GMS Journal for Medical Education最新文献

Background: Simulation-based medical education is increasingly important in postgraduate training, yet the comparative merits of in-house vs. society-accredited courses are still not well understood. This study examined these two approaches in three emergency medicine domains - prehospital, pediatric, and adult - to identify their respective strengths and potential limitations.

Methods: In a retrospective analysis, 1,263 participants from 57 sessions (2019-2023) evaluated six emergency medicine courses (three society-accredited, three in-house). A 25-item Likert-scale survey assessed aspects of course content, delivery, organization, and overall recommendation, alongside demographic questions and free-text comments. Mann-Whitney U tests and Cliff's Delta were used for statistical comparisons.

Results: Society-accredited courses generally scored higher on guideline adherence, presenter competence, and practical relevance, whereas in-house formats excelled in areas like content scope and communication. Participant specialty, workplace, and training stage influenced ratings. Free-text feedback praised hands-on learning and small-group design but called for earlier material distribution, better logistics, and clearer guidelines.

Conclusions: Both in-house and society-accredited SBME courses exhibit distinct strengths. Adopting best practices from both models, may guide a hybrid approach that optimizes SBME outcomes. However, reliance on self-reported data and a lack of controls for instructor competence or teaching style limit generalizability. Future research should include a broader sample, more rigorous content analysis, longitudinal follow-up, and detailed participant experience data to enhance the depth and applicability of findings.

Introduction: Stays abroad in the form of study visits and clinical traineeships, for example, have been rare in dentistry degree programmes in Germany to date. The new ZApprO (date of issue: 8 July 2019) offers the opportunity to integrate stays abroad into the degree programme through the introduction of modules, ECTS points and clinical traineeships, among other things. The aim of this study was to analyse the student perspective on this topic.

Methodology: In the summer term of 2021, a voluntary and anonymous online survey was conducted among dental students at the University of Münster. In addition to demographic data, the questionnaire also included key questions on content.

Results: With a response rate of 55%, a total of 371 students took part in the survey. 96% of the study participants stated that they would like to gain experience abroad as part of their studies, almost half of them even in the case of missing or only partial recognition of academic achievements. This includes clinical traineeships (30%) and semester-long stays (32%) or both (28%). The loss of time in the progression of studies, financing as well as time-consuming planning and family obligations are the most frequently cited reasons against a stay abroad.

Conclusion: The survey shows a very high level of interest among dental students in university-supported stays abroad. This includes both shorter periods of time, such as clinical traineeships, as well as longer stays, e.g. as part of Erasmus collaboration programmes. Based on the results, university-supported stays abroad should be made possible.

Objective: Experiences of discrimination in the context of medical care are not uncommon and have a significant impact on the health of those affected. For this reason, an elective course (28 units) on "dealing with discrimination in medical communication" was introduced at University Hospital Jena for medical students in the clinical section, which aims to improve the communicative skills of future doctors with marginalized patients. The course was tested for the first time in the winter semester 2023/24. The evaluation was used to check whether the course is suitable for expanding knowledge and skills in dealing with discrimination, as assessed by the students themselves.

Methodology: The course includes discrimination-sensitive treatment of blind/visually impaired patients, trans*/non-binary patients, patients with right-wing extremist attitudes and/or conspiracy beliefs, people without health insurance, as well as racism- and trauma-sensitive treatment and the use of language mediation. The course also contained numerous elements for self-reflection and reflection on one's own professional attitude as a doctor. The self-assessment of knowledge and competence gains is based on an online survey at the beginning of the first course and at the end of the last session.

Results: The participating students (N=13) had hardly had any contact with the content of the seminar series through their medical studies, although they rated the relevance for their own practical work as high. The evaluation of the pre- and post-survey showed that completing the course led to significant increases in self-assessed knowledge for all course topics. There was an increase in self-assessed competence, particularly in relation to dealing with blind/visually impaired people, traumatized people and the use of interpreters. The ability to self-reflect and deal with one's own weaknesses, as well as the awareness of recognizing discrimination, was rated significantly higher also.

Conclusion: The newly designed elective subject could help to subjectively improve medical students' knowledge and skills in dealing with discrimination in medical communication. The findings thus provide a good basis for the development of further teaching concepts.

We propose a new approach to deriving minimum standards for scientific training in medical studies. This approach allows specific learning objectives to be clearly defined and presented, in an easily comprehensible manner. We contend that a fundamental prerequisite for university studies is the instruction in the systematic scientific method that can be described through the scientific cycle. This instruction provides the foundation for the acquisition of scientific knowledge and evidence-based practice in medicine.

Objectives: The research focused on the recommendations of the International Council of Ophthalmology, specifically regarding the duration of ophthalmology education, areas of clinical exposure, essential skills, and adherence to these standards internationally.

Methodology: A thorough search was conducted in the PubMed, Cochrane Library, Scopus, and ERIC databases up to April 2024 to identify studies related to International Council of Ophthalmology (ICO) principles in undergraduate medical education. Two independent reviewers assessed citations for inclusion criteria, gathered data, and evaluated the risk of bias using the ROBIN-I tool, PROSPERO CRD42024517718.

Findings: From 537 unique references, only eight research articles qualified for inclusion. The primary educational aim in most studies was to meet the ICO requirements. Typically, medical students spend at least two weeks focusing on ophthalmology. These courses offer extensive exposure to ophthalmic patients across diverse clinical environments, such as ophthalmology clinics, emergency departments, and surgical theaters. Instructional methods include theoretical lectures, small group discussions, self-directed learning, and hands-on clinical experiences. The study found that the adoption of ICO recommendations varied from 20% to 36%.

Conclusions: This research evaluates how undergraduate ophthalmology education in medical schools correlates with ICO guidelines, indicating that implementation remains limited. Enhanced promotion of these standards in educational institutions is essential, alongside further studies.

Background: Given demographic changes and a rising prevalence of oncological diseases, understanding the importance of interdisciplinary collaboration and a timely integration of palliative care is crucial. However, both are underrepresented in medical curricula. To address this gap, we introduced a new elective in which students follow the journey of a fictitious patient with prostate cancer from diagnosis until death.

Method: The elective was conducted through repeated joint meetings by a multi-professional and interdisciplinary (palliative care, urology, radiation oncology, psychosomatic medicine) team. Alongside its development, an outcome evaluation was designed to assess satisfaction (Likert scale) and learning gains (comparative self-assessment, CSA [%]). After pilot testing, the content and structure were adapted. The elective followed a blended learning approach. The content covered guideline-adherent treatment of prostate cancer, breaking bad news, initial contact with palliative care, symptom control based on the total pain concept.

Results: Students (n=8) expressed high satisfaction. They found the structure comprehensible and considered the content valuable for medical practice. Students gained knowledge, especially in defining total pain (83%) and the indication of the timely integration of specialized palliative care (77%).

Conclusion: Using prostate cancer as an example disease, we integrated multiple disciplines into treatment strategies, demonstrating the benefits of multi-professional and multidisciplinary collaboration. This approach aids in identifying patients who could benefit from palliative care. Our concept is adaptable to other tumor types and settings, enhancing awareness of patient-centered issues that are often overlooked in medical curricula.

Background: Educational institutions in Germany are facing the challenge of providing healthcare professionals with the skills they need to collaborate interprofessionally. Appropriate skills can be acquired through suitable teaching/learning formats and cross-cutting topics. However, there is a lack of empirical results on the design of appropriate teaching/learning formats in order to apply the cross-cutting topics effectively in as many healthcare professions as possible.

Methodology: An integrative literature review on suitable teaching/learning formats was carried out in which 21 titles were analysed and presented in a table. The typology according to Sottas et al. was used as a deductive evaluation framework. In order to identify cross-cutting issues, an analysis of the training and examination regulations for healthcare professions in Germany was carried out, with an evaluation using frequency counts.

Results: The three most common cross-cutting topics are counselling, quality assurance and the structured care process. The topics are to be taught using methods such as case-based and problem-oriented learning, interprofessional group work or simulation. The debriefing of interprofessional teaching/learning formats is highly relevant.

Discussion & conclusion: Interprofessional teaching for healthcare professions rarely takes place in the form of observation-based and hands-on learning in Germany. In addition, only a few healthcare professions are usually involved in interprofessional teaching and learning formats. Both of these factors impede the teaching of complex interprofessional skills.

Objective: This project aims to provide doctors in postgraduate training (ÄiW) in general medicine with business knowledge of practice management through a modular training program within an e-learning environment, thereby reducing important barriers to establishing a medical practice.

Methodology: To develop the concept, a needs analysis (interviews with medical specialists, ÄiW, and medical students) was combined with teaching and informational materials from the Association of Statutory Health Insurance Physicians.

Results: The developed e-learning concept consists of twelve self-contained modules that include various formats (teaching letters, videos, audio slide presentations, and checklists) for knowledge transfer and reflection. By May 2024, 72 participants had started using the class. The needs initially stated by the participants largely corresponded with the content offered. So far, the possibility of feedback to adapt the content or questions about the content have not been used.

Conclusion: The modular e-learning class presented here covers business management topics in general practice and can help reduce this important barrier.

Background: In the academic year 2020/21, alterations were introduced in the admission procedures for medical studies, particularly within the selection quota (AdH). These changes reduced the significance of school-leaving grades (the Abitur) in favor of the Test for Medical Studies (TMS) and considerations of professional training & voluntary service as non-cognitive criteria. The waiting time regulation (WQ) was replaced by a "Special Aptitude Quota" (ZEQ), where experienced professionals were classified based on TMS results. This article examines whether and how those changes have influenced study success in the first two years of medical studies.

Methods: We compare the cohorts of 2020 and 2021 (new admission procedure) with the preceding three cohorts, admitted through the old admission process at Hannover Medical School (MHH). Dimensions of study success include dropout rates, progression in studies (completion of the first section within the standard study period), and performance in all written module examinations during the first two study years. The quota of high school top performers (AQ) serves as the reference group. Using ANOVA and comparative statistics, we investigate changes within and between quotas.

Results: Alterations in admission procedures resulted in ZEQ and AdH cohorts being admitted with significantly poorer Abitur grades. While dropout rates decreased in all considered quotas, it is not statistically significant. ZEQ students were more likely to complete the first section on time compared to WQ. AdH entrants after 2020 achieved significantly higher scores in examinations than cohorts from 2017-2019, closing the gap with high school top performers. Both groups consistently outperform WQ/ZEQ in examinations.

Discussion: Historically, Abitur grades have been a reliable predictor of study success. However, recent years have seen an inflation of excellent high school diplomas. We have demonstrated that a shift away from the Abitur toward aptitude tests and even explicitly non-cognitive criteria does not jeopardize success in medical studies. On the contrary, our findings suggest a trend toward increased study success among ZEQ and AdH. The gap towards AQ, however, remains sizeable.