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Janssen L, Schick K, Neurohr T, Pittroff SID, Reiser S, Bauer J, Berberat PO, Gartmeier M. Reflect to interact - fostering medical students' communication through reflection-focused e-learning. BMC Med Educ 2024; 24:541. [PMID: 38750528 PMCID: PMC11097513 DOI: 10.1186/s12909-024-05368-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 03/28/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Previous research indicates that reflection can foster medical communication competence. However, best practices for embedding reflection in online medical education are missing. This study examined how reflection processes can be promoted and embedded in an e-learning course on physician-patient communication to foster learning. METHODS We investigated three differently designed e-learning conditions featuring different proportions of reflection triggers and compared their effects on students' reflections. We had 114 medical students in their first clinical year complete one of the variants: video modelling (VM, n = 39), video reflection (VR, n = 39), or a variant merging both approaches (VMR, n = 36). Each student wrote a total of nine reflections based on the same guiding questions at three time points embedded in the course. The students' levels of reflection were measured using an adapted version of the REFLECT rubric (scale 0-18). RESULTS Students of all course variants achieved good levels of reflection beyond the descriptive level at all three time points, with no significant differences between the variants. The mean reflection scores at the end of the course were M = 14.22 for VM (SD = 2.23), M = 13.56 for VR (SD = 2.48), and M = 13.24 for VMR (SD = 2.21). Students who completed VM showed significantly improved levels of reflection over the course, whereas we found no statistically significant development for those in VR or VMR. The reflection scores correlated significantly positively with each other, as did the text lengths of the written reflections. Reflection scores also correlated significantly positively with text length. CONCLUSIONS Our study offers a teaching strategy that can foster good levels of reflection, as demonstrated in the three e-learning variants. The developed reflection prompts can be easily embedded in various e-learning environments and enable reflections of good quality, even in settings with limited available teaching time.
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Affiliation(s)
- Laura Janssen
- Department Clinical Medicine - TUM School of Medicine and Health, Technical University of Munich, TUM Medical Education Center, Munich, Germany.
| | - Kristina Schick
- Department Clinical Medicine - TUM School of Medicine and Health, Technical University of Munich, TUM Medical Education Center, Munich, Germany
| | - Tiziana Neurohr
- Department Clinical Medicine - TUM School of Medicine and Health, Technical University of Munich, TUM Medical Education Center, Munich, Germany
| | - Sylvia Irene Donata Pittroff
- Department Clinical Medicine - TUM School of Medicine and Health, Technical University of Munich, TUM Medical Education Center, Munich, Germany
| | - Sabine Reiser
- Educational Research and Methodology, University of Erfurt, Erfurt, Germany
| | - Johannes Bauer
- Educational Research and Methodology, University of Erfurt, Erfurt, Germany
| | - Pascal O Berberat
- Department Clinical Medicine - TUM School of Medicine and Health, Technical University of Munich, TUM Medical Education Center, Munich, Germany
| | - Martin Gartmeier
- Department Clinical Medicine - TUM School of Medicine and Health, Technical University of Munich, TUM Medical Education Center, Munich, Germany
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Schick K, Reiser S, Janssen L, Schacht L, Pittroff SID, Dörfler E, Klein E, Roenneberg C, Dinkel A, Fleischmann A, Berberat PO, Bauer J, Gartmeier M. Training in medical communication competence through video-based e-learning: How effective are video modeling and video reflection? Patient Educ Couns 2024; 121:108132. [PMID: 38184987 DOI: 10.1016/j.pec.2023.108132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 12/19/2023] [Accepted: 12/27/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE The present study investigated the efficacy of the didactic approaches of video modeling (VM, best-practice examples), video reflection (VR, problem-based approach), and the combination of both (VMR) in fostering medical communication competence in a video-based digital learning environment. METHODS N = 126 third-year medical students who participated in the pre-post study were assigned to either the intervention groups (VM, VR, and VMR) or the wait-list control group. The efficacy of the three approaches was assessed by means of a situational judgment test (SJT) of medical communication competence. To investigate the differences between the wait-list control and the intervention groups (H1), between the single-mode and combined conditions (H2), and between VM and VR (H3), we applied planned contrast analyses. RESULTS The planned contrasts showed that the VR condition significantly improved learning outcomes in comparison to the VM condition (H3). The decreased mean scores of the VM condition offset the increased mean scores of VR, and thus no significant differences could be found in H1 and H2. CONCLUSIONS Our study provides promising evidence that VR fosters medical communication competence more effectively than VM. PRACTICAL IMPLICATIONS Medical students' learning in video-based digital environments can be facilitated by the use of interactive VR.
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Affiliation(s)
- Kristina Schick
- Technical University of Munich, TUM School of Medicine & Health, Department Clinical Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675 München, Germany.
| | - Sabine Reiser
- University of Erfurt, Educational Research and Methodology, Nordhäuser Str. 63, 99089 Erfurt, Germany
| | - Laura Janssen
- Technical University of Munich, TUM School of Medicine & Health, Department Clinical Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675 München, Germany
| | - Laura Schacht
- University of Erfurt, Educational Research and Methodology, Nordhäuser Str. 63, 99089 Erfurt, Germany
| | - Sylvia Irene Donata Pittroff
- Technical University of Munich, TUM School of Medicine & Health, Department Clinical Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675 München, Germany
| | - Eva Dörfler
- Technical University of Munich, TUM Institute for LifeLong Learning, TUM ProLehre, Arcisstraße 21, 80333 München, Germany
| | - Evelyn Klein
- Technical University of Munich, TUM School of Medicine & Health, Department Clinical Medicine, Klinikum rechts der Isar, Department of Obstetrics and Gynecology, Ismaninger Straße 22, 81675 München, Germany
| | - Casper Roenneberg
- Technical University of Munich, TUM School of Medicine & Health, Department Clinical Medicine, Klinikum rechts der Isar, Department of Psychosomatic Medicine and Psychotherapy, Langerstr. 3, 81675 München, Germany
| | - Andreas Dinkel
- Technical University of Munich, TUM School of Medicine & Health, Department Clinical Medicine, Klinikum rechts der Isar, Department of Psychosomatic Medicine and Psychotherapy, Langerstr. 3, 81675 München, Germany
| | - Andreas Fleischmann
- Technical University of Munich, TUM Institute for LifeLong Learning, TUM ProLehre, Arcisstraße 21, 80333 München, Germany
| | - Pascal O Berberat
- Technical University of Munich, TUM School of Medicine & Health, Department Clinical Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675 München, Germany
| | - Johannes Bauer
- University of Erfurt, Educational Research and Methodology, Nordhäuser Str. 63, 99089 Erfurt, Germany
| | - Martin Gartmeier
- Technical University of Munich, TUM School of Medicine & Health, Department Clinical Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675 München, Germany
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Hillebrand G, Gartmeier M, Weiss N, Engelmann L, Stenzl A, Johnson F, Hofauer B. [Virtual DEGUM-certified course in the head and neck region-a useful complement to conventional course formats?]. HNO 2024; 72:154-160. [PMID: 38353674 PMCID: PMC10879222 DOI: 10.1007/s00106-023-01413-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2023] [Indexed: 02/22/2024]
Abstract
BACKGROUND Training in clinical ultrasound has become highly relevant for working as an otorhinolaryngologist. While there is a high demand for standardized and certified training courses, until recently, there was no possibility to attend web-based and exclusively virtual head and neck ultrasound courses certified by the Deutsche Gesellschaft für Ultraschall in der Medizin (DEGUM; German Society for Ultrasound in Medicine). OBJECTIVE The aim of this study was to provide a qualitative and semi-quantitative analysis of the first purely virtual DEGUM-certified head and neck ultrasound courses. MATERIALS AND METHODS In 2021, three purely web-based DEGUM-certified head and neck ultrasound courses were carried out and then qualitatively analyzed using questionnaires including an examination. RESULTS The purely virtual implementation of head and neck ultrasound courses proved to be a viable alternative to the conventional course format, with a high level of acceptance among the participants. The lack of practice among the participants remains a relevant criticism. CONCLUSION A more dominant role of web-based and remote ultrasound training is likely and should be considered as an alternative depending on existing conditions. Nevertheless, acquisition of practical sonographic skills remains a major hurdle if courses are purely digital.
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Affiliation(s)
- Gabriel Hillebrand
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar der TU München, Ismaninger Straße 22, 81675, München, Deutschland.
| | - Martin Gartmeier
- TUM Medical Education Center, Lehrstuhl für Medizindidaktik, medizinische Lehrentwicklung und Bildungsforschung, Fakultät für Medizin, Klinikum rechts der Isar, Nigerstraße 3, 81675, München, Deutschland
| | - Nora Weiss
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar der TU München, Ismaninger Straße 22, 81675, München, Deutschland
| | - Luca Engelmann
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar der TU München, Ismaninger Straße 22, 81675, München, Deutschland
| | - Anna Stenzl
- Klinik für Hals, Nasen und Ohrenheilkunde, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich
| | - Felix Johnson
- Klinik für Hals, Nasen und Ohrenheilkunde, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich
| | - Benedikt Hofauer
- Klinik für Hals, Nasen und Ohrenheilkunde, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich
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Blaschke AL, Hapfelmeier A, Rubisch HPK, Berberat PO, Gartmeier M. Structure and quality of bedside teaching: A videographic analysis. Med Teach 2023:1-9. [PMID: 38110186 DOI: 10.1080/0142159x.2023.2289860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 11/28/2023] [Indexed: 12/20/2023]
Abstract
Bedside teaching (BST) is a core element of medical education. In light of a reported decrease in BST, evidence on how to use BST time most efficiently should be developed. Given that little research into the tangible quality characteristics of good BST has been reported, we investigated the influence of various teacher and structural characteristics on the perceived quality of BST. We filmed and coded 36 BSTs involving 24 lecturers and 259 students. Structural characteristics of interest were: number of students and patients, overall duration, and the proportion of clinical examination. Lecturer questionnaires provided insight into teaching experience and intrinsic motivation, and student evaluations assessed the quality of BSTs in three dimensions. Correlations are reported using the Pearson r and a linear mixed model (LMM). The intrinsic motivation of lecturers was significantly positively correlated with perceived quality, but their experience was only weakly so correlated. In the LMM, a significant association was observed for the quality dimension of clinical teaching with the number of patients and the proportion of time spent on clinical examination. Based on our findings, we recommend including multiple patients in BSTs, and providing substantial opportunities for clinical examination. Regarding lecturers, motivation matters more than experience.
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Affiliation(s)
- Anna-Lena Blaschke
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Alexander Hapfelmeier
- Institute of AI and Informatics in Medicine, School of Medicine, Technical University of Munich, Munich, Germany
- Institute of General Practice and Health Services Research, School of Medicine, Technical University of Munich, Munich, Germany
| | - Hannah P K Rubisch
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Pascal O Berberat
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Martin Gartmeier
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Munich, Germany
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Rubisch HPK, Blaschke AL, Berberat PO, Fuetterer CS, Haller B, Gartmeier M. Student mistakes and teacher reactions in bedside teaching. Adv Health Sci Educ Theory Pract 2023; 28:1523-1556. [PMID: 37170035 PMCID: PMC10174607 DOI: 10.1007/s10459-023-10233-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/20/2023] [Indexed: 05/13/2023]
Abstract
We analyse interactions between teachers and students during video-recorded bedside teaching sessions in internal medicine, orthopaedics and neurology. Multiple raters used a high-inference categorical scheme on 36 sessions. Our research questions concern the types of student mistakes, clinical teachers' reactions to them and if they use different strategies to address different types of mistakes. We used a Poisson model and generalized mixed models to analyse these research questions. Most frequently, students made reproduction mistakes. Relatively high rates of rejection and a similar prevalence of low and high levels of elaboration and correction time for students were observed. Reproduction mistakes were associated with the highest level of rejection and the lowest level of elaboration. High levels of elaboration were observed when students were applying skills in new situations. Students were most often allowed time to correct when mistakes in the areas of analysis or application of skills and knowledge had occurred. There is a decrease in the rate of making mistakes for neurology and orthopaedics compared to internal medicine. Reproduction mistakes influence significantly the outcome feedback compared to application mistakes. Analytic and reproduction mistakes influence elaboration significantly compared to application mistakes. We found a significant effect whether the lecturer allows time for correction of reproduction mistakes compared to application mistakes. These results contribute to the understanding of interactive, patient-centred clinical teaching as well as student mistakes and how teachers are reacting to them. Our descriptive findings provide an empirical basis for clinical teachers to react to student mistakes in didactically fruitful ways.
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Affiliation(s)
- Hannah P K Rubisch
- Lehrstuhl für Medizindidaktik, medizinische Lehrentwicklung und Bildungsforschung Technical University of Munich (TUM), TUM School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675, Munich, Germany
| | - Anna-Lena Blaschke
- Lehrstuhl für Medizindidaktik, medizinische Lehrentwicklung und Bildungsforschung Technical University of Munich (TUM), TUM School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675, Munich, Germany
| | - Pascal O Berberat
- Lehrstuhl für Medizindidaktik, medizinische Lehrentwicklung und Bildungsforschung Technical University of Munich (TUM), TUM School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675, Munich, Germany
| | - Cornelia S Fuetterer
- Institute of AI and Informatics in Medicine, Technical University of Munich (TUM), TUM School of Medicine, Munich, Germany
| | - Bernhard Haller
- Institute of AI and Informatics in Medicine, Technical University of Munich (TUM), TUM School of Medicine, Munich, Germany
| | - Martin Gartmeier
- Lehrstuhl für Medizindidaktik, medizinische Lehrentwicklung und Bildungsforschung Technical University of Munich (TUM), TUM School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675, Munich, Germany.
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6
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Heim M, Schulz CM, Schneider F, Berberat PO, Gartmeier M, Schick K. Measuring informal workplace learning outcomes in residency training: a validation study. BMC Med Educ 2023; 23:549. [PMID: 37537584 PMCID: PMC10401809 DOI: 10.1186/s12909-023-04529-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 07/21/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Informal workplace learning (WPL) has no concrete learning objective and takes place without a responsible supervisor, which makes it difficult to assess its learning outcomes. Formal learning situations, as they are known from universities or schools, do not exist in this context and make a conventional assessment of learning goals and achievements impossible. Informal learning in the workplace is of central importance, and the assessment of informal learning outcomes in medical education is an under-researched area. The aim of our study was to adapt and validate an informal WPL questionnaire (originally developed for social workers) to assess learning outcomes due to informal WPL in residency training. METHODS A total of 528 residents (n = 339 female; age: M = 29.79; SD = 3.37 years) completed an adapted questionnaire on informal WPL outcomes and the Freiburg Questionnaire to Assess Competencies in Medicine (i.e. medical knowledge, communication, and scholarship). Exploratory factor analysis was used to determine the underlying factor structure. The reliability of the factors was tested using McDonald's omega, and the correlation between the factors and the three subscales of the Freiburg questionnaire was tested using Spearman's rho correlation coefficient. To investigate construct validity, a structural equation model was calculated to examine the relationships between medical competencies and informal learning outcomes. RESULTS The exploratory factor analysis yielded a four-factor solution that best fit the data. The scores of all four factors (GLO-CD: generic learning outcomes-competence development, GLO-R: generic learning outcomes-reflection, JSLO: job-specific learning outcomes, and OLLO: organisational learning outcomes) showed good internal consistency (Ω ≥ .69). The structural equation model showed that "medical expertise" had an impact on all four factors of informal learning at work. "Scholarship" seemed to predict GLO-CD and GLO-R. CONCLUSIONS Our four-factor model reveals meaningful determinants of informal WPL in relation to residency training. The instrument is therefore the first promising attempt to assess informal WPL in the broader context of medical education during residency, thus supporting its construct validity.
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Affiliation(s)
- Markus Heim
- Technical University of Munich, TUM School of Medicine, Department of Anesthesiology and Intensive Care Medicine, Ismaninger Straße 22, Munich, 81675, Germany
| | - Christian M Schulz
- Technical University of Munich, TUM School of Medicine, Department of Anesthesiology and Intensive Care Medicine, Ismaninger Straße 22, Munich, 81675, Germany
| | - Frederick Schneider
- Technical University of Munich, TUM School of Medicine, Department of Anesthesiology and Intensive Care Medicine, Ismaninger Straße 22, Munich, 81675, Germany
| | - Pascal O Berberat
- Technical University Munich, TUM School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, München, 81675, Germany
| | - Martin Gartmeier
- Technical University Munich, TUM School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, München, 81675, Germany
| | - Kristina Schick
- Technical University Munich, TUM School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, München, 81675, Germany.
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Faihs V, Heininger S, McLennan S, Gartmeier M, Berberat PO, Wijnen-Meijer M. Professional Identity and Motivation for Medical School in First-Year Medical Students: A Cross-sectional Study. Med Sci Educ 2023; 33:431-441. [PMID: 37261015 PMCID: PMC10226964 DOI: 10.1007/s40670-023-01754-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 06/02/2023]
Abstract
Background Professional identity formation (PIF) is a life-long process, starting even before professional education. High levels of motivation for medical school are essential for effective learning and academic success. Both are key factors in future physicians' professional and personal development, and according to self-determination theory, professional identity (PI) and students' levels of motivation could be closely linked. Therefore, we sought to investigate whether PI and strength of motivation for medical school are associated in new medical students. Methods In a cross-sectional survey, all new medical students in Munich, Germany, were asked to complete the Macleod Clark Professional Identity Scale (MCPIS-9) and the Strength of Motivation for Medical School-Revised questionnaire (SMMS-R) as well as to provide information about age, gender, and waiting time before starting medical school. Results Eight hundred eleven out of 918 new medical students participated in the survey. A positive correlation between the MCPIS-9 and the SMMS-R (p < 0.001) was found. Female students showed higher scores in the SMMS-R (p < 0.05) and the SMMS-R-subscale Readiness to Start (p < 0.001). The amount of waiting semesters showed a positive correlation with the total SMMS-R score (p < 0.01) as well as with the subscales Readiness to Start and Persistence (both p < 0.001). Discussion We found an association between PI and strength of motivation for medical school in a large cohort of new medical students. Female gender and more waiting semesters were associated with higher levels of self-perceived motivation and higher scores on the SMMS-R-subscale Readiness to Start. More research is needed to better understand this topic to further improve medical education.
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Affiliation(s)
- Valentina Faihs
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
- Department of Dermatology and Allergy Biederstein, TUM School of Medicine, Technical University of Munich, Biedersteiner Str. 29, 80802 Munich, Germany
| | - Susanne Heininger
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Stuart McLennan
- Institute of History and Ethics in Medicine, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Martin Gartmeier
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Pascal O. Berberat
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Marjo Wijnen-Meijer
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
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Heitmann H, Fischer E, Wagner P, Pötter D, Gartmeier M, Schmidt-Graf F. Flipping the classroom in neurological bedside teaching: a prospective controlled study. BMC Med Educ 2023; 23:164. [PMID: 36922824 PMCID: PMC10016155 DOI: 10.1186/s12909-023-04150-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Bedside teaching is essential to foster core clinical competences in medical education, especially in Neurology. However, bedside skills are declining and new concepts to enhance the effectiveness of bedside teaching are needed, also in view of limited in-person teaching possibilities in the ongoing pandemic situation. If theoretical knowledge is taught prior to in-person sessions this might allow to better focus on practical application aspects during bedside teaching. We thus aimed to answer the question to what extent such an approach can enhance the effectiveness of neurological bedside teaching. METHODS In this prospective controlled study, neurological bedside courses following a traditional and a flipped classroom (FC) approach were compared with regards to their effects on theoretical knowledge and practical skills of medical students. Evaluations were obtained from 161 students and their lecturers participating in a neurological bedside teaching course at a German university hospital between October 2020 and July 2021. Students were randomly assigned to course dates. However, the 74 students assigned to course dates from May to July 2021 completed a mandatory online preparation course prior to the bedside teaching. These students served as the interventional group (IG) and the remaining 87 students formed the control group (CG). Ratings of knowledge and skills provided by the students and their lecturers on numerical rating scales served as primary outcome measures. Moreover, the time needed to recapitulate theoretical contents during the in-person teaching session was assessed as a secondary outcome measure. Group comparisons were performed using t-statistics. RESULTS Theoretical knowledge upon entering the course was rated significantly higher in the IG by the students (p < 0.001) and lecturers (p = 0.003). Lecturers also rated the practical skills of students in the IG significantly higher (p < 0.001). Furthermore, significantly less time was needed to recapitulate theoretical contents during the in-person session in the IG (p = 0.03). CONCLUSIONS Using a FC approach enhances the effectiveness of in-person neurological bedside teaching. Thus, these concepts are particularly valuable in the ongoing pandemic situation. Moreover, they might allow to reuse e-learning contents developed during the pandemic and to develop future bedside teaching concepts.
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Affiliation(s)
- Henrik Heitmann
- Department of Neurology, School of Medicine, Technical University of Munich (TUM), Munich, Germany.
- Department of Psychosomatic Medicine and Psychotherapy, Technical University of Munich (TUM), Munich, Germany.
| | - Elisabeth Fischer
- Department of Neurology, School of Medicine, Technical University of Munich (TUM), Munich, Germany
| | - Philipp Wagner
- Department of Neurology, School of Medicine, Technical University of Munich (TUM), Munich, Germany
| | - Dennis Pötter
- Department of Anesthesiology and Operative Intensive Care Medicine, Klinikum Dortmund, Dortmund, Germany
- TUM Medical Education Center, School of Medicine, Technical University of Munich (TUM), Munich, Germany
| | - Martin Gartmeier
- TUM Medical Education Center, School of Medicine, Technical University of Munich (TUM), Munich, Germany
| | - Friederike Schmidt-Graf
- Department of Neurology, School of Medicine, Technical University of Munich (TUM), Munich, Germany
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Gartmeier M, Hapfelmeier A, Grünewald M, Häusler J, Pfurtscheller T, Seidel T, Berberat P. Is there an increase over time in the complexity of teacher questions and student responses in case-based clinical seminars? A cross-sectional video study. BMC Med Educ 2022; 22:871. [PMID: 36522722 PMCID: PMC9756639 DOI: 10.1186/s12909-022-03944-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Case-based group discussions (CBGD) are a specific, interaction-focused format dedicated to fostering medical students' skills in applying basic biomedical knowledge to patient cases. Existing conceptions of CBGD suggest that a gradient towards increased opportunities for students to make elaborative verbal contributions is an important element of such seminars. To verify this assumption, we investigate empirically if clinical teachers progress from more basic, knowledge-oriented questions towards more advanced, elaboration-oriented questions in such seminars. METHODS We videotaped 21 different clinical teachers and 398 medical students in 32 CBGD-seminars on surgery and internal medicine. We coded closed-reproductive and open-elaborative teacher questions as well as reproductive and elaborative student responses to these questions. Inter-rater reliability was satisfactory. To determine trends regarding the teacher questions / student responses, we compared eight time-segments of equal duration per seminar. RESULTS Overall, clinical teachers asked more closed-reproductive than open-elaborative questions. Students gave more reproductive than elaborative responses. Regarding the frequencies of these forms of teacher questions / student responses, we found no significant differences over time. CONCLUSIONS Clinical teachers did not deliberately modify the types of questions over time to push students towards more elaborative responses. We conclude that the critical question to which degree promising teaching approaches are actually put into clinical teaching practice should be raised more purposefully in medical education research.
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Affiliation(s)
- Martin Gartmeier
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany.
| | - Alexander Hapfelmeier
- Institute of General Practice and Health Services Research, Techincal University of Munich, TUM School of Medicine, Munich, Germany
| | - Marc Grünewald
- Department of Ophthalmology, Technical University of Munich, TUM School of Medicine, Munich, Germany
| | - Janina Häusler
- Technical University of Munich, TUM Graduate School, Munich, Germany
| | - Theresa Pfurtscheller
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Tina Seidel
- Friedl Schöller Endowed Chair for Educational Psychology, Technical University of Munich, TUM School of Education, Munich, Germany
| | - Pascal Berberat
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
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Blaschke AL, Rubisch HPK, Schindler AK, Berberat PO, Gartmeier M. How is modern bedside teaching structured? A video analysis of learning content, social and spatial structures. BMC Med Educ 2022; 22:790. [PMID: 36380308 PMCID: PMC9664733 DOI: 10.1186/s12909-022-03855-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 11/01/2022] [Indexed: 05/26/2023]
Abstract
BACKGROUND Bedside teaching (BST) is an essential and traditional clinical teaching format. It has been subject to various impediments and has transformed over time. Besides a decrease in bedside time, there has also been a didactic diversification. In order to use time at the bedside effectively and understand the current design of BST, we here offer an evidence-based insight into how BST is practiced. This may serve as a basis for a refinement of its didactic design. METHODS In the current study, we investigate the interrelationships between learning content and the social as well as spatial structures of BST. To this end, we have empirically analysed almost 80 hours of video material from a total of 36 BST sessions with good interrater reliability. RESULTS BST lasted on average 125 min, most of which was spent in plenary and less than a third of the time at the patient's bedside. History taking was primarily practiced at the bedside while case presentations, clinical reasoning and theoretical knowledge were largely taught away from the patient. Clinical examination took place to a similar extent in the patient's room and in the theory room. CONCLUSIONS Even though the filmed BSTs are not purely "bedside", the teaching format investigated here is a typical example of undergraduate medical education. In order to maximize the teaching time available, a suitable learning space should be provided in addition to the bedside. Moreover, the clinical examination should be revised in its general sequence prior to the BST, and conscious decisions should be made regarding the social structure so as to optimize the potential of small groups and plenary sessions.
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Affiliation(s)
- Anna-Lena Blaschke
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany.
| | - Hannah P K Rubisch
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Ann-Kathrin Schindler
- DEMEDA (Department of Medical Education), Medical Didactics and Educational Research, Medical Faculty, University of Augsburg, Universitätsstraße 2, 86159, Augsburg, Germany
| | - Pascal O Berberat
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Martin Gartmeier
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
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Fischer F, Bauer E, Seidel T, Schmidmaier R, Radkowitsch A, Neuhaus BJ, Hofer SI, Sommerhoff D, Ufer S, Kuhn J, Küchemann S, Sailer M, Koenen J, Gartmeier M, Berberat P, Frenzel A, Heitzmann N, Holzberger D, Pfeffer J, Lewalter D, Niklas F, Schmidt-Hertha B, Gollwitzer M, Vorholzer A, Chernikova O, Schons C, Pickal AJ, Bannert M, Michaeli T, Stadler M, Fischer MR. Representational scaffolding in digital simulations – learning professional practices in higher education. ILS 2022. [DOI: 10.1108/ils-06-2022-0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Purpose
To advance the learning of professional practices in teacher education and medical education, this conceptual paper aims to introduce the idea of representational scaffolding for digital simulations in higher education.
Design/methodology/approach
This study outlines the ideas of core practices in two important fields of higher education, namely, teacher and medical education. To facilitate future professionals’ learning of relevant practices, using digital simulations for the approximation of practice offers multiple options for selecting and adjusting representations of practice situations. Adjusting the demands of the learning task in simulations by selecting and modifying representations of practice to match relevant learner characteristics can be characterized as representational scaffolding. Building on research on problem-solving and scientific reasoning, this article identifies leverage points for employing representational scaffolding.
Findings
The four suggested sets of representational scaffolds that target relevant features of practice situations in simulations are: informational complexity, typicality, required agency and situation dynamics. Representational scaffolds might be implemented in a strategy for approximating practice that involves the media design, sequencing and adaptation of representational scaffolding.
Originality/value
The outlined conceptualization of representational scaffolding can systematize the design and adaptation of digital simulations in higher education and might contribute to the advancement of future professionals’ learning to further engage in professional practices. This conceptual paper offers a necessary foundation and terminology for approaching related future research.
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Reiser S, Schacht L, Thomm E, Figalist C, Janssen L, Schick K, Dörfler E, Berberat PO, Gartmeier M, Bauer J. A video-based situational judgement test of medical students' communication competence in patient encounters: Development and first evaluation. Patient Educ Couns 2022; 105:1283-1289. [PMID: 34481676 DOI: 10.1016/j.pec.2021.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 06/22/2021] [Accepted: 08/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE We developed and evaluated the Video-Based Assessment of Medical Communication Competence (VA-MeCo), a construct-driven situational judgement test measuring medical students' communication competence in patient encounters. METHODS In the construction phase, we conducted two expert studies (npanel1 = 6, npanel2 = 13) to ensure curricular and content validity and sufficient expert agreement on the answer key. In the evaluation phase, we conducted a cognitive pre-test (n = 12) and a pilot study (n = 117) with medical students to evaluate test usability and acceptance, item statistics and test reliability depending on the applied scoring method (raw consensus vs. pairwise comparison scoring). RESULTS The results of the expert interviews indicated good curricular and content validity. Expert agreement on the answer key was high (ICCs> .86). The pilot study showed favourable usability and acceptance by students. Irrespective of the scoring method, reliability for the complete test (Cronbach's α >.93) and its subscales (α >.83) was high. CONCLUSION There is promising evidence that medical communication competence can be validly and reliably measured using a construct-driven and video-based situational judgement test. PRACTICE IMPLICATIONS Video-based SJTs allow efficient online assessment of medical communication competence and are well accepted by students and educators.
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Affiliation(s)
- Sabine Reiser
- University of Erfurt, Educational Research and Methodology, Erfurt, Germany.
| | - Laura Schacht
- University of Erfurt, Educational Research and Methodology, Erfurt, Germany
| | - Eva Thomm
- University of Erfurt, Educational Research and Methodology, Erfurt, Germany
| | - Christina Figalist
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Laura Janssen
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Kristina Schick
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Eva Dörfler
- Technical University of Munich, ProLehre | Media and Didactics, Munich, Germany
| | - Pascal O Berberat
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Martin Gartmeier
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Johannes Bauer
- University of Erfurt, Educational Research and Methodology, Erfurt, Germany
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Gartmeier M, Schick C, Berberat PO, Hertel S. Theoretischer Beitrag: Befunde zur Förderung kommunikativer Kompetenz aus dem medizinischen Kontext: Welche Perspektiven ergeben sich daraus für die Ausbildung von Lehrpersonen im Hinblick auf das Führen von Elterngesprächen? Psychologie in Erziehung und Unterricht 2022. [DOI: 10.2378/peu2022.art06d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Heitmann H, Wagner P, Fischer E, Gartmeier M, Schmidt-Graf F. Effectiveness of non-bedside teaching during the COVID-19 pandemic: a quasi-experimental study. BMC Med Educ 2022; 22:73. [PMID: 35101016 PMCID: PMC8801559 DOI: 10.1186/s12909-022-03141-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 01/27/2022] [Indexed: 05/30/2023]
Abstract
BACKGROUND The COVID-19 pandemic poses a huge challenge for clinical teaching due to contact restrictions and social distancing. Medical teachers have to balance potential risks and benefits of bedside teaching, especially in course formats intended to foster practical clinical skills. In this context, we aimed to address the question, whether presence-based teaching formats without patient involvement are suitable to teach practical skills. METHODS In this quasi-experimental study, presence-based teaching formats with and without patient contact were retrospectively compared regarding their effects on medical students' theoretical knowledge and practical skills, i.e. the performance and clinical interpretation of the neurological exam. To this end, evaluations from 102 students and their lecturers participating in a neurological bedside teaching course at a German university hospital between October 2020 and April 2021 were obtained. Students were initially randomly assigned to course dates. However, 53 students assigned to courses in November and December 2020, were not able to go bedside due to contact restrictions. These students formed the interventional group and the remaining 49 students the control group. The primary outcome measures were students' overall grading of the course (school grades, 1-6) as well as ratings of knowledge and skills provided by the students themselves and their lecturers on a numerical rating scale (0-10). Comparison between groups was performed using frequentist and Bayesian t-statistics. RESULTS The teaching format without patient contact received a significantly poorer overall grade by the students (p = 0.018). However, improvements in the students' self-ratings of knowledge and skills did not differ between the two formats (all p > 0.05, BF10max = 0.42). Moreover, especially practical skills were even rated significantly better in the group without patient contact by the lecturers (p < 0.001). CONCLUSIONS Teaching formats without patient contact are less well-received by the students. However, they are able to teach practical skills regarding the performance and clinical interpretation of examination techniques. Still, the evaluations obtained might not adequately capture the importance of bedside teaching in preparing future physicians for their practice. Perspectively, hybrid teaching approaches including flipped-classroom concepts hold considerable potential to enhance effectiveness of bedside teaching in the present pandemic situation and in the future.
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Affiliation(s)
- Henrik Heitmann
- Department of Neurology, School of Medicine, Technical University of Munich (TUM), Munich, Germany.
| | - Philipp Wagner
- Department of Neurology, School of Medicine, Technical University of Munich (TUM), Munich, Germany
| | - Elisabeth Fischer
- Department of Neurology, School of Medicine, Technical University of Munich (TUM), Munich, Germany
| | - Martin Gartmeier
- TUM Medical Education Center, School of Medicine, TUM, Munich, Germany
| | - Friederike Schmidt-Graf
- Department of Neurology, School of Medicine, Technical University of Munich (TUM), Munich, Germany
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Mühlbauer L, Huber J, Fischer MR, Berberat PO, Gartmeier M. Medical students' engagement in the context of the SARS-CoV-2 pandemic: The influence of psychological factors on readiness to volunteer. GMS J Med Educ 2021; 38:Doc110. [PMID: 34651068 PMCID: PMC8493846 DOI: 10.3205/zma001506] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/12/2021] [Accepted: 04/26/2021] [Indexed: 06/13/2023]
Abstract
Objective: To avert staff shortages during the first wave of the SARS-CoV-2 pandemic in spring 2020, the medical faculties of the Technical University of Munich (TUM) and the Ludwig Maximilian University of Munich (LMU) appealed to their students to volunteer for relief work. In this study, we examine the influence of psychological factors on the students' decisions to respond to this call or not. Methodology: We report on a cross-sectional study based on an online survey among medical students at the TUM and LMU. The survey consisted of a questionnaire containing items on motivation and other factors related to the decision for or against volunteering. Questions were also asked about anxieties regarding COVID-19 and the occurrence of depressive symptoms, as well as about resilience. Results: Responses from 244 participants were analysed. Students' decisions to volunteer revealed both altruistic and introjected motivations. For those students who did not volunteer, time overlaps and workload related to other activities played an important role. Between the two groups, no significant difference was detected in terms of their resilience and COVID-19-related anxieties. However, the non-volunteering students reported a significantly higher prevalence of depressive symptoms. Conclusion: Sense of duty and the desire to help were, according to the students, the most important reasons for volunteering. Depressive symptoms and lack of time made volunteering less likely. Resilience and COVID-19-related anxieties do not seem to have had any influence on the decision to volunteer or not.
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Affiliation(s)
- Luisa Mühlbauer
- Technische Universität München, Fakultät für Medizin, Klinikum rechts der Isar, TUM Medical Education Center, München, Germany
| | - Johanna Huber
- LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin (DAM) am LMU Klinikum, München, Germany
| | - Martin R. Fischer
- LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin (DAM) am LMU Klinikum, München, Germany
| | - Pascal O. Berberat
- Technische Universität München, Fakultät für Medizin, Klinikum rechts der Isar, TUM Medical Education Center, München, Germany
| | - Martin Gartmeier
- Technische Universität München, Fakultät für Medizin, Klinikum rechts der Isar, TUM Medical Education Center, München, Germany
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Heininger SK, Baumgartner M, Zehner F, Burgkart R, Söllner N, Berberat PO, Gartmeier M. Correction to: Measuring hygiene competence: the picture-based situational judgement test HygiKo. BMC Med Educ 2021; 21:440. [PMID: 34412600 PMCID: PMC8377828 DOI: 10.1186/s12909-021-02877-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Susanne Katharina Heininger
- Klinikum rechts der Isar, TUM Medical Education Center, Fakultät für Medizin, TU München, Ismaninger Straße 22, D-81675, Munich, Germany.
| | - Maria Baumgartner
- Klinikum rechts der Isar, TUM Medical Education Center, Fakultät für Medizin, TU München, Ismaninger Straße 22, D-81675, Munich, Germany
| | - Fabian Zehner
- DIPF | Leibniz-Institut für Bildungsforschung und Bildungsinformation, Frankfurt, Germany
| | - Rainer Burgkart
- Klinik und Poliklinik für Orthopädie und Sportorthopädie, Fakultät für Medizin, Klinikum rechts der Isar, TU München, Munich, Germany
| | - Nina Söllner
- Klinikum rechts der Isar, TUM Medical Education Center, Fakultät für Medizin, TU München, Ismaninger Straße 22, D-81675, Munich, Germany
| | - Pascal O Berberat
- Klinikum rechts der Isar, TUM Medical Education Center, Fakultät für Medizin, TU München, Ismaninger Straße 22, D-81675, Munich, Germany
| | - Martin Gartmeier
- Klinikum rechts der Isar, TUM Medical Education Center, Fakultät für Medizin, TU München, Ismaninger Straße 22, D-81675, Munich, Germany
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17
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Heininger SK, Baumgartner M, Zehner F, Burgkart R, Söllner N, Berberat PO, Gartmeier M. Measuring hygiene competence: the picture-based situational judgement test HygiKo. BMC Med Educ 2021; 21:410. [PMID: 34330263 PMCID: PMC8323094 DOI: 10.1186/s12909-021-02829-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 07/14/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND With the onset of the COVID-19 pandemic at the beginning of 2020, the crucial role of hygiene in healthcare settings has once again become very clear. For diagnostic and for didactic purposes, standardized and reliable tests suitable to assess the competencies involved in "working hygienically" are required. However, existing tests usually use self-report questionnaires, which are suboptimal for this purpose. In the present study, we introduce the newly developed, competence-oriented HygiKo test instrument focusing health-care professionals' hygiene competence and report empirical evidence regarding its psychometric properties. METHODS HygiKo is a Situational Judgement Test (SJT) to assess hygiene competence. The HygiKo-test consists of twenty pictures (items), each item presents only one unambiguous hygiene lapse. For each item, test respondents are asked (1) whether they recognize a problem in the picture with respect to hygiene guidelines and, (2) if yes, to describe the problem in a short verbal response. Our sample comprised n = 149 health care professionals (79.1 % female; age: M = 26.7 years, SD = 7.3 years) working as clinicians or nurses. The written responses were rated by two independent raters with high agreement (α > 0.80), indicating high reliability of the measurement. We used Item Response Theory (IRT) for further data analysis. RESULTS We report IRT analyses that show that the HygiKo-test is suitable to assess hygiene competence and that it allows to distinguish between persons demonstrating different levels of ability for seventeen of the twenty items), especially for the range of low to medium person abilities. Hence, the HygiKo-SJT is suitable to get a reliable and competence-oriented measure for hygiene-competence. CONCLUSIONS In its present form, the HygiKo-test can be used to assess the hygiene competence of medical students, medical doctors, nurses and trainee nurses in cross-sectional measurements. In order to broaden the difficulty spectrum of the current test, additional test items with higher difficulty should be developed. The Situational Judgement Test designed to assess hygiene competence can be helpful in testing and teaching the ability of working hygienically. Further research for validity is needed.
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Affiliation(s)
- Susanne Katharina Heininger
- Klinikum rechts der Isar, TUM Medical Education Center, Fakultät für Medizin, TU München, Ismaninger Straße 22, D-81675 München, Germany
| | - Maria Baumgartner
- Klinikum rechts der Isar, TUM Medical Education Center, Fakultät für Medizin, TU München, Ismaninger Straße 22, D-81675 München, Germany
| | - Fabian Zehner
- DIPF | Leibniz-Institut für Bildungsforschung und Bildungsinformation, Frankfurt, Germany
| | - Rainer Burgkart
- Klinik und Poliklinik für Orthopädie und Sportorthopädie, Fakultät für Medizin, Klinikum rechts der Isar, TU München, München, Germany
| | - Nina Söllner
- Klinikum rechts der Isar, TUM Medical Education Center, Fakultät für Medizin, TU München, Ismaninger Straße 22, D-81675 München, Germany
| | - Pascal O. Berberat
- Klinikum rechts der Isar, TUM Medical Education Center, Fakultät für Medizin, TU München, Ismaninger Straße 22, D-81675 München, Germany
| | - Martin Gartmeier
- Klinikum rechts der Isar, TUM Medical Education Center, Fakultät für Medizin, TU München, Ismaninger Straße 22, D-81675 München, Germany
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18
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Zottmann JM, Horrer A, Chouchane A, Huber J, Heuser S, Iwaki L, Kowalski C, Gartmeier M, Berberat PO, Fischer MR, Weidenbusch M. Isn't here just there without a "t" - to what extent can digital Clinical Case Discussions compensate for the absence of face-to-face teaching? GMS J Med Educ 2020; 37:Doc99. [PMID: 33364378 PMCID: PMC7740012 DOI: 10.3205/zma001392] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/19/2020] [Accepted: 10/23/2020] [Indexed: 06/01/2023]
Abstract
Objective: COVID-19 challenges curriculum managers worldwide to create digital substitutes for classroom teaching. Case-based teaching formats under expert supervision can be used as a substitute for practical bedside teaching, where the focus is on teaching clinical reasoning skills. Methods: For medical students of LMU and TU Munich, the interactive, case-based, and supervised teaching format of Clinical Case Discussion (CCD) was digitised and implemented as dCCD in their respective curricula. Case discussions were realised as videoconferences, led by a student moderator, and took place under the supervision of a board-certified clinician. To prevent passive participation, additional cognitive activations were implemented. Acceptance, usability, and subjective learning outcomes were assessed in dCCDs by means of a special evaluation concept. Results: With regard to acceptance, students were of the opinion that they had learned effectively by participating in dCCDs (M=4.31; SD=1.37). The majority of students also stated that they would recommend the course to others (M=4.23; SD=1.62). The technical implementation of the teaching format was judged positively overall, but findings for usability were heterogeneous. Students rated their clinical reasoning skills at the end of the dCCDs (M=4.43; SD=0.66) as being significantly higher than at the beginning (M=4.33; SD=0.69), with low effect size, t(181)=-2.352, p=.020, d=0.15. Conclusion: Our evaluation data shows that the dCCD format is well-accepted by students as a substitute for face-to-face teaching. In the next step, we plan to examine the extent to which participation in dCCDs leads to an increase in objectively measured clinical reasoning skills, analogous to a face-to-face CCD with on-site attendance.
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Affiliation(s)
- Jan M. Zottmann
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
| | - Anna Horrer
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
| | - Amir Chouchane
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Johanna Huber
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
| | - Sonja Heuser
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
| | - Lica Iwaki
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
| | - Christian Kowalski
- LMU Munich, University Hospital, Department of Anesthesiology, Munich, Germany
| | - Martin Gartmeier
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Pascal O. Berberat
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Martin R. Fischer
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
| | - Marc Weidenbusch
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
- LMU Munich, University Hospital, Department of Internal Medicine IV, Munich, Germany
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Abstract
Medical education is a relatively young field of research that has been characterized by many innovations over the last 20 years. The main topics were the preparation of students for their medical work and imparting of profound knowledge about scientific contexts in medicine. For a long time, the main focus was on learning the necessary knowledge and skills; however, this is no longer considered sufficient. In order to carry out the work as a physician well, other qualities are also necessary, such as communication, collaboration, professionalism, science and reflectivity. Worldwide these aspects are being increasingly integrated into the learning objectives of medical schools and residency programs. The structure of medical studies at many universities has also changed. So-called vertical integration strengthens the integration of theoretical preclinical training and the clinical phase. This means that in the preclinical phase training is more practice-oriented and in the clinical phase a more structured form of training takes place. In the first years of study, students are prepared for the clinical phase by discussing patient cases and practicing skills in simulation centers. In addition, the clinical working environment is increasingly used as a learning environment. Developments have also been made regarding examinations: in addition to knowledge and skills, students and residents are now also assessed regarding performance in practice. Using more realistic assessments, e.g., Objective Structured Clinical Examinations and Workplace-based Assessments, students are evaluated more on their actual performance in practice. By means of the Entrustable Professional Activities method, students are gradually given more responsibility in order to prepare them for their future tasks.
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Affiliation(s)
- M Wijnen-Meijer
- TUM Medical Education Center, Fakultät für Medizin, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland.
| | - M Gartmeier
- TUM Medical Education Center, Fakultät für Medizin, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland
| | - P O Berberat
- TUM Medical Education Center, Fakultät für Medizin, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland
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Grünewald M, Klein E, Hapfelmeier A, Wuensch A, Berberat PO, Gartmeier M. Improving physicians' surgical ward round competence through simulation-based training. Patient Educ Couns 2020; 103:971-977. [PMID: 31810763 DOI: 10.1016/j.pec.2019.11.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 11/25/2019] [Accepted: 11/27/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Ward rounds are an essential part of physicians' daily routine. Existing studies suggest that their practical implementation is inconsistent. Therefore, developing interventions to train ward round competence and assessing if they are effective educational tools are crucial goals for research. METHODS We analysed a simulation-based tutorial dedicated to fourth-year medical students, including casework and ward round simulation. We investigated the effectiveness of this intervention regarding ward round competence through a randomized controlled trial. Performance was assessed with the modified/validated surgical ward round assessment tool by two blinded and trained raters. Supplementary, motivation during the ward round tutorial was assessed for all students at different time points. RESULTS Analysis of the ratings show that, in contrast to the control group (pre: 66.1 vs. post: 64.8 points, p = 0.72), the ward round competence of the intervention group (pre: 62.6 vs. post: 69.6 points, p = 0.0169) improved significantly after participating in the ward round tutorial. CONCLUSION The results show that our simulation-based training is an effective way to improve competence of medical students in conducting surgical ward rounds. PRACTICE IMPLICATIONS Participation in ward round trainings is a valuable tool to prepare students for their future professional practise.
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Affiliation(s)
- Marc Grünewald
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Nigerstr. 3, 81675 Munich, Germany.
| | - Evelyn Klein
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Nigerstr. 3, 81675 Munich, Germany; Department of Obstetrics and Gynecology, University Hospital rechts der Isar, Technical University of Munich, Ismaningerstrasse 22, 81675 Munich, Germany.
| | - Alexander Hapfelmeier
- Technical University of Munich, Institute of Medical Informatics, Statistics and Epidemiology, Ismaninger Str. 22, 81675 Munich, Germany.
| | - Alexander Wuensch
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Nigerstr. 3, 81675 Munich, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 5a, 79104 Freiburg, Germany.
| | - Pascal O Berberat
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Nigerstr. 3, 81675 Munich, Germany.
| | - Martin Gartmeier
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Nigerstr. 3, 81675 Munich, Germany.
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Gartmeier M, Reimer M, Huber J, Epstein N, Fischer MR, Berberat PO. International mobility of students in the medical disciplines from a comparative perspective. GMS J Med Educ 2020; 37:Doc34. [PMID: 32566736 PMCID: PMC7291386 DOI: 10.3205/zma001327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 01/15/2020] [Accepted: 02/19/2020] [Indexed: 05/28/2023]
Abstract
Objective: We analyze the extent to which students of human, veterinary and dental medicine complete study-related stays abroad (frequency, type and duration of stays abroad and countries visited). Furthermore, we investigate the possible correlations between completed stays abroad and the duration of studies, the completion of a doctorate and entering professional life. Methods: The data come from a written cross-sectional survey of 742 graduates of their respective study programs at Bavarian universities. The evaluation was carried out using descriptive and inferential statistical methods. Results: Slightly more than half of the surveyed students completed study-associated stays abroad, with notable differences between the three study programs. The students most frequently completed internships abroad lasting an average of nine weeks. Switzerland was the most common country of destination for the stays abroad. Furthermore, there were no or only weak correlations between stays abroad, the duration of studies and progress towards a doctorate or the commencement of professional employment abroad. There were no correlations with the stress experienced as part of initial employment after graduation. Conclusion: The results clearly indicate that stays abroad are quite usual for students in the medical disciplines and are almost standard in the study of human medicine. The selection of the countries visited indicates that the primary goal of the students' stays abroad is to deepen their competence with a view to later employment in their home country.
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Affiliation(s)
- Martin Gartmeier
- Technical University of Munich, Faculty of Medicine, Hospital rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Maike Reimer
- Bayrisches Staatsinstitut für Hochschulforschung und Hochschulplanung, Munich, Germany
| | - Johanna Huber
- LMU Munich, Hospital University Munich, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
| | - Nurith Epstein
- LMU Munich, Hospital University Munich, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
| | - Martin R. Fischer
- LMU Munich, Hospital University Munich, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
| | - Pascal O. Berberat
- Technical University of Munich, Faculty of Medicine, Hospital rechts der Isar, TUM Medical Education Center, Munich, Germany
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Schick K, Reiser S, Mosene K, Schacht L, Janssen L, Thomm E, Dinkel A, Fleischmann A, Berberat PO, Bauer J, Gartmeier M. How can communicative competence instruction in medical studies be improved through digitalization? GMS J Med Educ 2020; 37:Doc57. [PMID: 33225049 PMCID: PMC7672381 DOI: 10.3205/zma001350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 03/29/2020] [Accepted: 05/29/2020] [Indexed: 05/10/2023]
Abstract
The teaching of communicative competence plays an increasingly important role in medical education. In addition to traditional teaching formats, such as role-plays with simulated patients, technology-based approaches become more important in medical education. Teaching materials are increasingly augmented by videos of simulated doctor-patient conversations. This combination allows the content of teaching materials to be demonstrated with video or for videos to create a basis for reflection activities. In addition, conversation videos can illustrate different qualities of clinical communication and serve as illustrative material for describing particular issues in more detail. In addition to teaching clinical communicative competence, the assessment of this competence also plays an important role in medical educational research. So far, this has mainly been conducted through direct observation using checklists or rating scales. Relatively little is known about the assessment of communicative competence using standardized online-based tests. Situational Judgement Tests (SJTs) offer a promising approach in this respect. The BMBF-funded (BMBF = Bundesministerium für Bildung und Forschung - Federal Ministry of Education and Research) joint project voLeA (Entwicklung videobasierter Lehr- und Assessmentmodule zur Gesprächskompetenz im Medizinstudium = Development of video-based teaching and assessment modules for communicative competence in medical studies) addresses these two issues. Specifically, the project is engaged in developing e-learning modules to promote communicative competence and an assessment of this competence using an SJT. The present paper focuses on the benefits of technology-based learning and assessment units for clinical communicative competence in medical studies, using the voLeA project as an example.
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Affiliation(s)
- Kristina Schick
- Technical University of Munich, TUM Medical Education Center, Munich, Germany
- *To whom correspondence should be addressed: Kristina Schick, Technical University of Munich, TUM Medical Education Center, Ismaninger Str. 22, D-81675 Munich, Germany, Phone: +49 (0)89/4140-6311, E-mail:
| | - Sabine Reiser
- University Erfurt, Professur für Bildungsforschung und Methodenlehre, Erfurt, Germany
| | - Katharina Mosene
- Technical University of Munich, TUM Medical Education Center, Munich, Germany
| | - Laura Schacht
- University Erfurt, Professur für Bildungsforschung und Methodenlehre, Erfurt, Germany
| | - Laura Janssen
- Technical University of Munich, TUM Medical Education Center, Munich, Germany
| | - Eva Thomm
- University Erfurt, Professur für Bildungsforschung und Methodenlehre, Erfurt, Germany
| | - Andreas Dinkel
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Munich, Germany
| | - Andreas Fleischmann
- Technical University of Munich, Pro Lehre, Medien und Didaktik, Munich, Germany
| | - Pascal O. Berberat
- Technical University of Munich, TUM Medical Education Center, Munich, Germany
| | - Johannes Bauer
- University Erfurt, Professur für Bildungsforschung und Methodenlehre, Erfurt, Germany
| | - Martin Gartmeier
- Technical University of Munich, TUM Medical Education Center, Munich, Germany
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Gartmeier M, Fischer N, Gut R, Hoier S, Riedo D. Praxis psychologischer Beratung und Intervention: Konzeption und Transfer eines didaktischen Bausteins zum Aufbau der Kompetenz angehender Lehrpersonen im Bereich der Gesprächsführung mit Eltern. Psychologie in Erziehung und Unterricht 2019. [DOI: 10.2378/peu2020.art02d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Gartmeier M, Pfurtscheller T, Hapfelmeier A, Grünewald M, Häusler J, Seidel T, Berberat PO. Teacher questions and student responses in case-based learning: outcomes of a video study in medical education. BMC Med Educ 2019; 19:455. [PMID: 31805913 PMCID: PMC6896701 DOI: 10.1186/s12909-019-1895-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/29/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND Case-based learning (CBL) is a highly interactive instructional format widely used in medical education. One goal of CBL is to integrate basic biomedical knowledge and its application to concrete patient cases and their clinical management. In this context, we focus the role of teacher questions as triggers for reproductive vs. elaborative student responses. Specifically, our research questions concern the kinds of questions posed by clinical teachers, the kinds of responses given by students, the prediction of student responses based upon teacher questions, and the differences between the two medical disciplines in focus of our study, internal medicine and surgery. METHODS We analyse 19 videotaped seminars (nine internal medicine, ten surgery) taught by clinicians and attended by advanced medical students. Multiple raters performed a low-inference rating process using a theory-based categorical scheme with satisfactory interrater-reliability. RESULTS We found that medical teachers mostly posed initial (instead of follow-up) questions and that their questions were more often closed (instead of open). Also, more reasoning (than reproductive) questions were posed. A high rate of student non-response was observed while elaborative and reproductive student responses had a similar prevalence. In the prediction context, follow-up reasoning questions were associated with low non-response and many elaborative answers. In contrast, the highest student non-response rate followed open reproduction questions and initial reasoning questions. Most reproductive statements by students were made following closed reproduction questions. CONCLUSIONS These results deepen our understanding of interactive, questions-driven medical teaching and provide an empirical basis for clinical teachers to use questions in didactically fruitful ways.
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Affiliation(s)
- Martin Gartmeier
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Munich, Germany.
| | - Theresa Pfurtscheller
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Alexander Hapfelmeier
- Institute of Medical Informatics, Statistics and Epidemiology, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Marc Grünewald
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Janina Häusler
- Institute of Medical Informatics, Statistics and Epidemiology, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Tina Seidel
- TUM School of Education, Friedl Schöller Endowed Chair for Educational Psychology, Technical University of Munich, Munich, Germany
| | - Pascal O Berberat
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Munich, Germany
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Gartmeier M, Baumgartner M, Burgkart R, Heiniger S, Berberat PO. Why hand hygiene is not sufficient: modeling hygiene competence of clinical staff as a basis for its development and assessment. GMS J Med Educ 2019; 36:Doc39. [PMID: 31544139 PMCID: PMC6737265 DOI: 10.3205/zma001247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 05/06/2019] [Accepted: 05/28/2019] [Indexed: 06/10/2023]
Abstract
Adhering to hygiene standards in daily clinical work is an important characteristic of qualitatively high-value medical care. In this regards, hand hygiene is often focused on in the literature. From the viewpoint of medical education research, we argue that this focus is too narrow to explain how staff who are working clinically with patients implement and adhere to standards of hygiene across a wide variety of tasks of their daily clinical routine. We present basic features of a differentiated concept of hygiene competence, which includes specialized knowledge, corresponding inner attitudes, and action routines that are customized to the needs of specific situations. Building on that, we present a current simulation-based course concept aimed at developing hygiene competence in medical education. Furthermore, we describe a test instrument that is designed according to the principle of a situational judgment test and that appears promising for the assessment of hygiene competence. The course and the measurement instrument are discussed in regards to their fit to the competence model and the related perspectives for research and teaching.
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Affiliation(s)
- Martin Gartmeier
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Maria Baumgartner
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Rainer Burgkart
- Technical University of Munich, Klinikum rechts der Isar, Department of Orthopedics and Sports Orthopedics, Munich, Germany
| | - Susanne Heiniger
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Pascal O. Berberat
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany
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Schick K, Berberat PO, Kadmon M, Harendza S, Gartmeier M. German Language Adaptation of the Kalamazoo Communication Skills Assessment Form (KCSAF): A Multi-Method Study of Two Cohorts of Medical Students. Zeitschrift für Pädagogische Psychologie 2019. [DOI: 10.1024/1010-0652/a000241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract. This work investigates the German version of the Kalamazoo Communication Skills Assessment Form (KCSAFd) for three assessment methods: students' self-assessment (KCSAFd-self), assessment by standardised patients (KCSAFd-sPat) and video-assessment by trained raters (KCSAFd-video). Videotaped simulated patient consultations of N = 163 medical students from the first ( n = 97) and the final clinical years ( n = 66) were rated using the KCSAFd. Investigating the psychometric properties of the instrument, we found a two factor-construct with interpersonal and conversational competence. All methods showed good internal consistency and acceptable model fit values. Additionally, we found plausible relationships between the three methods and meaningful differences between the two groups of students.
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Abstract
This study investigates medical trainees' experiences with dying and death, by means of semistructured interviews. Nine medical students and nine residents reported a total of 114 experiences. The great majority of these experiences took place during the final year of medical school. The authors identified the latent characteristics, which illustrate an in-depth understanding of the significance of the described experiences. Three main themes emerged: circumstances of death, personal relationship, and one's own role. The age of the dying person, the extent of suffering, time frame and setting, and the patients' behaviors were factors that influence the perceptions of the experiences. The interviewees reported powerful emotional consternation by the patients' deaths with whom they had developed a close relationship. Failure, helplessness, and guilt were negatively associated perceptions of one's own role. This study illustrates the tension between emotional concern and professional detachment. It highlights the continuing existence of a physician image, in which control represents the key issue.
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Affiliation(s)
- Nana Jedlicska
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany.,Dagmara Srnová is now at Urological Clinic, Munich-Planegg, Germany. *Both the authors would like to share the role of first author as they contributed equally to the present work
| | - Dagmara Srnová
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany.,Dagmara Srnová is now at Urological Clinic, Munich-Planegg, Germany. *Both the authors would like to share the role of first author as they contributed equally to the present work
| | - Laura Scheide
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Marjo Wijnen-Meijer
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Martin Gartmeier
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Pascal O Berberat
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
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Epstein N, Huber J, Gartmeier M, Berberat PO, Reimer M, Fischer MR. Investigation on the acquisition of scientific competences during medical studies and the medical doctoral thesis. GMS J Med Educ 2018; 35:Doc20. [PMID: 29963610 PMCID: PMC6022582 DOI: 10.3205/zma001167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 12/12/2017] [Accepted: 01/26/2018] [Indexed: 05/30/2023]
Abstract
Background: Not only the amount of research related contents in German medical studies are objects of criticism, but also the medical doctoral thesis. However, the question which research competences are truly acquired within medical school and the doctoral phase is empirically open, and is thus pursued in the following research study. Methods: We used data from the Bavarian Medical Graduate Panel Survey (MediBAP) (N=455), where respondents assessed their own research competences. To consolidate the data, we analysed qualitative interviews with doctoral medical graduates and students from the E-Prom study (N=14). Results: The quantitative analyses show that medical graduates evaluate the medical curriculum's research contents and their acquired competences as rather low. Doctoral graduates rate their competence of pursuing research independently higher than medical graduates who have not finished their doctorate. The qualitative analyses are in line with these results, as they point to the predominant development of competences during the doctoral phase. Despite this clearly positive trend, the majority of the respondents don't feel confident enough to undertake research independently also after attaining their doctoral degree. Conclusion: The results of this study emphasize the need for a more systematic and targeted mediation and review of research competences within the regular medical curriculum.
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Affiliation(s)
- Nurith Epstein
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
| | - Johanna Huber
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
| | - Martin Gartmeier
- Technical University of Munich, University Hospital Rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Pascal O. Berberat
- Technical University of Munich, University Hospital Rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Maike Reimer
- Bavarian State Institute for Higher Education Research and Planning (IHF), Munich, Germany
| | - Martin R. Fischer
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
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Bauer J, Gartmeier M, Wiesbeck AB, Moeller GE, Karsten G, Fischer MR, Prenzel M. Differential learning gains in professional conversation training: A latent profile analysis of competence acquisition in teacher-parent and physician-patient communication. Learning and Individual Differences 2018. [DOI: 10.1016/j.lindif.2017.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kiessling C, Bauer J, Gartmeier M, Iblher P, Karsten G, Kiesewetter J, Moeller GE, Wiesbeck A, Zupanic M, Fischer MR. Development and validation of a computer-based situational judgement test to assess medical students' communication skills in the field of shared decision making. Patient Educ Couns 2016; 99:1858-1864. [PMID: 27345253 DOI: 10.1016/j.pec.2016.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 05/27/2016] [Accepted: 06/12/2016] [Indexed: 05/15/2023]
Abstract
OBJECTIVE To develop a computer-based test (CBT) measuring medical students' communication skills in the field of shared decision making (SDM) and to evaluate its construct validity. METHODS The CBT was developed in the context of an experimental study comparing three different trainings for SDM (including e-learning and/or role-play) and a control group. Assessment included a CBT (Part A: seven context-poor questions, Part B: 15 context-rich questions) and interviews with two simulated patients (SP-assessment). Cronbach's α was used to test the internal consistency. Correlations between CBT and SP-assessment were used to further evaluate construct validity of the CBT. RESULTS Seventy-two students took part in the study. Mean value for the CBT score was 72% of the total score. Cronbach's α was 0.582. After eliminating three items, Cronbach's α increased to 0.625. Correlations between the CBT and SP-assessment were low to moderate. The control group scored significantly lower than the training settings (p<0.001). CONCLUSION The CBT was reliable enough to test for group differences. For summative assessment purposes, considerably more questions would be needed. PRACTICE IMPLICATIONS We encourage teachers who particularly work with large student numbers to consider CBT as a feasible assessment method for cognitive aspects of communication skills.
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Affiliation(s)
- Claudia Kiessling
- Institut für Didaktik und Ausbildungsforschung in der Medizin am Klinikum der Universität München, Germany; Assessment Department, Brandenburg Medical School Theodor Fontane, Germany.
| | - Johannes Bauer
- TUM School of Education, Technische Universität München, Germany
| | - Martin Gartmeier
- TUM School of Education, Technische Universität München, Germany
| | - Peter Iblher
- Department of Anesthesiology, Universitätsklinikum Schleswig-Holstein, Germany
| | - Gudrun Karsten
- Centre for Medical Education, Deańs Office of Education, Christian-Albrechts-Universität zu Kiel, Germany
| | - Jan Kiesewetter
- Institut für Didaktik und Ausbildungsforschung in der Medizin am Klinikum der Universität München, Germany
| | - Grit E Moeller
- Centre for Medical Education, Deańs Office of Education, Christian-Albrechts-Universität zu Kiel, Germany
| | - Anne Wiesbeck
- TUM School of Education, Technische Universität München, Germany
| | - Michaela Zupanic
- Office for Student Affairs, Fakultät für Gesundheit, Universität Witten/Herdecke, Germany
| | - Martin R Fischer
- Institut für Didaktik und Ausbildungsforschung in der Medizin am Klinikum der Universität München, Germany
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Gartmeier M, Lehtinen E, Gruber H, Heid H. Erratum to: Negative expertise: comparing differently tenured elder care nurses’ negative knowledge. Eur J Psychol Educ 2011. [DOI: 10.1007/s10212-011-0057-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Gartmeier M, Lehtinen E, Gruber H, Heid H. Negative expertise: comparing differently tenured elder care nurses' negative knowledge. Eur J Psychol Educ 2010. [DOI: 10.1007/s10212-010-0042-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gartmeier M, Bauer J, Gruber H, Heid H. Workplace errors and negative knowledge in elder care nursing. Human Resource Development International 2010. [DOI: 10.1080/13678861003589057] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Gartmeier M, Hetzner S, Gruber H, Heid H. Fehlerorientierung und Eigeninitiative im Bankensektor. Zeitschrift für Arbeits- und Organisationspsychologie A&O 2009. [DOI: 10.1026/0932-4089.53.4.149] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
In einer querschnittlichen Feldstudie wurden Einstellungen gegenüber Fehlern am Arbeitsplatz als Prädiktoren der Eigeninitiative untersucht. Die Wahrnehmung von Psychological Safety in Bezug auf die Kollegenschaft und die Vorgesetzten wurde als Mediatorvariable berücksichtigt. Für die Studie wurden 84 Beschäftigte der Privatkundenberatung einer Bank befragt, deren Arbeitsplätze zum Zeitpunkt der Erhebung von gravierenden Arbeitsplatzveränderungen betroffen waren. Regressionsanalysen zeigten Fehlerkompetenz, Lernen aus Fehlern sowie Nachdenken über Fehler als bedeutsame Prädiktoren von Eigeninitiative. Für alle genannten Einflüsse konnte eine Mediation durch Psychological Safety – Kollegenschaft nachgewiesen werden; Psychological Safety – Vorgesetzte mediierte nur die Einflüsse von Fehlerkompetenz und Lernen aus Fehlern auf Eigeninitiative. Die Ergebnisse weisen darauf hin, dass die befragten Beschäftigten Innovationen eher innerhalb ihrer eigenen Arbeitsgruppe anstoßen.
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