GMS Journal for Medical Education最新文献

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.

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.