Academic Center for Medical Education Research (iMERR)

To improve health care by developing the scientific basis of medical education and providing evidence-based approaches to educate the future health care providers

Academic Center of Excellence

Research Activities

  1. Clinical reasoning : experimental studies on sources of diagnostic errors, strategies to counteract them, and on instructional approaches for teaching clinical reasoning.
  2. Diversity: research of non-traditional background students: adverse effects selection, assessment, and teaching
  3. Roles of medical specialists in our changing health care system are changing fast: it is therefore essential to follow if our current educational system delivers doctors that have sustainable quality, can embrace life-long-learning principles and adapt to changing needs. iMERR will set up a cohort study of medical school students and postgraduate training residents (both 2016 entry year).
  4. Development and application of serious games in medical education All research programs are multidisciplinary with input from the fields of cognitive and emotional psychology, work and organizational psychology, neuroscience, pedagogics, sociology, etc. (Inter)national collaborations: VU University; University of Maastricht; UMCG; Nanyang Technological University, Singapore; McMaster University and Sherbrooke University, Canada; Federal University of Minas Gerais, Brazil; University of Cape Town, South Africa; International Network of Researchers of Selection into Health care (INReSH); University of Dundee; University of Aberdeen; and others

Type of


(Inter)national collaborations: VU University; University of Maastricht; UMCG; Nanyang Technological University, Singapore; McMaster University and Sherbrooke University, Canada; Federal University of Minas Gerais, Brazil; University of Cape Town, South Africa; International Network of Researchers of Selection into Health care (INReSH); University of Dundee; University of Aberdeen; and others



IMERR provides education for MSc and PhD students. The direct contribution to the educational programmes of Erasmus MC lies in providing the basis and testing of new approaches in teaching clinical reasoning (bachelor, master, postgraduate: general practitioners, emergency medicine), co-developing cultural sensitivity and skills in the medical school curriculum and assist with the selection of an excelling student population that mirrors the patient population.

iMERR members have several advisory positions in committees involved in Erasmus MC medical education, including N=N, development new medical school master, admission bachelor, master, postgraduate, etc. Several members of iMERR are directors of residency programmes, and as such have developed and implemented competency based training. Furthermore a serious game was developed for pediatrics, internal medicine and emergency medicine, teaching resident the structured approach to acutely ill patients iMERR members are actively involved in the curriculum development and education of residents.

4 national PhD students;
8 international PhD students (Brazil, Saudi-Arabia, Canada, South Africa).


Care Activities

Recertification of medical specialists is subject to new legislation. Specialists will have to show continuous professional development through individual learning plans and multisource feedback.

iMERR will have an active role in translating portfolio knowledge to an active system in which quality of Erasmus MC specialists can be followed, measured and guaranteed. Thus, quality of patient care can be enhanced. Through its research, iMERR has a strong direct positive effect on MD quality and quality of patient care through its contribution to medical education: clinical reasoning, cultural skills and sensitivity, student cohort composition, innovation of recertification of medical specialists and determine quality and life-long learning activities of Erasmus MC specialists.

Societal Relevance to Research, Education and Patient Care

The societal relevance of IMERR lies in its contribution to medical education in the broadest sense: Improve the education of representative cohorts of future MDs in terms of clinical reasoning and cultural skills and sensitivity. With respect to medical specialists: safeguard quality of medical specialists through the development of recertification of Erasmus MC medical specialists requiring life-long learning.

All these efforts contribute positively to a sustainable high quality MD workforce and better health care and patient safety, all aspects with great societal relevance.

Viability of Research, Education and Patient Care

Knowledge sharing by iMERR is done through Erasmus MC biweekly work discussions, monthly colloquia with national and international speakers, publication in internationally peer-reviewed journals, in Dutch medical care journals, by presenting results at national and international educational meetings.

All PhD students in iMERR have an international career in terms of contacts, presentations and publications. Over 80% of iMERR publications are in the top 25% of the medical education field. Currently no formal bibliometric network analysis is available.

Key and relevant publications of the last five years

  • Mamede S, Van Gog T, Schuit SCE, Van den Berge K, Van Daele PLA, Bueving H, Van der Zee T, Van den Broek WW, Van Saase JCLM, Schmidt HG. Why patients’ disruptive behaviours impair diagnostic reasoning: a randomised experiment. BMJ Qual Saf. 2016 Mar 7. pii: bmjqs-2015-005065. doi: 10.1136/bmjqs-2015-005065. [Epub ahead of print]
  • Mamede S, Van Gog T, Sampaio AM, de Faria RM, Maria JP, Schmidt HG. How can students’ diagnostic competence benefit most from practice with clinical cases? The effects of structured reflection on future diagnosis of the same and novel diseases. Acad Med. 2014;89(1):121-7
  • KM Stegers‐Jager, EW Steyerberg, J Cohen‐Schotanus, APN Themmen Ethnic disparities in undergraduate pre‐clinical and clinical performance. Med Educ 2012 46 (6), 575-585
  • Urlings-Strop LC, Themmen AP, Stijnen T, Splinter TA. Selected medical students achieve better than lottery-admitted students during clerkships. Med. Educ. 2011;45(10):1032–1040.
  • Dankbaar, M., Alsma, J., Jansen, E., van Merrienboer, J., van Saase, L., & Schuit, S. (2015). An experimental study on the effects of a simulation game on students’ clinical cognitive skills and motivation. Advances in Health Sciences Education, October 2015 epub
  • Dankbaar, M. E. W., Stegers-Jager, K. M., Baarveld, F., van Merrienboer, J. J. G., Norman, G. R., Rutten, F. L., van Saase, J. L. M. C., & Schuit, S. C. E. (2014). Assessing the assessment in emergency care training. PLoS ONE, 9(12), e114663.
  • Zwaan, L., Monteiro, S., Sherbino, J., Ilgen, J.S., Howey, B., Norman, G., Is Bias in the Eye of the Beholder? A vignette study to assess recognition of cognitive biases in clinical case workups, BMJ Qual Saf, 2016, epub
  • Zwaan, L. The critical step to reduce diagnostic errors in medicine: Addressing the limitations of human information processing. Diagnosis, 2014;1(1): 139–141
  • KM Stegers‐Jager, J Cohen‐Schotanus, APN Themmen Motivation, learning strategies, participation and medical school performance. Med Educ 2012 46 (7), 678-688
  • Schmidt HG, Mamede S. How to improve the teaching of clinical reasoning: a narrative review and a proposal. Med Educ. 2015;49(10):961-73

PhD theses of the last five years

  • Susanna Lucieer: Selecting students for medical education; 2016
  • Karen Stegers-Jager; At-risk medical students. Characteristics and possible interventions; 2012
  • Mary Dankbaar: Serious games and blended learning; effects on performance and motivation in medical education. 2015
  • Martine Chamberland: Self-explanation fosters clinical reasoning among medical students. 2014
  • Laura Zwaan: Diagnostic Reasoning and Diagnostic Error in Medicine. 2012
  • José Batista Cisne Tomáz:Distributed problem-based learning in a low-resources setting. 2013
  • Kees van den Berge: Cognitive biases in medical diagnosis. 2012

Non-scientific publications related to the ACE

Principal coordinator(s)

Collaborating investigator(s)

Last updated: 365 days ago.