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Meyer B, Riedel F, Amann N, Graf A, Stuehrenberg A, Ritter V, Wallwiener M, Heublein S, Recker F, Weiss M, Riedel M. Exploring the current state of clinical and practical teaching in obstetrics and gynecology in the era of competency-based education: a nationwide survey among German teaching coordinators. BMC MEDICAL EDUCATION 2024; 24:165. [PMID: 38383443 PMCID: PMC10880315 DOI: 10.1186/s12909-024-05138-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 02/05/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Obstetrics and gynecology (OB/GYN) is an essential medical field that focuses on women's health. Universities aim to provide high-quality healthcare services to women through comprehensive education of medical students. In Germany, medical education is undergoing a phase of restructuring towards the implementation of competency-based learning. The objective of the current survey was to gain insights into the teaching methods, resources, and challenges at German medical universities in the field OB/GYN. This aims to document the current state of medical education and derive potential suggestions for improvements in the era of competency-based learning. The survey was conducted with teaching coordinators from the majority of OB/GYN departments at German universities. METHODS A questionnaire was sent to the teaching coordinators in all 41 OB/GYN departments at German university hospitals. The survey was delivered via email with a link to an online survey platform. RESULTS The study received 30 responses from 41 universities. Differences were observed in the work environment of teaching coordinators concerning release from clinical duties for teaching purposes and specialized academic training. Overall, medical education and student motivation were perceived positively, with noticeable gaps, particularly in practical gynecological training. Deficiencies in supervision and feedback mechanisms were also evident. Subfields such as urogynecology and reproductive medicine appear to be underrepresented in the curriculum, correlating with poorer student performance. E-learning was widely utilized and considered advantageous. CONCLUSION The present study provides valuable insights into the current state of medical education in OB/GYN at German universities from the perspective of teaching experts. We highlight current deficits, discuss approaches to overcome present obstacles, and provide suggestions for improvement.
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Affiliation(s)
- Bastian Meyer
- Department of Gynecology and Obstetrics, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany
| | - Fabian Riedel
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany
| | - Niklas Amann
- Department of Gynecology and Obstetrics, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Anna Graf
- Department of Gynecology and Obstetrics, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany
| | - Antonia Stuehrenberg
- Department of Gynecology and Obstetrics, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany
| | - Viktoria Ritter
- Department of Gynecology and Obstetrics, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany
| | - Markus Wallwiener
- Department of Gynecology and Obstetrics, Halle University, Halle, Germany
| | - Sabine Heublein
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany
- Department of Gynecology and Obstetrics, Halle University, Halle, Germany
| | - Florian Recker
- Department of Gynecology and Obstetrics, Bonn University Hospital, Bonn, Germany
| | - Martin Weiss
- Department of Women's Health, University of Tübingen, Tübingen, Germany
- NMI Natural and Medical Sciences Institute, University of Tübingen, Reutlingen, Germany
| | - Maximilian Riedel
- Department of Gynecology and Obstetrics, Klinikum Rechts Der Isar, Technical University Munich, Munich, Germany.
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Mink J, Zurek B, Götsch B, Mihaljevic AL, Mitzkat A, Trierweiler-Hauke B, Mahler C. How do former medical and nursing undergraduates describe their learning on an interprofessional training Ward 12-18 months later? - A retrospective qualitative analysis. BMC MEDICAL EDUCATION 2023; 23:275. [PMID: 37085857 PMCID: PMC10122365 DOI: 10.1186/s12909-023-04212-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 03/30/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Interprofessional training wards (IPTWs) seem to deliver good results in terms of development of interprofessional competencies. However, evidence of long-term effects of these training wards on learners' competency development is lacking and little is known about retrospective evaluation of IPTWs. Therefore, this study aimed to explore the retrospective evaluation of competency development and interprofessional collaboration of former undergraduates 12 or more months after a placement on an IPTW. METHODS Eight follow-up interviews were conducted with four nursing and four medical professionals 12-18 months after they had finished a placement on an ITPW throughout their vocational training. Interviews were translated verbatim and analysed deductively and inductively based on qualitative content analysis. RESULTS The qualitative content analyses deductively identified two main categories regarding the research question, namely the uniqueness of the programme and interprofessional competencies developed by the Interprofessional Education Collaborative. Sub categories were identified inductively, representing the perceived competency development and the learning opportunities on the IPTW as compared to other clinical placements throughout vocational training and in transition to practice. Interviewees seemed to have developed competencies that are important for interprofessional collaboration such as communication, roles and responsibilities, as well as competencies in patient care and management. Considered beneficial for learning were the opportunity to work self-responsibly and the interprofessional collaboration on the IPTW, both of which were neither possible in almost any other placement nor in transition to practice. CONCLUSION Findings show that IPTWs can be sufficient in competency development and role clarification and are perceived positively by learners, but structures in clinical practice can impede sustaining competency development and efficient interprofessional collaboration.
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Affiliation(s)
- Johanna Mink
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany.
| | - Bianka Zurek
- Faculty of Social Sciences, Institute of Sociology, Goethe-University Frankfurt am Main, Frankfurt, Germany
| | - Burkhard Götsch
- Nursing School, Academy of Health Professions Heidelberg, Heidelberg, Germany
| | - André L Mihaljevic
- Department of General and Visceral Surgery, University Hospital Ulm, Ulm, Germany
| | - Anika Mitzkat
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Birgit Trierweiler-Hauke
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Cornelia Mahler
- Department of Nursing Science, University Tübingen, Tübingen, Germany
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Brätz J, Bußenius L, Brätz I, Grahn H, Prediger S, Harendza S. Assessment of final-year medical students' entrustable professional activities after education on an interprofessional training ward: A case-control study. PERSPECTIVES ON MEDICAL EDUCATION 2022; 11:266-272. [PMID: 35864296 PMCID: PMC9302559 DOI: 10.1007/s40037-022-00720-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 06/12/2022] [Accepted: 06/27/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Interprofessional training wards (ITWs) are implemented to provide medical students with a holistic and authentic health care experience to improve their clinical competencies. Controlled outcome studies assessing students' competencies after ITW-training are uncommon. In this case-control study, we assessed final-year medical students who received ITW-training regarding entrustable professional activities (EPAs) and communicative as well as social competencies. METHODS In March 2021, 32 final-year students, 16 with (ITW group) and 16 without (control group) a previous four-week placement on an ITW participated in a training simulating the first day of residency. The simulated patients assessed students' communication and interpersonal skills for history taking with the ComCare index after every consultation. Twelve prospective EPAs were assessed by three senior physicians after watching videos of the students' case presentations. RESULTS While baseline characteristics and ComCare index ratings were not significantly different between the two groups, the overall mean entrustment level for the 12 EPAs was significantly higher (p < 0.001) in the ITW group compared to the control group (median = 3.15 versus 2.22). The interrater reliability for all EPAs was high and entrustment in students from the ITW group was significantly higher in 10 out of 12 EPAs. DISCUSSION ITW training seems to prepare medical students well to practice competencies which are relevant for prospective entrustment decisions and can be deduced by senior physicians from case presentations. Further studies with larger student cohorts are needed to corroborate this finding and observable EPAs could also be defined to assess students' competencies after ITW training.
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Affiliation(s)
- Julian Brätz
- Heart Center, Cardiology Division, Albertinen Hospital, Hamburg, Germany.
| | - Lisa Bußenius
- III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Irina Brätz
- Heart Center, Cardiology Division, Albertinen Hospital, Hamburg, Germany
| | - Hanno Grahn
- Department for Cardiology, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Sarah Prediger
- III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sigrid Harendza
- III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Riedel M, Amann N, Recker F, Hennigs A, Heublein S, Meyer B, Karge A, Eisenkolb G, Lammert J, Graf A, Klein E, Weiss M, Riedel F. The COVID-19 pandemic and its impact on medical teaching in obstetrics and gynecology—A nationwide expert survey among teaching coordinators at German university hospitals. PLoS One 2022; 17:e0269562. [PMID: 35930549 PMCID: PMC9355177 DOI: 10.1371/journal.pone.0269562] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/24/2022] [Indexed: 11/22/2022] Open
Abstract
Purpose The COVID-19 pandemic has imposed severe challenges on medical education at German university hospitals. In this first German nationwide expert survey, we addressed the responsible university teaching coordinators in obstetrics and gynecology departments and investigated their experiences during the pandemic as well as their opinions on future developments, especially with regard to the broader implementation of e-learning in the standard curriculum. Methods The questionnaire included 42 items and was disseminated among teaching coordinators at all 41 departments of obstetrics and gynecology at German university hospitals via an email that included a weblink to the online survey provider. Responses were collected between 19 April and 7 June 2021. Results In total, 30 responses were collected from 41 departments across Germany and their respective teaching coordinators in obstetrics and gynecology. The general opinion of the medical teaching provided during the pandemic was positive, whereas the teaching quality in practical skills was considered inferior and not equivalent to the standard face-to-face curriculum. Lectures and seminars had to be substituted by remote-learning alternatives, while clinical clerkships were reduced in length and provided less patient contact. Students in their final year experienced only a few differences in the clinical and teaching routine. Teaching coordinators in obstetrics and gynecology stated that they intend to incorporate more e-learning into the curriculum in the future. Conclusion The medical educators’ views presented here may help to complement the already-thoroughly investigated experiences of students under the restrictions of the COVID-19 pandemic. Medical educators in obstetrics and gynecology at German university hospitals have successfully established online and hybrid teaching alternatives to their standard face-to-face courses. Building on recent experiences, digitalization could help to improve future medical education.
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Affiliation(s)
- Maximilian Riedel
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University Munich (TU), Munich, Germany
- * E-mail:
| | - Niklas Amann
- Department of Gynecology and Obstetrics, Friedrich–Alexander-University Erlangen–Nuremberg (FAU), Erlangen, Germany
| | - Florian Recker
- Department of Gynecology and Obstetrics, Bonn University Hospital, Bonn, Germany
| | - André Hennigs
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany
| | - Sabine Heublein
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany
| | - Bastian Meyer
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University Munich (TU), Munich, Germany
| | - Anne Karge
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University Munich (TU), Munich, Germany
| | - Gabriel Eisenkolb
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University Munich (TU), Munich, Germany
| | - Jacqueline Lammert
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University Munich (TU), Munich, Germany
| | - Anna Graf
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University Munich (TU), Munich, Germany
| | - Evelyn Klein
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University Munich (TU), Munich, Germany
| | - Martin Weiss
- Department of Women’s Health, University of Tübingen, Tübingen, Germany
- NMI Natural and Medical Sciences Institute, University of Tübingen, Reutlingen, Germany
| | - Fabian Riedel
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany
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Constantinou C, Wijnen-Meijer M. Student evaluations of teaching and the development of a comprehensive measure of teaching effectiveness for medical schools. BMC MEDICAL EDUCATION 2022; 22:113. [PMID: 35183151 PMCID: PMC8858452 DOI: 10.1186/s12909-022-03148-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 01/29/2022] [Indexed: 06/14/2023]
Abstract
The evaluation of courses and faculty is of vital importance in all higher education institutions including medical schools. Student Evaluations of Teaching (SETs) commonly take the form of completion of anonymous questionnaires and even though they were originally developed to evaluate courses and programmes, throughout the years they have also been used to measure teaching effectiveness and subsequently to guide important decisions related to the faculty's career progression. Nevertheless, certain factors and biases may influence SET rates and may not measure teaching effectiveness objectively. Although the literature on course and faculty evaluations is well-researched in general higher education, there are concerns with regards to the use of the same tools for evaluation of courses and teachers in medical programmes. Specifically, the SETs in general higher education cannot be directly applied to the structure of courses and delivery of curriculum in medical schools. This review provides an overview of how SETs can be improved at the levels of instrumentation, administration and interpretation. In addition, the paper supports that through the collection and triangulation of data from multiple sources, including students, peers, program administrators and self-awareness via the use of different methods such as peer reviews, focus groups and self-evaluations, it will be possible to develop a comprehensive evaluation system that will present an effective measure of teaching effectiveness, will support the professional development of medical teachers and will improve the quality of teaching in medical education.
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Affiliation(s)
| | - Marjo Wijnen-Meijer
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675, Munich, Germany.
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Riedel M, Hennigs A, Dobberkau AM, Riedel C, Bugaj TJ, Nikendei C, Amann N, Karge A, Eisenkolb G, Tensil M, Recker F, Riedel F. The role of gender-specific factors in the choice of specialty training in obstetrics and gynecology: results from a survey among medical students in Germany. Arch Gynecol Obstet 2022; 305:129-137. [PMID: 34550446 PMCID: PMC8782790 DOI: 10.1007/s00404-021-06232-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 08/17/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE The field of obstetrics and gynecology (OB/GYN) is facing growing competition for young professionals in Germany, with high interest rates among female graduates and a declining proportion of male students who choose residency training in the field. The aim of this study is to analyze general and gender-dependent factors that influence the decision for or against specialty training in OB/GYN among medical students in Germany. METHODS Between February and November 2019, n = 346 medical students in their 5th and 6th year of undergraduate training at Heidelberg University received a questionnaire with 44 items. RESULTS n = 286 students (61.3 female; 38.7% male) participated in the study. 28% of the female students and 9% of the male students had considered OB/GYN for their specialty training. The students reported different general and gender-specific influencing factors in their choice of a specialty. Both genders desired a good work-life-balance, however, in comparison with their female colleagues, male students had heavily weighted factors related to their later careers and professional success, including competition among colleagues. Male students had gained little practical experience during compulsory internships (26.9% for females vs. 8.8% for males) or had chosen their final-year elective in OB/GYN (15.9% for females vs. 5.5% for males). Female students had worried about the negative effects of their sex on their career (35.4% for females vs. 5.9% for males). CONCLUSION OB/GYN must become more appealing and attractive to young female and male professionals alike. A better compatibility of career and family should go hand in hand with the implementation of differentiated, (extra) curricular teaching approaches that take the different preferences of female and male students into account.
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Affiliation(s)
- Maximilian Riedel
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - André Hennigs
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany
| | - Anna Maria Dobberkau
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany
| | - Caroline Riedel
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Till Johannes Bugaj
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Christoph Nikendei
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Niklas Amann
- Department of Obstetrics and Gynecology, Ludwig Maximilians University (LMU), Munich, Germany
| | - Anne Karge
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Gabriel Eisenkolb
- Department of Gynecology and Obstetrics, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Maria Tensil
- Kirinus Clinic for Psychotherapy, Munich, Germany
| | - Florian Recker
- Department of Obstetrics and Gynecology, Bonn University Hospital, Bonn, Germany
| | - Fabian Riedel
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany.
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Bugaj TJ, Heilborn M, Terhoeven V, Kaisinger S, Nagy E, Friederich HC, Nikendei C. What do Final Year Medical Students in Germany know and think about Climate Change? - The ClimAttitude Study. MEDICAL EDUCATION ONLINE 2021; 26:1917037. [PMID: 33886438 PMCID: PMC8079051 DOI: 10.1080/10872981.2021.1917037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Climate change (CC) is adversely affecting human health and will become far more dangerous in the future, if no substantial measures are taken. Young people in particular are taking an energetic stand for CC awareness. Some CC experts argue that medical doctors are especially well positioned to inform about the impact of CC on public health, as it is well established that they are among the most trusted members of society. However, medical doctors seem to be unsure of their role in addressing CC. This study aimed to investigate future doctors´, i.e., final year medical students´ (FYMS), attitudes towards CC and their personal role in CC education and health care. A questionnaire was developed to examine (1) the expected consequences of CC for FYMS, (2) their perceived individual responsibility, and their attitudes towards an additional (3) professional responsibility. To examine the climate-questionnaire's component correlations, we ran a factor analysis using oblique (promax) rotation and conducted a one-way ANOVA with repeated measures to compare the mean scores of the factors. Data are presented as mean ± SD or percentage, as appropriate. n = 65 FYMS (response rate: 87%) were participating and all of them completed the questionnaire. Items of the factor professional responsibility showed the lowest level of agreement (47.2 ± 21.2), while the 2 other factors showed higher levels of agreement (expected consequences (75.6 ± 18.4), individual responsibility (75.1 ± 20.6). Future doctors at Heidelberg University Hospital are well-informed about the expected health consequences of CC. They recognize human contributions to CC and make personal decisions to mitigate the impact. However, the opinion that they have a professional responsibility as physicians to patients or society in regard to CC is weaker. Specific teaching could help to change the way future doctors see their role and responsibility in tackling CC.
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Affiliation(s)
- Till Johannes Bugaj
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg Medical Hospital, Heidelberg, Germany
- CONTACT Till Johannes Bugaj Department of General Internal Medicine and Psychosomatics, University of Heidelberg Medical Hospital, Inf 410, HeidelbergD-69120, Germany
| | - Marie Heilborn
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg Medical Hospital, Heidelberg, Germany
| | - Valentin Terhoeven
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg Medical Hospital, Heidelberg, Germany
| | - Simon Kaisinger
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg Medical Hospital, Heidelberg, Germany
| | - Ede Nagy
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg Medical Hospital, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg Medical Hospital, Heidelberg, Germany
| | - Christoph Nikendei
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg Medical Hospital, Heidelberg, Germany
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Lauterjung ML, Ehlers C, Guntinas-Lichius O. PJplus - a project improving practical training during the final year of medical education. ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2021; 164:70-78. [PMID: 34253478 DOI: 10.1016/j.zefq.2021.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/17/2021] [Accepted: 05/23/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Practical training on the patient is crucial in medical students' last year education - the so-called practical year (PJ) in Germany. Due to difficulties in combining student training with the everyday tasks on ward, it is often criticised as not sufficient for a good preparation for later practical work. The Medical Faculty of the University of Jena therefore designed a project called "PJplus". The project includes mentoring and workplace-based assessment by means of Mini-Clinical Evaluation Exercise (Mini-CEX) in combination with training workshops for supervisors. Three years after the first clinical departments started voluntary participation, the project was evaluated by comparing the experience and the self-assessed learning progress of students from departments participating in this project (PJplus group) with those non-participating (control group). METHODS An online questionnaire was sent to all medical students registered at the University of Jena for PJ between March 2016 and April 2017. The students were invited to participate at the end of each section of their PJ within that period. The answers of the PJplus group were compared to the answers of the control group using descriptive and multivariable analysis. RESULTS 201 students participated in the survey and filled out 257 questionnaires. PJplus was recommended by 80% of the students participating in the project. The PJplus group (n=92) was significantly more satisfied with their PJ and felt significantly better prepared for work than the control group (n=165). The project's elements mentoring and feedback could lead to a better improvement in practical medical skills. However, only 17% of the students managed to conduct the required amount of three Mini-CEX during their PJ rotation and 52% of the students seemed to have lost contact to their mentor or did not have one at all. These difficulties arose due to unfamiliarity with the project, shortage of time and staff on ward or due to lack of motivation among supervisors. CONCLUSION Adding mentoring and feedback to the PJ helps to better prepare students for their practical work after finishing studies. With the project presented, it is feasible to integrate these elements in a structured way. Nevertheless, a good control of the elements' implementation and consistent training of the supervising physicians is needed to ensure long-term success.
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Affiliation(s)
- Marie-Luise Lauterjung
- Friedrich-Schiller University of Jena, Dean's office of Medical Faculty, Jena, Germany; Jena University Hospital, Paediatric Department, Jena, Germany
| | - Claudia Ehlers
- Friedrich-Schiller University of Jena, Dean's office of Medical Faculty, Jena, Germany
| | - Orlando Guntinas-Lichius
- Friedrich-Schiller University of Jena, Dean's office of Medical Faculty, Jena, Germany; Jena University Hospital, ENT-Department, Jena, Germany.
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Behling F, Nasi-Kordhishti I, Haas P, Sandritter J, Tatagiba M, Herlan S. One-on-one mentoring for final year medical students during the neurosurgery rotation. BMC MEDICAL EDUCATION 2021; 21:229. [PMID: 33882933 PMCID: PMC8061075 DOI: 10.1186/s12909-021-02657-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 04/01/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Medical students show varying clinical practical skills when entering their final year clinical clerkship, which is the final period to acquire and improve practical skills prior to their residency. We developed a one-on-one mentoring program to allow individually tailored teaching of clinical practical skills to support final year students with varying skill sets during their neurosurgical clinical clerkship. METHODS Each participating student (n = 23) was paired with a mentor. At the beginning students were asked about their expectations, teaching preferences and surgical interest. Regular meetings and evaluations of clinical practical skills were scheduled every 2 weeks together with fixed rotations that could be individually adjusted. The one-on-one meetings and evaluations with the mentor gave each student the chance for individually tailored teaching. After completion of the program each student evaluated their experience. RESULTS The mentoring program was well received by participating students and acquisition or improvement of clinical practical skills was achieved by most students. A varying practical skill level and interest in the field of surgery was seen. CONCLUSIONS A neurosurgical one-on-one mentoring program is well received by final year medical students and allows for individually tailored learning of clinical practical skills.
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Affiliation(s)
- Felix Behling
- Department of Neurosurgery, University Hospital Tübingen, Eberhard-Karls University Tübingen, Hoppe-Seyler Street 3, Tübingen, Germany.
- Center for CNS Tumors, Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Tübingen, Germany.
| | - Isabella Nasi-Kordhishti
- Department of Neurosurgery, University Hospital Tübingen, Eberhard-Karls University Tübingen, Hoppe-Seyler Street 3, Tübingen, Germany
- Center for CNS Tumors, Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Tübingen, Germany
| | - Patrick Haas
- Department of Neurosurgery, University Hospital Tübingen, Eberhard-Karls University Tübingen, Hoppe-Seyler Street 3, Tübingen, Germany
- Center for CNS Tumors, Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Tübingen, Germany
| | - Joey Sandritter
- Department of Neurosurgery, University Hospital Tübingen, Eberhard-Karls University Tübingen, Hoppe-Seyler Street 3, Tübingen, Germany
- Center for CNS Tumors, Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Tübingen, Germany
| | - Marcos Tatagiba
- Department of Neurosurgery, University Hospital Tübingen, Eberhard-Karls University Tübingen, Hoppe-Seyler Street 3, Tübingen, Germany
- Center for CNS Tumors, Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Tübingen, Germany
| | - Stephan Herlan
- Department of Neurosurgery, University Hospital Tübingen, Eberhard-Karls University Tübingen, Hoppe-Seyler Street 3, Tübingen, Germany
- Center for CNS Tumors, Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Tübingen, Germany
- Institute of Clinical Anatomy and Cell Analysis, Eberhard-Karls University Tübingen, Tübingen, Germany
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Schimbeno V, Bosle C, Stegmeier-Petroianu A, Etminan N, Hoffmann K. Competence-based teaching and learning in the outpatient clinic: development of a clinical elective in ambulatory medicine. GMS JOURNAL FOR MEDICAL EDUCATION 2019; 36:Doc36. [PMID: 31544136 PMCID: PMC6737268 DOI: 10.3205/zma001244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 04/02/2019] [Accepted: 05/28/2019] [Indexed: 06/10/2023]
Abstract
Aim: Although physicians have the most contact with patients in the outpatient setting, topics relating to ambulatory medicine have been less present in medical education. To teach professional skills, practical learning opportunities must be created in which students can practice medical skills under authentic working conditions in the outpatient setting. The clinical elective in ambulatory medicine has been developed, evaluated and revised at the Mannheim Medical School as a practical, competency-based learning experience in outpatient clinics (liver clinic, psychiatric outpatient clinic, uro-oncological consultations, etc.). Methods: The elective was designed using the plan-do-check-act (PDCA) cycle in the form of a longitudinal practical course during the fourth year of study. By selecting one of four concentrations in ambulatory care, students have the opportunity to focus on and pursue an individual interest. Students are given assignments during three separate sessions at an outpatient clinic and complete a log book which contains the learning objectives, assignments and grading criteria. Once the elective had been completed, the students (n=165) and mentors (n=7) had the option to participate in a survey to evaluate knowledge gain and satisfaction with the elective. Results: The students rated their personal growth in knowledge about common diseases and patient-centered communication positively, while rating their knowledge gain in ambulatory patient management somewhat lower. The first offering of the elective was evaluated as satisfactory by students and mentors. In 85.8% of the cases, students reported that they would recommend the selected outpatient clinic for this course. Suggestions for improvement, such as those concerning the log book and scheduling system, were considered during the first revision. Conclusion: This elective provides an opportunity to become familiar with ambulatory medicine in a practical and competency-based manner during medical studies. Skills in ambulatory medicine are already taught and applied in the fourth year of study in a practical setting and also deepened further through interconnections with other courses and chosen concentrations. Moreover, this elective format may be used by other medical schools depending on which aspects of ambulatory medicine are focused on.
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Affiliation(s)
- Vanessa Schimbeno
- University of Heidelberg, Medical Faculty Mannheim, Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim, Germany
| | - Catherin Bosle
- University of Heidelberg, Medical Faculty Mannheim, Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim, Germany
| | - Anka Stegmeier-Petroianu
- University of Heidelberg, Medical Faculty Mannheim, Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim, Germany
| | - Nima Etminan
- University of Heidelberg, University Hospital Mannheim, Department of Neurosurgery, Mannheim, Germany
| | - Kristina Hoffmann
- University of Heidelberg, Medical Faculty Mannheim, Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim, Germany
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11
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Baessler F, Zafar A, Schweizer S, Ciprianidis A, Sander A, Preussler S, Honecker H, Wolf M, Bartolovic M, Wagner FL, Klein SB, Weidlich J, Ditzen B, Roesch-Ely D, Nikendei C, Schultz JH. Are we preparing future doctors to deal with emotionally challenging situations? Analysis of a medical curriculum. PATIENT EDUCATION AND COUNSELING 2019; 102:1304-1312. [PMID: 30852116 DOI: 10.1016/j.pec.2019.02.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 02/21/2019] [Accepted: 02/23/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Skilful communication by doctors is necessary for healthcare delivery during emotionally challenging situations. This study analyses a medical curriculum for the frequency and intensity of teaching content on communication in emotionally challenging situations. METHODS A questionnaire with 31 questions ("EmotCog31") was used to evaluate teaching sessions at 17 departments of a medical school for one semester. RESULTS Teaching content on communication in emotionally challenging situations was observed in 62 of 724 (∼nine percent) teaching sessions. Fifty-six percent of these sessions were within psychosocial specialisations. Lecturers used mental diseases as teaching topics four times more than somatic diseases. Forty-two percent of the 62 sessions were large-group while fifty-eight percent were small-group, interactive sessions. Clinical examples were used in sixty-nine percent of these sessions. Eighty-one percent of the handouts provided and sixty-six percent of simulated patient scenarios used were rated as helpful. Two-thirds of teaching sessions were rated positively when they included practical context. CONCLUSION There was a considerable lack of teaching on communication skills in an emotional context. Teaching was limited to psychosocial specialties, reducing the impact of available knowledge for other medical specialties. PRACTICE IMPLICATIONS More interactive, practically oriented teaching methods are useful for teaching emotional communication skills.
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Affiliation(s)
- Franziska Baessler
- Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
| | - Ali Zafar
- Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
| | - Sophie Schweizer
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Germany.
| | - Anja Ciprianidis
- Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
| | - Anja Sander
- Institute of Medical Biometry and Informatics, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany.
| | - Stella Preussler
- Institute of Medical Biometry and Informatics, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany.
| | - Hannah Honecker
- Institute of Medical Biometry and Informatics, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany.
| | - Michael Wolf
- Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
| | - Marina Bartolovic
- Department of General Adult Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Germany.
| | - Fabienne Louise Wagner
- Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
| | - Sonja Bettina Klein
- Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
| | - Joshua Weidlich
- Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
| | - Beate Ditzen
- Institute of Medical Psychology, Heidelberg University Hospital, Bergfheimer Str. 20, 69115 Heidelberg, Germany.
| | - Daniela Roesch-Ely
- Department of General Adult Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Germany.
| | - Christoph Nikendei
- Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
| | - Jobst-Hendrik Schultz
- Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
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12
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Baessler F, Ciprianidis A, Rizvi AZ, Weidlich J, Wagner FL, Klein SB, Baumann TC, Nikendei C, Schultz JH. Delirium: Medical Students' Knowledge and Effectiveness of Different Teaching Methods. Am J Geriatr Psychiatry 2019; 27:737-744. [PMID: 31005497 DOI: 10.1016/j.jagp.2019.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/13/2019] [Accepted: 03/05/2019] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Medical schools are often blamed for inadequately training doctors on delirium. This study assesses the knowledge of medical students regarding delirium and evaluates different teaching methods for comparing learning outcomes. METHODS A video, a handout, and a video+handout were used as three different teaching methods. Students were randomly assigned to three groups and pre- and postintervention knowledge gains were compared. Interventions were held between 2015 and 2018 at the University of Heidelberg Medical School in Germany. Seventy-eight (video intervention 33; handout 26; video+handout 19) sixth-year medical students participated. Participants learned about delirium with the help of a video, a handout, and both a video+handout at the start of one-hour lectures dedicated to teaching about delirium. Pre- and postintervention questionnaires, comprising five multiple-choice questions and a self-estimated grade of knowledge about delirium, were used. Variables calculated were objective and subjective knowledge, recall, and accuracy of self-assessment. Microsoft Excel and analysis of covariance were used to analyze data. RESULTS Knowledge gains for all interventions were large (d>0.8) irrespective of gender. Post hoc comparison showed video and video+handout methods were more effective with high recall for video (92.8%). Students rated their knowledge as satisfactory, although they scored 11.4 out of 20. Preintervention knowledge level was correctly estimated by 31% of students, and postintervention by 40.3% students. CONCLUSION Teaching about delirium to medical students with a video resulted in better knowledge transfer and recall. Most medical students, particularly men, overestimated their knowledge about delirium.
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Affiliation(s)
- Franziska Baessler
- Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Heidelberg, Germany.
| | - Anja Ciprianidis
- Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Ali Z Rizvi
- Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Joshua Weidlich
- Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Fabienne L Wagner
- Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Sonja B Klein
- Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Tabea C Baumann
- Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Christoph Nikendei
- Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Jobst-Hendrik Schultz
- Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Heidelberg, Germany
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13
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Gollasch M, Kube P, Danz B, Arens S, Märdian S. [Project Report: Evaluation of the Practical Year (PY) at the Charité Medical School, University Medicine Berlin]. ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2019; 141-142:53-61. [PMID: 31072809 DOI: 10.1016/j.zefq.2019.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 03/27/2019] [Accepted: 03/29/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND In Germany, the final year of medical school consists of a series of clinical externships termed "Practical Year" (PY). Logbooks have been introduced to document the clinical experience and the value of the teaching program (First Ordinance amending the Licensing Regulations for Physicians, July 14, 2012). However, little is known about how PY education is experienced by students, what problems they face, what support they seek to manage their problems, and how the logbooks contribute to training. OBJECTIVE We assessed the PY education at the Charité Medical School (University Medicine Berlin) in terms of the requirement profile, quality of training, logbooks, satisfaction, and general conditions. MATERIAL AND METHODS We developed a questionnaire to assess PY education by relying on medical students' experiences. This tool was developed in parallel with the introduction of the logbooks. We contacted 6,068 students between May 2014 to September 2017 via e-mail. The students were asked to participate in the evaluation on a voluntary basis and answer 39 questions. The questionnaire was completed using an anonymous online form, taking into account legal data protection regulations. RESULTS We evaluated 1,957 questionnaires (31.1 %). The students were mostly satisfied (67.6 %) with their supervision. Patient encounters were, for the most part (85.5 %), perceived as informative, and the quality of continuing education as high (91.3 %), and most students (76.1 %) were directly involved in patient care. The students (87.8 %) felt that they had made progress during the PY teaching period, although the logbooks were rarely (14 %) used and apparently not reviewed by the teaching staff. The students judged some rotations harshly when they were dissatisfied with both teaching and supervision. CONCLUSIONS In general, the PY experience at the Charité was rated positively. Some rotations receiving poor evaluations desperately need to be reviewed. The role of the logbook seems to be imperfectly defined. The survey results suggest that further evaluation of our program is needed with ongoing participation of students and their representatives.
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Affiliation(s)
- Maik Gollasch
- Medizinische Klinik m.S. Nephrologie und Internistische Intensivmedizin, Experimental and Clinical Research Center (ECRC) am Max Delbrück Centrum für Molekulare Medizin, Berlin, Germany.
| | - Peter Kube
- Geschäftsbereich Lehre und Studium, Charité Campus Mitte, Berlin, Germany
| | - Burkhard Danz
- Geschäftsbereich Lehre und Studium, Charité Campus Mitte, Berlin, Germany
| | - Stephan Arens
- Klinik für Orthopädische, Unfall- und Wiederherstellungschirurgie, Charité Campus Benjamin Franklin, Berlin, Germany
| | - Sven Märdian
- Centrum für Muskuloskeletale Chirurgie, Charité Campus Virchow Klinikum Berlin, Germany
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Mink J, Mitzkat A, Mihaljevic AL, Trierweiler-Hauke B, Götsch B, Schmidt J, Krug K, Mahler C. The impact of an interprofessional training ward on the development of interprofessional competencies: study protocol of a longitudinal mixed-methods study. BMC MEDICAL EDUCATION 2019; 19:48. [PMID: 30732614 PMCID: PMC6367825 DOI: 10.1186/s12909-019-1478-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 01/29/2019] [Indexed: 05/06/2023]
Abstract
BACKGROUND To meet the patients' needs and to provide adequate health care, students need to be prepared for interprofessional collaborative practice during their undergraduate education. On interprofessional training wards (IPTW) undergraduates of various health care professions potentially develop a mutual understanding and improve their interprofessional competencies in clinical practice. To enhance collaboration of 6th-year medical students and nursing trainees in the third year of their vocational training an IPTW (Heidelberger Interprofessionelle Ausbildungsstation - HIPSTA) was implemented at the University Hospital Heidelberg, Germany. On HIPSTA future physicians and nurses take care of the patients self responsibly and in close interprofessional collaboration, supervised by facilitators of both professions. Although there are positive experiences with IPTWs internationally, little is known about the impact of IPTW on the acquisition of interprofessional competencies. For future interprofessional training and implementation of IPTWs evaluation of interprofessional learning and collaborative practice on Germany's first IPTW is of high relevance. METHODS To evaluate the acquisition of interprofessional competencies the study follows a mixed-methods approach. Quantitative data is collected from undergraduate participants, staff participants and facilitators on HIPSTA (intervention group) and undergraduate participants and staff participants on a comparable 'conventional' ward without special interprofessional training (comparison group) immediately pre and post HIPSTA and, as follow-up, after three to six months (T0, T1, T2), using three questionnaires, namely the University of the West of England Interprofessional Questionnaire (UWE-IP), the Interprofessional Socialization and Valuing Scale (ISVS) and the Assessment of Interprofessional Team Collaboration Scale (AITCS). Qualitative data is gathered in form of interviews and focus groups based on semi structured guidelines, video recordings of handovers and overt non-participant observations of daily rounds. Quantitative data will be analysed in a longitudinal comparison, presented descriptively and tested with an analysis of variance. Qualitative data will be analysed deductively and inductively. DISCUSSION The results of the evaluation will give insight in undergraduates', staff's and facilitators' experiences and their self-perception of competency development. In addition the results will help identify benefits, challenges and areas for modification when implementing and establishing similar interprofessional training wards.
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Affiliation(s)
- Johanna Mink
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, D-69120 Heidelberg, Germany
| | - Anika Mitzkat
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, D-69120 Heidelberg, Germany
| | - André L. Mihaljevic
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, D-69120 Heidelberg, Germany
| | - Birgit Trierweiler-Hauke
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, D-69120 Heidelberg, Germany
| | - Burkhard Götsch
- Academy of Health Professions Heidelberg, Nursing School, Wieblinger Weg 19, D-69123 Heidelberg, Germany
| | - Jochen Schmidt
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany
| | - Katja Krug
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, D-69120 Heidelberg, Germany
| | - Cornelia Mahler
- Department of Nursing Science, University Tübingen, Geissweg 5/1, D-72076 Tuebingen, Germany
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15
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Homberg A, Narciß E, Schüttpelz-Brauns K. What reasons do final-year medical students give for choosing the hospitals for their clinical training phases? A quantitative content analysis. GMS JOURNAL FOR MEDICAL EDUCATION 2019; 36:Doc38. [PMID: 31544138 PMCID: PMC6737269 DOI: 10.3205/zma001246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 04/12/2019] [Accepted: 06/06/2019] [Indexed: 05/15/2023]
Abstract
Aim: In the final (practical) year (PY), students have the opportunity to become familiar with their potential future place of work. At the same time, university hospitals and teaching hospitals compete to recruit the best junior staff from this pool. The aim of this study is to present students' selection criteria for the location of the final year in detail. Methods: On the formal evaluation of the final year at the Mannheim Medical Faculty, students were asked after each training period which reasons led to the selection of the location. Thirty-one subcategories were formed from the free-text responses, sorted according to their controllability and then grouped into 11 main categories. The Mannheim University Hospital introduced an expense allowance in November 2015. The data from the period before and after its introduction, the reasons given for choosing the location for the compulsory and elective subjects, and the reasons given for choosing a teaching hospital or university hospital were evaluated and compared separately. Results: A total of 1,164 questionnaires were evaluated from the period before the introduction of the expense allowance, and 1,120 questionnaires were evaluated from the period after the introduction. Overall, Proximity (19%), Financial incentives (18%) and Subject (18%) were the most frequently cited reasons. The Financial incentives subcategory was the most frequent in period 1 (32%), but lost relevance in period 2 (6%). In contrast, Recommendation gained in importance (from 8% to 15%). A comparison of the lead categories shows that teaching hospitals benefit more from their public image and university hospitals more from the subjects they offer. Conclusion: Students primarily choose the location for their final year for pragmatic reasons, such as Incentives and Living environment, but the Public image of the hospitals also plays a significant role. The frequency of the reasons given differs between compulsory and elective subjects, as well as between university hospitals and teaching hospitals. The results can help to improve the attractiveness of the location in a targeted manner and to present a specific image to the public.
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Affiliation(s)
- Angelika Homberg
- University Medicine Mannheim, Medical Faculty Mannheim at Heidelberg University, Department of Undergraduate Education and Educational Development, Mannheim, Germany
- *To whom correspondence should be addressed: Angelika Homberg, University Medicine Mannheim, Medical Faculty Mannheim at Heidelberg University, Department of Undergraduate Education and Educational Development, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim, Germany, E-mail:
| | - Elisabeth Narciß
- University Medicine Mannheim, Medical Faculty Mannheim at Heidelberg University, Department of Undergraduate Education and Educational Development, Mannheim, Germany
| | - Katrin Schüttpelz-Brauns
- University Medicine Mannheim, Medical Faculty Mannheim at Heidelberg University, Department of Undergraduate Education and Educational Development, Mannheim, Germany
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16
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Störmann S, Angstwurm MW. What do international health electives and state examination scores have in common? - A cohort study to compare the results of written medical licensing examinations with the participation in international health electives during the final year of undergraduate medical education in Germany. GMS JOURNAL FOR MEDICAL EDUCATION 2018; 35:Doc54. [PMID: 30637318 PMCID: PMC6326405 DOI: 10.3205/zma001200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 09/23/2018] [Accepted: 09/29/2018] [Indexed: 06/01/2023]
Abstract
Objective: The final year of undergraduate medical education in Germany is called the practical year (PY), where emphasis is placed on developing practical skills requisite of soon-to-be physicians. Many students choose to spend part of this year abroad, yet little is known about their results on the medical licensing examinations. Is there a predisposition of high-performing students to go abroad as compared to lower performers? Are international health electives during the PY followed by higher scores in the final section of the German medical licensing examination (GMLE2)? Methods: We conducted a retrospective cohort study among undergraduate medical students at the LMU Munich, who participated in the final section of the German medical licensing examination between autumn 2009 and spring 2011. Of the 1,731 eligible students, 554 (32%) participated in our study. We analyzed for statistical associations of international health electives with written test scores of both sections of the medical licensing examination as well as grades earned during medical school training. We then used multiple regression analysis to identify relevant predictors of GMLE2 scores. Results: Approximately half of study participants pursued international health electives during the PY (51.1%). The number of students going abroad increased with the scores achieved on the first section of the medical licensing examination (GMLE1, p<0.001). Stratified by their GMLE1 scores students who pursued electives abroad during their PY achieved higher GMLE2 scores (p<0.001). The strongest predictor for GMLE2 scores were grades obtained during medical school training; age and study duration indicated lower scores; and those engaging in international health electives correlated with higher scores. Conclusions: Students with higher GMLE1 scores go abroad during PY more often. Beyond that, students who pursue international health electives achieve higher GMLE2 scores than those who stay in Germany during PY. There is an unmet need for additional research to identify which factors make these students perform better and what motivates them to go abroad.
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Affiliation(s)
- Sylvère Störmann
- Klinikum der Universität München, Medizinische Klinik und Poliklinik IV, München, Germany
| | - Matthias W. Angstwurm
- Klinikum der Universität München, Medizinische Klinik und Poliklinik IV, München, Germany
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Scheffer C, Valk-Draad MP, Tauschel D, Büssing A, Humbroich K, Längler A, Zuzak T, Köster W, Edelhäuser F, Lutz G. Students with an autonomous role in hospital care - patients perceptions. MEDICAL TEACHER 2018; 40:944-952. [PMID: 29347873 DOI: 10.1080/0142159x.2017.1418504] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND There have been calls to enhance clinical education by strengthening supported active participation (SAP) of medical students in patient care. This study examines perceived quality of care when final-year medical students are integrated in hospital ward teams with an autonomous relationship toward their patients. METHODS We established three clinical education wards (CEWs) where final-year medical students were acting as "physician under supervision". A questionnaire-based mixed-method study of discharged patients was completed in 2009-15 using the Picker Inpatient Questionnaire complemented by specific questions on the impact of SAP. Results were compared with matched pairs of the same clinical specialty from the same hospital (CG1) and from nationwide hospitals (CG2). Patients free-text feedback about their hospital stay was qualitatively evaluated. RESULTS Of 1136 patients surveyed, 528 (46.2%) returned the questionnaire. The CEWs were highly recommended, with good overall quality of care and patient-physician/student-interaction, all being significantly (p < 0.001) higher for the CEW group while experienced medical treatment success was similar. Patient-centeredness of students was appreciated by patients as a support to a deeper understanding of their condition and treatment. CONCLUSION Our study indicates that SAP of final-year medical students is appreciated by patients with high overall quality of care and patient-centeredness.
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Affiliation(s)
- Christian Scheffer
- a Integrated Curriculum for Anthroposophic Medicine, Institute for Integrative Medicine, Faculty of Health , Witten Herdecke University , Witten , Germany
- b Department for Internal Medicine , Gemeinschaftskrankenhaus Herdecke , Witten , Germany
| | - Maria Paula Valk-Draad
- a Integrated Curriculum for Anthroposophic Medicine, Institute for Integrative Medicine, Faculty of Health , Witten Herdecke University , Witten , Germany
| | - Diethard Tauschel
- a Integrated Curriculum for Anthroposophic Medicine, Institute for Integrative Medicine, Faculty of Health , Witten Herdecke University , Witten , Germany
- c Department for Clinical Education, Faculty of Health , Witten Herdecke University , Witten , Germany
| | - Arndt Büssing
- d Institute for Integrative Medicine, Faculty of Health , Witten Herdecke University , Witten , Germany
- e Professorship for Quality of Life, Spirituality and Coping , Witten Herdecke University , Witten , Germany
| | - Knut Humbroich
- f Department for Neurology , Gemeinschaftskrankenhaus Herdecke , Witten , Germany
| | - Alfred Längler
- g Department for Pediatrics , Gemeinschaftskrankenhaus Herdecke , Witten , Germany
- h Professorship for Integrative Pediatrics , Witten Herdecke University , Witten , Germany
| | - Tycho Zuzak
- g Department for Pediatrics , Gemeinschaftskrankenhaus Herdecke , Witten , Germany
| | - Wolf Köster
- b Department for Internal Medicine , Gemeinschaftskrankenhaus Herdecke , Witten , Germany
| | - Friedrich Edelhäuser
- a Integrated Curriculum for Anthroposophic Medicine, Institute for Integrative Medicine, Faculty of Health , Witten Herdecke University , Witten , Germany
- i Department for Early Rehabilitation , Gemeinschaftskrankenhaus Herdecke , Witten , Germany
| | - Gabriele Lutz
- a Integrated Curriculum for Anthroposophic Medicine, Institute for Integrative Medicine, Faculty of Health , Witten Herdecke University , Witten , Germany
- j Department for Psychosomatic Medicine , Gemeinschaftskrankenhaus Herdecke , Witten , Germany
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Differential determination of perceived stress in medical students and high-school graduates due to private and training-related stressors. PLoS One 2018; 13:e0191831. [PMID: 29385180 PMCID: PMC5792003 DOI: 10.1371/journal.pone.0191831] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 01/11/2018] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Numerous studies from diverse contexts have confirmed high stress levels and stress-associated health impairment in medical students. This study aimed to explore the differential association of perceived stress with private and training-related stressors in medical students according to their stage of medical education. METHODS Participants were high-school graduates who plan to study medicine and students in their first, third, sixth, or ninth semester of medical school or in practical medical training. The self-administered questionnaire included items addressing demographic information, the Perceived Stress Questionnaire, and items addressing potential private and training-related stressors. RESULTS Results confirmed a substantial burden of perceived stress in students at different stages of their medical education. In particular, 10-28% of students in their third or ninth semesters of medical school showed the highest values for perceived stress. Training-related stressors were most strongly associated with perceived stress, although specific stressors that determined perceived stress varied across different stages of students' medical education. High-school graduates highly interested in pursuing medical education showed specific stressors similar to those of medical students in their third, sixth, or ninth semesters of medical school, as well as stress structures with heights of general stress rates similar to those of medical students at the beginning of practical medical training. CONCLUSIONS High-school graduates offer new, interesting information about students' fears and needs before they begin medical school. Medical students and high-school graduates need open, comprehensive information about possible stressors at the outset of and during medical education. Programmes geared toward improving resilience behaviour and teaching new, functional coping strategies are recommended.
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Beck S, Schirlo C, Breckwoldt J. How the Start into the Clinical Elective Year Could be Improved: Qualitative Results and Recommendations from Student Interviews. GMS JOURNAL FOR MEDICAL EDUCATION 2018; 35:Doc14. [PMID: 29497699 PMCID: PMC5827187 DOI: 10.3205/zma001161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 07/25/2017] [Accepted: 08/17/2017] [Indexed: 05/10/2023]
Abstract
Background: Entering the Clinical Elective Year (CEY) is a challenging transition phase for undergraduate medical students. Students become members of a professional team, thereby taking over certain tasks, which are executed more or less independently. Factors which facilitate (or impede) this transition in the perception of students are not well described. We therefore wanted to explore, what students perceived to be helpful during the first phase of the CEY and possibly derive respective recommendations. Methods: We conducted semi-structured interviews with 5th year medical students after they had completed the first two months of their CEY. Students were asked which problems they had faced and how they felt prepared for the CEY. Interviews were audio-recorded, transcribed, and analysed by qualitative content analysis. Results: From 34 interviews, we included 28 into analysis. Overall, 24 students were satisfied or very satisfied with their start into the CEY. Satisfaction was expressed with respect to workplace experiences, learning progress, responsibilities and team integration. Especially, students appreciated if they were integrated as active members of the team, were given responsibility for certain units of work, and received well-structured formal teaching and supervision. Students had divergent opinions about the quality of teaching and supervision, about their own achievements, and the recognition they received. Students recommended improvements in respect to formal teaching and supervision by clinical supervisors, preparation of the CEY by university, and supporting structures in the hosting institution. Conclusion: Students in this study were generally satisfied with the first two months of their CEY. Facilitating factors were active and responsible involvement into routine patient care, and high quality formal teaching and supervision. Findings may inform universities, teaching hospitals, and students how to better shape the first phase of the CEY.
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Affiliation(s)
- Samuel Beck
- University of Zurich, Faculty of Medicine, Dean's Office, Zurich, Switzerland
| | - Christian Schirlo
- University of Zurich, Faculty of Medicine, Dean's Office, Zurich, Switzerland
| | - Jan Breckwoldt
- University of Zurich, Faculty of Medicine, Dean's Office, Zurich, Switzerland
- *To whom correspondence should be addressed: Jan Breckwoldt, University of Zurich, Faculty of Medicine, Dean`s Office, Pestalozzistr. 3-5, CH-8091 Zurich, Switzerland, Tel.: +41 (0)44/634-1075, Fax: +41 (0)44/634-1088, E-mail:
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Bugaj TJ, Schmid C, Koechel A, Stiepak J, Groener JB, Herzog W, Nikendei C. Shedding light into the black box: A prospective longitudinal study identifying the CanMEDS roles of final year medical students' on-ward activities. MEDICAL TEACHER 2017; 39:883-890. [PMID: 28413889 DOI: 10.1080/0142159x.2017.1309377] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
INTRODUCTION To our best knowledge, a rigorous prospective analysis of final year medical students' (FY medical students) activity profiles during workplace learning is lacking. The present study investigated the CanMEDS characteristics of all on-ward activities performed by internal medicine FY medical students. We tested the hypotheses that during FY medical student workplace training (I) routine activities are predominantly performed, while supervised, more complex activities are underrepresented with (II) FY medical students performing an insufficient number of autonomous activities and that (III) the CanMEDS roles of the Communicator and the Professional prevail. METHODS During the second and the sixth week of their final year trimester at the University of Heidelberg Medical Hospital, N = 34 FY medical students (73% female; mean age 26.4 ± 2.4) were asked to keep a detailed record of all their on-ward activities and to document the duration, mode of action (active versus passive; independent versus supervised), estimated relevance for later practice, and difficulty-level in specially designed activity logbooks. CanMEDS roles were assigned to the documented activities via post-hoc expert consensus. RESULTS About 4308 activities lasting a total of 2211.4 h were documented. Drawing blood (20.8%) was the most frequently documented medical activity followed by full admission procedures (9.6%). About 14.9% of the time was spent with non-medical activities. About 82.1% of all medical activities performed went unsupervised. The Communicator (42%), the Professional (38%), and the Collaborator (7%) were assigned as the top three CanMEDS roles. CONCLUSIONS The results call for increased efforts in creating more authentic learning experiences for FY medical students shifting towards more complex, supervised tasks, and improved team integration.
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Affiliation(s)
- Till Johannes Bugaj
- a Department of General Internal and Psychosomatic Medicine , University of Heidelberg Medical Hospital , Heidelberg , Germany
| | - Carolin Schmid
- a Department of General Internal and Psychosomatic Medicine , University of Heidelberg Medical Hospital , Heidelberg , Germany
| | - Ansgar Koechel
- b Department of Dermatology , University of Heidelberg Medical Hospital , Heidelberg , Germany
| | - Jan Stiepak
- c Department of Cardiology, Angiology, and Pneumology , University of Heidelberg Medical Hospital , Heidelberg , Germany
| | - Jan B Groener
- d Department of Endocrinology and Metabolism , University of Heidelberg Medical Hospital , Heidelberg , Germany
| | - Wolfgang Herzog
- a Department of General Internal and Psychosomatic Medicine , University of Heidelberg Medical Hospital , Heidelberg , Germany
| | - Christoph Nikendei
- a Department of General Internal and Psychosomatic Medicine , University of Heidelberg Medical Hospital , Heidelberg , Germany
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Schüttpelz-Brauns K, Narciss E, Schneyinck C, Böhme K, Brüstle P, Mau-Holzmann U, Lammerding-Koeppel M, Obertacke U. Twelve tips for successfully implementing logbooks in clinical training. MEDICAL TEACHER 2016; 38:564-9. [PMID: 26841068 PMCID: PMC4926785 DOI: 10.3109/0142159x.2015.1132830] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
BACKGROUND Logbooks are widely used to set learning outcomes and to structure and standardize teaching in clinical settings. Experience shows that logbooks are not always optimally employed in clinical training. In this article, we have summarized our own experiences as well as results of studies into twelve tips on how to successfully implement logbooks into clinical settings. METHODS We conducted both a workshop concerning the importance of logbook training to exchange experiences in teaching practice, organization, didactic knowledge and a literature research to compare our own experiences and add additional aspects. RESULTS Tips include the process of developing the logbook itself, the change-management process, conditions of training and the integration of logbooks into the curriculum. CONCLUSIONS Logbooks can be a valuable tool for training in clinical settings, especially when multiple sites are involved, when you take our tips into consideration.
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Affiliation(s)
- Katrin Schüttpelz-Brauns
- Heidelberg University,
Germany
- Correspondence: Dr. Katrin Schüttpelz-Brauns,
Department of Undergraduate Education and Educational Development, University Medicine Mannheim (UMM)/Medical Faculty Mannheim at Heidelberg University, Theodor-Kutzer-Ufer 1-3,
68167Mannheim,
Germany. Tel: +49 621 383 96 38; Fax: +49 621 383 97 33; E-mail:
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Groener JB, Bugaj TJ, Scarpone R, Koechel A, Stiepak J, Branchereau S, Krautter M, Herzog W, Nikendei C. Video-based on-ward supervision for final year medical students. BMC MEDICAL EDUCATION 2015; 15:163. [PMID: 26419731 PMCID: PMC4588264 DOI: 10.1186/s12909-015-0430-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 09/02/2015] [Indexed: 05/26/2023]
Abstract
BACKGROUND Constructive feedback is an essential element of the educational process, helping trainees reach their maximum potential and increasing their skill level. Video-based feedback has been described as highly effective in various educational contexts. The present study aimed to evaluate the feasibility and acceptability of video-based, on-ward supervision for final year students in a clinical context with real patients. METHODS Nine final year medical students (three male, six female; aged 25.1 ± 0.7 years) and eight patients (five male, three female; aged 59.3 ± 16.8 years) participated in the pilot study. Final year students performed routine medical procedures at bedside on internal medicine wards at the University of Heidelberg Medical Hospital. Students were filmed and were under supervision. After performing the procedures, an oral feedback loop was established including student, patient and supervisor feedback on communicative and procedural aspects of skills performed. Finally, students watched their video, focusing on specific teachable moments mentioned by the supervisor. Written evaluations and semi-structured interviews were conducted that focused on the benefits of video-based, on-ward supervision. Interviews were analysed qualitatively, using open coding to establish recurring themes and overarching categories to describe patients' and students' impressions. Descriptive, quantitative analysis was used for questionnaire data. RESULTS Supervised, self-chosen skills included history taking (n = 6), physical examination (n = 1), IV cannulation (n = 1), and ECG recording (n = 1). The video-based, on-ward supervision was well accepted by patients and students. Supervisor feedback was rated as highly beneficial, with the video material providing an additional opportunity to focus on crucial aspects and to further validate the supervisor's feedback. Students felt the video material would be less beneficial without the supervisor's feedback. The setting was rated as realistic, with filming not influencing behaviour. CONCLUSION Video-based, on-ward supervision may be a powerful tool for improving clinical medical education. However, it should be regarded as an additional tool in combination with supervisors' oral feedback. Acceptance was high in both students and patients. Further research should address possibilities of efficiently combining and routinely establishing these forms of feedback in medical education.
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Affiliation(s)
- J B Groener
- Department of Endocrinology and Clinical Chemistry, University of Heidelberg, Heidelberg, Germany.
| | - T J Bugaj
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg, Heidelberg, Germany.
| | - R Scarpone
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg, Heidelberg, Germany
| | - A Koechel
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg, Heidelberg, Germany.
| | - J Stiepak
- Department of Cardiology, Angiology, Pneumology, University of Heidelberg, Heidelberg, Germany.
| | - S Branchereau
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg, Heidelberg, Germany.
| | - M Krautter
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany.
| | - W Herzog
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg, Heidelberg, Germany.
| | - C Nikendei
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg, Heidelberg, Germany.
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Ebrahimi-Fakhari D, Agrawal M, Wahlster L. International electives in the final year of German medical school education--a student's perspective. GMS ZEITSCHRIFT FUR MEDIZINISCHE AUSBILDUNG 2014; 31:Doc26. [PMID: 25228928 PMCID: PMC4152990 DOI: 10.3205/zma000918] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 11/23/2013] [Accepted: 04/29/2014] [Indexed: 11/30/2022]
Abstract
The final year of medical school has a unique role for introducing students to their future responsibilities and challenges. At many medical schools, electives at an accredited institution abroad are a common part of the student's final year experience. International electives provide an opportunity for a personal and academic experience that will often create new perspectives on clinical medicine and research, medical education and healthcare policy. In this article the authors reflect on their experience as elective students abroad and discuss the contribution of international electives to the constant development and progress of local final year rotations. They identify key areas for improving final year electives and outline essential features for a valuable and successful final year elective.
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Affiliation(s)
| | - Mridul Agrawal
- Ruprecht-Karls-University Heidelberg, Mannheim Medical School, Mannheim, Germany
| | - Lara Wahlster
- Ruprecht-Karls-University Heidelberg, Heidelberg Medical School, Heidelberg, Germany
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