GMS Journal for Medical Education最新文献

Continuous development of professional skills is particularly relevant for emergency physicians because of the daily stress and high-pressure working conditions they face. Nevertheless, workshops that provide practical exercises for better handling these working conditions, especially for emergency physicians, are rare. The present workshop was designed as a part of a pilot project with a blended-learning approach. It lasted for 10 hours and took place over 1.5 days. Twenty-five emergency physicians took part: 22 from anesthesia and one participant each from trauma surgery, general surgery, and radiology. Both before and after the workshop, the participants were asked to assess and describe their experiences with this and similar workshops. The pre-workshop survey revealed that all the emergency physicians had already been in situations with high psychological pressure. They rated the psychological stress as correspondingly high. According to the participants, improving their ability to deal with stress could enhance their work performance as emergency physicians. The results of the post-workshop survey indicate that the participants felt that they had benefited from the workshop and the techniques they had learned for coping with psychological pressure in emergency situations and were able to apply these in clinical practice. This and comparable teaching formats for managing the stress of emergency physicians may prove beneficial.

Objectives: Practitioners and institutions have stated a need for training on how to work with patients who experience various forms of eco-emotions as an addition to existing curricula in psychotherapy training. Even though first suggestions for psychotherapeutic approaches to eco-emotions exist, these have not been translated into training concepts so far.

Methods: The aim of the presented project was to develop and implement a training on dealing with eco-emotions in psychotherapy, based on the framework of competency-based education. A one-day training was developed according to Kern's cycle. It consisted of i) a lecture, ii) three role-play scenarios with standardized patients, and iii) reflecting group discussions, and was offered three times to a total of n=23 medical and psychological psychotherapists in training at the Heidelberg Institute for Psychotherapy (HIP) in Heidelberg, Germany. The implementation was evaluated regarding feasibility, the educational strategies were evaluated regarding usefulness, and the effects of the training on a gain in competencies were evaluated through self-assessment.

Results: The implementation of the training showed to be feasible. Being an observer during the scenarios and being the acting therapist was ranked to be equally useful for gains in competency. Acceptance for all role play scenarios was high, and participants reported a significant gain in self-assessed competencies.

Implications: Training competencies in working with eco-emotions in psychotherapy is feasible and can be integrated into psychotherapy curricula. Competency-based education as a framework and the use of standardized patients are well suited to train participants in dealing with eco-emotions in psychotherapy.

Since 2023, the multiple-mini-interview-based selection procedure Interactional Competencies Medicine (IC-MD) has been used in the Additional Aptitude Quota 1 (ZEQ-1) in Heidelberg. The IC-MD enables the identification of applicants who get access to medical studies through outstanding interactional skills. These skills are important for both studying as well as practicing as a doctor, as they are among the most relevant characteristics of what makes a good medical doctor. The IC-MD assesses these skills based on the concept of emotional availability and is evaluated by trained raters using a detailed manual. Data from a pilot study from 2019-2021 has now been used to analyze the stability of the measured interactional competencies (r=0.40) with follow-up assessments based on the IC-MD manual as part of the OSCE (Objective Structured Clinical Evaluation) examinations. Results show that interactional competencies are relatively stable over time: Students who demonstrate excellent interactional competencies at the beginning of their studies maintain those throughout their studies.

Objective: The development of didactic skills plays a relatively subordinate role in medical training. However, teaching makes a central contribution to the training of young physicians and is an important part of the profession. In the present study, we therefore examine the question of how physicians' teaching-related self-efficacy is related to aspects of their general job-related well-being. This construct is measured via the three components job satisfaction, job motivation and emotional exhaustion. From the results, we derive starting points for measures to increase the teaching-related self-efficacy of lecturers and the quality of teaching in clinical settings in the future.

Method: Between 10/2016 and 09/2018, participants in university didactics training courses for medical lecturers at the Technical University of Munich (TUM) University Hospital were surveyed in writing. On this basis, we were able to analyze data from 293 participating physicians. We examined the assumed connections between teaching-related self-efficacy and emotional exhaustion, job satisfaction, and job motivation using Pearson correlations. For the relation to teaching experience, we calculated a Spearman correlation. We examined by t-test a possible difference in teaching-related self-efficacy between physicians who had received didactic training prior to our training vs. those who had not.

Results: The study showed a statistically significant correlation between teaching-related self-efficacy and job satisfaction (r=0.138; p=0.020) as well as with job motivation (r=0.278; p<0.001). There was no statistically significant correlation with emotional exhaustion (r=-0.087; p=0.147) at work. Furthermore, teaching experience correlated positively with teaching-related self-efficacy (ρ=0.186; p=0.002) and physicians rated themselves significantly more self-efficacious in teaching if they had previously completed didactics training (t(282)=2.684, p=0.008).

Conclusion: The teaching-related self-efficacy of physicians teaching at university correlated closely with the aspects of job satisfaction and job motivation, but not with emotional exhaustion. These findings offer starting points for interventional studies to investigate causal relationships that foster approaches to promote physicians' teaching-related self-efficacy.

Background: The development of occupational identity is an open and dynamic process and represents an element of competence development. Measures to accompany this development include reflecting on typical professional situations, individual challenges and the professional role. Peer counselling in the format of peer group supervision appears suitable for creating the necessary opportunities for reflection.

Aim: The study investigates the influence of peer group supervision on the development of occupational identity and whether peer group supervision influences psychological well-being.

Methods: A group of apprentices (n=25) in the three-year nursing training programme were trained in peer group supervision and conducted it regularly over the course of a year. In a mixed-methods approach, the commitment questionnaire of the COMET instrument, the WHO-5 well-being index, progress logs and focus group interviews were used to determine the effects and influences of peer group supervision on occupational identity and well-being in the longitudinal section.

Results: Peer group supervision has a moderating influence on the development of occupational identity and contributes to competence development. Psychological well-being can be improved through peer group supervision.

Conclusions: Peer group supervision should be learned in a structured way and continuously be applied in vocational training.

Study aim: Interprofessional education (IPE) is necessary in the training of health care professionals in preparation for future teamwork. However, sustainable integration into the medical curriculum is currently restricted by heterogeneous legal regulations. This study examines the factors and conditions upon which the implementation of IPE in medical education in German-speaking countries is contingent.

Methods: A mixed-methods, cross-sectional approach was carried out. This included a quantitative data collection of established IPE courses (type of course of study and IPE), which was evaluated descriptively. A qualitative approach encompassed semi-structured interviews with experts at medical faculties in German-speaking countries. In addition, stakeholder analyses were conducted.

Results: Study results demonstrated that enablers of curricular implementation of IPE include structural and logistical factors, as well as legal frameworks. Other important factors include high interest and involvement of various stakeholders, investment in resources, and utilization of various strategies to address curricular requirements. Challenges for sustainable implementation include dealing with a strict curricular structure, low stakeholder motivation, and low prioritization of IPE. Recommendations for addressing these challenges were specified. The stakeholder analyses revealed distinct constellations of stakeholders across the institutions examined.

Conclusion: Legal regulations and licensing requirements, logistical and structural factors, as well as a creative approach to address curricular requirements play a crucial role in currently implemented IPE in German-speaking countries. Stakeholders with a strong interest in and understanding of IPE are fundamental to its success.

Background: The National Competence-Based Catalogue of Learning Objectives (NKLM) aims to set standards for undergraduate medical education programs in Germany. The NKLM 2.0 is currently under revision, and medical faculties have been invited to evaluate this version. This study maps the learning objectives of the Modular Curriculum of Medicine (MCM) of the Charité Berlin to the NKLM 2.0 items using approaches based to those of a previous mapping of NKLM 1.0 to allow comparison.

Methods: A two-step process was used to determine coverage. First, the MCM learning objectives were mapped to the NKLM 2.0 items using the LOOOP curriculum management platform. Next, the degree of coverage of the NKLM 2.0 by the MCM was calculated via three quantitative approaches and one qualitative approach (content comparison). Finally, the results of NKLM 2.0 coverage were compared with the results of the previous NKLM 1.0 mapping.

Results: The mapping process identified 11,879 matches between 4,396 MCM learning objectives and 2,813 NKLM 2.0 items. The degree of NKLM 2.0 coverage, based on a content comparison approach increased to 52% compared with 41% for the NKLM 1.0. While some NKLM 2.0 chapters showed considerable increases (VII +25%, VIII +20%), others showed relevant decreases (V -8%, VI -8%).

Discussion: The coverage of the NKLM 2.0 by MCM learning objectives has improved compared with the NKLM 1.0. However, the low level of coverage by the MCM of only 52% indicates that the content of future revisions of the NKLM needs to be reduced considerably; otherwise, the content cannot feasibly be taught and learned within the regulatory framework for undergraduate medical education in Germany.

Background: While previous systematic reviews have examined specific aspects of the career trajectories of bachelor-qualified nurses, including adjustment strategies, workplace challenges, and support programmes, no comprehensive synthesis exists addressing how these factors interact across the broader early career pathway.This article examines the drivers and barriers influencing entry, role transition, and retention of graduate nurses, providing insights that complement existing research.

Methods: A systematic literature search following the principles of a scoping review was conducted in the professional databases MEDLINE via PubMed and CINAHL via EBSCO in February and May 2022, as well as in August 2024. The characteristics of the included studies were summarised narratively in a pre-consented data extraction table. The synthesis of information was performed inductively and organised into three emergent themes: Career Entry, Role Development, and Retention.

Results: 31 publications from 13 countries were included in the synthesis and presentation of results. Among these, 18 studies examined factors inhibiting career entry, 10 studies explored role transition, and 3 studies investigated factors influencing retention. Barriers included insufficient team support, fear of making mistakes, and increased workload. Facilitators included support structures, such as mentors and peer networks, as well as designated transition periods.

Conclusion: To promote the academic professionalisation of nursing in Germany and integrate of bachelor-qualified nurses into practice, structural frameworks embedded within the nursing process and oriented across multiple levels are essential. These frameworks should address both the barriers and facilitators identified in this review.

Objective: This study examines the teaching motivation of pediatricians working in outpatient settings in Lower Saxony, aiming to promote medical student training in outpatient teaching practices. The focus lies on identifying motivating factors and barriers in order to develop concepts for establishing a "pediatric teaching network".

Methods: A digital, anonymous questionnaire survey was conducted between July and September 2024. The cross-sectional study, based on prior work from general practice, included 27 items addressing intrinsic and extrinsic motivation, as well as barriers related to student teaching. Responses were rated on a four-point Likert scale and supplemented with open-ended questions. Univariate analysis methods were applied, and factors influencing teaching motivation were explored.

Results: A total of 137 complete responses were evaluated. Given the total number of potential respondents, the generalizability of the results may be limited. The average teaching motivation was 7.5 out of 10 points. Intrinsic motives - such as promoting the next generation (99% agreement) and knowledge exchange (98% agreement) - were dominant. Extrinsic incentives, such as recognition as an "academic teaching practice" (78% agreement), were considered relevant, while financial incentives were of lesser importance. The main barrier identified was concern that students might disrupt practice operations (53% agreement).

Conclusion: The strong intrinsic teaching motivation of pediatricians indicates potential for developing pediatric teaching networks. However, targeted collaboration is needed to overcome structural barriers, such as integrating students into routine practice. Strategies to enhance teaching motivation include (medical) didactic training, flexible teaching models, and organizational support.