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Many medical skills are complex due to their requirements for integration of declarative (biomedical) knowledge with perceptual–motor and perceptual–cognitive proficiency. While feedback generally helps learners guide their actions, it is unclear how feedback supports the integration of declarative knowledge with skills. Thus, we investigated the effect of expert and augmented feedback on acquisition and retention of a complex medical skill (acquiring a transthoracic echocardiogram) in a simulation study. We randomly assigned 36 medical undergraduate students to one of three feedback sources: Expert (EF), Augmented visual (HS), and Expert plus Help Screen (EF + HS). Participants practiced until reaching proficiency. Outcome measures (knowledge test and practical skill ratings on a 5-point scale), were gathered at initial acquisition and at retention after 11 days, the time needed to obtain the images and the quality of images obtained. We divided the knowledge test into three topics: names of the images, manipulation of the probe, and anatomy of the heart. At acquisition, immediately after training, EF group participants were faster at obtaining images than participants in the two other groups. On the retention test, there were no group differences for speed of obtaining images, but the EF + HS group scored significantly higher than the other two groups on image quality. Thus, expert feedback best assisted initial acquisition and combined augmented and expert feedback best assisted retention of this complex medical task. Expert assistance reduced learners' cognitive load during initial practice, helping learners integrate declarative knowledge with physical skills. [ABSTRACT FROM AUTHOR]

As a work of art, the show Fleabag prompts differing kinds of judgements by critics. But as a project that reflects life in capitalist society, its gimmickry models the existentially fraught dynamics of despair. Informed by Sianne Ngai’s Theory of the Gimmick, this article explores three sets of gimmicks in relation to despair, where each holds differing pedagogical stakes for viewers: being alone; being a bad feminist; being smitten with a priest. Gimmickry, as a technique within the show, puts viewers on the hook for judging gimmicks as wonders or tricks. Gimmickry as an object of criticism, in turn, brings into view the political and existential significance of Fleabag for viewers.

Context: Social support helps prevent burnout and promotes its positive opposite, work engagement. With higher work engagement performance increases. The context-specific aspects of social support for medical educators, in their educator role, are unknown. To help facilitate social support our study describes the essential elements of social support and their meaning for medical educators., Methods: We held interviews with medical educators purposefully sampled for diverse backgrounds and working circumstances and who spent a considerable amount of time on education. Both clinicians and basic scientists participated. The Pictor technique guided the interviews. Participants were invited to talk about the breadth of social support and elaborate on meaningful experiences. Template analysis was used for a descriptive phenomenological approach., Results: Thirteen medical educators were interviewed. We identified four themes: (i) sources of support and their intent (e.g. a superior with the intent to stimulate personal growth); (ii) the materialisation of support (e.g. sought or offered); (iii) its manifestation (e.g. the act of providing protected time); and (iv) the overarching effect of social support, both in terms of practical effects and the meaning of support. We identified three sorts of meanings of social support for educators. Receiving support could lead to (i) feeling reassured and confident; (ii) feeling encouraged and determined and (iii) a sense of relatedness and acknowledgement of the educator role., Conclusion: Support for education comes from a wide range of sources because it is both sought and offered beyond the boundaries of the educational role. The resulting differences in support provided necessitate that educational leaders and policymakers consider the sources available to each educator, connecting educators where necessary. When facilitating or designing social support it is important that the need to feel reassured, encouraged or related is met., (© 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.)

Objectives: Undergraduate medical students are prone to struggle with learning in clinical environments. One of the reasons may be that they are expected to self-regulate their learning, which often turns out to be difficult. Students' self-regulated learning is an interactive process between person and context, making a supportive context imperative. From a socio-cultural perspective, learning takes place in social practice, and therefore teachers and other hospital staff present are vital for students' self-regulated learning in a given context. Therefore, in this study we were interested in how others in a clinical environment influence clinical students' self-regulated learning., Methods: We conducted a qualitative study borrowing methods from grounded theory methodology, using semi-structured interviews facilitated by the visual Pictor technique. Fourteen medical students were purposively sampled based on age, gender, experience and current clerkship to ensure maximum variety in the data. The interviews were transcribed verbatim and were, together with the Pictor charts, analysed iteratively, using constant comparison and open, axial and interpretive coding., Results: Others could influence students' self-regulated learning through role clarification, goal setting, learning opportunities, self-reflection and coping with emotions. We found large differences in students' self-regulated learning and their perceptions of the roles of peers, supervisors and other hospital staff. Novice students require others, mainly residents and peers, to actively help them to navigate and understand their new learning environment. Experienced students who feel settled in a clinical environment are less susceptible to the influence of others and are better able to use others to their advantage., Conclusions: Undergraduate medical students' self-regulated learning requires context-specific support. This is especially important for more novice students learning in a clinical environment. Their learning is influenced most heavily by peers and residents. Supporting novice students' self-regulated learning may be improved by better equipping residents and peers for this role., (© 2016 The Authors. Medical Education Published by John Wiley & Sons Ltd and The Association for the Study of Medical Education.)

Background: Beside acquiring knowledge, medical students should also develop the ability to apply and reflect on it, requiring higher-order cognitive processing. Ideally, students should have reached higher-order cognitive processing when they enter the clinical program. Whether this is the case, is unknown. We investigated students' cognitive processing, and awareness of their knowledge during medical school., Methods: Data were gathered from 347 first-year preclinical and 196 first-year clinical students concerning the 2008 and 2011 Dutch progress tests. Questions were classified based upon Bloom's taxonomy: "simple questions" requiring lower and "vignette questions" requiring higher-order cognitive processing. Subsequently, we compared students' performance and awareness of their knowledge in 2008 to that in 2011 for each question type., Results: Students' performance on each type of question increased as students progressed. Preclinical and first-year clinical students performed better on simple questions than on vignette questions. Third-year clinical students performed better on vignette questions than on simple questions. The accuracy of students' judgment of knowledge decreased over time., Conclusions: The progress test is a useful tool to assess students' cognitive processing and awareness of their knowledge. At the end of medical school, students achieved higher-order cognitive processing but their awareness of their knowledge had decreased.

Context: Patient care evokes emotional responses such as uncertainty, grief and pride in medical students. There is a need for opportunities to share and express such emotions because they influence students' professional development and well-being. There is a trend towards introducing mentor programmes into medical curricula. It remains unknown whether students are willing and able to share their emotional experiences within this formal setting. We set out to explore how medical students share their emotional experiences and why., Methods: We used thematic analysis, including purposeful sampling, parallel processes of data collection and constant comparative analysis, maintaining an audit trail for validation purposes. The study had a constructivist, interactional design and used Goffman's dramaturgical theory as an interpretive framework. Nineteen students participated in individual, semi-structured interviews., Results: Participants' narratives revealed a preference for sharing emotional experiences away from people who might expect them to uphold formal behaviour. They deliberately decided with whom to share their emotional experiences. Participants had a preference to talk to fellow students working in the same department, or family and friends outside medical school., Conclusions: Participants found it difficult to uphold behaviours that they thought patients, preceptors or the organisation expected of them as future doctors. In adjusting their behaviour to meet those expectations, they became attuned to how to best present themselves based on the people present. This influenced how they chose which emotional experiences to share with whom., (© 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.)

Background: Research from outside the medical field shows that leadership behaviours influence job satisfaction. Whether the same is true for the medical training setting needs to be explored. The aim of this study was to investigate the influence of residents' overall appreciation of their supervisor's leadership and observation of specific supervisor leadership behaviours on job satisfaction., Methods: We invited residents (N = 117) to rate how often they observed certain task and relation-oriented leadership behaviours in their supervisor and overall appreciation of their supervisor's leadership. Furthermore, they rated their satisfaction with 13 different aspects of their jobs on a 10-point scale. Using exploratory factor analysis we identified four factors covering different types of job satisfaction aspects: personal growth, autonomy, affective, and instrumental job satisfaction aspects. Influence of overall appreciation for supervisor leadership and observation of certain leadership behaviours on these job satisfaction factors were analysed using multiple regression analyses., Results: The affective aspects of job satisfaction were positively influenced by overall appreciation of leadership (B = 0.792, p = 0.017), observation of specific instructions (B = 0.972, p = 0.008) and two-way communication (B = 1.376, p = 0.008) and negatively by mutual decision-making (B = -1.285, p = 0.007). No effects were found for the other three factors of job satisfaction., Conclusions: We recommend that supervisors become more aware of whether and how their behaviours influence residents' job satisfaction. Especially providing specific instructions and using two-way communication seem important to help residents deal with their insecurities and to offer them support.

Veterinarians play an important role in the reduction of antimicrobial use in farm animals. This study aims to quantify opinions of veterinarians from the Netherlands and Flanders regarding antimicrobial use and resistance issues in farm animals. An online survey was sent out to 678 and 1100 farm animal veterinarians in Flanders and the Netherlands, of which 174 and 437 were returned respectively. Suboptimal climate conditions were regarded as the most important cause for high antimicrobial use in farm animals. Flemish veterinarians also regarded insufficient biosecurity measures and farmers' mentality as important determinants, while the Dutch respondents ranked insufficient immunity of young animals and economic considerations of farmers as major causes. The majority of Dutch respondents (63.8 per cent) supported the existing national policy, which aimed to halve veterinary antimicrobial use, while the Flemish (32.9 per cent) were less supportive of such a policy. Improvements in housing and climate conditions, biosecurity measures and strict control of specific infectious diseases were seen as important and promising measures to reduce antimicrobial use. To reduce antimicrobial use in farm animals, some shared approaches might be applicable in both countries. However, cultural, political and societal differences between Flanders and the Netherlands require differentiated approaches to reduce veterinary antimicrobial use., (British Veterinary Association.)

Introduction: Residents benefit from regular, high quality feedback on all CanMEDS roles during their training. However, feedback mostly concerns Medical Expert, leaving the other roles behind. A feedback system was developed to guide supervisors in providing feedback on CanMEDS roles. We analyzed whether feedback was provided on the intended roles and explored differences in quality of written feedback., Methods: In the feedback system, CanMEDS roles were assigned to five authentic situations: Patient Encounter, Morning Report, On-call, CAT, and Oral Presentation. Quality of feedback was operationalized as specificity and inclusion of strengths and improvement points. Differences in specificity between roles were tested with Mann-Whitney U tests with a Bonferroni correction (α = 0.003)., Results: Supervisors (n = 126) provided residents (n = 120) with feedback (591 times). Feedback was provided on the intended roles, most frequently on Scholar (78%) and Communicator (71%); least on Manager (47%), and Collaborator (56%). Strengths (78%) were mentioned more frequently than improvement points (52%), which were lacking in 40% of the feedback on Manager, Professional, and Collaborator. Feedback on Scholar was more frequently (p = 0.000) and on Reflective Professional was less frequently (p = 0.003) specific., Discussion and Conclusion: Assigning roles to authentic situations guides supervisors in providing feedback on different CanMEDS roles. We recommend additional supervisor training on how to observe and evaluate the roles.

The CanMEDS framework has been widely adopted in residency education and feedback processes are guided by it. It is, however, only one of many influences on what is actually discussed in feedback. The sociohistorical culture of medicine and individual supervisors' contexts, experiences and beliefs are also influential. Our aim was to find how CanMEDS roles are constructed in feedback in a postgraduate curriculum-in-action. We applied a set of discourse analytic tools to written feedback from 591 feedback forms from 7 hospitals, including 3150 feedback comments in which 126 supervisors provided feedback to 120 residents after observing their performance in authentic settings. The role of Collaborator was constructed in two different ways: a cooperative discourse of equality with other workers and patients; and a discourse, which gave residents positions of power-delegating, asserting and 'taking a firm stance'. Efficiency-being fast and to the point emerged as an important attribute of physicians. Patients were seldom part of the discourses and, when they were, they were constructed as objects of communication and collaboration rather than partners. Although some of the discourses are in line with what might be expected, others were in striking contrast to the spirit of CanMEDS. This study's findings suggest that it takes more than a competency framework, evaluation instruments, and supervisor training to change the culture of workplaces. The impact on residents of training in such demanding, efficiency-focused clinical environments is an important topic for future research.

Background: The early years in professional practice are for many veterinary and medical professionals a period of great challenges and consequently increased stress levels. Personal resources appear to have a positive impact on the course of this transition period. Personal resources are defined as developable systems of positive beliefs about one's self and the world that are generally linked to resilience. They are negatively related to burnout and positively and reciprocally to job resources, work engagement and job performance. With the aim of enhancing personal resources of recently graduated veterinarians, a 1 year multi-modular resources development programme was designed. This study was conducted to analyse: 1. if and how the development programme affected participants' personal resources, and 2. if and how personal resources affected participants' work characteristics and work engagement., Results: Quantitative study: Twenty-five participants and ten non-participants completed an online survey covering personal resources, job resources and work engagement at the start and finish of the programme. Results showed a significant increase of personal resources in participants for self-reported ratings of proactive behaviour (Effect Size=-0.4), self-efficacy (Effect Size=-0.6) and reflective behaviour (Effect Size=-0.6). Results of the control group were not significant, although some moderate effect sizes were found. Qualitative study: Additionally 16 semi-structured interviews with participants of the programme were taken 6 months after finishing the programme. Analysis of the interviews revealed that participants also developed other important personal resources namely self-acceptance, self-esteem, awareness of own influence and responsibility. The reflection process, which took place in the course of the programme, seemed to be a necessary step for the development of the other personal resources. According to participants of the resources development programme, the increase in personal resources also gave rise to an increase in job resources., Conclusion: The multi-modular resources development programme seems to support development of participants' personal resources. Because personal resources are beneficial in improving well-being irrespective of where an individual starts working, it is important to give them explicit attention in educational settings.

Background: Within the current health care system, leadership is considered important for physicians. leadership is mostly self-taught, through observing and practicing. Does the practice environment offer residents enough opportunities to observe the supervisor leadership behaviours they have to learn? In the current study we investigate which leadership behaviours residents observe throughout their training, which behaviours supervisors report to display and whether residents and supervisors have a need for more formal training., Methods: We performed two questionnaire studies. Study 1: Residents (n = 117) answered questions about the extent to which they observed four basic and observable Situational Leadership behaviours in their supervisors. Study 2: Supervisors (n = 201) answered questions about the extent to which they perceived to display these Situational Leadership behaviours in medical practice. We asked both groups of participants whether they experienced a need for formal leadership training., Results: One-third of the residents did not observe the four basic Situational Leadership behaviours. The same pattern was found among starting, intermediate and experienced residents. Moreover, not all supervisors showed these 4 leadership behaviours. Both supervisors and residents expressed a need for formal leadership training., Conclusion: Both findings together suggest that current practice does not offer residents enough opportunities to acquire these leadership behaviours by solely observing their supervisors. Moreover, residents and supervisors both express a need for more formal leadership training. More explicit attention should be paid to leadership development, for example by providing formal leadership training for supervisors and residents.

Background: Attention for the well-being of medical school faculty is not only important for the prevention of attrition and burnout, but may also boost performance in their tasks in medical education. Positive well-being can be conceptualized as work engagement and this is associated with increased performance. In this study we explore how demands and resources from different tasks affect work engagement specifically for education., Methods: Between June and September 2013, we conducted a multisite semi-structured interview study with a diverse group of medical school faculty and used an open-coding strategy within the Work Engagement Model on the transcribed interviews., Results: We interviewed 16 faculty members whose teaching experience ranged from 7 to 38 years and whose professional tasks ranged from being solely an educator to being a physician, researcher, educator and administrator simultaneously. All participants were clear on the perceived demands and resources, although similar aspects of the work environment could be perceived oppositely between participants. Overarching themes were perceptions related to the organization or department, often described as a general and long-term effect and perceptions directly related to a task, often described as a direct and short-term effect on well-being. Furthermore, the demands and resources as resultant of fulfilling multiple tasks were described clearly by participants., Conclusions: The ambiguous nature of the work environment in terms of demands and resources requires an individualized approach to supporting work engagement. Furthermore, faculty members perceive many resources from fulfilling multiple tasks in relation to their tasks in education. Faculty developers and administrators alike could use these findings to apply the concept of work engagement to their daily support of faculty in medical education.

Objectives: The importance of self-regulated learning (SRL) has been broadly recognised by medical education institutions and regulatory bodies. Supporting the development of SRL skills has proven difficult because self-regulation is a complex interactive process and we know relatively little about the factors influencing this process in real practice settings. The aim of our study was therefore to identify factors that support or hamper medical students' SRL in a clinical context., Methods: We conducted a constructivist grounded theory study using semi-structured interviews with 17 medical students from two universities enrolled in clerkships. Participants were purposively sampled to ensure variety in age, gender, experience and current clerkship. The Day Reconstruction Method was used to help participants remember their activities of the previous day. The interviews were transcribed verbatim and analysed iteratively using constant comparison and open, axial and interpretive coding., Results: Self-regulated learning by students in the clinical environment was influenced by the specific goals perceived by students, the autonomy they experienced, the learning opportunities they were given or created themselves, and the anticipated outcomes of an activity. All of these factors were affected by personal, contextual and social attributes., Conclusions: Self-regulated learning of medical students in the clinical environment is different for every individual. The factors influencing this process are affected by personal, social and contextual attributes. Some of these are similar to those known from previous research in classroom settings, but others are unique to the clinical environment and include the facilities available, the role of patients, and social relationships pertaining to peers and other hospital staff. To better support students' SRL, we believe it is important to increase students' metacognitive awareness and to offer students more tailored learning opportunities., (© 2015 John Wiley & Sons Ltd.)

Antimicrobial use in farm animals might contribute to the development of antimicrobial resistance in humans and animals, and there is an urgent need to reduce antimicrobial use in farm animals. Veterinarians are typically responsible for prescribing and overseeing antimicrobial use in animals. A thorough understanding of veterinarians' current prescribing practices and their reasons to prescribe antimicrobials might offer leads for interventions to reduce antimicrobial use in farm animals. This paper presents the results of a qualitative study of factors that influence prescribing behaviour of farm animal veterinarians. Semi-structured interviews with eleven farm animal veterinarians were conducted, which were taped, transcribed and iteratively analysed. This preliminary analysis was further discussed and refined in an expert meeting. A final conceptual model was derived from the analysis and sent to all the respondents for validation. Many conflicting interests are identifiable when it comes to antimicrobial prescribing by farm animal veterinarians. Belief in the professional obligation to alleviate animal suffering, financial dependency on clients, risk avoidance, shortcomings in advisory skills, financial barriers for structural veterinary herd health advisory services, lack of farmers' compliance to veterinary recommendations, public health interests, personal beliefs regarding the veterinary contribution to antimicrobial resistance and major economic powers are all influential determinants in antimicrobial prescribing behaviour of farm animal veterinarians. Interventions to change prescribing behaviour of farm animal veterinarians could address attitudes and advisory skills of veterinarians, as well as provide tools to deal with (perceived) pressure from farmers and advisors to prescribe antimicrobials. Additional (policy) measures could probably support farm animal veterinarians in acting as a more independent animal health consultant., (© 2014 Blackwell Verlag GmbH.)

Medical schools have recently witnessed a call for authentic research activities that equip students with the skills required for evidence-based medicine (EBM) and research. Because it is not always possible to make such activities available as a part of the curriculum, evaluating the effectiveness of the various choices of traditional and authentic EBM and research skills courses is essential. This study's purpose was to evaluate students' perceived EBM and research skill acquisition in three different courses in a Dutch medical school. Self-reported surveys were conducted among 163 Dutch medical undergraduates who participated in an undergraduate research project, a basic EBM skills elective, or a traditional lecture-based skills course. MANCOVA was employed to test for group differences in perceived skill acquisition. Students who finished their research project perceived themselves as more experienced in writing and information retrieval skills than students who participated in the lecture-based course or basic skills elective. Students in the lecture-based course identified themselves as being the most experienced in critical judgment. No group differences were found for overall gains. Authentic research activities may have benefits over traditional lecture-based courses in the undergraduate medical curriculum, especially in terms of equipping students with writing and information retrieval skills.

The Job Demands-Resources model (JD-R model) was used as the theoretical basis of a tailormade questionnaire to measure the psychosocial work environment and personal resources of recently graduated veterinary professionals. According to the JD-R model, two broad categories of work characteristics that determine employee wellbeing can be distinguished: job demands and job resources. Recently, the JD-R model has been expanded by integrating personal resource measures into the model. Three semistructured group interviews with veterinarians active in different work domains were conducted to identify relevant job demands, job resources and personal resources. These demands and resources were organised in themes (constructs). For measurement purposes, a set of questions ('a priori scale') was selected from the literature for each theme. The full set of a priori scales was included in a questionnaire that was administered to 1760 veterinary professionals. Exploratory factor analysis and reliability analysis were conducted to arrive at the final set of validated scales (final scales). 860 veterinarians (73 per cent females) participated. The final set of scales consisted of seven job demands scales (32 items), nine job resources scales (41 items), and six personal resources scales (26 items) which were considered to represent the most relevant potential predictors of work-related wellbeing in this occupational group. The procedure resulted in a tailormade questionnaire: the Veterinary Job Demands and Resources Questionnaire (Vet-DRQ). The use of valid theory and validated scales enhances opportunities for comparative national and international research.

With the aim to assess levels of burnout and work engagement in junior veterinarians and identify predictors of burnout and work engagement in male and female veterinarians, 1760 veterinarians who had graduated in The Netherlands between 1999 and 2009, received an electronic questionnaire. Veterinarians numbering 860 (73 per cent females) participated. Levels of exhaustion, cynicism and work engagement were significantly lower compared to the norm group (a random sample of the Dutch working population). Male veterinarians were less exhausted and more engaged than female veterinarians. Exhaustion decreased over the years. Job demands positively related to exhaustion were work-home interference and workload. Job resources positively related to work engagement were opportunities for professional development and skills discretion (ie, the ability to use and develop skills on the job. Personal resources explained more of the variance in work engagement of female and male veterinarians (31 per cent and 42 per cent) than of the variance in exhaustion (19 per cent and 21 per cent) and cynicism (19 per cent and 10 per cent). Personal resources positively related to work engagement were self-efficacy and proactive behaviour. Relative importance analysis revealed differences between men and women in the importance of various job demands, job resources and personal resources in explaining burnout and engagement in young veterinary professionals.

Background: Students are a popular source of data to evaluate the performance of clinical teachers. Instruments to obtain student evaluations must have proven validity. One aspect of validity that often remains underexposed is the possibility of effects of between-student differences and teacher and student characteristics not directly related to teaching performance., Aim: The authors examined the occurrence of such effects, using multilevel analysis to analyse data from the Maastricht clinical teaching questionnaire (MCTQ), a validated evaluation instrument, in a veterinary curriculum., Methods: The 15-item MCTQ covers five domains. The authors used multilevel analysis to divide the variance in the domain scores in components related to, respectively, teachers and students. They estimated subsequent models to explore how the MCTQ scores are dependent on teacher and student characteristics., Results: Significant amounts of variance in student ratings were due to between-teacher differences, particularly for learning climate, modelling and coaching. The effects of teacher and student characteristics were mostly non-significant or small., Conclusion: Large portions of variance in MCTQ scores were due to differences between teachers, while the contribution of student and teacher characteristics was negligible. The results support the validity of student ratings obtained with the MCTQ for evaluating teacher performance.

Background: Many medical and veterinary schools have curricula in which they use seminars of approximately 25 students to achieve their learning goals. There is not much research on seminar learning., Aim: To explore students' views regarding aspects that affect seminar learning., Methods: Twenty-four second-year students of a 3-year bachelor curriculum participated in semi-structured focus group interviews. The sessions were audio-taped and transcribed. Two researchers independently coded the data using qualitative methods. An iterative process of data reduction resulted in emerging aspects. The participating students were asked to comment on the preliminary results., Results: Course schedule, coherence and alignment of the different educational methods, the amount and type of seminar questions and the amount and clarity of the preparation materials affected seminar learning. Also, the didactic approach and facilitating methods used by the teachers, the group composition, size and atmosphere, the amount of active student participation and interaction and assessment influenced seminar learning according to students., Conclusion: Most aspects that affect seminar learning are consistent with aspects affecting small group learning. Course schedule and alignment seem to have a stronger impact on seminar learning.

Background: Feedback to aid teachers in improving their teaching requires validated evaluation instruments. When implementing an evaluation instrument in a different context, it is important to collect validity evidence from multiple sources., Aim: We examined the validity and reliability of the Maastricht Clinical Teaching Questionnaire (MCTQ) as an instrument to evaluate individual clinical teachers during short clinical rotations in veterinary education., Methods: We examined four sources of validity evidence: (1) Content was examined based on theory of effective learning. (2) Response process was explored in a pilot study. (3) Internal structure was assessed by confirmatory factor analysis using 1086 student evaluations and reliability was examined utilizing generalizability analysis. (4) Relations with other relevant variables were examined by comparing factor scores with other outcomes., Results: Content validity was supported by theory underlying the cognitive apprenticeship model on which the instrument is based. The pilot study resulted in an additional question about supervision time. A five-factor model showed a good fit with the data. Acceptable reliability was achievable with 10-12 questionnaires per teacher. Correlations between the factors and overall teacher judgement were strong., Conclusions: The MCTQ appears to be a valid and reliable instrument to evaluate clinical teachers' performance during short rotations.

Background: Changing concepts of education have led many medical schools to adopt student-centred approaches to teaching, requiring different teaching competencies than more traditional approaches., Aims: The aim of this study was to investigate whether participation in a faculty development (FD) programme had a positive effect on veterinary medical teachers' perceptions of their competence in seven different teaching roles., Method: All teaching staff of a veterinary medical school (251) were invited to complete a questionnaire asking about their perceived competence in seven teaching roles. A stepwise multiple linear regression analysis examined the effect of the completion of a FD programme on perceived teaching competence., Results: There was a significant positive effect of the FD programme on teachers' perceived competence in majority of the teaching roles at issue., Conclusions: FD appeared to have a positive effect on the perceived competence of veterinary medical teachers. Further research should investigate whether FD actually results in improved teaching performance.

Changes in society and dissatisfaction with current educational practices have led to changes in undergraduate veterinary curricula. New approaches that are thought to better prepare students for future professional veterinary practice are being introduced. One such change is a transition from conventional teacher-centred curricula to student-centred curricula. In student-centred curricula, students are actively involved in learning and teachers not only transmit knowledge but help students to obtain a deep understanding. Furthermore, learning within these curricula takes place in a multi-disciplinary context which is more relevant for the future of the profession. Another change is that more emphasis is put on training in academic skills, for instance, by establishing research internships. Finally, a new emphasis is being placed on training in more generic competencies, such as communication and business skills. These changes are assumed to better suit the profile of veterinary students today and in the future and to better prepare them for future veterinary practice.

Objectives: This study set out to examine how much time students and teachers devote to different learning-oriented interactions during seminar sessions and students' and teachers' perceptions about the occurrence and desirability of these interactions., Methods: Students and teachers participating in eight seminar group sessions in Year 4 of an undergraduate veterinary curriculum completed an 11-item questionnaire which asked them to rate, on a 5-point Likert scale, the frequency of occurrence and level of desirability of three learning-oriented types of interaction: exploratory questioning; cumulative reasoning, and handling of conflict about knowledge. The questionnaire also invited positive and negative responses to aspects of group interactions and an overall mark (1-10) for the seminars and group interactions. Four group sessions were video-recorded and analysed using a coding scheme. The amount of time devoted to the different interactions was calculated., Results: Both students and teachers gave scores of 3.0-3.5 for frequency of occurrence of exploratory questioning and cumulative reasoning and < 3.0 for occurrence of handling of conflict about knowledge. The desired occurrences of all interaction types were significantly higher than the actual occurrences according to students and teachers. Teachers were responsible for the majority of the interactions (93%). The percentages of session time devoted to teacher-centred cumulative reasoning, exploratory questioning and handling of conflict about knowledge were 65.8%, 15.6% and 3.1%, respectively., Conclusions: Group interactions in seminar groups are dominated by the posing of questions by teachers to students. The moderate occurrence of group interactions as perceived by students and teachers may be explained by the inadequate preparation of teachers and students to stimulate group interactions.

Context: Small-group learning is advocated for enhancing higher-order thinking and the development of skills and attitudes. Teacher performance, group interaction and the quality of assignments have been shown to affect small-group learning in hybrid and problem-based curricula., Objectives: This study aimed to examine the perceptions of student groups as to how teacher performance, group interaction and the quality of assignments are related to one another and to learning effects in seminars of 15-30 students in a hybrid curriculum., Methods: We constructed a 28-item questionnaire and administered it to 639 students attending 32 seminars in Years 1-4 of an undergraduate veterinary curriculum. We performed factor analysis and reliability analysis of the questionnaire. We used correlation and regression analyses to explore the interactions of the four-factor model, with teacher performance, group interaction and quality of assignments as independent variables and the perceived learning effect of the seminars as the dependent variable., Results: The response rate was 99%. Teacher performance (beta = 0.78) and group interaction (- 0.28) significantly influenced the perceived learning effect. The total effect of the quality of assignments (through effects on teacher performance and group interaction) was 0.47., Discussion: The strong relationship between teacher performance and learning effect suggests that students rely strongly on their teachers. The negative effect of group interaction may reflect poor alignment of teaching and assessment and poor organisation of group processes. This should be further examined. Comparative studies on seminars are also recommended.