Workplace mentoring of residents in generic competencies by an independent coach.

INTRODUCTION: During postgraduate education in pulmonology, supervisors are responsible for training residents in generic competencies such as communication, professionalism and collaboration, but their focus commonly lies more on medical-technical competencies. As an alternative approach to supporting residents to develop generic skills, we developed a personal mentoring program with a non-medical professional as mentor. In this study, the residents' experiences with the mentoring program were evaluated. METHODS: After an introductory session in which individual learning goals were established, pulmonology residents received at least six, 60-90-minute, individual, mentoring sessions largely consisting of feedback after being observed during daily clinical activities, over a period of 9 months. The residents' experiences with mentoring were explored through in-depth interviews followed by a qualitative content analysis. RESULTS: From March to November 2016, ten residents in pulmonology completed the program. Despite initial scepticism, mentoring encouraged residents to reflect deeply on their professional interactions. This caused an increased awareness of the effects of their communication and behaviour on patients. Experimenting with communication and different behaviours in subsequent interactions felt rewarding and contributed to further development, resulting in increased self-confidence and job satisfaction. DISCUSSION: Mentoring residents by non-medical coaching was associated with improved residents' proficiency in generic competencies.

Attitudes and perceptions of Dutch veterinarians on their role in the reduction of antimicrobial use in farm animals.

Little is known about attitudes of veterinarians towards antibiotic use and reduction opportunities, and their interaction with farmers herein. Therefore, a questionnaire was developed and sent out to Dutch farm animal veterinarians. The response rate was 40%. Categorical Principal Component Analysis (CATPCA) was conducted on statements measuring attitudes towards the use of antibiotics and reduction opportunities in farm animals, the veterinary pharmacy and the interaction of veterinarians with farmers in improving animal health. This resulted in 3 underlying dimensions. Additionally, possible explanatory variables (main farm animal species working with, years of experience in practice) were added to the CATPCA to identify differences between veterinarians. Veterinarians working with different animal species were comparable in their opinions towards the necessity to reduce veterinary antibiotic use and the current policy to halve veterinary antibiotic consumption. Veterinarians working with ruminants - "ruminant specialists" - and veterinarians working with several different animal species - "generalists" - reported to feel more uncertainty in acting independently from farmers' and significant others' (other advisors, colleagues) demands for antibiotics or opinions than veterinarians mainly working with intensively raised animals (pigs, poultry, veal calves) - "intensive specialists". Years of experience in practice was negatively related to feelings of uncertainty in acting independently. At the other hand, years of experience was associated with being less concerned about the possible contribution of veterinary antibiotic use to antimicrobial resistance, considering it more important to keep the right to prescribe and sell antibiotics, and being less hesitant to apply antibiotics to prevent (further dissemination of) animal diseases. Intensive specialists expected most from improving feed quality and benchmarking of antibiotic prescribing and use in reducing veterinary antibiotic use; ruminant specialists and generalists preferred improving housing and climate conditions and benchmarking. The by veterinarians perceived main reasons for farmers not to comply to veterinary advices to improve animal health were related to financial and time restrictions, although intensive specialists stressed the importance of conflicting advices from other advisors as a cause for non-compliance. The results showed that younger veterinarians might require additional support to act independently from farmers' and significant others'. Additionally, experienced veterinarians could be educated about possible risks related to veterinary overuse of antibiotics. Alternative approaches should be identified for veterinarians to preserve a decent income without pharmacy incomes. Especially in intensive farming, ways should be found to prevent contradictory advices as a barrier not to implement veterinary advices to improve animal health.