GMS Journal for Medical Education最新文献

Background: In addition to meeting legal requirements, education research studies in the health professions must also factor in aspects of ethical research. However, no specific guidance exists as of yet on how to implement these requirements and aspects in practice. Our aim was therefore to develop recommendations on how to apply aspects of ethical research when planning, conducting and publishing such studies.

Method: The recommendations were developed by the members of the DACH Association for Medical Education's Committee on Methodology in Educational Research in three steps: (1) identification of problematic areas in education research, (2) derivation of concrete measures and explanations, and (3) review of the recommendations by experts with different research perspectives.

Results: Two separate sets of recommendations were developed. One set contains actions to ensure data protection, free consent, no harm to and the autonomy of participants (six areas with a total of 29 measures); the other addresses the quality assurance of studies and publications (four areas with a total of 14 measures).

Discussion: The recommendations provide assistance when considering ethical aspects and applying them. However, they do not replace any existing rules or the individual reflections of the researchers. These recommendations should undergo continual development and be investigated in regard to their application and effect on decision-making processes in education research.

The article introduces the "research program subjective theories" (RPST), which was developed in the 1980s to systematically investigate individual thought processes. The focus lies on "subjective theories" - stable, structured systems of convictions that function in the same way as scientific theories, but are less formalized. Central to the RPST is the dialogical reconstruction of such theories through the exchange between researchers and interviewees, which leads to authentic insights and reflection of thought processes. The "structure-formation-technique" (SFT) method reconstructs and visualizes these processes. The RPST has evolved over the years and is now used in a variety of ways by research and education, and also expands the diversity of scientific approaches in medical education research. The article summarizes the scientific-theoretical fundamentals and research-methodological background of RPST and provides an overview that can be used as a basis for taking the first steps toward theory-based application of this approach.

Co-creation in health professions education (HPE) is gaining momentum as a vital approach to enhancing educational practices and outcomes. As the healthcare landscape evolves, the need for innovative educational models that actively involve learners and other stakeholders in educational design has become increasingly important. This innovative approach promotes learner engagement and ensures that educational programs are more aligned with the realities of contemporary healthcare delivery. Integrating diverse perspectives in co-creation initiatives aims to enrich the educational experience by harnessing the unique insights and experiences of all participants-learners, educators, and healthcare professionals. Though co-creation offers numerous benefits, its success depends on effective partnership dynamics. By considering the insights of participants, moderators, and organizers (also known as triangulation approach), we can identify facilitators, challenges, and opportunities for improvement. Triangulation refers to the process of using multiple sources or methods to gather data and insights. This comprehensive approach will help optimize co-creation initiatives and maximize their benefits for learners and educators alike. This commentary emphasizes the importance of integrating diverse perspectives to enhance our understanding of the co-creation process.

Introduction: Pain medicine is located in different sections of the medical curriculum. In the pandemic situation, an online teaching concept for Q14 which includes several disciplines had to be developed. The goal of the project was to create a fully digitized learning platform for the cross-sectional area Q14 that allows all participating disciplines to address the various learning goals without losing a practical component.

Project description: First, the students' expectations regarding education in the field of pain medicine were recorded by means of a survey among medical students. Based on this, a teaching module in a blended learning format was developed, which consisted of two parts. Within a digital learning platform, students were first required to complete consecutive learning units using an interactive learning management system. This was followed by a presence phase (online ZOOM seminar) in which, under the guidance of teaching staff, the therapy suggestions of the individual case studies from the previous learning program were reflected. In the second part, the acquired knowledge was applied to a simulated patient. An evaluation of the online module was carried out through free-text answers and self-assessment of the completion time. The ZOOM seminar was evaluated on the basis of an assessment by the teachers.

Results: The survey among students revealed a desire for practical training without "frontal teaching". The resulting project realized this aspect by teaching theory during an online module with case vignettes and interactive learning tasks. The subsequent online presence time during the ZOOM meeting enabled the students to repeat and deepen contents and to ask questions. 170 students completed the entire online program, of which evaluation data were available for 75 students. Self-assessment of completion time averaged at 4-6 hours. In the feedback, 90 aspects were addressed, including mainly comments on content (43%), praise (33%) and comments on technical problems (23%). According to the assessment of the presenters, the students were able to carry out the pain anamnesis survey in a structured manner. The submission of the therapy proposal, however, represents a particular hurdle.

Conclusion: With the presented blended learning concept it is possible to address the different learning goals and the interdisciplinarity of Q14 sufficiently. After further processing and improvement of the project, a controlled and more extensive collection of evaluation data is required to further investigate the benefit of the platform for the students regarding achievement of defined learning goals.

[This retracts the article DOI: 10.3205/zma001527.].

Background: Interprofessional healthcare requires interprofessional learning (IPL) starting during academic education. The aim of this study is to examine the implementation of IPL in the modules "Topical Workshop (TW) for Orthopaedic Rehabilitation" and "TW for Paediatrics and Child and Adolescent Psychosomatics" at the Universität zu Lübeck (UzL) from the perspective of students in occupational therapy, speech therapy, and physiotherapy.

Methods: This qualitative study was conducted in two phases. In phase 1, qualitative data was collected and analysed using Kuckartz's method of content-structuring qualitative content analysis. Building on this, two focus group interviews were conducted in phase 2 and analysed using the same method. The data was integrated using a triangulation approach. A final member reflection was carried out.

Results: The analysis of five interviews, five written pre-understandings, the central evaluation, and two focus group interviews shows: Joint learning of new content, understanding of profession-specific content, and the acquisition of interprofessional skills are at the core of IPL. In the modules, the various professions were involved to different extents, approaches to interprofessional collaboration (IPC) were demonstrated, and practical relevance was established. Facilitating factors such as practical content and group work were contrasted by challenges such as a lack of exchange and unsuitable tasks. The perceived learning gains resulted in wishes and ideas for shaping future TWs.

Conclusion: Both facilitating and inhibiting factors for IPL were identified. These lead to approaches for further developing the modules, which can be applied to similar academic contexts.

Background: Medical education traditionally involves directional flow of knowledge/skills/attitudes from a senior to junior individual. However, medical training also provides opportunities for expertise role-reversal, where the direction of flow is reversed. Unlike fields such as aviation, medicine has not yet begun to fully realise the educational potential of this approach.

Objective: To better understand how role-reversal is viewed by medical education participants, necessary for its use as a tool to advance both education and patient care.

Methods: A senior resident designed and led a feedback-writing workshop for her own consultants (conducted 2022). After the session, eight consultants were interviewed in a semi-structured format. Analysis was conducted using the Stenfors-Hayes phenomenographical approach.

Results: A multiplicity of experiential perspectives was identified by both consultants (teacher/participant/supporter/hierarchy member/colleague/holder of multiple perspectives) and trainee (presenter/subordinate/learner/researcher). The exercise increased appreciation and awareness of the complexity of the trainee-consultant educational-power relationship, though both parties maintained traditional hierarchy despite altered informational flow. Participants often held multiple articulated experiential perspectives simultaneously.

Conclusions: Consultants were able to assume a learning mindset while simultaneously maintaining awareness of their existing hierarchical relationship to the trainee-presenter; the trainee, conversely, struggled to adopt the teacher mindset. Deliberately viewing moments where trainees present new information to consultants as expertise role-reversal may provide a starting point for more equitable knowledge exchange between both parties in the clinical routine, and a foil for epistemic injustice. Increasing recognition and use of expertise role reversal can play a critical role in improving educational culture.

Introduction: Virtual Reality (VR) is playing an increasingly important role in medical education and training by enabling realistic and immersive learning environments. However, a comprehensive overview of how VR is implemented at medical faculties in German-speaking countries ("DACH region") is still lacking. This article aims to close this gap by providing an overview of the current use of VR at medical faculties in the region, with a particular focus on immersive VR applications and the use of Head-Mounted Displays (HMDs).

Methods: To investigate the use of VR, an online survey was sent to 53 medical faculties in the DACH region. The questionnaire, which was created by a consensus of experts, collected data on VR use, technical implementation and financing in addition to demographic information. The data were analysed descriptively using SPSS.

Results: A total of 36 faculties (68% of DACH institutions) participated in the survey. 56% already use HMD-based VR in teaching, 11% are planning to do so. The most common goals of using VR include preparation for clinical practice and training in procedures or rare and high-risk situations. Funding sources include third-party and institutional funding, with commercially licensed applications being the most commonly used software. Technical implementation varies, and VR headsets are mostly used in specially adapted rooms.

Discussion: The spread of VR is inhomogeneous. The main challenges relate to financing, technical infrastructure and concerns about data protection. There is currently no standardised and accessible platform for the networking and visibility of VR projects in the DACH region.

Conclusion: Just over half of the faculties surveyed are already using VR, while others are planning to implement it. Networking and standardized evaluations are necessary to establish VR in medical teaching. The VR Working Group (VR-AG) of the DACH Association for Medical Education (GMA) provides a useful basis for this. In addition, further studies are needed to evaluate the long-term learning effects and practical applicability of VR applications.

Objective: The aim of this study was to analyze the potential benefits of real-time feedback in resuscitation training for participants in the prehospital emergency chain and to compare differences in the quality of chest compressions (CC) with and without feedback.

Methods: The primary endpoint was to analyze the proportion of CC achieving the recommended depth (5-6cm) and frequency (100-120/min) during two minutes of CC. This prospective cohort study compares bystanders (N=75), paramedic trainees (N=75), and emergency physician trainees (N=75) with and without the feedback system of the Zoll X-Series^®.

Results: Without feedback, paramedics (P) achieved the target compression frequency in 82.7%, bystanders (B) in 49.8%, and emergency physician trainees (EP) in 75% (P vs. B, p<0.001; EP vs. P, p=0.759; EP vs. B, p=0.217). There were no significant differences in target compression depth without feedback.With feedback, P achieved the compression frequency in 90.7%, B in 72.8%, and EP in 91.4% (P vs. B, p<0.001; EP vs. P, p=0.425; EP vs. B, p<0.001).With feedback, P achieved the compression depth in 56.9%, B in 47.3%, and EP in 75.1% (P vs. B, p=0.759; EP vs. P, p=0.217; EP vs. B, p=0.002).

Conclusion: The results underscore the importance of real-time feedback in emergency medical training, especially for B. All cohorts showed significant improvement, indicating that feedback enhances CC and promotes skill development. Given the importance of high-quality CC, their early optimization in training is essential. This highlights the need for standardized training concepts, including timing recommendations for feedback systems. Future studies should consider real-life prehospital conditions and investigate chest compression to validate transferability to real-life scenarios.

Introduction: Simulation arenas, in which video recordings from multiple projectors are projected onto curved screens to increase the realism of emergency medical simulations, have so far been associated with high development costs of more than 100,000 euros. The objectives of this study were (1) to develop a cost-effective simulation arena, (2) to determine whether the simulation arena increases the realism of simulations and (3) whether it has an impact on the perception of stress and the associated quality of resuscitation.

Methods: A pilot study was conducted to assess the level of satisfaction, realism, and perceived stress in two student courses using a questionnaire. In the randomized controlled SIMARENA trial, third to sixth year students were assessed for subjective stress and subjective resuscitation quality by a visual analogue scale (VAS), objective resuscitation quality by a resuscitation feedback system, and objective stress by cardiac reactivity.

Results: The development costs of the SimArena Magdeburg (SAM) amounted to 7,726.50 euros. Almost all participants agreed that the SAM contributed to the perception of a realistic environment. There was a significant difference in perceived stress. Cardiac reactivity was also significantly higher when using the SAM. The subjective and objective resuscitation quality showed no significant difference.

Conclusions: The SAM is the first low-cost 180° simulation arena that enables emergency medical simulations in a realistic, secure, quickly interchangeable, and standardized environment. It causes an increased stress perception without reducing the quality of resuscitation, providing an optimal learning environment in which stress levels can be tailored to the participants' learning objectives through various parameters.