Fontys University of Applied Sciences

Introduction Patients with musculoskeletal complaints as a result of their bleeding disorder can benefit from primary care physiotherapy. The current study aims to describe physiotherapy services provided in primary care to patients with bleeding disorders and to what extent treatment was already in concordance with treatment recommendations as published in a clinical practice guideline in April 2024. Methods Researchers collected data from medical notes of primary care physiotherapists in the Netherlands treating a patient with a bleeding disorder. Collected data included; patient characteristics, condition for which treatment was initiated, total number of sessions, treatment modalities provided and outcome of treatment. Data from medical files was compared with 19 treatment recommendations stated in the newly developed clinical practice guideline. Results Data from 86 treatment episodes of 62 patients by 52 different physiotherapists was collected. Treatment episodes were initiated for haemophilic arthropathy ( n = 47), joint bleed ( n = 24), muscle bleed ( n = 9) and synovitis ( n = 6). The most frequently provided treatment modalities included manual techniques (in haemophilic arthropathy) and exercise therapy (in all other conditions). The percentage in which treatment was in concordance with the recommendation ranged between 17% and 100%. Conclusion The study indicated that exercise therapy was a commonly used treatment modality for all conditions. In contrast with other conditions, manual techniques were a frequently provided treatment modality in haemophilic arthropathy. Treatment was in many instances not in concordance with newly developed treatment recommendations. Dissemination and implementation of the recently developed treatment recommendations have the potential to improve primary care physiotherapy treatment for persons with bleeding disorders.

Introduction The rising global demand for district nursing care necessitates effective strategies to support evidence-based decision-making. Despite the extensive development of nursing guidelines, adherence by district nursing teams remains suboptimal, revealing a gap between guideline development and daily practice. The Learning And Reflection for Nurses (LEARN) programme aims to bridge this gap by enhancing guideline use and fostering a learning attitude among district nursing teams. This protocol outlines the programme’s development, components and evaluation approach. Methods and analysis An action research approach will be used to develop, adjust and evaluate the LEARN programme. The programme includes two interventions: a team-learning intervention focusing on guideline use and collective learning, and a leadership training intervention for district nurses to enhance their impact and role in adopting new knowledge. The team learning intervention will be sequentially deployed and evaluated in four district nursing teams across three care organisations, each lasting approximately 5 months. The leadership training will be conducted and evaluated in two cohorts, each lasting about 5 months. Participation in the team learning intervention requires at least one district nurse to participate in the leadership training. Each intervention will follow an action spiral structure, with learning outcomes from previous interventions carried over to the next. Data will be collected through observations, written reflections, focus groups and questionnaires via a mobile application. Data analysis will occur in two steps: parallel data collection and analysis during the intervention, followed by a longitudinal qualitative approach to identify learning processes over time and evaluate the intervention’s impact. Ethics and dissemination Ethics approval has been obtained from the Ethical Committee Research of the HU University of Applied Sciences Utrecht (reference numbers 165-001-2022 and 157-001-2022). Findings will be disseminated continuously throughout the research via workshops, presentations and summary documents for district nurses and their teams, care organisations, strategic policymakers and the academic community.

Introduction Midportion Achilles tendinopathy (mid-AT) is associated with tendon degeneration that may worsen due to mechanical loading. Contrastingly, load can also improve tendon structure. We aimed to evaluate short-term changes in midportion tendon structure and their associations with symptoms, following temporary replacement of running with low-impact exercises on a stair climber or cross-trainer, in service members with mid-AT. Methods We recruited 40 service members (40 symptomatic tendons) for this study. Ultrasound tissue characterisation (UTC) was used to quantify aligned fibrillar structure (echo-type I+II) and disorganised structure (echo-type III+IV), in the tendon midportion (2–7 cm) and in the area of maximum degeneration (AoMD) within the midportion. Symptoms were evaluated with the modified Victorian Institute of Sports Assessment – Achilles (VISA-A) questionnaire. All measurements were performed at baseline and after 8 weeks. The Wilcoxon signed-rank test was used to evaluate differences in UTC and VISA-A. Spearman’s rho was used to calculate the correlations between UTC and VISA-A change scores. Results Tendon structure did neither change significantly in the midportion: echo-type I+II from median 64.7% (IQR 19.4) to 68.6% (IQR 25.1) (p=0.793); echo-type III+IV from median 35.3% (IQR 19.4) to 31.5% (IQR 25.1) (p=0.775) nor in the AoMD: echo-type I+II from median 56.3% (IQR 18.0) to 57.9% (IQR 32.0) (p=0.677); echo-type III+IV from median 43.8% (IQR 18.0) to 42.3% (IQR 32.1) (p=0.572). On the other hand, VISA-A improved significantly (p=0.000) from baseline (median 46.5, IQR 16.0) to follow-up (median 56.0, IQR 9.0). Correlations between UTC and VISA-A change scores were consistently graded as low (range: 0.309–0.338). Conclusions Although the replacement of running with low-impact exercises improved symptoms, no changes in tendon structure were observed after 8 weeks. Changes in midportion structure and symptoms were poorly associated. These findings can support loading advice in patients with mid-AT when aiming to prevent progressive degeneration or tendon rupture. Trial registration number NL69527.028.19, "Centrale Commissie Mensgebonden Onderzoek" (CCMO).

Metal-organic frameworks (MOFs) and covalent-organic frameworks (COFs) are highly versatile materials based on inorganic modes connected via organic linkers or purely via the connection of organic building blocks, respectively. This results in 3-D nanoporous frameworks, which, due to their combination of high porosity and variability of building blocks, can exhibit exceptional properties that make them attractive. Certain applications (e.g., in electronics and as membranes) require a thin film or even a patterned morphology on various substrates. Inkjet printing of MOFs has emerged as a simple and effective technique for the scalable production of a wide range of MOF (gradient) films and patterns on a wide range of substrates according to specific requirements. This review comprehensively reviews the achievements in inkjet printing of both MOFs and COFs. We discuss the different substrates, ink formulation, and hardware intertwined requirements needed to achieve high-resolution printing and obtain desired properties such as porosity, physical-mechanical characteristics, and uniform thickness. Crucial aspects related to ink formulation, such as colloidal stability and size control of MOFs and COFs, are discussed. Additionally, we highlight potential opportunities for furthering the development of inkjet printing of MOFs/COFs and critically assess the reporting of the printing procedures and characterization of the resultant materials. In this manner, this review aims to contribute to the advancements in understanding and optimization of inkjet printing of MOFs and COFs, as this technique holds great potential for diverse applications and functionalization of MOF/COF films and patterns.

Introduction The use of autologous human primary articular chondrocytes (hPACs) for repairing damaged cartilage is the golden standard; however, their 2-dimensional (2D) expansion induces dedifferentiation, making it challenging to create hyaline cartilage. Spinner flasks are efficient for generating cartilage organoids, allowing hPACs to proliferate without dedifferentiation; however, porcine notochordal cell-derived matrix (NCM) is needed for aggregation, limiting clinical application. Human articular chondroprogenitor cells (hACPCs) can be expanded many fold while maintaining chondrogenic potential. Therefore, the scalable production of hACPC cartilage organoids without NCM in spinner flasks was investigated in this study. Methods hPAC organoids with NCM and hACPC organoids using bone morphogenetic protein 9 (BMP-9) were produced in spinner flasks in 14 days. Thereafter, approximately 20 organoids were fused in low adhesive wells for 21 days. Organoids underwent mechanical testing, and both organoids and fused constructs were evaluated using biochemical, histological, and immunohistochemical analysis. Results The hACPCs self-assembled and synthesized abundant extracellular matrix once stimulated with BMP-9. The hPAC and hACPC organoids showed similar mechanical properties, but hACPC organoids and fused constructs showed a more uniform matrix and cell distribution. Conclusion The hACPC organoids fused into a neo-hyaline cartilage-like tissue, demonstrating their potential for improved, scalable cartilage tissue repair.

ChatGPT is a new technological tool with the potential to impact education. Using Vergnaud’s notion of “use schemes,” we analyzed three interviews with engineering students who discovered ChatGPT and started to develop initial utilization schemes of the tool. Results showed that there were three domains of use of ChatGPT: (a) in mathematics/engineering; (b) for general academic purposes; and (c) in the students’ personal lives. Domain (a), with a focus on mathematical modelling, has a relation to mathematics education. Students used ChatGPT to foster their conceptual understanding, to find alternative modelling strategies, to translate mathematical models to computer code, and to optimize this computer code. The students developed a critical attitude in relation to the limitations of the tool and, according to the interview data, their schemes developed over time. The interview data show some evidence for the emergence of a hybrid form of learning in which ChatGPT became a co-agent of learning, an interactive resource with which the students could discuss their ideas. We consider the case as a positive example of how ChatGPT can contribute to student agency in education and support the development of knowledge and student competencies.

Introduction: Despite decades of school improvement efforts, maintaining lasting change in schools remains challenging. So far, traditional interventions have been unsuccessful in recognising schools’ unique and complex contexts, which is why a shift towards a more reciprocal, emergent, and contextualised approach is necessary. Objective: Our aim is to develop citizenship education with students and staff in vocational education and training (VET), which increases student voice and fits the complex school system. Methods: We involved students and staff in citizenship education development and identified relevant factors that influenced this process. This participatory action research (PAR) study used a retrospective design assessing logbook entries, observations, interviews, and focus group discussions collected between September 2020 and September 2023 in four study programmes from one VET institution in the Netherlands. Thematic analysis was used to code the datasources. Results: Collaboration between students and staff flourished while using the curriculum negotiation tool. Relevant factors influencing the process were: alignment between project and participants’ priorities and goals, receptivity to student and teacher voices, leadership engagement, and tensions and intentions about roles and responsibilities between participants. Conclusions: This study emphasises the promise of involving students and staff in educational development. When teachers startedworking collaboratively with students, many of their initial doubts decreased, which led to renewed motivation for becoming student voice advocates. PAR has the potential of starkly disrupting the existing status quo and breaking through ingrained patterns within complex systems to ensure influence for students from all levels of education.

Background Conventional medical management, while essential, cannot address all multifaceted consequences of Parkinson’s disease (PD). This pilot study explores the potential of a co-designed creative arts therapy on health-related quality of life, well-being, and pertinent non-motor symptoms. Methods We conducted an exploratory pilot study with a pre-post design using validated questionnaires. Eight individuals with PD participated in the program. The investigated intervention was a 10-week creative arts therapy with weekly 90–120-min sessions, guided by three creative therapists. Participants were allowed to autonomously select from multiple creative media based on their personal preferences. Explored co-primary outcomes included health-related quality of life (PDQ-39), well-being (ICECAP-A), anxiety/depression (HADS), executive functioning (BRIEF-A), resilience/mental flexibility (FIT-60), and self-efficacy (GSES). We used paired sample t tests for pre–post analysis of the co-primary outcomes and Wilcoxon signed-rank tests for PDQ-39 sub-scores. We also included aesthetic responsiveness (AReA) and healthcare consumption (IMCQ adapted for PD) questionnaires reported as descriptive statistics. Results The results showed a significant reduction in anxiety and an increase in well-being. We also observed a slight improvement in cognitive functioning. Finally, we noted a reduction in healthcare consumption (fewer visits at neurologists, specialized PD nurses, and allied healthcare professionals). Conclusion These findings cautiously suggest that our co-designed, multi-media creative arts therapy has the potential to increase well-being and reduce anxiety, while reducing healthcare consumption. These preliminary findings support the need for a larger, randomized controlled trial to explore the therapeutic potential of creative arts therapy in PD care.

Background Patient safety requires mindful routines in the operating room. Usually, time pressure is presented as an unavoidable constraint to mindful routines and a consequence of workload imposed on teams. We aim to understand time pressure and how it interacts with developing mindful routines. Methods This naturalistic case study was conducted with a surgical team in a Dutch academic hospital using ethnographic methods including participant observation, interviews, and fieldnotes. The researcher observed the team for 103 h. Our analysis integrates habit theory and mindful organising principles. Results Team culture reflected deference to speed, preoccupation with productivity, conflict avoidance, and value on affective relationships. Conflicting priorities arose from differences in safety norms, worries about time, and beliefs about what saves time. Addressing these conflicting priorities, however, was rare. Creating shared Situational Awareness (SA) helped prevent or mitigate time pressure, though it was not a consistently embedded routine. New routines were often compromised under time pressure, while established habits showed resilience to time constraints. Conclusions Rather than being workload-driven, time pressure emerged as a co-constructed outcome of conflicting priorities and the preservation of affective relationships. The imperative to save time motivated shared situational awareness and the formation of new mindful routines. We recommend enhancing mindful routines by refining current practices in mortality and morbidity meetings, expanding stakeholder involvement, and addressing prevailing concerns.

Background Recent research in the field of “Arts and Health” has demonstrated the beneficial impact of arts-based interventions on health and well-being across diverse populations. Recognizing their potential, especially in cases where conventional healthcare cannot address the multifaceted impact of conditions such as in Parkinson's disease (PD), our study advocates for an integrative approach in medical practice and neuroscience. We recommend incorporating learning environments from the design phase through long-term care. The arts offer a unique opportunity to create such environments. In this study, we specifically focus on individuals with PD, co-designing an intervention as a creative engagement learning environment and a PD-specific creative arts therapy. In this study, the narratives of those affected contribute as scientific knowledge, shaping care and increasing the intervention's relevance to participants' lives. Methods We used a participatory design-based research approach. Fourteen individuals with PD, along with three creative therapists and three researchers, collaborated through iterative design cycles to co-develop a creative arts therapy intervention. Qualitative data were collected through interviews, group reflections, and ethnographic observations. Data were analyzed using reflexive thematic analysis. Results The co-creation process resulted in a 10-week creative engagement intervention delivered in a “creative playground” setting. Participants chose from multiple media and autonomously decided their creative activities. Guidance from the creative therapists was provided as needed to support individual engagement and guide reflection and learning processes. Narratives offered insights into the relevance of autonomy in care, the role of the arts, and the individuality of disease experience, resulting in seven key features of our intervention framework, which include (i) intervention structure (e.g., duration of the intervention and sessions), (ii) freedom in selection of creative media, (iii) environment as a creative playground, (iv) skills of creative therapists, (v) PD-specific considerations, (vi) financial considerations and logistics, and we list (vii) responsibilities of the Design Team. Discussion This study establishes an initial framework for a PD-specific creative arts therapy intervention designed as a creative engagement learning environment. Future research will focus on rigorously evaluating its effectiveness and exploring its scalability in diverse settings.

Shared governance in hospitals promotes the inclusion of nurses' expertise, knowledge and skills in organisational processes, and nurses increasingly fulfil positions in organisational hierarchies. However, incorporating nursing expertise in strategic governance structures might be complicated, as these structures are primarily linked to managerial and biomedical expertise. Drawing on a Foucauldian perspective on knowledge and power, intertwined and embedded in everyday (inter)actions, we study how newly appointed directors of nursing challenge these dominant 'modes of knowing'. By focusing on a (Dutch) healthcare organisation, a large academic medical centre, we gained insight into how the history of director of nursing roles relates to how nursing expertise is valued. We gathered qualitative data (from multiple sources) to get close to the daily practices of these directors. In this way, we were able to highlight three tactics that enable directors to relate to new 'knowledge-power knots': (1) positioning, by creating more unity; (2) profiling, by showing significance and (3) powering, by being alert and intervening. With these tactics, the directors of nursing try to embed themselves and their expertise in hospital governance. This study contributes to an everyday understanding of power and the tactics that directors of nursing employ as an ongoing practice. This provides practical starting points for embedding nursing in governance and decision-making.

Introduction: Data are lacking on the optimal neoadjuvant systemic treatment (NST) for women with hormone receptor-positive (HR+) human epidermal growth factor receptor 2-positive (HER2+) breast cancer if they are unfit to receive the combination of chemotherapy and anti-HER2 therapy. The aim of this study was to determine whether the rates of ypT0 and ypN0 differ between patients treated with neoadjuvant endocrine therapy (NET) versus NET combined with anti-HER2 therapy (NET+aHER2). Materials and Methods: Data from the Netherlands Cancer Registry were analysed to identify women diagnosed with primary HR+/HER2+ breast cancer between 2008 and 2019, treated with either NET or NET+aHER2. The ypT0 and ypN0 rates were analysed (using uni- and multivariable logistic regression analyses, as applicable) in relation to the characteristics of the patient, the tumour, and the treatment. Results: Of the 190 patients identified (median age 77), 150 had been treated with NET and 40 with NET+aHER2. Patients with clinically node-positive disease (cN+) were significantly more likely to have been treated with NET+aHER2 (p = 0.029). The ypT0 rate was significantly higher after NET+aHER2, with 10.0% (4/40) versus 1.3% (2/150) following NET (p = 0.019). The ypN0 rate was significantly higher after NET+aHER2, with 25.0% (6/24) versus 5.5% (3/55) following NET in the cN+ patients (p = 0.020) and 81.3% (13/16) versus 55.8% (53/95) after NET in the cN- patients (p = 0.047). In the cN- patients, the ypN0 status was independently associated with age (p = 0.008) and the administration of NET+aHER2 (p = 0.016). Conclusions: The rates of ypT0 and ypN0 in women with HR+/HER2+ breast cancer treated with NST was significantly higher following NET+aHER2 than after NET.

Background Evidence-based practice (EBP) is crucial for appropriate, effective, and affordable care. Despite EBP education, barriers like low self-efficacy and outcome expectancy limit nurses’ engagement in EBP. Reliable scales are essential to evaluate interventions aimed at improving self-efficacy and outcome expectancy in EBP. The English Self-efficacy and Outcome Expectancy in EBP scales are psychometrically sound. Objectives To describe the translation, construct validity and internal consistency of the Dutch Self-efficacy and Outcome Expectancy in EBP Scales. Method The scales were translated forward and backward, piloted for comprehensibility and completeness and then administered among Dutch nurses and nursing students. Results Pilot testing confirmed comprehensibility, completeness, and relevance of the items. Confirmatory factor analysis (CFA) (n = 769) tested a second-order model for the Self-efficacy scale (Comparative Fit Index (CFI)=0.96, Tucker-Lewis Index (TLI)=0.95, Root Mean Square Error of Approximation (RMSEA)=0.06, Standardized Root Mean Residual (SRMR)=0.04) and a single-factor model for the Outcome Expectancy Scale (CFI=0.99, TLI=0.99, RMSEA=0.06, SRMR=0.01). Chi-squared tests remained significant. Hypothesis testing confirmed construct validity of the Self-efficacy (r = 0.77) and Outcome Expectancy Scale (r = 0.74). Both scales exhibited high internal consistency with McDonald's Omega and Cronbach's Alpha values above 0.95. Discussion Both scales exhibit theoretical soundness and positive fit indices. Significant chi-square tests and high correlations between weighted and unweighted scores support using unweighted scores over utilizing the estimated model to calculate weighted scores. Conclusions Construct validity and internal consistency of the Dutch Self-efficacy and Outcome Expectancy in EBP Scales are good. Future research should prioritize responsiveness and test-retest reliability.

Introduction Mild to moderate depression, anxiety, and stress imbalances are prevalent emotional issues among college students and are primary factors leading to deficiencies in social-emotional skills within this population. Without timely intervention, these mild to moderate emotional issues may escalate into more severe conditions. Social-Emotional Learning (SEL) programs are effective for building social-emotional skills. However, current research on SEL programs has not adequately addressed the issue of high-quality teacher-student interactions for students who suffer emotional problems. To tackle this issue, this study proposes a curriculum approach that integrates mindfulness with rhythmic music? and evaluated the emotional changes of students after mindfulness with rhythmic music curriculum. Methods This study adopted a pre-post experimental design. Two hundred and ninety-four firefighting universities students participated in a one-semester “online mindfulness combined with music rhythm SEL course”. The study used the Beck Anxiety Inventory, Center for Epidemiologic Studies Depression Scale and Perceived Stress Scale to measure the anxiety, depression and stress levels of the participants before and after the course, and used the participants' self-reflection reports as a method to explore the students' emotional transformation patterns. Results The research findings indicate that: (1) eighth-note, quarter-note, and sixteenth-note rhythmic music significantly improve the emotional wellbeing of students with depression, anxiety, and stress imbalances, respectively. (2) The degree of emotional improvement has a certain impact on academic performance. (3) Students with anxiety require more instructional support focused on attention concentration during the early phases of the course; students with depression should not be scheduled for social skills learning modules in the short term and need long-term instructional guidance; individuals experiencing stress imbalances require attention to their personal music preferences and benefit from additional listening activities and exercise. Discussion These findings assist teachers in accurately identifying emotional changes among students with emotional problems and managing the patterns of these emotional transitions, thereby providing effective instructional support and promoting high-quality interactions between teachers and students.

Current attempts to implement and apply automated control systems for the management of glucose homeostasis in individuals with diabetes are partly successful. In most semi and closed loop control systems to mimic the action of a normal pancreas in diabetes patients, insulin is administered subcutaneously. However, the parameters for insulin diffusion and transport time constants are relatively large and have wide individual variations. Therefore, deviation from a normal meal can result in suboptimal euglycemic control. Stable and reliable closed loop feedback control using continuous glucose monitoring under these conditions is difficult and needs regular interventions from the user. This article describes the translation of the endocrine physiology of a normal pancreas to an electronic equivalent. With this translation, the complex effects of a direct intravenous pulsatile method of insulin and glucagon administration can be simulated in accordance with physiological observations in a healthy subject and has been built with standard electronic components. This device is applicable for any individual and under any condition to automatically maintain the desired optimal euglycemic condition. The insulin and glucagon response control is presented in the same physiological pulsatile manner as is observed in healthy individuals.

Formative assessment (FA) is an effective educational approach for optimising student learning and is considered as a promising avenue for assessment within physical education (PE). Nevertheless, implementing FA is a complex and demanding task for in-service PE teachers who often lack formal training on this topic. To better support PE teachers in implementing FA into their practice, we need better insight into teachers’ experiences while designing and implementing formative strategies. However, knowledge on this topic is limited, especially within PE. Therefore, this study examined the experiences of 15 PE teachers who participated in an 18-month professional development programme. Teachers designed and implemented various formative activities within their PE lessons, while experiences were investigated through logbook entries and focus groups. Findings indicated various positive experiences, such as increased transparency in learning outcomes and success criteria for students as well as increased student involvement, but also revealed complexities, such as shifting teacher roles and insufficient feedback literacy among students. Overall, the findings of this study underscore the importance of a sustained, collaborative, and supported approach to implementing FA.

Flexible rotors must pass through at least one critical speed before reaching its nominal or working speed. During passage through this resonance, transient vibrations are introduced in the rotor. For a better performance of the machinery, these vibrations must be kept below a certain threshold to keep a small clearance between the rotor and the stator. Modal coupling by periodic control is a modern approach which is capable of transferring kinetic energy between two selected modes. By introducing a time-periodic variation of the bearing characteristics, a modal energy transfer is induced in a flexible rotor during run-up and run-down. This concept reduces the main resonance peak during passage through resonance compared to the nominal run-up. By the application of this technique, we were able to reduce the maximum amplitude response during the run-up to 25.4 percent and during the run-down to 27.1 percent.

Background Teachers' and parents' judgements of pupils' cognitive abilities influence pupils' daily learning opportunities and experiences, as these judgements affect the difficulty level of materials and instruction that teachers and parents provide. Over time, these judgements thus significantly shape educational success. However, pupils' characteristics, such as special educational needs (SEN), giftedness and socioeconomic status (SES) can influence and bias judgement accuracy. Aims The present study aimed to investigate the relation between pupils' cognitive abilities and their teachers' and parents' judgements of these abilities, and potential bias in these judgements related to SEN, giftedness, and SES. Sample The sample consisted of 1073 primary school pupils from grades 4–6 from 77 classes in 16 schools, and their teachers and parents. Methods Teachers and parents rated their pupils' cognitive abilities. Pupils completed the COVAT‐3, a cognitive ability test. Results Multilevel analyses revealed that parent judgements were significantly higher than teacher judgements, but both informants' judgements were equally strong related to the cognitive ability scores. When controlling for pupils' assessed cognitive abilities, the results revealed small judgement biases: negative for SEN, positive for giftedness, and finally positive for high SES, but only in teachers. Conclusions Overall, the results indicated that teachers and parents can judge their pupils abilities to a moderate degree, but they also hold judgement biases related to SEN, giftedness and SES. As these biases can affect pupils' opportunities, it is important to increase teachers' and parents' awareness.

Objective To explain how Dutch novice physical therapists experience their transition from student to physical therapist in private practice. Methods A qualitative, phenomenological study was performed in The Netherlands to collect personal experiences from novice physical therapists who graduated <1 year ago. Data were collected with semi-structured interviews and analyzed using interpretative phenomenological analysis. Results The transition experience from student to novice physical therapist is a personal, complex, and context-dependent phenomenon. Sixteen novice physical therapists (of whom 10 were still working in private practice) said their transition was liberating, stressful, insecure, unexpected, chaotic, and challenging. The variety in experiences occurred from the fact that the impact of an experience varies from one individual to the other, depending on their previous (life) experiences, uncertainty tolerance, coping, and personal and professional environment. Four overarching themes emerged: (1) ‘Suddenly, I was on my own’, (2) ‘I was unprepared for the hassle and demands of clinical practice’, (3) ‘I couldn’t make the impact I expected’, and (4) ‘I had to find a new me’. Conclusions A novice physical therapist’s transition is a context-related phenomenon, unique for each individual and determined by individual experiences and coping strategies. Novice physical therapists described a feeling of ‘faking’: they had to pretend to know what they were doing [while treating a patient] while in reality, they felt like they did not. For some novice physical therapists, a primary reason to leave the profession.