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Qiao L, Li R. Influence of Personalized Health Management Model Based on Internet Mode on Self-Management Ability and Life Quality of Patients with Chronic Diseases Undergoing Physical Examination. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:4434436. [PMID: 35983524 PMCID: PMC9381198 DOI: 10.1155/2022/4434436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022]
Abstract
Objective To explore the influence of personalized health management model based on the Internet mode on self-management ability and life quality of patients with chronic diseases of physical examination. Methods Sixty patients with chronic diseases who went through physical examination from February 2019 to April 2021 were enrolled in our hospital. The patients were arbitrarily assigned into control and research group. The former group received routine nursing, and the latter group received personalized health management mode based on the Internet mode. The nursing satisfaction, self-management behavior ability, blood pressure level, physiological index, mastery of health knowledge, and life quality scores were compared. Results In terms of nursing satisfaction, the research group was very satisfied in 20 cases, satisfactory in 9 cases, and general in 1 case, with a satisfaction rate of 100.00%; In the control group, 15 cases were very satisfied, 9 cases were satisfied, 1 case was general, 5 cases were not satisfied, and the satisfaction rate was 83.33%; The nursing satisfaction of the research group was higher (P < 0.05). Compared with the self-management behavior ability, the scores of diet control, regular medication, correct medication, and smoking cessation in the research group were remarkably higher (P < 0.05). There exhibited no significant difference in blood pressure level before intervention (P > 0.05); after intervention, the blood pressure levels lessened. Compared with the control group, the systolic blood pressure and diastolic blood pressure of the research group were lower (P < 0.05). The levels of triglyceride, total cholesterol, low-density lipoprotein, and fasting blood glucose in the research group were remarkably lower (P < 0.05). Compared with the control group, the scores of health knowledge in the research group were remarkably higher, including the harm of smoking, the use of drugs, the importance of persisting in taking drugs, the pathogenesis of chronic diseases, the effect of emotional management on the disease, and the dietary awareness in the research group (P < 0.05). There exhibited no significant difference in the score of life quality before nursing (P > 0.05); after nursing, the score of life quality lessened, and the scores of physiological function, psychological function, social function, and health self-cognition in the research group were lower (P < 0.05). Conclusion The personalized health management model based on the Internet mode can effectively enhance the chronic disease physiological indexes such as blood pressure, blood lipids, and blood sugar and improve the self-management ability of the patients with chronic disease, which is worth further popularizing and applying in the clinical physical examination in clinic.
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Affiliation(s)
- Li Qiao
- Physical Examination Department, Yuncheng First Hospital Yuncheng, Shanxi 044000, China
| | - Ruijuan Li
- The Pain Department, Yuncheng First Hospital Yuncheng, Shanxi 044000, China
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Nagy E, Luta GMM, Huhn D, Cranz A, Schultz JH, Herrmann-Werner A, Bugaj TJ, Friederich HC, Nikendei C. Teaching patient-centred communication skills during clinical procedural skill training - a preliminary pre-post study comparing international and local medical students. BMC MEDICAL EDUCATION 2021; 21:469. [PMID: 34479572 PMCID: PMC8414705 DOI: 10.1186/s12909-021-02901-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 08/22/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND International medical students are frequently confronted with intercultural, psychosocial, and language barriers and often receive lower marks in written, oral, and clinical-practical examinations than fellow local students. Training communication competence in procedural skills, such as blood sampling, is further challenge in this particular group of medical students. This pre-post comparative intervention study aimed to investigate the effects of training communication skills during the performance of procedural skills (taking blood samples from a silicone model) in international and local students as part of their clinical practical medical training. METHODS Study participants performed blood sampling on an arm prosthesis model (part-task trainer) before and after the communication skills training, focusing on accompanying communication with a simulation patient sitting next to the arm model. The pre- and post-evaluation video was assessed by two independent evaluators using a binary checklist, the Integrated Procedural Performance Instrument (IPPI) and global assessments of clinical professionalism in terms of procedural and communication performance. Linear models with mixed effects were used. Group differences regarding global competence levels were analysed with χ2-tests. RESULTS International medical students did not perform as well as their local counterparts in the pre- and post-examinations. Both groups improved their performance significantly, whereby the international students improved more than their local counterparts in terms of their communication performance, assessed via binary checklist. Clinical professionalism evaluated via global assessments of procedural and communication performance highlights the intervention's impact insofar as no international student was assessed as clinically not competent after the training. CONCLUSIONS Our results suggest that already a low-dose intervention can lead to improved communication skills in medical students performing procedural tasks and significantly increase their confidence in patient interaction.
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Affiliation(s)
- Ede Nagy
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, University of Heidelberg, Thibautstraße 4, 69115 Heidelberg, Germany
| | - Gloria Matondo Miguel Luta
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, University of Heidelberg, Thibautstraße 4, 69115 Heidelberg, Germany
| | - Daniel Huhn
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, University of Heidelberg, Thibautstraße 4, 69115 Heidelberg, Germany
| | - Anna Cranz
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, University of Heidelberg, Thibautstraße 4, 69115 Heidelberg, Germany
| | - Jobst-Hendrik Schultz
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, University of Heidelberg, Thibautstraße 4, 69115 Heidelberg, Germany
| | - Anne Herrmann-Werner
- Internal Medicine VI - Psychosomatic Medicine and Psychotherapy, University of Tübingen, Tuebingen, Germany
- Competence Center for University Teaching in Medicine, Faculty of Medicine, University of Tuebingen, Tuebingen, Germany
| | - Till Johannes Bugaj
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, University of Heidelberg, Thibautstraße 4, 69115 Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, University of Heidelberg, Thibautstraße 4, 69115 Heidelberg, Germany
| | - Christoph Nikendei
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, University of Heidelberg, Thibautstraße 4, 69115 Heidelberg, Germany
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Rahm AK, Töllner M, Hubert MO, Klein K, Wehling C, Sauer T, Hennemann HM, Hein S, Kender Z, Günther J, Wagenlechner P, Bugaj TJ, Boldt S, Nikendei C, Schultz JH. Effects of realistic e-learning cases on students' learning motivation during COVID-19. PLoS One 2021; 16:e0249425. [PMID: 33882079 PMCID: PMC8059845 DOI: 10.1371/journal.pone.0249425] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/18/2021] [Indexed: 12/30/2022] Open
Abstract
Background Keeping up motivation to learn when socially isolated during a pandemic can be challenging. In medical schools, the COVID-19 pandemic required a complete switch to e-learning without any direct patient contact despite early reports showing that medical students preferred face-to-face teaching in clinical setting. We designed close to real-life patient e-learning modules to transmit competency-based learning contents to medical students and evaluated their responses about their experience. Methods Weekly e-learning cases covering a 10-week leading symptom-based curriculum were designed by a team of medical students and physicians. The internal medicine curriculum (HeiCuMed) at the Heidelberg University Medical School is a mandatory part of clinical medical education in the 6th or 7th semester. Case-design was based on routine patient encounters and covered different clinical settings: preclinical emergency medicine, in-patient and out-patient care and follow-up. Individual cases were evaluated online immediately after finishing the respective case. The whole module was assessed at the end of the semester. Free-text answers were analyzed with MaxQDa following Mayring`s principles of qualitative content analyses. Results N = 198 students (57.6% female, 42.4% male) participated and 1252 individual case evaluations (between 49.5% and 82.5% per case) and 51 end-of-term evaluations (25.8% of students) were collected. Students highly appreciated the offer to apply their clinical knowledge in presented patient cases. Aspects of clinical context, interactivity, game-like interface and embedded learning opportunities of the cases motivated students to engage with the asynchronously presented learning materials and work through the cases. Conclusions Solving and interpreting e-learning cases close to real-life settings promoted students’ motivation during the COVID-19 pandemic and may partially have compensated for missing bedside teaching opportunities.
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Affiliation(s)
- Ann-Kathrin Rahm
- Heidelberg University Medical School, Heidelberg, Germany
- Department of Cardiology, Heidelberg University Hospital, Heidelberg, Germany
- * E-mail:
| | | | - Max Ole Hubert
- Heidelberg University Medical School, Heidelberg, Germany
| | - Katrin Klein
- Department of Nephrology, Heidelberg University Hospital, Heidelberg, Germany
| | - Cyrill Wehling
- Department of Gastroenterology, Infectious Diseases and Intoxication, Heidelberg, Germany
| | - Tim Sauer
- Department of Hematology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Selina Hein
- Department of Cardiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Zoltan Kender
- Department of Endocrinology, Diabetology and Clinical Chemistry, Heidelberg University Hospital, Heidelberg, Germany
| | - Janine Günther
- Department of Hematology, Heidelberg University Hospital, Heidelberg, Germany
| | - Petra Wagenlechner
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Till Johannes Bugaj
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Sophia Boldt
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Christoph Nikendei
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Jobst-Hendrik Schultz
- Heidelberg University Medical School, Heidelberg, Germany
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
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The AaLplus near-peer teaching program in Family Medicine strengthens basic medical skills-A five-year retrospective study. PLoS One 2020; 15:e0233748. [PMID: 32470972 PMCID: PMC7259978 DOI: 10.1371/journal.pone.0233748] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 05/08/2020] [Indexed: 01/22/2023] Open
Abstract
Background Basic medical skills such as history taking and physical examination are essential components of clinical work profiles, but nevertheless have been neglected by conventional preclinical curricula. The near-peer-teaching program AaLplus [living anatomy plus] teaches basic medical skills, especially history taking, physical examination, and venepuncture, to preclinical students. It is a highly popular compulsory course in the first four semesters (320 students/year, 9h/semester) at Heidelberg University and ends with a formative Objective Structured Clinical Examination (OSCE) during which students receive structured in-depth feedback on their performance. AaLplus is part of the Department of General Practice’s longitudinal curriculum for Family Medicine. Objectives This study aims to assess whether the AaLplus program has positive effects on students’ clinical skill development and subjective confidence in history taking, physical examination and venepuncture. Methods From 2015 to 2019, we asked all AaLplus participants to rate the program and self-assess their medical skills on 5-point Likert scales (min 1, max 5). In 4-station OSCEs, trained tutors rated the students’ performance in all taught skills using standardized checklists. Results From 2015 to 2019 n = 1534 questionnaires returned (response rate = 98.6%, 52.7% females). After course completion, students felt able to take a patient’s history (mean 3.97, SD = 0.75) and perform physical examinations (means range 3.82–4.36, SDs range 0.74–0.89) as well as venepuncture (mean 4.12, SD = 0.88). A large majority of students claimed they acquired these skills in the AaLplus program. During OSCE, 81.9% passed anamnesis, 93.1% passed physical examination, and 95.4% passed venepuncture (of n = 1556). Students mostly rated the feedback they received during the OSCE as “helpful” or “very helpful” (means for different stations 4.69–4.76, SDs 0.50–0.70). Conclusions AaLplus is a positive example of a peer teaching program in the preclinical stage of medical studies. It successfully trains junior students in essential medical abilities and increases their confidence in their skills. A high percentage of students pass the formative OSCE and evaluate it positively. Consistently high ratings indicate the program’s routine viability. Further studies are needed to analyze if programs like AaLplus could have an impact on the number of graduates choosing career in Family Medicine.
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Schwill S, Fahrbach-Veeser J, Moeltner A, Eicher C, Kurczyk S, Pfisterer D, Szecsenyi J, Loukanova S. Peers as OSCE assessors for junior medical students - a review of routine use: a mixed methods study. BMC MEDICAL EDUCATION 2020; 20:17. [PMID: 31948425 PMCID: PMC6966898 DOI: 10.1186/s12909-019-1898-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 12/03/2019] [Indexed: 05/30/2023]
Abstract
BACKGROUND Peer-assisted learning is well established in medical education; however, peer tutors rarely act as assessors for the OSCE. In the compulsory, near-peer teaching programme covering basic medical skills at the University of Heidelberg, peer tutors serve as assessors on a formative OSCE. This study aimed to investigate the feasibility and acceptance of peer assessors and to survey the perceived advantages and disadvantages of their use. METHODS In 2016 and 2017 all OSCE peer assessors (third to sixth-year medical students) and all of the peer-assessed students in 2017 (second-year-medical students) were invited to participate in a survey. Both groups were asked to complete a tablet-based questionnaire immediately after the OSCE. Peer assessors were asked to rate eight statements and the peer-assessed students to rate seven statements on a five-point Likert scale. Both were asked to comment on the advantages and disadvantages of peer-assessors. RESULTS Overall, 74 of 76 peer assessors and 307 of 308 peer-assessed students participated in the study. 94% (67/74) of peer assessors and 90% (276/307) of the peer-assessed group thought that it is important to have peer tutors as assessors. Of the peer assessors, 92% (68/74) felt confident in giving structured feedback during the OSCE and 66% (49/74) felt they had improved their teaching skills. Of the peer-assessed students, 99% (306/307) were satisfied with their peers as OSCE assessors and 96% (292/307) considered the peer feedback during the OSCE as helpful. The participants mentioned structural benefits, such as lower costs, and suggested the quality of the OSCE was higher due to the use of peer assessors. The use of peer assessors was found to be beneficial for the learners in the form of high-quality feedback and an overall reduction in stress. Furthermore, the use of peer assessors was found to be beneficial for the peer assessors (improved teaching and clinical skills). CONCLUSION From a learner's perspective, the use of peer assessors for a formative OSCE that is part of a near-peer teaching program aimed at junior medical students is favourable for all. A broad implementation of peer assessment in the formative OSCE should be encouraged to investigate effects on quality and stress-reduction.
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Affiliation(s)
- Simon Schwill
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Johanna Fahrbach-Veeser
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Andreas Moeltner
- Competence Center Assessment in Medical Education, University of Heidelberg, Heidelberg, Germany
| | - Christiane Eicher
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Sonia Kurczyk
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - David Pfisterer
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Joachim Szecsenyi
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Svetla Loukanova
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
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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: 34] [Impact Index Per Article: 6.8] [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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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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Krautter M, Diefenbacher K, Schultz JH, Maatouk I, Herrmann-Werner A, Koehl-Hackert N, Herzog W, Nikendei C. Physical examination skills training: Faculty staff vs. patient instructor feedback-A controlled trial. PLoS One 2017; 12:e0180308. [PMID: 28692703 PMCID: PMC5503248 DOI: 10.1371/journal.pone.0180308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 06/13/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Standardized patients are widely used in training of medical students, both in teaching and assessment. They also frequently lead complete training sessions delivering physical examination skills without the aid of faculty teaching staff-acting as "patient instructors" (PIs). An important part of this training is their ability to provide detailed structured feedback to students which has a strong impact on their learning success. Yet, to date no study has assessed the quality of physical examination related feedback by PIs. Therefore, we conducted a randomized controlled study comparing feedback of PIs and faculty staff following a physical examination assessed by students and video assessors. METHODS 14 PIs and 14 different faculty staff physicians both delivered feedback to 40 medical students that had performed a physical examination on the respective PI while the physicians observed the performance. The physical examination was rated by two independent video assessors to provide an objective performance standard (gold standard). Feedback of PI and physicians was content analyzed by two different independent video assessors based on a provided checklist and compared to the performance standard. Feedback of PIs and physicians was also rated by medical students and video assessors using a questionnaire consisting of 12 items. RESULTS There was no statistical significant difference concerning overall matching of physician or PI feedback with gold standard ratings by video assessment (p = .219). There was also no statistical difference when focusing only on items that were classified as major key steps (p = .802), mistakes or parts that were left out during physical examination (p = .219) or mistakes in communication items (p = .517). The feedback of physicians was significantly better rated than PI feedback both by students (p = .043) as well as by video assessors (p = .034). CONCLUSIONS In summary, our study demonstrates that trained PIs are able to provide feedback of equal quantitative value to that of faculty staff physicians with regard to a physical examination performed on them. However, both the students and the video raters judged the quality of the feedback given by the physicians to be significantly better than that of the PIs.
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Affiliation(s)
- Markus Krautter
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Katja Diefenbacher
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Medical Centre, Heidelberg, Germany
| | - Jobst-Hendrik Schultz
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Medical Centre, Heidelberg, Germany
| | - Imad Maatouk
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Medical Centre, Heidelberg, Germany
| | - Anne Herrmann-Werner
- Department of Psychosomatic Medicine and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Nadja Koehl-Hackert
- Department of General Practice and Health Services Research, University of Heidelberg, Heidelberg, Germany
| | - Wolfgang Herzog
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Medical Centre, Heidelberg, Germany
| | - Christoph Nikendei
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Medical Centre, Heidelberg, Germany
- * E-mail:
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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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