Online or face-to-face instruction? A qualitative study on the electrocardiogram course at the University of Ulm to examine why students choose a particular format

BACKGROUND

Since the introduction of the e-learning electrocardiogram (ECG) course 'ECG Online' into the curriculum at the University of Ulm, a small but relatively constant number of students have decided not to participate in the online course but to attend the face-to-face course, although the content of both courses is identical. The present study examined why students prefer one format or the other.

METHODS

In a qualitative research approach, ten medical students were questioned in a guided interview. At the time of the survey the interviewees were enrolled in the 7th to 10th semesters. Among the respondents, 2 had participated only in the face-to-face ECG course, 4 only in the online version and 4 in both the face-to-face and the online course.

RESULTS

Interestingly, the very factors associated with e-learning - and always praised as advantages of it - are viewed critically by the students. Thus, although the 24-h access to learning content was consistently evaluated positively, the unlimited availability (lack of expiry date) was not seen as conducive to learning. The lack of fixed time constraints and the attendant lack of pressure were important reasons why some of the students had discontinued the online course prematurely. A similar distinction was seen in the flexibility of location for e-learning, because the very obligation to be physically present on a particular day at a fixed time led to a higher degree of commitment to courses and a willingness to actually attend the course until the end. In addition, if the content has a high degree of perceived professional relevance face-to-face courses are preferred because they offer the possibility of direct interaction.

CONCLUSIONS

Even though the small sample size limits the generalisability of the results, our findings indicate that when developing online courses students' needs could be better met if measures were included to strengthen extrinsic and intrinsic motivation and formats were favoured that enable students to have a minimum level of personal interaction with the lecturer.

Safety of conscious sedation in electroanatomical mapping procedures and cryoballoon pulmonary vein isolation

Immobilization of patients during electrophysiological procedures, to avoid complications by patients' unexpected bodily motion, is achieved by moderate to deep conscious sedation using benzodiazepines and propofol for sedation and opioids for analgesia. Our aim was to compare respiratory and hemodynamic safety endpoints of cryoballoon pulmonary vein isolation (PVI) and electroanatomical mapping (EAM) procedures. Included patients underwent either cryoballoon PVI or EAM procedures. Sedation monitoring included non-invasive blood pressure measurements, transcutaneous oxygen saturation (tSpO₂) and transcutaneous carbon-dioxide (tpCO₂) measurements. We enrolled 125 consecutive patients, 67 patients underwent cryoballoon atrial fibrillation ablation and 58 patients had an EAM and radiofrequency ablation procedure. Mean procedure duration of EAM procedures was significantly longer (p < 0.001) and propofol doses as well as morphine equivalent doses of administered opioids were significantly higher in EAM patients compared to cryoballoon patients (p < 0.001). Cryoballoon patients display higher tpCO₂ levels compared to EAM patients at 30 min (cryoballoon: 51.1 ± 7.0 mmHg vs. EAM: 48.6 ± 6.2 mmHg, p = 0.009) and at 60 min (cryoballoon: 51.4 ± 7.3 mmHg vs. EAM: 48.9 ± 6.6 mmHg, p = 0.07) procedure duration. Mean arterial pressure was significantly higher after 60 min (cryoballoon: 84.7 ± 16.7 mmHg vs. EAM: 76.7 ± 13.3 mmHg, p = 0.017) in cryoballoon PVI compared to EAM procedures. Regarding respiratory and hemodynamic safety endpoints, no significant difference was detected regarding hypercapnia, hypoxia and episodes of hypotension. Despite longer procedure duration and deeper sedation requirement, conscious sedation in EAM procedures appears to be as safe as conscious sedation in cryoballoon ablation procedures regarding hemodynamic and respiratory safety endpoints.

Cluster-randomized Studies in Educational Research: Principles and Methodological Aspects

An increasing number of studies are being performed in educational research to evaluate new teaching methods and approaches. These studies could be performed more efficiently and deliver more convincing results if they more strictly applied and complied with recognized standards of scientific studies. Such an approach could substantially increase the quality in particular of prospective, two-arm (intervention) studies that aim to compare two different teaching methods. A key standard in such studies is randomization, which can minimize systematic bias in study findings; such bias may result if the two study arms are not structurally equivalent. If possible, educational research studies should also achieve this standard, although this is not yet generally the case. Some difficulties and concerns exist, particularly regarding organizational and methodological aspects. An important point to consider in educational research studies is that usually individuals cannot be randomized, because of the teaching situation, and instead whole groups have to be randomized (so-called "cluster randomization"). Compared with studies with individual randomization, studies with cluster randomization normally require (significantly) larger sample sizes and more complex methods for calculating sample size. Furthermore, cluster-randomized studies require more complex methods for statistical analysis. The consequence of the above is that a competent expert with respective special knowledge needs to be involved in all phases of cluster-randomized studies. Studies to evaluate new teaching methods need to make greater use of randomization in order to achieve scientifically convincing results. Therefore, in this article we describe the general principles of cluster randomization and how to implement these principles, and we also outline practical aspects of using cluster randomization in prospective, two-arm comparative educational research studies.

Did video kill the XR star? Digital trends in medical education before and after the COVID-19 outbreak from the perspective of students and lecturers from the faculty of medicine at the University of Ulm

Aim: Using a comparison of digital teaching in medicine before and after the COVID-19 outbreak, the aim of the study was to examine how ad hoc digitization has changed (1) the design of digital teaching, (2) the attitudes toward and the capabilities of digital teaching and learning and (3) the future importance of individual digital teaching elements. Methods: Students and lecturers from the Medical Faculty of Ulm were asked to voluntarily participate in online surveys during the summer semesters of 2019 and 2020. The data was subsequently analyzed from a longitudinal and cross-sectional view descriptively as well as by using t-tests and Chi2-tests. In addition, using regression analyses, the results were controlled for associations with age, study progress, and media affinity. Results: In the summer semester 2019, 163 students (6.1% response rate) and 56 lecturers (11.5%) participated in the surveys. In the following year, the participation increased to 285 students (10.4%) and 64 lecturers (12.8%). Video-based teaching elements such as videoconferencing and lecture recordings were increasingly used after the COVID-19 outbreak and considered more significant for future teaching. In contrast, virtual reality, augmented reality and 360°-videos, grouped under the term extended reality (XR), are descriptively becoming less important. Most lecturers would like to teach more digitally even after the pandemic but fear a decrease in learning effectiveness and contact with students, who tend to prefer asynchronous learning opportunities. Conclusion: Video-based teaching elements proved to be a low-threshold and time-efficient solution during the lockdown and were also recommended for future use. The XR technology has been put on the back burner for the time being, but in view of the increased digital teaching motivation and capabilities, it can be assumed that lecturers will recognize and use the potential of XR as soon as they have the freedom to design innovative teaching again.

Implementation and sex-specific analysis of students' attitudes toward a longitudinal, gender-specific medical curriculum - a pilot study

BACKGROUND

Gender medicine has gained importance over the past 20 years. Nevertheless, the scientific findings concerning gender- and sex-specific patient care have not been sufficiently integrated into the education of physicians. It was therefore our aim, against initial resistance in our school, to integrate clinically relevant aspects of gender medicine into the existing medical curriculum. This paper describes the implementation process of a lecture-based interdisciplinary, longitudinal, basic gender curriculum and evaluates students' attitudes in relation to sex and semester level.

METHODS

The curriculum encompasses 15 lecture sessions scheduled in years 1 through 5 of the medical curriculum at Ulm University, Germany. Prospectively gathered evaluation data of two cross-sectional analyses of this basic curriculum in the first and fifth semesters are analyzed by sex.

RESULTS

More than 80% of the students have registered for this new curriculum. Evaluation data show a predominantly positive (75.5%) student response; however, only about half of those surveyed indicated that they had learned new material or judged the content on gender to be relevant to their practice of medicine. Students at a more advanced semester level (88.2% vs. 55.2%) and male participants more than female participants (36.7% vs. 62.4%) showed lower acceptance.

DISCUSSION

It was possible to integrate gender issues into the existing medical student curriculum. Despite the overall positive rating, our evaluation data identified the aspects of rejection and resistance in some students, particularly male and more advanced students. Further studies on the development of student attitudes toward gender issues are needed.

Effects and sustainability of trainings for the oral and practical part of the German final exam in medicine

Study Goals: It is known that the manifold limitations of oral and practical examinations can be improved by specific training. With the help of an online survey, our present study analyzes the effects that can be achieved by the training conducted at the University of Ulm for examiners in the final medical examination, the long-lasting impact of the training, and differences among participant subgroups.

Method: All 367 participants in the training at Ulm (2007- 2012) were contacted via email. Sixty-three persons responded to the survey that included 28 items concerning demographic data, effectiveness, and sustainability.

Results: Six main effects of the training were identified (meaning effects rated with a grade of 1 or 2 on a 6-point scale by two thirds of the participants, with 1=“applicable” and 6=“not applicable”; cumulated percentage of answers of 1 or 2 in parentheses):

Conscious handling of strengths and weaknesses of oral examinations (71%),

Knowledge of factors contributing to the reliability of oral/practical examinations (76%),

Knowledge of factors contributing to the validity of oral/practical examinations (75%),

Improvement of competence in task construction (68%),

Improvement of competence in respect to examination formalities (75%),

Implementation of the concept of “structured oral examinations” (a priori planning of examination subjects, tasks, levels of expectation and grading criteria) (86%).

The responses of participants trained more than two years ago were not significantly different from the answers given by recently trained persons. This is an argument for the sustainability of the training effects.

Furthermore, participants without relevant prior experience in oral/practical examinations profited significantly more from the trainings, especially in the areas of stress reduction, confidence in grading, and competence in critical discrimination of grading.

Conclusion: The positive and sustained effects of the examiner training argue for continuing the training program, especially for inexperienced examiners. Expansion of the successful training program to include the first medical exam should be considered.

[Augmented Reality in Ophthalmology: Technical Innovation Complements Education for Medical Students]

BACKGROUND

At the Medical Faculty of the University of Ulm, the learning objectives of ophthalmology are taught to students in a one-week block course in the fourth year of study. According to the National Competency-based Learning Objective Catalogue Medicine (NKLM), one of these learning objectives is the clinical examination of the eye, including the eye fundus examination. In order to best train this expertise as defined in the NKLM, a novel, augmented reality-based training simulator (Eyesi Indirect, VRmagic Holding AG, Mannheim, Germany) was integrated into the teaching at the University Eye Hospital Ulm. During the block week, two key questions were examined: Does the one week block lesson increase interest in ophthalmology? How do students assess the use of an innovative e-learning technology compared to three other classical teaching methods for learning ophthalmoscopy?

MATERIAL/METHODS

As part of the student teaching (block weeks July and October 2016), 292 students were questioned by questionnaire anonymously and on a voluntary basis regarding their assessment of the block week and the training simulator at the beginning and end of the one week event. The ophthalmoscopies were classically practiced on the ophthalmoscope trainer, head model and on fellow students and then performed on the new training simulator.

RESULTS

Overall, there was little interest among the students in ophthalmology. However, the block week helped to increase interest (p < 0.001). The assessments of attractiveness before and after the block week of ophthalmology as a later professional goal and as an optional subject in the practical year were also significantly increased (p < 0.001 or p = 0.031). With regard to the use of e-learning technologies, it was shown that the handling of the simulator for learning ophthalmoscopy was rated more attractive by the students than the classical technology-based teaching methods (all p < 0.01). The joy of learning could only be further increased by practicing on a fellow student (p = 0.051).

CONCLUSION

The results of the present study show a positive impact of the block week on the attractiveness assessment of the specialty by the participating students. Innovative e-learning methods can increase the enjoyment of learning. However, the training simulator cannot provide a complete replacement of the training on a real person.

How do German medical students perceive role models during clinical placements ("Famulatur")? An empirical study

BACKGROUND

Studies have demonstrated the importance of role models in medical education. Medical students in Germany participate in clinical placements ("Famulatur") that last 4 months in total and represent the first real-world setting where students encounter possible role models in their clinical education. These placements are an extracurricular activity, however, and regarded as the "black box" of medical education. This study aimed to evaluate whether and how students experience role models during clinical placements, the qualities associated with potential role models and whether role model-related learning gains are relevant.

METHODS

We recruited 96 students (mean age: 23.83 years; 75% female) in their 5th to 9th semesters at the Faculty of Medicine at the University of Ulm, Germany, who were participating in a clinical placement between July and October 2015. Participants completed a questionnaire at the beginning of a 5-day working week to record sociodemographic and other information and another one at the end of the week to assess various aspects of their experiences. On each of the 5 days, they completed a structured questionnaire to record their perceived role models and self-assessed learning gains.

RESULTS

Role models and role modelling play an important role in clinical placements. The positive function of medical staff as role models predominated (88.4%) across all specialties. Junior doctors were the most frequently perceived role models (28.5%), followed by consultants (25.1%) and nursing staff (22.4%). The most commonly perceived positive quality was the interaction with students (16.5%), followed by team behaviour (13.6%), interaction with patients (13.6%) and professional expertise (13.4%). Students also had various kinds of learning gains such as knowledge or skills.

CONCLUSIONS

Although these clinical placements are extracurricular activities in Germany and their content is not regulated, they are home to a relevant amount of role modelling. Students experience the various medical professions in different roles and in a range of tasks and interactions. Defining basic learning objectives could help to increase the relevance of these placements for the medical curriculum in Germany and transfer the associated learning gains from the hidden to the open curriculum.

Gender-Specific Differences in Sedation-Associated Outcomes During Complex Electrophysiological Procedures

Background: Interventional electrophysiology is a rapidly advancing field, with sedation essential for patient comfort and immobility during complex electrophysiological procedures (EPS). However, sedatives and analgesics can cause respiratory depression and hypotension. Gender-specific differences (GDs) are often overlooked in medical research, as protocols and dosages are typically based on male subjects, potentially compromising treatment safety and efficacy for women. This study examines GDs in CO2 levels, respiratory rate, arterial blood pressure (ABP), and anesthetic requirements during deep sedation for EPS. Methods: This prospective study at Ulm University Heart Center included 702 patients (405 men and 297 women) treated under deep sedation between August 2019 and October 2023. Standard monitoring included an electrocardiogram (ECG) with heart rate, non-invasive ABP, oxygen saturation (SpO2), and a frequent venous blood gas analysis (vBGA). The primary composite endpoint was GDs in SpO2 dips below 90% and pathological vBGA changes. Results: The primary composite endpoint was reached by 177 women (59.6%) and 213 men (52.6%), showing no significant difference (p = 0.102). Women had a 1,6-fold higher risk of experiencing SpO2 dips below 90% (p = 0.001). Additionally, women had 1.7 times higher hypoxia rates (p < 0.001) and were 1.5 times more likely to have a mean ABP below 65 mmHg (p < 0.001). On average, they received 65.3 mg less total propofol than men (p = 0.005) and a higher midazolam dose per kilogram of body weight (p < 0.001). Conclusions: Although the primary composite endpoint showed no significant GDs, secondary outcomes highlight the need to consider gender-specific sedation adjustments, particularly for women. This study underscores the need for personalized sedation management and patient monitoring regarding GDs.

FAMULATUR PLUS - A successful model for improving students' physical examination skills?

Introduction/Project description: Several studies have revealed insufficient physical examination skills among medical students, both with regard to the completeness of the physical examination and the accuracy of the techniques used. FAMULATUR PLUS was developed in response to these findings. As part of this practice-oriented instructional intervention, physical examination skills should be taught through examination seminars and problem-oriented learning approaches. In order to ensure practical relevance, all courses are integrated into a 30-day clinical traineeship in the surgery or internal medicine department of a hospital (FAMULATUR PLUS). Research question: Does participation in the FAMULATUR PLUS project lead to a more optimistic self-assessment of examination skills and/or improved performance of the physical examination? Methodology: A total of 49 medical students participated in the study. The inclusion criteria were as follows: enrollment in the clinical studies element of their degree program at the University of Ulm and completion of the university course in internal medicine examinations. Based on their personal preferences, students were assigned to either the intervention (surgery/internal medicine; n=24) or the control group (internal medicine; n=25). All students completed a self-assessment of their physical examination skills in the form of a questionnaire. However, practical examination skills were only assessed in the students in the intervention group. These students were asked to carry out a general physical examination of the simulation patient, which was recorded and evaluated in a standardized manner. In both instances, data collection was carried out prior to and after the intervention. Results: The scores arising from the student self-assessment in the intervention (IG) and control groups (CG) improves significantly in the pre-post comparison, with average scores increasing from 3.83 (±0.72; IG) and 3.54 (±0.37; CG) to 1.92 (±0.65; IG) and 3.23 (±0.73; CG). The general physical examination, which was only assessed among the students in the intervention group, was performed more completely after the instructional intervention than prior to it. Discussion: On the basis of the data collected, it can be deduced that the FAMULATUR PLUS course has a positive effect on the self-assessment of medical students with regard to their physical examination skills. The validity of this conclusion is limited by the small sample size. In addition, it remains unclear whether a more positive self-assessment correlates with an objective improvement in physical examination skills.

[To what extent do reviewers of multiple-choice questions need to be trained? A comparison between handing out information sheets and brief workshop sessions]

BACKGROUND

A competent review process is crucial to ensure the quality of multiple-choice (MC) questions. However, the acquisition of reviewing skills should not cause any unnecessary additional burden for a medical staff that is already facing heavy workloads.

METHODS

100 MC questions, for which an expert review existed, were presented to 12 novices. In advance, six participants received a specific information sheet covering critical information for high-calibre review; the other six participants attended a 2.5-hour workshop covering the same information. The review results of both groups were analysed with a licensed version of the IBM software SPSS 19.0 (SPSS Inc., Chicago, IL).

RESULTS

The results of the workshop group were distinctly closer to the experts' results (gold standard) than those of the information sheet group. For the quantitatively important category of medium quality MC questions, the results of the workshop group did not significantly differ from the experts' results. In the information sheet group the results were significantly poorer than the experts', regardless of the quality of the questions.

CONCLUSIONS

Distributing specific information sheets to MC question reviewers is not sufficient for ensuring the quality of the review so that - regardless of the increased effort involved - a recommendation to conduct specific workshops must be made.

The FAMULATUR PLUS as an innovative approach for teaching physical examination skills

The FAMULATUR PLUS is an innovative approach to teaching physical examination skills. The concept is aimed at medical students during the clinical part of their studies and includes a clinical traineeship (English for "Famulatur") extended to include various courses ("PLUS"). The courses are divided into clinical examination courses and problembased-learning (PBL) seminars. The concept's special feature is the full integration of these courses into a 30-day hospital traineeship. The aim is to facilitate the transfer of knowledge from the courses into daily practice. Each week of the FAMULATUR PLUS is structured in line with the courses and focuses on a particular part of the body (e.g., abdomen). A physical examination course under the supervision of a physician is offered at the beginning of the week. Here, medical students learn the relevant examination techniques by practicing on each other (partner exercises). Subsequently, the techniques taught are applied independently during everyday work on the ward, corrected by the supervisor, if necessary, and thereby reinforced. The final POL seminar takes place towards the end of the week. Possible differential diagnoses are developed based on a clinical case study. The goal is to check these by taking a fictitious medical history and performing a physical examination, as well as to make a preliminary diagnosis. Finally, during the PBL seminar, medical students will be shown how physical examination techniques can be efficiently applied in the diagnosis of common cardinal symptoms (e.g., abdominal pain). The initial implementation of the FAMULATUR PLUS proved the practical feasibility of the concept. In addition, the accompanying evaluation showed that the participants of the pilot project improved with regard to their practical physical examination skills.

Student experiences of professionalism and role models in an oral and maxillofacial surgery internship: A qualitative study

INTRODUCTION

Dental students have a clear concept of professionalism and the importance of role models. Our aim was to determine how dental students experience their first oral and maxillofacial surgery internship in terms of their concept of professionalism and their perception of role models.

METHODS

From June to August 2020, semi-structured telephone interviews were conducted with 22 dental students in their eighth and ninth semesters at the Medical Faculty of the University of Ulm. The interviews were transcribed and evaluated by qualitative content analysis according to Mayring.

RESULTS

The students' concept of dental professionalism was shaped by the elements of a good approach to patients, professional competence, and manual skills. This perception was not changed by the internship. Having a role model was seen as an important learning strategy, and role models were perceived in both positive and negative ways. Role models were perceived as positive if they corresponded to the student's concept of professionalism and as negative if they did not correspond to this concept, especially with regard to social interaction or the approach to patients. Students' reactions to discrepancies between their own moral values and the role models' behaviour were characterised by passivity and withdrawal. With regard to potential future careers, positive internship experiences supported student goals, whereas negative experiences raised doubts about them.

CONCLUSION

Supervising dentists may still underestimate the considerable impact of internships, and their awareness of this impact needs to be increased. Students' reactions to conflicts between reality and their own values do not appear to be constructive. One approach to solving this problem may be to include discussions of professional development in curricula.

Virtual reality against Zoom fatigue? A field study on the teaching and learning experience in interactive video and VR conferencing

Aim

During the COVID-19 pandemic, the absence of in-person teaching was partially compensated for through videoconferencing. However, lecturers complain that students do not participate actively in video-based online seminars. One reason cited for this is Zoom fatigue. Conferences in virtual reality (VR), accessible with and without head-mounted display, represent one potential remedy to this issue. The research to date does not shed any light on the (1.) teaching experience, (2.) student demand, (3.) learning experience (including participation and social presence), and (4.) learning performance (declarative and spatial) associated with VR conferences. The present work will compare these aspects for videoconferencing, independent study, and - in the case of teaching experience - with in-person teaching.

Methods

A compulsory seminar in General Physiology was offered during the 2020/21 winter semester and the 2021 summer semester as part of the Human Medicine program at the Faculty of Medicine at Ulm University. The seminars were offered in three different formats with identical content: (a) VR conference, (b) video conference, and (c) independent study, with students selecting the format of their choice. In the VR conferences, the lecturer taught using a head-mounted display while students participated via PC, laptop, or tablet. The learning experience and learning performance were assessed using questionnaires and a knowledge test. A semi-structured interview was conducted to assess the VR teaching experience.

Results

The lecturer's teaching experience in the VR conferences was similar to in-person teaching. Students predominantly chose independent study and videoconferencing. The latter resulted in worse outcomes with regard to learning experience (including participation and social presence) and spatial learning performance than the VR conferences. Declarative learning performance differed only slightly between teaching formats.

Conclusions

VR conferencing offers lecturers new didactic opportunities and a teaching experience similar to that of in-person teaching. Students prefer time-efficient videoconferencing and independent study, but rate participation and social presence, among other things, higher in VR conferencing. If faculty and students are open to the technology, VR conferencing can promote interactive exchange in online seminars. This subjective assessment is not associated with better declarative learning performance.

Prospective randomized evaluation of transcutaneous carbon dioxide monitoring during complex electrophysiological procedures under deep sedation: the TRACES trial

BACKGROUND

The field of interventional electrophysiology is rapidly growing. For safe and efficient procedures sedation is needed for patient comfort and immobility. However, sedative and analgesic agents can induce respiratory depression, risking hypercapnia, hypoxia, and hypotension. This study evaluates the impact of adding transcutaneous carbon-dioxide (CO2) monitoring to standard monitoring practices in electrophysiological procedures under deep sedation.

METHODS

This prospective, randomized study at Ulm University Heart Center included 726 patients undergoing treatment under deep sedation between August 2019 and October 2023. Patients were randomly assigned to standard monitoring or standard monitoring with continuous transcutaneous CO2 monitoring (TCM-group). Standard monitoring involved non-invasive blood pressure, oxygen saturation (SpO2), and frequent peripheral venous blood gas analysis. The primary composite endpoint was SpO2 dips below 90% and pathological changes in venous blood gas analysis.

RESULTS

The TCM-group included 357 patients, and the standard group had 348. The primary composite endpoint was reached by 195 patients (54.8%) in the TCM-group and 195 patients (56.5%) in the standard group (p = 0.642). However, peripheral venous CO2 partial pressure increased by more than 30% from baseline more often in the standard group than in the TCM-group (p = 0.005). Additionally, a venous pH below 7.25 was more common in the standard group (p = 0.047).

CONCLUSION

While transcutaneous CO2 monitoring offers no significant benefit for the primary combined endpoint over standard monitoring during electrophysiological procedures, it helps mitigate significant CO2 elevations and respiratory acidosis.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov, NCT04038476, 29 July 2019.

Understanding of professionalism among medical students in the first year of the COVID-19 pandemic - a qualitative monocentric study

Objective

The existing literature indicates that medical students' understanding of professionalism is influenced by internal and external factors. Therefore, this study aimed to evaluate whether the early phase of the pandemic affected the understanding of professionalism among medical students at the University of Ulm.

Methods

In May and June 2020, semi-structured telephone interviews were conducted with 21 students (in the 8^th and 9^th semester) at the Medical Faculty of the University of Ulm. The interviews were transcribed and analyzed by a qualitative content analysis according to Mayring.

Results

The results showed shifts in students' perception of the importance of certain aspects of medical professionalism. Not only competency in the disciplines hygiene, virology, and microbiology came to the fore, but also personal qualities such as "radiating a sense of calm", empathy, and altruism; communicative competency; and the capacity for reflection. The students also perceived changes in the expectations placed on them. More emphasis was placed on their roles as scientific or medical advisors and as helpers in the health care system, a change that was sometimes emotionally stressful. With respect to the study objective, both limiting and supporting factors were named. For example, the clarification of the relevance of the medical professional was motivating.

Conclusion

The study showed that students' understanding of professionalism depends on context, as was suggested by earlier studies in experts. The perception of changed role expectations may thereby also play a role. One consequence of the findings may be to address such dynamics in suitable curricular events and discuss them with students to prevent them proceeding in an uncontrolled manner.

Artificial Intelligence and ChatGPT in Medical Education: A Cross-Sectional Questionnaire on students' Competence

Artificial intelligence is rapidly transforming the field of health science and medical education, but less is known about the students´ competencies related to knowledge, skills and attitudes towards the application of AI tools like ChatGPT. Therefore, a unicentric questionnaire-based cross-sectional study was applied to students in the medical field (n = 207). The data revealed that while most students were familiar with ChatGPT (66.7%), other AI tools were significantly less known or utilised for study purposes. Students approached AI tools rather informally, often preferring to use them as a simple search engine. More than half of the students admitted that they were not sufficiently informed about the underlying technology of AI. They applied ChatGPT in a self-directed manner but expressed considerable uncertainty regarding effective prompt engineering and ChatGPT's legal implications. Overall, the majority of respondents showed interest in and positivity towards the introduction of AI. However, they did not feel adequately prepared to handle AI confidently, leading many to express interest in further training. This training should be directly related to students' professional roles, e.g. as a physician. The three most favoured AI-topics for voluntary learning formats were AI in their studies (62.5%), AI in general (58.0%), and the use of AI in scientific writing (57.0%). Notable subgroup differences related to the students" gender or self-assessed study performance were observed and should be considered in future research.