Gersten Jonker

50   Chapter 3 TABLE 1: Key features of the Utrecht Acute Care Transitional Year (ACTY) Key features of the ACTY Thematic rather than narrowly specialty-focused Three clinical electives and one research elective, limited to anesthesiology, cardiology, emergency medicine, intensive care medicine, and respiratory medicine Three transdisciplinary Entrustable Professional Activities related to acute care EPA 1: Recognition and initial treatment of vitally threatened patients EPA 2: Evaluation and initial treatment of respiratory compromised patients EPA 3: Evaluation and initial treatment of circulatory compromised patients Performance target: (near) independent supervision Workplace assessments linked to EPAs Tailored observation forms in conjunction with existing general observation forms Pre-test and post-test of knowledge, know-how, skills, and (simulated) clinical performance Written exam, case-based discussions, OSCEs and simulated management of critically ill patients Monthly teaching sessions Interactive small group teaching, peer supervision, integration & deepening of knowledge Senior residents acting as mentors Longitudinal developmental support, buddy METHODS Study design To investigate the experiences with the ACTY an explorative qualitative study of perceptions from students, graduates and faculty was conducted. The study was conducted within the interpretivist research paradigm that considers social reality to be formed by subjective human experiences and social contexts [18, 19]. We took an appreciative inquiry (AI) methodological approach. AI identifies strengths and possibilities for change to unlock future potential, instead of diagnosing deficits in the process of interest [20]. The Ethical Review Board of the Dutch Association for Medical Education (NVMO) granted ethical approval for this study (NERB file 823). Setting Every six weeks, two to six students enroll in this year-long program on a rotational basis. Students take three clinical rotations and a research elective in UMC Utrecht and affiliated regional teaching hospitals. At any time, 15 to 25 students are taking part in the ACTY simultaneously. Departments also host other final year medical students not taking the ACTY.