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Background: Allergen component sensitisation testing is becoming increasingly important in the diagnosis of peanut allergy. The aim of the present study was to evaluate the relationship between sensitisation and symptoms of allergic disease in children by testing a large panel of inhalants, food allergens, and allergen components.Methods: For 287 children visiting our laboratory for allergy testing, symptoms of allergic disease were recorded by standardised validated questionnaires. Specific IgE to 11 whole allergens was assessed by ImmunoCAP, and to 112 allergen components by ISAC ImmunoCAP assay. We used latent class analysis (LCA) to distinguish clinical phenotypes.Results: Inhalant and food allergen sensitisation was common, irrespective of the children's allergic symptom type. Less than 10% of the variance in symptom scores was explained by variations in the number of allergens (components) that the child was sensitised to. In LCA, 135 children (50.2%) had mild allergy, with few symptoms and sensitisation to no or few allergens, 74 children (27.5%) had more symptoms and sensitisation to inhalant allergens (respiratory allergy) and 60 children (22.3%) showed polysensitisation to a median of six allergens and had more severe symptoms of different organ systems. Adding allergen component test results to LCA failed to result in identifiable classes of allergic disease in children.Conclusions: In this group of children with allergic symptoms, referred for allergy testing by their physician, broad screening for allergen component sensitisation did not contribute to distinguishing phenotypes of allergic disease. (C) 2022 Codon Publications. Published by Codon Publications.

A supervisor's feedback can change a medical learner's behaviour consistently if the learner views the supervisor as a credible role model. A learner's trust in the supervisor is a prerequisite for feedback to contribute to effective learning. In current educational practice, coaching for improvement and summative assessment are frequently mixed, which leads medical learners to experience workplace based assessments as tests and makes them unresponsive to formative feedback. Carefully separating coaching for improvement from summative assessment is required to allow the learner to accept and apply the feedback given by the supervisor. Supervisors should focus their attention to providing formative feedback, not to documenting it. The R2C2 model (rapport - receptivity - content - coaching) is a useful tool to effectively provide constructive formative feedback.

Objective Because both clerks and medical faculty quality management workers expressed the need for it, we aimed to develop a compact, valid and uniform instrument to assess the quality of Dutch clinical clerkships across all medical faculties in the Netherlands. Method We divided all 249 items from existing published and unpublished clerkship quality instruments into the three essential learning environment domains: content, atmosphere and organisation. In a 3-stage Delphi procedure, the 45 most relevant items from this list were selected that comprehensively covered the three domains. All clinical clerks in the country’s northeastern educational region were invited to evaluate their last clerkship using this draft instrument. We used half of these data for item reduction and the other half to validate the final instrument, the QUality Instrument for ClerKships (QUICK). Results After the Delphi procedure and further item reduction, the QUICK comprises 15 items, 5 in each domain. The internal consistency of the QUICK and each of the three domains was satisfactory (Cronbach’s α 0.88, 0.73, 0.84 and 0.67, respectively). The variance of the draft instrument domain scores were explained for >80% by item variance of the final QUICK. A panel of educational experts and medical faculty quality management workers evaluated QUICK’s face validity as good. Conclusion The QUICK is a concise and valid instrument to assess the quality of Dutch clinical clerkships. Its repeated use in a quality cycle can contribute to monitoring and ongoing development of the quality of this key phase in the medical education curriculum.

In January 2020, the Dutch law on the medical treatment agreement was updated. In this update, shared decision-making is explicitly mentioned as a prerequisite during doctor-patient encounters. This entails explicit exploration of the patient's wishes, views and preferences and their integration in medical decision-making. There is growing interest in shared decision-making from patient advocacy and professional societies, the government, and healthcare insurers. However, both care professionals and patients are not yet used to applying this in their encounters. Creating awareness, training and organisational changes are essential aspects to foster shared decision-making. Various (umbrella) organisations in healthcare have developed (digital) tools for both care professionals and patients to support shared decision-making. This article addresses these tools to nudge all stakeholders towards shared decision-making.