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[The diagnostic course : A new form of teaching in otorhinolaryngology education]. HNO 2021; 69:52-57. [PMID: 32885309 PMCID: PMC7806532 DOI: 10.1007/s00106-020-00929-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Hintergrund Fehlende praktische Übungen sowie Anstieg der Studierendenzahlen führen zu der Notwendigkeit innovativer Lehrmethoden. Wir etablierten einen Diagnostik-Parcours zur Darstellung der Sinne unseres Faches. Ziel der Arbeit Das vorwiegende Ziel der Einführung des Diagnostik-Parcours war die kompakte Darstellung der Funktionsdiagnostik einer HNO(Hals-Nasen-Ohrenheilkunde)-Abteilung sowie die praktische und abwechslungsreiche Gestaltung des bestehenden Blockpraktikums.
Material und Methoden Am ersten Tag des fünftägigen Blockpraktikums wird ein „HNO-Spiegelkurs“ durchgeführt, bei dem die Studierenden lernen, einen HNO-Spiegelbefund zu erheben. Nach der Einteilung auf den HNO-Stationen, in der Poliklinik sowie in den Operationssälen erfolgt am 5. Tag der Diagnostik-Parcours, bei dem vier verschiedene Stationen der Diagnostik einer HNO-Klinik in praktischen Übungen durchlaufen werden. Ergebnisse In der Evaluation des Blockpraktikums konnten wir unsere Bewertung durch Einführung des Diagnostik-Parcours signifikant verbessern. So lag im Sommersemester 2019 die Note bei 1,4 bei 38 % von n = 105. Auch persönliche Rückmeldungen sowie mehrere Famulaturanfragen verdeutlichen das positive Feedback. Schlussfolgerung Der Vorteil des Diagnostik-Parcours ist die Möglichkeit, praktische Fertigkeiten direkt anzuwenden. Außerdem ist die kleine Gruppengröße von maximal fünf Studierenden als positiv zu werten. Somit kann das Fach der Hals-Nasen-Ohren-Heilkunde mit seinem abwechslungsreichen Charakter attraktiv dargestellt werden. Auch wenn der vorgestellte Parcours einen hohen personellen Aufwand bedeutet, sollte dies in der universitären Lehre ermöglicht werden.
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Bugaj TJ, Blohm M, Schmid C, Koehl N, Huber J, Huhn D, Herzog W, Krautter M, Nikendei C. Peer-assisted learning (PAL): skills lab tutors' experiences and motivation. BMC MEDICAL EDUCATION 2019; 19:353. [PMID: 31521146 PMCID: PMC6744669 DOI: 10.1186/s12909-019-1760-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 08/20/2019] [Indexed: 05/21/2023]
Abstract
BACKGROUND Peer-assisted learning (PAL) is a common teaching and learning method in medical education worldwide. In the setting of skills laboratories (skills labs), student tutors are often employed as an equivalent alternative to faculty teachers. However, to the best of our knowledge, there is a lack of qualitative studies which explore the reasons for the personal commitment of student tutors. The aim of our study was to examine how undergraduate students experienced and evaluated their roles as skills lab student tutors, what their motivation was, and whether social and cognitive congruence played a role in their teaching experiences. METHODS We conducted in-depth, semi-structured interviews with student tutors who were currently teaching in a skills lab. After the interviews had been transcribed verbatim, two independent investigators performed a qualitative content analysis according to Mayring. RESULTS In total, we conducted nine interviews with student tutors. Our results revealed that all student tutors showed great enthusiasm and motivation for their jobs as peer teachers. One of the main motivating factors for student tutors to teach in a skills lab was the possibility to simultaneously share and improve their knowledge and expertise. In general, the participants of our study had high aspirations for their teaching. They found it particularly important to be empathetic with the student learners. At the same time, they thought they would personally benefit from their teaching activities and develop a certain expertise as student tutors. CONCLUSIONS With the present study we are able to gain some insight into what motivates student tutors to teach in a skills lab and what kind of experiences they have. Our results provide an important input for the future training of highly qualified student tutors.
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Affiliation(s)
- T. J. Bugaj
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg Medical Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - M. Blohm
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum Esslingen, Esslingen, Germany
| | - C. Schmid
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg Medical Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - N. Koehl
- Practice Drs./NL Albertus Arends, Heidelberg, Germany
| | - J. Huber
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg Medical Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - D. Huhn
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg Medical Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - W. Herzog
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg Medical Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - M. Krautter
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
- Clinic for Kidney, Hypertension and Autoimmune Diseases, Klinikum Stuttgart, Stuttgart, Germany
| | - C. Nikendei
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg Medical Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
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Bugaj TJ, Nikendei C, Groener JB, Stiepak J, Huber J, Möltner A, Herzog W, Koechel A. Ready to run the wards? - A descriptive follow-up study assessing future doctors' clinical skills. BMC MEDICAL EDUCATION 2018; 18:257. [PMID: 30419869 PMCID: PMC6233503 DOI: 10.1186/s12909-018-1370-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 10/31/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Recent studies have shown that clinical tasks only represent a small percentage in the scope of final-year medical students' activities and often lack sufficient supervision. It appears that final-year medical students are frequently deployed to perform "routine tasks" and show deficits in the performance of more complex activities. This study aimed to evaluate final-year students' clinical performance in multiple impromptu clinical scenarios using video-based assessment. METHODS We assessed final-year medical students' clinical performance in a prospective, descriptive, clinical follow-up study with 24 final-year medical students during their Internal Medicine rotation. Participating students were videotaped while practicing history taking, physical examination, IV cannulation, and case presentation at the beginning and end of their rotation. Clinical performance was rated by two independent, blinded video assessors using binary checklists, activity specific rating scales and a five-point global rating scale for clinical competence. RESULTS Students' performance, assessed by the global rating scale for clinical competence, improved significantly during their rotation. However, their task performance was not rated as sufficient for independent practice in most cases. Analysis of average scores revealed that overall performance levels differed significantly, whereby average performance was better for less complex and more frequently performed activities. CONCLUSIONS We were able to show that students' performance levels differ significantly depending on the frequency and complexity of activities. Hence, to ensure adequate job preparedness for clinical practice, students need sufficiently supervised and comprehensive on-ward medical training.
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Affiliation(s)
- Till Johannes Bugaj
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Medical Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Christoph Nikendei
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Medical Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Jan Benedikt Groener
- Department of Endocrinology and Clinical Chemistry, University of Heidelberg, Medical Hospital, Heidelberg, Germany
| | - Jan Stiepak
- Department of Cardiology, Angiology, Pneumology, University of Heidelberg, Medical Hospital, Heidelberg, Germany
| | - Julia Huber
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Medical Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Andreas Möltner
- Center of Excellence in Medical Assessment, Faculty of Medicine, University of Heidelberg, Heidelberg, Germany
| | - Wolfgang Herzog
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Medical Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Ansgar Koechel
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Medical Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
- Department of Dermatology, University of Tübingen, Medical Centre, Tübingen, Germany
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Knauber J, König AK, Herion T, Tabatabai J, Kadmon M, Nikendei C. "Heidelberg Standard Examination" - Final year students' experiences with a handbook and instructional videos to improve medical competence in conducting physical examinations. GMS JOURNAL FOR MEDICAL EDUCATION 2018; 35:Doc38. [PMID: 30186948 PMCID: PMC6120156 DOI: 10.3205/zma001184] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 05/07/2018] [Accepted: 06/07/2018] [Indexed: 06/08/2023]
Abstract
Background: The physical examination (PE) of patients is a core competence in almost all medical disciplines. The teaching materials "Heidelberger Standard Examination", consisting of a handbook and accompanying videos, were developed with the objective of providing medical students with an innovative faculty-wide teaching and examination standard to sustainably advance students' PE competences during medical training. Methods: In a "mixed-method approach" comprising both quantitative and qualitative measures, our study examined Heidelberg University Hospital final year (FY) medical students' use and evaluation of the individual teaching material components. Therefore, 92 FY students completed quantitative evaluation measures and ten FY students took part in individual 30-minute semi-structured interviews. Results: Of the sample of n=77 students, who had completed the clinical part of their studies at Heidelberg University Hospital, 97.4% (n=75) had used the handbook and 35.0% (n=27) the accompanying videos. The teaching materials were evaluated via the common German six-point school grading system with an average mark of 1.35±0.5 for the handbook and a mark of 2.15±1.0 for the accompanying videos. Further, our results show that FY students especially valued the "Heidelberg Standard Examination" handbook as a guide and general reference work and felt the materials improved their self-perceived PE competence. Although FY students saw the accompanying video material as helpful, it was less frequently used, indicating further development potential. Overall, results reveal that FY students perceive the "Heidelberg Standard Examination" teaching program to contribute to the improvement of the quality of their PE training.
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Affiliation(s)
- Julia Knauber
- University Hospital Heidelberg, Department of General Internal Medicine and Psychosomatics, Heidelberg, Germany
| | | | - Tobias Herion
- University Hospital Heidelberg, Department of surgery, Heidelberg, Germany
| | - Julia Tabatabai
- University Hospital Heidelberg, Center for Child and Adolescent Medicine, Pediatrics Clinic I, Heidelberg, Germany
- University Hospital Heidelberg, Centre for Infectiology, Virology, Heidelberg, Germany
- University Hospital Heidelberg, German Centre for Infection Research, Heidelberg, Germany
| | - Martina Kadmon
- University Hospital Heidelberg, Department of surgery, Heidelberg, Germany
- University of Augsburg, Department of Medicine, Augsburg, Germany
| | - Christoph Nikendei
- University Hospital Heidelberg, Department of General Internal Medicine and Psychosomatics, Heidelberg, Germany
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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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Dilly M, Read EK, Baillie S. A Survey of Established Veterinary Clinical Skills Laboratories from Europe and North America: Present Practices and Recent Developments. JOURNAL OF VETERINARY MEDICAL EDUCATION 2017; 44:580-589. [PMID: 28534722 DOI: 10.3138/jvme.0216-030r1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Developing competence in clinical skills is important if graduates are to provide entry-level care, but it is dependent on having had sufficient hands-on practice. Clinical skills laboratories provide opportunities for students to learn on simulators and models in a safe environment and to supplement training with animals. Interest in facilities for developing veterinary clinical skills has increased in recent years as many veterinary colleges face challenges in training their students with traditional methods alone. For the present study, we designed a survey to gather information from established veterinary clinical skills laboratories with the aim of assisting others considering opening or expanding their own facility. Data were collated from 16 veterinary colleges in North America and Europe about the uses of their laboratory, the building and associated facilities, and the staffing, budgets, equipment, and supporting learning resources. The findings indicated that having a dedicated veterinary clinical skills laboratory is a relatively new initiative and that colleges have adopted a range of approaches to implementing and running the laboratory, teaching, and assessments. Major strengths were the motivation and positive characteristics of the staff involved, providing open access and supporting self-directed learning. However, respondents widely recognized the increasing demands placed on the facility to provide more space, equipment, and staff. There is no doubt that veterinary clinical skills laboratories are on the increase and provide opportunities to enhance student learning, complement traditional training, and benefit animal welfare.
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Dilly M, Tipold A, Geuenich K. Stressed out or subjective acquisition of competence--how do veterinary students see their curative work placement? GMS JOURNAL FOR MEDICAL EDUCATION 2016; 33:Doc9. [PMID: 26958657 PMCID: PMC4766928 DOI: 10.3205/zma001008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 12/07/2015] [Accepted: 12/09/2015] [Indexed: 06/05/2023]
Abstract
Veterinary studies in Germany are regulated by the Veterinary Certification Act (TAppV). The practical part of the education consists of 1,170 hours, whereby up to 850 hours can be spent on the curative work placement. A curative work placement can result in physical and psychological stress in the sense of a professional overload. It is the aim of this study to find out in what areas and to what extent competence is acquired and psychological stress exists in students during their work placement. Veterinary students (n=142) from all German education institutes participated in a voluntary online-study based on Burnout Screening Scales (BOSS) as well as a questionnaire regarding the acquisition of competence and excessive stress during the work placement (FKÜP). The distribution of values for work placement related stress show that such work placement related stress is generally slightly increased (T=60) and lies above that of occupational stresses within the normal population. Work placement related physical complaints also show a significant slight increase (T=61). A value (T=42) within the normal range was determined for the resource values. Few of the students questioned considered themselves to be excessively stressed in favour of a high subjective acquisition of competences. The largest increase regarding the acquisition of competence was noted for the areas of animal handling/restraint and application and injection techniques. In the sense of a perceived excessive demand regarding practical capabilities the areas of emergency management, surgery and medication dispensation were mentioned. With regard to the load structure and the acquisition of competence by veterinary students during their work placement, more support of the individual and a balancing of teaching/learning goals would be desirable and represents a promising approach.
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Affiliation(s)
- Marc Dilly
- University of Veterinary Medicine Hannover, Foundation, Clinical Skills Lab, Hannover, Germany
| | - Andrea Tipold
- University of Veterinary Medicine Hannover, Foundation, Small Animal Clinical, Hannover, Germany
| | - Katja Geuenich
- Park Clinic Röhrer, Academy for Psychosomatics in the World of Work, Eschweiler, Germany
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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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Mortsiefer A, Immecke J, Rotthoff T, Karger A, Schmelzer R, Raski B, Schmitten JID, Altiner A, Pentzek M. Summative assessment of undergraduates' communication competence in challenging doctor-patient encounters. Evaluation of the Düsseldorf CoMeD-OSCE. PATIENT EDUCATION AND COUNSELING 2014; 95:348-355. [PMID: 24637164 DOI: 10.1016/j.pec.2014.02.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 02/18/2014] [Accepted: 02/23/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To evaluate the summative assessment (OSCE) of a communication training programme for dealing with challenging doctor-patient encounters in the 4th study year. METHODS Our OSCE consists of 4 stations (breaking bad news, guilt and shame, aggressive patients, shared decision making), using a 4-item global rating (GR) instrument. We calculated reliability coefficients for different levels, discriminability of single items and interrater reliability. Validity was estimated by gender differences and accordance between GR and a checklist. RESULTS In a pooled sample of 456 students in 3 OSCEs over 3 terms, total reliability was α=0.64, reliability coefficients for single stations were >0.80, and discriminability in 3 of 4 stations was within the range of 0.4-0.7. Except for one station, interrater reliability was moderate to strong. Reliability on item level was poor and pointed to some problems with the use of the GR. CONCLUSION The application of the GR on regular undergraduate medical education shows moderate reliability in need of improvement and some traits of validity. Ongoing development and evaluation is needed with particular regard to the training of the examiners. PRACTICE IMPLICATIONS Our CoMeD-OSCE proved suitable for the summative assessment of communication skills in challenging doctor-patient encounters.
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Affiliation(s)
- Achim Mortsiefer
- Institute of General Practice, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf 40225, Germany.
| | - Janine Immecke
- Institute of General Practice, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf 40225, Germany
| | - Thomas Rotthoff
- Deanery of Study and Department for Endocrinology and Diabetes, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf 40225, Germany
| | - André Karger
- Clinical Institute of Psychosomatic Medicine and Psychotherapy, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf 40225, Germany
| | - Regine Schmelzer
- Clinical Institute of Psychosomatic Medicine and Psychotherapy, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf 40225, Germany
| | - Bianca Raski
- Clinical Institute of Psychosomatic Medicine and Psychotherapy, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf 40225, Germany
| | - Jürgen In der Schmitten
- Institute of General Practice, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf 40225, Germany
| | - Attila Altiner
- Institute of General Practice, Medical Faculty of the University of Rostock, Rostock 18057, Germany
| | - Michael Pentzek
- Institute of General Practice, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf 40225, Germany
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Dilly M, Tipold A, Schaper E, Ehlers JP. Setting up a veterinary medicine skills lab in Germany. GMS ZEITSCHRIFT FUR MEDIZINISCHE AUSBILDUNG 2014; 31:Doc20. [PMID: 24872855 PMCID: PMC4027805 DOI: 10.3205/zma000912] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 10/08/2013] [Accepted: 04/02/2014] [Indexed: 11/30/2022]
Abstract
The amendments introduced to the current Veterinary Licensing Ordinance (TAppV) by the Veterinary Licensing Regulation (TAppO) have brought a high degree of skills orientation to fill the gap between academic study and preparing for a wide range of professional skills. In order to improve the veterinary skills of students while conveying fundamental methods in a structured and reproducible way, the University of Veterinary Medicine Hannover, Foundation, has set up the first central veterinary skills lab in Germany. Practical training is provided by means of a three-tier delivery approach. This involves around 40 simulators on an area of approx. 800 m(2) under the guidance of 6-8 staff members, along with supplementary resources such as posters, text instructions and YouTube videos. Since it opened in March 2013, there have been 769 visits to the skills lab and 30,734 hits on YouTube. Initial results show that the skills lab helps to maintain student motivation by teaching them practical skills at an early stage of the basic study-based acquisition of knowledge, whilst reinforcing skills acquisition per se in competence-based teaching. It enables veterinary students to prepare for their first examinations and treatments of live patients in a manner compliant with animal welfare.
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Affiliation(s)
- Marc Dilly
- University of Veterinary Medicine Hannover, Foundantion, Clinical Skills Lab, Hannover, Germany
| | - Andrea Tipold
- University of Veterinary Medicine Hannover, Foundation, Clinic for small animals, Hannover, Germany
| | - Elisabeth Schaper
- University of Veterinary Medicine Hannover, Foundation, Competence centre for E-Learning, Didaktic and Education in Medicine, Hannover, Germany
| | - Jan P Ehlers
- University of Veterinary Medicine Hannover, Foundation, Competence centre for E-Learning, Didaktic and Education in Medicine, Hannover, Germany
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Celebi N, Tsouraki R, Engel C, Holderried F, Riessen R, Weyrich P. Does doctors' workload impact supervision and ward activities of final-year students? A prospective study. BMC MEDICAL EDUCATION 2012; 12:24. [PMID: 22540897 PMCID: PMC3372449 DOI: 10.1186/1472-6920-12-24] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2011] [Accepted: 04/27/2012] [Indexed: 05/26/2023]
Abstract
BACKGROUND Hospital doctors face constantly increasing workloads. Besides caring for patients, their duties also comprise the education of future colleagues. The aim of this study was to objectively investigate whether the workload arising from increased patient care interferes with student supervision and is associated with more non-medical activities of final-year medical students. METHODS A total of 54 final-year students were asked to keep a diary of their daily activities over a three-week period at the beginning of their internship in Internal Medicine. Students categorized their activities--both medical and non-medical--according to whether they had: (1) only watched, (2) assisted the ward resident, (3) performed the activity themselves under supervision of the ward resident, or (4) performed the activity without supervision. The activities reported on a particular day were matched with a ward specific workload-index derived from the hospital information system, including the number of patients treated on the corresponding ward on that day, a correction factor according to the patient comorbidity complexity level (PCCL), and the number of admissions and discharges. Both students and ward residents were blinded to the study question. RESULTS A total of 32 diaries (59 %, 442 recorded working days) were handed back. Overall, the students reported 1.2 ± 1.3 supervised, 1.8 ± 1.6 medical and 3.6 ± 1.7 non-medical activities per day. The more supervised activities were reported, the more the number of reported medical activities increased (p < .0001). No relationship between the ward specific workload and number of medical activities could be shown. CONCLUSIONS There was a significant association between ward doctors' supervision of students and the number of medical activities performed by medical students. The workload had no significant effect on supervision or the number of medical or non-medical activities of final-year students.
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Affiliation(s)
- Nora Celebi
- Department of Internal Medicine, Division of Diabetes, Endocrinology, Angiology, Nephrology and Clinical Chemistry, University Hospital of Tübingen, Tübingen, Germany
| | | | - Corinna Engel
- Institute for Medical Biometry, University of Tübingen, Tübingen, Germany
| | - Friederike Holderried
- Department of the Dean of Student Affairs, University of Tübingen, Tübingen, Germany
| | - Reimer Riessen
- Department of Internal Medicine, Medical Intensive Care Unit, University Hospital of Tübingen, Tübingen, Germany
| | - Peter Weyrich
- Department of Internal Medicine, Division of Diabetes, Endocrinology, Angiology, Nephrology and Clinical Chemistry, University Hospital of Tübingen, Tübingen, Germany
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Mortsiefer A, Rotthoff T, Schmelzer R, Immecke J, Ortmanns B, in der Schmitten J, Altiner A, Karger A. Implementation of the interdisciplinary curriculum Teaching and Assessing Communicative Competence in the fourth academic year of medical studies (CoMeD). GMS ZEITSCHRIFT FUR MEDIZINISCHE AUSBILDUNG 2012; 29:Doc06. [PMID: 22403591 PMCID: PMC3296104 DOI: 10.3205/zma000776] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 10/04/2011] [Accepted: 11/07/2011] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Implementation of a longitudinal curriculum for training in advanced communications skills represents an unmet need in most German medical faculties, especially in the 4rth and 5th years of medical studies. The CoMeD project (communication in medical education Düsseldorf) attempted to establish an interdisciplinary program to teach and to assess communicative competence in the 4th academic year. In this paper, we describe the development of the project and report results of its evaluation by medical students. METHODS Teaching objectives and lesson formats were developed in a multistage process. A teaching program for simulated patients (SP) was built up and continuous lecturer trainings were estabilshed. Several clinical disciplines co-operated for the purpose of integrating the communication training into the pre-existing clinical teaching curriculum. The CoMeD project was evaluated using feedback-forms after each course. RESULTS Until now, six training units for especially challenging communication tasks like "dealing with aggression" or "breaking bad news" were implemented, each unit connected with a preliminary tutorial or e-learning course. An OSCE (objective structured clinical examination) with 4 stations was introduced. The students' evaluation of the six CoMeD training units showed the top or second-best rating in more than 80% of the answers. DISCUSSION Introducing an interdisciplinary communication training and a corresponding OSCE into the 4th year medical curriculum is feasible. Embedding communication teaching in a clinical context and involvement of clinicians as lecturers seem to be important factors for ensuring practical relevance and achieving high acceptance by medical students.
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Affiliation(s)
- Achim Mortsiefer
- University Düsseldorf, Medical Faculty, Institute of General Practice, Düsseldorf, Germany.
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Nikendei C, Krautter M, Celebi N, Obertacke U, Jünger J. Final Year Medical Education in Germany. ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2012; 106:75-84. [DOI: 10.1016/j.zefq.2012.01.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Revised: 01/09/2012] [Accepted: 01/17/2012] [Indexed: 12/01/2022]
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14
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Krautter M, Jünger J, Koehl-Hackert N, Nagelmann L, Nikendei C. [Evaluation of a structured, longitudinal training program for the preparation for the second state exam (M2) - a quantitative analysis]. ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2011; 106:110-5. [PMID: 22480894 DOI: 10.1016/j.zefq.2011.09.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 08/31/2011] [Accepted: 09/07/2011] [Indexed: 10/17/2022]
Abstract
INTRODUCTION The implementation of the amendment to the German medical licensing regulations ("Approbationsordnung") in 2002 led to a reduction in the number of state examinations from four to two exams, with the date of the second state exam being shifted to the end of the final clinical year. Students now face a double burden: on the one hand, they need to get ready for their future job, and on the other hand, they need to prepare for the state exam. This is why the Medical Faculty of Heidelberg introduced a preparation programme for the second state exam. The focus of this study was to evaluate the acceptance of the different modules of this programme and to compare the results against each other. METHODS 39 students (15 male / 24 female; mean age 26.6 ± 1.9 years) took part in the exam preparation programme at the Medical University Hospital Heidelberg. Five different modules were implemented: an informational meeting, a key-feature written exam, case-based multiple-choice exams, a simulated practical examination and a simulated oral examination. Acceptance was measured using a six-point Likert scale (1=very good, 6=unsatisfactory and 1=I completely agree, 6=I completely disagree, respectively) RESULTS The exam preparation programme as a whole was rated good: overall rating key-feature written exam 3.33 ± 1.17; case-based multiple-choice exams 2.61 ± 1.61; simulated practical exam 1.61 ± 0.54; simulated oral exam 1.55 ± 0.50. A comparison of the different modules demonstrated significantly better ratings for the practical and oral examinations than the case-based multiple-choice exams (p<0.001). DISCUSSION The presented exam preparation programme is well accepted and facilitates the preparation for the second state exam, particularly with regard to the oral-practical examination.
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Affiliation(s)
- Markus Krautter
- Nierenzentrum Heidelberg, Sektion Nephrologie, Medizinische Klinik, Universität Heidelberg
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15
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Nikendei C, Mennin S, Weyrich P, Kraus B, Zipfel S, Schrauth M, Jünger J. Effects of a supplementary final year curriculum on students' clinical reasoning skills as assessed by key-feature examination. MEDICAL TEACHER 2009; 31:e438-42. [PMID: 19811181 DOI: 10.1080/01421590902845873] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND The final year of medical education is considered crucial in making students 'fit for purpose'. Studies have shown that many students leave medical school without having experienced sufficient preparation for their upcoming professional life. AIM The aim of this study was to examine the effectiveness of a supplementary internal medicine final year curriculum on clinical reasoning skills. METHOD Final year internal medicine students from two universities participated in the study which was based on a static-group design. The experimental group (n = 49) took part in a final year student curriculum with interactive case-based seminars and skills training sessions. The comparison group (n = 25) did not receive any additional training beyond working on the ward. Clinical reasoning skills were assessed using a key-feature pre-post test. RESULTS Prior to their clinical rotation, the two groups did not differ in the key-feature examination (p < 0.924). The experimental group performed significantly better than the comparison group (p < 0.028) in the post-intervention key-feature examination. CONCLUSIONS Supplementary interactive case-based seminars and skills training sessions are effective and significantly improve the clinical reasoning skills of final year students in internal medicine. Further study is warranted and should look to examine the effectiveness of a final year student curriculum on other performance measures.
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Affiliation(s)
- C Nikendei
- Department of Psychosomatic and General Internal Medicine, University of Heidelberg Medical Hospital, Heidelberg, Germany.
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Schrauth M, Weyrich P, Kraus B, Jünger J, Zipfel S, Nikendei C. [Workplace learning for final-year medical students: a comprehensive analysis of student's expectancies and experiences]. ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2009; 103:169-74. [PMID: 19554893 DOI: 10.1016/j.zefq.2008.05.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The amended German license to practice medicine (AAppO) focuses on practically oriented, patient-centred medical education. After the cancellation of the former medical doctor traineeship "Arzt im Praktikum" (AiP) qualification period in October 2004, the final year of medical education, the so-called "practical year" (PJ), has become a key teaching module in realising the demands of the AAppO. So far no studies have been carried out in the German-speaking area to qualitatively assess the specific needs and central problems that PJ students are facing. The aim of this investigation was to representatively evaluate the expectancies and experiences of final-year medical students in a workplace learning environment. METHODS 65 students (30 male, 35 female, age 25.4 +/- 2 years) of two German university hospitals participated in focus groups both prior and subsequent (n = 60; drop-out rate 7.7%) to a 4-month period of internal medicine traineeship during their final year. Focus group protocols were transcribed and subjected to content analysis. RESULTS 1137 individual statements on relevant topics were identified from the transcriptions. Students widely reported lack of time on the part of supervising doctors and exorbitant assignment to routine jobs. This results in insufficient training of independent patient management, followed by feelings of uncertainty and the fear of making medical errors. CONCLUSIONS Specific educational strategies and motivation of medical teachers are important factors to the workplace learning environment. A structured curriculum including cognitive, procedural and communicative learning objectives and the introduction of defined time slots for bedside teaching is considered a good first step in this process.
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Affiliation(s)
- Markus Schrauth
- Medizinische Klinik für Psychosomatische Medizin und Psychotherapie, Universität Tübingen
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Abstract
Following the changes made to the medical licensing regulations of 2002, medical education in Germany has been subject to radical modification, especially at undergraduate level. The implementation of the Bologna Process is still a matter of intense political debate, whilst positive movement has occurred in developing the professionalisation of teaching staff through a Masters Degree in Medical Education. In the area of postgraduate medical education, major restructuring of programmes is occurring, whilst the debate in continuing medical education is related to the amount of practical clinical education that is required.
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Topping K. Peer-assisted learning: a planning and implementation framework. Guide supplement 30.1--viewpoint. MEDICAL TEACHER 2008; 30:440. [PMID: 18589884 DOI: 10.1080/01421590802150945] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Keith Topping
- College of Arts & Social Sciences, School of Education, Social Work and Community Education, University of Dundee, UK.
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