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  • 1
    Online-Ressource
    Online-Ressource
    Learning collaboration at the primary-secondary care interface: a dual-method study to define design principles for interventions in postgraduate training programmes
    Springer Science and Business Media LLC ; 2023
    In:  BMC Medical Education Vol. 23, No. 1 ( 2023-05-03)
    Details
    In: BMC Medical Education, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2023-05-03)
    Kurzfassung: Collaboration between primary and secondary care (PSCC) is important to provide patient-centered care. Postgraduate training programmes should provide training to learn PSCC. With a design based research (DBR) approach design principles can be formulated for designing effective interventions in specific contexts. The aim of this study is to determine design principles for interventions aimed to learn PSCC in postgraduate training programmes. Methods DBR is characterised by multi-method studies. We started with a literature review on learning collaboration between healthcare professionals from different disciplines within the same profession (intraprofessional) to extract preliminary design principles. These were used to inform and feed group discussions among stakeholders: trainees, supervisors and educationalists in primary and secondary care. Discussions were audiotaped, transcribed and analysed using thematic analysis to formulate design principles. Results Eight articles were included in the review. We identified four preliminary principles to consider in the design of interventions: participatory design, work process involvement, personalised education and role models. We conducted three group discussions with in total eighteen participants. We formulated three design principles specific for learning PSCC in postgraduate training programmes: (1) The importance of interaction, being able to engage in a learning dialogue. (2) Facilitate that the learning dialogue concerns collaboration. (3) Create a workplace that facilitates engagement in a learning dialogue. In the last design principle we distinguished five subcategories: intervention emphasises the urge for PSCC and is based on daily practice, the presence of role models, the work context creates time for learning PSCC, learning PSCC is formalised in curricula and the presence of a safe learning environment. Conclusion This article describes design principles for interventions in postgraduate training programmes with the aim to learn PSCC. Interaction is key in learning PSCC. This interaction should concern collaborative issues. Furthermore, it is essential to include the workplace in the intervention and make adjacent changes in the workplace when implementing interventions. The knowledge gathered in this study can be used to design interventions for learning PSCC. Evaluation of these interventions is needed to acquire more knowledge and adjust design principles when necessary.
    Materialart: Online-Ressource
    ISSN: 1472-6920
    URL: Article
    DOI: 10.1186/s12909-023-04254-9
    Sprache: Englisch
    Verlag: Springer Science and Business Media LLC
    Publikationsdatum: 2023
    ZDB Id: 2044473-4
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
    Online-Ressource
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    Preventing acute kidney injury in high-risk patients by temporarily discontinuing medication – an observational study in general practice
    Springer Science and Business Media LLC ; 2019
    In:  BMC Nephrology Vol. 20, No. 1 ( 2019-12)
    Details
    In: BMC Nephrology, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2019-12)
    Kurzfassung: Elderly, patients with chronic kidney disease (CKD) and patients with heart failure who continue using renin-angiotensin-aldosterone-system (RAAS) inhibitors, diuretics, or non-steroidal-anti-inflammatory drugs (NSAIDs) during times of fluid loss have a high risk of developing complications like acute kidney injury (AKI). The aim of this study was to assess how often advice to discontinue high-risk medication was offered to high-risk patients consulting the general practitioner (GP) with increased fluid loss. Furthermore, we assessed the number and nature of the complications that occurred after GP consultation. Methods We performed a cross-sectional study with patients from seven Dutch general practices participating in the Family Medicine Network between 1 and 6-2013 and 1-7-2018. We included patients who used RAAS-inhibitors, diuretics, or NSAIDs, and had at least one of the following risk factors: age ≥ 70 years, CKD, or heart failure. From this population, we selected patients with a ‘dehydration-risk’ episode (vomiting, diarrhoea, fever, chills, or gastrointestinal infection). We manually checked their electronic patient files and assessed the percentage of episodes in which advice to discontinue the high-risk medication was offered and whether a complication occurred in 3 months after the ‘dehydration-risk’ episode. Results We included 3607 high-risk patients from a total of 44.675 patients (8.1%). We found that patients were advised to discontinue the high-risk medication in 38 (4.6%) of 816 ‘dehydration-risk’ episodes. In 59 of 816 episodes (7.1%) complications (mainly AKI) occurred. Conclusions Dutch GPs do not frequently advise high-risk patients to discontinue high-risk medication during ‘dehydration-risk’ episodes. Complications occur frequently. Timely discontinuation of high-risk medication needs attention.
    Materialart: Online-Ressource
    ISSN: 1471-2369
    URL: Article
    DOI: 10.1186/s12882-019-1636-z
    Sprache: Englisch
    Verlag: Springer Science and Business Media LLC
    Publikationsdatum: 2019
    ZDB Id: 2041348-8
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 3
    Online-Ressource
    Online-Ressource
    Learning intraprofessional collaboration by participating in a consultation programme: what and how did primary and secondary care trainees learn?
    Springer Science and Business Media LLC ; 2017
    In:  BMC Medical Education Vol. 17, No. 1 ( 2017-12)
    Details
    In: BMC Medical Education, Springer Science and Business Media LLC, Vol. 17, No. 1 ( 2017-12)
    Materialart: Online-Ressource
    ISSN: 1472-6920
    URL: Article
    DOI: 10.1186/s12909-017-0961-9
    Sprache: Englisch
    Verlag: Springer Science and Business Media LLC
    Publikationsdatum: 2017
    ZDB Id: 2044473-4
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 4
    Online-Ressource
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    Professional development arising from multiple-site workplace learning: boundary crossing between the education and clinical contexts
    Springer Science and Business Media LLC ; 2020
    In:  BMC Medical Education Vol. 20, No. 1 ( 2020-12)
    Details
    In: BMC Medical Education, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2020-12)
    Kurzfassung: This research explores the value of an inter-organisational jurisdiction, on the professional development of faculty members in their roles of researcher and educator. Faculty members from a Dutch university of applied sciences, who work in both the education and clinical practice contexts, participated in this research. Methods Individual semi-structured interview were conducted with nine faculty members, from various academic health professions, on their experiences of professional development arising from working in both the clinical and education contexts. In this exploratory, post-positive interview study, interview transcripts were analysed thematically. Results Participants reported that working in two organisational contexts, whilst performing two faculty roles that span both contexts, enhances their ability to broker connections between research, teaching and practice. The boundary crossing activities which participants performed, contributed to professional development in all faculty roles. The broker role was not seen as being a unique role which is distinct from research and practice roles. Broker activities were seen as generic and supportive of the roles that bestow academic status and expertise. Conclusions To the participants in this research, the relevance of the broker role in professional development is not as evident as the relevance of roles that enhance specialisation and subject specific expertise. They consider broker activities as supportive to the roles of researcher and teacher. The broker role is time consuming, but not yet visible as a distinct professionalisable work-package in its own right. It is also not well defined in literature. A better understanding of the broker role could lead to its development in order to harness its professional development potential tenably across academic roles.
    Materialart: Online-Ressource
    ISSN: 1472-6920
    URL: Article
    DOI: 10.1186/s12909-020-02225-y
    Sprache: Englisch
    Verlag: Springer Science and Business Media LLC
    Publikationsdatum: 2020
    ZDB Id: 2044473-4
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 5
    Online-Ressource
    Online-Ressource
    Classification of chronic kidney disease 10 years on: what have we learnt in the Netherlands
    Oxford University Press (OUP) ; 2018
    In:  Family Practice Vol. 35, No. 6 ( 2018-12-12), p. 744-745
    Details
    In: Family Practice, Oxford University Press (OUP), Vol. 35, No. 6 ( 2018-12-12), p. 744-745
    Materialart: Online-Ressource
    ISSN: 0263-2136 , 1460-2229
    URL: Article
    DOI: 10.1093/fampra/cmy036
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2018
    ZDB Id: 1484852-1
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 6
    Online-Ressource
    Online-Ressource
    What is the relationship between renal function and visit-to-visit blood pressure variability in primary care? Retrospective cohort study from routinely collected healthcare data
    BMJ ; 2016
    In:  BMJ Open Vol. 6, No. 6 ( 2016-06), p. e010702-
    Details
    In: BMJ Open, BMJ, Vol. 6, No. 6 ( 2016-06), p. e010702-
    Materialart: Online-Ressource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2015-010702
    Sprache: Englisch
    Verlag: BMJ
    Publikationsdatum: 2016
    ZDB Id: 2599832-8
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 7
    Online-Ressource
    Online-Ressource
    How does portfolio use affect self-regulated learning in clinical workplace learning: What works, for whom, and in what contexts?
    Ubiquity Press, Ltd. ; 2022
    In:  Perspectives on Medical Education Vol. 11, No. 5 ( 2022-09-22), p. 1-11
    Details
    In: Perspectives on Medical Education, Ubiquity Press, Ltd., Vol. 11, No. 5 ( 2022-09-22), p. 1-11
    Kurzfassung: Introduction Portfolio use to support self-regulated learning (SRL) during clinical workplace learning is widespread, but much is still unknown regarding its effectiveness. This review aimed to gain insight in the extent to which portfolio use supports SRL and under what circumstances. Methods A realist review was conducted in two phases. First, stakeholder interviews and a scoping search were used to formulate a program theory that explains how portfolio use could support SRL. Second, an in-depth literature search was conducted. The included papers were coded to extract context–mechanism–outcome configurations (CMOs). These were synthesized to answer the research question. Results Sixteen papers were included (four fulfilled all qualitative rigor criteria). Two primary portfolio mechanisms were established: documenting as a moment of contemplation (learners analyze experiences while writing portfolio reports) and documentation as a reminder of past events (previous portfolio reports aid recall). These mechanisms may explain the positive relationship between portfolio use and self-assessment, reflection, and feedback. However, other SRL outcomes were only supported to a limited extent: formulation of learning objectives and plans, and monitoring. The partial support of the program theory can be explained by interference of contextual factors (e.g., system of assessment) and portfolio-related mechanisms (e.g., mentoring). Discussion Portfolio research is falling short both theoretically—in defining and conceptualizing SRL—and methodologically. Nevertheless, this review indicates that portfolio use has potential to support SRL. However, the working mechanisms of portfolio use are easily disrupted. These disruptions seem to relate to tensions between different portfolio purposes, which may undermine learners’ motivation.
    Materialart: Online-Ressource
    ISSN: 2212-277X
    URL: Article
    DOI: 10.1007/S40037-022-00727-7
    Sprache: Unbekannt
    Verlag: Ubiquity Press, Ltd.
    Publikationsdatum: 2022
    ZDB Id: 2670231-9
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 8
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    Comparing Blood Pressure Measurement Methods: Differences Depend on Blood Pressure Height
    Ovid Technologies (Wolters Kluwer Health) ; 2010
    In:  Hypertension Vol. 56, No. 1 ( 2010-07)
    Details
    In: Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 56, No. 1 ( 2010-07)
    Materialart: Online-Ressource
    ISSN: 0194-911X , 1524-4563
    URL: Article
    DOI: 10.1161/HYPERTENSIONAHA.110.152926
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2010
    ZDB Id: 2094210-2
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 9
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    Competencies for collaboration between general practitioners and medical specialists: a qualitative study of the patient perspective
    BMJ ; 2020
    In:  BMJ Open Vol. 10, No. 7 ( 2020-07), p. e037043-
    Details
    In: BMJ Open, BMJ, Vol. 10, No. 7 ( 2020-07), p. e037043-
    Kurzfassung: To explore the patient view of competencies essential for doctors to provide good collaboration at the primary–secondary care interface. Design We used a qualitative research approach. Focus groups with patients were conducted to explore their opinions of doctors’ competencies to provide good collaboration between primary and secondary care doctors. Transcripts were analysed using thematic analysis. Setting Dutch primary–secondary care interface. Participants Sixteen participants took part in five focus groups. Patients treated in both primary and secondary care, defined as having a minimum of two contacts with their general practitioner and two contacts with a medical specialty in the last 6 months, were included. Psychiatric patients and children were excluded from this study. Results Three groups of competencies were identified: (1) relationship building, both with patients and with other doctors; (2) transparent collaborating: be able to provide clarity on the process of collaboration and on roles and responsibilities of those involved and (3) reflective practising: to be willing to acknowledge mistakes, give and receive feedback and act as a lifelong learner. Conclusions This focus group study enhances our understanding of the patient perspective on doctors’ collaborative competencies at the primary–secondary care interface. With this information, doctors can improve their collaborative skills to a level that would meet their patients’ needs. Patients expect doctors to be able to build relationships and act as reflective practitioners. Including patients in the collaborative process by giving them a role that is appropriate to their abilities and by making collaboration more explicit could help to improve collaboration between general practitioners and medical specialists.
    Materialart: Online-Ressource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2020-037043
    Sprache: Englisch
    Verlag: BMJ
    Publikationsdatum: 2020
    ZDB Id: 2599832-8
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 10
    Online-Ressource
    Online-Ressource
    Do you know how COVID-19 is changing general practice/family medicine education?
    Informa UK Limited ; 2020
    In:  Education for Primary Care Vol. 31, No. 3 ( 2020-05-03), p. 196-197
    Details
    In: Education for Primary Care, Informa UK Limited, Vol. 31, No. 3 ( 2020-05-03), p. 196-197
    Materialart: Online-Ressource
    ISSN: 1473-9879 , 1475-990X
    URL: Article
    DOI: 10.1080/14739879.2020.1755609
    Sprache: Englisch
    Verlag: Informa UK Limited
    Publikationsdatum: 2020
    Standort Signatur Einschränkungen Verfügbarkeit
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