Willem De Grave | Maastricht University, Faculty of Health Medicine and Life sciences (original) (raw)

Papers by Willem De Grave

BMC Medical Education

Background: In health profession education, learners are often coached by mentors for development... more Background: In health profession education, learners are often coached by mentors for development of competencies, self-direction of learning and professionalism. It is important that the mentee-mentor relationship is aligned in terms of mutual expectations. Methods: A dual-purpose questionnaire capturing both the mentor and mentee perceptions on the actual and preferred mentoring functions was designed and validated, by performing a principal component analysis (PCA) using the data of mentees (n = 103) and mentors (n = 23) of a medical course. As a proof of concept, alignment of needs and changes in the mentoring perceptions in mentee groups of different years were determined. Results: PCA showed that specific sets of questions addressed important elements in the mentoring process, such as self-direction of learning and reflection (Scale 1), guidance of behavioural change (Scale 4), addressing personal issues and professional identity development (Scale 3 and 5) and how the mentor and mentee presents oneself in the mentoring relationship (Scale 2). Mentors and mentees perceived comparable situations as critical for an effective mentoring process, such as mentor presence and guidance of reflection, although there was also evidence of gaps, such as perception of cultural issues. By comparison of the mentee groups in the different years of the program, the dynamic or evolving nature of the mentor process became evident, mentees experienced more emphasis by the mentor on reflection (Scale 1), at a constant level of mentor presence (Scale 2). Conclusion: Given the individualized, context-specific, and dynamic nature of mentoring, programmes would benefit from a regular evaluation of mentoring practices, e.g. by using questionnaires, in order to facilitate organizational revisions and further development of the mentoring competencies.

Education For Primary Care, May 1, 2012

Most teacher development initiatives focus on enhancing knowledge of teaching (pedagogy), whilst ... more Most teacher development initiatives focus on enhancing knowledge of teaching (pedagogy), whilst largely ignoring other important features of teacher knowledge such as subject matter knowledge and awareness of the learning context. Furthermore, teachers' ability to learn from faculty development interventions is limited by their existing (often implicit) pedagogical knowledge and beliefs. Pedagogical content knowledge (PCK) represents a model of teacher knowledge incorporating what they know about subject matter, pedagogy and context. PCK can be used to explore teachers' prior knowledge and to structure faculty development programmes so that they take account of a broader range of teachers' knowledge. We set out to examine the application of a PCK model in a general practice education setting. This study is part of a larger study that employed a mixed method approach (concept mapping, phenomenological interviews and video-stimulated recall) to explore features of GP teachers' subject matter knowledge, pedagogical knowledge and knowledge of the learning environment in the context of a general practice tutorial. This paper presents data on GP teachers' pedagogical and context knowledge. There was considerable overlap between different GP teachers' knowledge and beliefs about learners and the clinical learning environment (i.e. knowledge of context). The teachers' beliefs about learners were largely based on assumptions derived from their own student experiences. There were stark differences, however, between teachers in terms of pedagogical knowledge, particularly in terms of their teaching orientations (i.e. transmission or facilitation orientation) and this was manifest in their teaching behaviours. PCK represents a useful model for conceptualising clinical teacher prior knowledge in three domains, namely subject matter, learning context and pedagogy. It can and should be used as a simple guiding framework by faculty developers to inform the design and delivery of their faculty development programmes.

Kidney …, 1996

A prospective study of the natural history of idiopathic non-proteinuric hematuria. In a prospect... more A prospective study of the natural history of idiopathic non-proteinuric hematuria. In a prospective study of idiopathic glomerulonephritis we determined the natural history of 49 adult patients (12 primary IgA nephropathy, 13 thin GBM nephropathy, 20 normal renal tissue and 4 ...

Kidney …, 1996

A prospective study of the natural history of idiopathic non-proteinuric hematuria. In a prospect... more A prospective study of the natural history of idiopathic non-proteinuric hematuria. In a prospective study of idiopathic glomerulonephritis we determined the natural history of 49 adult patients (12 primary IgA nephropathy, 13 thin GBM nephropathy, 20 normal renal tissue and 4 ...

Intensive Care Medicine, 2010

Introduction: The emphasis on the importance of professionalism in a recent CoBaTrICE-IT paper wa... more Introduction: The emphasis on the importance of professionalism in a recent CoBaTrICE-IT paper was impressive. However, insight into the elements of professionalism as perceived relevant for intensivists from the fellows' view, and how these are taught and learned, is limited. Objectives and methods: A nationwide study was performed in 2007-2008. All ICM fellows (n = 90) were sent a questionnaire containing the following questions regarding training in professionalism (7-point Likert scale (1 = very inadequate, 7 = very adequate)): which are the elements perceived to be important in intensivists'' daily practice (38 items, cat.

Medical Teacher, 2013

Background: Teachers' belief in their ability to teach influences how much of the new knowledge a... more Background: Teachers' belief in their ability to teach influences how much of the new knowledge and skills gained during faculty development (FD) programs are actually implemented at the workplace. Aim: To study the effect of a longitudinal FD program on the self-efficacy beliefs (SEB) of teachers of health professions using quasi-experimental methodology. Methods: The SEB of 70 teachers of health professions enrolling for a longitudinal FD program at three sites in India and one site in South Africa and an equal number of comparable controls were measured using the ''teacher efficacy belief systems-self'' (TEBS-self) scale. The scale was re-administered at 6 and 12 months to both the groups. Results: Teachers enrolled in the program had lower scores than controls at the beginning of the program but demonstrated a significant increase at 6 months with an effect size of 0.56. The 12-month scores demonstrated a further rise in the participating teachers. The control group maintained the scores but did not show any significant change either at 6 or at 12 months. Conclusion: Longitudinal FD program has positive effect on SEB of teachers.

American Journal of Educational Research, 2014

Context: Only a small proportion of knowledge and skills acquired during faculty development is a... more Context: Only a small proportion of knowledge and skills acquired during faculty development is actually applied on the job, leading to poor transfer of training. This results in wastage of training efforts. The present study was designed to predict the intention to transfer after participation in a faculty development workshop using theory of planned behavior (TPB). Methods: A questionnaire was designed covering direct measures of the TPB constructs viz. 'attitudes towards behavior', 'perceived control over behavior' and 'subjective norms', which was used to predict intention to transfer. Three hundred twenty four mid-level medical educators took the survey. Results: Respondents had a mean of 10.59 ± 7.39 and 5.25 ± 5.24 years of experience of teaching undergraduate and postgraduate classes respectively. The model accounted for 41% change in intention to transfer, with standard regression co-efficient equal to 0.51 for 'attitudes towards behavior', 0.21 for 'perceived control over behavior' and 0.07 for 'subjective norm'. Discussion: Attitudes towards behavior and perceived control over behavior had greater influence over intention to transfer compared to subjective norms. The faculty development programs should focus on developing positive attitudes and perceived control over behavior of the participants.

European Journal of Paediatric Neurology

Visual expertise relies on perceptive as well as cognitive processes. At present, knowledge of th... more Visual expertise relies on perceptive as well as cognitive processes. At present, knowledge of these processes when diagnosing clinical cases mainly stems from studies with still pictures. In contrast, patient video cases constitute a dynamic diagnostic challenge that may simulate seeing and diagnosing a patient in person.This study investigates visual attention and the concomitant cognitive processes of clinicians diagnosing authentic paediatric video cases.A total of 43 clinicians with varying levels of expertise took part in this cross-sectional study. They diagnosed four brief video recordings of children: two with seizures and two with disorders imitating seizures. We used eye tracking to investigate time looking at relevant areas in the video cases and a concurrent think-aloud procedure to explore the associated clinical reasoning processes.More experienced clinicians were more accurate in visual diagnosis and spent more of their time looking at relevant areas. At the same time, they explored data less, yet they built and evaluated more diagnostic hypotheses.Clinicians of varying expertise analyse patient video cases differently. Clinical teachers should take these differences into account when optimising educational formats with patient video cases.► We examined eye movements and think-aloud in clinicians analysing video cases. ► Clinicians of varying expertise analysed patient video cases differently. ► More experienced clinicians looked more at relevant areas. ► More experienced clinicians were more accurate in visual diagnosis. ► More experienced clinicians built and evaluated more diagnostic hypotheses.

Education for health (Abingdon, England), 2009

Residents' perceived needs in communication skills training are important to identify before ... more Residents' perceived needs in communication skills training are important to identify before designing context-specific training programmes, since learrners' perceived needs can influence the effectiveness of training. To explore residents' perceptions of their training needs and training experiences around communication skills, and whether these differ between residents training in inpatient and outpatient clinical settings. Four focus groups (FG) and a self-administered questionnaire were conducted with residents working in in- and outpatient medical service settings at a Swiss University Hospital. Focus groups explored residents' perceptions of their communication needs, their past training experiences and suggestions for future training programmes in communication skills. Transcripts were analysed in a thematic way using qualitative analytic approaches. All residents from both settings were asked to complete a questionnaire that queried their sociodemographics an...

Medical Teacher, 2009

Background: Lack of faculty training is often cited as the main obstacle to post-graduate teachin... more Background: Lack of faculty training is often cited as the main obstacle to post-graduate teaching in communication skills. Aims: To explore clinical supervisors' needs and perceptions regarding their role as communication skills trainers. Methods: Four focus group discussions were conducted with clinical supervisors from two in-patient and one out-patient medical services from the Geneva University Hospitals. Focus groups were audio taped, transcribed verbatim and analyzed in a thematic way using Maxqdaß software for qualitative data analysis. Results: Clinical supervisors said that they frequently addressed communication issues with residents but tended to intervene as rescuers, clinicians or coaches rather than as formal instructors. They felt their own training did not prepare them to teach communication skills. Other barriers to teach communication skills include lack of time, competing demands, lack of interest and experience on the part of residents, and lack of institutional priority given to communication issues. Respondents expressed a desire for experiential and reflective training in a work-based setting and emphasised the need for a non-judgmental learning atmosphere. Conclusions: Results suggest that organisational priorities, culture and climate strongly influence the degree to which clinical supervisors may feel comfortable to teach communication skills to residents. Attention must be given to these contextual factors in the development of an effective communication skills teaching program for clinical supervisors.

Education for health (Abingdon, England), 2009

Residents' perceived needs in communication skills training are important to identify before ... more Residents' perceived needs in communication skills training are important to identify before designing context-specific training programmes, since learrners' perceived needs can influence the effectiveness of training. To explore residents' perceptions of their training needs and training experiences around communication skills, and whether these differ between residents training in inpatient and outpatient clinical settings. Four focus groups (FG) and a self-administered questionnaire were conducted with residents working in in- and outpatient medical service settings at a Swiss University Hospital. Focus groups explored residents' perceptions of their communication needs, their past training experiences and suggestions for future training programmes in communication skills. Transcripts were analysed in a thematic way using qualitative analytic approaches. All residents from both settings were asked to complete a questionnaire that queried their sociodemographics an...

Medical Teacher, 2002

The tutor role in problem-based learning (PBL) has attracted the interest of many researchers and... more The tutor role in problem-based learning (PBL) has attracted the interest of many researchers and has led to an abundance of studies. This article reports on major trends in studies investigating the tutor during the past 10 years. Three major trends were observed by the authors while analysing the studies conducted: studies on the differential influence of content expert and non-content expert tutors on student achievement, studies on process variables, and studies on the relationship between tutor characteristics and differential contextual circumstances. The aim of this article is to summarize the main findings of the studies conducted so far within the three trends observed, to provide directions for educational practitioners and policy makers, and to suggest directions for future research questions. The studies included were selected by conducting a literature search in medical journals, which was complemented with the personal archives of the authors. The results of the studies conducted within the three trends of research have led to advanced insights in tutoring. The outcomes revealed that content expert tutors tend to use their subject-matter expertise more to direct the discussion in the tutorial group, whereas non-content expert tutors tend to use their process-facilitation expertise more to direct the tutorial group. Furthermore, a tutor's performance is not a stable characteristic but is partly situation specific. It is concluded that a tutor should both know how to deal with the subject matter expertise and should know how to facilitate the learning process. Faculty and policy makers should put substantial efforts into designing curricula and cases and developing tutors' skills by faculty development strategies that stimulate reflection. The research agenda should be driven more by modern educational theories of learning in which tutoring is a process aimed at stimulating constructive, self-directed, situated and collaborative learning by students. Furthermore, more qualitative studies should be conducted to gain better insights in teachers' conceptions about the tutor role and student learning to better understand their behaviours.

Advances in Health Sciences Education, 2008

Teachers' reflections are often narrowly focused on technical questions ('how to') and less on th... more Teachers' reflections are often narrowly focused on technical questions ('how to') and less on the underlying moral, political and emotional aspects of their functioning. However, for a better understanding of teaching practice it is important to uncover beliefs and values that usually remain implicit. Meeting with others is considered crucial for enhancing the quality of teachers' reflections. However, little is known about how any beneficial effects of such meetings are brought about. We explored the relationship between medical teachers' interactions and collaborative reflection processes during peer meetings. Five experienced teachers and a teacher trainer participated in the study. Three peer meetings were videotaped and transcribed. Teachers' interactions and collaborative reflective processes were analysed. The interactions promoted reflection not only on technical questions but also on moral, political, and emotional issues. 'Guiding/directing', 'proposing an alternative' and 'exploring an alternative' appeared to be the principal interactions. The results may be useful for teachers and trainers who are considering organising and/or improving peer meetings.

Assessment & Evaluation in Higher Education

Student evaluation committees play a crucial role in internal quality assurance processes as repr... more Student evaluation committees play a crucial role in internal quality assurance processes as representatives of the student body. However, the students on these committees sometimes experience difficulty in providing constructive and structured feedback to faculty in an environment characterised by a strong power differential between student and staff. This study aimed to evaluate a leadership and quality assurance training implemented for students involved in internal quality assurance. Furthermore, we explored how students give shape to their internal quality assurance role. Students from three health sciences programmes participated in a mixed methods study to evaluate the training and reflect on their internal quality assurance role. Overall, the students were very enthusiastic about the training. Qualitative data analysis indicated that in their internal quality assurance role, students: (1) harnessed the power of the entire student population; (2) tried to create focus and tak...

Instructional Science, Jan 1, 2001

The Purpose of this study was to examine effects of group discussion of a medical problem on the ... more The Purpose of this study was to examine effects of group discussion of a medical problem on the comprehension of a subsequent problem-relevant text by first year medical students.

Academic Emergency Medicine, 2012

Objectives: Program evaluation remains a critical but underutilized step in medical education. Th... more Objectives: Program evaluation remains a critical but underutilized step in medical education. This study compared traditional and retrospective pre-post self-assessment methods to objective learning measures to assess which correlated better to actual learning.

BMC Medical Education

Background: In health profession education, learners are often coached by mentors for development... more Background: In health profession education, learners are often coached by mentors for development of competencies, self-direction of learning and professionalism. It is important that the mentee-mentor relationship is aligned in terms of mutual expectations. Methods: A dual-purpose questionnaire capturing both the mentor and mentee perceptions on the actual and preferred mentoring functions was designed and validated, by performing a principal component analysis (PCA) using the data of mentees (n = 103) and mentors (n = 23) of a medical course. As a proof of concept, alignment of needs and changes in the mentoring perceptions in mentee groups of different years were determined. Results: PCA showed that specific sets of questions addressed important elements in the mentoring process, such as self-direction of learning and reflection (Scale 1), guidance of behavioural change (Scale 4), addressing personal issues and professional identity development (Scale 3 and 5) and how the mentor and mentee presents oneself in the mentoring relationship (Scale 2). Mentors and mentees perceived comparable situations as critical for an effective mentoring process, such as mentor presence and guidance of reflection, although there was also evidence of gaps, such as perception of cultural issues. By comparison of the mentee groups in the different years of the program, the dynamic or evolving nature of the mentor process became evident, mentees experienced more emphasis by the mentor on reflection (Scale 1), at a constant level of mentor presence (Scale 2). Conclusion: Given the individualized, context-specific, and dynamic nature of mentoring, programmes would benefit from a regular evaluation of mentoring practices, e.g. by using questionnaires, in order to facilitate organizational revisions and further development of the mentoring competencies.

Education For Primary Care, May 1, 2012

Most teacher development initiatives focus on enhancing knowledge of teaching (pedagogy), whilst ... more Most teacher development initiatives focus on enhancing knowledge of teaching (pedagogy), whilst largely ignoring other important features of teacher knowledge such as subject matter knowledge and awareness of the learning context. Furthermore, teachers' ability to learn from faculty development interventions is limited by their existing (often implicit) pedagogical knowledge and beliefs. Pedagogical content knowledge (PCK) represents a model of teacher knowledge incorporating what they know about subject matter, pedagogy and context. PCK can be used to explore teachers' prior knowledge and to structure faculty development programmes so that they take account of a broader range of teachers' knowledge. We set out to examine the application of a PCK model in a general practice education setting. This study is part of a larger study that employed a mixed method approach (concept mapping, phenomenological interviews and video-stimulated recall) to explore features of GP teachers' subject matter knowledge, pedagogical knowledge and knowledge of the learning environment in the context of a general practice tutorial. This paper presents data on GP teachers' pedagogical and context knowledge. There was considerable overlap between different GP teachers' knowledge and beliefs about learners and the clinical learning environment (i.e. knowledge of context). The teachers' beliefs about learners were largely based on assumptions derived from their own student experiences. There were stark differences, however, between teachers in terms of pedagogical knowledge, particularly in terms of their teaching orientations (i.e. transmission or facilitation orientation) and this was manifest in their teaching behaviours. PCK represents a useful model for conceptualising clinical teacher prior knowledge in three domains, namely subject matter, learning context and pedagogy. It can and should be used as a simple guiding framework by faculty developers to inform the design and delivery of their faculty development programmes.

Kidney …, 1996

A prospective study of the natural history of idiopathic non-proteinuric hematuria. In a prospect... more A prospective study of the natural history of idiopathic non-proteinuric hematuria. In a prospective study of idiopathic glomerulonephritis we determined the natural history of 49 adult patients (12 primary IgA nephropathy, 13 thin GBM nephropathy, 20 normal renal tissue and 4 ...

Kidney …, 1996

A prospective study of the natural history of idiopathic non-proteinuric hematuria. In a prospect... more A prospective study of the natural history of idiopathic non-proteinuric hematuria. In a prospective study of idiopathic glomerulonephritis we determined the natural history of 49 adult patients (12 primary IgA nephropathy, 13 thin GBM nephropathy, 20 normal renal tissue and 4 ...

Intensive Care Medicine, 2010

Introduction: The emphasis on the importance of professionalism in a recent CoBaTrICE-IT paper wa... more Introduction: The emphasis on the importance of professionalism in a recent CoBaTrICE-IT paper was impressive. However, insight into the elements of professionalism as perceived relevant for intensivists from the fellows' view, and how these are taught and learned, is limited. Objectives and methods: A nationwide study was performed in 2007-2008. All ICM fellows (n = 90) were sent a questionnaire containing the following questions regarding training in professionalism (7-point Likert scale (1 = very inadequate, 7 = very adequate)): which are the elements perceived to be important in intensivists'' daily practice (38 items, cat.

Medical Teacher, 2013

Background: Teachers' belief in their ability to teach influences how much of the new knowledge a... more Background: Teachers' belief in their ability to teach influences how much of the new knowledge and skills gained during faculty development (FD) programs are actually implemented at the workplace. Aim: To study the effect of a longitudinal FD program on the self-efficacy beliefs (SEB) of teachers of health professions using quasi-experimental methodology. Methods: The SEB of 70 teachers of health professions enrolling for a longitudinal FD program at three sites in India and one site in South Africa and an equal number of comparable controls were measured using the ''teacher efficacy belief systems-self'' (TEBS-self) scale. The scale was re-administered at 6 and 12 months to both the groups. Results: Teachers enrolled in the program had lower scores than controls at the beginning of the program but demonstrated a significant increase at 6 months with an effect size of 0.56. The 12-month scores demonstrated a further rise in the participating teachers. The control group maintained the scores but did not show any significant change either at 6 or at 12 months. Conclusion: Longitudinal FD program has positive effect on SEB of teachers.

American Journal of Educational Research, 2014

Context: Only a small proportion of knowledge and skills acquired during faculty development is a... more Context: Only a small proportion of knowledge and skills acquired during faculty development is actually applied on the job, leading to poor transfer of training. This results in wastage of training efforts. The present study was designed to predict the intention to transfer after participation in a faculty development workshop using theory of planned behavior (TPB). Methods: A questionnaire was designed covering direct measures of the TPB constructs viz. 'attitudes towards behavior', 'perceived control over behavior' and 'subjective norms', which was used to predict intention to transfer. Three hundred twenty four mid-level medical educators took the survey. Results: Respondents had a mean of 10.59 ± 7.39 and 5.25 ± 5.24 years of experience of teaching undergraduate and postgraduate classes respectively. The model accounted for 41% change in intention to transfer, with standard regression co-efficient equal to 0.51 for 'attitudes towards behavior', 0.21 for 'perceived control over behavior' and 0.07 for 'subjective norm'. Discussion: Attitudes towards behavior and perceived control over behavior had greater influence over intention to transfer compared to subjective norms. The faculty development programs should focus on developing positive attitudes and perceived control over behavior of the participants.

European Journal of Paediatric Neurology

Visual expertise relies on perceptive as well as cognitive processes. At present, knowledge of th... more Visual expertise relies on perceptive as well as cognitive processes. At present, knowledge of these processes when diagnosing clinical cases mainly stems from studies with still pictures. In contrast, patient video cases constitute a dynamic diagnostic challenge that may simulate seeing and diagnosing a patient in person.This study investigates visual attention and the concomitant cognitive processes of clinicians diagnosing authentic paediatric video cases.A total of 43 clinicians with varying levels of expertise took part in this cross-sectional study. They diagnosed four brief video recordings of children: two with seizures and two with disorders imitating seizures. We used eye tracking to investigate time looking at relevant areas in the video cases and a concurrent think-aloud procedure to explore the associated clinical reasoning processes.More experienced clinicians were more accurate in visual diagnosis and spent more of their time looking at relevant areas. At the same time, they explored data less, yet they built and evaluated more diagnostic hypotheses.Clinicians of varying expertise analyse patient video cases differently. Clinical teachers should take these differences into account when optimising educational formats with patient video cases.► We examined eye movements and think-aloud in clinicians analysing video cases. ► Clinicians of varying expertise analysed patient video cases differently. ► More experienced clinicians looked more at relevant areas. ► More experienced clinicians were more accurate in visual diagnosis. ► More experienced clinicians built and evaluated more diagnostic hypotheses.

Education for health (Abingdon, England), 2009

Residents' perceived needs in communication skills training are important to identify before ... more Residents' perceived needs in communication skills training are important to identify before designing context-specific training programmes, since learrners' perceived needs can influence the effectiveness of training. To explore residents' perceptions of their training needs and training experiences around communication skills, and whether these differ between residents training in inpatient and outpatient clinical settings. Four focus groups (FG) and a self-administered questionnaire were conducted with residents working in in- and outpatient medical service settings at a Swiss University Hospital. Focus groups explored residents' perceptions of their communication needs, their past training experiences and suggestions for future training programmes in communication skills. Transcripts were analysed in a thematic way using qualitative analytic approaches. All residents from both settings were asked to complete a questionnaire that queried their sociodemographics an...

Medical Teacher, 2009

Background: Lack of faculty training is often cited as the main obstacle to post-graduate teachin... more Background: Lack of faculty training is often cited as the main obstacle to post-graduate teaching in communication skills. Aims: To explore clinical supervisors' needs and perceptions regarding their role as communication skills trainers. Methods: Four focus group discussions were conducted with clinical supervisors from two in-patient and one out-patient medical services from the Geneva University Hospitals. Focus groups were audio taped, transcribed verbatim and analyzed in a thematic way using Maxqdaß software for qualitative data analysis. Results: Clinical supervisors said that they frequently addressed communication issues with residents but tended to intervene as rescuers, clinicians or coaches rather than as formal instructors. They felt their own training did not prepare them to teach communication skills. Other barriers to teach communication skills include lack of time, competing demands, lack of interest and experience on the part of residents, and lack of institutional priority given to communication issues. Respondents expressed a desire for experiential and reflective training in a work-based setting and emphasised the need for a non-judgmental learning atmosphere. Conclusions: Results suggest that organisational priorities, culture and climate strongly influence the degree to which clinical supervisors may feel comfortable to teach communication skills to residents. Attention must be given to these contextual factors in the development of an effective communication skills teaching program for clinical supervisors.

Education for health (Abingdon, England), 2009

Residents' perceived needs in communication skills training are important to identify before ... more Residents' perceived needs in communication skills training are important to identify before designing context-specific training programmes, since learrners' perceived needs can influence the effectiveness of training. To explore residents' perceptions of their training needs and training experiences around communication skills, and whether these differ between residents training in inpatient and outpatient clinical settings. Four focus groups (FG) and a self-administered questionnaire were conducted with residents working in in- and outpatient medical service settings at a Swiss University Hospital. Focus groups explored residents' perceptions of their communication needs, their past training experiences and suggestions for future training programmes in communication skills. Transcripts were analysed in a thematic way using qualitative analytic approaches. All residents from both settings were asked to complete a questionnaire that queried their sociodemographics an...

Medical Teacher, 2002

The tutor role in problem-based learning (PBL) has attracted the interest of many researchers and... more The tutor role in problem-based learning (PBL) has attracted the interest of many researchers and has led to an abundance of studies. This article reports on major trends in studies investigating the tutor during the past 10 years. Three major trends were observed by the authors while analysing the studies conducted: studies on the differential influence of content expert and non-content expert tutors on student achievement, studies on process variables, and studies on the relationship between tutor characteristics and differential contextual circumstances. The aim of this article is to summarize the main findings of the studies conducted so far within the three trends observed, to provide directions for educational practitioners and policy makers, and to suggest directions for future research questions. The studies included were selected by conducting a literature search in medical journals, which was complemented with the personal archives of the authors. The results of the studies conducted within the three trends of research have led to advanced insights in tutoring. The outcomes revealed that content expert tutors tend to use their subject-matter expertise more to direct the discussion in the tutorial group, whereas non-content expert tutors tend to use their process-facilitation expertise more to direct the tutorial group. Furthermore, a tutor's performance is not a stable characteristic but is partly situation specific. It is concluded that a tutor should both know how to deal with the subject matter expertise and should know how to facilitate the learning process. Faculty and policy makers should put substantial efforts into designing curricula and cases and developing tutors' skills by faculty development strategies that stimulate reflection. The research agenda should be driven more by modern educational theories of learning in which tutoring is a process aimed at stimulating constructive, self-directed, situated and collaborative learning by students. Furthermore, more qualitative studies should be conducted to gain better insights in teachers' conceptions about the tutor role and student learning to better understand their behaviours.

Advances in Health Sciences Education, 2008

Teachers' reflections are often narrowly focused on technical questions ('how to') and less on th... more Teachers' reflections are often narrowly focused on technical questions ('how to') and less on the underlying moral, political and emotional aspects of their functioning. However, for a better understanding of teaching practice it is important to uncover beliefs and values that usually remain implicit. Meeting with others is considered crucial for enhancing the quality of teachers' reflections. However, little is known about how any beneficial effects of such meetings are brought about. We explored the relationship between medical teachers' interactions and collaborative reflection processes during peer meetings. Five experienced teachers and a teacher trainer participated in the study. Three peer meetings were videotaped and transcribed. Teachers' interactions and collaborative reflective processes were analysed. The interactions promoted reflection not only on technical questions but also on moral, political, and emotional issues. 'Guiding/directing', 'proposing an alternative' and 'exploring an alternative' appeared to be the principal interactions. The results may be useful for teachers and trainers who are considering organising and/or improving peer meetings.

Assessment & Evaluation in Higher Education

Student evaluation committees play a crucial role in internal quality assurance processes as repr... more Student evaluation committees play a crucial role in internal quality assurance processes as representatives of the student body. However, the students on these committees sometimes experience difficulty in providing constructive and structured feedback to faculty in an environment characterised by a strong power differential between student and staff. This study aimed to evaluate a leadership and quality assurance training implemented for students involved in internal quality assurance. Furthermore, we explored how students give shape to their internal quality assurance role. Students from three health sciences programmes participated in a mixed methods study to evaluate the training and reflect on their internal quality assurance role. Overall, the students were very enthusiastic about the training. Qualitative data analysis indicated that in their internal quality assurance role, students: (1) harnessed the power of the entire student population; (2) tried to create focus and tak...

Instructional Science, Jan 1, 2001

The Purpose of this study was to examine effects of group discussion of a medical problem on the ... more The Purpose of this study was to examine effects of group discussion of a medical problem on the comprehension of a subsequent problem-relevant text by first year medical students.

Academic Emergency Medicine, 2012

Objectives: Program evaluation remains a critical but underutilized step in medical education. Th... more Objectives: Program evaluation remains a critical but underutilized step in medical education. This study compared traditional and retrospective pre-post self-assessment methods to objective learning measures to assess which correlated better to actual learning.