Robbert Duvivier Robbert Duvivier Philip Driessen

Changing the face of clinical skills training while doing a double degree

Written by  Hanna Mclean Friday, 07 December 2012 14:05

At 28 years old, Robbert Duvivier has accomplished a huge amount for someone so young. In eight years he’s completed an MD in medicine and turned in his PhD dissertation on clinical skills training for medical students.

 

“I started with medicine as a regular six year student and later got involved with educational research. That spun out of hand and turned into my PhD,” explained Duvivier. “I’ll do my PhD defence on 12 December and get my formal medical degree. It’s special to have both on the same day.”

Getting started

Once the idea of studying medicine entered Duvivier’s mind in secondary school, he couldn’t let it go. “I enjoy working with people. I wanted to help others in need,” he said.

Following a visit to the medical school at Maastricht University, Duvivier knew he was going in the right direction. “The skills lab they offered fuelled my desire to go to medical school. It was impressive. I loved the hands-on approach. It wasn’t all about the books. You got to use real medical instruments, like a stethoscope, too,” he reflects. “Luckily I had good grades and got into the school of my choice, which was Maastricht.”

Passionate preacher

In his first year, Duvivier became a student representative at the Institute of Medical Education. During this time he became fascinated with the medical school’s inner workings. “I appreciated the educational philosophy at Maastricht University, which was the problem based learning system (PBL), and became a passionate preacher of PBL because it fit with the way I wanted to learn,” he explains.

Duvivier’s interest in education and his drive to make a difference led him to become a student assistant where he was introduced to educational science. “I helped run a study with Albert Scherpbier, the dean of the Faculty of Health, Medicine, and Life Sciences and professor Cees van der Vleuten, focusing on how to improve the efficiencies of staff development for clinical skills teachers,” Duvivier says. “Afterwards I continued my research and noticed a gap in the literature. I came back with not one proposal, but 5 individual studies. It was then that my supervisor, Jan van Dalen, suggested I do a PhD. It was daunting, but I said yes. The rest just fell into place.”

Cracks in the foundation

As a doctor, you must be able to examine a patient and find what’s wrong with them, therefore clinical skills are important. Duvivier noticed cracks in the way students are taught these skills. “The way we train students isn’t thoroughly researched, although we do know that it works. It has just developed over the years and there’s no scientific underpinning to it,” explains Duvivier. “With my PhD I zoomed in on different aspects of student behaviour and tried to distil what makes some students better at the end of the year and why. Turns out, if you train students first at the university before letting them loose on patients, they learn better and are more determined to make the most of the learning experience.”

In his research Duviver looked at what students can do to improve, at how teachers can help students learn better, and at what happens when students go into clinical rotations and start seeing patients. How do they adapt to the environment?

Feedback

“We often assume students learn when they start seeing patients, but that’s not the case,” says Duvivier. “Students need to be made aware of their deficiencies so they can work on those outside of regular training hours. The current teaching model also focuses too much on the skill and how to do it and we need to include possible diagnoses and discussions of pathology in that training.”

Duvivier also believes more formative feedback should be given to students, particularly in the hospital. “You don’t go into the hospital and learn how to be a doctor via osmosis. Students need more support than that,” he explains. “We need to be careful how we teach students clinical skills.”

What’s next?

Taking on an MD and PhD was taxing, but Duvivier has no regrets. “I probably pushed myself too hard in the end, but that’s past now,” he says. “I’m proud of the work. I didn’t cut any corners.”

For those wanting to follow in Duvivier’s footsteps, he has advice, “If you’re passionate about the topic, you’ll succeed. If you’re just doing a PhD to spice up your resume, find something else to do.”

Following his defence Duvivier will do a fellowship with the World Health Organisation where he’ll look at ways to train health professionals and see how to address the needs of Africa and South America while ensuring the quality of education provided. The rest is still unknown. “My passion is education. I can’t see what’s ahead, but I feel things are flowing in the right direction,” he says.

Robbert Duvivier (1984) (PhD) has an MD in medicine and a PhD on ‘Teaching and Learning Clinical Skills: Mastering the Art of Medicine’. He will complete his dissertation defence on 12 December 2012.

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