[Education of medical students in urology in Germany: present status]

[New approbation regulations-new concepts in urological undergraduate training?]

New research findings, changing health care structures and digitalisation are prompting further development of medical studies in Germany. The current amendment of the approbation regulations ("Ärztliche Approbationsordnung") focuses on the promotion of practical relevance and competence orientation of the course content and examinations, the redesign of the practical year and the expansion of general medicine in medical studies. This creates opportunities and challenges for urological training at the undergraduate level in Germany. In order to integrate basic scientific and clinical content, the existing curricula of the medical faculties must be adapted and further developed. There is an opportunity to implement innovative teaching and examination concepts in urological teaching and to attract the next generation of academics via scientific work in urology. In addition, the inclusion of teaching hospitals and outpatient areas can support university hospitals in urological training and show students the full range of the specialty. At the same time, given the limited time available for medical studies, there is the challenge of ensuring sufficient space for urology in the curricula. In order to fully implement the upcoming reform of medical studies, adequate financial and human resources are needed, as well as active commitment on the part of the teaching staff at the medical faculties.

E-Learning in Urology: Implementation of the Learning and Teaching Platform CASUS® - Do Virtual Patients Lead to Improved Learning Outcomes? A Randomized Study among Students

Background: E-learning is playing an increasing role in medical education, supporting a problem-based and practical oriented education without putting patients at risk and compensating for the decrease in instructor-centered teaching. Not much research has been done concerning learning effects and reaction on behalf of the students. Methods: We created computer-based cases for four important diagnoses in urology using the authoring system CASUS®. Fourth-year medical school students were randomized into two groups: (1) the CASUS® group, using the online cases for preparation, and (2) the book group, using a textbook. A multiple-choice test referring to the prepared topic had to be completed at the beginning of each lecture and the results were analyzed. Evaluation of the students concerning the acceptance of the program was done at the end of the semester. Results: Members of the CASUS® group scored significantly higher with an average of 20% better test results than students using textbooks for preparation. Evaluation regarding the program showed a highly positive rating. Limitations include the small study population and the possibly biased test performance of the students. Conclusion: Computerized patient cases facilitate practice-oriented teaching and result in an interesting and engaging learning model with improved learning outcomes.

[Objects from scientific collections in demand: the value of the various collections of the Urologic History Center of the German Society of Urology for modern teaching purposes in urology]

The use of artifacts and objects from scientific medical collections and museums for academic teaching purposes are one of the main qualifying tasks of those institutions. In recent years, this aspect of scientific collections has again become on focus within academics. The collections offer a unique chance for visual and haptic forms of teaching in many fields. Due to the potential of scientific collections, educators in all branches in academic learning should be familiar with handling objects for such purposes.

[Rheumatology training for medical students. Comparison of learning success and acceptance with virtual vs. real patient demonstrations]

BACKGROUND

Recently, new teaching methods, such as internet-based e-learning, have gained importance at German universities. At the same time, however, students see fewer patients with rheumatic diseases during their medical education.

OBJECTIVE

The aim of the study was to compare the gain of knowledge and the acceptance of the teaching methodology between educational films and patient-related teaching.

MATERIALS AND METHODS

Both teaching methods communicated identical facts concerning representative rheumatic diseases. Afterwards, participants had to pass a knowledge test and had to evaluate both teaching methods.

RESULTS

Patient-related teaching achieved a better increase of knowledge and better results in evaluations than the educational films. The combination of both teaching methods produced better results than any form on its own.

CONCLUSIONS

Educational films are suited to improve the practical teaching. However, the results stress the importance of practical lessons with real-life cases and argue against the reduction of the educational capacity at German universities.

Bringing excellence into urology: How to improve the future training of residents?

The problem

The demographic development of society leads to an increased demand for physicians. Particularly in the surgical disciplines, there is a noticeably declining interest among graduates from medical schools worldwide. For reasons discussed in detail, this applies especially to urology.

Solutions

We indicate possibilities on how to counteract this trend, by improving the training for urology residents. Whereas some major changes for the better have already been introduced into the curricula in some countries, others will have to be further specified in the future. This article gives an overview of the requirements of a specific training programme, from a planning phase to its certification. Aspects such as the selection of candidates, the goals of a good training programme, and an implementation strategy are presented. Essential elements of a urology resident programme for effective coaching, improving medical skills (e.g. in surgical laboratories), knowledge revision, progress evaluation, and retrospection are discussed critically, giving an understanding of the crucial requirements of a good and attractive education in urology.

Conclusion

A structured and well organised training programme might attract additional medical students towards urology and contribute significantly to the further development of the speciality. This can be seen as an initiative to counteract the decline of urology as an attractive field of interest to upcoming generations of physicians, and therefore to ensure urological care of the highest quality that patients deserve.

[Undergraduate teaching of anaesthesiology : a nationwide survey in Germany]

BACKGROUND

In 2003 anaesthesiology was implemented as a compulsory speciality of undergraduate teaching in Germany due to the revised regulations of medical education. Besides the preexisting subject of emergency medicine an obligatory course in anaesthesiology was introduced. Thus anaesthesiology has gained considerable importance in all medical faculties. To gain insight into the current status of undergraduate medical education in the university departments of anaesthesiology a nationwide survey at all university departments in Germany was initiated.

METHODS

In cooperation with the German Society of Anaesthesiology and Intensive Care Medicine (DGAI) a standardized questionnaire was developed and sent to 36 departments of anaesthesiology of all German medical faculties. Questions concerned the structure of the respective curriculum, learning goals, teaching, assessment and evaluation methods as well as facultative courses.

RESULTS

Of the 36 university departments of anaesthesiology, 35 returned the questionnaire. In 66% undergraduate education in anaesthesiology is part of the fourth or fifth year of medical training. In 91% of the faculties lectures were accompanied by teaching in small student groups. A simulator-based training is integrated either in anaesthesiology and/or in emergency medicine in 91% of the departments of anaesthesiology. In 69% of the departments contents of anaesthesia, critical care medicine, emergency medicine and pain management are an integral part of undergraduate teaching in anaesthesiology. The primary learning goals are directed towards general anaesthesia and there is less focus on topics of preoperative or postoperative care, such as preoperative risk evaluation, postoperative pain management and regional anaesthesia. Besides a multiple choice test (91%) oral (63%) and/or practical examinations (71%) are used as assessment tools. In 71% of the medical faculties the respective departments of anaesthesiology are leading and organising skills laboratories. In student evaluations anaesthesiology achieved best ranking in 66% of the medical faculties compared to other specialties. The possibility to take an elective course in anaesthesiology exists in 74% of the faculties. Half of these faculties organize this elective as a longitudinal course for one complete semester, the other half as a full time course over mostly 1 or 2 weeks. At present E-learning plays a minor role.

CONCLUSIONS

This survey provides detailed information about the current status of undergraduate teaching of the university departments of anaesthesiology in Germany. The study shows a remarkable consistency of structure, contents and methods of education in anaesthesiology throughout all university departments of anaesthesiology. This information is the basis for triggering synergistic effects, for improving educational standards in anaesthesiology and for introducing a platform for developing modern learning media, e.g. through the scientific society DGAI.

[Is the training and continuing education for urologists in Germany still up to date?]

Besides its role in bladder and kidney cancer, urology plays a leading part in oncology particularly with regard to prostate cancer, the most frequent malignant tumor found in men. The multitude of hereditary anomalies of the urogenital tract and the resultant medical conditions, the importance of urinary tract infections including the still deadly urosepsis, urolithiasis which has become as widespread a condition as diabetes mellitus, and urinary incontinence as an increasing problem of a continuously aging population play such a large role in routine practice that every practicing physician must acquire the necessary skills for appropriate diagnosis and treatment. Is our current curriculum for training and continuing education adequate for this task?The primary goal of a meaningful program for continuing education must be to impart the corresponding qualities to young colleagues to ensure optimal patient care. The specialist certification exam itself should invariably be based nationwide on an objective written test: the existing European Board of Urology exam would be ideally suited to facilitate a comparison with other countries across Europe.