78 Chapter 4 Methods Study design The study consisted of two nationwide cross-sectional surveys conducted in April 2018 in the Netherlands among EPs and ED managers. According to the Dutch ‘Medical Research involving human subjects Act’, neither obtaining informed consent nor formal ethical approval for this study was required. Participants All EPs working in Dutch hospitals and managers of all EDs were eligible for participation in the survey. In the flow chart (figure 1) and supplement 1 we described recruitment and selection procedure and their results. Data Collection Two questionnaires were developed by researchers, managers and clinicians from the departments of Emergency Medicine and Geriatrics of the Radboudumc. Supplement 2 describes the development, pilot testing and distribution of the questionnaires to study participants. Figure 1 Diagram of study participation among emergency physicians Non-eligible (n=38) - Other specialties (n=24) - Living abroad: (n=14) Initial sample n=503 (100%) Eligible questionnaires n=465 Questionnaires not returned n=275 (62.2%) Final sample, n=190 (37.8%) - 157 complete questionnaires - 33 incomplete questionnaires
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