The effectiveness of Collaborative Online International Learning (COIL) on intercultural competence development in higher education.

In this study we measured the effect of COIL on intercultural competence development using a quasi-experimental design. Our sample consisted of 108 undergraduate students from two universities, one located in the Netherlands (NL) and one in the United States (US). Students' self-reported intercultural competence was measured using a pre-post survey which included the Cultural Intelligence Scale (CQS) and Multicultural Personality Questionnaire (MPQ). Qualitative data were collected to complement our quantitative findings and to give a deeper insight into the student experience. The data showed a significantly bigger increase in intercultural competence for the US experimental group compared to the US control group, supporting our hypothesis that COIL develops intercultural competence. This difference was not observed for the NL students, possibly due to the NL control group being exposed to other international input during the course. Supplementary Information: The online version contains supplementary material available at 10.1186/s41239-022-00373-3.

Professionals' adaptive expertise and adaptive performance in educational and workplace settings: an overview of reviews.

Professionals will increasingly be confronted with new insights and changes. This raises questions as to what kind of expertise professionals need, and how development of this expertise can be influenced within the contexts of both education and work. The terms adaptive expertise and adaptive performance are well-known concepts in the domains of education and Human Resource Development respectively. The literature, however, lacks a conceptual overview. Our research seeks to provide an overview on how adaptive expertise and adaptive performance are conceptualized. In addition we looked for what individual, task and organizational characteristics relate to adaptive expertise. We mined information drawn from existing reviews in an overview of reviews. Nine reviews met the inclusion criteria. Adaptive performance is best referred to as the visible expression of an adaptive expert and this is triggered by 'change'. The scope of this 'change' lies somewhere between change that is 'new for the learner' and change that is 'new for everyone in the whole world'. The extent to and way in which a learner or professional is able to deal with this change depends on the maturity of the learner or professional. We found numerous individual, task and environmental characteristics related to adaptive expertise and adaptive performance. The nature and relation of these characteristics, and their specificity in relation to adaptive expertise and adaptive performance are visualized in a figure, but also provide several suggestions for future research.

Correction: Krause et al. Higher Order Thinking by Setting and Debriefing Tasks in Dutch Geography Lessons. Eur. J. Investig. Health Psychol. Educ. 2022, 12, 11-27.

In the original publication [...].

Test- or judgement-based school track recommendations: Equal opportunities for students with different socio-economic backgrounds?

BACKGROUND: There are concerns that school track recommendations that are mostly based on teachers' judgements of students' performance ('judgement-based recommendations') are more biased by students' SES than school track recommendations that are mostly based on standardized test results ('test-based recommendations'). A recent policy reform of the Dutch educational system has provided us the unique opportunity to compare the effects of students' SES on these two types of track recommendations. AIMS: The aim of this study was to examine the differences between test-based and judgement-based recommendations regarding the direct and indirect effect of students' SES at student level and school level. SAMPLE: The sample consisted of 8,639 grade 6 students from 105 Dutch primary schools. METHODS: Data were analysed using two-level multilevel mediation models. RESULTS: Track recommendations were higher for high-SES students. This was mostly due to differences in students' prior performance. SES also had a small, direct effect on judgement-based, but not on test-based recommendations. The effects were partly situated at school level. CONCLUSION: Overall, the results indicated that teachers based their track recommendations mostly on students' prior performance without being biased by students' SES.

Where the rubber meets the road - An integrative review of programmatic assessment in health care professions education.

INTRODUCTION: Programmatic assessment was introduced as an approach to design assessment programmes with the aim to simultaneously optimize the decision-making and learning function of assessment. An integrative review was conducted to review and synthesize results from studies investigating programmatic assessment in health care professions education in practice. METHODS: The authors systematically searched PubMed, Web of Science, and ERIC to identify studies published since 2005 that reported empirical data on programmatic assessment. Characteristics of the included studies were extracted and synthesized, using descriptive statistics and thematic analysis. RESULTS: Twenty-seven studies were included, which used quantitative methods (n = 10), qualitative methods (n = 12) or mixed methods (n = 5). Most studies were conducted in clinical settings (77.8%). Programmatic assessment was found to enable meaningful triangulation for robust decision-making and used as a catalyst for learning. However, several problems were identified, including overload in assessment information and the associated workload, counterproductive impact of using strict requirements and summative signals, lack of a shared understanding of the nature and purpose of programmatic assessment, and lack of supportive interpersonal relationships. Thematic analysis revealed that the success and challenges of programmatic assessment were best understood by the interplay between quantity and quality of assessment information, and the influence of social and personal aspects on assessment perceptions. CONCLUSION: Although some of the evidence may seem compelling to support the effectiveness of programmatic assessment in practice, tensions will emerge when simultaneously stimulating the development of competencies and assessing its result. The identified factors and inferred strategies provide guidance for navigating these tensions.

Clinician-Scientists in-and-between Research and Practice: How Social Identity Shapes Brokerage.

Clinician-scientists (CSs) are vital in connecting the worlds of research and practice. Yet, there is little empirical insight into how CSs perceive and act upon their in-and-between position between these socio-culturally distinct worlds. To better understand and support CSs' training and career development, this study aims to gain insight into CSs' social identity and brokerage. The authors conducted semi-structured, in-depth interviews with 17, purposively sampled, CSs to elicit information on their social identity and brokerage. The CSs differ in how they perceive their social identity. Some CSs described their social identity strongly as either a research or clinical identity (dominant research or clinical identity). Other CSs described combined research and clinical identities, which might sometimes be compartmentalised, intersected or merged (non-dominant-identity). In the types of brokerage that they employ, all CSs act as representatives. CSs with a non-dominant identity mostly act as liaison and show considerable variability in their repertoire, including representative and gatekeeper. CSs with a dominant identity have less diversity in their brokerage types. Those with a dominant research identity typically act as a gatekeeper. Combining lenses of social identity theory and brokerage types helps understand CSs who have a dual position in-and-between the worlds of clinical practice and research. Professional development programs should explicitly address CSs' professional identities and subsequent desired brokerage. Research and policy should aim to clarify and leverage the position of CSs in-and-between research and practice.

Between trust and control: Teachers' assessment conceptualisations within programmatic assessment.

OBJECTIVES: Programmatic assessment attempts to facilitate learning through individual assessments designed to be of low-stakes and used only for high-stake decisions when aggregated. In practice, low-stake assessments have yet to reach their potential as catalysts for learning. We explored how teachers conceptualise assessments within programmatic assessment and how they engage with learners in assessment relationships. METHODS: We used a constructivist grounded theory approach to explore teachers' assessment conceptualisations and assessment relationships in the context of programmatic assessment. We conducted 23 semi-structured interviews at two different graduate-entry medical training programmes following a purposeful sampling approach. Data collection and analysis were conducted iteratively until we reached theoretical sufficiency. We identified themes using a process of constant comparison. RESULTS: Results showed that teachers conceptualise low-stake assessments in three different ways: to stimulate and facilitate learning; to prepare learners for the next step, and to use as feedback to gauge the teacher's own effectiveness. Teachers intended to engage in and preserve safe, yet professional and productive working relationships with learners to enable assessment for learning when securing high-quality performance and achievement of standards. When teachers' assessment conceptualisations were more focused on accounting conceptions, this risked creating tension in the teacher-learner assessment relationship. Teachers struggled between taking control and allowing learners' independence. CONCLUSIONS: Teachers believe programmatic assessment can have a positive impact on both teaching and student learning. However, teachers' conceptualisations of low-stake assessments are not focused solely on learning and also involve stakes for teachers. Sampling across different assessments and the introduction of progress committees were identified as important design features to support teachers and preserve the benefits of prolonged engagement in assessment relationships. These insights contribute to the design of effective implementations of programmatic assessment within the medical education context.

Understanding the influence of teacher-learner relationships on learners' assessment perception.

Low-stakes assessments are theorised to stimulate and support self-regulated learning. They are feedback-, not decision-oriented, and should hold little consequences to a learner based on their performance. The use of low-stakes assessment as a learning opportunity requires an environment in which continuous improvement is encouraged. This may be hindered by learners' perceptions of assessment as high-stakes. Teachers play a key role in learners' assessment perceptions. By investigating assessment perceptions through an interpersonal theory-based perspective of teacher-learner relationships, we aim to better understand the mechanisms explaining the relationship between assessment and learning within medical education. First, twenty-six purposefully selected learners, ranging from undergraduates to postgraduates in five different settings of programmatic assessment, were interviewed about their assessment task perception. Next, we conducted a focussed analysis using sensitising concepts from interpersonal theory to elucidate the influence of the teacher-learner relationship on learners' assessment perceptions. The study showed a strong relation between learners' perceptions of the teacher-learner relationship and their assessment task perception. Two important sources for the perception of teachers' agency emerged from the data: positional agency and expert agency. Together with teacher's communion level, both types of teachers' agency are important for understanding learners' assessment perceptions. High levels of teacher communion had a positive impact on the perception of assessment for learning, in particular in relations in which teachers' agency was less dominantly exercised. When teachers exercised these sources of agency dominantly, learners felt inferior to their teachers, which could hinder the learning opportunity. To utilise the learning potential of low-stakes assessment, teachers are required to stimulate learner agency in safe and trusting assessment relationships, while carefully considering the influence of their own agency on learners' assessment perceptions. Interpersonal theory offers a useful lens for understanding assessment relationships. The Interpersonal Circumplex provides opportunities for faculty development that help teachers develop positive and productive relationships with learners in which the potential of low-stakes assessments for self-regulated learning is realised.

Stakes in the eye of the beholder: an international study of learners' perceptions within programmatic assessment.

OBJECTIVES: Within programmatic assessment, the ambition is to simultaneously optimise the feedback and the decision-making function of assessment. In this approach, individual assessments are intended to be low stakes. In practice, however, learners often perceive assessments designed to be low stakes as high stakes. In this study, we explored how learners perceive assessment stakes within programmatic assessment and which factors influence these perceptions. METHODS: Twenty-six learners were interviewed from three different countries and five different programmes, ranging from undergraduate to postgraduate medical education. The interviews explored learners' experience with and perception of assessment stakes. An open and qualitative approach to data gathering and analyses inspired by the constructivist grounded theory approach was used to analyse the data and reveal underlying mechanisms influencing learners' perceptions. RESULTS: Learners' sense of control emerged from the analysis as key for understanding learners' perception of assessment stakes. Several design factors of the assessment programme provided or hindered learners' opportunities to exercise control over the assessment experience, mainly the opportunities to influence assessment outcomes, to collect evidence and to improve. Teacher-learner relationships that were characterised by learners' autonomy and in which learners feel safe were important for learners' believed ability to exercise control and to use assessment to support their learning. CONCLUSIONS: Knowledge of the factors that influence the perception of assessment stakes can help design effective assessment programmes in which assessment supports learning. Learners' opportunities for agency, a supportive programme structure and the role of the teacher are particularly powerful mechanisms to stimulate the learning value of programmatic assessment.

Professional identity in clinician-scientists: brokers between care and science.

CONTEXT: Despite increasing numbers of publications, science often fails to significantly improve patient care. Clinician-scientists, professionals who combine care and research activities, play an important role in helping to solve this problem. However, despite the ascribed advantages of connecting scientific knowledge and inquiry with health care, clinician-scientists are scarce, especially amongst non-physicians. The education of clinician-scientists can be complex because they must form professional identities at the intersection of care and research. The successful education of clinician-scientists requires insight into how these professionals view their professional identity and how they combine distinct practices. OBJECTIVES: This study sought to investigate how recently trained nurse- and physiotherapist-scientists perceive their professional identities and experience the crossing of boundaries between care and research. METHODS: Semi-structured interviews were conducted with 14 nurse- and physiotherapist-scientists at 1 year after they had completed MSc research training. Interviews were thematically analysed using insights from the theoretical frameworks of dialogical self theory and boundary crossing. RESULTS: After research training, the initial professional identity, of clinician, remained important for novice clinician-scientists, whereas the scientist identity was experienced as additional and complementary. A meta-identity as broker, referred to as a 'bridge builder', seemed to mediate competing demands or tensions between the two positions. Obtaining and maintaining a dual work position were experienced as logistically demanding; nevertheless, it was considered beneficial for crossing the boundaries between care and research because it led to reflection on the health profession, knowledge integration, inquiry and innovation in care, improved data collection, and research with a focus on clinical applicability. CONCLUSIONS: Novice clinician-scientists experience dual professional identities as care providers and scientists. The meta-position of being a broker who connects care and research is seen as core to the unique clinician-scientist identity. To develop this role, identity formation and boundary-crossing competencies merit explicit attention within clinician-scientist programmes.

Students generate items for an online formative assessment: Is it motivating?

BACKGROUND: A reported problem with e-learning is sustaining students' motivation. We propose a framework explaining to what extent an e-learning task is motivating. This framework includes students' perceived Value of the task, Competence in executing the task, Autonomy over how to carry out the task, and Relatedness. METHODS: To test this framework, students generated items in an online environment and answered questions developed by their fellow students. Motivation was measured by analyzing engagement with the task, with an open-ended questionnaire about engagement, and with the motivated strategies for learning questionnaire (MSLQ). RESULTS: Students developed 59 questions and answered 1776 times on the questions. Differences between students who did or did not engage in the task are explained by the degree of self-regulation, time management, and effort regulation students report. There was a significant relationship between student engagement and achievement after controlling for previous academic achievement. CONCLUSIONS: This study proposes a way of explaining the motivational value of an e-learning task by looking at students' perceived competence, autonomy, value of the task, and relatedness. Student-generated items are considered of high task value, and help to perceive relatedness between students. With the right instruction, students feel competent to engage in the task.

The articulation of integration of clinical and basic sciences in concept maps: differences between experienced and resident groups.

To determine the content of integrated curricula, clinical concepts and the underlying basic science concepts need to be made explicit. Preconstructed concept maps are recommended for this purpose. They are mainly constructed by experts. However, concept maps constructed by residents are hypothesized to be less complex, to reveal more tacit basic science concepts and these basic science concepts are expected to be used for the organization of the maps. These hypotheses are derived from studies about knowledge development of individuals. However, integrated curricula require a high degree of cooperation between clinicians and basic scientists. This study examined whether there are consistent variations regarding the articulation of integration when groups of experienced clinicians and basic scientists and groups of residents and basic scientists-in-training construct concept maps. Seven groups of three clinicians and basic scientists on experienced level and seven such groups on resident level constructed concept maps illuminating clinical problems. They were guided by instructions that focused them on articulation of integration. The concept maps were analysed by features that described integration. Descriptive statistics showed consistent variations between the two expertise levels. The concept maps of the resident groups exceeded those of the experienced groups in articulated integration. First, they used significantly more links between clinical and basic science concepts. Second, these links connected basic science concepts with a greater variety of clinical concepts than the experienced groups. Third, although residents did not use significantly more basic science concepts, they used them significantly more frequent to organize the clinical concepts. The conclusion was drawn that not all hypotheses could be confirmed and that the resident concept maps were more elaborate than expected. This article discusses the implications for the role that residents and basic scientists-in-training might play in the construction of preconstructed concept maps and the development of integrated curricula.

Integration of clinical and basic sciences in concept maps: a mixed-method study on teacher learning.

BACKGROUND: The explication of relations between clinical and basic sciences can help vertical integration in medical curricula. Concept mapping might be a useful technique for this explication. Little is known about teachers' ability regarding the articulation of integration. We examined therefore which factors affect the learning of groups of clinicians and basic scientists on different expertise levels who learn to articulate the integration of clinical and basic sciences in concept maps. METHODS: After a pilot for fine-tuning group size and instructions, seven groups of expert clinicians and basic scientists and seven groups of residents with a similar disciplinary composition constructed concept maps about a clinical problem that fit their specializations. Draft and final concepts maps were compared on elaborateness and articulated integration by means of t-tests. Participants completed a questionnaire on motivation and their evaluation of the instructions. ANOVA's were run to compare experts' and residents' views. Data from video tapes and notes were qualitatively analyzed. Finally, the three data sources were interpreted in coherence by using Pearson's correlations and qualitative interpretation. RESULTS: Residents outshone experts as regards learning to articulate integration as comparison of the draft and final versions showed. Experts were more motivated and positive about the concept mapping procedure and instructions, but this did not correlate with the extent of integration fond in the concept maps. The groups differed as to communication: residents interacted from the start (asking each other for clarification), whereas overall experts only started interaction when they had to make joint decisions. CONCLUSIONS: Our results suggest that articulation of integration can be learned, but this learning is not related to participants' motivation or their views on the instructions. Decision making and interaction, however, do relate to the articulation of integration and this suggests that teacher learning programs for designing integrated educational programmes should incorporate co-construction tasks. Expertise level turned out to be decisive for both the level of articulation of integration, the ability to improve the articulated integration and the cooperation pattern.

How pre-service teachers' personality traits, self-efficacy, and discipline strategies contribute to the teacher-student relationship.

BACKGROUND: Although the teacher-student relationship is a well-documented phenomenon, few attempts have been made to identify its predictors. Research has mainly focused on in-service teachers, less is known about characteristics of pre-service teachers in relation to the teacher-student relationship. AIMS: The purpose of this study was to identify the predictors of pre-service secondary teachers' relationships with their students. It was hypothesized that friendliness and extraversion, self-efficacy in classroom management and in student engagement, and various discipline strategies would contribute to the teacher-student relationship in terms of influence and affiliation. SAMPLE: A total of 120 pre-service teachers in teacher education programmes participated. METHOD: Data on pre-service teachers' background (e.g., gender and age), personality traits, and self-efficacy were gathered with teacher questionnaires; data on teachers' discipline strategies and the teacher-student relationship with student questionnaires. RESULTS: The two personality traits and self-efficacy appeared not to be related to the teacher-student relationship in terms of affiliation or influence. However, significant relationships were found between the different discipline strategies and the teacher-student relationship in terms of influence and affiliation. There were differential effects for gender on the relationship between discipline strategies on the one hand and influence and affiliation on the other. CONCLUSION: This study provides relevant new insights into the research fields of classroom management and interpersonal relationships in education. It contributes to our understanding of discipline strategies by fine tuning an existing instrument and revealing interesting connections with the teacher-student relationship. Specific gender effects on this connection are discussed, as are implications for practice.

The use of programmatic assessment in the clinical workplace: a Maastricht case report.

The differences of learning experiences in the workplace put challenges on the assessment: the assessment programme should be aligned with the general competency framework of the curriculum and also fit to the differences in learning contexts of the workplace. We used van der Vleuten's programmatic assessment model to develop a workplace-based assessment programme for final year clerkships. We aimed to design a programme that stimulates learning, supports assessment decision, is feasible and non-bureaucratic. The first experiences with the programme show that students think that the programme has high learning value and the assessment is sufficiently robust. Many of the commonly reported weaknesses of work-based assessment (not a good fit with the educational context, too complex, too bureaucratic and too much work) were not mentioned by the students.

The differential effect of the teacher-student interpersonal relationship on student outcomes for students with different ethnic backgrounds.

BACKGROUND: The differential effectiveness of schools and teachers receives a growing interest, but few studies focused on the relevance of student ethnicity for this effectiveness and only a small number of these studies investigated teaching in terms of the teacher-student interpersonal relationship. Furthermore, the methodology employed often restricted researchers to investigating direct effects between variables across large samples of students. AIMS: This study uses causal modelling to investigate associations between student background characteristics, students' perceptions of the teacher-student interpersonal relationship, and student outcomes, across and within several population subgroups in Dutch secondary multi-ethnic classes. METHODS AND SAMPLE: Multi-group structural equation modelling was used to investigate causal paths between variables in four ethnic groups: Dutch (N=387), Turkish first- and second-generation immigrant students (N=267), Moroccan first and second generation (N=364), and Surinamese second-generation students (N=101). RESULTS: Different structural paths were necessary to explain associations between variables in the different (sub) groups. Different amounts of variance in student attitudes could be explained by these variables. CONCLUSIONS: The teacher-student interpersonal relationship is more important for students with a non-Dutch background than for students with a Dutch background. Results suggest that the teacher-student relationship is more important for second generation than for first-generation immigrant students. Multi-group causal model analyses can provide a better, more differentiated picture of the associations between student background variables, teacher behaviour, and student outcomes than do more traditional types of analyses.

Portfolios for assessment and learning: AMEE Guide no. 45.

In 1990, Miller wrote that no tools were available for assessment of what a learner does when functioning independently at the clinical workplace (Miller 1990 ). Since then portfolios have filled this gap and found their way into medical education, not only as tools for assessment of performance in the workplace, but also as tools to stimulate learning from experience. We give an overview of the content and structure of various types of portfolios, describe the potential of electronic portfolios, present techniques and strategies for using portfolios as tools for stimulating learning and for assessment, and discuss factors that influence the success of the introduction. We conclude that portfolios have a lot of potential but that their introduction also often leads to disappointment, because they require a new perspective on education from mentors and learners and a significant investment of time and energy.

Web- or paper-based portfolios: is there a difference?

OBJECTIVE: To determine the differential effects of a paper-based versus a web-based portfolio in terms of portfolio quality, user-friendliness and student motivation. METHODS: An experimental design was used to compare Year 1 medical students' reflective portfolios. The portfolios differed in presentation medium only (i.e. web-based versus paper-based). Content analysis, a student questionnaire and mentor interviews were used to evaluate portfolio quality, user-friendliness and student motivation. A total of 92 portfolios were scored independently by 2 raters using a portfolio quality-rating instrument. RESULTS: Portfolio structure, quality of reflection and quality of evidence showed no significant effects of presentation medium. Multi-level analysis showed a significant effect for student motivation: web-based portfolios scored 0.39 more than paper-based portfolios (P < 0.05; effect size 0.76). The mentors reported no differences in portfolio quality, except that there were more visuals in web-based portfolios. Students spent significantly more time preparing the web-based than the paper-based portfolios (15.4 hours versus 12.2 hours; t = 2.1, P < 0.05; effect size 0.46). The 2 student groups did not differ significantly in terms of their satisfaction with the portfolio. The mentors perceived the web-based portfolios as more user-friendly. CONCLUSIONS: The web-based portfolios were found to enhance students' motivation, were more user-friendly for mentors, and delivered the same content quality compared with paper-based portfolios. This suggests that web-based presentation may promote acceptance of portfolios by students and teachers alike.