GMS Journal for Medical Education最新文献

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.

Description of project/objectives: Internationally, healthcare students call for more interprofessional education (IPE) and in Switzerland some of them formed the Swiss Health Alliance for Interprofessional Education (SHAPED, [https://www.shaped-ip.ch/]). As a students' and young professionals' association, SHAPED has developed multiple participatory, realistic, and enjoyable interprofessional (IP) learning activities. This project report describes the development as well as the implementation of these IP learning activities, initially in the extra-, and more recently also in the intracurricular setting. Additionally, it evaluates their benefits to students.

Results: From 2020 to 2024, more than 2,000 students stemming from ten different healthcare professions participated in IP learning activities developed by SHAPED. Quantitative analysis using the Students Perception of Interprofessional Clinical Education Revised (SPICE-R) instrument showed a significant increase in students' perception of IPE pre-to-post participation, with a medium effect size (t(540)=-13.4, p<.001, d=0.574). This increase in perception was similar for both, the intra- and extracurricular setting.Qualitative analysis confirmed that while refinement of format and content was sometimes indicated, most of the participants appreciated the interactive nature of SHAPED's activities and enjoyed learning new aspects about the roles and responsibilities of other healthcare professions.

Conclusion: SHAPED is an exemplary project showcasing how the student-led development and implementation of IP learning activities can overcome many barriers faced by IPE-inclined faculty and why it should thus be considered as a valid alternative to advance IPE everywhere.

Objective: At the Hannover Medical School (MHH), a compulsory science module was introduced into the medical curriculum for the 2020/2021 academic year. This article presents the didactic premises - with a focus on teaching scientific skills and critical thinking - and describes their implementation in the form of a longitudinal teaching concept with a final research paper. Results on the students' learning gains are reported against this background.

Methods: The National Competence-Based Learning Objectives Catalogue for Medicine (NKLM) and the results of curriculum mapping were used to identify learning objectives and teaching formats. Learning gains in the newly designed module were assessed using student competence assessments. The research paper concept and initial results are evaluated on the basis of around 200 papers submitted. Furthermore, student feedback (N=81) was collected and analysed using an online questionnaire that was administered after the submission of the research paper.

Results: The science module was implemented as a longitudinal teaching concept. The learning objectives are taught through electronic assessment portfolio tasks (ePF tasks), seminars and a final research paper. Formative feedback is provided to assess the ePF tasks. Around 90% of a cohort successfully completed the tasks and achieved significant learning gains. To date, around 200 students have successfully completed a 10-15 page research paper. They consider the acquisition of scientific writing skills and the ability to conduct structured literature research to be the greatest learning gains.

Conclusion: The introduction of additional components of scientific training offers numerous opportunities and challenges. Teaching the relevant skills is resource-intensive, as teaching usually requires smaller supervision ratios. To strengthen the feedback culture in medical education, little-used teaching methods such as assessment portfolios and research papers can be employed.

This article discusses the integration of planetary health and sustainable healthcare into family medicine education, focusing on undergraduate medical training. While environmental impacts on health have been recognized since ancient times, the urgency of addressing climate change in healthcare has escalated, especially as the healthcare sector contributes significantly to greenhouse gas emissions. The article highlights practical ways for medical educators to incorporate sustainable healthcare practices in family medicine settings. Through four "teachable moments", it demonstrates how medical students can engage in sustainability efforts, from reducing practice carbon footprints to minimizing unnecessary tests and treatments. The challenges of incorporating planetary health into an already crowded medical curriculum are acknowledged, and the authors propose an integrative approach, leveraging family practices' flexibility. They emphasize the importance of involving students in sustainability efforts, fostering bidirectional learning that benefits both the teaching practice and the students' future careers.

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.