[Educational trajectory of forensic medical expert in the system of continuous medical education]

The objective of the study is to determine the possibility and the right to choose the directions of self-education and self-development by forensic medical experts within the framework of personal and professional development program in the educational trajectory formation. The materials of special and encyclopaedic literature including pedagogical and sociological sciences, as well as legal framework regulating the processes of continuing medical education have been studied. The choice of educational trajectory of forensic physician depending on personal benchmarks, self-education building and participation in educational activities has been defined.

[Russian Medical Academy of Continuing Professional Education - the leading educational institution in the country for the training of forensic medical personnel (for the 90th anniversary from the establishment of the department of forensic medicine)]

The article presents a detailed analysis of the stages of formation, development and achievements of the forensic medicine department of the Russian Medical Academy of Continuing Professional Education of the Ministry of Health of the Russian Federation, established in 1933 yr. More than 100 resident doctors and 15 PhD students have been trained in the department for 90 years. As a part of additional professional education implementation, more than 800 cycles of training courses for forensic medical and forensic experts and more than 30 cycles of professional retraining for doctors of other specialties have been carried out. More than 160 thous. specialists have been trained at the department since its establishment. Many employees of the department were directly involved in the performance of the most complicated and socially significant forensic medical examinations. The article describes the main achievements and scientific directions of the department's staff activity, directions and prospects of improving the training of forensic medical personnel in the country.

Problems in Postmortem Pathology Training

OBJECTIVE

In Turkey, autopsy performers, namely forensic medicine practitioners, are neither pathologists nor have properly received pathology training during residency in contrast to the Anglo-Saxon model of forensic medicine practices, since the current curriculum of forensic medicine residency lacks adequate training in post-mortem histopathology. Likewise, pathologists lack a specific post-mortem pathology clerkship. In this study, we intended to determine whether forensic physicians in Turkey find themselves competent in post-mortem histopathology or were adequately trained during their residencies.

MATERIAL AND METHOD

Turkish forensic medicine practitioners were administered an online questionnaire whereby self-evaluations of their histopathology knowledge and their views on histopathology training during forensic medicine residency were assessed. The 151 physicians who completed the questionnaire made up the study group.

RESULTS

It was found out that the majority of Turkish forensic medicine practitioners (85.4%) did not find the histopathology training during their residency adequate. Similarly, 85.4% of the participants indicated their incompetence in histopathological examination of post-mortem tissue of any kind, and showed their willingness for further training in pathology. 66.9% strongly agreed that post-mortem histopathology requires training that is distinct from surgical pathology. In case of providing post-mortem histopathology training within the scope of forensic medicine residency, topics such as microscopic morphology of post-mortem changes, histological changes related to injuries, and estimation of wound age are expected to be beneficial to 88.7% 83.4%, and 83.4% of the participants respectively.

CONCLUSION

The current curriculum should be revised in a way that the surgical pathology clerkship meets forensic physicians' needs, so that they can then refer more difficult, non-routine histopathological consultations to pathologists who are also well-trained in postmortem histopathology. Consideration should also be given to establishing a subspecialty training - a master's or doctoral degree programs in forensic pathology.

Indiana Sexual Assault Nurse Examiner Training Initiative: Positive Impacts for Medical Forensic Care

BACKGROUND

Indiana ranks among the highest in the nation for child abuse and neglect reports. Already facing a persistent shortage of sexual assault nurse examiners (SANEs) to serve patients across the life span, residents with medical forensic needs were often being referred to other hospitals across the state for care or simply were not receiving medical forensic examinations because of lack of access to trained examiners. The Indiana SANE Training Project was established to evaluate the forensic nursing workforce throughout Indiana and work to expand access to qualified SANEs through training and collaboration with stakeholders, with a focus on rural and underserved areas of the state.

METHODS

The Project gathered information from nurses who participated in activities during the first Project year. This information was evaluated for service gaps and ongoing training needs. The project coordinator then convened a workgroup of stakeholders and subject matter experts to evaluate and respond to the most immediate need-limited access to pediatric medical forensic providers.

RESULTS

From September 2018 to December 2019, nurses were trained by the Project ( n = 160). Of those, 86% indicated that their hospital did not provide medical forensic examinations to pediatric patients. The Pediatric SANE Intensive was launched in October 2020 and trained pediatric SANEs ( n = 28). Upon completion, participants reported 47% increase in confidence and 56% increase in competence related to caring for pediatric patients.

DISCUSSION

Statewide collaboration is a critical component of establishing a consistent approach to care, strengthening multidisciplinary partnerships, increasing access to medical forensic services across the life span and in rural and underserved areas, and promoting the Indiana Guidelines for Medical Forensic Examination of Pediatric Sexual Abuse Patients.

[History of the department of forensic medicine, named after P.A. Minakov of the medical faculty of the Pirogov Russian national research medical university]

The article is devoted to the history of the formation and development of the department of forensic medicine named after P.A. Minakov of the medical faculty of the Pirogov russian national research medical university for 115 years. Periodicity of the development of directions in the field of scientific research, the organization of teaching, expert and public activities of the Moscow school of forensic doctors and the invaluable contribution of the heads of the department in each of the periods are shown.

Shifting Sexual Assault Forensic Examiners Orientation From Prosecutorial to Patient-Centered: The Role of Training

Sexual assault forensic examiners (SAFEs) have a complex role that entails providing health care and medical forensic evidence collection. The literature indicates that there are two orientations that guide SAFEs in this role. A patient-centered orientation emphasizes attending to emotional needs, offering options, and respecting survivors' decisions, which has been linked to positive emotional outcomes. A prosecutorial orientation places emphasis on evidence collection and has been associated with providing fewer comprehensive services. SAFE training may play a pivotal role in guiding new SAFEs to adopt a patient-centered orientation. However, there is a paucity of research examining how training can bolster the adoption of this orientation. Thus, the current qualitative study explored if and how a national blended SAFE training influenced participants' adoption of a patient-centered orientation. Semistructured qualitative interviews were conducted with 64 health care professionals who participated in a national SAFE training. Utilizing analytic induction, the results suggest that the majority of participants entered the training with a prosecutorial orientation but shifted to a patient-centered orientation. Multiple elements of the training influenced this shift including (a) content that dispelled misconceptions of survivors; (b) providing explanations of how attending to survivors' well-being can lead to positive outcomes; (c) earlier placement of patient-centered content to allow instructors to explain how patient-centered care can be applied to each component of the SAFE role including the medical forensic exam; and (d) continual emphasis on patient-centered care.

A Needs Assessment and Educational Intervention Addressing the Care of Sexual Assault Patients in the Emergency Department

Emergency department (ED) providers serve as the primary point-of-contact for many survivors of sexual assault but are often ill-prepared to address their unique treatment needs. Sexual assault nurse examiners (SANEs) are therefore an important resource for training other ED providers. The objective of this project was to create a SANE-led educational intervention addressing this training gap. We achieved this objective by (a) conducting a needs assessment of ED providers' self-reported knowledge of, and comfort with, sexual assault patient care at an urban academic adult ED and, (b) using these results to create and implement a SANE-led educational intervention to improve emergency medicine residents' ability to provide sexual assault patient care. From the needs assessment survey, ED providers reported confidence in medical management but not in providing trauma-informed care, conducting forensic examinations, or understanding hospital policies or state laws. Less than half of the respondents felt confident in their ability to avoid retraumatizing sexual assault patients, and only 29% felt comfortable conducting a forensic examination. On the basis of these results, a SANE-led educational intervention was developed for emergency medicine residents, consisting of a didactic lecture, two standardized patient cases, and a forensic pelvic examination simulation. Preintervention and postintervention surveys showed an increase in respondents' self-perceived ability to avoid retraumatizing patients, comfort with conducting forensic examinations, and understanding of laws and policies. These results show the value of an interprofessional collaboration between physicians and SANEs to train ED providers on sexual assault patient care.

Severe traumatic brain injury (TBI) - a seven-year comparative study in a Department of Forensic Medicine

Deaths caused by traumatic brain injury (TBI) increase in incidence every year worldwidely, mainly in developing countries. Thus, World Health Organization (WHO) estimates that in 2020, TBI will become the third main cause of death. In our study, we evaluated the deaths caused by TBI recorded within the Institute of Forensic Medicine of Craiova, Romania, between 2011 and 2017. Therefore, according to age, the cases were divided into two groups: people aged 0-18 years old (including 18 years old) and people aged over 18 years old (a total of 1005 cases, of which 971 were adults and 34 included in the age group 0-18 years old). In both groups, most patients were males from the rural area. In adults, falling was the main legal entity of the cases, followed by car accidents (which were the most common in children). In both groups, in car accidents, most of them were pedestrians and car occupants. Various aggressions (human, animal, self-injury) were found in 94 (9.68%) of the adult cases and in four (11.76%) cases of children. Another parameter under study was the blood alcohol concentration, being observed that most of the subjects with positive blood alcohol content died from car accidents. By evaluating the Glasgow Coma Scale (GCS) score as a prognostic factor, most of the subjects presented third and fourth degree coma at admission; still, 5.14% of the adult patients who deceased had GCS score 15 at admission, death occurring probably by developing some intracranial hematomas in time. Regarding the morphology of the lesions, most patients presented various forms of cranial fractures, 185 (19.05%) adults in association with extradural hemorrhages∕hematomas, but also there were four cases with extradural hematomas without any cranial fractures. In children, there was highlighted a single case of extradural hemorrhage under the fracture line. Seventy-eight percent of the adults and 44.12% of children presented subdural hematomas associated with other meningo-cerebral lesions. Also, 83.63% of the adults and 97% of children presented brain contusions. In both groups, brain laceration was observed in approximately 50% of the cases.

Perceptions of medical students towards autopsy teaching and its significance

The importance of autopsies in medical education is multidimensional. In accordance with the existing medical curriculum in India, forensic medicine is a subject taken up during the second year of the MBBS, and undergraduate students of medicine are expected to witness a minimum of 10 autopsies during the third to fifth semesters. This research analyses the perceptions of medical students towards medico-legal autopsy teaching and its significance at one medical institution in India. A total of 450 MBBS students participated in the study and submitted their responses to the predesigned semi-structured 20-point questionnaire on autopsy viewing and its relevance in general. The obtained data were analysed statistically using SPSS software. More than 75% of students agreed that they could appreciate the actual morphology and pathological changes in the human organs. There was a positive response from 54.9% students, who affirmed that autopsy helped refresh and improve their knowledge of human anatomy. More than 60% students agreed to have gained understanding of clinical–pathological correlations and became acquainted with death certification. The majority of the students (53.6%) agreed that autopsy postings made them mentally and emotionally stronger. The present study provides useful evidence regarding the perceptions of medical students towards autopsy teaching, and intends to highlight the utility of autopsies in enhancing the knowledge of medical students and its significance in the medical education curriculum.

[The psychological recommendations on the organization of the self-directed learning among the students based at a department of forensic medicine]

The authors propose the recommendations for the organization of the self-directed learning among the students who study forensic medicine. These recommendations can be of help for the forensic medical experts involved in the continuous medical education programs.

Evaluation of a CIAP session for students in Medicine, Pediatrics module

BACKGROUND

Teaching by the Clarification, Illustration, Application and Participation of Students (CIAP) approach is a method of participatory pedagogy that helps active learning to help the learner understand and integrate the new Knowledge to be able to apply them. The objectives of this work were to describe the conduct of a CIAP session and to evaluate this method of learning among students.

METHODS

The session took place in a room in the Forensic Medicine Department of the Charles Nicolle Hospital in Tunis on April 18, 2017 for 60 minutes. Our population was made up of DCEM2 students undergoing pediatrics and neonatology at the Charles Nicolle Hospital. The chosen topic was post-infectious acute glomerulonephritis. The assessment consisted in a written test given at baseline before the teaching sessions and repeated immediately afterwards. Students were also asked to grade the quality of the teaching received.

RESULTS

In total, 13/22 students were present. Clarifications were given at the request of the students. The illustration showed capillary proliferation and extra-capillary proliferation. Clinical cases have sparked a lot of interaction. All the students participated in the session: seven of them participated actively, the other six were solicited to participate. Pre-test scores varied from 2/10 to 7/10. Post-test scores ranged from 4/10 to 10/10. The mean score for the pre-test was 4.61 ± 1.6 and, the mean score for the post-test was 8.23 ± 2.31 / 10, the difference being statistically significant (p = 0.03). For students, the choices of educational objectives were relevant and were achieved, the session was coherent with the professional reality and brought new knowledge. The majority of students felt that there was good interaction. All students were satisfied with listening to the teacher and her answers to their questions. All students reported that the CIAP session provided them with a better clarification of the theoretical course, a sufficient illustration, and enabled them to participate actively in teaching. The students reported that there was a good application of the theoretical course.

CONCLUSION

The CIAP session improved student knowledge. The students were generally satisfied with this teaching.

[The history of collaboration between the Bureau of Forensic Medical Expertise of the Moscow Health Department and the Department of Forensic Medicine of the Sechenovsky University]

This article presents the materials devoted to the long-term history of collaboration between the Bureau of Forensic Medical Expertise of the Moscow Health Department and the Department of Forensic Medicine of the Sechenovsky University. Special attention is given to the contribution made by the Department of Forensic Medicine to the scientific and practical activities, methodological and staffing support first of the Moscow forensic medical services and thereafter of the Bureau of Forensic Medical Expertise operating under the auspices of the Moscow Health Department. Simultaneously, the influence of the work of the Moscow Bureau of Forensic Medical Expertise on the development and improvement of the scientific, methodological, and pedagogical activities of the Russia's oldest Department of Forensic Medicine is overviewed. The personal contribution of the most prominent forensic medical experts and physicians of Moscow to medical science and practice is illustrated by concrete examples.

[The All-Russian forensic medicine Olympiad 'The moves toward professional skills' and its role in the overall educational process]

This article is published on the occasion of the 2^nd All-Russian forensic medicine student Olympiad. The Olympiad has been held during three years in succession and attracts attention of the students from different Universities of the Russian Federation and the former Soviet republics. The Olympiad is considered to be a highly efficient form of the intellectual leisure activities of the students; moreover, it facilitates formation of motivation for the self-education and the acquisition of the professional skills and competences envisaged by the state standards for higher education that have not yet been incorporated into the program of modern medical education adopted in the Russian Federation.

Interdisciplinary teaching and training - A medicolegal specialty

The Frankfurt model is described to exemplify the teaching and training concepts implemented at the Institute of Legal Medicine in Frankfurt am Main up to 2015. The Frankfurt model describes a comprehensive, networked teaching system aiming at an interdisciplinary training. Interdisciplinarity is a domain of forensic medicine as a broadly diversified subject related to various scientific disciplines. The importance of the medicolegal triad (research, teaching, services) rooted in the university setting, on which the success of this interdisciplinary teaching and training concept is based, is illustrated. Sufficient funding is required to maintain this medicolegal triad, and the consequences of potential reductions due to fiscal reasons are outlined.

Increasing the Accessibility of Sexual Assault Forensic Examinations: Evaluation of Texas Law SB 1191

INTRODUCTION

Texas SB 1191 was enacted in 2013 with the intent of increasing access to medical forensic examinations for sexual assault victims by requiring every hospital with an emergency department to be prepared to provide a medical forensic examination if requested by a sexual assault victim. To realize that goal, the law also required basic forensic training for medical professionals before conducting a medical forensic examination as well as a requirement that hospitals develop a "plan to train personnel on sexual assault forensic evidence collection."

METHODS

Interviews were conducted in 18 healthcare facilities (five with sexual assault nurse examiner [SANE] programs and 13 without SANE programs) in Dallas, Lubbock, and Austin to determine their awareness and compliance with SB 1191.

RESULTS

The data suggest that the law had a little effect on actual practice, and sexual assault survivors still sought a SANE program for a medical forensic examination.

DISCUSSION

Although SB 1191 is an important state level effort to make forensic examinations more readily available, it did not fully account for the challenges faced by smaller hospitals that do not see enough sexual assault victims to justify training staff to SANE standards and did not adequately address the training required by medical professionals to feel prepared to conduct a medical forensic examination.

[The problems of professional competence in the complementary professional forensic medical expertise programs of advanced training and professional requalification]

This article reports the results of the analysis of the new tendencies and normatives of the working legislation in the field of additional professional education in the speciality of «forensic medical expertise» and the application of the competency-based approach to the training of specialists in the framework of professional requalification and advanced training programs. Special attention is given to the problems of organization of the educational process and the elaboration of additional training programs based on the competency approach to the training of specialists at the Department of Forensic Medicine and Law with the professor V.N. Kryukov Course of Advanced Professional Training and Professional Requalification of Specialists at the state budgetary educational Institution of higher professional education «Altai State Medical University», Russian Ministry of Health. The study revealed the problems pertaining to the development of professional competencies in the framework of educational programs for the professional requalification and advanced training in the speciality «forensic medical expertise». The authors propose the legally substantiated approaches to the solution of these problems.

[Realization of the modern educational concept for the organization of the teaching and learning activities at the Department of Forensic Medicine of I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation]

The modern educational concept for the organization of the teaching and learning activities (continuous, free, and open education) implies the necessity for its implementation the development and introduction of the new approaches to the work with the students. This problem should be addressed based on the use of the up-to-date technologies for education of the adult subjects. Such technologies find the increasingly wider application at the Department of Forensic Medicine of the I.M. Sechenov First Moscow State Medical University. It markedly contributes to the improvement of the quality of education.

Undergraduate teaching of forensic medicine in Saudi Arabia

Medico-legal tasks are not exclusive to forensic medical experts -any physician may face medico-legal issues in his career. Hence, the practice of medicine requires education in legal issues. In Saudi Arabia, there are 30 universities with medical colleges, but we do not know how they teach undergraduate forensic medicine and medico-legal issues. The aim of this study was to discover undergraduate training courses in forensic medicine in Saudi universities. We conducted a cross-sectional study involving all colleges of medicine in Saudi Arabia. A structured, self-administered questionnaire containing 13 items relating to the undergraduate forensic medicine course was distributed. Out of a total of 30 universities, 27 universities responded. Of these 27 universities, 16 (59.26%) teach forensic medicine to undergraduate medical students, and 11 (40.74%) do not teach forensic medicine in their undergraduate curriculum. Of the 27 universities that responded, none has a department of forensic medicine. Eleven universities that do not teach forensic medicine have no forensic medicine unit/division or faculty at all. Forensic medicine belongs to the pathology department in 11 universities, while it belongs to different departments in five universities. There is variation in teaching methods, years where the course is taught and length of the course. Practical and morgue visits take place in 7/16 (43.8%) universities, while 9/16 (56.3%) universities only teach the theoretical aspects of forensic medicine. All 16 universities teach forensic medicine only to medical students and do not teach it to students in other colleges such as dentistry and nursing.

Investigation on legal problems encountered by emergency medicine physicians in Turkey

Background

Medicine is a profession that carries certain risks. One risky area of practice is the emergency department. Emergency physicians diagnose and treat a high volume of patients, and are also responsible for preparing reports for forensic cases. In this study, we aim to investigate emergency physicians’ legal-administrative problems and reveal their level of understanding on forensic cases.

Methods

An electronic questionnaire form was prepared after the approval of an ethical committee. This form was sent to the residents, specialists and academicians of emergency medicine by e-mail. The physicians were asked to fill out the form online. All the gathered data was analyzed. Descriptive statistics were presented as frequency percentages with mean and standard deviation. Chi-square tests were used to compare the groups. Correlation between number of complaint cases and age, sex, career, institution, and duration of service in emergency department were investigated. p<0.05 was considered statistically significant.

Results

294 physicians participated in the questionnaire. According to the questionnaire, 170 of the physicians were reported to the patient communication units due to medical malpractice. Mean number of compliant reports was 3.20±3.5. 29 of the physicians received administrative penalties. 42 of the physicians were judged in the court for medical malpractice. 1 physician was fined 5000 Turkish Liras as a result of these judgments.

Conclusion

We found that the number of complaint reports is negatively correlated with duration of service in emergency medicine and age. There was a significant difference between number of complaint reports and career (p<0.05). The physicians’ level of awareness on forensic cases was found to be insufficient. Lack of legislation knowledge may be an important cause of complaint reports concerning emergency physicians, who have a high load of patients. Thus, we think that increasing the frequency of post-graduate education sessions and periodical reviews might be beneficial.

Predictors of attrition for a sexual assault forensic examiner (SAFE) blended learning training program

INTRODUCTION

Participant attrition is a major concern for online continuing education health care courses. The current study sought to understand what factors predicted health care professionals completing the online component of a sexual assault forensic examiner (SAFE) blended learning training program (12-week online course and 2-day in-person clinical skills workshop).

METHODS

The study used a Web-based survey to examine participant characteristics, motivation, and external barriers that may influence training completion. Hierarchical logistic regression was utilized to examine the predictors of training completion, while the Cox proportional hazards (Cox PH) regression model helped determine the factors associated with the timing of participant attrition.

RESULTS

Results show that 79.3% of the enrolled professionals completed the online component. The study also found that clinicians who work in rural communities and those who were interested in a 2-day clinical skills workshop were more likely to complete the online course. In terms of when attrition occurred, we found that participants who were motivated by the 2-day clinical workshop, those who worked in a rural community, and participants interested in the training program because of its online nature were more likely to complete more of the online course.

DISCUSSION

Blending an online course with a brief in-person clinical component may serve as a motivator for completing an online course because it provides the opportunity to develop clinical skills while receiving immediate feedback. Participant attrition appears to be less of a concern for rural clinicians because this modality can reduce their barriers to accessing continuing education.

[Forensic medical examinations and teaching: disagreements and discussions within the Brazilian Society of Neurology, Psychiatry, and Forensic Medicine]

In order to observe the influence wielded by forensic medicine in the development of the field of psychiatry in Brazil, this research note analyzes the debates that took place from May to July 1918 within the Brazilian Society of Neurology, Psychiatry, and Forensic Medicine over the use of forensic medical examinations as course material in the study of Public Medicine at the Rio de Janeiro School of Medicine. The focus is on how the controversy unfolded within the Society and how this scientific organization influenced the institution of the theoretical and practical training of medical experts.

THE MEDICAL COLLECTIONS OF THE UNIVERSITY OF TARTU

In the year 1999, a new and modern building Biomedicum was finished addressed to preclinic subjects of the Medical Faculty of the University of Tartu; the institutions of anatomy as well as pathological anatomy and forensic medicine moved there. However; no place was planned to exhibit the collections of specimens. Many of the specimens which had so far only been used for learning purposes found their place in the Old Anatomical Theatre, in the hope that this could be transformed as a museum. The medical collections of the Medical Faculty were opened up for a broader audience in October 2005. With the support of the national programme "The collections of humanities and natural sciences", the medical study specimens, models, moulages, and literature related to them in danger of being destroyed were collected from several subdivisions and buildings of the Medical Faculty. In 2012, the medical exhibition moved to the premises of Science Centre AHHAA and in the same time a specifc educational study began to be developed.

[History of medicine by prof. Sebastian Girtlera]

Sebastian Girtler (1767-1833), who later became rector of the Jagiellonian University is known primarily as a lecturer and author of several works of forensic medicine, police attention and veterinary medicine. Not so often we hear of him as a historian of medicine, subject of Girtler's interests, which had a lot of his attention and work. This text, to a significant extent based on archival materials, seeks to reconstruct the teaching program and analyses the content and methodology of the two works directly related to past of medical sciences, which had been written by Girtler himself.

[The teaching and guiding forensic medical commission: its significance role in the educational process]

The activities of the Educational and Methodological Association (EMA) for pharmaceutical teaching in the Russian higher education institutions were renewed and updated. The Educational and Methodological Commission (EMC) on forensic medicine is an integral part of EMA. EMC was set up with an object of further developing the system of continuous professional education, implementing the federal state educational standard of the third generation, preserving and maintaing the uniform educational environment. The work of EMC in the field of forensic medicine is of primary importance for the optimization of academic activities in medical higher education institutions and research institutes training personnel for forensic medical facilities.

[Forensic medicine as the cradle of toxicology in Russia]

Modern toxicology as a science and educational subject originated from forensic medicine in the middle of the XIXth century. In the beginning, selected toxicological problems were taught in the Emperor's Medical Surgical Academy (presently S.M. Kirov Military Medical Academy, Sankt-Peterburg) and at the Medical Faculty of the Moscow University (presently I.M. Sechenov First Moscow State Medical University, Moscow). The greatest contribution to the development of toxicology was made by such outstanding scientists as professors S.A. Gromov, P.P. Pelekhin, P.P. Zablotsky-Desyatovsky, E.V. Pelikan, Ya.A. Chistovich, G.I. Blosfel'd, I.M. Sorokin, D.P. Kosorotov, A.V. Grigoriev, V.V. Andreev, A.A. Glebovich, A.N. Grigoriev, B.I. Predtechensky, V.M. Rozhkov, S.S. Vail, M.N. Lubotsky, etc. The works of these researchers predetermined the further development of toxicology in this country, its main purpose being provision of medical aid in case of poisoning and diseases of chemical etiology. Another line of toxicological research became industrial and environmental toxicology having the purpose of hygienic rating and prevention of poisoning. Nevertheless, all aspects of the multifaceted science of toxicology are related to forensic medicine as the cradle in which it originated, evolved, and turned into a self-consistent science.

[Some general problems of the involvement of the Department of Forensic Medical Expertise in the character formation of modern doctors]

The authors expound their views of the final goal of specialist training based at a medical higher education institution. They consider the essence of such notions as medical competence, knowledge, abilities, and skills of the future doctors. Moreover, the original approach is proposed to the organization and contents of the lectures, practical work, seminars, and self-guided work of the students seeking to acquire knowledge in forensic medicine and to the development of principles on which to base formation of clinical and expert thinking.

Explore and experience: mobile augmented reality for medical training

In medicine, especially in basic education, it may sometimes be inappropriate to integrate real patients into classes due to ethical issues that must be avoided. Nevertheless, the quality of medical education may suffer without the use of real cases. This is especially true of medical specialties such as legal medicine: survivors of a crime are already subjected to procedures that constitute a severe emotional burden and may cause additional distress even without the added presence of students. Using augmented reality based applications may alleviate this ethical dilemma by giving students the possibility to practice the necessary skills based on virtual but nevertheless almost realistic cases. The app "mARble®" that is presented in this paper follows this approach. The currently available learning module for legal medicine gives users an opportunity to learn about various wound patterns by virtually overlaying them on their own skin and is applicable in different learning settings. Preliminary evaluation results covering learning efficiency and emotional components of the learning process are promising. Content modules for other medical specialtiesare currently under construction.

[Ignored homicides]

Forensic medicine is a fundamental science for a good evolution of the law and a serious protection of citizens. This science is also inextricably linked to public health. As basic discipline, we consider useful to revisit homicides which escape the investigators'sagacity and especially to know the reasons of this missing. Forensic high quality depends on respect of the crime scene, through specialized training and above all the recognition of this crucial discipline in our contemporary society.

[The scoring and rating system for the estimation of the teaching efficiency in forensic medicine]

The authors developed a system of criteria for the evaluation of the results of education of forensic medical students based on the scoring and rating scale. The major requirements for the organization of academic activities are considered. It is emphasized that the compliance with these requirements is an indispensable prerequisite for the introduction of the above system in the training routine at the Department of Forensic Medicine.

[Reform of forensic autopsy in the German Code of Criminal Procedure]

The Federal Ministry of Justice has presented another proposal to rephrase the wording of Section 87 of the German Code of Criminal Procedure (StPO). The new version of Section 87 StPO is to be rejected as it would lead to a loss of institutional and professional standards. The bill is clearly influenced by a tendency towards privatisation for the benefit of a small group of specialists in forensic medicine mostly organised in limited liability companies and thus at the expense of institutes of legal medicine affiliated to universities or physicians working in the forensic service of regional courts. In the long run, this reform would not only jeopardize medicolegal research and teaching but also medical education and specialist medical training. For future severe negative consequences would have to be expected on the rule of law and legal certainty.

Is knowledge power? The effects of a victimology course on victim blaming

The current study examines the impact of a victimology course on students' perceptions of the blameworthiness of crime victims and knowledge of victimization issues. Victim-blaming attitudes among college students enrolled in a victimology course were compared with students enrolled in other courses. Results from a pretest and posttest suggest that the victimology students were significantly less likely to blame victims and these students also gained significantly more knowledge over time compared with the students who did not enroll in the course. Results from the multivariate analysis indicate that less knowledge over time and a higher propensity to blame victims at the beginning of the semester predicted more victim-blaming attitudes on the posttest. Overall, the findings suggest that knowledge of victimology significantly affects students' propensity to blame victims of crime.

[The use of the andragogic model of education at different stages of studying the "forensic medicine" discipline]

The technology of education for adult subjects, i.e. the scientifically-sound system of andragogic principles for the education of adults (both teachers and learners), is considered. Putting these principles into practice leads with a high degree of probability to the achievement of the sought goals of education. These principles as well as the andragogic educational model itself are recommended for a wider application to the system of education for senior students, junior physicians, and resident medical practitioners with a view to improving the efficacy of the educational process.