GMS Journal for Medical Education最新文献

Objectives: Animal assisted intervention is an increasingly accepted tool to improve human well-being. The present study was performed to assess whether dog assisted education has a positive effect on children suffering from rheumatic disorders with pain and adolescents with chronic pain syndrome.

Design: Two groups of juvenile patients were recruited: 7-17-year-old children in children with rheumatic diseases and adolescents with chronic pain syndromes. Overall, n=26 participated in the intervention, and n=29 in the control group.

Setting: The intervention group met once a month, 12 times overall, for working with man trailing dogs in various locations.

Main outcome measures: The influence of dog assisted education on quality of life (PedsQL^TM Scoring Algorithm), pain intensity, perception, coping (Paediatric Pain Coping Inventory-Revised), and state anxiety (State Trait Anxiety Inventory) was assessed.

Results: The quality of life increased significantly in the investigated period, but for both, the intervention and the control group. The state anxiety of children was lower after the dog assisted education than before. After the dog training sessions, state anxiety was 18% to 30% lower than before the intervention. Some participants noted subjectively improved pain coping and changes in pain perception, which were not found in the data.

Conclusion: Our results indicate that for children with rheumatic diseases and adolescents with chronic pain syndromes dog assisted education (1) might lead to an increase of the quality of life, (2) leads to decreased state anxiety from pre to post intervention and (3) does not influence pain perception, frequency and intensity.

Introduction: Simulation-based training is increasingly used in pediatrics to teach technical skills, teamwork, and team communication, and to improve potential deficiencies in pediatric emergency care. Team performance must be observed, analyzed, and evaluated by trained raters. The structured training of medical students for the assessment of simulated pediatric emergencies has not yet been investigated.

Methods: We developed a rater training program for medical students to assess guideline adherence, teamwork, and team communication in simulated pediatric emergencies. Interrater reliability was measured at each training stage using Kendall tau coefficients.

Results: In 10 out of 15 pairs of raters interrater reliability was moderate to high (tau>0.4), whereas it was low in the remaining 5 pairs of raters.

Discussion: The interrater reliability showed good agreement between medical students and expert raters at the end of the rater training program. Medical students can be successfully involved in the assessment of guideline adherence as well as teamwork and team communication in simulated pediatric emergencies.

Background: The MAAS Global (Maastricht History-taking and Advice Scoring List) is an internationally widely-used instrument in under- and postgraduate medical education. The focus is on the assessment of medical communication and clinical skills. The assessment tool, which has also been used in Germany since 2015, has a high-quality design (e.g. comprehensible structure, appropriate complexity), good psychometric properties and is very user-friendly. An update of MAAS Global, MAAS 2.0, was published in March 2021 with a new and greater focus on context and the formative.

Method: The revised version of the MAAS 2.0 assessment sheet was translated into German with the authors' permission. Open questions were discussed with the revision process project manager.

Results: The revision was carried out with a view to focusing on the patient's frame of reference, removing ambiguities identified previously while using MAAS Global, and closer alignment with the underlying Calgary-Cambridge model. Furthermore, the scale used for the evaluation was modified and now uses a formative evaluation range without grade-related classification.

Conclusion: With the content reorientation of MAAS Global to MAAS 2.0, and the associated focus on frame of reference, context, the formative, the revision presented here sets new priorities for future evaluations in the context of under- and postgraduate medical education and the assessment of medical patient communication in general.

Introduction: Students frequently rely on part-time jobs to earn a living wage. We sought to evaluate the sociodemographic status of Swiss medical students and their perception regarding equal career opportunities in view of impaired part-time job opportunities under the COVID-19 pandemic.

Methods: We conducted an anonymous online survey among Swiss medical students from Bern and Geneva over a period of 4 months between December 2020 and April 2021. We evaluated sociodemographic data, current living situation, part-time job occupation as well as other sources of income to fund living expenses, and, by means of a five-point Likert scale (1=strongly disagree and 5=strongly agree), whether COVID-19 was perceived as impeding equal career opportunities.

Results: Of 968 participants, corresponding to around 13.8% of all medical students in Switzerland, 81.3% had part-time jobs. Amongst the employed, 54.8% worked to afford living expenses and 28.9% reported a negative financial impact due to reduced part-time jobs under the pandemic. The loss of part-time jobs was perceived to make medical studies a privilege for students with higher socioeconomic status (4.11±1.0), whose opportunity to study is independent of a regular income. A governmental backup plan was considered crucial to support affected students (4.22±0.91).

Discussion: COVID-19 and its sequelae are perceived as a threat for Swiss medical students and lead to a disadvantage for those with lower socioeconomic status. Nationwide measures should be established to foster equal career opportunities.

Aim: During the COVID-19 pandemic, the absence of in-person teaching was partially compensated for through videoconferencing. However, lecturers complain that students do not participate actively in video-based online seminars. One reason cited for this is Zoom fatigue. Conferences in virtual reality (VR), accessible with and without head-mounted display, represent one potential remedy to this issue. The research to date does not shed any light on the (1.) teaching experience, (2.) student demand, (3.) learning experience (including participation and social presence), and (4.) learning performance (declarative and spatial) associated with VR conferences. The present work will compare these aspects for videoconferencing, independent study, and - in the case of teaching experience - with in-person teaching.

Methods: A compulsory seminar in General Physiology was offered during the 2020/21 winter semester and the 2021 summer semester as part of the Human Medicine program at the Faculty of Medicine at Ulm University. The seminars were offered in three different formats with identical content: (a) VR conference, (b) video conference, and (c) independent study, with students selecting the format of their choice. In the VR conferences, the lecturer taught using a head-mounted display while students participated via PC, laptop, or tablet. The learning experience and learning performance were assessed using questionnaires and a knowledge test. A semi-structured interview was conducted to assess the VR teaching experience.

Results: The lecturer's teaching experience in the VR conferences was similar to in-person teaching. Students predominantly chose independent study and videoconferencing. The latter resulted in worse outcomes with regard to learning experience (including participation and social presence) and spatial learning performance than the VR conferences. Declarative learning performance differed only slightly between teaching formats.

Conclusions: VR conferencing offers lecturers new didactic opportunities and a teaching experience similar to that of in-person teaching. Students prefer time-efficient videoconferencing and independent study, but rate participation and social presence, among other things, higher in VR conferencing. If faculty and students are open to the technology, VR conferencing can promote interactive exchange in online seminars. This subjective assessment is not associated with better declarative learning performance.

Background of the project: Stakeholders in healthcare and science increasingly demand the rapid integration of teaching content on planetary health (PIH) into the curricula of all the healthcare professions. In medical education, such topics are currently only covered inadequately and are mostly limited to elective courses.

Why was the project initiated?: In order to reach all medical students in the sense of a learning spiral and promote an interdisciplinary understanding of planetary health, a longitudinal mosaic curriculum is being developed that introduces aspects of planetary health throughout the entire course of study. We share the first experiences of the start of this project as an example to inspire similar activities elsewhere.

Implementation of the project: We mapped all the courses at the Faculty of Medicine in Würzburg and compared them with existing learning objectives on planetary health topics from the National Competency-Based Catalog of Learning Objectives for Medical Education. We then identified curricular injection points and held consultations with teaching staff and course coordinators from 26 different specialities in order to integrate the respective contents into the courses and, if necessary, develop new content. An overview of all curricular injection points with the corresponding topics, learning objectives, and teaching and examination methods is under development.

Evaluation of the project: The lecturers exchanged ideas with the project team of the teaching clinic of the Faculty of Medicine; further networking meetings to coordinate a learning spiral are to follow. The lecturers were asked to provide structured learning objectives in the categories "knowledge", "attitudes", "skills", and "confidence" on the topics integrated into the courses. Oral as well as written evaluations using Evasys^® questionnaires among students and lecturers are planned.

Final overall assessment outlook: Planetary Health topics have been introduced in several courses following our intervention. In the context of a learning spiral, teaching staff from further medical disciplines will be contacted so that more perspectives can be highlighted at different points in the curriculum. In addition, interdisciplinary teaching formats will be developed in order to take the complexity of the interrelationships into account.

Objective: Climate change is a key threat to human health worldwide. Accordingly, medical education should prepare future physicians for climate-associated hazards and corresponding professional challenges. Currently, this is not yet implemented across the board. The aim of this review is to present (I) the knowledge and (II) the attitudes of medical students and physicians towards climate change and (III) the expectations of medical education as formulated by medical students. In addition, the available literature will be used to look at (IV) global teaching activities, (V) international learning goals and learning goal catalogues, and (VI) applied teaching methods and formats. This review should simplify and, considering the urgency of the topic, accelerate the design of future teaching activities.

Methodology: The paper is based on a selective literature search supplemented by a topic-guided internet search.

Results: Knowledge about the causes and concrete health consequences of climate change seems to be incomplete. The majority of medical students consider human health to be at risk from climate change and the health sector to be inadequately prepared. A majority of surveyed medical students would like to see teaching about climate change. It is evident that internationally, teaching projects on climate change and climate health, as well as topic-specific learning objectives and learning goal catalogues, have been developed and integrated into medical education.

Conclusion: There is a need for and acceptance of teaching climate change in the medical curriculum. This literature review can assist in the development and implementation of new teaching formats.

Aim: Many universities offer rural medical internships for medical students. The present survey was designed to show how rural medical work is perceived by students, whether these perceptions are associated with origin and previous experience, and how well medical students know rural regions in the vicinity of their university. In addition, students were asked how to support and inspire medical students to later work in a rural region.

Methods: This cross-sectional study was based on an anonymous online survey of medical students at the Universities of Halle-Wittenberg and Leipzig. The evaluations included descriptive statistics, statistical group comparisons, and qualitative content analysis of free text answers.

Results: A total of 882 students took part in the survey. Students who had grown up in a rural region or had lived there for a longer time (71.7% of the respondents) rated the work-life balance better (p<0.01) and the patient variety in the countryside slightly higher (p<0.05) than their fellow students from the big city. Students who had worked in a rural practice or hospital before (62.2%) rated patient diversity (p<0.001) and work variety (p<0.001), as well as workload (p<0.01), slightly higher in rural areas than students with no prior experience. On average, the specified rural model regions were still unknown to more than 60% of the students. The suggestions for attracting medical students to later work as rural physicians included financial incentives and, above all, better information about life as a rural physician and the rural regions.

Conclusion: Thus, the medical faculties of the universities as well as the counties threatened by medical undersupply should further expand the transfer of knowledge and experience regarding rural physician life for the students.

Background: The development in teaching dental education toward ever greater digitization has gained enormous momentum in the last 2 years due to the pandemic. However, acceleration is not synonymous with improvement, especially from the learners' point of view. Therefore, the aim of this survey among students of dentistry was to determine which digital learning strategies and which media are preferred.

Method: Undergraduate students of clinical semesters (6^th to 9^th) in dental medicine during at the University of Freiburg participated in an online-survey. Questions were asked about personal learning strategies for and experience with using digital media for private and educational reasons. Furthermore, students were asked which digital learning formats they preferred for different learning phases.

Results: Students (N=148) are experienced in using digital media for learning. They prefer classical media (such as textbooks and lectures) for acquiring basic theoretical knowledge and mention digital teaching formats more in relation to practical training and complex treatment procedures. 67% prefer learning alone and 90% rate visualizations as helpful for learning. 78% report, that they feel well supported in the learning process by digital media and 83% agree that e-learning offerings are a quality factor for university teaching. 82% state e.g. that the growing range of online content allows a more flexible approach to face to face-teaching, enriches classroom teaching (78%) and helps organize one's own study (79%).

Conclusion: Students have a positive attitude towards the use of digital media, especially when it comes to having more time available for practical exercises. They also see an advantage in the fact that through the use of digital media, lectures can be organized more flexibly and also the organization of their studies can be optimized. New digital teaching media should be created based on these results. It is important to consider which digital formats seem suitable for which content during different semesters.

Aim: Stigmatization by healthcare workers poses a challenge to providing care to the mentally ill. Bedside teaching during undergraduate medical education offers students an opportunity to directly interact with patients with a range of psychiatric disorders and thereby gather reflective experience. The present study investigates if this supervised contact with mentally ill patients during a one-week clinical course on psychosomatic medicine leads to stigma reduction in medical students. The factors influencing stigmatization were also investigated.

Method: This was a prospective, non-randomized, controlled interventional study done in the 2019/20 winter semester involving fourth-year medical students who attended a week-long practical block on psychosomatic medicine (intervention group). This group was compared to students who had attended a week-long practical block with a somatic focus during the same time period (control group). Stigmatization was measured before and immediately upon completion of the week using the MICA-4 scale. Data on age, sex, experience with the mentally ill, interest in psychiatry/psychosomatics, and sense of self-worth were also gathered prior to starting the practical block. Analysis of the sample of 143 students with a complete basic data set was carried out using mixed ANOVA, multiple linear regression and moderator analysis.

Results: In the context of clinical teaching with psychiatric patients, the stigmatization of the mentally ill among medical students decreased significantly more in the intervention group compared to the students in the control group who received instruction on somatic topics (p=.019, η²_p=.04). In addition, being female, having previous experience with the mentally ill and general interest in the subjects of psychiatry or psychosomatics at T₀ associated with lower stigma. In contrast, stigmatization was increased at the beginning of the study in males and those with low self-esteem. A moderating effect of the factors on stigma reduction was not seen.

Conclusion: Undergraduate clinical instruction that enables direct contact and reflective experiences with the mentally ill leads to a reduction in the stigmatizing attitudes held by medical students toward the mentally ill. This underscores the need to have practical clinical instruction using patients.