GMS Journal for Medical Education最新文献

Background: The use of tobacco, alcohol and other drugs has considerable health consequences. Substance histories are often only incompletely taken in everyday clinical practice. When learning to take a medical history in medical school, one of the learning objectives is to inquire about consumption behavior. The aim of this exploratory study was therefore to examine the content and language of substance histories taken by medical students.

Methods: From a simulation training of a first working day in hospital, 91 video films of medical histories were available, which advanced medical students had conducted with six patients with different consumer behavior. These interviews were verbatim transcribed and analyzed using content-structuring qualitative content analysis according to Kuckartz. For all substances, the reasons for the questions and the depth of the respective substance use were categorized and errors in the questions were examined. In addition, a linguistic analysis of the verbal ways in which the substances were inquired about was carried out.

Results: The students most frequently asked about smoking (73.3%). In only 15.4% of the interviews were all substances asked about, in none were all substances asked about completely. A total of 112 protocol questions and 21 occasion-related questions were identified. Logical errors and double questions were found. Most of the questions were asked in a factual manner. However, questions in the categories "evasive" and "stigmatizing" were also found.

Conclusion: The content-related and linguistic deficits of medical students in the collection of substance histories identified in this study should be addressed in communication courses at an early stage of undergraduate medical studies.

Objective: Interprofessional education (IPE) can cultivate competencies in multidisciplinary collaboration for patient safety, and both face-to-face and online IPE programs have recently been introduced. This study aimed to elucidate the effects of the online IPE program on undergraduate students after the coronavirus disease 2019 pandemic.

Methods: The difference-in-differences method was used to assess undergraduate students in the Schools of Medicine and Health Sciences and in the Faculty of Pharmacy at Takasaki University of Health and Welfare who participated in IPE programs at Gunma University (face-to-face IPE was implemented in 2019 and online IPE in 2020). We distributed a questionnaire that included modified versions of the Attitudes Toward Health Care Teams Scale (ATHCTS) and the Teamwork Attitudes Questionnaire (T-TAQ) to evaluate attitudes toward health-care teams and collaboration for patient safety, respectively, and then compared the differences.

Results: The mean score on the "team efficiency" subscale of the ATHCTS in the online IPE program was significantly lower than that in the face-to-face IPE program. Scores on the T-TAQ in two categories, "mutual support" and "communication", were significantly higher in the online IPE program, which suggests that it may have a similar effect on students learning collaborative practice for patient safety. However, due to technological difficulties, the online IPE program reduced the educational effects for "team efficiency". The improvements in "mutual support" and "communication" seen in the online IPE program, suggest its necessity for collaborative practice for patient safety.

Conclusion: These findings suggest that an online IPE program for patient safety may provide better education effects as a whole, but efforts are needed to minimize the associated technological difficulties.

Objectives: Teaching of ECG interpretation frequently relies on visual schemas. However, subsequent student ECG interpretation skills are often poor. Expertise research shows that expert looking patterns frequently deviate from the steps taught in schema learning. The present study made a cardiology expert's gaze interpreting ECGs visible - through eye-tracking videos with cued retrospective reporting (CRR) - and investigated the potential as an additional expert-driven route to improve medical students' ECG interpretation skills.

Methods: N=91 Medical students participated in the RCT of an ECG e-learning session aimed at medical students' ECG interpretation skills gain, either receiving the newly developed eye-tracking video with CRR audio commentary materials (n=47) or studying via four clinical cases only (n=44). Three outcome scores relating to different aspects of ECG interpretation skills were derived from pre-post MCQ ECG tests. The effect of the EYE-ECG training and additional characteristics (e.g., prior experience, interest) on student ECG interpretation skills were evaluated using t-tests and multivariate linear regression.

Results: A small, non-significant advantage of the EYE-ECG training signifying a tendency for greater knowledge gain was observed, compared to training as usual. In multivariate regression models, the predictive value of clinical case 1 was an unexpected finding warranting further exploration.

Conclusion: Additional gains after an only 9-minute intervention using videos of expert's real-time gaze pattern in combination with hearing their thought processes during ECG interpretation is a promising finding. Furthermore, a number of specific performance characteristics enabling students to best benefit from ECG training were identified and possible modifications to the learning intervention suggested.

Objective: This position paper of the Committee on Methodology in Educational Research sets out the criteria for the acceptance, revision, or rejection of manuscripts of the article types project report and how to in the GMS Journal for Medical Education, as well as outlining the development of these criteria.

Methods: In a workshop with writers, reviewers, and editors, we formulated and discussed common core elements for articles. We did this by consulting the journal's editorial board on the basis of guidelines for authors and reviewers from other journals and by using examples of articles considered less or more successful. From this, we derived specific aspects to be addressed and rejection criteria for the respective article types.

Results: We have identified the target group, relevance, justification, and implication as the common core elements for both article types. We have also derived specific aspects to be addressed and rejection criteria from these core elements for each article type.

Conclusion: A manuscript lacking core elements will be rejected. If aspects are not described sufficiently or are not clearly comprehensible, the manuscript must be revised.

The objective of academic training is to prepare midwives as independent healthcare professionals to make a substantial contribution to the healthcare of women in their reproductive years as well as to the health of their children and families. This article therefore describes the professional and educational requirements derived from the legal midwifery competencies within the new midwifery act. Furthermore, it identifies the conditions that need to be established to enable midwives in Germany to practise to their full scope in compliance with statutory responsibilities. Educational science, academic efforts, policymaking and accompanying research should work in synergy. This in turn enables midwives to achieve the maximum scope of their skills, with the objective of promoting physiological pregnancies and births. Consequently, it can strengthen early parenthood in alignment with the national health objectives of "health around childbirth". The academisation of the midwifery profession presents a profound opportunity for professional development in Germany. It is essential that midwives receive training based on the principles of educational science and care structures that are yet to be developed. This can enable them to perform within the wide range of their professional tasks to the highest standards, thereby ensuring the optimal care of their clients. Moreover, there is a chance to implement sustainable improvements in healthcare provision for women and their families during the reproductive phase and the period of parenthood in Germany.

Objectives: Surgical undergraduate training takes place in a male-dominated work environment that struggles with recruitment problems. Experiences of cultural and sex/gender-specific barriers of women in surgery have been reported worldwide. Overall, the experiences that students have in coping with the emotional impact of surgery as a profession are thought to be crucial to their subsequent career choices. We investigated whether students' self-reported experiences differed by sex/gender in terms of frequency and content, and whether they were related to their career aspirations.

Methods: In Germany, the final year represents the last part of the undergraduate medical study program. At the Mannheim Medical Faculty, a 12-week surgical training is mandatory. After completing their surgical training, the students were asked about their experiences and their later career aspirations. These experiences were analysed using quantitative content analysis. The relationship between the quality of experience and career aspirations as well as sex/gender differences were statistically measured.

Results: In the 475 questionnaires analysed (response rate 52%), the number of positive and negative mentions does not differ by sex/gender. However, male students feel more actively involved and female students feel poorly briefed and think that supervisors are less interested in their training. A significant influence on career aspirations was found in the performance category for female and male students, and in the supervision category for female students.

Conclusion: The positive experiences that students gain while performing surgical activities have an impact on their subsequent career choices. In particular, a good settling-in period and encouragement to actively participate could help to attract more women to surgery.

Objectives: Teaching communication skills plays a pivotal role in medical curricula. The aim of this article is to describe and evaluate a new communication curriculum developed at the Faculty of Medicine, University of Augsburg (KomCuA), which was conceptualized by an interdisciplinary team based on recommended quality standards (i.e., helical, integrated, longitudinal).

Methods: A total of 150 medical students enrolled in the 1^st, 3^rd, and ≥5^th semester participated in the study. They completed an online survey (numerical rating scales and validated questionnaires) evaluating their current communication skills, how these developed across the curriculum in terms of quality and self-confidence, and how helpful they considered practicing in small group tutorials with simulated patients. The students' attitudes towards communication and empathy in the context of medical care were additionally assessed. The students' responses were compared across semesters using one-way univariate analysis of variance (ANOVA).

Results: Overall, students reported improved communications skills due to attending the KomCuA and further considered practicing with simulated patients as being very helpful (large effect sizes). Compared to 1^st semester students, 3^rd and ≥5^th semester students reported better communication skills (medium to large effect sizes). Additionally, ≥5^th semester students showed stronger agreement towards the relevance of empathy in the context of medical care (medium effect size) compared to both 1^st and 3^rd semester students.

Conclusion: The KomCuA has shown to be an effective communication curriculum to support medical students in the development of their communication skills and positive attitudes towards empathy. Additional studies assessing students' communication skills and empathic attitudes longitudinally are warranted to confirm the present results and to gain further knowledge on how these essential skills and attitudes develop across medical curricula.

Objectives: The care of women and their families around childbirth requires effective interprofessional collaboration of the midwifery and medical profession. Given the academisation of midwifery, early interaction between students of midwifery and medicine is both necessary and feasible. As there is a lack of comprehensive data on interprofessional education (IPE) for midwifery and medical students at higher education institutions in Germany, Austria, and Switzerland (DACH region), the aim was to identify existing IPE activities, and their curricular determination.

Methods: The exploratory study was conducted in the DACH region over three months (Dec. 2022-Feb. 2023). Higher education institutions offering midwifery science and/or medicine were invited to participate in a web-based survey. The questionnaire focused on the structure and curricular implementation of IPE courses, on cooperation, financial support and more.

Results: A total of 58 out of 96 invited institutions (60%) participated in the survey, of which 34 (59%) offered IPE. Eighteen institutions (19%) offered 32 IPE courses for midwifery and medical students through cooperation within faculty (n=8) and between faculties (n=10). Notably, most of these IPE courses (60%) were integrated into the required curriculum of both study programmes. Most IPE courses were offered without financial support (71%).

Conclusion: The current status quo highlighted the existence of numerous IPE offers for midwifery and medical students in the DACH region that warrant further curricular integration of proven and well-established best practice examples to further enhance these initiatives.

The current situation in Germany is characterised by significant differences between the two types of higher education institutions offering bachelor's degree programmes in midwifery at both universities of applied sciences and universities. These differences are noticeable in admission procedures, resource allocation, content focus and competence assessment at the respective institutions, which in turn result in heterogeneous study experiences. This article highlights the challenges currently facing bachelor degree programmes and the academic qualification of midwives, and identifies future requirements for the development of degree programmes in theory and practice as well as theory-practice transfer, and assessment formats. Furthermore, this article covers the content-related and structural-organisational requirements to develop in-depth academic skills grounded in theory teaching, the facilitation of clinical placements at an academic level, the training of qualified practical instructors and the development of applicable competence-based assessment formats, especially for the state exam. The development of a standardised, high-quality academic education for midwives in Germany requires networking of the different academic sites/locations to exchange experiences in teaching/learning and assessment formats. Furthermore, it can facilitate the development of a standardised competence-oriented model and core curriculum as well as the definition of quality criteria and standards for study programmes of midwifery science. The Midwifery Science Committee (AHW) in the DACH Assoviation for Medical Education (GMA) offers an optimal platform for cooperation between the different universities. The existing challenges for the further professional development of midwives can only be overcome by collaboration and pooled expertise.

What is the context informing the project?: Effective communication within a medical team is crucial not only because it results in higher job satisfaction and better joint decision-making among team members, but also because, ultimately, it makes for high-quality, patient-centered care. Since the transition to the clinical phase of study poses a challenge for many medical students, the University of Lübeck introduced "Ich im Team" (me as team member), a German-language communication workshop for third-year medical students, in the 2020/21 winter semester.

Why was the project started?: The workshop forms a basis for future collaboration and is meant to strengthen the interpersonal skills needed for working in teams, communicating with patients, and supporting a no-blame culture.

How is the project carried out?: This workshop, which incorporates elements of improvisational theater and coaching, was offered for the first time in 2020/21. Due to the positive evaluations, it has been a required component of the curriculum since the 2021/22 winter semester.

How is the project evaluated?: The students have accepted the workshop very well, which is reflected in the excellent evaluations of it. Furthermore, a research study carried out during the first two times the workshop was conducted showed, among other things, directly positive effects on the ability to work in interprofessional teams and handle mistakes.

Final overall assessment and outlook: The workshop offers students a solid point of entry into the clinical setting and an awareness of their own role on a given team. Covering the content in more depth and the possible inclusion of other study programs are being discussed.