Is the modernisation of postgraduate medical training in the Netherlands successful? Views of the NVMO Special Interest Group on Postgraduate Medical Education

Abstract

The discussion about the aims of modern medical education could benefit from a more structured and transdisciplinary approach. Research is warranted on the interface between health care provision and those sciences that specialise in generic professional skills and in the societal context. Training professionals and educating 'enlightened change agents' for transformation in health care requires more governance and support from academic leaders with a broader perspective on the future of health care.

Program directors in their role as leaders of teaching teams in residency training

“…If these conditions are met, a safe learning environment can develop, providing residents with an optimum opportunity to learn (Teunissen 2011). The program director, who has a formal leading position within the teaching team, has to connect the individual expectations of team members and to promote a common understanding regarding residents' expected professional performance (Scheele et al 2014). It has been suggested that program directors are more focused on the task of teaching residents than giving attention to teamwork of clinical teachers.…”

Are they ready? Organizational readiness for change among clinical teaching teams

“…12 However, details of generic models for CBME are not always explicitly outlined, which leads to a lack of clarity about its content, meaning, and relevance. [13][14][15][16][17] In addition, the implementation of CBME frameworks is further complicated by a lack of support from expert facilitators such as educationalists who can help with understanding the educational concepts and relating them to the clinical work environment. 6,18 Despite the challenges that PGME is facing with the implementation of CBME, attention to a change management perspective on supporting these processes is still rather limited.…”

Transformative thinkers needed for transformative postgraduate education

“…Moreover, in many countries trainee doctors are considered a valuable part of the workforce, and hence there is a political desire to ensure that the composition of postgraduate training programmes include training posts at non-university hospitals. Therefore, in PGME reforms issues of governance, organisation, and structure are always high on the agenda (The Danish Ministry of Health 2000; Wallenburg et al 2012;Scheele et al 2014). In several countries this is reflected in a move away from professional self-governance of PGME towards co-regulation by state, healthcare institutions, and professional bodies (The Danish Ministry of Health 2000; Malling 2011, Wallenburg et al 2012.…”

“…In this issue, Scheele et al (2014) reflect on the modernisation of postgraduate medical training in the Netherlands from the perspective of three levels of learning -informative learning, formative learning and transformative learning. They report more or less successful implementation at the first level, aiming to create 'medical expertise' and the second level aiming at fostering professionalism.…”

“…those related generic competencies, have been difficult to translate into PGME curricula and into the clinical teaching and assessment practice (Lillevang 2009). Several countries have chosen a traditional educational approach by implementing courses on generic competencies (Malling 2011;Scheele et al 2014) and selecting a key set of standard workplace-based assessment tools. While courses on the generic competencies may have some effect regarding trainees' perceived preparedness for practice (Westerman et al 2013;Berkenbosch et al 2013) the effect of standard evaluations on doctors' learning and performance is uncertain (Miller & Archer 2010).…”