Activities Report 2022 / 2023
Public Health Rotterdam

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IMERR

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iMERR improves quality of healthcare through research in health professions education and supporting evidence-based innovations in education

 

Our research spans the spectrum of health professional education, ranging from the selection of candidates for bachelor programs to the training of healthcare professionals. We focus on two research areas:

‘Clinical Reasoning & Patient Safety’ making sure that future doctors learn to diagnose and manage patients’ problems in the right way. Our research ranges from theory building and fundamental research around the nature of clinical reasoning till the investigation of the magnitude of the problem of diagnostic errors and its origins and research on solutions to improve clinical reasoning in clinical practice and education.

´Selection & Assessment: Performance, Well-being and Diversity’. To contribute positively to inclusive selection and assessment practices and policies that foster the learning and development of a diverse pool of health professionals aligned with societal needs, iMERR examines factors and educational interventions influencing the performance, well-being, and diversity of students and the (future) health professional population.

A robust network of researchers and stakeholders from (inter)national universities and organizations around the world creates conditions to conduct many of our projects as joint studies in different countries. Our close ties with teachers and program directors empower us to apply our knowledge effectively, thereby enhancing health professions education.

For scientific output, please visit the iMERR website.

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Fostering Diversity in Healthcare Professionals: Selection Challenges and Solutions

A diverse healthcare workforce is crucial not only for issues of equity and fairness but also to enhance and equalize access to high-quality healthcare for the entire population. Concerns have arisen about the potential early-stage hindrance of diversity among health professionals during the selection of prospective students.

Our investigation into the impact of selection processes on student diversity in undergraduate health professions education revealed that traditional tools emphasizing cognitive abilities may disadvantage applicants with lower socioeconomic status, while CVs and curriculum-sampling tests may negatively affect ethnic minority applicants. The influence of these tools on diversity varies across programs, underscoring the significance of context. Additionally, differences in scores on individual tools do not always correlate with subgroup variations in the likelihood of selection. Thus, selection procedures can impede student diversity, contingent on the choice of tools and the context of their application.

We uncovered that applicants favour selection tools allowing a demonstration beyond cognitive abilities. Curriculum-sampling tests and interviews were most positively perceived, while lotteries and grades were least favoured. Disparities in selection outcomes were not mirrored in applicant perceptions, which were consistent across diverse subgroups. Despite this, applicants expressed concerns about equal opportunities. These studies offer insights for programs to decide on inclusive selection tools, justify negatively perceived tools to applicants, and adapt tools to better align with applicants' needs.

New NWO Vidi Project: Unraveling the best strategies for physician-computer collaboration in the diagnostic process.

A Vidi grant was awarded in 2023 to Dr. Laura Zwaan. This means the start of a new iMERR project, which will study the innovation of artificial intelligence (AI) in the diagnostic process.

‘The computer will see you now’, ‘Skin cancer now best diagnosed by algorithms’. These headlines suggest that physicians will soon be replaced by computers, but reality is that we are far from ready for broadly adopting AI-tools in clinical practice. There is a large gap between the technical innovations and the understanding of how they transform the diagnostic process.

As AI-tools and physicians make different types of mistake, the best performance is expected by collaboration between physicians and AI-tools, so-called augmented AI. Ongoing efforts focus on improving the tool quality, gaining trust from users and on generalizable implementation strategies that fit in many situations. From the cognitive psychology and diagnostic decision-making perspective, we propose that there is no one-size-fits-all solution and AI-tools have to be tailored to the expertise of the user and the disease prevalence.

The project will focus on skin cancer, a serious disease where technological advances are rapid and AI-tools can soon be implemented in general practice and dermatology. We will determine how different ways of implementing AI-tool (i.e. variations in AI-tool quality, outputs and levels of automation) affect the diagnostic reasoning process.

The project will run for the coming 5 years.

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Section: IMERR