GMS Journal for Medical Education最新文献_第10页

The climate crisis and planetary health in teaching. 教学中的气候危机与地球健康。

IF 1.5 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

GMS Journal for Medical Education

Pub Date : 2023-05-15 eCollection Date: 2023-01-01 DOI: 10.3205/zma001621

Christoph Nikendei, Susanne J Kühl, Till Johannes Bugaj

引用次数: 0

Christoph Nikendei, Till Johannes Bugaj, Anna Cranz, Alina Herrmann, Julia Tabatabai: Heidelberger Standards der Klimamedizin – Wissen und Handlungsstrategien für den klinischen Alltag und die medizinische Lehre im Klimawandel Christoph Nikendei、Till Johannes Bugaj、Anna Cranz、Alina Herrmann、Julia Tabatabai：海德堡气候医学标准——气候变化中临床日常生活和医学教学的知识和行动策略

IF 1.6 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

GMS Journal for Medical Education

Pub Date : 2023-05-15 DOI: 10.3205/zma001607

Lorena Morschek

The climate crisis threatens our natural livelihoods and civilization in many ways. With the steady increase in mean global temperature, the crossing of irreversible climate tipping points is becoming increasingly likely. There is a threat of a massive acceleration of biodiversity loss, acidification of the oceans, more frequent food shortages, an increase in extreme weather events, and climate-related refugee movements. As a compact “pocket book”, the Heidelberg standards of climate medicine provides broad knowledge, as well as practice-oriented recommendations for action on the scientific basics, the (medical) treatment of physical and psychological effects of the climate crisis, and the necessary transformation processes towards a more ecologically sustainable health sector. In 12 chapters with a total of 45 articles, the participating authors summarize the current state of research and information from their (medical) practice and provide useful tips and advice for the everyday professional life of all participants in the health sector. First, the Heidelberg standards of climate medicine provide a brief and concise overview of the scientific basics of the climate crisis (chapter 1) and their impact on natural and social systems (chapter 2). The knowledge of these basics will, on the one hand, help the reader with regard to the following book chapters, and, on the other hand, it should serve as a practical tool in (scientific) discourse. Two comprehensive chapters then highlight the numerous direct and indirect impacts of the climate crisis on human health. In the third chapter on the physical impacts of the climate crisis, it becomes evident how closely environmental changes (e.g., more frequent extreme weather events, heat waves, increased incidence of tropical pathogens) are linked to human health: The occurrence of many diseases, such as heat stroke, COPD, allergies, diabetes, or kidney failure, are influenced by the climate crisis. In addition to explaining this relationship, the chapter presents definitions relevant to clinicians, pathophysiological processes, key recommendations for clinical care, and helpful therapeutic strategies. The psychological effects of climate change are reflected upon in more detail in chapter 4, ranging from trauma in the context of natural disasters, to connections between climate, weather, and suicidality. Additionally, chapter 5 is dedicated to general cognitive processes and biases in psychological perceptions and processing of climate change. The discrepancy between knowledge and action regarding the climate crisis is also impressively illustrated. Subsequently, the Heidelberg standards of climate medicine reveals concrete fields of action in the health sector (including the reduction of emissions by means of changing the food supply, energymanagement, and drug supply in hospitals) in order to decisively counter the health crisis stemming from the climate crisis (chapter 6). Afterwards, various health co

气候危机在许多方面威胁着我们的自然生计和文明。随着全球平均气温的稳步上升，跨越不可逆转的气候临界点的可能性越来越大。生物多样性急剧丧失、海洋酸化、粮食短缺更加频繁、极端天气事件增加以及与气候有关的难民流动都面临着威胁。作为一本紧凑的"袖珍书"，海德堡气候医学标准提供了广泛的知识和面向实践的行动建议，内容涉及科学基础、气候危机的生理和心理影响的(医学)治疗，以及朝着生态上更可持续的卫生部门的必要转型进程。在12章共45篇文章中，参与的作者总结了他们(医疗)实践的研究现状和信息，并为卫生部门所有参与者的日常职业生活提供了有用的提示和建议。首先，海德堡气候医学标准对气候危机的科学基础(第1章)及其对自然和社会系统的影响(第2章)进行了简要而简明的概述。这些基础知识一方面将帮助读者了解接下来的书中的章节，另一方面，它应该作为(科学)话语中的实用工具。然后，有两个全面的章节强调了气候危机对人类健康的众多直接和间接影响。在关于气候危机的物理影响的第三章中，环境变化(例如，更频繁的极端天气事件、热浪、热带病原体发病率增加)与人类健康的密切关系变得很明显:许多疾病的发生，如中暑、慢性阻塞性肺病、过敏、糖尿病或肾衰竭，都受到气候危机的影响。除了解释这种关系之外，本章还介绍了与临床医生相关的定义，病理生理过程，临床护理的关键建议以及有用的治疗策略。气候变化的心理影响在第4章中有更详细的反映，从自然灾害背景下的创伤，到气候、天气和自杀之间的联系。此外，第五章还专门讨论了气候变化心理感知和加工中的一般认知过程和偏见。关于气候危机的知识和行动之间的差异也令人印象深刻。随后，海德堡气候医学标准揭示了卫生部门的具体行动领域(包括通过改变食品供应，能源管理和医院药物供应来减少排放)，以便果断地应对气候危机引起的健康危机(第6章)。随后，使用合理的例子解释了气候保护措施的各种健康协同效益(第7章)，并以气候敏感的实用技巧为框架

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引用次数: 0

Medical students' perspectives on racism in medicine and healthcare in Germany: Identified problems and learning needs for medical education. 医学生对德国医学和医疗保健中的种族主义的看法：医学教育中发现的问题和学习需求。

IF 1.5 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

GMS Journal for Medical Education

Pub Date : 2023-04-17 eCollection Date: 2023-01-01 DOI: 10.3205/zma001604

Simon Matteo Gerhards, Mark Schweda, Merle Weßel

Objective: Against the backdrop of considerable lack of research, this study provides the first exploration of medical students' perspectives on racism in medicine and healthcare in Germany. The aim is to identify problems and learning needs for medical education. We address the following research questions: - How do medical students perceive racism in medicine and healthcare in Germany? - How do they address, understand, and discuss different aspects of racism in this context? - What are their expectations regarding the role of medical education?

Methods: Semi-structured online focus group discussions were conducted with 32 medical students from 13 different medical schools in Germany. The discussions were transcribed and analyzed using qualitative content analysis.

Results: Based on the analysis of the focus groups, four main hypotheses could be formulated: 1. Medical students perceive racism in medicine and healthcare in Germany as a ubiquitous phenomenon. 2. They have problems to identify racist behaviour and structures due to conceptual knowledge gaps. 3. They are insecure how to deal with racism on a situational level. 4. They hold medical education accountable to tackle racism in medicine and healthcare on various levels.

Conclusion: Our study raises specific learning needs for addressing racism in medicine and healthcare in Germany. Research from the US-context might inspire innovative approaches for German medical education but needs to take national specificities into account. Further research is needed to prepare the implementation of antiracist training in German medical education.

研究目的在研究相当缺乏的背景下，本研究首次探讨了德国医科学生对医学和医疗保健中的种族主义的看法。目的是找出医学教育中存在的问题和学习需求。我们将探讨以下研究问题- 医学生如何看待德国医学和医疗中的种族主义？- 在此背景下，他们如何处理、理解和讨论种族主义的不同方面？- 他们对医学教育的作用有何期望？对来自德国 13 所不同医学院校的 32 名医学生进行了半结构化在线焦点小组讨论。采用定性内容分析法对讨论内容进行了转录和分析：根据对焦点小组的分析，可以提出四个主要假设：1.医学生认为德国医学和医疗保健领域的种族主义现象无处不在。2.2. 由于概念上的知识差距，医学生在识别种族主义行为和结构方面存在问题。3.3. 他们对如何在情境中应对种族主义缺乏安全感。4.他们认为医学教育有责任在不同层面上解决医学和医疗中的种族主义问题：我们的研究提出了在德国应对医学和医疗保健中的种族主义的具体学习需求。来自美国的研究可能会对德国医学教育的创新方法有所启发，但也需要考虑到德国的具体国情。需要进一步开展研究，为在德国医学教育中实施反种族主义培训做好准备。

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引用次数: 0

Norbert Donner-Banzhoff: Die ärztliche Diagnose: Erfahrung – Evidenz – Ritual bozhoff:医学诊断:证据的

IF 1.6 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

GMS Journal for Medical Education

Pub Date : 2023-04-17 DOI: 10.3205/zma001596

S. Harendza

The most important statement of this book right at the beginning: “Diagnoses are not found, they are made”. This is likely to come as a bit of a shock to anyone who has enjoyed watching Dr. House or is looking forward to a new episode of Adventure Diagnosis in the media library. However, Norbert Donner-Banzhoff manages the miracle of covering the entire spectrum of medical thought and action, including cognitive psychology and medical history perspectives, in order to explain this statement without once using the term clinical reasoning. Never before have I enjoyed reading about strategies for prevalence enrichment or regression to the mean so much, not tomention the excellent explanations and illustrations of the four-field table, where, after reading it, really no one can claim not to have understood it. And: the fact that tests only modify disease probabilities according to Bayes’ theoremand that the pre-test probability is decisive for this cannot be read often enough – so here also. For this is often forgotten in everyday clinical practice, as the author explains with striking and also somewhat frightening examples. Complete certainty can thus not be achieved in the always tricky contexts of diagnosing. Perhaps it would have been even more useful at these points for a better understanding of this fact not to speak of a disease being “ruled out” but rather of it being made “less likely” by a test. But this is whining on a high level. This book is not just a guide to making a medical diagnosis, it is much more than that. It offers insight into the daily work of physicians in the trickiest task and the greatest professional challenge: making (i.e., “making”) a diagnosis. In doing so, it is devoted to historical perspectives and scientific traditions of different countries that approach the diagnostic process in different ways. This offers an excellent opportunity to reflect on one's own medical work – and teaching – and to open up to sometimes painful insights. The author discusses how reference ranges come about and that biological fluctuations are the greatest source of uncertainty, as well as the overestimation of technical findings in everyday medical practice and the harmful consequences of overdiagnosis and overtreatment. Theoretical, partly philosophical passages explaining important background information on the status quo of medical diagnosis with its problematic consequences (“X-rays and injections are powerful rituals”) alternate with current practical references. These are strikingly accessible to those working in the medical field, students and teachers, and offer good starting points for reflecting on one’s own actions. It is very pleasant to note that, with very few exceptions, English terms have been translated into German. The chosen form of gendering – the female form is used everywhere, except when exclusively men are meant – keeps the text pleasantly readable, even if this principle weakens somewhat in some places toward the

这本书最重要的一句话就在开头:“诊断不是发现的，而是做出来的”。这可能会让那些喜欢看豪斯医生或期待在媒体图书馆看到新一集冒险诊断的人感到有点震惊。然而，Norbert Donner-Banzhoff创造了奇迹，涵盖了整个医学思想和行动的范围，包括认知心理学和医疗史的观点，为了解释这个陈述，一次也没有使用临床推理这个术语。我以前从未如此喜欢阅读有关流行率富集或回归均值的策略，更不用说四字段表的出色解释和插图了，在读完它之后，真的没有人能声称自己不理解它。而且:根据贝叶斯定理，测试只修改疾病概率，即测试前概率是决定性的，这一事实不能经常读到——所以这里也是。因为在日常的临床实践中，这常常被遗忘，正如作者用惊人的，也有些可怕的例子来解释的那样。因此，在复杂的诊断环境中，不可能完全确定。也许在这一点上，更好地理解这一事实会更有用，不是说一种疾病被“排除”，而是通过测试使其“不太可能”。但这是高层次的抱怨。这本书不仅仅是一本医学诊断指南，它远不止于此。它提供了对医生日常工作中最棘手的任务和最大的专业挑战的见解:诊断(即“做出”)。在此过程中，它致力于以不同方式处理诊断过程的不同国家的历史观点和科学传统。这提供了一个极好的机会来反思自己的医疗工作和教学，并开放有时痛苦的见解。作者讨论了参考值范围是如何产生的，生物波动是不确定性的最大来源，以及在日常医疗实践中对技术结果的高估以及过度诊断和过度治疗的有害后果。解释医学诊断现状及其问题后果(“x光和注射是强有力的仪式”)的重要背景信息的理论性、部分哲学性段落与当前的实际参考文献交替出现。对于那些在医学领域工作的人，学生和老师来说，这些都是非常容易理解的，并且为反思自己的行为提供了很好的起点。非常高兴地注意到，除了极少数例外，英语术语已被翻译成德语。性别的选择形式——女性的形式在任何地方都被使用，除了专门指男性的时候——保持了文本的可读性，即使这个原则在接近结尾的一些地方有所减弱。每一章的结尾都有一个集中的观点，最终将所读到的内容带到了重点上，并对每个案例的基本方面进行了很好的总结。尽管有广泛的科学基础，这本书读起来几乎像一本小说或侦探小说，因为阅读的流程没有脚注的干扰。基础文献的概述可以在章节的末尾找到，甚至在更大程度上，可以从网站下载的注释数字补充材料。专业初级社会化以科学知识("疾病")为基础，而在与病人的日常工作中，每个人代表一个个案("疾病")。在我看来，这是诺伯特·唐纳·班佐夫在诊断中指出的最重要的见解。为了“做出”诊断，每个病人都必须单独“了解”。这也被视为医学教学面临的最大挑战，迄今为止，医学教学对这方面的关注很少。问题的复杂性

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引用次数: 0

Friedrich Edelhäuser: Wahrnehmen und Bewegen – Grundlagen einer allgemeinen Bewegungslehre Friedrich Edelhäuser：感知与运动——运动一般理论的基础

IF 1.6 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

GMS Journal for Medical Education

Pub Date : 2023-02-15 DOI: 10.3205/zma001584

C. Scheffer

How does a human being move? Are his actions an expression of his primary motor cerebral cortex or do they reflect the intentions of a human individuality? How do we see? Are we passive recipients or do we have to actively shape our seeing? What results from approaching these questions by bringing together scientific and phenomenological-philosophical insights? Can guiding viewpoints for person-centeredmedicine be gained from this? These questions are illuminated comprehensively and in many ways in the newly published book “Wahrnehmen und Bewegen – Grundlagen einer allgemeinen Bewegungslehre” (Perceiving and Moving Foundations of a General Theory of Movement) by Friedrich Edelhäuser. In doing so, the author takes us to astonishing phenomena, to reflections worth considering, and to profound questions. Using the example of looking at a mountain landscape, the first phenomena of seeing are looked at: our gaze goes inwardly through the picture, searching for various objects and contours and arranging the details into a meaningful overall context. What at first appears to be fixed thus becomes experienceable as a process. In the “objectifying” view of physiology, vision is characterized as a process akin to a camera in which light passes through a lens onto the retina and then leads to electrochemical nervous processes. In this process, the qualitative perceptions melt down into a measurable but qualityless process. Vision thus becomes an example of the stimulus-response sequence, in which an external sensory stimulus becomes electrochemical processes inside, i.e. in the brain, and is answered with a reaction. Thereby not only the quality of the perceived disappears, but also the perceiving person. In the following, this socalled third-person-perspective as an objectifying approach is supplemented by introspection, the first-personperspective. In chapter 5 “perceiving and moving” the process of seeing is examined more closely. In doing so, one becomes aware of the fact that seeing includes an inner scanning of the contour to be perceived. This unconscious movement of the eyeballs can be represented technically and shows individual movement patterns, similar to gait or handwriting. If this movement is suppressed, the perceived blurs to a gray-in-gray for a short time due to the lack of contrast. During further analysis, it is noticeable that one is not only aligned to the object to be seen with one's eye muscles, but with one's entire head and body posture. Only this self-movementmakes seeing possible. Something similar can be shown for hearing and other sensory modalities. Looking back at the mountain landscape, it becomes clear that there is a circular relationship, the perception of the image and the contours that can be found in it are guiding the scanningmovements of the eye, which in turn are conditions for what is to be seen. Thus, there is no monocausal relationship with temporal succession, but a mutually dependent one. In chapter 6 the Gesta

人类是如何移动的?他的行为是他的初级运动大脑皮层的表达还是反映了人类个性的意图?我们怎么看?我们是被动的接受者，还是必须主动塑造我们的视觉?通过结合科学和现象学哲学的见解来解决这些问题会产生什么结果?能否从中获得以人为本的医学指导观点?这些问题在弗里德里希Edelhäuser新出版的《运动一般理论的感知和运动基础》一书中得到了全面的阐述。在这样做的过程中，作者将我们带入了惊人的现象，值得思考的反思，以及深刻的问题。以观看山景为例，观看的第一个现象是:我们的目光通过画面向内，寻找各种物体和轮廓，并将细节安排到一个有意义的整体背景中。最初看来是固定的东西，因此成为可经验的过程。在生理学的“物化”观点中，视觉被描述为一个类似于照相机的过程，在这个过程中，光线通过透镜进入视网膜，然后导致电化学神经过程。在这个过程中，定性的感知融化成一个可测量但没有质量的过程。视觉因此成为刺激-反应序列的一个例子，在这个序列中，外部的感官刺激变成了大脑内部的电化学过程，并以反应来回应。因此，不仅被感知的品质消失了，感知的人也消失了。接下来，这种所谓的第三人称视角作为一种客观化的方法，被第一人称视角——内省所补充。在第5章“感知和移动”中，更仔细地研究了观看的过程。在这样做的过程中，一个人意识到这样一个事实，即观看包括对被感知的轮廓的内部扫描。这种眼球的无意识运动可以从技术上表现出来，并显示出个人的运动模式，类似于步态或笔迹。如果这种运动被抑制，由于缺乏对比度，感知到的图像会在短时间内模糊为灰中灰。在进一步的分析中，可以注意到，一个人不仅用眼肌对准要看的物体，而且用整个头部和身体的姿势。只有这种自我运动才能使视觉成为可能。类似的情况也可以出现在听觉和其他感官模式上。回头看山景，很明显有一个圆形的关系，图像的感知和可以在其中找到的轮廓引导着眼睛的扫描运动，这反过来又成为所看到的东西的条件。因此，与时间演替没有单因果关系，而是相互依赖的关系。第六章介绍了w.v. Weizsäcker的格式塔循环，并对感知和运动的相互使能进行了更详细的研究。生物与环境的关系是在一个包含的、循环的感知和运动过程中构成的。现在，有意注意作为一个进一步的研究对象加以考察。在光学的例子中，人们可以根据意图在相同的形式环境中看到不同的东西(例如，一个透明的立方体朝向前方或向后)，很明显，感知不是简单地给予或描绘的东西，而是放弃的东西，是由直接的，有意识的感知行为产生的东西。这种有意识的注意力以不同的方式影响我的视觉，所以它可以在中心和边缘之间，在前景和后面之间变化

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引用次数: 0

Development of a project for interprofessional collaboration between medical and pharmacy students to improve medication safety in polypharmacy (PILLE). 开发医学和药学专业学生之间的跨专业合作项目，以改善多种药物的用药安全（PILLE）。

IF 1.5 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

GMS Journal for Medical Education

Pub Date : 2023-02-15 eCollection Date: 2023-01-01 DOI: 10.3205/zma001585

Sabine Gehrke-Beck, Maike Petersen, Wolfram J Herrmann, Nicole Zimmermann, Eva Daub, Johanna Seeger, Josefine Schulz, Constanze Czimmeck, Noemi Lauterbach, Harm Peters, Charlotte Kloft, Martin Schulz, Ingo Siebenbrodt, Ronja Behrend

Aim: Interprofessional collaboration is particularly relevant to patient safety in outpatient care with polypharmacy. The educational project "PILLE" is meant to give medical and pharmacy students an understanding of the roles and competencies needed for cooperation in the provision of healthcare and to enable interprofessional learning.

Method: The curriculum is aimed at pharmacy and medical students and was developed in six steps according to the Kern cycle. It is comprised of an interprofessional seminar, a joint practical training in a simulated pharmacy, and a tandem job shadowing at a primary care practice. The project was implemented in three stages due to the pandemic: The interprofessional online seminar based on the ICAP model and the digital inverted classroom was held in the 2020 winter semester; the interprofessional practical training was added in the 2021 summer semester; and the interprofessional tandem job shadowing at a primary care practice in the 2021 winter semester. Attitudes toward interprofessional learning, among other things, was measured in the evaluation using the SPICE-2D questionnaire (Student Perceptions of Physician-Pharmacist Interprofessional Clinical Education).

Results: In the first three semesters, a total of 105 students (46 pharmacy, 59 medicine) participated in the project, of which 78 participated in the evaluation (74% response rate). The students stated, in particular, that they had learned about the competencies and roles of the other profession and desired additional and more specific preparatory materials for the course sessions. The SPICE-2D questionnaire showed high values for both groups of students already in the pre-survey and these increased further as a result of the project.

Conclusion: Joint case-based learning could be implemented under the conditions imposed by the pandemic. Online teaching is a low-threshold means to enable interprofessional exchange.

目的：跨专业合作与门诊多药治疗中的患者安全尤为相关。PILLE "教育项目旨在让医学生和药剂学学生了解在提供医疗保健服务时开展合作所需的角色和能力，并促进跨专业学习：该课程针对药学和医学专业的学生，按照克恩周期分六个步骤开发。该课程包括跨专业研讨会、模拟药房联合实践培训以及在初级保健实践中的串联工作实习。由于大流行病的影响，该项目分三个阶段实施：在 2020 年冬季学期举办了基于 ICAP 模型和数字反转课堂的跨专业在线研讨会；在 2021 年夏季学期增加了跨专业实践培训；在 2021 年冬季学期在初级保健实践中开展了跨专业串联工作实习。评估中使用 SPICE-2D 问卷（学生对医师-药剂师跨专业临床教育的看法）测量了学生对跨专业学习的态度等：在前三个学期，共有 105 名学生（46 名药剂学学生，59 名医学学生）参加了该项目，其中 78 名学生参加了评估（回复率为 74%）。学生们特别表示，他们了解了其他专业的能力和作用，并希望在课程课时获得更多更具体的准备材料。SPICE-2D 问卷调查显示，两组学生在预调查中的得分都很高，项目实施后，得分进一步提高：结论：基于案例的联合学习可以在大流行病的条件下实施。在线教学是实现跨专业交流的低门槛手段。

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引用次数: 0

"And how am I going to ask about this?" - introducing the course "sexual anamnesis" in peer teaching for medical students in Würzburg. "那我该如何询问呢？- 在维尔茨堡医科学生的同伴教学中引入 "性回忆 "课程。

IF 1.5 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

GMS Journal for Medical Education

Pub Date : 2023-02-15 eCollection Date: 2023-01-01 DOI: 10.3205/zma001592

Jessica Ruck, Maria Pramberger, Isabelle Späth, Anne Simmenroth, Janina Zirkel

Aim: A course on sexual anamnesis based on peer teaching was developed, piloted, and evaluated at the medical school of the University of Würzburg. The course is part of the expansion of the communication curriculum and in order to close existing gaps in medical education. An implementation of the course in the curriculum is meant to give all students the opportunity to acquire professional skills in this area.

Method: The course consists of knowledge transfer, interactive exercises, role plays with structured feedback, and an exchange with practitioners. A standardized online evaluation of the course took place in regard to teaching quality, subjective learning success, and acceptance. The voluntary course was conducted online in the summer semester of 2021 and in person in the winter semester of 2021/22. A total of 68 students participated. The training of the tutors was realized in cooperation with the "Deutsche Aidshilfe" (DAH).

Results: The course was successfully conducted online and in person. A total of 60 students participated in the evaluation. More than 80% of the students rated the course as structured. They assessed an adequate mix of knowledge transfer and practical exercises. More than half of the students reported that they were more confident in performing sexual anamnesis after they participated in the course. There was an open exchange among the students. More than 90% of the students found the peer teaching by the tutors helpful.

Conclusion: The implementation of the course closes a relevant gap of the curriculum in Würzburg. Sexual anamnesis will be a regular part of the curriculum starting in the winter semester 2022/23. The concept can also be transferred to other universities.

目的：维尔茨堡大学医学院在同伴教学的基础上开发、试行并评估了一门关于性病病史的课程。该课程是拓展交流课程的一部分，目的是弥补医学教育中的现有差距。在课程中实施该课程的目的是让所有学生都有机会获得这方面的专业技能：课程包括知识传授、互动练习、角色扮演和结构化反馈，以及与从业人员的交流。对课程的教学质量、主观学习成功率和接受度进行了标准化在线评估。该自愿性课程于 2021 年夏季学期在线开展，2021/22 年冬季学期面授。共有 68 名学生参加。辅导员的培训是与 "德国援助"（DAH）合作进行的：该课程通过在线和面授方式成功举办。共有 60 名学生参加了评估。超过 80% 的学生认为课程结构合理。他们认为知识传授和实践练习充分结合。半数以上的学员表示，在参加课程后，他们对进行性解剖更有信心了。学员之间进行了开放式交流。超过 90% 的学生认为导师的同伴教学很有帮助：该课程的实施填补了维尔茨堡相关课程的空白。从 2022/23 冬季学期开始，性解剖将成为课程的常规部分。这一概念也可以推广到其他大学。

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引用次数: 0

Acknowledgement to the reviewers of GMS Journal for Medical Education 对《GMS医学教育杂志》审稿人的致谢

IF 1.6 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

GMS Journal for Medical Education

Pub Date : 2023-02-15 DOI: 10.3205/zma001583

Martin R. Fischer, Götz Fabry

• Christian Abshagen, Windisch • Kambiz Afshar, Hannover • Matthias Angstwurm, München • Tsedeke Asaminew, Jimma (ET) • Cadja Bachmann, Rostock • Ivan Bank, Amsterdam (NL) • Daniel Bauer, Bern (CH) • Nicola Bauer, Köln • Jan Becker, Münster • Marianne Behrends, Hannover • Sven Benson, Essen • Pascal Berberat, München • Tanja Birrenbach, Bern (CH) • Kerstin Bitter, Berlin • Mozhgan Bizhang, Witten • Sebastian Bode, Ulm • Christoph Bohne, Frankfurt/Main • Hans Martin Bosse, Düsseldorf • Cindy Brandes, Osnabrück • Barbara Braun, Mannnheim • Andreas Breuer-Kaiser, Bochum • Christoph Broding, Witten • Monika Brodmann Maeder, Bern (CH) • Irene Brunk, Berlin • Petra Brzank, Nordhausen • Heinz Hans Florian Buchner, Wien (A) • Rainer Büscher, Essen • Jean-Francois Chenot, Greifswald • Iris Demmer, Göttingen • Jana Deppermann, Oldenburg • Andreas Dinkel, München • Carsten Döing, Düsseldorf • Fabian Dupont, Homburg • Jan P. Ehlers, Witten • Maren Ehrhardt, Hamburg • Tobias Eichinger, Zürich (CH) • Yannick G. Eller, Bern (CH) • Caroline Elliott, Coventry (UK) • Gundula Ernst, Hannover • Rebecca Sarah Erschens, Tübingen • Mona Eulitz, Witten • Folkert Fehr, Sinsheim an der Elsenz • Teresa Festl-Wietek, Tübingen • Sabine Ingrid Fischbeck, Mainz • Volkhard Fischer, Hannover • Michael Freitag, Oldenburg • Martin Gartmeier, München • Robert Gaschler, Hagen • Nadja Gebhardt, Heidelberg • Waltraud Georg, Augsburg • Heide Götze, Leipzig • Joachim Graf, Tübingen • David Groneberg, Frankfurt/Main • Claudia Gundacker, Wien (A) • David Gurrea Salas, Windisch • Jennifer Guse, Hamburg • Stefan Gysin, Luzern (CH)

•Christian Abshagen，Windisch•Kambiz Afshar，汉诺威•Matthias Angstwurm，慕尼黑•Tsedeke Asaminew，Jimma（ET）•Cadja Bachmann，Rostock•Ivan Bank，阿姆斯特丹（NL）•Daniel Bauer，伯尔尼（CH）•Nicola Bauer，科隆•Jan Becker，Münster•Marianne Behrends，汉诺威•Sven Benson，Essen•Pascal Berberat，慕尼黑•Tanja Birrenbach，伯尔尼（CH）•Kerstin Bitter，柏林•Mozhgan Bizhang，Witten•Sebastian Bode，Ulm•Christoph Bohne，法兰克福/美因河畔•Hans Martin Bosse，杜塞尔多夫•Cindy Brandes，Osnabrück•Barbara Braun，Mannheim•Andreas Breuer Kaiser，波鸿•Christoph Broding，Witteen•Monika Brodmann Maeder，伯尔尼（CH）•Irene Brunk，柏林•Petra Brzank，Nordhausen•Heinz Hans-Florian Buchner，维也纳（A）•Rainer Büscher，Essen•Jean-Francois Chenot，Greifswald•Iris Demmer，Göttingen•Jana Deppermann，Oldenburg•Andreas Dinkel，慕尼黑•Carsten Döing，Düsseldorf•Fabian Dupont，Homburg•Jan P.Ehlers，Witten•Maren Ehrhardt，汉堡•Tobias Eichinger，苏黎世（CH）•Yannick G.Eller，伯尔尼（CH），汉诺威•Rebecca Sarah Erschens，Tübingen•Mona Eulitz，Witten•Folkert Fehr，Sinsheim an der Elsenz•Teresa Festl Wietek，Tü宾根•Sabine Ingrid Fischbeck，Mainz•Volkhard Fischer，汉诺威•Michael Freitag，Oldenburg•Martin Gartmeier，慕尼黑•Robert Gaschler，Hagen•Nadja Gebhardt，海德堡•Waltraud Georg，Augsburg•Heide Götze，莱比锡•Joachim Graf，Tübingen•David Groneberg，法兰克福/美因河畔•Claudia Gundacker，维也纳（A）•David Gurrea Salas，Windisch•Jennifer Guse，汉堡•Stefan Gysin，卢塞恩（CH）

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引用次数: 0

Final-year information on didactic and organizational issues for students and supervising physicians - project report on the development and implementation of the cross-site website PJ-input. 关于学生和指导医生的教学和组织问题的最后一年信息-关于跨站点网站pj的开发和实施的项目报告。

IF 1.6 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

GMS Journal for Medical Education

Pub Date : 2023-01-01 DOI: 10.3205/zma001588

Angelika Homberg, Elisabeth Narciß, Julia Thiesbonenkamp-Maag, Felix Heindl, Katrin Schüttpelz-Brauns

Objective: Final-year training is becoming increasingly important in medical studies and requires a high degree of personal responsibility from students. It is the task of supervising physicians to make informal learning opportunities available to students when working with and on patients and to gradually transfer responsibility to them. Both students and physicians have a great need for information regarding the contextual conditions and didactic realization of this transfer of responsibility. Up to now, the faculties have only provided information and support in a sporadic manner and with little standardization. With MERLIN, the joint project undertaken by the Competence Network for Teaching Medicine in Baden-Württemberg, a platform for the final year was developed and released on the web. The aim was to bundle information in order to support students and supervising physicians in their teaching-learning process and to improve the quality of teaching in the final year.

Project description: The development process of this platform took place in several steps across all faculties. Content and materials were compiled and structured based on a needs assessment. The first draft was evaluated by means of a simulation by students and then revised. A professional internet agency was involved for the technical implementation. The newly designed website PJ-input ("PJ" being the abbreviation for "Praktisches Jahr", the final year) contains areas for students and supervising physicians, as well as faculty-specific and general information about the final year. Faculty-specific content can be entered directly by the respective staff via an input mask and updated at any time. The provision of didactic materials can support competency-oriented teaching and learning in the final year. Here, for example, the concept of the Entrustable Professional Activities (EPA) was taken up, which gives students and supervising physicians orientation for the gradual assumption or transfer of responsibility. The platform was launched in spring 2021. Usage behavior is continuously recorded via the web application.

Results and conclusion: The evaluation results show that the website is visited often and perceived as supportive. Increasing usage figures and the high frequency of use by students in the sections "im PJ" (during the final year) and "nach dem PJ" (after the final year) for the faculties involved in the MERLIN project confirm the target group-oriented design and use. The site should be promoted even more to pre-final-year students, as well as across state borders and to the target group of faculties. It is expected that nationwide faculty participation will make a significant contribution to the competency-based shift in teaching and the standardization of training during the final year of study under the new licensing regulations.

目的:最后一年的培训在医学研究中变得越来越重要，要求学生高度的个人责任感。监督医生的任务是为学生提供非正式的学习机会，并逐步将责任转移给他们。学生和医生都非常需要关于这种责任转移的背景条件和教学实现的信息。到目前为止，各院系只是零星地提供信息和支持，缺乏规范化。巴登-符腾堡州医学教学能力网络联合项目MERLIN为最后一年开发了一个平台，并在网上发布。目的是将信息捆绑起来，以便在教学过程中支持学生和监督医生，并提高最后一年的教学质量。项目描述:该平台的开发过程分几个步骤进行，涉及所有院系。内容和材料是根据需求评估汇编和组织的。学生通过模拟的方式对初稿进行评价，然后进行修改。一个专业的互联网机构参与了技术实施。新设计的网站PJ-input(“PJ”是最后一年“Praktisches Jahr”的缩写)包含学生和指导医生的区域，以及关于最后一年的教师特定信息和一般信息。教师特定的内容可以由各自的工作人员通过输入掩码直接输入并随时更新。教学材料的提供可以支持能力导向的教学和学习在最后一年。例如，这里采用了可信赖的专业活动(EPA)的概念，它为学生和指导医生提供了逐渐承担或转移责任的方向。该平台于2021年春季启动。使用行为通过web应用程序持续记录。结果与结论:评价结果显示，该网站经常被访问，并被认为是支持的。在参与MERLIN项目的院系中，学生在“im PJ”(最后一年)和“nach dem PJ”(最后一年之后)部分的使用数字不断增加，使用频率也很高，这证实了面向目标群体的设计和使用。该网站应该更多地推广给即将毕业的学生，以及跨州和目标教师群体。预计全国教师的参与将对在新许可条例下的最后一年学习期间以能力为基础的教学转变和培训标准化做出重大贡献。

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引用次数: 0

Implicit expression of uncertainty in medical students during different sequences of clinical reasoning in simulated patient handovers. 医学生在模拟病人交接过程中不同临床推理顺序的不确定性内隐表达。

IF 1.6 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

GMS Journal for Medical Education

Pub Date : 2023-01-01 DOI: 10.3205/zma001589

Sigrid Harendza, Hans Jakob Bacher, Pascal O Berberat, Martina Kadmon, Julia Gärtner

Background: Dealing with medical uncertainty is an essential competence of physicians. During handovers, communication of uncertainty is important for patient safety, but is often not explicitly expressed and can hamper medical decisions. This study examines medical students' implicit expression of uncertainty in different sequences of clinical reasoning during simulated patient handovers.

Methods: In 2018, eighty-seven final-year medical students participated in handovers of three simulated patient cases, which were videotaped and transcribed verbatim. Sequences of clinical reasoning and language references to implicit uncertainty that attenuate and strengthen information based on a framework were identified, categorized, and analyzed with chi-square goodness-of-fit tests.

Results: A total of 6358 sequences of clinical reasoning were associated with the four main categories "statement", "assessment", "consideration", and "implication", with statements occurring significantly (p<0.001) most frequently. Attenuated sequences of clinical reasoning occurred significantly (p<0.003) more frequently than strengthened sequences. Implications were significantly more often attenuated than strengthened (p<0.003). Statements regarding results occurred significantly more often plain or strengthened than statements regarding actions (p<0.0025).

Conclusion: Implicit expressions of uncertainty in simulated medical students' handovers occur in different degrees during clinical reasoning. These findings could contribute to courses on clinical case presentations by including linguistic terms and implicit expressions of uncertainty and making them explicit.

背景:处理医疗不确定性是医生的基本能力。在交接过程中，沟通不确定性对患者安全很重要，但往往没有明确表达，可能会妨碍医疗决策。本研究探讨医学生在模拟病人交接过程中，在不同的临床推理顺序中，不确定性的内隐表达。方法:2018年，87名大四医学生参与了3例模拟病例的交接，并对其进行了录像和逐字记录。临床推理序列和基于框架的隐式不确定性信息的语言参考被识别、分类并使用卡方拟合优度检验进行分析。结果:临床推理共有6358个序列与“陈述”、“评估”、“考虑”、“暗示”四个主要类别相关，且陈述显著(p结论:模拟医学生移交过程中不确定性的内隐表达在临床推理中不同程度地出现。这些发现可以通过将不确定性的语言术语和隐性表达纳入并使其明确化，为临床病例报告课程做出贡献。

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引用次数: 0