1
|
Nealy J, van de Ridder JMM. How the Use of Kinesthetic Methods Impacted My Teaching. Med Sci Educ 2023; 33:1571. [PMID: 38188401 PMCID: PMC10767144 DOI: 10.1007/s40670-023-01904-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/21/2023] [Indexed: 01/09/2024]
Affiliation(s)
- Joshua Nealy
- Hospital Español Auxilio Mutuo, Avenida Ponce de Leon, Parada 37 ½, Hato Rey, PR 00919 USA
| | | |
Collapse
|
2
|
van de Ridder JMM, Arora B, Bush CM. In Reply to Pylman and Greenberg. Acad Med 2023; 98:1100-1101. [PMID: 37459164 DOI: 10.1097/acm.0000000000005327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Affiliation(s)
- J M Monica van de Ridder
- Adjunct assistant professor, Michigan State University College of Human Medicine, Grand Rapids, Michigan; ; Twitter: @MvdRidder; ORCID: https://orcid.org/0000-0003-3401-3523
| | - Bhawana Arora
- Program director, Pediatric Emergency Medicine Fellowship, Michigan State University College of Human Medicine, Grand Rapids, Michigan; ORCID: https://orcid.org/0000-0003-2584-1773
| | - Colleen M Bush
- Interim assistant dean for clinical experiences, Michigan State University College of Human Medicine, Grand Rapids, Michigan
| |
Collapse
|
3
|
Lee J, Ahn S, Henning MA, van de Ridder JMM, Rajput V. Micromanagement in clinical supervision: a scoping review. BMC Med Educ 2023; 23:563. [PMID: 37559079 PMCID: PMC10410949 DOI: 10.1186/s12909-023-04543-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 07/27/2023] [Indexed: 08/11/2023]
Abstract
Micromanagement in clinical supervision in health professions education generally refers to supervision characterized by unproductive excessive control and attention to detail. It can affect autonomy, competence, well-being of learners, teamwork, and ultimately patient care. Despite its potential negative impact on learners and patients, no comprehensive review of this phenomenon has been conducted. This scoping review aims to explore the breadth of extant literature concerning micromanagement in clinical supervision in health professions education and map the body of research on the topic. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis: Extension for Scoping Review (PRISMA-ScR). We searched eight databases, and the final review and analysis comprised 12 articles that examined micromanagement in clinical supervision across health professions education. Micromanagement was conceptualized as ineffective supervisory practices such as undue scrutiny, excessive control, domination, and ineffectual leadership. Conversely, alternatives to micromanagement included entrusting or granting autonomy, coaching for independent practice, and providing effective supervision and leadership. Overall, micromanagement was attributed to individual behavioral and personality factors, such as distrust, perfectionism, self-conviction, and low self-esteem. The consequences of micromanagement included inadequacies in professional development and well-being of trainees and patient care, and organizational dysfunction. Suggested solutions included entrusting or empowering trainees with encouragement and clear communication, open communication efforts by trainees, organizational management for quality supervision, and faculty's valuing both clinical and educational goals. Current literature on micromanagement-in the context of clinical supervision in health professions education-was found to be sparse, implying a need for more rigorous research and discourse on this understudied area. The findings can be used to recognize, solve, and prevent the prevalent, and often unrecognized, phenomena of micromanagement, which may improve clinical supervision, the professional development of trainees and faculty, organizational management, and ultimately patient care.
Collapse
Affiliation(s)
- Jihyun Lee
- Department of Dental Education & Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
| | - Solmoe Ahn
- Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Marcus A Henning
- Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | | | - Vijay Rajput
- Department of Medical Education, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Florida, USA
| |
Collapse
|
4
|
Affiliation(s)
- J M Monica van de Ridder
- Adjunct assistant professor, College of Human Medicine, Michigan State University, Grand Rapids, Michigan; ; Twitter: @MvdRidder; ORCID: https://orcid.org/0000-0003-3401-3523
| | - Mohammadali M Shoja
- Associate professor of medical education, Department of Medical Education, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida; ORCID: https://orcid.org/0000-0001-9668-5558
| | - Vijay Rajput
- Professor and chair of medical education, Department of Medical Education, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida; ORCID: https://orcid.org/0000-0001-5203-5342
| |
Collapse
|
5
|
Fune J, Hoppe A, Perez JC, Jaji A, van de Ridder JMM. Guidance for Partnering With Interpreters to Improve Communication. Acad Med 2023; 98:754. [PMID: 35976712 DOI: 10.1097/acm.0000000000004936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Jan Fune
- assistant professor of pediatrics, Icahn School of Medicine at Mount Sinai
| | - Allison Hoppe
- general surgery resident, Spectrum Health/Michigan State University, College of Human Medicine
| | | | - Amina Jaji
- pediatric cardiology fellow, Advocate Children's Hospital
| | | |
Collapse
|
6
|
Arora B, Schoonover A, Bush C, van de Ridder JMM. Peyton's Model: Modifications and Applications for Teaching Clinical Skills. Acad Med 2023; 98:533. [PMID: 36512827 DOI: 10.1097/acm.0000000000005101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Affiliation(s)
- Bhawana Arora
- assistant professor, Department of Emergency Medicine, Spectrum Health/Michigan State University College of Human Medicine
| | - Amanda Schoonover
- medical student, Michigan State University College of Human Medicine
| | - Colleen Bush
- assistant professor, Department of Emergency Medicine, Spectrum Health/Michigan State University College of Human Medicine
| | | |
Collapse
|
7
|
van de Ridder JMM, Kachur EK, Jirasevijinda TJ, Wijnen-Meijer M. Health Science Education in International Context: Strategies for Bridging Cultural Differences. Med Sci Educ 2022; 32:1251-1253. [PMID: 36532392 PMCID: PMC9755451 DOI: 10.1007/s40670-022-01638-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/12/2022] [Indexed: 06/17/2023]
Abstract
With increasing globalization, many students and staff are experiencing how difficult it is to work in a different culture. Different ways of communicating, for example, can lead to misunderstandings, as the results of a small survey show. This article proposes a workshop to support people who work internationally.
Collapse
Affiliation(s)
| | | | | | - Marjo Wijnen-Meijer
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
| |
Collapse
|
8
|
Mengsteab MY, van de Ridder JMM. Comment on "Medical Students Who Do Not Match to Psychiatry: What Should They Do, and What Should We Do?". Acad Psychiatry 2021; 45:780-781. [PMID: 34268677 DOI: 10.1007/s40596-021-01499-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/09/2021] [Indexed: 06/13/2023]
|
9
|
Fune J, Chinchilla JP, Hoppe A, Mbanugo C, Zuellig R, Abboud AT, Oboh O, Monica van de Ridder JM. Lost in Translation: An OSCE-Based Workshop for Helping Learners Navigate a Limited English Proficiency Patient Encounter. MedEdPORTAL 2021; 17:11118. [PMID: 33768150 PMCID: PMC7970641 DOI: 10.15766/mep_2374-8265.11118] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 12/30/2020] [Indexed: 05/20/2023]
Abstract
INTRODUCTION Residents have been known to report a lack of self-efficacy in their ability to provide care for limited English proficiency (LEP) patients. Interpreters must be utilized to help navigate these patient encounters, but many institutions do not have a curriculum focused on utilizing interpreters effectively. METHODS We created a 3-hour workshop for physician learners working with the pediatric population. It included a panel discussion, best-practices presentation, video demonstration, observing scenarios, and pre- and postworkshop objective structured clinical exams (OSCEs). The first OSCE introduced learners to a scenario (4-day-old with jaundice with an LEP parent) where interpreter use was imperative. The second OSCE allowed learners to perform another case (12-year-old with an abscess with an LEP parent) and practice newly obtained skills from the workshop. Both OSCEs were scored using a 16-item yes/no checklist. All pediatric residents filled out an eight-item survey to evaluate the workshop; a subset of that group performed the pre- and postworkshop OSCEs. RESULTS Forty pediatric residents attended the workshop and completed the survey. The workshop was well received, with the majority of residents stating they would change their current interpreter usage practices. Ten pediatric residents performed the pre- and postworkshop OSCEs; all improved their scores. DISCUSSION The workshop was effective in improving how residents navigated LEP encounters. It is applicable to learners of all levels who want to improve their communication skills to provide better care for LEP patients and can be tailored to fit the needs of a specific institution.
Collapse
Affiliation(s)
- Jan Fune
- Second-Year Pediatric Hospital Medicine Fellow, Department of Pediatrics, Helen DeVos Children's Hospital; Clinical Instructor, Michigan State University College of Human Medicine
- Corresponding author:
| | | | - Allison Hoppe
- Second-Year Medical Student, Michigan State University College of Human Medicine
| | - Chineze Mbanugo
- Second-Year Medical Student, Michigan State University College of Human Medicine
| | - Rachel Zuellig
- Third-Year Medical Student, Michigan State University College of Human Medicine
| | - Ali T. Abboud
- Third-Year Medical Student, Michigan State University College of Human Medicine
| | - Oselenonome Oboh
- Third-Year Medical Student, Michigan State University College of Human Medicine
| | - J. M. Monica van de Ridder
- Assistant Professor, Department of Emergency Medicine, Michigan State University College of Human Medicine; Development and Learning Specialist, Office of Research and Medical Education, Spectrum Health
| |
Collapse
|
10
|
van de Ridder JMM, DeSanctis JT, Mookerjee AL, Rajput V. Micromanagement Creates a Nonconducive Learning Environment for a Teaching Team. J Grad Med Educ 2020; 12:639-640. [PMID: 33149840 PMCID: PMC7594795 DOI: 10.4300/jgme-d-20-00926.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- J M Monica van de Ridder
- Assistant Professor, College of Human Medicine, Michigan State University
- Specialist Learning and Development, Spectrum Health
| | - Jorgelina T DeSanctis
- Program Director, Infectious Disease Fellowship, Spectrum Health
- Clinical Assistant Professor in Medicine, College of Human Medicine, Michigan State University
| | | | - Vijay Rajput
- Chair, Department of Medical Education, and Professor of Medical Education, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University
| |
Collapse
|
11
|
van de Ridder JMM, Arora B, Abbas S. Impact of rater training on the quality improvement cycle of a faculty development programme. Med Educ 2020; 54:480. [PMID: 32323391 DOI: 10.1111/medu.14108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 01/29/2020] [Indexed: 06/11/2023]
|
12
|
de Vries-Erich J, Reuchlin K, de Maaijer P, van de Ridder JMM. Identifying facilitators and barriers for implementation of interprofessional education: Perspectives from medical educators in the Netherlands. J Interprof Care 2017; 31:170-174. [PMID: 28181853 DOI: 10.1080/13561820.2016.1261099] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Patient care and patient safety can be compromised by the lack of interprofessional collaboration and communication between healthcare providers. Interprofessional education (IPE) should therefore start during medical training and not be postponed until after graduation. This case study explored the current situation in the Dutch context and interviewed experts within medical education and with pioneers of successful best practices to learn more about their experiences with IPE. Data analysis started while new data were still collected, resulting in an iterative, constant comparative process. Using a strengths, weaknesses, opportunities, and threats (SWOT) analysis framework, we identified barriers and facilitators such as lack of a collective professional language, insufficient time or budget, stakeholders' resistance, and hierarchy. Opportunities and strengths identified were developing a collective vision, more attention for patient safety, and commitment of teachers. The facilitators and barriers relate to the organisational level of IPE and the educational content and practice. In particular, communication, cohesiveness, and support are influenced by these facilitators. An adequate identification of the SWOT elements in the current situation could prove beneficial for a successful implementation of IPE within the healthcare educational system.
Collapse
Affiliation(s)
- Joy de Vries-Erich
- a Center for Evidence-Based Education , University of Amsterdam , Amsterdam , the Netherlands
| | - Kirsten Reuchlin
- b Medical Faculty , University of Utrecht , Utrecht , the Netherlands
| | - Paul de Maaijer
- c Medical Faculty , University of Amsterdam , Amsterdam , the Netherlands
| | - J M Monica van de Ridder
- d Office of Medical Education Research and Development, College of Human Medicine , Michigan State University , Grand Rapids , Michigan , USA
| |
Collapse
|
13
|
van de Ridder JMM, Berk FCJ, Stokking KM, Ten Cate OTJ. Feedback providers' credibility impacts students' satisfaction with feedback and delayed performance. Med Teach 2015; 37:767-774. [PMID: 25306959 DOI: 10.3109/0142159x.2014.970617] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
PURPOSE Medical students receive feedback during clerkships from many different sources: attendings, residents, paramedics, other clerks and even patients. Not all feedback providers have similar impact on learning. One characteristic that is believed to have impact is their credibility to the recipient. This study investigates the effects of feedback provider credibility on medical student satisfaction, self-efficacy and performance with a trained skill. METHODS A single-blind randomized controlled between-subjects design was used, with feedback provider credibility (high-low) as independent variable and examination of hearing abilities as the task. First year medical students' (n = 68) satisfaction, self-efficacy and performance were the dependent variables and were measured both directly after the intervention and after a three-week delay. RESULTS Credibility did not significantly affect immediate or delayed self-efficacy. Students receiving feedback from a high-credibility source were more satisfied with the feedback. They did not perform significantly better immediately after the feedback intervention, but did so three weeks after the intervention. High credibility was associated with a perception of a negative feedback message and an unsocial feedback provider. CONCLUSIONS Feedback provider credibility impacts satisfaction with feedback and delayed performance. If feedback is not effective in clinical settings, feedback providers may reconsider their credibility.
Collapse
|
14
|
van de Ridder JMM, Peters CMM, Stokking KM, de Ru JA, Ten Cate OTJ. Framing of feedback impacts student's satisfaction, self-efficacy and performance. Adv Health Sci Educ Theory Pract 2015; 20:803-16. [PMID: 25542198 DOI: 10.1007/s10459-014-9567-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Accepted: 11/12/2014] [Indexed: 05/19/2023]
Abstract
Feedback is considered important to acquire clinical skills. Research evidence shows that feedback does not always improve learning and its effects may be small. In many studies, a variety of variables involved in feedback provision may mask either one of their effects. E.g., there is reason to believe that the way oral feedback is framed may affect its effect if other variables are held constant. In a randomised controlled trial we investigated the effect of positively and negatively framed feedback messages on satisfaction, self-efficacy, and performance. A single blind randomised controlled between-subject design was used, with framing of the feedback message (positively-negatively) as independent variable and examination of hearing abilities as the task. First year medical students' (n = 59) satisfaction, self-efficacy, and performance were the dependent variables and were measured both directly after the intervention and after a 2 weeks delay. Students in the positively framed feedback condition were significantly more satisfied and showed significantly higher self-efficacy measured directly after the performance. Effect sizes found were large, i.e., partial η (2) = 0.43 and η (2) = 0.32 respectively. They showed a better performance throughout the whole study. Significant performance differences were found both at the initial performance and when measured 2 weeks after the intervention: effects were of medium size, respectively r = -.31 and r = -.32. Over time in both conditions performance and self-efficacy decreased. Framing the feedback message in either a positive or negative manner affects students' satisfaction and self-efficacy directly after the intervention be it that these effects seem to fade out over time. Performance may be enhanced by positive framing, but additional studies need to confirm this. We recommend using a positive frame when giving feedback on clinical skills.
Collapse
Affiliation(s)
- J M Monica van de Ridder
- Center for Research and Development of Education, University Medical Center Utrecht, Utrecht, The Netherlands,
| | | | | | | | | |
Collapse
|
15
|
van de Ridder JMM, McGaghie WC, Stokking KM, ten Cate OTJ. Variables that affect the process and outcome of feedback, relevant for medical training: a meta-review. Med Educ 2015; 49:658-73. [PMID: 26077214 DOI: 10.1111/medu.12744] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 07/29/2014] [Accepted: 02/04/2015] [Indexed: 05/11/2023]
Abstract
CONTEXT Feedback is considered important in medical education. The literature is not clear about the mechanisms that contribute to its effects, which are often small to moderate and at times contradictory. A variety of variables seem to influence the impact of feedback on learning. The aim of this study was to determine which variables influence the process and outcomes of feedback in settings relevant to medical education. METHODS A myriad of studies on feedback have been conducted. To determine the most researched variables, we limited our review to meta-analyses and literature reviews published in the period from January 1986 to February 2012. According to our protocol, we first identified features of the feedback process that influence its effects and subsequently variables that influence these features. We used a chronological model of the feedback process to categorise all variables found. RESULTS A systematic search of ERIC, PsycINFO and MEDLINE yielded 1101 publications, which we reduced to 203, rejecting papers on six exclusion criteria. Of these, 46 met the inclusion criteria. In our four-phase model, we identified 33 variables linked to task performance (e.g. task complexity, task nature) and feedback reception (e.g. self-esteem, goal-setting behaviour) by trainees, and to observation (e.g. focus, intensity) and feedback provision (e.g. form, content) by supervisors that influence the subsequent effects of the feedback process. Variables from all phases influence the feedback process and effects, but variables that influence the quality of the observation and rating of the performance dominate the literature. There is a paucity of studies addressing other, seemingly relevant variables. CONCLUSIONS The larger picture of variables that influence the process and outcome of feedback, relevant for medical education, shows many open spaces. We suggest that targeted studies be carried out to expand our knowledge of these important aspects of feedback in medical education.
Collapse
Affiliation(s)
| | - William C McGaghie
- Department of Medical Education, Feinberg School of Medicine Northwestern University, Chicago, Illinois, USA
| | - Karel M Stokking
- Department of Educational Sciences, Utrecht University, Utrecht, the Netherlands
| | - Olle T J ten Cate
- Center for Research and Development of Education, University Medical Centre Utrecht, School of Medical Sciences, Utrecht University, Utrecht, the Netherlands
| |
Collapse
|
16
|
Abstract
OBJECTIVE Feedback is important in clinical education. However, the medical education literature provides no consensual definition of feedback. The aim of this study is to propose a consensual, research-based, operational definition of feedback in clinical education. An operational definition is needed for educational practice and teacher training, and for research into the effectiveness of different types of feedback. METHODS A literature search about definitions of feedback was performed in general sources, meta-analyses and literature reviews in the social sciences and other fields. Feedback definitions given from 1995 to 2006 in the medical education literature are also reviewed. RESULTS Three underlying concepts were found, defining feedback as 'information'; as 'reaction', including information, and as a 'cycle', including both information and reaction. In most medical education and social science literature, feedback is usually conceptualised as information only. Comparison of feedback definitions in medical education reveals at least 9 different features. The following operational definition is proposed. Feedback is: 'Specific information about the comparison between a trainee's observed performance and a standard, given with the intent to improve the trainee's performance.' CONCLUSIONS Different conceptual representations and the use of different key features might be a cause for inconsistent definitions of feedback. The characteristics, strengths and weaknesses of this research-based operational definition are discussed.
Collapse
Affiliation(s)
- J M Monica van de Ridder
- Centre for Research and Development, University Medical Centre Utrecht, Utrecht, The Netherlands.
| | | | | | | |
Collapse
|
17
|
Abstract
OBJECTIVE Feedback is important in clinical education. However, the medical education literature provides no consensual definition of feedback. The aim of this study is to propose a consensual, research-based, operational definition of feedback in clinical education. An operational definition is needed for educational practice and teacher training, and for research into the effectiveness of different types of feedback. METHODS A literature search about definitions of feedback was performed in general sources, meta-analyses and literature reviews in the social sciences and other fields. Feedback definitions given from 1995 to 2006 in the medical education literature are also reviewed. RESULTS Three underlying concepts were found, defining feedback as 'information'; as 'reaction', including information, and as a 'cycle', including both information and reaction. In most medical education and social science literature, feedback is usually conceptualised as information only. Comparison of feedback definitions in medical education reveals at least 9 different features. The following operational definition is proposed. Feedback is: 'Specific information about the comparison between a trainee's observed performance and a standard, given with the intent to improve the trainee's performance.' CONCLUSIONS Different conceptual representations and the use of different key features might be a cause for inconsistent definitions of feedback. The characteristics, strengths and weaknesses of this research-based operational definition are discussed.
Collapse
Affiliation(s)
- J M Monica van de Ridder
- Centre for Research and Development, University Medical Centre Utrecht, Utrecht, The Netherlands.
| | | | | | | |
Collapse
|