Marlot Kuiper

279 Conclusion Secondly, medical education already is in transition. There are many efforts to improve students’ skills and competency, for instance through competency based frameworks that explicitly incorporate ‘teamplayer’ as professional role (Frank & Danoff, 2007). Next, there is attention for so called ‘Entrustable Professional Activities’ (ten Cate, 2005, 2013) that aim to contextualize professional training and focus on ‘activities’, thus professional work in context, rather than skills. Nonetheless, these competencies and activities are still trained within professional segments, and supervised and evaluated individually. Is this professional a team player? Can we entrust this individual to perform a certain (clinical) task? If we want to diminish notions of ‘us’ and ‘them’ and train professional teams with a shared responsibility for work processes, we should break through these borders already in education. For example, I could imagine that young surgeons are involved in multidisciplinary training modules in which they are trained together with anaesthesiologists, nurse anaesthetists and scrub nurses, and they also evaluate each other’s performance and discuss together what is ‘good practice’. Curricular development takes time, but it might be worthwhile to consider different ways of training and evaluation that do justice to the collaborative practices young professionals are expected to engage in. Recommendations for Supervisory boards (i.e. Inspectorates and accreditation organisations): Focus on the qualitative Start the conversation Another recommendation is one for health care inspectorates and accreditation organisations. I should be careful in this though, as their perspective is only little included in this study. Still, from a professionals’ perspective, there are a few things to say on accountability measures. During the fieldwork, I encountered one unannounced visit of the Health Care Inspectorate. Recommendations are thus based on a single observation, but supported by multiple perspectives of frontline professionals. Observations are difficult to conduct. As an observer, you should focus your observations to be able to see, but at the same time you should not be blinded by this. Quantitative observations are valuable; if people wear hats and caps does provide us with valuable information. Those quantitative measures are also the most easy ones, because you know what you want to see. My recommendation is that inspectors should focus more on qualitative observations. Concentrate field visits more 8