GMS Zeitschrift fur Medizinische Ausbildung最新文献

Introduction: The decision to consolidate European higher education was reached by the Bologna Conference. Based on the Anglo-American system, a two-cycle degree program (Bachelor and Master) has been introduced. Subjects culminating in a state examination, such as Medicine and Dentistry, were excluded from this reform. Since the state examination is already comparable in its caliber to a Master's degree in Medicine or Dentistry, only advanced Master's degree programs with post-graduate specializations come into consideration for these subjects. In the field of dentistry numerous post-graduate study programs are increasingly coming into existence. Many different models and approaches are being pursued.

Method: Since the 2004-2005 winter semester, the University of Greifswald has offered the Master's degree program in Dental Functional Analysis and Therapy. Two and a half years in duration, this program is structured to allow program participation while working and targets licensed dentists who wish to attain certified skills for the future in state-of-the-art functional analysis and therapy.

Aim: The design of this post-graduate program and the initial results of the evaluation by alumni are presented here.

Conclusion: Our experiences show that the conceptual idea of an advanced Master's program has proved successful. The program covers a specialty which leads to increased confidence in handling challenging patient cases. The sharing of experiences among colleagues was evaluated as being especially important.

Aim: Student tutorials are now firmly anchored in medical education. However, to date there have only been isolated efforts to establish structured teacher training for peer tutors in medicine. To close this gap, a centralized tutor training program for students, culminating in an academic certificate, was implemented at Heidelberg University Medical School. The program also counts within the scope of the post-graduate Baden-Württemberg Certificate in Academic Teaching (Baden-Württemberg Zertifikat für Hochschuldidaktik).

Method: Based on a needs assessment, a modular program comprised of four modules and a total of 200 curricular units was developed in cooperation with the Department for Key Competencies and Higher Education at Heidelberg University and implemented during the 2010 summer semester. This program covers not only topic-specific training sessions, but also independent teaching and an integrated evaluation of the learning process that is communicated to the graduates in the form of structured feedback. In addition, to evaluate the overall concept, semi-structured interviews (N=18) were conducted with the program graduates.

Results: To date, 495 tutors have been trained in the basic module on teaching medicine, which is rated with a mean overall grade of 1.7 (SW: 0.6) and has served as Module I of the program since 2010. A total of 17% (N=83) of these tutors have gone on to enroll in the subsequent training modules of the program; 27 of them (m=12, f=15) have already successfully completed them. Based on qualitative analyses, it is evident that the training program certificate and its applicability toward the advanced teacher training for university instructors pose a major incentive for the graduates. For successful program realization, central coordination, extensive coordination within the medical school, and the evaluation of the attained skills have proven to be of particular importance.

Conclusion: The training program contributes sustainably to both quality assurance and professionalism, as well as to solving the issue of resources in medical education. The introduction and continued development of similar programs is desirable.

This article refers to a correspondence letter recently published in The Lancet, describing successful student-led research initiatives in Latin America, which were introduced because of low support from universities and governments. As a final-year medical student with keen interest in science, the topic of student engagement in research activities caught my interest. Literature shows that while junior doctors are required to perform research on their own and face intense pressure to publish, formal training in principles of research and scientific writing is often neglected by medical schools. This contrast is worrying, as the progression of the medical profession and the quality of patient care depend on high-quality research and on future generations of physician-scientists being both enthusiastic and competent. Hence, this article summarizes suggestions to increase both students' research proficiency and participation in scientific activities, and offers a critical view on this important topic, as medical schools without curricular research education and without active student integration should urgently consider revising their policies.

Background and aim: The dissection course is an essential part of preclinical medical education. At the Medical Faculty of Duesseldorf, an education concept has been developed with the aim, to reflect with students their experiences and to support them in dealing with the donor and preparation. The aim of this paper is to present the concept.

Method: The education concept had a peer group approach. It comprised a lecture, a small group seminar and an online diary as core element. Finally, the concept was evaluated.

Results: Approximately one sixth of students made use of the online diary. Selected entries are presented here. Also, one sixth of students took part in the evaluation. They rated the activity as helpful to prepare for the dissection course.

Discussion: The education concept could be a corner stone of a longitudinal training to promote the adequate encounter with topics such as dying and death.

Objective: The selection of a future medical specialty is a challenge all medical students face during the course of their studies. Students can choose from more than sixty specialties after graduation. There is usually no structured career counselling program available at German medical faculties. So far only little data on acceptance, formats and effects of different career counselling programs are available. The aim of this study is to describe an innovative format of career counselling for medical students including its evaluation of acceptance and its possible influence on medical specialty preferences.

Methods: The need for career counselling became evident after the analysis of mentor-mentee conversations held within the mentoring program of our medical faculty, an online-based survey, an ad-hoc focus group and a pilot event. Panel discussions as an interactive format of presenting related medical specialties were developed and hence held four times under the name "FacharztDuell". Students evaluated all events separately with a questionnaire and changes in medical specialty choice preferences were documented using an Audience-Response-System (ARS). The FacharztDuell is organized regularly and supported by faculty teaching funds.

Results: Among the student body FacharztDuell was well accepted (an average of 300 participants/event) and rated (average grade of 1.8 (SD= 0.7, 1=very good, 6=unsatisfactory, n=424). On average, 77.8% of the participating students considered the FacharztDuell to be a decision support for their future selection of a specialty. Up to 12% of the students changed their medical specialty choice preference throughout the event.

Conclusion: FacharztDuell was well accepted by medical students of all semesters and seems to be supportive for their selection of a future medical specialty. However, longitudinal studies are necessary to better understand the decision making process of medical students along their career path. The FacharztDuell is easily transferrable to other faculties with respect to organization, staff and technical resources.

Although some recent studies concluded that dexterity is not a reliable predictor of performance in preclinical laboratory courses in dentistry, they could not disprove earlier findings which confirmed the worth of manual dexterity tests in dental admission. We developed a wire bending test (HAM-Man) which was administered during dental freshmen's first week in 2008, 2009, and 2010. The purpose of our study was to evaluate if the HAM-Man is a useful selection criterion additional to the high school grade point average (GPA) in dental admission. Regression analysis revealed that GPA only accounted for a maximum of 9% of students' performance in preclinical laboratory courses, in six out of eight models the explained variance was below 2%. The HAM-Man incrementally explained up to 20.5% of preclinical practical performance over GPA. In line with findings from earlier studies the HAM-Man test of manual dexterity showed satisfactory incremental validity. While GPA has a focus on cognitive abilities, the HAM-Man reflects learning of unfamiliar psychomotor skills, spatial relationships, and dental techniques needed in preclinical laboratory courses. The wire bending test HAM-Man is a valuable additional selection instrument for applicants of dental schools.

Objectives: As a fundamental element of medical practice, clinical reasoning should be cultivated in courses of study in human medicine. To date, however, no conclusive evidence has been offered as to what forms of teaching and learning are most effective in achieving this goal. The Diagnostic Thinking Inventory (DTI) was developed as a means of measuring knowledge-unrelated components of clinical reasoning. The present pilot study examines the adequacy of this instrument in measuring differences in the clinical reasoning of students in varying stages of education in three curricula of medical studies.

Methods: The Diagnostic Thinking Inventory (DTI) comprises 41 items in two subscales ("Flexibility in Thinking" and "Structure of Knowledge in Memory"). Each item contains a statement or finding concerning clinical reasoning in the form of a stem under which a 6-point scale presents opposing conclusions. The subjects are asked to assess their clinical thinking within this range. The German-language version of the DTI was completed by 247 student volunteers from three schools and varying clinical semesters. In a quasi-experimental design, 219 subjects from traditional and model courses of study in the German state of North Rhine-Westphalia took part. Specifically, these were 5(th), 6(th) and 8(th) semester students from the model course of study at Witten/Herdecke University (W/HU), from the model (7(th) and 9(th) semester) and traditional (7(th) semester) courses of study at the Ruhr University Bochum (RUB) and from the model course of study (9(th) semester) at the University of Cologne (UoC). The data retrieved were quantitatively assessed.

Results: The reliability of the questionnaire in its entirety was good (Cronbach's alpha between 0.71 and 0.83); the reliability of the subscales ranged between 0.49 and 0.75. The different groups were compared using the Mann-Whitney test, revealing significant differences among semester cohorts within a school as well as between students from similar academic years in different schools. Among the participants from the model course of study at the W/HU, scores increased from the 5(th) to the 6(th) semester and from the 5(th) to the 9(th) semester. Among individual cohorts at RUB, no differences could be established between model and traditional courses of study or between 7(th) and 9(th) semester students in model courses of study. Comparing all participating highest semester students, the 8(th) semester participants from the W/HU achieved the highest scores - significantly higher than those of 9(th) semester RUB students or 9(th) semester UoC students. Scores from the RUB 9(th) semester participants were significantly higher than those of the 9(th) semester UoC participants.

Discussion: The German-language version of the DTI measures self-assessed differences in diagnostic reasoning among students from various semesters an

The amendments introduced to the current Veterinary Licensing Ordinance (TAppV) by the Veterinary Licensing Regulation (TAppO) have brought a high degree of skills orientation to fill the gap between academic study and preparing for a wide range of professional skills. In order to improve the veterinary skills of students while conveying fundamental methods in a structured and reproducible way, the University of Veterinary Medicine Hannover, Foundation, has set up the first central veterinary skills lab in Germany. Practical training is provided by means of a three-tier delivery approach. This involves around 40 simulators on an area of approx. 800 m(2) under the guidance of 6-8 staff members, along with supplementary resources such as posters, text instructions and YouTube videos. Since it opened in March 2013, there have been 769 visits to the skills lab and 30,734 hits on YouTube. Initial results show that the skills lab helps to maintain student motivation by teaching them practical skills at an early stage of the basic study-based acquisition of knowledge, whilst reinforcing skills acquisition per se in competence-based teaching. It enables veterinary students to prepare for their first examinations and treatments of live patients in a manner compliant with animal welfare.

Background: Whilst the structure of primary care vocational training in Germany is being increasingly formalized there remains an abundance of disparate locally defined criteria for the training practices. Advanced medical training in the ambulatory setting has also been identified as an area of need by other specialties.

Goal: In contrast to the current practice of a unregulated authorization by regional medical associations this catalogue provide transparent, clearly defined criteria for the assignment of training practice status.

Methods: The first draft of the criteria catalogue integrates feedback from 30 academic general practitioners. The feasibility of the catalogue was tested by a further 30 surgeries. Analysis included an assessment of the sociodemographic characteristics of the trainers and their practices as well as satisfaction of the participants with the approved authorization period.

Results: The criteria catalogue comprises 19 items within the domains of trainer qualification, practice infrastructure and patient specific factors as well as mandatory criteria. The points scored through this system confer a variable period of authorization. Of the 30 participants 17 were satisfied with the period of authorization they received, 10 were dissatisfied, and one was indifferent. Satisfaction showed no correlation with sex, experience as a trainer, or with the score achieved through the criteria catalogue. It correlated little with the length of time practicing as a doctor.

Conclusion: The criteria catalogue reflects both the breadth of general practice as well as the skills of the trainers. Satisfaction of participants in the test group was good, and infers a basis for applying the catalogue through regional medical associations to assign teaching practice status. It may also be used as a blue-print for other medical specialties.