Walther Van Mook

Walther Van Mook
Maastricht University | UM · Department of Intensive Care

Maastricht University - Faculty of Health, Medicine, and Life Sciences - Chair Committee on Professional Behaviour - Postgraduate Dean Maastricht University Medical Centre - Professor of Professional Development

About

316
Publications
64,921
Reads
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5,826
Citations
Additional affiliations
May 2016 - present
Maastricht University Medical Centre, Maastricht, The Netherlands
Position
  • Director/Dean of the Academy for Postgraduate Medical Training
May 2012 - present
Maastricht University
Position
  • Professor (Associate)
April 2002 - present
Maastricht Universitair Medisch Centrum
Position
  • Internist intensivist

Publications

Publications (316)
Article
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Background Residents who do not internalize professional values may not be a good fit for their specialty and compromise the quality of their patient care. Research aimed at recognizing residents’ shortcomings in professionalism may help to prevent future shortcomings towards patients. The aim of this study was to increase insight into residents’ s...
Article
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Achtergrond. In Nederland is het mogelijk om, nadat aan alle zorgvuldigheidseisen voor euthanasie is voldaan, organen te doneren. Bij orgaandonatie na euthanasie (ODE) kunnen weefsels, lever, hart, nieren, longen en pancreas worden gedoneerd. De procedure voor ODE wordt zorgvuldig beschreven in de landelijke richtlijn Orgaandonatie na euthanasie va...
Article
Background More self‐efficacy leads to greater confidence in one's ability to perform actions to achieve treatment goals. Therefore, self‐efficacy may affect patient recovery and health‐related quality of life (HRQoL) after ICU discharge. Aim In a cohort of mechanically ventilated COVID‐19 survivors, we examined the associations between self‐effic...
Article
Background: In the Netherlands, it is possible for patients to donate organs after having received euthanasia. In many cases of organ donation after euthanasia (ODE), tissues, as well as the liver, heart, kidneys, lungs, and pancreas, can be donated. The procedure for ODE is described in the national guideline for organ donation after euthanasia b...
Article
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Veel patiënten gebruiken sociale media. De zorgverantwoordelijke kan dit gebruik beperken als vorm van verplichte zorg volgens de Wet verplichte GGZ (Wvggz). Wij beschrijven welke gedragingen van patiënten op sociale media aanleiding waren tot het beperken van hun telecommunicatie. Wij vonden 38 uitspraken sinds de invoering van de Wvggz. Beperking...
Article
Sinds 1 augustus 2022 dienen werkgevers kosteloos verplichte scholing te bieden aan hun werknemers. Toch zijn er nog steeds situaties waarin de werkgever tenminste een deel van de scholingskosten op de werknemer kan verhalen, bijvoorbeeld met een beroep op het goed werknemerschap bij een gebrek aan inzet van de werknemer. In dit artikel beschrijven...
Article
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Volgens de Governance Code Zorg moeten raden van toezicht transparantie bevorderen en hun toezicht verantwoorden. Verantwoording vindt (vooral) plaats via jaarverslagen. We vergeleken ons onderzoek uit 2020/2021 naar transparant toezicht van ziekenhuizen met de jaarverslagen van 2023. In 2022 werd immers de Governance Code aangescherpt. In de recen...
Article
Background In 2020, a mandatory, nationwide 1-day bronchoscopy simulation-based training (SBT) course was implemented for novice pulmonology residents in the Netherlands. This pretest–posttest study was the first to evaluate the effectiveness of such a nationwide course in improving residents’ simulated basic bronchoscopy skills. Methods After pas...
Article
Sociale media zijn niet meer weg te denken uit onze samenleving. Sociale media zijn relevant voor communicatie, reclame en dienstverlening, maar spelen ook een rol in klachten en geschillen. Dat geldt ook binnen de zorgsector. In dit artikel behandelen wij uitspraken van geschillencommissies voor de Wet kwaliteit, klachten en geschillen zorg (Wkkgz...
Article
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The outcome of kidneys transplanted following organ donation after euthanasia (ODE) remains unclear. This study analyzed all kidney transplantations in the Netherlands from January 2012 to December 2021, comparing the outcomes following ODE, donation after circulatory death (DCD-III), and donation after brain death (DBD). 9,208 kidney transplantati...
Article
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De #MeToo-beweging vergrootte de aandacht voor ongewenste intimiteiten in het algemeen aanzienlijk, maar de specifieke aandacht voor onderzoek naar gedragingen van studenten in het Hoger Onderwijs was beperkt.Wij onderzochten instellingsmaatregelen opgelegd vanwege seksueel grensoverschrijdende gedragingen door studenten die ter discussie stonden b...
Article
De Wet kwaliteit, klachten en geschillen zorg (Wkkgz) is reeds acht jaar van kracht. In hoeverre en in welke context er onder deze wet bij geschillencommissies over zorgaanbieders in relatie tot seks wordt geklaagd is nog onbekend. Derhalve doorzochten wij voor dit uitsprakenonderzoek de openbare databank de 'geschillencommissiezorg.nl' van 2016 to...
Article
STARS (Students and Trainees Advocating for Resource Stewardship) is a medical student leadership program that promotes integration of resource stewardship (RS) into medical education in at least seven countries. Little is known about how participation affects student leaders. To understand how partaking in STARS impacted participants’ knowledge, s...
Article
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This perspective article discusses the classification challenges encountered in organ donation after euthanasia (ODE) among individuals with psychiatric disorders, as highlighted in our recent case series. In cases involving "somatic symptoms and related disorders, " somatic symptoms are connected to excessive thoughts, feelings, and behaviors, cau...
Article
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19). Commonly used methods for both clinical diagnosis of SARS-CoV-2 infection and management of infected patients involve the detection of viral RNA, but the presence of infectious virus particles is unknown. Viability PCR (v-PCR) uses a photoreacti...
Article
Objective To explore how the disciplinary board allocates responsibility between the resident in training and the supervisor. Design Case law analysis. Method All published disciplinary judgments containing the term 'resident in training' from January 1, 2010, to April 1, 2020 on www.tuchtrecht.overheid.nl were analyzed. Results 116 law cases invol...
Article
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Background A significant proportion of patients and informal caregivers favor an active role in decisions concerning their health. Simultaneously, governments aim to shift treatment from a professional care setting to a community setting, in light of an ageing population, a decreasing number of health workers and allocation of scarce resources. Thi...
Article
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Het betrekken van patiënten en mantelzorgers bij geneeskundige behandeling staat toenemend in de belangstelling. In dit artikel bespreken we de verantwoordelijkheden en aansprakelijkheid van de zorgaanbieder, zorgverleners en mantelzorgers. We pleiten ervoor de wettelijke zorgvuldigheidseisen voor zorgverleners zoveel mogelijk, maar met oog voor de...
Article
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Introduction Role models are powerful contributors to residents’ professional identity formation (PIF) by exhibiting the values and attributes of the community. While substantial knowledge on different attributes of role models exists, little is known about their influence on residents’ PIF. The aim of this study was to explore surgical residents’...
Presentation
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Artsen in opleiding tot specialist (aios) die onvoldoende functioneren behoeven begeleiding en mogelijk formele remediering. Als remediering onvoldoende effectief blijkt, dan kan de opleider, als uiterste, de opleiding van de aios beëindigen. Internationaal is er echter nauwelijks onderzoek gedaan naar de effectiviteit van remediering binnen de opl...
Presentation
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Artsen in opleiding tot specialist (AIOS) die een geschil hebben met hun opleider kunnen de Centrale Opleidingscommissie (COC) verzoeken om bemiddeling. Wanneer dit onvoldoende blijkt te zijn, kan de AIOS zich wenden tot de geschillencommissie van de Registratiecommissie Geneeskundig Specialisten (GC-RGS) en verzoeken om een uitspraak te doen. Waar...
Presentation
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Professionaliteit is een van de kerncompetenties uit het CanMEDS-competentiemodel. Wat professionaliteit precies is, is niet eenvoudig te zeggen. Mak-van der Vossen (e.a. 2020) construeerde het 4I's model door onprofessionele gedragingen van medisch studenten te categoriseren in de categorieën inzet, interactie, integriteit, introspectie. Dit model...
Article
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Linking skills training and academic education is a formidable challenge in many professional fields. At modern military academies, officer cadets learn military skills and strategic thinking, fostered by skills training and academic education respectively. As an example, we briefly elaborate on these two learning tracks at the Royal Military Acade...
Presentation
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De komst van sociale media en de dilemma's (kansen en uitdagingen) die dat met zich meebrengt vraagt om nieuwe vormen van professioneel handelen. Wij onderzochten alle gepubliceerde uitspraken van tuchtzaken tussen 01-01-2010 en 01-01-2020, die gingen over grensoverschrijdend gedrag middels sociale media door de zorgverlener binnen de psychiatrie....
Article
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The CoLab score was developed and externally validated to rule out COVID-19 among suspected patients presenting at the emergency department. We hypothesized a within-patient decrease in the CoLab score over time in an intensive care unit (ICU) cohort. Such a decrease would create the opportunity to potentially rule out the need for isolation when t...
Article
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Background The burnout rates among residents urge for adequate interventions to improve resilience and prevent burnout. Peer reflection, also called group intervision sessions, is a potentially successful intervention to increase the resilience of young doctors. We aimed to gain insight into the perceived added value of intervision sessions and the...
Article
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Limb ischaemia is a clinically relevant complication of venoarterial extracorporeal membrane oxygenation (VA ECMO) with femoral artery cannulation. No selective distal perfusion or other advanced techniques were used in the past to maintain adequate distal limb perfusion. A more recent trend is the shift from the reactive or emergency management to...
Article
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Introduction Insufficient introspection as part of the 4I’s model of medical professionalism (introspection, integrity, interaction, and involvement) is considered an important impediment in trainees. How insufficient introspection relates to decisions to terminate residency training remains unclear. Insights into this subject provide opportunities...
Article
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Objectives The present study examines the temporal association between the changes in SARS-CoV-2 viral load during infection and whether the CoLab-score can facilitate de-isolation. Methods Nasal swabs and blood samples were collected from ICU-admitted SARS-CoV-2 positive patients at Maastricht UMC+ from March 25, 2020 to October 1, 2021. The CoLa...
Article
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Objectives: The present study examines the temporal association between the changes in SARS-CoV-2 viral load during infection and whether the CoLab-score can facilitate de-isolation. Methods: Nasal swabs and blood samples were collected from ICU-admitted SARS-CoV-2 positive patients at Maas-tricht UMC+ from March 25, 2020 to October 1, 2021. The Co...
Article
Background: Several initiatives have been developed to target low-value care (i.e. waste) in decision-making with varying success. As such, decision-making is a complex process and context’s influence on decisions concerning low-value care is limitedly explored. Hence, a more detailed understanding of residents’ decision-making is needed to reduce...
Article
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Euthanasia in psychiatric patients presents unique challenges, especially when combined with organ donation. In this article, the hurdles psychiatric patients might encounter after expressing their wish for organ donation after euthanasia, are discussed and illustrated by the case of Martijn, a 45-year-old psychiatric patient who altruistically don...
Article
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Background Recognition of poor performance in General Practice trainees is important because underperformance compromises patients’ health and safety. However, in General Practice, research on persistent underperformance while in training and its ultimate consequences is almost completely lacking. We aim to explore the unprofessional behaviours of...
Article
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Background In the Netherlands, 2 to 10% of the residents terminate training prematurely. Infrequently, termination of training is by dismissal. Incidentally, residents may disagree, dispute and challenge these decisions from the programme directors. Resident dismissal is always a difficult decision, most commonly made after, repeated assessments, a...
Article
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Background Assessing trainees is crucial for development of their competence, yet it remains a challenging endeavour. Identifying contributing and influencing factors affecting this process is imperative for improvement. Methods We surveyed residents, fellows, and intensivists working in an intensive care unit (ICU) at a large non-university hospi...
Article
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Purpose: Professional Identity Formation (PIF) is crucial for high-quality patient care and physician well-being. Few empirical studies examined PIF in residency from the perspective of supervisors. In GP residency, residents are supervised with an 'end in mind' that remains unexplored. To encourage supervisors to reflect on their teaching behavio...
Article
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In de medische vervolgopleidingen komen ­op­­leidingsgeschillen geregeld voor en worden ­ervaren als ingewikkeld en tijdrovend. Begrijpelijk, maar we kunnen van die geschillen ook leren en het opleidingsklimaat ermee verbeteren. Drie waargebeurde geschillen laten zien hoe. Het is cruciaal om conflicterende belangen laagdrempelig te bespreken, en we...
Article
Background: Patients use social media on a daily basis, and they can be restricted under the new Dutch Compulsory Mental Healthcare Act. Aim: To describe which social media behaviors of psychiatric patients were rightfully restricted by health care professionals and reveal underlying reasons. Method: We searched for law cases of the courts of...
Article
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Hoewel sociale media inmiddels bij het medialandschap horen, begon het gebruik ervan onder studenten. Welke rol sociale media in studentenzaken spelen is niet eerder systematisch onderzocht. Voor dit onderzoek doorzochten wij de jurisprudentiebundels van het College voor Beroep voor het Hoger onderwijs (CBHO) in Den Haag van 2000 tot en met 2022. W...
Article
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Background Extra-hepatic vitamin K-status, measured by dephosphorylated uncarboxylated matrix Gla protein (dp-ucMGP), maintains vascular health, with high levels reflecting poor vitamin K status. The occurrence of extra-hepatic vitamin K deficiency throughout the disease of COVID-19 and possible associations with pulmonary embolism (PE), and mortal...
Article
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Soms blijken aios en opleiding geen goede match. De ­procedure die dan volgt is langdurig en vol onzekerheden voor aios en opleider. Judith Godschalx e.a. stellen maat­regelen voor om deze periode voor beide partijen prettiger, korter en zinvoller te maken.
Article
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Background Organ donation after euthanasia (ODE) has been performed over 100 times in the Netherlands, primarily involving patients suffering from a neurodegenerative or psychiatric disease. In recent years, the number of euthanasia cases related to dementia has increased in the Netherlands, with some patients living with dementia expressing a wish...
Article
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Background The association between team performance and patient care was an immense boost for team-based education in health care. Behavioural skills are an important focus in these sessions, often provided via a mannikin-based immersive simulation experience in a (near) authentic setting. Observation of these skills by the facilitator(s) is paramo...
Article
BACKGROUND Stroke patients admitted to an intensive care unit (ICU) follow a particular survival pattern with a high short-term mortality, but if they survive the first 30 days, a relatively favourable subsequent survival is observed. OBJECTIVES The development and validation of two prognostic models predicting 30-day mortality for ICU patients wi...
Article
Objectives Peripheral venoarterial extracorporeal membrane oxygenation (ECMO) with femoral access is obtained through unilateral or bilateral groin cannulation. Whether one cannulation strategy is associated with a lower risk for limb ischemia remains unknown. We aim to assess if one strategy is preferable. Design A retrospective cohort study base...
Preprint
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Background The burn-out rates among residents urge for adequate interventions to improve resilience and prevent burnout. Peer reflection, also called group intervision sessions, is a potentially successful intervention to increase the resilience of young doctors. We aimed to gain insight into the perceived added value of intervision sessions and th...
Article
Statement Transborder curriculum partnerships in health professions education have been increasing in numbers in recent years. These partnerships present unique challenges when transferring curricula from one context to another. It has been noted that cultural differences between institutions, faculty, staff, and learners can have profound effects...
Presentation
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In contemporary postgraduate medical education (PGME) based on the CanMEDS framework, competency-based assessment is increasingly used. One of the CanMEDS competencies is professionalism, a concept that is not univocally defined and gauged. Based on the literature, Mak – Van der Vossen et al. (2017; 2020) constructed the 4I’s model (Involvement, In...
Chapter
This chapter describes a structured, evidence-based approach to professionalism remediation in four phases: ‘Identify and Evaluate’, ‘Explore and understand’, ‘Remediate’, and ‘Gather evidence for dismissal’. Illustrative cases provide guidelines for the frontline teachers who conduct essential tasks in the first two phases, such as explicitly and...
Article
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Objective: To investigate whether observable differences exist between patterns of withdrawal of life-sustaining measures (WLSM) for patients eligible for donation after circulatory death (DCD) in whom donation was attempted compared with those patients in whom no donation attempts were made. Setting: Adult intensive care units from 20 centres in C...
Preprint
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Background Trainees’ assessment is needed, yet challenging, to achieve competence development. To improve the assessment process, it is important to identify its contributing and influencing factors. Methods Intensive care unit (ICU)-residents, -fellows, and intensivists from a large non-university hospital were surveyed about the challenges in as...
Article
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Background The Netherlands introduced an opt-out donor system in 2020. While the default in (presumed) consent cases is donation, family involvement adds a crucial layer of influence when applying this default in clinical practice. We explored how clinicians discuss patients’ donor registrations of (presumed) consent in donor conversations in the f...
Article
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Inleiding: De arts in opleiding (AIOS) kan de Centrale Opleidingscommissie (COC) verzoeken om bemiddeling bij een geschil met de opleider. Indien onbemiddelbaar, kan de AIOS de geschillencommissie van de Registratiecommissie Geneeskundig Specialisten (RGS) verzoeken een uitspraak te doen. Wat leren we van deze uitspraken voor de opleidingspraktijk?...
Article
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Abstract Background Mistreatment is a behavior that reflects disrespect for the dignity of others. Mistreatment can be intentional or unintentional, and can interfere with the process of learning and perceived well-being. This study explored the prevalence and characteristics of mistreatment, mistreatment reporting, student-related factors, and con...
Article
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Samenvatting De Maastricht UMC+ Academie voor Patiënt en Mantelzorger is opgericht om patiënten en mantelzorgers optimaal te ondersteunen bij het zelf voeren van de regie over hun zorg en gezondheid. Een palet aan activiteiten biedt patiënten en mantelzorgers de mogelijkheid om in toenemende mate als volwaardig partner in het zorgteam te participer...
Article
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In deze bijdrage beschrijven we de transparantie van ziekenhuizen door de jaarverslagen van de Raad van Toezicht (RvT) van Universitaire Medisch Centra (UMCs) te vergelijken met perifere opleidingsziekenhuizen en Britse academische ziekenhuizen. We bevelen aan om de transparantie in Nederlandse RvT jaarverslagen te verbeteren wat betreft zelf-evalu...
Article
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Purpose: To ensure a value-based health care system, it is becoming increasingly important that residents are trained in making value-based decisions. This study explored the social network influencing residents' value-based decisions. Method: To explore the social network influencing residents' value-based decisions, the authors used a semistru...
Poster
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De centrale opleidingscommissies (COC) van de opleidingsziekenhuizen dienen een systeem te onderhouden voor melding en behandeling van geschillen tussen artsen en hun opleiders. Binnen 2 weken nadat een geschil onbemiddelbaar blijkt, kan de arts de landelijke Geschillencommissie van de Registratiecommissie Geneeskundige Specialisten (RGS) verzoeken...
Article
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Background The COVID-19 pandemic required science to provide answers rapidly to combat the outbreak. Hence, the reproducibility and quality of conducting research may have been threatened, particularly regarding privacy and data protection, in varying ways around the globe. The objective was to investigate aspects of reporting informed consent and...
Article
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Organ donation after euthanasia is performed in Belgium, the Netherlands, Canada and Spain. Directed deceased organ donation is currently possible under strict conditions in a limited number of countries, while it is currently not possible to opt for directed donation following euthanasia. While organ donation after euthanasia is a deceased donatio...
Article
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We would like to respond to the comment we received from our colleagues on our case report about organ donation after euthanasia starting at home. We reply to their statements on medical and legal aspects, and provide more information on our view of informed consent.
Article
Background: Transfusion guidelines regarding platelet-count thresholds before the placement of a central venous catheter (CVC) offer conflicting recommendations because of a lack of good-quality evidence. The routine use of ultrasound guidance has decreased CVC-related bleeding complications. Methods: In a multicenter, randomized, controlled, no...
Presentation
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De centrale opleidingscommissie (COC) dient een systeem te onderhouden voor melding en behandeling van geschillen tussen artsen en hun opleiders. We deden tussen januari en mei 2022 een uitvraag over hoe de COCs van UMCs hun bemiddelingsrol invulden in de periode van 2011 tot 2020 wat betreft doel, protocol, betrokkenen en aantal behandelde geschil...
Presentation
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Het herkennen van disfunctioneren onder artsen in opleiding (aios) tot huisarts is belangrijk vanwege de patiëntveiligheid. Helaas is er nauwelijks onderzoek gedaan naar disfunctionerende aios. Wij onderzochten de kenmerken van aios huisartsgeneeskunde die van het hoofd van de opleiding hun opleiding moesten beëindigen en daartegen procedeerden bij...
Article
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Bij geschillen tussen aiossen en opleiders organiseert de Centrale Opleidingscommissie (COC) bemiddeling. Maar hier valt het nodige op af te dingen. Om te beginnen melden aiossen maar weinig geschillen. Aiossen zijn bang dat meldingen bij de eigen opleider terechtkomen. De opleider zelf, is afhankelijk van de COC, door diens toezicht op de opleidin...
Article
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Introduction Limb ischemia is a severe complication of peripheral veno-arterial extracorporeal life support (V-A ECLS). Several techniques have been developed to prevent this, but it remains a major and frequent adverse event (incidence: 10–30%). In 2019, a new cannula with bidirectional flow (retrograde towards the heart and antegrade towards the...
Article
Background: The implementation of simulation-based training (SBT) to teach flexible bronchoscopy (FB) skills to novice trainees has increased during the last decade. However, it is unknown whether SBT is effective to teach FB to novices and which instructional features contribute to training effectiveness. Research question: How effective is FB...
Article
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Aim: Rhythmic and periodic patterns (RPPs) on the electroencephalogram (EEG) in comatose patients after cardiac arrest have been associated with high case fatality rates. A good neurological outcome according to the Cerebral Performance Categories (CPC) has been reported in up to 10% of cases. Data on cognitive, emotional, and quality of life outc...
Article
ArbeidsRecht 2023/21 Een werknemer kan een arbeidsovereenkomst hebben waaraan een opleidingsovereenkomst is gekoppeld in de vorm van een ontbindende voorwaarde. Als de opleiding niet wordt voltooid, kan daardoor de arbeidsovereenkomst van rechtswege eindigen. De koppeling tussen beide overeenkomsten verbindt via het goed werkgeverschap beginselen u...
Article
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Objectives During the COVID-19 pandemic, the staff in the intensive care unit (ICU) was materially, physically and emotionally challenged. This qualitative study investigated the effects that ICU staff experienced and were considered of value to be permanently implemented. Setting ICU in an university medical centre during the first wave of the CO...
Article
With the free movement of people within the European Union (EU), it occurs that EU citizens need healthcare in and different country, other than their country of origin. Identification of patients is important, and the EU is currently implementing a digital Patient Summary to provide physicians with essential information concerning an European pati...
Article
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Objective: Dutch psychiatry residents who are dismissed from their training program have the opportunity to appeal the decision. Those appeals are publicly available. This report explores the appeals of residents dismissed for unprofessional behavior. Methods: The authors analyzed caselaw of dismissed psychiatry residents brought before the conc...
Article
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Procedural aspects of compassionate care such as the terminal extubation are understudied. We used machine learning methods to determine factors associated with the decision to extubate the critically ill patient at the end of life, and whether the terminal extubation shortens the dying process. We performed a secondary data analysis of a large, pr...
Article
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In healthcare settings, compliance with clinical protocols and medical guidelines is important to ensure high-quality, safe and effective treatment of patients. How to measure compliance and how to represent compliance information in an interpretable and actionable way is still an open challenge. In this paper, we propose new metrics for compliance...
Article
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Euthanasia based on psychiatric suffering, followed by subsequent organ donation, is considered medically and legally permissible in the Netherlands. Although organ donation after euthanasia (ODE) in patients suffering from unbearable psychiatric illness is performed, it is not specifically addressed in the Dutch guideline on organ donation after e...
Article
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