Study context Clause Samples

Study context. The Dutch health care system is funded by a combination of tax contributions and a compulsory health insurance consisting of a per capita payment and fee-for-service. GPs are responsible for patients enlisted in their practice 24/7. On weekdays between 8:00 AM and 5:00 PM, primary medical health care is delivered by the GP practice. Outside office hours, care is outsourced to the local OOH GP centres. Here, GPs answer emergency calls, offer consultations and arrange home visits(48). The OOH GP cooperative in the present study (GP Services Rijnland) consists of three OOH GP care clinics. These clinics provide care for patients enlisted in GP practices in eight municipalities in both rural and (sub-)urban areas, adding up to 325,000 inhabitants. These three clinics provide 75,000 calls, consultations and home visits annually. If patients are dissatisfied with their care, they can lodge a complaint, either written, by email, telephone, a form on the website or face-to-face, in a robust complaint system managed by a complaints officer. In this retrospective observational study, a content analysis was performed of all unsolicited healthcare complaints lodged at the OOH GP centre between 2009 and 2019, and all related relevant correspondence. For the purpose of this study, a complaint letter was defined as a letter (or transcript of a telephone or face-to-face encounter) which addresses one or more type of wrong doing, offence, grievance or resentment arising from the offered OOH GP service. A complaint was defined as every separately distinguishable type of wrong doing, offence, grievance or resentment which could be distilled from a complaint letter. All complaint letters were retrieved from storage, anonymised and digitalised by the OOH GP complaints officer. Excel software was used to organise the data. Descriptive statistics were used for quantitative analysis of the codes and categories. We used the STROBE guidelines in the conduct and reporting of this study(49). The study was performed in three steps. The members of the research team were purposefully sampled to prevent blind spots in the analysis. All authors work as educational researchers and medical educators; four authors are clinicians, three are GPs. ▇▇▇▇▇▇ NKA ▇▇▇ ▇▇▇▇ is an intensivist, ▇▇▇▇▇ ▇▇▇ ▇▇▇▇▇▇ is a psychologist, and ▇▇▇▇ ▇▇▇▇▇▇▇▇ is a health scientist specialised in health behaviour.

Study context. Before enrolling in a Dutch specialist GP training program, most recently graduated doctors work for some years in their field of interest to gain additional experience as a practicing physician. GP resideny training is offered at one of the eight Dutch GP training institutes and consists of three years of workplace-based learning, combined with formal training activities in a university setting. In years one and three of the program, GP-trainees work in a general practice where they are coached and instructed by a supervising senior GP. GP clinical supervisors are offered faculty development programmes in supervising and assessing GP- trainees. These compulsory programmes, in which the trainers are GP faculty and behavioural science teachers, are held multiple times annually at the affiliated GP training institute. Year two of GP residency training consists of rotations in hospitals, nursing homes and psychiatric outpatient clinics with various supervisors. Trainees typically work four days a week in their training practice. On the fifth day, they participate in a so-called ‘day release program’ staffed by GP faculty and behavioural science teachers. On these days designed to facilitate and deepen learning from experiences in practice residents learn in small groups (10 to 15 residents) about case histories, protocols, skills and Entrustable Professional Activities (EPAs), with dedicated time for collaborative reflection. Residents’ progress towards standard performance is monitored using the proven reliable and valid Competency Assessment List (Compass), of which professionalism is an integral part(33). Each of the eight Dutch GP training institutes has one designated professionalism faculty member – either a GP or behavioural scientist - responsible for attending to lapses in professionalism and remediation of unprofessional behaviour.

Study context. This study is an explorative analysis of baseline data from an ongoing prospective cohort study aiming to assess the correlation between lower limb function and early post- traumatic osteoarthritis after ACLR.20 Participants were consecutively recruited from the department of orthope- dics, Skåne University Hospital. All patients who had un- dergone an ACLR during the time period January 2017- Feb- ruary 2019 were asked to participate via letter. Inclusion criteria were i) one year (10-16 months) after ACLR, with or without associated injuries to other knee structures, ii) age between 18-35 years. Exclusion criteria were i) previous se- rious injury or surgery to either knee, ii) other diseases or disorders affecting lower extremity function (e.g., hernia). The present study has received ethical approval from the Swedish Ethical Review Board (Dnr 2017/916). The partic- ipants received a letter with information of the study and gave their written consent before participating in the study. All participants were informed that they were allowed to cancel their participation in the study at any time. Baseline data for the prospective cohort study was collected between March 2018 and March 2020. One physiotherapist (AC) collected all data. Demographic data (age, height, weight, type of ACL graft) was collected prior to the testing. Before executing the tests, all participants performed a five-minute warm up on an ergometer bicycle. The HHD torque measures were performed first and then the IKD as- sessments for all participants, allowing for a rest period of at least five minutes in between. HAND-HELD DYNAMOMETER Isometric knee extension torque was measured with a HHD (Power Track II Commander Echo; JTECH Medical, Salt Lake City, Utah, USA) with the participants sitting on a treat- ment table with their knee in 90° flexion and their thighs fixated to the treatment table with a strap. Another strap was used around the leg of the treatment table and the HHD, which was placed on the anterior side of the partic- ipants’ distal tibia. The participants were asked to extend their knee with maximal effort. Isometric knee flexion torque was tested with the par- ticipants laying on their stomach on a treatment table with their knee in 90° flexion. The examiner was sitting on the end of the table with a strap around the pelvis and around the HHD placed on the posterior side of the participants’ distal tibia. The pelvis and the leg that was not being tested were fixated to t...