An exploration of governance in teaching hospitals in the Netherlands focused on educational objectives

Abstract Background Many countries are improving medical education in teaching hospitals through more focus on internal quality assurance, for example by creating new stakeholders like hospital-wide education committees. Adequate oversight is thought essential to ensure the quality of medical educat...

Full description

Saved in:
Bibliographic Details
Main Authors: L. M. van der Baaren, R. E. Gifford, N. A. van der Baan, M. N. Sosef, J. H. Blaauw, R. J. Bennink, I. C. Heyligers
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Medical Education
Subjects:
Online Access:https://doi.org/10.1186/s12909-025-06680-3
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832594637647249408
author L. M. van der Baaren
R. E. Gifford
N. A. van der Baan
M. N. Sosef
J. H. Blaauw
R. J. Bennink
I. C. Heyligers
author_facet L. M. van der Baaren
R. E. Gifford
N. A. van der Baan
M. N. Sosef
J. H. Blaauw
R. J. Bennink
I. C. Heyligers
author_sort L. M. van der Baaren
collection DOAJ
description Abstract Background Many countries are improving medical education in teaching hospitals through more focus on internal quality assurance, for example by creating new stakeholders like hospital-wide education committees. Adequate oversight is thought essential to ensure the quality of medical education. How teaching hospitals distribute roles and responsibilities for quality control across educational stakeholders to organize this oversight is rarely investigated. This study aims to answer the following exploratory question: Who are the primary stakeholders involved in educational governance, and what are their roles in safeguarding educational quality in teaching hospitals? Methods We conducted an exploratory qualitative study of educational governance structures in all teaching hospitals in the Netherlands with at least three training programs. We carried out document analysis of recent governance codes, documents drafted by Dutch teaching hospitals to describe their methods of internal governance for the national accreditor, and analyzed the data using a thematic analysis approach through the lens of organizational theories of Mintzberg and Freidson. Results The study identified key stakeholders in quality management of medical education in all teaching hospitals of the Netherlands. An overview of their roles and responsibilities is given and a stakeholder map is drafted. Teaching hospitals gave the hospital-wide education committee three different roles: an advisory role, a quality controller role and a conflict mediation role. Discussion Hospitals have set up the assignment of decision-making power in different ways, creating different variants of hospital-wide education committees and potentially causing them to be less effective at quality management. Whether these different roles affect the quality management of medical education in practice requires practice-oriented research. The study reveals remarkable ambiguity regarding the assignment and exercise of decision-making power between actors. This study contributes to the literature by identifying key actors and their roles in the quality management of postgraduate medical education, providing a foundation for follow-up research.
format Article
id doaj-art-9d152eb1fa0b455398d60f5275230fa6
institution Kabale University
issn 1472-6920
language English
publishDate 2025-01-01
publisher BMC
record_format Article
series BMC Medical Education
spelling doaj-art-9d152eb1fa0b455398d60f5275230fa62025-01-19T12:27:48ZengBMCBMC Medical Education1472-69202025-01-0125111010.1186/s12909-025-06680-3An exploration of governance in teaching hospitals in the Netherlands focused on educational objectivesL. M. van der Baaren0R. E. Gifford1N. A. van der Baan2M. N. Sosef3J. H. Blaauw4R. J. Bennink5I. C. Heyligers6Health Services Research, School CAPHRI, Fac. Health, Medicine and Life Sciences, Maastricht UniversityHealth Services Research, School CAPHRI, Fac. Health, Medicine and Life Sciences, Maastricht UniversitySHE School of Health Professions Education, Fac. Health, Medicine and Life Sciences, Maastricht UniversityDepartment of SurgeryRoyal Dutch Medical Association (KNMG)Department of Radiology and Nuclear Medicine, Amsterdam University Medical CenterSHE School of Health Professions Education, Fac. Health, Medicine and Life Sciences, Maastricht UniversityAbstract Background Many countries are improving medical education in teaching hospitals through more focus on internal quality assurance, for example by creating new stakeholders like hospital-wide education committees. Adequate oversight is thought essential to ensure the quality of medical education. How teaching hospitals distribute roles and responsibilities for quality control across educational stakeholders to organize this oversight is rarely investigated. This study aims to answer the following exploratory question: Who are the primary stakeholders involved in educational governance, and what are their roles in safeguarding educational quality in teaching hospitals? Methods We conducted an exploratory qualitative study of educational governance structures in all teaching hospitals in the Netherlands with at least three training programs. We carried out document analysis of recent governance codes, documents drafted by Dutch teaching hospitals to describe their methods of internal governance for the national accreditor, and analyzed the data using a thematic analysis approach through the lens of organizational theories of Mintzberg and Freidson. Results The study identified key stakeholders in quality management of medical education in all teaching hospitals of the Netherlands. An overview of their roles and responsibilities is given and a stakeholder map is drafted. Teaching hospitals gave the hospital-wide education committee three different roles: an advisory role, a quality controller role and a conflict mediation role. Discussion Hospitals have set up the assignment of decision-making power in different ways, creating different variants of hospital-wide education committees and potentially causing them to be less effective at quality management. Whether these different roles affect the quality management of medical education in practice requires practice-oriented research. The study reveals remarkable ambiguity regarding the assignment and exercise of decision-making power between actors. This study contributes to the literature by identifying key actors and their roles in the quality management of postgraduate medical education, providing a foundation for follow-up research.https://doi.org/10.1186/s12909-025-06680-3Postgraduate medical educationTeaching hospitalsGovernanceQuality managementStakeholders
spellingShingle L. M. van der Baaren
R. E. Gifford
N. A. van der Baan
M. N. Sosef
J. H. Blaauw
R. J. Bennink
I. C. Heyligers
An exploration of governance in teaching hospitals in the Netherlands focused on educational objectives
BMC Medical Education
Postgraduate medical education
Teaching hospitals
Governance
Quality management
Stakeholders
title An exploration of governance in teaching hospitals in the Netherlands focused on educational objectives
title_full An exploration of governance in teaching hospitals in the Netherlands focused on educational objectives
title_fullStr An exploration of governance in teaching hospitals in the Netherlands focused on educational objectives
title_full_unstemmed An exploration of governance in teaching hospitals in the Netherlands focused on educational objectives
title_short An exploration of governance in teaching hospitals in the Netherlands focused on educational objectives
title_sort exploration of governance in teaching hospitals in the netherlands focused on educational objectives
topic Postgraduate medical education
Teaching hospitals
Governance
Quality management
Stakeholders
url https://doi.org/10.1186/s12909-025-06680-3
work_keys_str_mv AT lmvanderbaaren anexplorationofgovernanceinteachinghospitalsinthenetherlandsfocusedoneducationalobjectives
AT regifford anexplorationofgovernanceinteachinghospitalsinthenetherlandsfocusedoneducationalobjectives
AT navanderbaan anexplorationofgovernanceinteachinghospitalsinthenetherlandsfocusedoneducationalobjectives
AT mnsosef anexplorationofgovernanceinteachinghospitalsinthenetherlandsfocusedoneducationalobjectives
AT jhblaauw anexplorationofgovernanceinteachinghospitalsinthenetherlandsfocusedoneducationalobjectives
AT rjbennink anexplorationofgovernanceinteachinghospitalsinthenetherlandsfocusedoneducationalobjectives
AT icheyligers anexplorationofgovernanceinteachinghospitalsinthenetherlandsfocusedoneducationalobjectives
AT lmvanderbaaren explorationofgovernanceinteachinghospitalsinthenetherlandsfocusedoneducationalobjectives
AT regifford explorationofgovernanceinteachinghospitalsinthenetherlandsfocusedoneducationalobjectives
AT navanderbaan explorationofgovernanceinteachinghospitalsinthenetherlandsfocusedoneducationalobjectives
AT mnsosef explorationofgovernanceinteachinghospitalsinthenetherlandsfocusedoneducationalobjectives
AT jhblaauw explorationofgovernanceinteachinghospitalsinthenetherlandsfocusedoneducationalobjectives
AT rjbennink explorationofgovernanceinteachinghospitalsinthenetherlandsfocusedoneducationalobjectives
AT icheyligers explorationofgovernanceinteachinghospitalsinthenetherlandsfocusedoneducationalobjectives