Karen D. Könings

Maastricht University | UM · Department of Educational Research and Development

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...

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...

Students’ learning environments often change during school career, due to school transitions and the introduction of educational innovations, causing discontinuity in teaching and learning. Success of students entering a new learning environment depends in part on their prior expectations of education, as these influence later perceptions. Heteroge...

Purpose Medical students’ transition to postgraduate training, given the complexity of new roles and responsibilities, requires the engagement of all involved stakeholders. This study aims to co-create a transition curriculum and determine the value of involving the key stakeholders throughout such transition in its design process. Methods We cond...

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...

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...

Introduction: Verbal feedback from trainees to supervisors is rare in medical education, although valuable for improvement in teaching skills. Research has mostly examined narrative comments on resident evaluations of their supervisors. This study aimed to explore supervisors' and residents' beliefs and experiences with upward feedback, along with...

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...

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...

Background More and more female residents enter postgraduate medical training (PGMT). Meanwhile, women are still underrepresented in academic medicine, in leadership positions and in most surgical specialties. This suggests that female residents’ career development may still be negatively impacted by subtle, often unconscious stereotype association...

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...

In this mixed-methods study, we hypothesized that social cognitive theory (SCT)-based educational interventions for healthcare participation can improve the self-efficacy of older rural citizens in participating in their health management without any difficulties. Quasi-experimental study before and after SCT-based educational interventions and sem...

Background The clinical workplace offers residents many opportunities for learning. Reflection on workplace experiences drives learning and development because experiences potentially make residents reconsider existing knowledge, action repertoires and beliefs. As reflective learning in the workplace cannot be taken for granted, we aimed to gain a...

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...

This AMEE guide aims to emphasize the value of active learner involvement in the design and development of education, referred to as co-creation, and provides practical tips for medical edu- cators interested in implementing co-created educational initiatives at their own institutions. Starting with definitions of co-creation and related terms, we...

Background Training residents in delivering high-value, cost-conscious care (HVCCC) is crucial for a sustainable healthcare. A supportive learning environment is key. Yet, stakeholders’ attitudes toward HVCCC in residents’ learning environment are unknown. Objective We aimed to measure stakeholders’ HVCCC attitudes in residents’ learning environme...

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 To receive high-quality healthcare, citizens should actively participate in public healthcare programs and share decision-making with medical professionals, especially in rural areas; this requires support for citizens in the form of education. Few studies examine educational interventions’ effects on rural citizens’ motivation to partic...

Background: Residents have to learn to provide high value, cost-conscious care (HVCCC) to counter the trend of excessive healthcare costs. Their learning is impacted by individuals from different stakeholder groups within the workplace environment. These individuals' attitudes toward HVCCC may influence how and what residents learn. This study was...

Background The R2C2, a 4-phase feedback and coaching model, builds relationships, explores reactions, determines content and coaches for change, and facilitates formal feedback conversations between clinical supervisors/preceptors and residents. Formal discussions about performance are typically based on collated information from daily encounter sh...

Stakeholders in vocational education have difficulties communicating and collaborating on the design of education because they often lack a shared understanding of what constitutes effective student learning. The aim of this study is to investigate whether the perspectives of teacher educators, teachers and students on good education in vocational...

This AMEE guide provides a framework and practical strategies for teachers, learners and institutions to promote meaningful feedback conversations that emphasise performance improvement and professional growth. Recommended strategies are based on recent feedback research and literature, which emphasise the sociocultural nature of these complex inte...

Background: Mentoring plays a pivotal role in workplace-based learning, especially in the medical realm. Organising a formal mentoring programme can be labor and time intensive and generally impractical in resource constrained medical schools with limited numbers of mentors. Hence, informal mentoring offers a valuable alternative, but will be more...

This chapter describes an empirically derived model for impactful feedback discussions. The R2C2 model has four phases: Educators build the relationship (R) between educator and learner, gain learner reactions (R) to the feedback which can be used to determine the potential for change and development, and explore and ensure a mutual understanding o...

Purpose: Newer definitions of feedback emphasize learner engagement throughout the conversation, yet teacher and learner perceptions of each other's behaviors during feedback exchanges have been less well studied. This study explored perceptions of residents and faculty regarding effective behaviors and strategies during feedback conversations and...

Background: Students are ever more involved in the design of educational practices, which is reflected in the growing body of literature about approaches to student participation. Similarities and differences between these approaches often remain vague since the terms are used interchangeably. This confusing and fragmented body of literature hamper...

Background Asian educators have struggled to implement problem-based learning (PBL) because students rarely discuss their work actively and are not sufficiently engaged in self-directed learning. Supplementing PBL with additional e-learning, i.e. ‘blended’ PBL (bPBL), could stimulate students’ learning process. Methods We investigated the effects...

Background: Recruiting and retaining students in preventive medical (PM) specialties has never been easy; one main challenge is how to select appropriate students with proper motivation. Understanding how students perceive PM practice differently from practicing doctors is necessary to guide students, especially for those for whom PM is only a sub...

Feedback is defined as a regulatory mechanism where the effect of an action is fed back to modify and improve future action. In medical education, newer conceptualizations of feedback place the learner at the center of the feedback loop and emphasize learner engagement in the entire process. But, learners reject feedback if they doubt its credibili...

Objectives Coaching in medical education has recently gained prominence, but minimal attention has been given to key skills and determining how they work to effectively ensure residents are progressing and developing self‐assessment skills. This study examined process‐oriented and content‐oriented coaching skills used in coaching sessions, with par...

Giving students complex learning tasks combined with peer-assessment tasks can impose a high cognitive load. Scaffolding has proven to reduce cognitive load during learning and improve accuracy on domain-specific tasks. This study investigated whether scaffolding has a similar, positive effect on the learning of peer-assessment tasks. We hypothesis...

Background Physicians in training must achieve a high degree of proficiency in performing physical examinations and must strive to become experts in the field. Concerns are emerging about physicians’ abilities to perform these basic skills, essential for clinical decision making. Learning at the bedside has the potential to support skill acquisitio...

Mentoring Relationships of Female Doctors in Three Different Countries: Are they Perceived as Friendships? Heba A. Mohtady1,2,4, Karen D. Könings2, Mohamed M. Al-Eraky3, Arno M.M. Muijtjens2, and Jeroen J.G. van Merriënboer2 1 Fakeeh College for Medical Sciences, Saudi Arabia 2 Maastricht University, the Netherlands 3 Imam Abdulrahman Bin Faisal...

Background: Public health leaders are confronted with complex problems, and developing effective leadership competencies is essential. The teaching of leadership is still not common in public health training programs around the world. A reconceptualization of professional training is needed and can benefit from innovative educational approaches. Ou...

Purpose: To explore resident and faculty perspectives on what constitutes feedback culture, their perceptions of how institutional feedback culture (including politeness concepts) might influence the quality and impact of feedback, feedback seeking, receptivity, and readiness to engage in bidirectional feedback. Method: Using a constructivist gr...

Objectives In undergraduate medical education, the topics of errors in medicine and patient safety are under-represented. The aim of this study was to explore undergraduate medical students’ behavioural intentions when confronted with an error. Design A qualitative case vignette survey was conducted including one of six randomly distributed case s...

Feedback in medical education has traditionally showcased techniques and skills of giving feedback, and models used in staff development have focused on feedback providers (teachers) not receivers (learners). More recent definitions have questioned this approach, arguing that the impact of feedback lies in learner acceptance and assimilation of fee...

Purpose: The authors previously developed and tested a reflective model for facilitating performance feedback for practice improvement, the R2C2 model. It consists of four phases: relationship building, exploring reactions, exploring content, and coaching. This research studied the use and effectiveness of the model across different residency prog...

THE CHALLENGES OF DEVELOPING INFORMAL MENTORSHIPS IN THE MEDICAL FIELD Mohtady H, 1 Könings KD, 2 van Merriënboer JJG2 1Medical Education Department, Fakeeh College for Medical Sciences, Saudi Arabia and Faculty of Medicine, Zagazig University Egypt, 2Department of Educational Development and Research, School of Health Professions Education, Maast...

Students’ educational engagement is both an important predictor of study success and a key preventive factor for dropout. Vocational tracks in secondary education show high dropout rates. There is strong evidence that the solution to educational disengagement lies in student‐centred, powerful learning environments (PLEs). This study investigates ch...

Background Challenges in recruiting and retaining medical staff in preventive medical specialties have recently been the subject of numerous studies. To improve selection procedures, it is important to understand the career preferences and incentives of students in preventive medicine (PM), who initially marked the program as either their first cho...

Aim: Self-assessment and reflection are essential for meaningful feedback. We aimed to explore whether the well-known Johari window model of self-awareness could guide feedback conversations between faculty and residents and enhance the institutional feedback culture. Methods: We had previously explored perceptions of residents and faculty regardin...

It is recognised that educational environments influence learning experiences, so it is important to ensure that educational buildings are designed to be fit for purpose. In order to ensure that educational buildings meet the needs of those who use them, all relevant stakeholders should be involved in the design process. However, this is not straig...

User participation is a key element in decision processes concerning the accommodation of dynamic organisations such as schools. This article addresses the discrepancy between the perspectives of the architects and engineers, as the makers of school buildings, and school management, teachers and students, as the users of the buildings, and proposes...

Background Despite growing evidence of the benefits of including assessment for learning strategies within programmes of assessment, practical implementation of these approaches is often problematical. Organisational culture change is often hindered by personal and collective beliefs which encourage adherence to the existing organisational paradigm...

Background Electronic medical records (EMR) are more used in university hospitals, but the use of EMR by medical students at the workplace is still a challenge, because the conflict of interest between medical accountability for hospitals and quality of medical education programs for students. Therefore, this study investigates the use of EMR from...

The aim of this study is to compare the role of the tutor in an online and a face-to-face problem-based learning (PBL) session to shed light on potential differences of the tutor role in both settings. In this practice-based study we compared the two groups with the same tutor undertaking the same module. Students completed questionnaires about tut...

Approach: Using a constructivist grounded theory approach, we sought to examine residents' perspectives on institutional factors that affect the quality of feedback, factors that influence receptivity to feedback, and quality and impact of faculty feedback. Four focus group discussions were conducted, with two investigators present at each. One fa...

Informal mentoring is based on a natural match between a junior individual and a senior one who share mutual interests. It usually aids in the professional and personal development of both parties involved. We reviewed the literature regarding factors that make informal mentoring effective within the medical realm, by searching a major academic sea...

Past practices shape and limit the design imagination of teachers, pupils, parents, governors and others concerned with designing modern schools. Bringing histories of education to the table in the participatory design process of new school buildings and curricula is necessary. Schools having an extraordinary past have the potential to draw from th...

Change processes, like educational innovations, can cause increased workload and resistance to change. Implementing an innovative learning environment on board of training ships in Maritime Training requires supervisors to be coach and expert. This new role and work setting can cause higher workload. This study investigates supervisors’ expectation...

Introduction Feedback after assessment is essential to support the development of optimal performance, but often fails to reach its potential. Although different assessment cultures have been proposed, the impact of these cultures on students’ receptivity to feedback is unclear. This study aimed to explore factors which aid or hinder receptivity to...

Trainees can participate in organizational training programs voluntarily or mandatorily. To date, research reported mixed evidence on the question whether voluntary or mandatory participation is associated with higher motivation and transfer of training. Grounded in the frameworks of participatory design, the notion of autonomy in basic psychologic...

Veranderingsprocessen, zoals onderwijsinnovaties, kunnen leiden tot verhoogde werkdruk en weerstand tegen verandering. De invoering van innovatieve werkplekstages in het maritieme onderwijs stelt stagebegeleiders aan boord van trainingsschepen voor de uitdaging om een nieuwe rol als coach te vervullen. Bij innovaties anticiperen betrokkenen op vera...

R2C2 is an evidence-based reflective model for providing assessment feedback. It includes four phases: (1) relationship building, (2) exploring reactions to the feedback, (3) exploring understanding of feedback content, and (4) coaching for performance change. It provides a strategy for facilitating feedback conversations that promote engagement wi...

E-learning, broadly defined as all IT employed to support or improve the learning process of students, is becoming mainstream. Can e-learning also support the learning principles of problem-based learning (PBL)? This chapter focuses on how e-learning has been described to support PBL in groups working either face-to-face or online. A systematic lit...

Problem: Reflecting on workplace-based experiences is necessary for professional development. However, residents need support to raise their awareness of valuable moments for learning and to thoughtfully analyze those learning moments afterwards. Approach: From October to December 2012, the authors held a multidisciplinary six-week postgraduate...

Individuals with adaptive expertise possess the skills to deal with novel problems. Whereas this concept has been around since the mid-1980s, no instrument exists that provides a good operationalization of the theoretical construct. This inhibits the further development of research on adaptive expertise and the evaluation of employees’ adaptive exp...

Blended learning, defined as a combination of face-to-face and online learning, is expected to lead to improved education. Besides, practical reasons, like increased access to education and resource management, are mentioned for its implementation. To examine whether the expectation of improved education is met, meta-analyses were conducted. They r...

Preservice teachers’ professional vision is an important indicator of their initial acquisition of integrated knowledge structures within university-based teacher education. To date, empirical research investigating which factors contribute to explaining preservice teachers’ professional vision is scarce. This study aims to determine which factors...

Despite calls for feedback to be incorporated in all assessments, a dichotomy exists between formative and summative assessments. When feedback is provided in a summative context, it is not always used effectively by learners. In this study we explored the reasons for this. We conducted individual interviews with 17 students who had recently receiv...

Teachers are not typically involved as participatory designers in the design of technology-enhanced learning environments. As they have unique and valuable perspec- tives on the role of technology in education, it is of utmost importance to engage them in a participatory design process. Adopting a case study methodology, we aim to reveal in what wa...

Every year, thousands of students go abroad for part of their study programme. Supervision from the home institution is then crucial for good study progress. Providing supervision and feedback at a distance is challenging. This project aims to identify bottlenecks for supervision and hypothesises that online supervi- sory group meetings with videoc...

A strong need exists to connect learner experiences at the workplace with formal training activities. This would improve authenticity of learning, but surprisingly few initiatives have been taken so far. In this project mobile devices (smartphones) were used while students were attending clinical clerkships. We aimed to develop learning practices -...

If teachers and teacher educators are willing to support the learning of students, it is important for them to learn what motivates students to engage in learning. Students have their own preferences on design characteristics of powerful learning environments in vocational education. We developed an instrument - the Inventory Powerful Learning Envi...