Jeroen J. G. Van Merrienboer

Maastricht University | UM · School of Health Professions Education

Background Healthcare simulation education often aims to promote transfer of learning: the application of knowledge, skills, and attitudes acquired during simulations to new situations in the workplace. Although achieving transfer is challenging, existing theories and models can provide guidance. Recommendations This paper provides five general re...

Applying professional-vision skills to classroom situations depends on knowledge about what matters in these situations. In an experiment with 85 biology pre-service teachers, we investigated a 90-min intervention combining both acquisition and application of knowledge about tutoring. The intervention started with an introductory text, followed by...

This chapter discusses research themes that are pertinent to the field of instructional design. It provides a brief description of the ADDIE model that characterises the main phases in instructional design: analysis, design, development, implementation and evaluation. Instructional design is both a practical field and a research field. The chapter...

When analyzing classroom video, pre-service teachers can improve their professional vision, that is, their ability to notice important events in a classroom and to interpret them based on theoretical knowledge. However, learning with video is especially challenging for novice learners. Thus, video needs to be embedded into an instructional context...

Abstract Introduction Clinical practice variability is characterized by two or more expert clinicians who make different treatment decisions despite encountering a similar case. Thrombosis Medicine is an example of a specialty that has a large evidence base to support decision-making and where practice variability is common. Our objective was to...

Decision-making in congenital cardiac care, although sometimes appearing simple, may prove challenging due to lack of data, uncertainty about outcomes, underlying heuristics, and potential biases in how we reach decisions. We report on the decision-making complexities and uncertainty in management of five commonly encountered congenital cardiac pro...

Introduction Since the beginning of the 21st century, competency-based education has been proposed as an approach to education in many disciplines including the medical sciences and it has become a dominant approach in many countries. We aimed to explore the lived experiences of general medical students about the change toward competency-based curr...

Introduction: Healthcare systems require healthcare professionals and students educated in an interprofessional (IP) context. Well-designed assessments are needed to evaluate whether students have developed IP competencies, but we currently lack evidence-informed guidelines to create them. This study aims to provide guidelines for the assessment o...

Background Systematic reviews on simulation training effectiveness have pointed to the need to adhere to evidence-based instructional design (ID) guidelines. ID guidelines derive from sound cognitive theories and aim to optimize complex learning (integration of knowledge, skills, and attitudes) and learning transfer (application of acquired knowled...

Objectives To map the evidence on learning practices currently used by experienced healthcare teams and dyads. The hypothesis is that through reviewing the literature we will identify the number and array of current learning practices. Through the lens of collaboration, the authors’ goal is to map current practice to guide future research, policy a...

Background Teachers with a teacher-centred perspective have difficulties applying student-centred approaches in Problem Based Learning (PBL) because they are inclined to show teacher-centred behaviours. The six aspects explained in Korthagen’s Onion Model (environment, behaviour, competencies, beliefs, identity, and mission) are assumed to contribu...

Student performance in general subjects such as language and mathematical skills is poor in secondary vocational education. A professional culture of teaching—including recruitment of well qualified teachers, effective teacher collaboration and effective teaching practice—could be the key to success. To what extent is there a professional culture o...

Although retrieval practice is a more effective learning strategy than restudy, students oftentimes prefer the latter. Previous studies have investigated this suboptimal decision at strategy level. The present study, however, focused on the learning task level: How perceived mental effort and perceived learning during task performance influence lea...

Video-based training offers teacher students approximations of practice for developing professional vision (PV; i.e., noticing and reasoning) of core teaching practices. While much video analysis research focuses on whole-classroom scenarios, for early PV training, it is unclear whether the focused instructional context of tutoring could be an appr...

In game-based learning, adaptive scaffolding can enhance the learning of domain-specific skills, known as first-order scaffolding, and self-regulatory skills, known as second-order scaffolding. To design adaptive scaffolding, we need indicators that identify learning opportunities. Therefore we investigated how indicators of performance and self-re...

Co-creating faculty development courses or activities through student teacher partnership is a promising recent educational advancement that also introduces new challenges. This study aimed at exploring the perceptions of students and teachers regarding their experiences as co-creators of a faculty development programmes so that valuable lessons ca...

Successful learners should self-regulate their motivation to learn. Although 8 motivational regulation strategies (MRSs) have been described, their relations with student motivation remain underexplored. To analyze this relationship, we conducted a correlational study grounded in Wolters’ theory of MRSs and Ivannikov's adaptation of Leont'ev's acti...

The testing effect—the power of retrieval practice to enhance long-term knowledge retention more than restudying does—is a well-known phenomenon in learning. However, retrieval practice is hardly appreciated by students and underutilized when studying. One of the reasons is that learners usually do not experience immediate benefits of such practice...

Cognitive Load Theory has emerged as an important approach to improving instruction in the health professions workplace, including patient handovers. At the same time, there is growing recognition that emotion influences learning through numerous cognitive processes including motivation, attention, working memory, and long-term memory. This study e...

Background Teachers with a teacher-centred perspective have difficulties applying student-centred approaches in Problem Based Learning (PBL) because they are inclined to show teacher-centred behaviours. The six aspects explained in Korthagen’s Onion Model (environment, behaviour, competencies, beliefs, identity, and mission) are assumed to contribu...

A sample of 33 experiments was extracted from the Web-of-Science database over a 5-year period (2016–2020) that used physiological measures to measure intrinsic cognitive load. Only studies that required participants to solve tasks of varying complexities using a within-subjects design were included. The sample identified a number of different phys...

Radiologists can visually detect abnormalities on radiographs within 2s, a process that resembles holistic visual processing of faces. Interestingly, there is empirical evidence using functional magnetic resonance imaging (fMRI) for the involvement of the right fusiform face area (FFA) in visual-expertise tasks such as radiological image interpreta...

Background Achieving changing needs, advancing knowledge, and innovations in higher education require the constant changes of medical school curricula and successfully applying the new reforms requires some modifications in the medical educators’ core beliefs. The purpose of this study was to describe the medical educators’ beliefs about the alignm...

To gain insight into the availability of training for robot assisted surgery (RAS) and the possibility to perform RAS during Dutch residency curriculum and to analyze the effects on surgical skills by the introduction of an advanced course in RAS for residents. A combination of a validated snap shot survey and a prospective cohort study. Structured...

Background Curriculum viability is determined by the degree to which quality standards have or have not been met, and by the inhibitors that affect attainment of those standards. The literature reports many ways to evaluate whether a curriculum reaches its quality standards, but less attention is paid to the identification of viability inhibitors i...

Perceptions of teachers and students about curriculum viability inhibitors are equally important yet may differ. Divergence can lead to destructive friction and adversely affect curriculum viability. Our team aimed to find the perceptions of teachers and students on inhibitors affecting the viability of an implemented medical curriculum, report the...

Introduction When there is miscommunication and poor coordination between experienced clinician dyads, teamwork suffers. Research on expert learning practices for the smallest team, and arguably the most important team, the healthcare dyad, is limited. The objective of this study is to map the extent and range of evidence available on learning prac...

Background Emergency physicians often experience high cognitive load (CL) due to the inherent nature of working in acute care settings. CL has traditionally been measured in educational studies but has not been well studied in the clinical environment. Methods Emergency medicine attending physicians and residents working in an academic urgent care...

To understand the influence of proctored guidance versus simulator generated guidance (SGG) on the acquisition dexterity skills in novice surgeons learning RAS (robot assisted surgery). Prospective non-blinded 3-arm randomised controlled trial (RTC). Exclusion criteria: previous experience in RAS or robotic surgery simulation. The participants were...

This paper describes how an interdisciplinary design team used the Four-Component Instructional Design (4C/ID) model and its accompanying Ten Steps design approach to systematically design a professional development program for teaching differentiation skills to primary school teachers. This description illustrates how insights from a cognitive tas...

The COVID-19 pandemic has been forcing people to work remotely in virtual teams around the globe. Global virtual teamwork will continue, and people are not sufficiently prepared for this, resulting in reduced team commitment and lower performance. Higher education institutions need to equip their graduates with International Online Collaboration Co...

Background Less attractive specialties in medicine are struggling to recruit and retain physicians. When properly organized and delivered, continuing medical education (CME) activities that include short courses, coaching in the workplace, and communities of practice might offer a solution to this problem. This position paper discusses how educatio...

Handover between colleagues is a complex task. The problem is that handovers are often inadequate because they are not structured according to theoretically grounded guidelines. Based on the cognitive load theory, we suggest that allowing a clarifying dialogue and thereby optimizing germane cognitive load enhances the information quality and diagno...

This quasi-experimental study investigates the effects of using an electronic development portfolio (PERFLECT) with teacher-guided student self-coaching on the development of students' self-directed learning skills and motivation. In a 12-week program in senior vocational education, students in the PERFLECT group used the portfolio to help self-dir...

Research has shown that taking “timeouts” in medical practice improves performance and patient safety. However, the benefits of taking timeouts, or pausing, is not sufficiently acknowledged in workplaces and training programs. To promote this acknowledgment, we suggest a systematic conceptualization of the medical pause, focusing on its importance,...

The ABCDE method, used internationally to treat seriously ill patients, is a guideline for performing the complex skill of resuscitation that is commonly trained in face-to-face-courses. In the abcdeSIM game, used as a preparation for these courses, players treat patients in a virtual emergency department. We used the Four-Component Instructional D...

Construct: Entrustable professional activities (EPAs) provide a novel approach to support teachers’ structured professionalization and to assess improvement in teaching competence thereafter. Despite their novelty, it is important to assess EPAs as a construct to ensure that they accurately reflect the work of the targeted profession. Background: T...

Background Task-specific checklists and global rating scales are both recommended assessment tools to provide constructive feedback on surgical performance. This study evaluated the most effective feedback tool by comparing the effects of the Observational Clinical Human Reliability Analysis (OCHRA) and the Objective Structured Assessment of Techni...

Background The effect of three-dimensional (3D) vs. two-dimensional (2D) video on performance of a spatially complex procedure and perceived cognitive load were examined among residents in relation to their visual-spatial abilities (VSA). Methods In a randomized controlled trial, 108 surgical residents performed a 5-Flap Z-plasty on a simulation m...

Background Curriculum viability is determined by the degree to which quality standards have or have not been met, and by the inhibitors that affect attainment of those standards. The literature reports many ways to evaluate whether a curriculum reaches its quality standards, but less attention is paid to the identification of viability inhibitors i...

Aim To evaluate the diagnostic performance for margin assessment of specimen radiography (SR) in breast conserving surgery (BCS) using radioactive I¹²⁵-seed localization (RSL). Methods The clinical, radiographic and histopathological data of women who underwent BCS after pre-operative RSL with intraoperative SR during nine consecutive years were a...

Practice testing and distributed practice are effective in enhancing learning outcomes and long-term retention. Yet, many students use ineffective learning strategies instead and are reluctant to change them because they hold erroneous beliefs about practice testing and distributed practice. This intervention study examined whether narratives, comp...

Background Factors that facilitate transfer of training in paediatric echocardiography remain poorly understood. This study assessed whether high-variation training facilitated successful transfer in paediatric echocardiography. Methods A mixed-methods study of transfer of technical and interpretive skill application amongst postgraduate trainees....

Background: Recent reports suggest that faculty development (FD) programs need a structured framework to design training and assess improvement in teaching performance of participants. Entrustable professional activities (EPAs) can serve as a novel framework to plan and conduct structured FD programs, and to assess the proficiency of small group fa...

Objective To investigate the feasibility of urethral stump length and width measurements in recorded videos of robot assisted radical prostatectomy procedures using the Kinovea software and to assess if these measurements could be used as predictors of postoperative urinary continence. Methods Fifty‐three patients were selected from an institution...

Background The Observational Clinical Human Reliability Assessment (OCHRA) can be used to score errors during surgical procedures. To construct an OCHRA-checklist, steps, substeps, and hazards of a surgical procedure need to be defined. A step-by-step framework was developed to segment surgical procedures into steps, substeps, and hazards. The firs...

Background: Achieving changing needs, advancing knowledge, and innovations in higher education require constant changes of medical school curricula and brings greater clarity to the influence of the core beliefs held by medical educators. The purpose of this study was to describe medical educators’ beliefs about alignment of learning goals, teachin...

Background: Achieving changing needs, advancing knowledge, and innovations in higher education require the constant changes of medical school curricula and successfully applying the new reforms requires some modifications in the medical educators' core beliefs. The purpose of this study was to describe the medical educators’ beliefs about the align...

Purpose Simulation training allows trainees to gain experience in a safe environment. Computer simulation and animal models to practice a Lichtenstein open inguinal hernia repair (LOIHR) are available; however, a low-cost model is not. We constructed an inexpensive model using fabric, felt, and yarn that simulates the anatomy and hazards of the LOI...

Buku Panduan Adaptasi Pendidikan Kedokteran dan Profesi Kesehatan di Era Pandemi COVID-19 adalah karya kolaborasi berbagai institusi pendidikan di Indonesia untuk mengantisipasi perubahan proses pendidikan profesi kesehatan di era pandemi COVID-19. Isi buku ini juga telah disampaikan dalam bentuk serial webinar pendidikan profesi kesehatan selama p...

Cognitive-load researchers attempt to engineer the instructional control of cognitive load by designing methods that substitute productive for unproductive cognitive load. This article highlights proven and new methods to achieve this instructional control by focusing on the cognitive architecture used by cognitive-load theory and aspects of the le...

ntroduction and hypotheses: valuation of surgical skills, both technical and non- technical, is possible through observations and video analysis. Besides technical failures, adverse outcomes in surgery can also be related to hampered communi- cation, moderate teamwork, lack of leadership, and loss of situational awareness. Even though some surgeons...

Secondary school students often learn new cognitive skills by practicing with tasks that vary in difficulty, amount of support and/or content. Occasionally, they have to select these tasks themselves. Studies on task-selection guidance investigated either procedural guidance (specific rules for selecting tasks) or strategic guidance (general rules...

Background: Effective training and assessment of performance are fundamental to ensuring that surgeons reach their intended goal and operate safely with maximum preservation of functions. The field of video review and postoperative results analysis is focused on predicting postoperative results and reducing complications. Even though multiple group...

Curriculum evaluation is typically done by using quality standards defined by accrediting bodies. This does not include inhibitors that hinder the achievement of standards. Hence, to address both standards and inhibitors, we have coined the new concept of “curriculum viability.” This study establishes consensus among experts on curriculum viability...

Cognitive load theory has become a leading model in educational psychology and has started to gain traction in the medical education community over the last decade. The theory is rooted in our current understanding of human cognitive architecture in which an individual's limited working memory and unlimited long-term memory interact during the proc...

Das Vier-Komponenten Instructional Design Modell (four-component instructional design model: 4C/ID) wird derzeit viel beachtet, da es aktuellen Trends im Bereich der Bildung entspricht: (a) Schwerpunkt auf der Entwicklung komplexer Fähigkeiten bzw. beruflicher Kompetenzen, (b) zunehmender Transfer dessen was in der Schule gelernt wird auf neue Situ...

Background: Primary health care (PHC), of which preventive medicine (PM) is a subspecialty, will have to cope with a deficiency of staff in the future, which makes the retention of graduates urgent. This study was conducted in Vietnam, where PM is an undergraduate degree in parallel to medical training. It aims to identify facilitating and hinderi...

Background Situated cognition theory argues that thinking is inextricably situated in a context. In clinical reasoning, this can lead to context specificity : a physician arriving at two different diagnoses for two patients with the same symptoms, findings, and diagnosis but different contextual factors (something beyond case content potentially in...