GMS Journal for Medical Education最新文献

Objectives: Compile information on the current measures undertaken by German universities to accredit and qualify primary care teaching practices.

Methods: Nationwide online survey of teaching practice coordinators using a self-developed questionnaire, descriptive analysis of the quantitative data and qualitative content analysis of the free-text responses.

Results: A total of 32 out of 41 university sites provided information. A structured accreditation process is conducted at 29 sites, most commonly by personally visiting the medical practices (n=22), alternatively through video calls (n=10) or telephone calls (n=9). 18 sites have a process in place to qualify medical practices for the block practicum (obligatory for qualification at 15 of these sites), 17 sites have one for the practical year (obligatory at 12), and 22 sites offer other additional training (mandatory at 8). Procedural formats and length of time vary. The imparted content includes organizational information, targeted learning objectives, and teaching methods.

Conclusion: Structured accreditation and qualification measures are carried out by many universities. A nationwide harmonization of teaching practice qualification is advantageous for enabling cross-site qualification programs.

This work presents a structured cross-course teaching concept designed for biomedical engineering students, focusing on acquiring technical skills through the construction and application of 3D-printed robotic and holographic microscopes, spanning over different lectures. The project is embedded within the lectures of Medical Engineering, Medical Imaging and Anatomy and Physiology, aiming to bridge theoretical knowledge and hands-on applications. The concept includes theoretical lectures, interactive seminars, and practical laboratory sessions as well as self-study phases and project implementation phases. Students are guided through the technical implementation such as 3D printing, wiring, programming and assembly as well as the use of the microscopes. Key learning objectives include physics, mastering manufacturing processes, and applying open-source resources and finally using their own built microscope within the practical part of a medical lecture. Besides that, the project-based approach should foster methodological competence and problem-solving skills as well as social competences and teamwork. The first run shows increased student engagement and improved exam performance among participants, while qualitative feedback highlights the project's motivational impact. Although designed for biomedical engineering students, the concept offers transferable elements for a wide range of usage within medical education. Besides the didactic aspects the use of DIY approaches based on open-source and 3D printing offer cost-effective, sustainable alternatives to cost-intensive, traditional lab equipment.

Background: The second victim phenomenon describes the psychological, cognitive and physical reactions of healthcare professionals who are directly or indirectly involved in adverse patient events or errors and are themselves impaired as a result. Common symptoms include anxiety, guilt, grief, depression and burn-out, which can significantly restrict their ability to work. Surveys in German-speaking countries show that the prevalence of the second victim phenomenon is as high as 89% across all healthcare professions.

Objective: This paper aims to synthesise learning objectives pertaining to the second victim phenomenon from the current literature and thus provide a basis for training medical students.

Methods: Design: Qualitative synthesis of relevant categories using "best fit" framework synthesis based on the European Researchers' Network Working on Second Victims. Data collection: Literature search in PubMedCentral, MEDLINE, Cochrane and CINAHL based on the categories. Data analysis: Qualitative document analysis according to Mayring with synthesis of the learning objectives and definition of the depths of competency: According to the depths of competency in knowledge, practical knowledge, and practical skills, based on the taxonomy of the National Competency-based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM).

Results: The analysis resulted in the definition of a framework catalogue with four subcategories: I: Basic concepts and definition of the second victim phenomenon, II: Symptoms of the second victim phenomenon and need for support, III: Intervention options, and IV: Contextualisation of the second victim phenomenon in the broader context of employee welfare. These categories were assigned to seven areas of knowledge and, based on this, seven learning objectives with their respective depths of competence were defined.

Conclusion: In this study, seven evidence-based learning objectives concerning the second victim phenomenon were defined for medical students and systematically integrated into the NKLM's taxonomy. The results provide a structured basis for anchoring this topic into the curriculum in order to impart knowledge about the second victim phenomenon early on and minimise long-term, negative consequences for healthcare professionals.

Introduction: Multisource Feedback (MSF) is one form of assessment in medical training. It provides individual feedback based on multiple ratings, which can then be used to develop learning goals during a feedback conversation between supervisor and resident. We conducted this study to investigate how the resident and supervisor set the learning goals and what the learning goals refer to.

Methods: The study comprised 75 sets of MSF, each consisting of 12-15 external ratings per resident and one self-rating per resident. Data included 1015 external ratings and 75 self-ratings. As ten sets missed learning goals, only 65 sets of MSF could be analysed. Data comprised written MSF feedback, including scale-based ratings and narrative comments, structured minutes from the feedback conversations and the resulting learning goals, which were sorted into themes. We used multiple linear regressions to determine the associations between feedback data, conversation topics and learning goals.

Results: Topics were more likely to be discussed as strengths during the feedback conversation if scale-based ratings were high and there were many favourable comments on an item. Topics were more likely to be discussed as areas for improvement if the number of unfavourable comments was high. Topics with many (favourable and unfavourable) comments and topics discussed as an area for improvement were more likely to result in learning goals. We found a number of learning goals beyond the competences on the MSF-questionnaire, that can be understood as connected to Professional Identity Formation.

Conclusion: As the feedback and learning goals clearly exceeded the expected competences from the MSF questionnaire, we see the need for addressing these broader topics of residents' development. Hence, we encourage supervisors and residents to explicitly include Professional Identity Formation topics such as career plans, engagement in research or personal attitudes into regular assessments and feedback conversations. Thus, MSF might be a fitting tool to support professional identity development.

Objective: Communication skills are a central component of the medical profession and are already taught during medical studies. However, the design of teaching content for doctor-patient communication across Germany is not based on empirical data collected from physicians' everyday professional practice, meaning optimal preparation for future work is not guaranteed. The aim of this study was to identify the need for relevant topic content and to use the limited teaching time in communication courses for these topics, providing educators with empirically based selection criteria.

Methodology: Using an exploratory sequential mixed-methods design, the need for relevant topics was determined. All teaching practices of the University of Lübeck were invited in writing to participate in the study. Teaching physicians rated, using a topic catalogue, which topics they considered relevant for communication courses in medical studies, as well as how challenging and frequent these topics are in everyday professional life.

Results: The questionnaire was completed by 46 of the 70 invited teaching physicians (65.7%). Fifteen topics, including breaking bad news and communicating one's own mistakes, were rated as relevant for communication courses.

Conclusion: The results provide tailored recommendations for case studies in communication courses that are relevant for medical students' later professional practice. A concrete implementation involves the selection of relevant topics, enabling the practice of frequently encountered but less challenging topics at the beginning of studies and more difficult but rarer topics in advanced studies.

Objective: This study aimed to evaluate the effectiveness of an enhanced eye-tracking video intervention (EYE-ECG2) in improving ECG interpretation skills of medical students. Building on the foundational EYE-ECG1 study [Scherff et al. GMS J Med Educ. 2024], which tested the utility of expert eye movement modelling and retrospective think-aloud commentary for ECG skill acquisition, this follow-up study introduces modifications designed to optimise learning outcomes.

Methods: A randomised controlled trial was conducted with medical students (N=94) allocated to either the control group (TAU) with standard ECG interpretation training, consisting of a validated set of 4 ECG cases for ECG interpretation; or the intervention group (INT) who additionally received the EYE-ECG2 video. The EYE-ECG2 video included refined ECG gaze cues and Cued Retrospective Reporting (CRR) by a senior cardiology expert. Performance was assessed pre- and post-training. Data were analysed to compare improvements in diagnostic accuracy, decision-making processes and student feedback were evaluated.

Results: The results of the previous study were successfully replicated, showing an overall significant learning benefit from the cases and a moderate, yet nonsignificant tendency for INT>TAU (ΔM=0.80-2.42%; p=.79-.30). Randomised case presentation attenuated the special role of learning case 1 observed previously in EYE-ECG1. Exploration of student feedback showed a largely positive or neutral evaluation (74%), and a prior cardiological clerkship was a distinguishing factor resulting in positive (vs. neutral/negative) sentiment regarding the eyetracking videos with CRR (χ²(2)=7.57, p=.03).

Conclusion: The ECG training significantly improved participants' ECG interpretation skills, with a strong start in the training session playing a key role in these improvements. Student feedback indicated that certain subgroups, particularly those with prior cardiological experience, may derive a greater self-reported benefit from the EYE-ECG2 videos.

Introduction: During the COVID-19 pandemic, many medical students played an active role in the healthcare sector. This cross-sectional survey was used to record the participants´ work and learning experiences.

Methodology: During the first lockdown (May/June 2020), we conducted a nationwide online survey of medical students who took part in pandemic assignments.

Results: A total of 381 medical students on placement participated in the survey. The most common placement locations were hospitals (60%), followed by outpatient care (21%) and the public health services (18%). Tasks included in particular nursing activities, blood sampling, patient consultations and smear tests. Most students felt well integrated. Hospitals were associated with more stress and excessive demands.The greatest learning gains were experienced in the areas of collaboration, communication, knowledge of the health system, practical skills, insights into everyday medical practice and crisis management. In the free text responses, many respondents criticised the healthcare system particularly the focus on economics, bureaucratic processes and hierarchical structures. Positive feedback related to appreciation of nursing care. Many students said that they missed support from the faculty. Looking to the future, many would like to see more practical and responsible activities in healthcare. 80% of participants would be available for such an assignment again.

Conclusion: The integration of the students can be considered a success. Many experienced progresses in key areas of expertise and would like to see more structured active participation in healthcare.

Background: Planetary health education highlights the growing impact of climate change on human health - an urgent and relevant issue for healthcare providers that remains inadequately addressed in medical education.

Method: A student-led initiative at the University of Münster, Germany, has developed the "Klima-LIMETTE" (Engl.: "Climate-LIMETTE"), a course that teaches the health implications of climate change. It builds on the established infrastructure "LIMETTE" (Lernzentrum für individualisiertes medizinisches Tätigkeitstraining, Engl.: Learning center for individual medical skills training), that uses medical scenarios with simulated patients. Scenarios were developed based on current research on the effects of climate change on health with a focus in Germany. An additional blended e-learning course was designed to convey the knowledge needed for the case simulations and to promote a comprehensive understanding of planetary health.

Results: The "Klima-LIMETTE" was conducted twice as a pilot study with 32 students. The cases were evaluated to be realistic and relevant. Students ranked the "Klima-LIMETTE" as "good" or "very good" on a six-point Likert scale.

Conclusion: Health-relevant climate information can be presented practically and theoretically in medical education. This course acts as a best-practice example of Planetary Health Education in medical teaching through interdisciplinary cooperation. The course is now implemented in the curriculum and jointly organized by four complementary institutes within the University of Münster.

Background: Stigmatization of people with visible skin diseases (VSD) is a widespread problem that can lead to severe psychosocial stress. Owing to its great significance, there is also a need to develop and evaluate teaching opportunities for medical students to address stigmatization and the resulting negative consequences.

Project description: The development of the seminar was based on the 6-step Kern cycle. Through the collaboration of dermatologists, psychologists, and an expert on stigmatization in psoriasis, a team-teaching seminar concept on the stigmatization and psychosocial burden of people with psoriasis was developed and implemented in standard teaching at the University Medical Center Hamburg-Eppendorf.

Results: The seminar was held 19 times from October 2023 to July 2024; it was attended by 315 students. Participation in the voluntary questionnaire survey during the seminar was 93% (n=293). Data from 284 students were analyzed. This revealed an increase in self-reported knowledge regarding psychosocial stress and stigma among people with VSD. The students rated their ability to advise and support patients who had experienced stigmatization after attending the seminar as higher. Among the students who attended the seminar, 95% were satisfied with it; the majority rated team teaching as useful and the implementation of interdisciplinary teaching as successful.

Discussion: The seminar we designed closes the gap in the standard teaching of clinical and psychosocial subjects on the topic of stigmatization of VSD. By combining different teaching methods (frontal teaching, small group exercises, and discussions) with interdisciplinary team teaching, the sensitive topic of stigmatization in VSD was examined from dermatological and psychological perspectives. Appropriate teaching opportunities for students can improve their medical competence regarding stigmatization and psychosocial stress in people with VSD.