines of clinical departments influence medical students' SRL. METHODS Six focus groups including 39 purposively sampled participants from one Dutch university were organized to study how characteristic routines of clinical departments influenced medical students' SRL from a constructivist paradigm, using grounded theory methodology. The focus groups were audio recorded, transcribed verbatim and were analyzed iteratively using constant comparison and open, axial and interpretive coding. RESULTS Students described that clinical departments influenced their SRL through routines which affected the professional relationships they could engage in and affected their perception of a department's invested effort in them. Students' SRL in a clerkship can be supported by enabling them to engage others in their SRL and by having them feel that effort is invested in their learning. CONCLUSIONS Our study gives a practical insight in how clinical departments influenced students' SRL. Clinical departments can affect students' motivation to engage in SRL, influence the variety of SRL strategies that students can use and how meaningful students perceive their SRL experiences to be.
Collapse
Affiliation(s)
- J J Berkhout
- a Center for Evidence-Based Education, Academic Medical Center (AMC-UvA) , University of Amsterdam , Amsterdam , The Netherlands
| | - I A Slootweg
- a Center for Evidence-Based Education, Academic Medical Center (AMC-UvA) , University of Amsterdam , Amsterdam , The Netherlands
| | - E Helmich
- b Center for Research and Innovation in Medical Education , University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
| | - P W Teunissen
- c Department of Obstetrics and Gynecology , VU University Medical Center, VU University Amsterdam , Amsterdam , The Netherlands
- d Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands
| | - C P M van der Vleuten
- d Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands
| | - A D C Jaarsma
- b Center for Research and Innovation in Medical Education , University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
| |
Collapse
|
5
|
Berkhout JJ, Teunissen PW, Helmich E, van Exel J, van der Vleuten CPM, Jaarsma DADC. Patterns in clinical students' self-regulated learning behavior: a Q-methodology study. Adv Health Sci Educ Theory Pract 2017; 22:105-121. [PMID: 27235123 PMCID: PMC5306423 DOI: 10.1007/s10459-016-9687-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 05/14/2016] [Indexed: 05/24/2023]
Abstract
Students feel insufficiently supported in clinical environments to engage in active learning and achieve a high level of self-regulation. As a result clinical learning is highly demanding for students. Because of large differences between students, supervisors may not know how to support them in their learning process. We explored patterns in undergraduate students' self-regulated learning behavior in the clinical environment, to improve tailored supervision, using Q-methodology. Q-methodology uses features of both qualitative and quantitative methods for the systematic investigation of subjective issues by having participants sort statements along a continuum to represent their opinion. We enrolled 74 students between December 2014 and April 2015 and had them characterize their learning behavior by sorting 52 statements about self-regulated learning behavior and explaining their response. The statements used for the sorting were extracted from a previous study. The data was analyzed using by-person factor analysis to identify clusters of individuals with similar sorts of the statements. The resulting factors and qualitative data were used to interpret and describe the patterns that emerged. Five resulting patterns were identified in students' self-regulated learning behavior in the clinical environment, which we labelled: Engaged, Critically opportunistic, Uncertain, Restrained and Effortful. The five patterns varied mostly regarding goals, metacognition, communication, effort, and dependence on external regulation for learning. These discrete patterns in students' self-regulated learning behavior in the clinical environment are part of a complex interaction between student and learning context. The results suggest that developing self-regulated learning behavior might best be supported regarding individual students' needs.
Collapse
Affiliation(s)
- Joris J Berkhout
- Center for Evidence-Based Education, Academic Medical Center (AMC-UvA), University of Amsterdam, Amsterdam, The Netherlands.
| | - Pim W Teunissen
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Obstetrics and Gynecology, VU University Medical Center, VU University Amsterdam, Amsterdam, The Netherlands
| | - Esther Helmich
- Center for Evidence-Based Education, Academic Medical Center (AMC-UvA), University of Amsterdam, Amsterdam, The Netherlands
| | - Job van Exel
- Institute of Health Policy and Management (BMG), Erasmus University, Rotterdam, The Netherlands
| | - Cees P M van der Vleuten
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Debbie A D C Jaarsma
- Center for Research and Innovation in Medical Education, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
6
|
Berkhout JJ, Helmich E, Teunissen PW, van der Vleuten CPM, Jaarsma ADC. How clinical medical students perceive others to influence their self-regulated learning. Med Educ 2017; 51:269-279. [PMID: 27882583 PMCID: PMC5324607 DOI: 10.1111/medu.13131] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 04/25/2016] [Accepted: 06/01/2016] [Indexed: 05/06/2023]
Abstract
OBJECTIVES Undergraduate medical students are prone to struggle with learning in clinical environments. One of the reasons may be that they are expected to self-regulate their learning, which often turns out to be difficult. Students' self-regulated learning is an interactive process between person and context, making a supportive context imperative. From a socio-cultural perspective, learning takes place in social practice, and therefore teachers and other hospital staff present are vital for students' self-regulated learning in a given context. Therefore, in this study we were interested in how others in a clinical environment influence clinical students' self-regulated learning. METHODS We conducted a qualitative study borrowing methods from grounded theory methodology, using semi-structured interviews facilitated by the visual Pictor technique. Fourteen medical students were purposively sampled based on age, gender, experience and current clerkship to ensure maximum variety in the data. The interviews were transcribed verbatim and were, together with the Pictor charts, analysed iteratively, using constant comparison and open, axial and interpretive coding. RESULTS Others could influence students' self-regulated learning through role clarification, goal setting, learning opportunities, self-reflection and coping with emotions. We found large differences in students' self-regulated learning and their perceptions of the roles of peers, supervisors and other hospital staff. Novice students require others, mainly residents and peers, to actively help them to navigate and understand their new learning environment. Experienced students who feel settled in a clinical environment are less susceptible to the influence of others and are better able to use others to their advantage. CONCLUSIONS Undergraduate medical students' self-regulated learning requires context-specific support. This is especially important for more novice students learning in a clinical environment. Their learning is influenced most heavily by peers and residents. Supporting novice students' self-regulated learning may be improved by better equipping residents and peers for this role.
Collapse
Affiliation(s)
- Joris J Berkhout
- Center for Evidence‐Based EducationAcademic Medical Center (AMC‐UvA)University of AmsterdamAmsterdamThe Netherlands
| | - Esther Helmich
- Center for Evidence‐Based EducationAcademic Medical Center (AMC‐UvA)University of AmsterdamAmsterdamThe Netherlands
| | - Pim W Teunissen
- Department of Educational Development and ResearchFaculty of HealthMedicine and Life SciencesMaastricht UniversityMaastrichtThe Netherlands
- Department of Obstetrics and GynecologyVU University Medical CenterVU University AmsterdamAmsterdamThe Netherlands
| | - Cees P M van der Vleuten
- Department of Educational Development and ResearchFaculty of HealthMedicine and Life SciencesMaastricht UniversityMaastrichtThe Netherlands
| | - A Debbie C Jaarsma
- Center for Research and Innovation in Medical EducationUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| |
Collapse
|
7
|
|
8
|
van den Berg JW, Verberg CPM, Berkhout JJ, Lombarts MJMH, Scherpbier AJJA, Jaarsma ADC. A qualitative interview study on the positive well-being of medical school faculty in their teaching role: job demands, job resources and role interaction. BMC Res Notes 2015; 8:401. [PMID: 26329102 PMCID: PMC4556414 DOI: 10.1186/s13104-015-1393-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 08/24/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Attention for the well-being of medical school faculty is not only important for the prevention of attrition and burnout, but may also boost performance in their tasks in medical education. Positive well-being can be conceptualized as work engagement and this is associated with increased performance. In this study we explore how demands and resources from different tasks affect work engagement specifically for education. METHODS Between June and September 2013, we conducted a multisite semi-structured interview study with a diverse group of medical school faculty and used an open-coding strategy within the Work Engagement Model on the transcribed interviews. RESULTS We interviewed 16 faculty members whose teaching experience ranged from 7 to 38 years and whose professional tasks ranged from being solely an educator to being a physician, researcher, educator and administrator simultaneously. All participants were clear on the perceived demands and resources, although similar aspects of the work environment could be perceived oppositely between participants. Overarching themes were perceptions related to the organization or department, often described as a general and long-term effect and perceptions directly related to a task, often described as a direct and short-term effect on well-being. Furthermore, the demands and resources as resultant of fulfilling multiple tasks were described clearly by participants. CONCLUSIONS The ambiguous nature of the work environment in terms of demands and resources requires an individualized approach to supporting work engagement. Furthermore, faculty members perceive many resources from fulfilling multiple tasks in relation to their tasks in education. Faculty developers and administrators alike could use these findings to apply the concept of work engagement to their daily support of faculty in medical education.
Collapse
Affiliation(s)
- J W van den Berg
- Center for Evidence-Based Education, Academic Medical Center-University of Amsterdam, Meibergdreef 15, Room J1A-138, 1105 AZ, Amsterdam, The Netherlands.
| | - C P M Verberg
- Center for Evidence-Based Education, Academic Medical Center-University of Amsterdam, Meibergdreef 15, Room J1A-138, 1105 AZ, Amsterdam, The Netherlands.
| | - J J Berkhout
- Center for Evidence-Based Education, Academic Medical Center-University of Amsterdam, Meibergdreef 15, Room J1A-138, 1105 AZ, Amsterdam, The Netherlands.
| | - M J M H Lombarts
- Center for Evidence-Based Education, Academic Medical Center-University of Amsterdam, Meibergdreef 15, Room J1A-138, 1105 AZ, Amsterdam, The Netherlands.
| | - A J J A Scherpbier
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
| | - A D C Jaarsma
- Center for Research and Innovation in Medical Education, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| |
Collapse
|
9
|
Berkhout JJ, Helmich E, Teunissen PW, van den Berg JW, van der Vleuten CPM, Jaarsma ADC. Exploring the factors influencing clinical students' self-regulated learning. Med Educ 2015; 49:589-600. [PMID: 25989407 DOI: 10.1111/medu.12671] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 09/06/2014] [Accepted: 12/01/2014] [Indexed: 05/26/2023]
Abstract
OBJECTIVES The importance of self-regulated learning (SRL) has been broadly recognised by medical education institutions and regulatory bodies. Supporting the development of SRL skills has proven difficult because self-regulation is a complex interactive process and we know relatively little about the factors influencing this process in real practice settings. The aim of our study was therefore to identify factors that support or hamper medical students' SRL in a clinical context. METHODS We conducted a constructivist grounded theory study using semi-structured interviews with 17 medical students from two universities enrolled in clerkships. Participants were purposively sampled to ensure variety in age, gender, experience and current clerkship. The Day Reconstruction Method was used to help participants remember their activities of the previous day. The interviews were transcribed verbatim and analysed iteratively using constant comparison and open, axial and interpretive coding. RESULTS Self-regulated learning by students in the clinical environment was influenced by the specific goals perceived by students, the autonomy they experienced, the learning opportunities they were given or created themselves, and the anticipated outcomes of an activity. All of these factors were affected by personal, contextual and social attributes. CONCLUSIONS Self-regulated learning of medical students in the clinical environment is different for every individual. The factors influencing this process are affected by personal, social and contextual attributes. Some of these are similar to those known from previous research in classroom settings, but others are unique to the clinical environment and include the facilities available, the role of patients, and social relationships pertaining to peers and other hospital staff. To better support students' SRL, we believe it is important to increase students' metacognitive awareness and to offer students more tailored learning opportunities.
Collapse
Affiliation(s)
- Joris J Berkhout
- Centre for Evidence-Based Education, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Esther Helmich
- Centre for Evidence-Based Education, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Pim W Teunissen
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
- Department of Obstetrics and Gynaecology, VU University Medical Centre, VU University Amsterdam, Amsterdam, the Netherlands
| | - Joost W van den Berg
- Centre for Evidence-Based Education, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Cees P M van der Vleuten
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - A Debbie C Jaarsma
- Centre for Evidence-Based Education, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
- Centre for Research and Innovation in Medical Education, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| |
Collapse
|
10
|
|
11
|
Berkhout JJ, Luiten OJ, Setija ID, Hijmans TW, Mizusaki T, Walraven JT. Quantum reflection: Focusing of hydrogen atoms with a concave mirror. Phys Rev Lett 1989; 63:1689-1692. [PMID: 10040645 DOI: 10.1103/physrevlett.63.1689] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
|
12
|
|
13
|
Berkhout JJ, Wolters EJ, Walraven JT. Vanishing sticking probabilities and enhanced capillary flow of spin-polarized hydrogen. Phys Rev Lett 1986; 57:2387-2390. [PMID: 10033712 DOI: 10.1103/physrevlett.57.2387] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
|