Learning in peer teaching of patient relations and communication skills at the "Anamnesegruppen" Munich - proof-of-concept and lessons learned

Background: Due to the ban on classroom teaching during the pandemic, the Munich "Anamnesegruppen" had to be switched to e-learning at short notice. There were no established concepts for this, which is why digitalization was piloted and evaluated for feasibility. Student "Anamnesegruppen": "Anamnesegruppen" have existed for over 50 years and are organized as independent student peer teaching. In small groups of medical and psychology students, interviews with patients are conducted once a week during the semester. This is followed by a feedback and discussion round, in which ethical and professional questions are discussed in addition to the patient's medical history. The goal is to train the participants' ability to communicate and reflect. Adaptation to digital methods: The anamnesis seminars have been moved to a virtual group room using video conference. Patients were mainly recruited from the participants' circle of acquaintances. The group size was set at eight people each in four groups and supervised by a pair of student tutors. Confidentiality and data protection declarations were obtained in writing. Results: By switching to digital anamnesis groups, all four groups were successfully completed. Both the final supervision of the tutors and the electronic evaluation of the participants yielded positive feedback. Compared to the two previous evaluations of the semesters in classroom sessions, there were no significant differences in the evaluation. Discussion: The continuously good evaluation results, which did not differ between the digital format and the classroom course of the previous semesters, show that an ad hoc conversion to digital teaching is possible. We want to stress the fact that elements reflecting the doctor-patient relationship were successfully preserved. For the similarly structured Balint groups, virtual sessions may also be considered. Further research, especially prospective, is desirable in order to better understand the possibilities of digital teaching in this area.

Densitometric control of retinal vascular reactions after mandibular nerve anesthesia

In a group of 44 patients, fundus photographs were taken before and after mandibular nerve anesthesia and examined by densitometry. These patients were divided into subgroups receiving 4 cm3 of Xylocitin 2% alone or in combination with 0.005% norepinephrine, or 0.00125 or 0.002% epinephrine. In the presence of epinephrine, the retinal arterioles reacted with a temporary age-dependent narrowing. A placebo group received normal saline or had just the needle inserted. With one interesting exception, the reactions were minimal. The cause of this reaction is a multifactorial one. In the first period, vagovagal reflexes are important; in the later phase, processes comparable to autoregulation play the main role.

[Late recurrence of ameloblastoma]

Two cases of late recurrence (31 and 33 years after radical surgery) of an ameloblastoma induced us to explain our operative approach on the basis of experience with 37 patients operated on for ameloblastoma at our clinic. With special consideration of the biology, clinic and histopathology of this tumour, we have tried to establish operative guidelines with regard to radical surgery. We arrived at the conclusion that ameloblastomas regarded as malignant should be treated by radical surgery; and those considered to be benign, by conservative surgery, individual decisions being imperative. Our clinical observations and analyses are compared with the results of other authors.

[Impacted wisdom tooth 48]

To illustrate the great variety of wisdom teeth impactions, the authors report a case where a vertically impacted 48 projected with its apex over the mandibular border by almost 2 mm. Possible causes of impaction and their consideration in the surgical removal of such teeth are mentioned.

[Therapeutic aspects of odontogenic maxillary sinusitis]

On the basis of observations in 90 patients with odontogenic maxillary sinusitis who had been re-examined clinically and radiologically, the authors deal with the optimal utilization of all possibilities of conservative treatment. 74% of the patients were symptom-free, 55% presented a radiologically well pneumatized sinus. The healing quality of inflammatory alterations of the sinusal mucosa is once again confirmed by the observation of the course of the disease.

[A dentinoma with rare localization]

On the basis of a report of a dentinoma measuring 2 X 2 cm that had rounded the carious tooth and extended far into the antrum, the authors present some fundamental ideas of the pathogeny, clinical picture, therapy and morphology.