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Papers by nettie blankenstein
Tijdschrift voor medisch onderwijs, Apr 1, 2008
BMC Family Practice, Oct 19, 2021
European Journal of General Practice, May 16, 2011
Journal of Cancer Survivorship, Apr 25, 2022
Frontiers in Psychiatry, Apr 4, 2022
PubMed, Sep 22, 2016
Ethnocultural diversity among medical students is important in order to guarantee a true reflecti... more Ethnocultural diversity among medical students is important in order to guarantee a true reflection of society in the medical profession. It is known that students from ethnic minority groups perform less well in assessments during medical training. This is partly due to language problems but also to differences in culture. In order to keep these students in medical training, assessments should ideally be free of ethnocultural prejudice. Furthermore, it is important to ensure that there is no discrimination. To get a valid impression of these students it is important that multiple assessments be performed by several assessors. Then the real problems can be exposed and students from ethnic minority groups can get the support they need to become good physicians.
Huisarts En Wetenschap, Jun 1, 2002
semenvatting Overvloedig, tussentijds of onregelmatig vaginaal bloedverlies berust vaak op een b... more semenvatting Overvloedig, tussentijds of onregelmatig vaginaal bloedverlies berust vaak op een betrekkelijk onschuldige hormonale ontregeling of is een bijwerking van anticonceptie, antistolling of andere medicatie. Met behulp van anamnese, inspectie van de vulva, speculumonderzoek en vaginaal toucher schat men de kans in op organische oorzaken zoals zwangerschapscomplicaties, pelvic inflammatory disease, vaginitis, cervicitis, poliepen en myomen. Bij postmenopauzaal bloedverlies zijn maligniteiten niet
International journal of person centered medicine, Apr 26, 2016
Objectives: Medically unexplained physical symptoms (MUPS) burden patients in their well-being an... more Objectives: Medically unexplained physical symptoms (MUPS) burden patients in their well-being and functioning and have a prevalence of approximately 25-50% in primary and specialist care. Medical specialists often find patients with unexplained symptoms difficult to deal with, whereas patients are not always understood. We report effects on patient outcomes of an evidence-based MUPS-focused communication training for medical specialists.Methods: In a multi-center randomized controlled trial medical specialists and residents allocated to the intervention received a 14-hour MUPS-focused communication training. They practiced a patient-centered approach, including multi-factorial symptom exploration and explanation of MUPS with perpetuating factors. To study intervention effects, each doctor had to include three MUPS patients before and three after the intervention and to ask them to complete questionnaires at baseline and at 3 and 6 months follow-up. The questionnaires included illness worries (Whitely Index), symptom severity (Visual Analogue Scale), distress, depression, anxiety and somatization (4DSQ) and daily functioning (SF-36).Results: A sufficient number of 123 medical specialists and residents participated in the study. They included 478 MUPS patients. Out of them, 297 patients filled out questionnaires at baseline, 165 patients at 3-months follow-up and 71 patients at 6-months follow-up. Recruitment of patients was lower than expected and patients’ non-response to baseline and follow-up questionnaires was higher than estimated. No significant effects were found on patient outcomes.Conclusions: It remains unclear whether medical specialist training results in better patient outcomes in MUPS as the trial was underpowered. New research with special attention to patient recruitment and retention is needed to answer this question.
The Journal of Pain, Dec 1, 2018
BMJ Open
ObjectivePatients with persistent physical symptoms (PPS) require an explanation that is acceptab... more ObjectivePatients with persistent physical symptoms (PPS) require an explanation that is acceptable and comprehensible to them. Central sensitisation (CS) is an explanatory model for PPS and chronic pain that has been broadly applied in the context of pain medicine, but, until recently, not by general practitioners (GPs). We explored how GPs used the CS model in their consultations with patients with PPS.Design and settingA qualitative focus group study among GPs in the Netherlands.MethodsWe instructed 33 GPs on how to explain CS to patients with PPS. After 0.5–1.5 years of using the CS model, 26 GPs participated in focus groups and interviews to report and discuss their experiences with CS as an explanatory model. Audio recordings were transcribed and two researchers independently analysed the data. The text was coded, codes were organised into themes and discussed until consensus was reached.ResultsWe identified eleven themes and grouped these into four categories.The GPs regarded...
Advances in Health Sciences Education, 2021
Direct observation (DO) of residents by supervisors is a highly recommended educational tool in p... more Direct observation (DO) of residents by supervisors is a highly recommended educational tool in postgraduate medical education, yet its uptake is poor. Residents and supervisors report various reasons for not engaging in DO. Some of these relate to their interaction with patients during DO. We do not know the patient perspectives on these interactions, nor, more broadly, what it is like to be a patient in a DO situation. Understanding the patient perspective may lead to a more complete understanding of the dynamics in DO situations, which may benefit patient wellbeing and improve the use of DO as an educational tool. We conducted a phenomenological interview study to investigate the experience of being a patient in a DO situation. Our analysis included multiple rounds of coding and identifying themes, and a final phase of phenomenological reduction to arrive at the essential elements of the experience. Constant reflexivity was at the heart of this process. Our results provide a new ...
Journal of Psychosomatic Research, 2018
Tijdschrift voor medisch onderwijs, Apr 1, 2008
BMC Family Practice, Oct 19, 2021
European Journal of General Practice, May 16, 2011
Journal of Cancer Survivorship, Apr 25, 2022
Frontiers in Psychiatry, Apr 4, 2022
PubMed, Sep 22, 2016
Ethnocultural diversity among medical students is important in order to guarantee a true reflecti... more Ethnocultural diversity among medical students is important in order to guarantee a true reflection of society in the medical profession. It is known that students from ethnic minority groups perform less well in assessments during medical training. This is partly due to language problems but also to differences in culture. In order to keep these students in medical training, assessments should ideally be free of ethnocultural prejudice. Furthermore, it is important to ensure that there is no discrimination. To get a valid impression of these students it is important that multiple assessments be performed by several assessors. Then the real problems can be exposed and students from ethnic minority groups can get the support they need to become good physicians.
Huisarts En Wetenschap, Jun 1, 2002
semenvatting Overvloedig, tussentijds of onregelmatig vaginaal bloedverlies berust vaak op een b... more semenvatting Overvloedig, tussentijds of onregelmatig vaginaal bloedverlies berust vaak op een betrekkelijk onschuldige hormonale ontregeling of is een bijwerking van anticonceptie, antistolling of andere medicatie. Met behulp van anamnese, inspectie van de vulva, speculumonderzoek en vaginaal toucher schat men de kans in op organische oorzaken zoals zwangerschapscomplicaties, pelvic inflammatory disease, vaginitis, cervicitis, poliepen en myomen. Bij postmenopauzaal bloedverlies zijn maligniteiten niet
International journal of person centered medicine, Apr 26, 2016
Objectives: Medically unexplained physical symptoms (MUPS) burden patients in their well-being an... more Objectives: Medically unexplained physical symptoms (MUPS) burden patients in their well-being and functioning and have a prevalence of approximately 25-50% in primary and specialist care. Medical specialists often find patients with unexplained symptoms difficult to deal with, whereas patients are not always understood. We report effects on patient outcomes of an evidence-based MUPS-focused communication training for medical specialists.Methods: In a multi-center randomized controlled trial medical specialists and residents allocated to the intervention received a 14-hour MUPS-focused communication training. They practiced a patient-centered approach, including multi-factorial symptom exploration and explanation of MUPS with perpetuating factors. To study intervention effects, each doctor had to include three MUPS patients before and three after the intervention and to ask them to complete questionnaires at baseline and at 3 and 6 months follow-up. The questionnaires included illness worries (Whitely Index), symptom severity (Visual Analogue Scale), distress, depression, anxiety and somatization (4DSQ) and daily functioning (SF-36).Results: A sufficient number of 123 medical specialists and residents participated in the study. They included 478 MUPS patients. Out of them, 297 patients filled out questionnaires at baseline, 165 patients at 3-months follow-up and 71 patients at 6-months follow-up. Recruitment of patients was lower than expected and patients’ non-response to baseline and follow-up questionnaires was higher than estimated. No significant effects were found on patient outcomes.Conclusions: It remains unclear whether medical specialist training results in better patient outcomes in MUPS as the trial was underpowered. New research with special attention to patient recruitment and retention is needed to answer this question.
The Journal of Pain, Dec 1, 2018
BMJ Open
ObjectivePatients with persistent physical symptoms (PPS) require an explanation that is acceptab... more ObjectivePatients with persistent physical symptoms (PPS) require an explanation that is acceptable and comprehensible to them. Central sensitisation (CS) is an explanatory model for PPS and chronic pain that has been broadly applied in the context of pain medicine, but, until recently, not by general practitioners (GPs). We explored how GPs used the CS model in their consultations with patients with PPS.Design and settingA qualitative focus group study among GPs in the Netherlands.MethodsWe instructed 33 GPs on how to explain CS to patients with PPS. After 0.5–1.5 years of using the CS model, 26 GPs participated in focus groups and interviews to report and discuss their experiences with CS as an explanatory model. Audio recordings were transcribed and two researchers independently analysed the data. The text was coded, codes were organised into themes and discussed until consensus was reached.ResultsWe identified eleven themes and grouped these into four categories.The GPs regarded...
Advances in Health Sciences Education, 2021
Direct observation (DO) of residents by supervisors is a highly recommended educational tool in p... more Direct observation (DO) of residents by supervisors is a highly recommended educational tool in postgraduate medical education, yet its uptake is poor. Residents and supervisors report various reasons for not engaging in DO. Some of these relate to their interaction with patients during DO. We do not know the patient perspectives on these interactions, nor, more broadly, what it is like to be a patient in a DO situation. Understanding the patient perspective may lead to a more complete understanding of the dynamics in DO situations, which may benefit patient wellbeing and improve the use of DO as an educational tool. We conducted a phenomenological interview study to investigate the experience of being a patient in a DO situation. Our analysis included multiple rounds of coding and identifying themes, and a final phase of phenomenological reduction to arrive at the essential elements of the experience. Constant reflexivity was at the heart of this process. Our results provide a new ...
Journal of Psychosomatic Research, 2018