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Kulgemeyer C, Riese J, Vogelsang C, Buschhüter D, Borowski A, Weißbach A, Jordans M, Reinhold P, Schecker H. How authenticity impacts validity: Developing a model of teacher education assessment and exploring the effects of the digitisation of assessment methods. ZEITSCHRIFT FUR ERZIEHUNGSWISSENSCHAFT : ZFE 2023; 26:1-25. [PMID: 37359180 PMCID: PMC10244832 DOI: 10.1007/s11618-023-01154-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 11/25/2022] [Accepted: 01/06/2023] [Indexed: 06/28/2023]
Abstract
Based on a literature review of studies on teachers' professional competence and related assessment tools, this paper introduces a model of teacher education assessment. It is influenced by Miller's (1990) framework of assessment in medical education and includes, among other aspects, performance assessments. This model is used to understand the potential effects of transferring assessment tools into a digital format with assessment feedback. Five examples for such a transfer will be discussed: three methods for various aspects of communication, a test for pedagogical content knowledge, and a test for content knowledge. All five are established instruments well-described in terms of validity. All five have recently been transferred into a digital format. The analysis of this transfer also reveals a potentially harmful effect of digital assessment. The closer an assessment instrument is to assessing action-related parts of professional competence, the more authenticity is required; however, digitisation tends to decrease this authenticity. This suggests that an increasing number of digital assessment tools in teacher education might result in an even more dominant focus on knowledge tests, ignoring other parts of professional competence. This article highlights the role of authenticity in validity and discusses the most suitable assessment format to address various parts of professional competence. It ends by highlighting the lessons learned from the transfer of assessment instruments into a digital format that other academic disciplines might find interesting.
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Affiliation(s)
- Christoph Kulgemeyer
- Institut für Didaktik der Naturwissenschaften, Abt. Physikdidaktik, Universität Bremen, Otto-Hahn-Allee 1, 28334 Bremen, Germany
| | - Josef Riese
- Fakultät für Naturwissenschaften, Department Physik, Universität Paderborn, Warburger Str. 100, 33098 Paderborn, Germany
| | - Christoph Vogelsang
- Fakultät für Naturwissenschaften, Department Physik, Universität Paderborn, Warburger Str. 100, 33098 Paderborn, Germany
| | - David Buschhüter
- Institut für Physik und Astronomie, Lehrstuhl Didaktik der Physik, Universität Potsdam, Karl-Liebknecht-Str. 24/25, 14476 Potsdam-Golm, Germany
| | - Andreas Borowski
- Institut für Physik und Astronomie, Lehrstuhl Didaktik der Physik, Universität Potsdam, Karl-Liebknecht-Str. 24/25, 14476 Potsdam-Golm, Germany
| | - Anna Weißbach
- Institut für Didaktik der Naturwissenschaften, Abt. Physikdidaktik, Universität Bremen, Otto-Hahn-Allee 1, 28334 Bremen, Germany
| | - Melanie Jordans
- I. Phys. Institut IA, RWTH Aachen University, Sommerfeldstr. 14, 52074 Aachen, Germany
| | - Peter Reinhold
- Fakultät für Naturwissenschaften, Department Physik, Universität Paderborn, Warburger Str. 100, 33098 Paderborn, Germany
| | - Horst Schecker
- Institut für Didaktik der Naturwissenschaften, Abt. Physikdidaktik, Universität Bremen, Otto-Hahn-Allee 1, 28334 Bremen, Germany
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Ang WHD, Chew HSJ, Ong YHN, Zheng ZJ, Shorey S, Lau Y. Becoming More Resilient during COVID-19: Insights from a Process Evaluation of Digital Resilience Training. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12899. [PMID: 36232196 PMCID: PMC9564846 DOI: 10.3390/ijerph191912899] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/01/2022] [Accepted: 10/05/2022] [Indexed: 05/17/2023]
Abstract
Resilience training is gaining attention as a strategy to build students' resistance to adversity and promote their mental well-being. However, owing to inconsistencies and variations in the content and delivery of resilience training, more work is needed to examine students' experiences and preferences to address issues relating to intervention fidelity. This study adopted a qualitative approach in exploring students' experience of synchronous and asynchronous versions of a digital resilience training program. Seventeen students were interviewed using a semi-structured virtual face-to-face interview via Zoom. The thematic analyses unveiled four themes: embarking on a journey toward resilience, discovering strategies to develop resilience, finding a balance to benefit from resilience skill enhancement, and instilling resilience in the everyday. Future resilience training should consider students' workload and interactivity to enhance their engagement. As being resilient is associated with better mental well-being, the findings of this study may support the development of future wellness programs.
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Affiliation(s)
- Wei How Darryl Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
| | - Han Shi Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
| | | | - Zhongjia James Zheng
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
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Dargahi H. Organizational behaviour management in clinical laboratory: A literature review. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:210. [PMID: 34395647 PMCID: PMC8318186 DOI: 10.4103/jehp.jehp_1000_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 08/31/2020] [Indexed: 06/13/2023]
Abstract
BACKGROUND The clinical laboratories require organizational behavior management approach that creates a balance between directors' expectations and staffs' needs in this field. This study was aimed to explain the role of organizational behavior management in clinical laboratories and suggest mechanisms for its implementation in these organizations. MATERIALS AND METHODS In this research, using several Persian and English databases by keywords consist of the clinical laboratory, organizational behavior management, and staff diversity. Three hundred and fifty four references from 1990 to 2020 were studied, and 72 references, including abstracts and full papers utilized for this research, and excluded papers presented at conferences, seminars, and dissertations. Using MESH strategy and Pico's instruction. RESULTS The results of studies revealed staffs' individual differences in all aspects, including early and secondary dimensions may influenced the style of leadership implemented in clinical laboratories, "job-personality compatibility theory," job satisfaction and job commitment of staffs work in clinical laboratories and the way the directors and managers can develop the job loyalty and improve the organizational productivity in these organizations. CONCLUSION It is suggested a conceptual model for understanding and assessing the different organizational behaviors of clinical laboratories staffs based on communication skills, staffs' interaction, and socio-political, economic, and cultural elements, which should be more developed in future using the other similar studies.
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Affiliation(s)
- Hossein Dargahi
- Department of Health Management and Economics, Health Information Management Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Posenau A, Handgraaf M. Framework for interprofessional case conferences - empirically sound and competence-oriented communication concept for interprofessional teaching. GMS JOURNAL FOR MEDICAL EDUCATION 2021; 38:Doc65. [PMID: 33824901 PMCID: PMC7994863 DOI: 10.3205/zma001461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 11/24/2020] [Accepted: 01/09/2021] [Indexed: 06/12/2023]
Abstract
Aims/objectives: Interprofessional case conferences support future team-based approaches to healthcare, and inevitably require targeted communication between the various participants. However, the success of communication during a case conference must be learnt explicitly. The subject of conversation is often the only outcome of the case conference that is discussed in plenary or small groups. Communication processes are hardly taken into account. However, integrating process orientation and making communication relevant to goal achievement is mandatory in order to teach in a competence-oriented fashion in this area. The aim of this article is to present an empirically sound framework for teaching case conferences, with the help of which conversation processes can be practiced, evaluated and analysed in interprofessional case conferences. Methodology: With the aid of literature analysis, insights from empirical conversation research and the International Classification of Functioning and Health (ICF), we have developed an empirically and theoretically sound framework for interprofessional case conferences. This is intended to support the training of communication skills and to serve as a basis for assessing them. Results: In practice, it has been shown that embedding case conferences in higher education curricula is feasible and effective for a group size of 200 students. The framework has proven itself in verbal training while aligning itself with concepts of sharing for the negotiation of leadership, goals and decisions. In addition, it could also be used as a theoretical construct for the "interprofessional objective structured clinical examination" (iOSCE) at graduation from the module "Interprofessional Case Conference" at the Hochschule für Gesundheit. Conclusion: The topics of interprofessional practice (IPP) and communication are now the subject of curricula in the health professions, both nationally and internationally. In addition, various competence settings are available that can support didactic orientation. However, the authors believe that there are no concrete imperatives for competence-oriented implementation in teaching and examination. In the area of communication teaching, one can integrate empirically sound concepts instead of induction into degree course for the health professions, in order to provide a basis for the further development of communicative competence in this field.
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Affiliation(s)
- André Posenau
- Hsg Bochum – Hochschule für Gesundheit, Bochum, Germany
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Maini A, Fyfe M, Kumar S. Medical students as health coaches: adding value for patients and students. BMC MEDICAL EDUCATION 2020; 20:182. [PMID: 32493308 PMCID: PMC7271500 DOI: 10.1186/s12909-020-02096-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 05/28/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Underlying the global burden of chronic disease are common and modifiable risk factors such as unhealthy diet, physical inactivity and tobacco use. Health coaching is being introduced into healthcare as an effective tool in facilitating behaviour change and addressing lifestyle risk factors in patients. Although some medical schools are training students in health coaching, there is little research on this emerging practice. This qualitative study explores the experience and application of health coaching approaches by third year medical students that have been trained in health coaching. METHODS Six focus groups were conducted with medical students (n = 39) who had participated in an experiential health coaching training module and practiced their health coaching skills in primary care settings. Interactive facilitated discussions between students aimed to explore experiences of health coaching, how this related to their ongoing practice, and their perceived impacts of engagement with patients. Data was thematically analysed. RESULTS Themes emerged around 'mindset', 'skills', 'application of skills', 'perceived value' and 'context'. Training in health coaching prompted a shift towards a non-judgemental, solution-oriented mindset in which students increasingly accepted the ability of each person to define their needs and identify individually appropriate solutions. Mindset change supported skill development in person-centred communication, active listening, and self-refection. Mindset and skills related to changes in how students conducted patient consultations, their practice of self-refection, and their personal relationships. Perceived value of coaching approaches reinforced mindset. Students described facilitators to their coaching practice, and also tensions due to misalignment between their coaching mindset and ongoing practices in medical education and service delivery. CONCLUSIONS Training medical students in health coaching and supporting them to contribute meaningfully through empowering patients in real-world settings can help develop students' professional identity and a non-judgemental, solution-oriented mindset and skills in self-reflection, person-centred care and facilitating health behaviour change.
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Affiliation(s)
- Arti Maini
- Medical Education Innovation and Research Centre (MEdIC), School of Public Health, Imperial College London, Room 331, 3rd floor Reynolds Building, Charing Cross Campus, St Dunstan's Rd, London, W6 8RP, UK.
| | - Molly Fyfe
- Medical Education Innovation and Research Centre (MEdIC), School of Public Health, Imperial College London, Room 331, 3rd floor Reynolds Building, Charing Cross Campus, St Dunstan's Rd, London, W6 8RP, UK
| | - Sonia Kumar
- Medical Education Innovation and Research Centre (MEdIC), School of Public Health, Imperial College London, Room 331, 3rd floor Reynolds Building, Charing Cross Campus, St Dunstan's Rd, London, W6 8RP, UK
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Graf J, Loda T, Zipfel S, Wosnik A, Mohr D, Herrmann-Werner A. Communication skills of medical students: survey of self- and external perception in a longitudinally based trend study. BMC MEDICAL EDUCATION 2020; 20:149. [PMID: 32393242 PMCID: PMC7216673 DOI: 10.1186/s12909-020-02049-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 04/21/2020] [Indexed: 05/27/2023]
Abstract
BACKGROUND As good communication skills are crucial for doctor-patient interactions, it is recommended to incorporate them in medical school programs from the very beginning. On this basis medical schools in Germany introduced the OSCE (objective structured clinical examination) to examine and by this foster learning of communication skills as assessment drives learning. The aim of the study was to examine the development of the communication skills of medical students during an OSCE to investigate how communication competence has developed between different student cohorts. METHODS This study is a longitudinal trend study based on seven semester-cohorts, examining the communication skills of medical students in the OSCE both from the perspective of students and from the viewpoint of standardized patients (SP). Altogether, 1027 students from seven semester cohorts were asked to rate their own communication skills (self-perception) before the OSCE exam started. Here, sub-analyses were performed to outline a potential influence of previous history-taking group participation. The SP evaluated the students' communication skills in external perception during the OSCE exam at each station with history-taking or physical examinations. The communication skills in both groups were ascertained in the dimensions of empathy, content structure, verbal expression, and non-verbal expression. RESULTS Only in the dimension of non-verbal expression could a statistically significant change be found in students' self-perception over the years. Notably, the rating of communication skills as self-rated by the students has risen constantly, whereas they deteriorated from the perspective of standardized patients (SP). It has also been found that previous history-taking courses have a positive influence on the structural dimension of communication skills in particular. CONCLUSIONS The results of this study support conclusions of other studies which also suggest differences between self- and external perception of medical students' communication skills. Nevertheless, students showed good overall communication skills in the four dimensions of empathy, content structure, verbal expression, and non-verbal expression, as demonstrated in a longitudinal trend study over seven semesters. However, we noted that externally rated empathy levels declined over the semester cohorts, suggesting the need for new priorities to be set in student teaching.
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Affiliation(s)
- Joachim Graf
- University Hospital Tuebingen, Institute for Health Sciences, Section of Midwifery Science, Hoppe-Seyler-Strasse 9, 72076 Tuebingen, Germany
| | - Teresa Loda
- Internal Medicine, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Osianderstrasse 5, 72076 Tuebingen, Germany
| | - Stephan Zipfel
- Internal Medicine, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Osianderstrasse 5, 72076 Tuebingen, Germany
- Medical Faculty Tuebingen, Dean’s Office for Students’ Affairs, Geissweg 5, 72076 Tuebingen, Germany
| | - Annette Wosnik
- Medical Faculty Tuebingen, Dean’s Office for Students’ Affairs, Geissweg 5, 72076 Tuebingen, Germany
| | - Daniela Mohr
- Medical Faculty Tuebingen, Dean’s Office for Students’ Affairs, Geissweg 5, 72076 Tuebingen, Germany
| | - Anne Herrmann-Werner
- Internal Medicine, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Osianderstrasse 5, 72076 Tuebingen, Germany
- Medical Faculty Tuebingen, Interdisciplinary Training Centre DocLab, Elfriede-Aulhorn-Strasse 10, 72076 Tuebingen, Germany
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Mansoorian MR, Jalili M, Khosravan S, Shariati M. Exploring undergraduate medical students' perception of learning procedural skills and its outcomes in clinical settings. JOURNAL OF ADVANCES IN MEDICAL EDUCATION & PROFESSIONALISM 2019; 7:175-182. [PMID: 31750355 PMCID: PMC6820010 DOI: 10.30476/jamp.2019.74866.0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 06/03/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Learning procedural skills is one of the essential aspects of undergraduate medical education. However, learning procedural skills in clinical settings is less widely considered. This study aimed to explore the Iranian undergraduate medical students' perception of learning procedural skills and its outcomes in three universities of medical sciences in Iran. METHODS A descriptive exploratory qualitative methodology with an in-depth unstructured, face-to-face interview, and content analysis was used in this study. Sixteen students in clinical phases of general medical education programs from educational hospitals were selected using purposive sampling. According to the preferences of the participants, the interviews were conducted in medical schools or in hospitals. RESULTS The students participating in this study included 7 females and 9 males (totally 16 people) with a mean age of 23.7 years old with a range of 21-27 years. The three main themes of this study were "the gap of transferring formal teaching from skill lab to clinical placement", "learning self-leading procedural skills in clinical settings", and "students' dissatisfaction with patients' vulnerability" with 8 subthemes which were extracted and explained based on the students' perception. CONCLUSION Unsupervised and self-learning by medical students and weakness in controlling the learning process have undesirable results for patients and students.
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Affiliation(s)
- Mohammad Reza Mansoorian
- Department of Medical Education, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Jalili
- Emergency Medicine, Department of Medical Education, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahla Khosravan
- Management and Community Health Nursing Department, Social Determinants of Health Research Centre, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mohammad Shariati
- Department of Community Medicine, Medical Education Department, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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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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Kuckuck K, Schröder H, Rossaint R, Stieger L, Beckers SK, Sopka S. Comparison of a newly established emotional stimulus approach to a classical assessment-driven approach in BLS training: a randomised controlled trial. BMJ Open 2018; 8:e017705. [PMID: 29472255 PMCID: PMC5855479 DOI: 10.1136/bmjopen-2017-017705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE The study objective was to implement two strategies (short emotional stimulus vs announced practical assessment) in the teaching of resuscitation skills in order to evaluate whether one led to superior outcomes. SETTING This study is an educational intervention provided in one German academic university hospital. PARTICIPANTS First-yearmedical students (n=271) during the first3 weeks of their studies. INTERVENTIONS Participants were randomly assigned to one of two groups following a sequence of random numbers: the emotional stimulus group (EG) and the assessment group (AG). In the EG, the intervention included watching an emotionally stimulating video prior to the Basic Life Support (BLS) course. In the AG, a practical assessment of the BLS algorithm was announced and tested within a 2 min simulated cardiac arrest scenario. After the baseline testing, a standardised BLS course was provided. Evaluation points were defined 1 week and 6 months after. PRIMARY OUTCOME MEASURES Compression depth (CD) and compression rate (CR) were recorded as the primary endpoints for BLS quality. RESULTS Within the study, 137 participants were allocated to the EG and 134 to the AG. 104 participants from EG and 120 from AG were analysed1 week after the intervention, where they reached comparable chest-compression performance without significant differences (CR P=0.49; CD P=0.28). The chest-compression performance improved significantly for the EG (P<0.01) and the AG (P<0.01) while adhering to the current resuscitation guidelines criteria for CD and CR. CONCLUSIONS There was no statistical difference between both groups' practical chest-compression-performance. Nevertheless, the 2 min video sequence used in the EG with its low production effort and costs, compared with the expensive assessment approach, provides broad opportunities for applicability in BLS training.
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Affiliation(s)
- Karl Kuckuck
- Department of Anaesthesiology, University Hospital RWTH Aachen University, Aachen, Germany
| | - Hanna Schröder
- Department of Anaesthesiology, University Hospital RWTH Aachen University, Aachen, Germany
| | - Rolf Rossaint
- Department of Anaesthesiology, University Hospital RWTH Aachen University, Aachen, Germany
| | - Lina Stieger
- AIXTRA—Aachen Interdisciplinary Training Centre for Medical Education, University Hospital RWTH Aachen University, Aachen, Germany
| | - Stefan K Beckers
- Department of Anaesthesiology, University Hospital RWTH Aachen University, Aachen, Germany
- AIXTRA—Aachen Interdisciplinary Training Centre for Medical Education, University Hospital RWTH Aachen University, Aachen, Germany
| | - Sasa Sopka
- Department of Anaesthesiology, University Hospital RWTH Aachen University, Aachen, Germany
- AIXTRA—Aachen Interdisciplinary Training Centre for Medical Education, University Hospital RWTH Aachen University, Aachen, Germany
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Störmann S, Stankiewicz M, Raes P, Berchtold C, Kosanke Y, Illes G, Loose P, Angstwurm MW. How well do final year undergraduate medical students master practical clinical skills? GMS JOURNAL FOR MEDICAL EDUCATION 2016; 33:Doc58. [PMID: 27579358 PMCID: PMC5003129 DOI: 10.3205/zma001057] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 03/11/2016] [Accepted: 05/10/2016] [Indexed: 05/28/2023]
Abstract
INTRODUCTION The clinical examination and other practical clinical skills are fundamental to guide diagnosis and therapy. The teaching of such practical skills has gained significance through legislative changes and adjustments of the curricula of medical schools in Germany. We sought to find out how well final year undergraduate medical students master practical clinical skills. METHODS We conducted a formative 4-station objective structured clinical examination (OSCE) focused on practical clinical skills during the final year of undergraduate medical education. Participation was voluntary. Besides the examination of heart, lungs, abdomen, vascular system, lymphatic system as well as the neurological, endocrinological or orthopaedic examination we assessed other basic clinical skills (e.g. interpretation of an ECG, reading a chest X-ray). Participants filled-out a questionnaire prior to the exam, inter alia to give an estimate of their performance. RESULTS 214 final year students participated in our study and achieved a mean score of 72.8% of the total score obtainable. 9.3% of participants (n=20) scored insufficiently (<60%). We found no influence of sex, prior training in healthcare or place of study on performance. Only one third of the students correctly estimated their performance (35.3%), whereas 30.0% and 18.8% over-estimated their performance by 10% and 20% respectively. DISCUSSION Final year undergraduate medical students demonstrate considerable deficits performing practical clinical skills in the context of a formative assessment. Half of the students over-estimate their own performance. We recommend an institutionalised and frequent assessment of practical clinical skills during undergraduate medical education, especially in the final year.
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Affiliation(s)
- Sylvère Störmann
- Klinikum der Universität München, Medizinische Klinik und Poliklinik IV, München, Germany
| | - Melanie Stankiewicz
- Klinikum der Universität München, Medizinische Klinik und Poliklinik IV, München, Germany
| | - Patricia Raes
- Klinikum der Universität München, Medizinische Klinik und Poliklinik IV, München, Germany
| | - Christina Berchtold
- Klinikum der Universität München, Medizinische Klinik und Poliklinik IV, München, Germany
| | - Yvonne Kosanke
- Klinikum der Universität München, Medizinische Klinik und Poliklinik IV, München, Germany
| | - Gabrielle Illes
- Klinikum der Universität München, Medizinische Klinik und Poliklinik IV, München, Germany
| | - Peter Loose
- 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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Jerg A, Öchsner W, Wander H, Traue HC, Jerg-Bretzke L. The FAMULATUR PLUS as an innovative approach for teaching physical examination skills. GMS JOURNAL FOR MEDICAL EDUCATION 2016; 33:Doc4. [PMID: 26958652 PMCID: PMC4766938 DOI: 10.3205/zma001003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 08/18/2015] [Accepted: 10/13/2015] [Indexed: 06/05/2023]
Abstract
The FAMULATUR PLUS is an innovative approach to teaching physical examination skills. The concept is aimed at medical students during the clinical part of their studies and includes a clinical traineeship (English for "Famulatur") extended to include various courses ("PLUS"). The courses are divided into clinical examination courses and problembased-learning (PBL) seminars. The concept's special feature is the full integration of these courses into a 30-day hospital traineeship. The aim is to facilitate the transfer of knowledge from the courses into daily practice. Each week of the FAMULATUR PLUS is structured in line with the courses and focuses on a particular part of the body (e.g., abdomen). A physical examination course under the supervision of a physician is offered at the beginning of the week. Here, medical students learn the relevant examination techniques by practicing on each other (partner exercises). Subsequently, the techniques taught are applied independently during everyday work on the ward, corrected by the supervisor, if necessary, and thereby reinforced. The final POL seminar takes place towards the end of the week. Possible differential diagnoses are developed based on a clinical case study. The goal is to check these by taking a fictitious medical history and performing a physical examination, as well as to make a preliminary diagnosis. Finally, during the PBL seminar, medical students will be shown how physical examination techniques can be efficiently applied in the diagnosis of common cardinal symptoms (e.g., abdominal pain). The initial implementation of the FAMULATUR PLUS proved the practical feasibility of the concept. In addition, the accompanying evaluation showed that the participants of the pilot project improved with regard to their practical physical examination skills.
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Affiliation(s)
- Achim Jerg
- University Hospital Ulm, Department of Psychosomatic Medicine and Psychotherapy, Medical Psychology, Ulm, Germany
| | - Wolfgang Öchsner
- University Hospital Ulm, Department for Cardiac Anesthesiology, Ulm, Germany
- University of Ulm, Office of the Dean of Medical Studies, Ulm, Germany
| | - Henriette Wander
- University Hospital Ulm, Department of Psychosomatic Medicine and Psychotherapy, Medical Psychology, Ulm, Germany
| | - Harald C. Traue
- University Hospital Ulm, Department of Psychosomatic Medicine and Psychotherapy, Medical Psychology, Ulm, Germany
| | - Lucia Jerg-Bretzke
- University Hospital Ulm, Department of Psychosomatic Medicine and Psychotherapy, Medical Psychology, Ulm, Germany
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Nikendei C, Ganschow P, Groener JB, Huwendiek S, Köchel A, Köhl-Hackert N, Pjontek R, Rodrian J, Scheibe F, Stadler AK, Steiner T, Stiepak J, Tabatabai J, Utz A, Kadmon M. "Heidelberg standard examination" and "Heidelberg standard procedures" - Development of faculty-wide standards for physical examination techniques and clinical procedures in undergraduate medical education. GMS JOURNAL FOR MEDICAL EDUCATION 2016; 33:Doc54. [PMID: 27579354 PMCID: PMC5003136 DOI: 10.3205/zma001053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 02/22/2016] [Accepted: 02/25/2016] [Indexed: 05/13/2023]
Abstract
The competent physical examination of patients and the safe and professional implementation of clinical procedures constitute essential components of medical practice in nearly all areas of medicine. The central objective of the projects "Heidelberg standard examination" and "Heidelberg standard procedures", which were initiated by students, was to establish uniform interdisciplinary standards for physical examination and clinical procedures, and to distribute them in coordination with all clinical disciplines at the Heidelberg University Hospital. The presented project report illuminates the background of the initiative and its methodological implementation. Moreover, it describes the multimedia documentation in the form of pocketbooks and a multimedia internet-based platform, as well as the integration into the curriculum. The project presentation aims to provide orientation and action guidelines to facilitate similar processes in other faculties.
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Affiliation(s)
- C. Nikendei
- Heidelberg University Hospital, University Medical Center, Internal Medicine II, Department of General Internal Medicine and Psychosomatics, Heidelberg, Germany
- *To whom correspondence should be addressed: C. Nikendei, Heidelberg University Hospital, University Medical Center, Internal Medicine II, Department of General Internal Medicine and Psychosomatics, Im Neuenheimer Feld 410, D-69120 Heidelberg, Germany, Phone: +49 (0)6221/56-38663, E-mail:
| | - P. Ganschow
- Heidelberg University Hospital, Department of General, Visceral and Transplantation Surgery, Heidelberg, Germany
- University Hospital of Munich, Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Munich, Germany
| | - J. B. Groener
- Heidelberg University Hospital, University Medical Center, Internal Medicine I, Department of Endocrinology, Metabolism and Clinical Chemistry, Heidelberg, Germany
| | - S. Huwendiek
- University of Bern, Institute of Medical Education, Department of Assessment and Evaluation, Bern, Switzerland
- Heidelberg University Hospital, Center for Child and Adolescent Medicine, Clinic 1, Heidelberg, Germany
| | - A. Köchel
- Heidelberg University Hospital, University Medical Center, Internal Medicine II, Department of General Internal Medicine and Psychosomatics, Heidelberg, Germany
| | - N. Köhl-Hackert
- Heidelberg University Hospital, Department of General Medicine and Health Services Research, Heidelberg, Germany
| | - R. Pjontek
- Heidelberg University Hospital, Department of General, Visceral and Transplantation Surgery, Heidelberg, Germany
- University Hospital RWTH Aachen, Department of Diagnostic and Interventional Neuroradiology, Department of Neurology, Aachen, Germany
| | - J. Rodrian
- Heidelberg University Hospital, Department of General, Visceral and Transplantation Surgery, Heidelberg, Germany
| | - F. Scheibe
- Heidelberg University Hospital, Department of General, Visceral and Transplantation Surgery, Heidelberg, Germany
- Ortenau Hospital Offenburg-Gengenbach, Department of Cardiology, Pneumology, Angiology and Intensive Care Medicine, Offfenburg-Gengenbach, Germany
| | - A.-K. Stadler
- Heidelberg University Hospital, Department of General, Visceral and Transplantation Surgery, Heidelberg, Germany
| | - T. Steiner
- Klinikum Frankfurt Höchst, Department of Neurology, Frankfurt/Main, Germany
| | - J. Stiepak
- Heidelberg University Hospital, University Medical Center, Internal Medicine III, Department of Cardiology, Angiology and Pneumology, Heidelberg, Germany
| | - J. Tabatabai
- Heidelberg University Hospital, Department of Pediatrics I, Center for Child and Adolescent Medicine, Heidelberg, Germany
| | - A. Utz
- Heidelberg University Hospital, Department of General, Visceral and Transplantation Surgery, Heidelberg, Germany
- Ortenau Hospital Offenburg-Gengenbach, Department of Gynecology, Offenburg-Gengenbach, Germany
| | - M. Kadmon
- Carl von Ossietzky University of Oldenburg, School of Medicine and Health Sciences, Oldenburg, Germany
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Bugaj TJ, Nikendei C. Practical Clinical Training in Skills Labs: Theory and Practice. GMS JOURNAL FOR MEDICAL EDUCATION 2016; 33:Doc63. [PMID: 27579363 PMCID: PMC5003146 DOI: 10.3205/zma001062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 02/15/2016] [Accepted: 05/09/2016] [Indexed: 05/13/2023]
Abstract
Today, skills laboratories or "skills labs", i.e. specific practical skill training facilities, are a firmly established part of medical education offering the possibility of training clinical procedures in a safe and fault-forging environment prior to real life application at bedside or in the operating room. Skills lab training follows a structured teaching concept, takes place under supervision and in consideration of methodological-didactic concepts, ideally creating an atmosphere that allows the repeated, anxiety- and risk-free practice of targeted skills. In this selective literature review, the first section is devoted to (I) the development and dissemination of the skills lab concept. There follows (II) an outline of the underlying idea and (III) an analysis of key efficacy factors. Thereafter, (IV) the training method's effectiveness and transference are illuminated, before (V) the use of student tutors, in the sense of peer-assisted-learning, in skills labs is discussed separately. Finally, (VI) the efficiency of the skills lab concept is analyzed, followed by an outlook on future developments and trends in the field of skills lab training.
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Affiliation(s)
- T. J. Bugaj
- University Hospital Heidelberg, Center for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, Heidelberg, Germany
| | - C. Nikendei
- University Hospital Heidelberg, Center for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, Heidelberg, Germany
- *To whom correspondence should be addressed: C. Nikendei, University Hospital Heidelberg, Center for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, Im Neuenheimer Feld, D-69120 Heidelberg, Germany, Phone: +49 (0)6221/56-38663, Fax: +49 (0)6221/56-5749, E-mail:
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14
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Profanter C, Perathoner A. DOPS (Direct Observation of Procedural Skills) in undergraduate skills-lab: Does it work? Analysis of skills-performance and curricular side effects. GMS ZEITSCHRIFT FUR MEDIZINISCHE AUSBILDUNG 2015; 32:Doc45. [PMID: 26483858 PMCID: PMC4606486 DOI: 10.3205/zma000987] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 12/19/2014] [Indexed: 10/31/2022]
Abstract
OBJECTIVE Sufficient teaching and assessing clinical skills in the undergraduate setting becomes more and more important. In a surgical skills-lab course at the Medical University of Innsbruck fourth year students were teached with DOPS (direct observation of procedural skills). We analyzed whether DOPS worked or not in this setting, which performance levels could be reached compared to tutor teaching (one tutor, 5 students) and which curricular side effects could be observed. METHODS In a prospective randomized trial in summer 2013 (April - June) four competence-level-based skills were teached in small groups during one week: surgical abdominal examination, urethral catheterization (phantom), rectal-digital examination (phantom), handling of central venous catheters. Group A was teached with DOPS, group B with a classical tutor system. Both groups underwent an OSCE (objective structured clinical examination) for assessment. 193 students were included in the study. Altogether 756 OSCE´s were carried out, 209 (27,6%) in the DOPS- and 547 (72,3%) in the tutor-group. RESULTS Both groups reached high performance levels. In the first month there was a statistically significant difference (p<0,05) in performance of 95% positive OSCE items in the DOPS-group versus 88% in the tutor group. In the following months the performance rates showed no difference anymore and came to 90% in both groups. In practical skills the analysis revealed a high correspondence between positive DOPS (92,4%) and OSCE (90,8%) results. DISCUSSION As shown by our data DOPS furnish high performance of clinical skills and work well in the undergraduate setting. Due to the high correspondence of DOPS and OSCE results DOPS should be considered as preferred assessment tool in a students skills-lab. The approximation of performance-rates within the months after initial superiority of DOPS could be explained by an interaction between DOPS and tutor system: DOPS elements seem to have improved tutoring and performance rates as well. DOPS in students 'skills-lab afford structured feedback and assessment without increased personnel and financial resources compared to classic small group training. CONCLUSION In summary, this study shows that DOPS represent an efficient method in teaching clinical skills. Their effects on didactic culture reach beyond the positive influence of performance rates.
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Affiliation(s)
- Christoph Profanter
- Medical University Innsbruck, Department of Visceral, Transplant and Thoracic Surgery, Innsbruck, Austria
| | - Alexander Perathoner
- Medical University Innsbruck, Department of Visceral, Transplant and Thoracic Surgery, Innsbruck, Austria
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Rösch T, Schaper E, Tipold A, Fischer MR, Dilly M, Ehlers JP. Clinical skills of veterinary students - a cross-sectional study of the self-concept and exposure to skills training in Hannover, Germany. BMC Vet Res 2014; 10:969. [PMID: 25528469 PMCID: PMC4300046 DOI: 10.1186/s12917-014-0302-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 12/11/2014] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Students of veterinary medicine should achieve basic professional competences required to practise their profession. A main focus of veterinary education is on developing clinical skills. The present study used the guidelines of the "Day-One Skills" list of European Association of Establishments for Veterinary Education (EAEVE) to create an online questionnaire for assessing the skills acquired by students at the University of Veterinary Medicine Hannover (TiHo). The theoretical and practical veterinary knowledge levels of the students and postgraduates are determined and compared. RESULTS In two batches, 607 people responded (response batch 1, 23.78%; response batch 2, 23.83%). From 49 defined skills, 28 are actually practised during training at the university and 21 activities are known only theoretically. Furthermore, the students showed great willingness to use simulators and models in a clinical skills lab. CONCLUSIONS The results of this survey highlight that the opening of a clinical skills lab at the University of Veterinary Medicine Hannover and its incorporation into the study programme are ideal tools to promote practical competences and foster the motivation to learn.
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Affiliation(s)
- Tanja Rösch
- University of Veterinary Medicine Hannover, Competence Centre for e-Learning, Didactics and Education Research in Veterinary Medicine, Hannover, Germany.
| | - Elisabeth Schaper
- University of Veterinary Medicine Hannover, Competence Centre for e-Learning, Didactics and Education Research in Veterinary Medicine, Hannover, Germany.
| | - Andrea Tipold
- University of Veterinary Medicine Hannover, Teaching, Small Animal Clinic, Hannover, Germany.
| | - Martin R Fischer
- Didactics and Education Research in Medicine, University Hospital, Ludwig Maximilian University, Munich, Germany.
| | - Marc Dilly
- University of Veterinary Medicine Hannover, Veterinary Director, Clinical Skills Lab, Hannover, Germany.
| | - Jan P Ehlers
- University of Veterinary Medicine Hannover, Competence Centre for e-Learning, Didactics and Education Research in Veterinary Medicine, Hannover, Germany.
- Witten/Herdecke University, Faculty of Health, Didactics and Education Research in Health Science, Herdecke, Germany.
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16
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Bergelt C, Lauke H, Petersen-Ewert C, Jücker M, Bauer CK. "Alcohol and nicotine"--Concept and evaluation of an interdisciplinary elective course with OSPE in preclinical medical education. GMS ZEITSCHRIFT FUR MEDIZINISCHE AUSBILDUNG 2014; 31:Doc9. [PMID: 24575160 PMCID: PMC3935170 DOI: 10.3205/zma000901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 11/20/2013] [Accepted: 01/06/2014] [Indexed: 11/30/2022]
Abstract
In the last decade, increasing interest has been paid to interdisciplinary and practical courses in the medical education in Germany. This report describes the implementation and outcome of a preclinical interdisciplinary elective course with a team-teaching concept developed by lecturers in medical psychology, anatomy, physiology and biochemistry. The practical orientation of the course led to the implementation of a final interdisciplinary OSPE to ensure fair consideration of the different disciplines involved in grading. Individual OSPE results correlate well with the fact that different skills are required in medical psychology compared to those required in anatomy, physiology and biochemistry. Student course evaluation and lecturers` experience indicate the success of this elective course. Its concept can be well adapted to other interdisciplinary courses.
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Affiliation(s)
- Corinna Bergelt
- University Medical Center Hamburg-Eppendorf, Department of Medical Psychology, Hamburg, Germany
| | - Heidrun Lauke
- University Medical Center Hamburg-Eppendorf, Department of Anatomy and Experimental Morphology, Hamburg, Germany
| | - Corinna Petersen-Ewert
- University Medical Center Hamburg-Eppendorf, Department of Medical Psychology, Hamburg, Germany ; University of Applied Sciences, Department of Nursing and Management, Hamburg, Germany
| | - Manfred Jücker
- University Medical Center Hamburg-Eppendorf, Department of Biochemistry and Signal Transduction, Hamburg, Germany
| | - Christiane K Bauer
- University Medical Center Hamburg-Eppendorf, Department of Cellular and Integrative Physiology, Hamburg, Germany
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