1
|
Schnabel KP, Lörwald AC, Beltraminelli H, Germano M, Brem BG, Wüst S, Bauer D. Development and evaluation of three-dimensional transfers to depict skin conditions in simulation-based education. GMS JOURNAL FOR MEDICAL EDUCATION 2024; 41:Doc14. [PMID: 38779694 PMCID: PMC11106571 DOI: 10.3205/zma001669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/20/2023] [Accepted: 02/09/2024] [Indexed: 05/25/2024]
Abstract
Modern medical moulages are becoming increasingly important in simulation-based health professions education. Their lifelikeness is important so that simulation engagement is not disrupted while their standardization is crucial in high-stakes exams. This report describes in detail how three-dimensional transfers are developed and produced so that educators will be able to develop their own. In addition, evaluation findings and lessons learnt from deploying transfers in summative assessments are shared. Step-by-step instructions are given for the creation and application of transfers, including materials and photographic visualizations. We also examined feedback on 10 exam stations (out of a total of 81) with self-developed three-dimensional transfers and complement this with additional lessons learnt. By the time of submission, the authors successfully developed and deployed over 40 different three-dimensional transfers representing different clinical findings in high-stakes exams using the techniques explained in this article or variations thereof. Feedback from students and examiners after completing the OSCE is predominantly positive, with lifelikeness being the quality most often commented upon. Caveats derived from feedback and own experiences are included. The step-by-step approach reported can be adapted and replicated by healthcare educators to build their own three-dimensional transfers. This should widen the scope and the lifelikeness of their simulations. At the same time we propose that this level of lifelikeness should be expected by learners as not to disrupt simulation engagement. Our evaluation of their use in high-stakes assessments suggests they are both useful and accepted.
Collapse
Affiliation(s)
- Kai Philipp Schnabel
- University of Bern, Faculty of Medicine, Institute for Medical Education, Bern, Switzerland
| | - Andrea Carolin Lörwald
- University of Bern, Faculty of Medicine, Institute for Medical Education, Bern, Switzerland
| | - Helmut Beltraminelli
- Inselspital, Bern University Hospital, University of Bern, Department of Dermatology, Bern, Switzerland
- Università della Svizzera Italiana (USI), Department of Dermatology, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
| | - Miria Germano
- University of Bern, Faculty of Medicine, Institute for Medical Education, Bern, Switzerland
| | - Beate Gabriele Brem
- University of Bern, Faculty of Medicine, Institute for Medical Education, Bern, Switzerland
| | - Sandra Wüst
- University of Bern, Faculty of Medicine, Institute for Medical Education, Bern, Switzerland
- University of Bern, Faculty of Medicine, Institute of Primary Health Care, Bern, Switzerland
| | - Daniel Bauer
- University of Bern, Faculty of Medicine, Institute for Medical Education, Bern, Switzerland
| |
Collapse
|
2
|
Steglich J, Hempel L, Jaspers S, Stoevesandt D, Weber M, Kunze C, Weihrauch-Blüher S, Kühnöl C, Woydt L. [Using simulated patients to test competency in child protection medicine in the third section of the medical examination]. Monatsschr Kinderheilkd 2022:1-5. [PMID: 36589716 PMCID: PMC9795424 DOI: 10.1007/s00112-022-01674-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/15/2022] [Indexed: 12/30/2022]
Abstract
During the COVID-19 pandemic, the third section of the medical examination could be performed with simulation patients. Simulations enable standardized examinations of medical competency according to the educational objectives of the national learning objectives catalogue. The evaluation of student's medical response to child abuse and neglect seems to be an appropriate opportunity to increase attention of prospective physicians for potential child abuse. The presented case reports the simulation of a pediatric nonaccidental trauma.
Collapse
Affiliation(s)
- Jonas Steglich
- Dorothea Erxleben Lernzentrum, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 12, 06112 Halle (Saale), Deutschland
| | - Linn Hempel
- Dorothea Erxleben Lernzentrum, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 12, 06112 Halle (Saale), Deutschland
| | - Susanna Jaspers
- Dorothea Erxleben Lernzentrum, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 12, 06112 Halle (Saale), Deutschland
| | - Dietrich Stoevesandt
- Dorothea Erxleben Lernzentrum, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 12, 06112 Halle (Saale), Deutschland
| | - Marko Weber
- Institut für Rechtsmedizin, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Christian Kunze
- Universitätsklinik und Poliklinik für Radiologie, Universitätsklinikum Halle, Halle (Saale), Deutschland
| | - Susann Weihrauch-Blüher
- Universitätsklinik und Poliklinik für Pädiatrie I, Universitätsklinikum Halle, Halle (Saale), Deutschland
| | - Caspar Kühnöl
- Universitätsklinik und Poliklinik für Pädiatrie I, Universitätsklinikum Halle, Halle (Saale), Deutschland
| | - Lina Woydt
- Institut für Rechtsmedizin, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| |
Collapse
|
3
|
Cartledge S, Ward D, Stack R, Terry E. Adaptations in clinical examinations of medical students in response to the COVID-19 pandemic: a systematic review. BMC MEDICAL EDUCATION 2022; 22:607. [PMID: 35932046 PMCID: PMC9356416 DOI: 10.1186/s12909-022-03662-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 06/27/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Clinical examinations (assessments) are integral to ensuring that medical students can treat patients safely and effectively. The COVID-19 pandemic disrupted traditional formats of clinical examinations. This prompted Medical Schools to adapt their approaches to conducting these examinations to make them suitable for delivery in the pandemic. This systematic review aims to identify the approaches that Medical Schools, internationally, adopted in adapting their clinical examinations of medical students in response to the COVID-19 pandemic. METHODS Three databases and four key medical education journals were systematically searched up to 22 October 2021; a grey literature search was also undertaken. Two reviewers independently screened at title, abstract stage and full text stage against predefined eligibility criteria. Discrepancies were resolved by discussion and involvement of senior authors. Risk of bias assessment was performed using an adapted version of a pre-existing risk of bias assessment tool for medical education developments. Results were summarised in a narrative synthesis. RESULTS A total of 36 studies were included, which documented the approaches of 48 Medical Schools in 17 countries. Approaches were categorised into in-person clinical examinations (22 studies) or online clinical examinations (14 studies). Authors of studies reporting in-person clinical examinations described deploying enhanced infection control measures along with modified patient participation. Authors of studies reporting online clinical examinations described using online software to create online examination circuits. All authors reported that adapted examinations were feasible, scores were comparable to previous years' student cohorts, and participant feedback was positive. Risk of bias assessment highlighted heterogeneity in reporting of the clinical examinations. CONCLUSIONS This review identified two broad approaches to adapting clinical examinations in the pandemic: in-person and online. Authors reported it was feasible to conduct clinical examinations in the pandemic where medical educators are given sufficient time and resources to carefully plan and introduce suitable adaptations. However, the risk of bias assessment identified few studies with high reporting quality, which highlights the need for a common framework for reporting of medical education developments to enhance reproducibility across wider contexts. Our review provides medical educators with the opportunity to reflect on past practises and facilitate the design and planning of future examinations.
Collapse
Affiliation(s)
| | - Derek Ward
- University of Birmingham, Birmingham, B15 2TT, UK
| | | | - Emily Terry
- University of Birmingham, Birmingham, B15 2TT, UK
| |
Collapse
|
4
|
[New approbation regulations-new concepts in urological undergraduate training?]. Urologe A 2021; 60:1006-1012. [PMID: 34228143 DOI: 10.1007/s00120-021-01559-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2021] [Indexed: 10/20/2022]
Abstract
New research findings, changing health care structures and digitalisation are prompting further development of medical studies in Germany. The current amendment of the approbation regulations ("Ärztliche Approbationsordnung") focuses on the promotion of practical relevance and competence orientation of the course content and examinations, the redesign of the practical year and the expansion of general medicine in medical studies. This creates opportunities and challenges for urological training at the undergraduate level in Germany. In order to integrate basic scientific and clinical content, the existing curricula of the medical faculties must be adapted and further developed. There is an opportunity to implement innovative teaching and examination concepts in urological teaching and to attract the next generation of academics via scientific work in urology. In addition, the inclusion of teaching hospitals and outpatient areas can support university hospitals in urological training and show students the full range of the specialty. At the same time, given the limited time available for medical studies, there is the challenge of ensuring sufficient space for urology in the curricula. In order to fully implement the upcoming reform of medical studies, adequate financial and human resources are needed, as well as active commitment on the part of the teaching staff at the medical faculties.
Collapse
|
5
|
Bauer D, Lörwald AC, Wüst S, Beltraminelli H, Germano M, Michel A, Schnabel KP. Development, production and evaluation of 2-dimensional transfer tattoos to simulate skin conditions in health professions education. BMC MEDICAL EDUCATION 2021; 21:350. [PMID: 34154591 PMCID: PMC8218469 DOI: 10.1186/s12909-021-02763-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 05/26/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Moulages can greatly extend the possibilities of simulation in teaching and assessment. Since moulages that fit an educator's exact needs are often unavailable commercially, this paper explains how 2-dimensional transfer tattoos can be independently developed, produced, and evaluated. METHODS From representative photographs of the specific skin condition an analogue copy of the pathological finding is drawn. Once validated by the medical expert, it can be digitized by scanning and processed using graphics software. The final digital image file is printed onto transfer paper. Once applied and fixed onto the intended wearer, usually a simulated patient, its authenticity can be confirmed, and further transfer tattoos can be produced. RESULTS Using this moulage technique we produced 10 different 2-dimensional transfer tattoos to date, including hematoma, Janeway lesions and splinter nails. These moulages are used in clinical skills training, formative and high-stakes summative assessment in undergraduate medical and nursing programs. CONCLUSIONS By sharing our development process for 2-dimensional transfer tattoos, health profession educators can produce their own that best fit their local educational needs. Due to their high authenticity and standardization, 2-dimensional transfer tattoos are ideal for use in high-stakes assessment.
Collapse
Affiliation(s)
- Daniel Bauer
- Institute for Medical Education; Faculty of Medicine, University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland.
| | - Andrea C Lörwald
- Institute for Medical Education; Faculty of Medicine, University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland
| | - Sandra Wüst
- Institute for Medical Education; Faculty of Medicine, University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland
| | | | - Miria Germano
- Institute for Medical Education; Faculty of Medicine, University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland
| | - Adrian Michel
- Institute for Medical Education; Faculty of Medicine, University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland
| | - Kai P Schnabel
- Institute for Medical Education; Faculty of Medicine, University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland
| |
Collapse
|