Faculty of Medical Sciences

Since the Faculty of Medical Sciences is a collaborative faculty between Radboud university medical center and Radboud University, Radboud university medical center devotes a great deal of attention to the quality of the study programmes the faculty offers. The efforts are focused in two directions: on the quality of the various study programmes as implemented and on the further development and innovation of the courses on offer and the scientific research that contributes to them. The study financing resources have made it possible to invest extra money in the quality of implementation, development and innovation.

In their 2019-2024 Quality Plan, Radboud university medical center chose to focus on three themes: increased and improved guidance of students (theme 2), appropriate educational facilities of good quality (theme 5) and continued professional development of lecturers (theme 6). No priority was given to the other themes – more intensive and smaller-scale education (theme 1), study success (theme 3) and educational differentiation (theme 4) – because these themes are already more than adequately provided for within the curricula (smaller-scale education and differentiation) or are not considered a problem at the faculty (study success).

The three chosen themes fit well with the policy priorities of Radboudumc Health Academy (RHA). RHA is the institute that steers, supports and co-implements the core task of education and training at Radboud university medical center. RHA promotes (space for) lifelong interprofessional learning by health professionals. The priorities of RHA were chosen in relation to external (social) developments and the strategy of Radboud university medical center. They are in line with RHA’s ‘quadruple aim’ (learners’ experiences, learning outcomes, a sustainable organisation and the well-being of study programme teams). In the study programmes, these priorities constitute input for the implementation and revision of the Quality Plan. Students in the study programmes are considered to be novice, learning health professionals. They receive a person-centred and innovative range of training, room to learn on the job and opportunities for interprofessional learning. They develop as people and professionals with a focus on their own health and well-being, and they take control of their own learning process.

The original expenditure plan of the 2019-2024 Quality Plan is shown in Table 35 . This includes the amounts after the acceleration of the allocation of the study financing resources by Radboud University’s Executive Board at the end of 2019. In addition to the study financing resources, Radboud university medical center also uses resources from the regular faculty education budget to implement the Quality Plan.

Table 35 Original expenditure plan for the quality agreements¹

Table 36 shows the realisation in recent years (2019-2021) together with the current budget for the coming years (2022-2024). Changes in the budget are due to adjustments and expansion of the plans, as further specified in section 2. After an initial underspend in 2019 because projects needed more time to get started, the realisation in 2020 and 2021 was generally in line with the budget. From 2022, the budget will increase due to an increase in study financing resources and additional use of own resources. This will make it possible to start several new projects, such as a programme for the use of Extended Reality (XR) as a learning tool and an additional focus on diversity and inclusiveness in education. The selection of these and other new projects was made in consultation with the various study programme committees and the UMC Council. The detailed budget for 2022 is attached for information purposes.

Table 36 Realisation in 2019, 2020 and 2021, and the current budgets for 2022, 2023 and 2024

The following overarching projects are being carried out within this theme (see Table 37). More was spent than originally budgeted on appointing coaches due to the expansion to several curricula. Less was spent than originally budgeted on the Well-being and Vitality project.

Table 37. Amounts budgeted¹ and realised in 2019–2021 for theme 2

During the development of updated curricula for Bachelor’s degree programmes in Medicine (GNK) and Biomedical Sciences (BMW) in 2015, Radboud university medical center made an effort to incorporate intensive and individual coaching for students as part of the Professionalism learning pathway. Radboud university medical center pre-funded this in anticipation of the granting of study financing resources. The purpose of this learning pathway is to guide students in reflection and professional development in order to shape a personal learning process, stimulate self-directed and lifelong learning, and prevent study stress. The use of these coaches places a large demand on the available resources of the Quality Plan. In 2021–2022, 130 coaches will be appointed for 178 coaching groups of 8-9 students (lecturer compensation for 190, 150 and 90 hours per coaching group in Bachelor’s programme year 1, 2 and 3, respectively). Many of these coaches have been working in that role for this learning pathway for several years; the professionalisation of coaches is addressed in theme 6 of the Quality Plan. The participational bodies (programme committees) are included in the further development of the coaching programme through the annual programme evaluations of the learning pathway.

As part of our communication to students and lecturers about the Quality Plan, three short films were included (see link) that give a good idea of the implementation and yield of the coaching within the learning pathway from the student and coach perspective.

Students’ and lecturers’ appreciation of this coaching and the learning pathway has grown over the years; adjustments to the learning objectives, organisation, curriculum and assessment have contributed to this. Many students and lecturers now consider the use of coaches to be extremely valuable. Radboud University has expressed the ambition to set up comparable educational programmes for all study programmes. Study financing resources are also used to employ and/or train coaches in the other study programmes at Radboud university medical center (Master’s programmes in Biomedical Sciences (BMS) and Molecular Mechanisms of Disease (MMD)). These coaches supervise students’ personal and professional development.

In 2022, the personal and professional development learning pathway will be expanded in the Dentistry study programme (THK), following the model of the Medicine and Biomedical Sciences study programmes and in conjunction with the review of the Bachelor’s degree programme. Quality Plan resources will be used for development, support and implementation (including the use of coaches). The expenditure for the deployment of coaches in the Quality Plan therefore shows an upward trend.

Alongside coaches, student advisors play a key role in student guidance. To ensure a clear division of tasks and better cooperation between coaches and student advisors, all student advisors have followed a personal development programme combined with peer consultation. This development programme was completed in early 2021. It has had positive effects on the personal leadership of student advisors and has created a mindset for improving processes in collaboration with colleagues so there is ultimately more space for students.

In consultation with the UMC Council, one of the points for improvement has been taken up as an extra project within the Quality Plan, namely the appointment of a junior student advisor. It is hoped that this will increase and accelerate access to student counselling and create more space for prevention. There was still space in the 2021 budget to achieve this. An evaluation of this position is planned for early 2022.

Another issue arising from the development programme for student advisors – the possibility to refer students to a professional coach for individual guidance – was made possible in 2021 as a pilot project with a limited scale (10–20 students). The students and student advisors who participated in this pilot had positive experiences. Before any extension or expansion is decided upon, the participational bodies will be asked for their advice and we will assess how this provision overlaps with the RU Student Guidance 2023 project and the possibilities offered by the RU student psychologist.

The budget via the Quality Plan for increased and improved guidance of students by student advisors has been used flexibly in recent years to achieve the best possible support. New insights are still being gained.

Until 2019, the activities of Radboud university medical center’s Career Service were mainly generic in nature, and it appeared that there was a need for a more focused, specific offering of career orientation and guidance for students in the Bachelor’s and Master’s programmes in Biomedical Sciences (BMW/BMS). Since a lecturer/researcher from the BMW/BMS study programme was appointed as a part-time Career Officer in 2020, extra attention has been paid to this need and specific personal career advice has been given more often. With the support of a student assistant, this Career Officer has also developed brochures and workshops in English; see the offerings here. As a result of these English resources and the extra capacity, students in the Master’s programme in Molecular Mechanisms of Disease (MMD) have also been able to use the Career Service since 2021.

The scope of the Career Officer’s appointment is limited, which also forces choices. The Career Service has developed a Brightspace course/toolbox about Career Orientation for Dutch students, and this will be translated into English. It is expected that this course will be available to all students at Radboud university medical center in early 2022. To maintain sufficient capacity and expertise for targeted career-oriented guidance of BMW, BMS and MMD students, the additional Career Officer will remain necessary in the coming years.

In the Well-being and Vitality project, training is developed, implemented and evaluated with the aim of increasing student well-being, preventing stress/burnout and promoting personal leadership. The goal of this training – an innovative programme focused on student well-being – is that students will later be able to work as healthy professionals and that the number of students who experience high levels of stress and drop out will be substantially lower.

Starting in 2019, this training was developed, adjusted and integrated into the Professionalism learning pathway for the curricula for the Bachelor’s degree programmes in Medicine (GNK) and Biomedical Sciences (BMW). In 2021, coaches received extra training on integrating topics related to well-being and vitality at appropriate points in the learning pathway. Various modules were also developed and implemented for the Dentistry study programme (THK) and the Master’s programme in Medicine (GNK). These addressed topics like resilience, personal leadership, perfectionism, fear of failure and careers. Especially during the first COVID-19 lockdown, extra training was developed to help students cope better with their studies and stress in that uncertain period.

Scientific researchers have also studied the language of well-being, behavioural changes due to education and the influence of COVID-19 on well-being. These findings are being developed into publications. It is not yet clear whether the goal of reducing student drop out due to stress has been achieved; this may be investigated at a later date. The effects of the COVID-19 pandemic make it difficult to identify specific effects of this training. Staff changes and other tasks mean that less time has been spent than originally budgeted for this project, which is reflected in underspending on it.

Several overarching projects are being pursued within this theme, the largest of which is the provision of campus licences for textbooks that support students in self-directed learning. The faculty is also investing heavily in digital education innovation as a blended learning tool for the future and an essential tool for online learning.

Table 38. Amounts budgeted¹ and realised in 2019–2021 for theme 5

¹Budgeted amounts in original expenditure plan, including acceleration and adjustments to the budgets for 2020 and 2021.

Good accessibility to up-to-date study materials is an essential condition for being able to manage one’s own study programme. Making study materials like e-books available also allows students to save on study costs. That is why, from the start of the Quality Plan, we have invested in campus licences for relevant textbooks available as e-books.

Every year, the educational management team for the Bachelor’s programmes in Medicine (GNK) and Biomedical Sciences (BMW) evaluates the need for changes to the e-books on offer. One concern is the fact that publishers have a monopoly, which can cause costs to increase annually. For example, publisher Elsevier’s change of policy meant that in 2021–2022 it was only possible to purchase a much larger range of e-books for a substantial additional fee (€74,000/year). The alternative – no access to Elsevier e-books – was not an option because they publish many core texts used in the study programmes. The extent to which the availability of digital textbooks actually contributes to self-direction has not been evaluated. For an overview of the current collection of e-books, see link.

5.2 E-learning modules

The faculty also invests in e-learning modules that offer students alternative learning paths and provide opportunities for self-direction. E-learning modules receive generally high scores on student evaluations. Several e-learning modules were produced or purchased in 2019 and 2020, covering topics like statistics, physiology and clinical reasoning. The 25 patient cases for clinical reasoning in the Medicine study programme were delayed because the COVID-19 pandemic meant that no recordings with (simulated) patients could be made for quite a while. Eventually, the backlog was cleared. Case studies will be updated and supplemented in 2021–2022, and their further embedding in the curriculum and within the RHA (working method, functional management) will be a central issue.

In 2021, there were fewer requests for the production of e-learning modules; possible causes include unfamiliarity with the ‘construction team’, the absence of an invitation to tender and a higher workload due to COVID-19 measures. However, various programme committees have reported a need for more digital knowledge clips, illustrations, e-learning modules and so on, especially support in making them. Therefore, in 2022, by means of a targeted request via the education management teams, more promotion and a voucher system, additional efforts will be made to update existing and create new e-learning modules. An extra amount (€60,000) has been budgeted for this in 2022 in the Quality Plan.

5.3 Digital education innovation projects

A plan for digital education innovation (DOI’t) was drawn up in 2019 and is being implemented in phases. In spring 2020, COVID-19 accelerated many DOI’t projects. The need to shift to online education with the use of digital resources led lecturers and RHA staff to take significant steps in using and supporting digital teaching materials. Many lecturers have started to use H5P, and the Radboud Edit toolkit has been filled in and adapted to RU/Radboud university medical center study programmes. This makes it easier for lecturers to find a suitable mode of instruction that includes stimulating digital resources.

In 2021, unlocking, enriching and reusing (open) online teaching materials (Repository) and exploring and developing tools for AR/VR (augmented reality/virtual reality) applications in education were addressed in DOI’t. The Repository project – including subprojects to implement a repository for digital teaching materials and a search portal, compile collections and metadata, professionalise lecturers and RHA employees, and implement workflows/processes at RHA/UL – has been delayed due to limited capacity in connection with vacancies at RHA and Information Management and reorganisation at the University Library. As a result, several subprojects will start later, and the Repository project will continue into 2022.

The investigation into the use of AR/VR in education is progressing at a faster pace. Several skills and communication courses are offered (partly) via AR/VR, such as using a burns application from the 3D lab or using a VR module to hold a ‘motivating conversation’. At the moment, efforts are being made to further develop an upscaling tool in the 3D lab with cases for various study programmes (e.g., root canals for Dentistry, burn wounds for Medicine). Education has also been fully digitised to replace an internship in the ICU. Various digital teaching materials have been developed for this: interactive H5P e-learning modules and 360-degree videos of the ICU, so that these images can be offered to students via VR. For an example, see the short film that was made about this.

In 2020, €57,000 extra was spent on DOI’t projects, partly due to the peak load of the first COVID-19 lockdown. In 2021, mainly due to vacancies, there was an underspend of €75,000 in the project. These vacancies were filled by the end of 2021, which limits the project delay.

New developments

Several new projects related to theme 5, appropriate facilities, will be launched in 2022. Based on perceived bottlenecks, RHA policy priorities and input from programme committees, the following new targets were chosen after consultation with the UMC Council. These expenditures will be financed through a combination of an increase in the study financing resources and the addition of extra own resources to the Quality Plan. The budget for this theme will increase from €512,000 in 2021 to €1,082,000 in 2022.

The goals of the programme will be achieved through four subprojects that will focus on learning questions distributed over the university study programmes in Medicine, Dentistry and Biomedical Sciences.

The quality of lecturers and coaches is essential for the training of ‘healthy professionals’. Lecturers help ensure that university education leads to person-centred care, that students learn to contribute to health care innovation and that they learn in and from practice. They also teach students to take control of their own study programme and prepare them for lifelong learning. Person-centred care requires interprofessional collaboration and thus interprofessional learning and interprofessional education. That is why Radboud university medical center has placed extra emphasis on providing appropriate training courses and various career initiatives: to further facilitate and encourage lecturers in their development, so they have the skills to train students in the Radboud university medical center subjects. Several overarching projects are being carried out within this theme (see Table 39).

Table 39. Amounts budgeted¹ and realised in 2019–2021 for theme 6

A group of senior lecturers was recruited in 2020 to coach lecturers who were working to obtain their UTQ or ETQ. That group was called the Guidance and Appraisal of Educational Qualifications group (BBOK group). The BBOK group tries to prevent lecturers from dropping out of the sometimes lengthy UTQ/ETQ processes and to create more clarity about the requirements of an educational qualification portfolio. Starting in September 2020, BBOK members also assess UTQ/ETQ portfolios. In 2021, additional guidance was offered to help lecturers who had not yet submitted their portfolios for appraisal (as scheduled) finish their portfolios. About 30 lecturers used this guidance and it appears to have been successful. On average, a new group of UTQ lecturers starts online about 10 times a year. The BBOK group is also involved in other activities, like improving the connection between the Nijmegen Curriculum course and the Starting Day for the UTQ trajectory and updating the ETQ trajectory.

To encourage lecturers to participate in professionalisation activities, a ‘menu’ of various activities has been developed and implemented (see link). Lecturers can participate in these courses free of charge because they are funded by the Quality Plan. After a tentative start in 2019, the addition of activities focused on online education made participation in these courses much higher during the first COVID-19 lockdown in 2020. Unfortunately, interest in these activities declined again in 2021, and there is a clear underutilisation of resources. Lecturers’ high workloads (partly due to COVID-19) seem to be a factor in this. Many lecturers who are following a UTQ trajectory are indeed using the offerings on the menu. However, the supply of workshops and the demands of lecturers do not always match. To improve this, the courses have been transferred to the Radboud university medical center online learning environment, where it is easier to align supply and demand.

It is not clear to what extent these courses contribute to lecturers’ skills in guiding students towards the Radboud university medical center profile. A targeted survey, a qualitative focus group interview or inspection of lecturers’ UTQ reflections might provide more insight.

The original plans for the Quality Agreements described the formation of an RHA core group for lecturer professionalisation who would create an integrated policy. This did not occur for various reasons, including the long-term absence of the former project manager, COVID-19 priorities and increasing understanding of the situation. No further steps were taken in this regard in 2019 or 2020. However, there were regular lecturer professionalisation courses on the menu, specific tracks for professionalisation of coaches, and guidance for lecturers working towards the UTQ or ETQ in 2019 and 2020. It should be noted that many courses were delayed in the spring and summer of 2020 because lecturers and support staff prioritised dealing with the consequences of the COVID-19 pandemic and/or because courses could not be taught in person.

Specific groups of lecturers whose training was financed by resources from the Quality Plan include coaches for the Bachelor’s curricula in Biomedical Sciences and Medicine. For this purpose, a pilot project was set up and carried out in 2019 – the pilot project for professionalisation of coaches – using dedicated intensive training combined with peer consultation. The training of the first 16 coaches with supervised individual study, group meetings and individual coaching was extremely successful. The evaluation showed that all the participants were enthusiastic, and their work as coaches really improved as a result of this training. Other coaches were also quite interested in following this training and since then, a second group of 16 coaches has finished it and a third group has begun. In addition, since 2021, all coaches of Bachelor’s curricula have participated in peer consultation meetings (once a quarter in fixed groups) with opportunities for guidance on request.

Another professionalisation programme, for lecturer-coaches in the Dentistry degree programmes, began in 2021. Commitment agreements are used to encourage lecturer-coaches (especially those in the Master’s phase) to start an active improvement process. Because this programme partially involves the Dentistry staff training days, lecturers in the Bachelor’s programme are also actively involved. There is still a challenging road ahead to change (decades of) existing behaviour.

For the mentors/coaches in the Master’s programmes in Biomedical Sciences and Molecular Mechanisms of Disease, a short, dedicated English-language workshop was developed to teach coaching skills to senior researchers involved in mentoring/coaching. The workshop focused on practising conversation techniques and sharing experiences. Again, the participants indicated that they found this workshop to be very useful. However, it is difficult to estimate what this will yield in practice for the individual student after this one-off implementation. But the participants’ reactions were so positive that an annual ‘refresher’ workshop will be offered to continue working on coaching skills with this group of mainly senior researchers. It will focus on specific subjects, such as intercultural cooperation.

In addition to the professionalisation of groups of lecturers, the quality plan for the RHA also pays extra attention to the professionalisation of lecturers in certain content areas. As already mentioned, interprofessional learning and training are extremely important to person-centred care. That is why a memorandum on securing and further promoting interprofessional learning and collaboration was drawn up within the framework of the Quality Plan. However, the further development of interprofessional education in the curricula has not been as successful as hoped. Other stakeholder priorities due to COVID-19, as well as logistical and organisational obstacles in course-based Bachelor’s education, play a role in this. With the revision of the Master’s programme in Medicine, it is expected that greater steps can be taken. However, interprofessional learning is clearly embedded in the revised curriculum for the Bachelor’s programme in Dentistry.

An ‘interprofessional learning expedition’ was fully planned and prepared for the departments at Radboud university medical center in April 2020. However, this research on interprofessional collaboration in hospital practice was delayed by the pandemic, and the expedition could only take place very recently. The data from it are now being processed and will result in feedback to the participating departments in early 2022. This feedback will be supplemented with recommendations for how the departments can further improve interprofessional collaboration.

Within theme 6.4, Professionalisation related to content areas, several new projects will be launched starting in 2021–2022. Based on perceived bottlenecks, RHA policy priorities and input from programme committees, the following new projects for 2022 onwards have been identified after consultation with the UMC Council.

In 2021, a project was also started to develop career paths for education and training. This will again give a strong boost to the policy on lecturer professionalisation. The quality of education and training depends primarily on the contributions of the professionals involved. This project aims to stimulate, support, recognise and reward academic and health care professionals as learning professionals in health (care) education who continue to combine their teaching and training duties with duties in health care and/or research. We connect to the ideas in the teaching framework (Graham), offer suitable development and learning paths, and – in collaboration with HR – design and implement suitable career paths with a focus on education and training.

Communication

An informative web page was set up to make it easier for students and lecturers to see what the Quality Plan entails and yields. Short videos about the use of coaches for the Bachelor’s study programmes in Medicine and Biomedical Sciences were also made and promoted via social media. The videos show the students’ and lecturers’ perspectives on coaching. Follow-up videos are planned about the use of digital educational innovation and other projects from the Quality Plan. See this link for the web page and videos.

A progress report is compiled twice a year to ensure accountability to the participational bodies. That report briefly describes the status of each project in the Quality Plan. The RHA management can use this to direct the plans, and the participational bodies can influence the spending of the study financing resources.

The faculty’s plans for the Quality Agreements 2019–2024 were drawn up in 2018 in partnership with the dean, the director of RHA, the Programme Directors from the university study programmes, the Faculty Student Council (FSR) and members of the UMC Council. The final plan was submitted to the UMC Council in October 2018, and they approved it on 25 October 2018. The UMC Council and FSR have been involved in the further development, evaluation and proposed changes to this plan. The UMC Council’s approval is required each year for the budget of the quality agreements.

A contingent from the UMC Council education group, together with lecturers and students from the UMC Council and FSR, is involved in monitoring the progress of plan formation and plan implementation. This contingent from the education group meets every six weeks to discuss and evaluate projects from the Quality Plan in depth with project managers, discuss (draft) progress reports, and collect input for preparing and updating the (draft) budget. The communication to students and lecturers about the Quality Plan and results achieved (website and social media videos) was also set up in consultation with this group.

The members of the Quality Agreements education group can provide feedback to the UMC Council as a whole and discuss any recommendations with them. In October 2021, the UMC Council indicated that it wished to discuss the progress of the quality agreements as a whole. This is in addition to the discussions via the education group and the agenda for the budget/progress report in the autumn. This will be addressed and further developed in 2022.

In 2021, all the faculty’s programme committees were asked to provide input for the Quality Plan budget. This provided valuable information that was discussed in the education group and incorporated into the budget preparations. This procedure will be continued in 2022.

In 2020 and 2021, there were also discussions with the contingent from the education group about the preferred manner of evaluating the projects from the Quality Plan. Every year, programme committees and education management teams evaluate various activities and projects (e.g., the use of coaches in the Professionalism learning path and the use of (new) e-learning modules) through the regular quality assurance process. Other projects are evaluated separately as part of the Quality Plan programme. An opportunity for evaluation is created by the concise progress report (twice a year, in September and February) and in-depth discussions about content with the education group. A separate report, policy recommendation or detailed project proposal is expected for a limited number of larger projects (e.g., the XR programme or exploratory studies including patient participation and diversity and inclusion). The purpose of this approach is to avoid bureaucracy and spending unnecessary time on additional, extensive written evaluations. By aligning with regular educational evaluations and possibly using targeted questions to obtain additional information on a limited number of subjects, the evaluators can see whether the desired objectives are being achieved. The balance between time investment and yield of evaluations remains a topic of discussion with the participational bodies.

Members of the contingent from the UMC Council education group reviewing quality agreements 2019–2021

Prof. Roland Laan (chair)

UMC Council lecturer members: Dr Anita Huis, Dr Michiel Schokking

UMC Council/FSR student members:

2019–2020: Nicole Waalders, Marike Lombaers, Niels van Beek 2020–2021: Lisa Houtman, Emma Kooistra, Nicole de Kort

2021–2022: Frederike Harthoorn, Mirèse Kleuskens, Emma Kooistra Dr Helma Pluk (coordinator; from March 2020)

* There is no record of discussions with the steering group in 2019.