Higher education faces several challenges including both increased student diversity and the use of technologies. The flipped classroom approach has been proposed as a way to address some of these challenges. This study examined the effects of a flipped classroom trial conducted during a Master's course at the Vrije Universiteit Amsterdam in the Netherlands. Half of the course was taught in a traditional lecture style while the remaining half was replaced by flipped classrooms. Interviews and focus-group discussions were conducted with the students to gather information about their experiences of the flipped classroom. Questionnaires completed by the students, as well as an interview with the tutor, were used to gain further insights into the effects of the flipped classroom on learning processes, such as pre-class preparation and in-class activities. Findings highlight the success of this trial based on the positive feedback from both students and the tutor. In particular, the combination of personalised pre-class learning and peer-learning classroom activities facilitated deeper learning. Surprisingly, even though the overall experience was good, not all students agreed that the flipped classroom contributed to positive learning outcomes, which should be investigated further because such outcomes could differ depending on students' general learning styles and preferences. Moreover, in order to facilitate flipped classrooms on a larger scale, considerable institutional support is required to enable their practical implementation and to provide flexible assessments. Our study thus sheds light on the feasibility of implementing flipped classroom teaching in higher education.

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Object: This article explores the experiences of professional hospice workers using a creative process for debriefing them in order to facilitate the expression and communication of complex thoughts and feelings. The creative arts workshops were developed with the understanding in mind that caring for terminally ill patients can be challenging and stressful and professional hospice workers are subsequently at risk of developing compassion fatigue. The workshops focussed on skills transfers as well as self-healing by experiencing and teaching a diverse range of creative arts like music, drama, art, touch therapy, storytelling and movement. Design: Case study design. Setting: Gauteng, South Africa. Methods: Data collection included individual interviews with 19 trainees at nine different hospices, focus group interviews, observations during the workshops as well as a researcher journal. Themes were generated through thematic analysis to describe the experiences of the caregivers. Results: We found that the expressive arts facilitated communication and self-care and improved the wellbeing of the professional hospice workers. Conclusion: These findings add to understanding of the healing effects of the creative arts and especially the benefits in the hospice setting.

Evidence-based guidelines in HIV care aim to improve patients' health outcomes, quality of care, and cost-effectiveness. Laboratory monitoring plays an important role in assessing clinical status of patients and forms an integral part of HIV treatment guidelines. The Dutch HIV monitoring foundation (Stichting HIV Monitoring) previously observed variation between HIV treatment centres in the Netherlands in terms of compliance with guidelines for performing laboratory tests. Drawing on qualitative research methods, this article aims to describe factors that influence guideline compliance for laboratory monitoring in outpatient HIV care in the Netherlands. Twelve semi-structured in-depth interviews were conducted with a convenience sample of physicians from four HIV treatment centres. In general, physicians perceived laboratory guidelines as useful. However, unclear online visual representation of the guidelines, a lack of set reminders for tests, and assessment of patients' risk behaviour, which differs per patient, were identified as barriers to guideline compliance. The compartmentalisation of the Dutch healthcare system was viewed as hampering guideline compliance. A clinical-decision-support tool could possibly facilitate compliance with laboratory monitoring guidelines. Moreover, better alignment of HIV outpatient care, municipal health services and primary care, in terms of laboratory testing, could optimize efficiency, increase cost-effectiveness, and improve quality of HIV care.