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How can postgraduate pharmacotherapy education be optimized?

Period: 2012-2019
Medication errors are a major international healthcare issue and lead to preventable harm to patients. Many interventions with different focus have been developed to improve the medication and prescribing process, but the effects of these interventions on actual patient harm are not established yet. Many researchers argue that education in prescribing is an important target for preventing medication errors. Prescribing habits begin to develop during clinical clerkships but are primarily formed during the first years after graduation and these habits are carried through a physician’s practice experience. However, junior doctors indicate that they don’t feel well prepared for their prescribing responsibilities and experience a deficit in training and feedback on their therapeutic reasoning process in the post graduate teaching situation. The aim of this thesis is to develop pharmacotherapy educational tools for the post graduate teaching of registrars internal medicine and general practice.

IMproving Adherence to Guidelines in Infectious diseases through Nudging and Education (IMAGINE)

Period: 2014-2018
All hospitals strive for sound antibiotic and infection prevention policies, but in the Netherlands adherence to hand hygiene guidelines is only 20% and inappropriate prescribing of antibiotics is frequent with 30-70% guideline deviation. In hospitals, mainly junior doctors fulfil the role of ward-physician. They are responsible for the majority of antibiotic prescriptions and play an essential role in preventing healthcare associated infections through adequate hand hygiene. These responsibilities are to be met in a stressful period of transition from student to physician, during which they perceive a lack of knowledge and skills, specifically in prescribing medication. Education at commencement of work, aimed at practicing guideline-based medicine in busy daily practice could facilitate this transition. As sound preparation alone is insufficient to change behaviour and guideline adherence detiorates with experience, measures to support the effect of such education are essential. One such method, not yet commonly applied in health care, is nudging: a friendly push to encourage desired behaviour. Combining preparatoy education and behavioural nudges seems perfectly suited to improve antibiotic prescribing and infection prevention among junior doctors.

Promoting pharmacovigilance in our future healtcare professionals

Period: 2016-2019
Millions of patients experience adverse drug reactions (ADRs) from the use of medicinal drugs. These symptoms can range from a mild headache to hospital admissions and even death. With the increasing use of drugs the number and influence of ADRs seem to be increasing. Pharmacovigilance, the monitoring of ADRs after marketing approval, is essential for identifying these previously undetected, uncommon, or serious ADRs and for improving understanding of drug risk profiles and medication safety. Despite this essential task our healthcare professionals are mostly unaware of the extent of the problem and essential competences to adequately monitor ADRs are lacking. In this thesis/PhD project we will research the educational value of interventions that promote pharmacovigilance in predominantly undergraduate medical education. We hypothesize that context based learning (CBL) in pharmacovigilance education can substantially increase intrinsic motivation on medication safety, enhance ADR-reporting and drug monitoring responsibilities and ultimately lead to safer use of medicinal drugs in our future healthcare professionals.
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