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Schumm M, Teufel D, Brunnhuber M, Wijnen-Meijer M, Berberat PO. Seeing with Different Eyes. The Module Life & Science of the Elite-Master Program Biomedical Neuroscience. Med Sci Educ 2024; 34:463-469. [PMID: 38686155 PMCID: PMC11055818 DOI: 10.1007/s40670-024-01992-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/18/2024] [Indexed: 05/02/2024]
Abstract
From its beginnings in 2018, the international elite-master program Biomedical Neuroscience of TUM School of Medicine and Health at Technical University of Munich was guided by two convictions: First, excellent research depends not only on the mediation of scientific knowledge and skills, but also on a multifaceted understanding of science itself. Second, teaching must recognize and support not only student's growing expertise but also their personal and professional development. To this end, the module Life & Science was designed. It gives students the opportunity to explore neuroscience from different angles to deepen the epistemological, sociological, and cultural understanding of their chosen profession.
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Affiliation(s)
- Moritz Schumm
- Technical University of Munich, TUM School of Medicine and Health – University Hospital rechts der Isar, TUM Medical Education Center (TUM MEC), Nigerstraße 3, Munich, Bavaria 81675 Germany
| | - Daniel Teufel
- Technical University of Munich, TUM School of Medicine and Health – University Hospital rechts der Isar, TUM Medical Education Center (TUM MEC), Nigerstraße 3, Munich, Bavaria 81675 Germany
| | - Michael Brunnhuber
- Technical University of Munich, TUM School of Medicine and Health – University Hospital rechts der Isar, TUM Medical Education Center (TUM MEC), Nigerstraße 3, Munich, Bavaria 81675 Germany
| | - Marjo Wijnen-Meijer
- Technical University of Munich, TUM School of Medicine and Health – University Hospital rechts der Isar, TUM Medical Education Center (TUM MEC), Nigerstraße 3, Munich, Bavaria 81675 Germany
| | - Pascal O. Berberat
- Technical University of Munich, TUM School of Medicine and Health – University Hospital rechts der Isar, TUM Medical Education Center (TUM MEC), Nigerstraße 3, Munich, Bavaria 81675 Germany
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Schick K, Reiser S, Janssen L, Schacht L, Pittroff SID, Dörfler E, Klein E, Roenneberg C, Dinkel A, Fleischmann A, Berberat PO, Bauer J, Gartmeier M. Training in medical communication competence through video-based e-learning: How effective are video modeling and video reflection? Patient Educ Couns 2024; 121:108132. [PMID: 38184987 DOI: 10.1016/j.pec.2023.108132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 12/19/2023] [Accepted: 12/27/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE The present study investigated the efficacy of the didactic approaches of video modeling (VM, best-practice examples), video reflection (VR, problem-based approach), and the combination of both (VMR) in fostering medical communication competence in a video-based digital learning environment. METHODS N = 126 third-year medical students who participated in the pre-post study were assigned to either the intervention groups (VM, VR, and VMR) or the wait-list control group. The efficacy of the three approaches was assessed by means of a situational judgment test (SJT) of medical communication competence. To investigate the differences between the wait-list control and the intervention groups (H1), between the single-mode and combined conditions (H2), and between VM and VR (H3), we applied planned contrast analyses. RESULTS The planned contrasts showed that the VR condition significantly improved learning outcomes in comparison to the VM condition (H3). The decreased mean scores of the VM condition offset the increased mean scores of VR, and thus no significant differences could be found in H1 and H2. CONCLUSIONS Our study provides promising evidence that VR fosters medical communication competence more effectively than VM. PRACTICAL IMPLICATIONS Medical students' learning in video-based digital environments can be facilitated by the use of interactive VR.
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Affiliation(s)
- Kristina Schick
- Technical University of Munich, TUM School of Medicine & Health, Department Clinical Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675 München, Germany.
| | - Sabine Reiser
- University of Erfurt, Educational Research and Methodology, Nordhäuser Str. 63, 99089 Erfurt, Germany
| | - Laura Janssen
- Technical University of Munich, TUM School of Medicine & Health, Department Clinical Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675 München, Germany
| | - Laura Schacht
- University of Erfurt, Educational Research and Methodology, Nordhäuser Str. 63, 99089 Erfurt, Germany
| | - Sylvia Irene Donata Pittroff
- Technical University of Munich, TUM School of Medicine & Health, Department Clinical Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675 München, Germany
| | - Eva Dörfler
- Technical University of Munich, TUM Institute for LifeLong Learning, TUM ProLehre, Arcisstraße 21, 80333 München, Germany
| | - Evelyn Klein
- Technical University of Munich, TUM School of Medicine & Health, Department Clinical Medicine, Klinikum rechts der Isar, Department of Obstetrics and Gynecology, Ismaninger Straße 22, 81675 München, Germany
| | - Casper Roenneberg
- Technical University of Munich, TUM School of Medicine & Health, Department Clinical Medicine, Klinikum rechts der Isar, Department of Psychosomatic Medicine and Psychotherapy, Langerstr. 3, 81675 München, Germany
| | - Andreas Dinkel
- Technical University of Munich, TUM School of Medicine & Health, Department Clinical Medicine, Klinikum rechts der Isar, Department of Psychosomatic Medicine and Psychotherapy, Langerstr. 3, 81675 München, Germany
| | - Andreas Fleischmann
- Technical University of Munich, TUM Institute for LifeLong Learning, TUM ProLehre, Arcisstraße 21, 80333 München, Germany
| | - Pascal O Berberat
- Technical University of Munich, TUM School of Medicine & Health, Department Clinical Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675 München, Germany
| | - Johannes Bauer
- University of Erfurt, Educational Research and Methodology, Nordhäuser Str. 63, 99089 Erfurt, Germany
| | - Martin Gartmeier
- Technical University of Munich, TUM School of Medicine & Health, Department Clinical Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675 München, Germany
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Blaschke AL, Hapfelmeier A, Rubisch HPK, Berberat PO, Gartmeier M. Structure and quality of bedside teaching: A videographic analysis. Med Teach 2023:1-9. [PMID: 38110186 DOI: 10.1080/0142159x.2023.2289860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 11/28/2023] [Indexed: 12/20/2023]
Abstract
Bedside teaching (BST) is a core element of medical education. In light of a reported decrease in BST, evidence on how to use BST time most efficiently should be developed. Given that little research into the tangible quality characteristics of good BST has been reported, we investigated the influence of various teacher and structural characteristics on the perceived quality of BST. We filmed and coded 36 BSTs involving 24 lecturers and 259 students. Structural characteristics of interest were: number of students and patients, overall duration, and the proportion of clinical examination. Lecturer questionnaires provided insight into teaching experience and intrinsic motivation, and student evaluations assessed the quality of BSTs in three dimensions. Correlations are reported using the Pearson r and a linear mixed model (LMM). The intrinsic motivation of lecturers was significantly positively correlated with perceived quality, but their experience was only weakly so correlated. In the LMM, a significant association was observed for the quality dimension of clinical teaching with the number of patients and the proportion of time spent on clinical examination. Based on our findings, we recommend including multiple patients in BSTs, and providing substantial opportunities for clinical examination. Regarding lecturers, motivation matters more than experience.
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Affiliation(s)
- Anna-Lena Blaschke
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Alexander Hapfelmeier
- Institute of AI and Informatics in Medicine, School of Medicine, Technical University of Munich, Munich, Germany
- Institute of General Practice and Health Services Research, School of Medicine, Technical University of Munich, Munich, Germany
| | - Hannah P K Rubisch
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Pascal O Berberat
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Martin Gartmeier
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Munich, Germany
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Sapoutzis N, Schneider A, Brandhuber T, Berberat PO, Wijnen-Meijer M. Development and internal validation of an instrument to measure the motivation of residents for family medicine. Eur J Gen Pract 2023; 29:2212903. [PMID: 37227049 DOI: 10.1080/13814788.2023.2212903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND For several decades, medical school graduates' motivation to specialise in family medicine is decreasing. Therefore, residents in family medicine must be motivated for the profession and finish their residency. OBJECTIVES Goal of the current study is the development and internal validation of an instrument to measure the residents' motivation for family medicine, which is based on the self-determination theory: STRength mOtivatioN General practitioner (STRONG). METHODS We used an existing instrument, the 'Strength of Motivation for Medical School,' adapted the 15 items and added a 16th item to make it suitable for residency in family medicine. After a review by experts, the questionnaire was sent to 943 residents of family medicine in Bavaria, Germany, in December 2020. An exploratory factor analysis for the STRONG item scores was carried out. The items were analysed for grouping into subscales by using principal component analysis. Cronbach's alpha for internal consistency was determined for calculating the reliability of the subscales. RESULTS After analysis, the questionnaire appeared to consist of two subscales: 'Willingness to sacrifice' (eight items, Cronbach's alpha is 0.82) and 'Persuasion' (five items, Cronbach's alpha is 0.61). The factor analysis with Promax rotation resulted in two factors explaining 39.6% of the variance. The Cronbach's alpha of the full scale is 0.73. CONCLUSION Based on the internal validation, the STRONG Instrument appears to have good reliability and internal validity, assuming a two-factor structure. This may therefore be a helpful instrument for measuring the strength of the motivation of (future) family medicine residents.
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Affiliation(s)
- Nikolaos Sapoutzis
- TUM Medical Education Center, School of Medicine, Technical University of Munich, Munich, Germany
- Public Health Department Hochtaunuskreis, Bad Homburg vor der Höhe, Germany
| | - Antonius Schneider
- School of Medicine, Institute of Family Medicine and Health Services Research, Technical University of Munich, Munich, Germany
| | - Tom Brandhuber
- School of Medicine, Institute of Family Medicine and Health Services Research, Technical University of Munich, Munich, Germany
| | - Pascal O Berberat
- TUM Medical Education Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Marjo Wijnen-Meijer
- TUM Medical Education Center, School of Medicine, Technical University of Munich, Munich, Germany
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Rubisch HPK, Blaschke AL, Berberat PO, Fuetterer CS, Haller B, Gartmeier M. Student mistakes and teacher reactions in bedside teaching. Adv Health Sci Educ Theory Pract 2023; 28:1523-1556. [PMID: 37170035 PMCID: PMC10174607 DOI: 10.1007/s10459-023-10233-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/20/2023] [Indexed: 05/13/2023]
Abstract
We analyse interactions between teachers and students during video-recorded bedside teaching sessions in internal medicine, orthopaedics and neurology. Multiple raters used a high-inference categorical scheme on 36 sessions. Our research questions concern the types of student mistakes, clinical teachers' reactions to them and if they use different strategies to address different types of mistakes. We used a Poisson model and generalized mixed models to analyse these research questions. Most frequently, students made reproduction mistakes. Relatively high rates of rejection and a similar prevalence of low and high levels of elaboration and correction time for students were observed. Reproduction mistakes were associated with the highest level of rejection and the lowest level of elaboration. High levels of elaboration were observed when students were applying skills in new situations. Students were most often allowed time to correct when mistakes in the areas of analysis or application of skills and knowledge had occurred. There is a decrease in the rate of making mistakes for neurology and orthopaedics compared to internal medicine. Reproduction mistakes influence significantly the outcome feedback compared to application mistakes. Analytic and reproduction mistakes influence elaboration significantly compared to application mistakes. We found a significant effect whether the lecturer allows time for correction of reproduction mistakes compared to application mistakes. These results contribute to the understanding of interactive, patient-centred clinical teaching as well as student mistakes and how teachers are reacting to them. Our descriptive findings provide an empirical basis for clinical teachers to react to student mistakes in didactically fruitful ways.
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Affiliation(s)
- Hannah P K Rubisch
- Lehrstuhl für Medizindidaktik, medizinische Lehrentwicklung und Bildungsforschung Technical University of Munich (TUM), TUM School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675, Munich, Germany
| | - Anna-Lena Blaschke
- Lehrstuhl für Medizindidaktik, medizinische Lehrentwicklung und Bildungsforschung Technical University of Munich (TUM), TUM School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675, Munich, Germany
| | - Pascal O Berberat
- Lehrstuhl für Medizindidaktik, medizinische Lehrentwicklung und Bildungsforschung Technical University of Munich (TUM), TUM School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675, Munich, Germany
| | - Cornelia S Fuetterer
- Institute of AI and Informatics in Medicine, Technical University of Munich (TUM), TUM School of Medicine, Munich, Germany
| | - Bernhard Haller
- Institute of AI and Informatics in Medicine, Technical University of Munich (TUM), TUM School of Medicine, Munich, Germany
| | - Martin Gartmeier
- Lehrstuhl für Medizindidaktik, medizinische Lehrentwicklung und Bildungsforschung Technical University of Munich (TUM), TUM School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675, Munich, Germany.
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Hinzmann D, Wijnen-Meijer M, Corazza L, Becker V, Kagerbauer S, Haseneder R, Berberat PO, Jedlicska N. Experiences of medical students and nursing trainees from unexpected death through simulation training. BMC Med Educ 2023; 23:667. [PMID: 37710319 PMCID: PMC10503193 DOI: 10.1186/s12909-023-04638-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/30/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Dying in simulation training is controversially discussed. On the one hand, the danger of an emotional overload of the learners is pointed out. On the other hand, dying in simulation settings is addressed as an opportunity to prepare future health professionals to deal with patient death. The present study investigates how medical students and nursing trainees experience the sudden death of a simulated patient and how and under which conditions it can be valuable to simulate the patient's death. METHODS At the TUM School of Medicine in Munich, Germany, we developed an interprofessional, simulation-based course in which participants were unexpectedly confronted with a cardiac arrest scenario within which resuscitation had to be discontinued due to an advanced directive. After the course, focus groups were conducted with nine medical students and six nursing trainees. Data were analysed using Grounded Theory techniques. RESULTS The participants reported low to high emotional involvement. The active renunciation of life-sustaining measures was felt to be particularly formative and caused a strange feeling and helplessness. Questions of what could have been done differently determined interviewees' thoughts. The participants appreciated the opportunity to experience what it feels like to lose a patient. The course experience encouraged interviewees to reflect on dying and the interviewees explained that they feel better prepared to face death after the course. The unexpected character of the confrontation, presence of the advanced directive and debriefing positively affected the impact of the simulation. CONCLUSIONS The study recognises simulation training as a promising approach for preparing future health care professionals to encounter a patient's death.
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Affiliation(s)
- Dominik Hinzmann
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Munich, Germany
- Department of Anesthesiology and Intensive Care, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Marjo Wijnen-Meijer
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Laura Corazza
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Veronika Becker
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Simone Kagerbauer
- Department of Anesthesiology and Intensive Care, TUM School of Medicine, Technical University of Munich, Munich, Germany
- Department of Anesthesiology and Intensive Care Medicine, University of Ulm, Ulm, Germany
| | - Rainer Haseneder
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Munich, Germany
- Department of Anesthesiology and Intensive Care, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Pascal O Berberat
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Nana Jedlicska
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Munich, Germany.
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Corazza L, Shirkhani S, Berberat PO, Wijnen-Meijer M. Structured interviews on self-regulated learning strategies of medical students in the final year of medical school. BMC Med Educ 2023; 23:604. [PMID: 37620862 PMCID: PMC10464390 DOI: 10.1186/s12909-023-04607-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 08/23/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND In the final year of medical school, the educational focus is on experiences in the clinical environment. This is where students acquire most of their practical knowledge for their future career and need to optimise their Self-Regulated Learning (SRL) strategies. Hence, the current study aims to explore which SRL strategies medical students use during their clerkships in different learning settings. METHODS Structured interviews were conducted between May 2019 and December 2020 with 43 medical students during their final year in Munich, Germany. The students were surveyed about their SRL strategies. The transcribed data were thematically analysed using the measurements Strategy Use (SU) and Strategy Frequency (SF). RESULTS Interview data were organized into 11 SRL strategy categories. The most used SRL strategy in general was "seeking information in the internet in form of a text" (SU: 1; SF: 2.605), with an e-learning tool; followed by "seeking social assistance from doctors" (SU: 0.977; SF: 1.884), and "seeking information in books" (SU: 0.884; SF: 1.419). There were differences in the usage of SRL in different learning contexts between female and male students. For example, 95.3% of students are "seeking social assistance from doctors" when having difficulties on the ward, but only 55.8% when they need help with written tasks (e.g. medical letter). The results show a difference in SRL usage when preparing for oral-practical (79.1% books) and written (97.7% e-learning tool) exam. However, it also appears that some students do not have SRL strategies for certain situations, mostly due to a lack of time. CONCLUSION Medical students in the clinical phase are adapting their SRL strategy to the learning situation. To better support students´ SRL, it is necessary to ensure availability for their preferred resources: e-learning tool and experienced physicians as supervisors. Future research should focus on strategies to handle the limited time during clerkships.
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Affiliation(s)
- Laura Corazza
- Technical University of Munich (TUM), School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675, Munich, Germany
| | - Sepide Shirkhani
- Technical University of Munich (TUM), School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675, Munich, Germany
| | - Pascal O Berberat
- Technical University of Munich (TUM), School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675, Munich, Germany
| | - Marjo Wijnen-Meijer
- Technical University of Munich (TUM), School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675, Munich, Germany.
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Heim M, Schulz CM, Schneider F, Berberat PO, Gartmeier M, Schick K. Measuring informal workplace learning outcomes in residency training: a validation study. BMC Med Educ 2023; 23:549. [PMID: 37537584 PMCID: PMC10401809 DOI: 10.1186/s12909-023-04529-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 07/21/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Informal workplace learning (WPL) has no concrete learning objective and takes place without a responsible supervisor, which makes it difficult to assess its learning outcomes. Formal learning situations, as they are known from universities or schools, do not exist in this context and make a conventional assessment of learning goals and achievements impossible. Informal learning in the workplace is of central importance, and the assessment of informal learning outcomes in medical education is an under-researched area. The aim of our study was to adapt and validate an informal WPL questionnaire (originally developed for social workers) to assess learning outcomes due to informal WPL in residency training. METHODS A total of 528 residents (n = 339 female; age: M = 29.79; SD = 3.37 years) completed an adapted questionnaire on informal WPL outcomes and the Freiburg Questionnaire to Assess Competencies in Medicine (i.e. medical knowledge, communication, and scholarship). Exploratory factor analysis was used to determine the underlying factor structure. The reliability of the factors was tested using McDonald's omega, and the correlation between the factors and the three subscales of the Freiburg questionnaire was tested using Spearman's rho correlation coefficient. To investigate construct validity, a structural equation model was calculated to examine the relationships between medical competencies and informal learning outcomes. RESULTS The exploratory factor analysis yielded a four-factor solution that best fit the data. The scores of all four factors (GLO-CD: generic learning outcomes-competence development, GLO-R: generic learning outcomes-reflection, JSLO: job-specific learning outcomes, and OLLO: organisational learning outcomes) showed good internal consistency (Ω ≥ .69). The structural equation model showed that "medical expertise" had an impact on all four factors of informal learning at work. "Scholarship" seemed to predict GLO-CD and GLO-R. CONCLUSIONS Our four-factor model reveals meaningful determinants of informal WPL in relation to residency training. The instrument is therefore the first promising attempt to assess informal WPL in the broader context of medical education during residency, thus supporting its construct validity.
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Affiliation(s)
- Markus Heim
- Technical University of Munich, TUM School of Medicine, Department of Anesthesiology and Intensive Care Medicine, Ismaninger Straße 22, Munich, 81675, Germany
| | - Christian M Schulz
- Technical University of Munich, TUM School of Medicine, Department of Anesthesiology and Intensive Care Medicine, Ismaninger Straße 22, Munich, 81675, Germany
| | - Frederick Schneider
- Technical University of Munich, TUM School of Medicine, Department of Anesthesiology and Intensive Care Medicine, Ismaninger Straße 22, Munich, 81675, Germany
| | - Pascal O Berberat
- Technical University Munich, TUM School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, München, 81675, Germany
| | - Martin Gartmeier
- Technical University Munich, TUM School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, München, 81675, Germany
| | - Kristina Schick
- Technical University Munich, TUM School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, München, 81675, Germany.
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Mosene K, Kleinesper C, Prokop G, Caroli F, Teufel D, Berberat PO, Wijnen-Meijer M. OPEN Hackathon at the TUM School of Medicine, Germany. GMS J Med Educ 2023; 40:Doc15. [PMID: 37361247 PMCID: PMC10285373 DOI: 10.3205/zma001597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 12/22/2022] [Accepted: 01/11/2023] [Indexed: 06/28/2023]
Abstract
The OPEN Hackathon of the Technical University of Munich (TUM) 2020 set out to address challenges and potential solutions for medical education at the School of Medicine to kick off the 2020/21 winter semester. The event lasted 36 hours, during which medical students, teachers and staff members had the opportunity to tackle current problems in education and to develop co-created, customized solutions through creative teamwork for the School of Medicine at the TUM. The resulting solutions are now being realized and implemented in teaching. This paper describes the process and organization of the hackathon. Furthermore, the result of the evaluation of the event are described. In this paper, we aim to present the project as a valuable pioneer in the field of developing medical-educational topics within the framework of innovative methodological formats.
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Affiliation(s)
- Katharina Mosene
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
| | | | - Georg Prokop
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Friedrich Caroli
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Daniel Teufel
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Pascal O. Berberat
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Marjo Wijnen-Meijer
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
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Faihs V, Heininger S, McLennan S, Gartmeier M, Berberat PO, Wijnen-Meijer M. Professional Identity and Motivation for Medical School in First-Year Medical Students: A Cross-sectional Study. Med Sci Educ 2023; 33:431-441. [PMID: 37261015 PMCID: PMC10226964 DOI: 10.1007/s40670-023-01754-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 06/02/2023]
Abstract
Background Professional identity formation (PIF) is a life-long process, starting even before professional education. High levels of motivation for medical school are essential for effective learning and academic success. Both are key factors in future physicians' professional and personal development, and according to self-determination theory, professional identity (PI) and students' levels of motivation could be closely linked. Therefore, we sought to investigate whether PI and strength of motivation for medical school are associated in new medical students. Methods In a cross-sectional survey, all new medical students in Munich, Germany, were asked to complete the Macleod Clark Professional Identity Scale (MCPIS-9) and the Strength of Motivation for Medical School-Revised questionnaire (SMMS-R) as well as to provide information about age, gender, and waiting time before starting medical school. Results Eight hundred eleven out of 918 new medical students participated in the survey. A positive correlation between the MCPIS-9 and the SMMS-R (p < 0.001) was found. Female students showed higher scores in the SMMS-R (p < 0.05) and the SMMS-R-subscale Readiness to Start (p < 0.001). The amount of waiting semesters showed a positive correlation with the total SMMS-R score (p < 0.01) as well as with the subscales Readiness to Start and Persistence (both p < 0.001). Discussion We found an association between PI and strength of motivation for medical school in a large cohort of new medical students. Female gender and more waiting semesters were associated with higher levels of self-perceived motivation and higher scores on the SMMS-R-subscale Readiness to Start. More research is needed to better understand this topic to further improve medical education.
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Affiliation(s)
- Valentina Faihs
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
- Department of Dermatology and Allergy Biederstein, TUM School of Medicine, Technical University of Munich, Biedersteiner Str. 29, 80802 Munich, Germany
| | - Susanne Heininger
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Stuart McLennan
- Institute of History and Ethics in Medicine, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Martin Gartmeier
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Pascal O. Berberat
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Marjo Wijnen-Meijer
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
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11
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Harendza S, Bacher HJ, Berberat PO, Kadmon M, Gärtner J. Implicit expression of uncertainty in medical students during different sequences of clinical reasoning in simulated patient handovers. GMS J Med Educ 2023; 40:Doc7. [PMID: 36923315 PMCID: PMC10010770 DOI: 10.3205/zma001589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 08/19/2022] [Accepted: 11/23/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Dealing with medical uncertainty is an essential competence of physicians. During handovers, communication of uncertainty is important for patient safety, but is often not explicitly expressed and can hamper medical decisions. This study examines medical students' implicit expression of uncertainty in different sequences of clinical reasoning during simulated patient handovers. METHODS In 2018, eighty-seven final-year medical students participated in handovers of three simulated patient cases, which were videotaped and transcribed verbatim. Sequences of clinical reasoning and language references to implicit uncertainty that attenuate and strengthen information based on a framework were identified, categorized, and analyzed with chi-square goodness-of-fit tests. RESULTS A total of 6358 sequences of clinical reasoning were associated with the four main categories "statement", "assessment", "consideration", and "implication", with statements occurring significantly (p<0.001) most frequently. Attenuated sequences of clinical reasoning occurred significantly (p<0.003) more frequently than strengthened sequences. Implications were significantly more often attenuated than strengthened (p<0.003). Statements regarding results occurred significantly more often plain or strengthened than statements regarding actions (p<0.0025). CONCLUSION Implicit expressions of uncertainty in simulated medical students' handovers occur in different degrees during clinical reasoning. These findings could contribute to courses on clinical case presentations by including linguistic terms and implicit expressions of uncertainty and making them explicit.
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Affiliation(s)
- Sigrid Harendza
- Universitätsklinikum Hamburg-Eppendorf, III. Medizinische Klinik, Hamburg, Germany
| | - Hans Jakob Bacher
- Universitätsklinikum Hamburg-Eppendorf, III. Medizinische Klinik, Hamburg, Germany
| | - Pascal O. Berberat
- Technische Universität München, Fakultät für Medizin, TUM Medical Education Center, München, Germany
| | - Martina Kadmon
- Universität Augsburg, Medizinische Fakultät, Dekanat, Augsburg, Germany
| | - Julia Gärtner
- Universitätsklinikum Hamburg-Eppendorf, III. Medizinische Klinik, Hamburg, Germany
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12
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Blaschke AL, Rubisch HPK, Schindler AK, Berberat PO, Gartmeier M. How is modern bedside teaching structured? A video analysis of learning content, social and spatial structures. BMC Med Educ 2022; 22:790. [PMID: 36380308 PMCID: PMC9664733 DOI: 10.1186/s12909-022-03855-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 11/01/2022] [Indexed: 05/26/2023]
Abstract
BACKGROUND Bedside teaching (BST) is an essential and traditional clinical teaching format. It has been subject to various impediments and has transformed over time. Besides a decrease in bedside time, there has also been a didactic diversification. In order to use time at the bedside effectively and understand the current design of BST, we here offer an evidence-based insight into how BST is practiced. This may serve as a basis for a refinement of its didactic design. METHODS In the current study, we investigate the interrelationships between learning content and the social as well as spatial structures of BST. To this end, we have empirically analysed almost 80 hours of video material from a total of 36 BST sessions with good interrater reliability. RESULTS BST lasted on average 125 min, most of which was spent in plenary and less than a third of the time at the patient's bedside. History taking was primarily practiced at the bedside while case presentations, clinical reasoning and theoretical knowledge were largely taught away from the patient. Clinical examination took place to a similar extent in the patient's room and in the theory room. CONCLUSIONS Even though the filmed BSTs are not purely "bedside", the teaching format investigated here is a typical example of undergraduate medical education. In order to maximize the teaching time available, a suitable learning space should be provided in addition to the bedside. Moreover, the clinical examination should be revised in its general sequence prior to the BST, and conscious decisions should be made regarding the social structure so as to optimize the potential of small groups and plenary sessions.
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Affiliation(s)
- Anna-Lena Blaschke
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany.
| | - Hannah P K Rubisch
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Ann-Kathrin Schindler
- DEMEDA (Department of Medical Education), Medical Didactics and Educational Research, Medical Faculty, University of Augsburg, Universitätsstraße 2, 86159, Augsburg, Germany
| | - Pascal O Berberat
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
| | - Martin Gartmeier
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany
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13
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Faihs V, Figalist C, Bossert E, Weimann K, Berberat PO, Wijnen-Meijer M. Medical Students and Their Perceptions of Digital Medicine: a Question of Gender? Med Sci Educ 2022; 32:941-946. [PMID: 36276758 PMCID: PMC9584022 DOI: 10.1007/s40670-022-01594-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 06/02/2023]
Abstract
Digital technologies play an essential role in the medical sector of today and the future. In a cross-sectional online survey at a German medical university, male students more frequently reported keeping themselves informed about digital medicine outside of their studies across all clinical years of study. While female students self-assessed their knowledge in different fields of digital medicine as worse than their male peers in the first clinical years of study, no more gender differences could be found towards the final year. However, students of both genders showed a strong desire for further education on the topic of digital medicine.
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Affiliation(s)
- Valentina Faihs
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
- Department of Dermatology and Allergy Biederstein, TUM School of Medicine, Technical University of Munich, Biedersteiner Str. 29, 80802 Munich, Germany
| | - Christina Figalist
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Eileen Bossert
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Katja Weimann
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Pascal O. Berberat
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Marjo Wijnen-Meijer
- TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
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14
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Schwill S, Kadmon M, Hahn EG, Kunisch R, Berberat PO, Fehr F, Hennel E. The WFME global standards for quality improvement of postgraduate medical education: Which standards are also applicable in Germany? Recommendations for physicians with a license for postgraduate training and training agents. GMS J Med Educ 2022; 39:Doc42. [PMID: 36310882 PMCID: PMC9585417 DOI: 10.3205/zma001563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 06/02/2022] [Accepted: 07/05/2022] [Indexed: 06/16/2023]
Abstract
Background: In Germany, the (model) regulation for postgraduate medical education 2018, the professional codes of conduct of the regional medical councils and the health professions chamber laws of the federal states are the formal basis of postgraduate medical education, but say little about its structure, processes and results. The World Federation for Medical Education (WFME) has developed global standards for improving the quality of postgraduate medical education and published them in a revised edition in 2015. A German version which takes the specifics of medical training in Germany into account has not been published to date. Objective: The Committee for Postgraduate Medical Education (PGME) of the Society for Medical Education (GMA) has set itself the goal of firstly translating the WFME standards into German and secondly making recommendations for physicians with a license for post-graduate training (PLT) and training agents (TA) in clinics and practices which have been adapted to the German context. Methods: The WFME standards were translated into German by a working group of the GMA Committee for PGME, the terminology adapted to PGME in Germany and checked by an interdisciplinary panel of experts made up of 9 members of the committee. In a second step, the WFME basic standards and quality standards for PGME relevant to PLTs and TAs in Germany were iteratively determined by this panel of experts using the Nominal Group Technique (NGT) and compiled in the form of recommendations. Results: The translation of the WFME guidelines was approved by the expert group without any changes to the content, taking into account the terminological system of PGME in Germany. In a second step, 90 standards were identified which were considered helpful for PGME in Germany, especially for PLTs and TAs (such as development of a professional identity, a more patient-centered approach or support of self-directed learning). Care was taken to only give recommendations which can be influenced by PLTs and TAs. These standards have been summarized as recommendations to PLTs and TAs and take into account all chapters of the WFME standards. Conclusion: The WFME standards selected here are recommended to PLTs and TAs in clinics and practices to achieve high-quality PGME. Empirical longitudinal studies will be required to examine both the implementation and the results of applying the modified WFME criteria in Germany.
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Affiliation(s)
- Simon Schwill
- University Hospital Heidelberg, Department for General Practice and Healthcare Research, Heidelberg, Germany
| | - Martina Kadmon
- University of Augsburg, Faculty of Medicine, Dean, Augsburg, Germany
| | - Eckhart G. Hahn
- Friedrich-Alexander University Erlangen, Faculty of Medicine, Erlangen, Germany
| | - Raphael Kunisch
- University Hospital Erlangen, Institute for General Practice, Erlangen, Germany
| | - Pascal O. Berberat
- Technical University of Munich. Medical Education Center, Munich, Germany
| | - Folkert Fehr
- Dr. Folkert Fehr & Dr. Jan Buschmann Joint Practice, Sinsheim, Germany
| | - Eva Hennel
- University of Bern, Institute for Medical Education, Department for Assessment and Evaluation, Bern, Switzerland
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15
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Sapoutzis N, Schneider A, Brandhuber T, Berberat PO, Wijnen-Meijer M. Programs to encourage working as a general practitioner in rural areas: why do medical students not want to participate? A cross-sectional study. BMC Med Educ 2022; 22:622. [PMID: 35978341 PMCID: PMC9382807 DOI: 10.1186/s12909-022-03688-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND In many countries, not enough students are interested to work as general practitioners in rural areas. To solve this problem, several, sometimes partly extracurricular, programs have been developed. Most of these programs are based on continuity, which means that students stay in a rural region for an extended period of time, by completing clerkships. Although the effects of these programs are positive, it is often difficult to motivate students to participate. The purpose of the present study is to get insight into the reasons why students choose not to participate in these programs. METHODS We carried out a questionnaire study among medical students in the clinical phase of the Technical University of Munich in Germany. First, we asked the students whether they actively informed themselves about the program which aims to reduce the shortage of general practitioners in rural areas in Bavaria. Furthermore, the questionnaire focused on the reasons for not participating in this program. RESULTS Based on the answers of 442 students from study years 3-6, the most frequently chosen reason for not participating in the program is "identification with another discipline" with 61.0%, directly followed by "not willing to commit long-term" (56.1%). In third place is "personal connections to another region" with 30.5%. In the open comments, we find the same reasons: many students do not want to commit to a certain direction too early. In addition, students indicate that the number of regions where this program is offered is too limited for them. CONCLUSIONS Offering programs to prepare and motivate students for work as general practitioners in rural areas can contribute to increasing the pool of future general practitioners. To encourage students to participate in such a program, it is important to consider the motives of students. Many students who might be interested in general practice do not choose to take part in such a program because they do not want to commit to a particular specialty or region at an early stage. It is important to take these insights into account when designing and implementing these programs.
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Affiliation(s)
- Nikolaos Sapoutzis
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675, Munich, Germany
- Public Health Department Hochtaunuskreis, Bad Homburg vor der Höhe, Germany
| | - Antonius Schneider
- Technical University of Munich, School of Medicine, Institute of Family Medicine and Health Services Research, Munich, Germany
| | - Tom Brandhuber
- Technical University of Munich, School of Medicine, Institute of Family Medicine and Health Services Research, Munich, Germany
| | - Pascal O Berberat
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675, Munich, Germany
| | - Marjo Wijnen-Meijer
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Ismaninger Straße 22, 81675, Munich, Germany.
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16
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Reiser S, Schacht L, Thomm E, Figalist C, Janssen L, Schick K, Dörfler E, Berberat PO, Gartmeier M, Bauer J. A video-based situational judgement test of medical students' communication competence in patient encounters: Development and first evaluation. Patient Educ Couns 2022; 105:1283-1289. [PMID: 34481676 DOI: 10.1016/j.pec.2021.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 06/22/2021] [Accepted: 08/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE We developed and evaluated the Video-Based Assessment of Medical Communication Competence (VA-MeCo), a construct-driven situational judgement test measuring medical students' communication competence in patient encounters. METHODS In the construction phase, we conducted two expert studies (npanel1 = 6, npanel2 = 13) to ensure curricular and content validity and sufficient expert agreement on the answer key. In the evaluation phase, we conducted a cognitive pre-test (n = 12) and a pilot study (n = 117) with medical students to evaluate test usability and acceptance, item statistics and test reliability depending on the applied scoring method (raw consensus vs. pairwise comparison scoring). RESULTS The results of the expert interviews indicated good curricular and content validity. Expert agreement on the answer key was high (ICCs> .86). The pilot study showed favourable usability and acceptance by students. Irrespective of the scoring method, reliability for the complete test (Cronbach's α >.93) and its subscales (α >.83) was high. CONCLUSION There is promising evidence that medical communication competence can be validly and reliably measured using a construct-driven and video-based situational judgement test. PRACTICE IMPLICATIONS Video-based SJTs allow efficient online assessment of medical communication competence and are well accepted by students and educators.
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Affiliation(s)
- Sabine Reiser
- University of Erfurt, Educational Research and Methodology, Erfurt, Germany.
| | - Laura Schacht
- University of Erfurt, Educational Research and Methodology, Erfurt, Germany
| | - Eva Thomm
- University of Erfurt, Educational Research and Methodology, Erfurt, Germany
| | - Christina Figalist
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Laura Janssen
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Kristina Schick
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Eva Dörfler
- Technical University of Munich, ProLehre | Media and Didactics, Munich, Germany
| | - Pascal O Berberat
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Martin Gartmeier
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Johannes Bauer
- University of Erfurt, Educational Research and Methodology, Erfurt, Germany
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17
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Becker V, Jedlicska N, Scheide L, Nest A, Kratzer S, Hinzmann D, Wijnen-Meijer M, Berberat PO, Haseneder R. Changes in medical students´ and anesthesia technician trainees´ attitudes towards interprofessionality - experience from an interprofessional simulation-based course. BMC Med Educ 2022; 22:273. [PMID: 35418136 PMCID: PMC9006475 DOI: 10.1186/s12909-022-03350-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/07/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Interprofessional simulation based education (IPSBE) programs positively impact participants' attitudes towards interprofessional collaboration and learning. However, the extent to which students in different health professions benefit and the underlying reasons for this are subject of ongoing debate. METHODS We developed a 14-h IPSBE course with scenarios of critical incidents or emergency cases. Participants were final year medical students (FYMS) and final year anesthesia technician trainees (FYATT). To assess attitudes towards interprofessionalism, the University of the West of England Interprofessional Questionnaire was administrated before and after the course. Using focus group illustration maps, qualitative data were obtained from a subcohort of the participants (n = 15). RESULTS After the course, self-assessment of communication and teamwork skills, attitudes towards interprofessional interactions and relationships showed comparative improvement in both professions. Attitudes towards interprofessional learning improved only in FYMS. Qualitative data revealed teamwork, communication, hierarchy and the perception of one's own and other health profession as main topics that might underlie the changes in participants' attitudes. An important factor was that participants got to know each other during the course and understood each other's tasks. CONCLUSIONS Since adequate communication and teamwork skills and positive attitudes towards interprofessionality account to effective interprofessional collaboration, our data support intensifying IPSBE in undergraduate health care education.
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Affiliation(s)
- Veronika Becker
- Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Nana Jedlicska
- Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Laura Scheide
- Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Alexandra Nest
- Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Stephan Kratzer
- Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, Department of Anaesthesiology and Intensive Care, Munich, Germany
| | - Dominik Hinzmann
- Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany
- Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, Department of Anaesthesiology and Intensive Care, Munich, Germany
| | - Marjo Wijnen-Meijer
- Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Pascal O Berberat
- Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Rainer Haseneder
- Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany.
- Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, Department of Anaesthesiology and Intensive Care, Munich, Germany.
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18
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Gärtner J, Bußenius L, Schick K, Prediger S, Kadmon M, Berberat PO, Harendza S. Validation of the ComCare index for rater-based assessment of medical communication and interpersonal skills. Patient Educ Couns 2022; 105:1004-1008. [PMID: 34389227 DOI: 10.1016/j.pec.2021.07.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/12/2021] [Accepted: 07/29/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To develop and validate a short instrument to assess undergraduate medical students' communication and interpersonal skills in videographed history taking situations with simulated patients. METHODS Sixty-seven undergraduate medical students participating in an assessment including videographed physician-patient encounters for history taking with five simulated patients were included in this study. The last video of each participant's consultation hour was rated by two independent assessors with the eight-item ComCare index for assessment of communication and interpersonal skills newly designed for the external rater perspective (ComCareR). We compared the sum scores of the ComCareR with ratings of the same videos with the Kalamazoo Communication Skills Assessment Form from an observational perspective (KCSAFd-video) and the Global Rating scale (GR), which also measure communication and interpersonal skills. RESULTS The ComCareR showed an excellent interrater reliability (ICC = .85). We found a small but significant correlation with the KCSAFd-video Interpersonal Competence (ρ = .34, 95% CI [.10,.54]) and a high positive correlation with the GR (ρ = .59, 95% CI [.40,.73]). CONCLUSIONS The ComCareR is a valid and brief index for holistic assessment of communication and interpersonal skills in physician-patient encounters. PRACTICE IMPLICATIONS The ComCareR can be used for quick rater-based assessment of physicians' communication and interpersonal skills.
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Affiliation(s)
- Julia Gärtner
- III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lisa Bußenius
- Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kristina Schick
- TUM Medical Education Center, Technical University of Munich, Munich, Germany
| | - Sarah Prediger
- III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martina Kadmon
- Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Pascal O Berberat
- TUM Medical Education Center, Technical University of Munich, Munich, Germany
| | - Sigrid Harendza
- III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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19
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Gartmeier M, Schick C, Berberat PO, Hertel S. Theoretischer Beitrag: Befunde zur Förderung kommunikativer Kompetenz aus dem medizinischen Kontext: Welche Perspektiven ergeben sich daraus für die Ausbildung von Lehrpersonen im Hinblick auf das Führen von Elterngesprächen? Psychologie in Erziehung und Unterricht 2022. [DOI: 10.2378/peu2022.art06d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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20
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Bußenius L, Kadmon M, Berberat PO, Harendza S. Evaluating the Global Rating scale's psychometric properties to assess communication skills of undergraduate medical students in video-recorded simulated patient encounters. Patient Educ Couns 2022; 105:750-755. [PMID: 34112546 DOI: 10.1016/j.pec.2021.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To evaluate the psychometric properties of the Global Rating scale (GR) as an observer-based tool to assess communication skills of undergraduate medical students in video-recorded patient encounters. METHODS Seventy advanced undergraduate medical students participated in a simulation-based assessment including patient consultations. Simulated patients rated these encounters with the Consultation and Relational Empathy (CARE) scale. Two independent, blinded raters assessed the videos of the encounters with the GR and another blinded rater with the Clinical Reasoning Indicators Scale (CRI-HT-S). To assess the GR's psychometric properties, we analysed reliability by means of a G-study, interrater reliability by ICC, convergent validity (correlation of GR and CARE), and divergent validity (correlation of GR and CRI-HT-S). RESULTS We analysed 325 videos of 65 students (56.9% female, mean age 26.1 ± 2.2 years). The G-coefficient was.90. Interrater reliability of the GR was ICC = .95, 95% CI [.91,.97]. CARE and GR correlated moderately (ρ = .47, 95% CI [.25,.65]). GR and CRI-HT-S did not correlate (ρ = .09, 95% CI [-.16,.34]). CONCLUSIONS With excellent reliability and adequate validity, the quality of the GR as assessment instrument for communication skills could be demonstrated. PRACTICE IMPLICATIONS The GR is a suitable instrument for video-based rating of communication skills.
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Affiliation(s)
- Lisa Bußenius
- Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martina Kadmon
- Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Pascal O Berberat
- TUM Medical Education Center, Technical University of Munich, Munich, Germany
| | - Sigrid Harendza
- III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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21
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Gärtner J, Prediger S, Berberat PO, Kadmon M, Harendza S. Frequency of medical students' language expressing implicit uncertainty in simulated handovers. Int J Med Educ 2022; 13:28-34. [PMID: 35220275 PMCID: PMC9017509 DOI: 10.5116/ijme.61e6.cde0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 01/18/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the number and type of implicit expressions of uncertainty by medical students during simulated patient handovers. METHODS Eighty-seven volunteer medical students, a convenience sample collected on a first-come, first-served basis, participated in simulated handovers. They each worked with three simulated patients who presented with different chief complaints and personal conditions. The handovers were video recorded and transcribed. A framework of implicit expressions of uncertainty was used to identify and count modifiers that attenuate or strengthen medical information using MAXQDA lexical search. We analysed the findings with respect to the patients' contexts. RESULTS Implicit uncertainty expressions which attenuate or strengthen information occurred in almost equal frequency, 1879 (55%) versus 1505 (45%). Attenuators were found most frequently in the category 'Questionable', 1041 (55.4%), strengtheners in the category 'Focused', 1031 (68.5%). Most attenuators and strengtheners were found in the handover of two patients with challenging personal conditions ('angry man', 434 (23.1%) versus 323 (21.5%); 'unfocused woman', 354 (19.4%) versus 322 (21.4%)) and one patient with abnormal laboratory findings ('elevated creatinine', 379 (20.2%) versus 285 (18.9%)). CONCLUSIONS Medical students use a variety of implicit expressions of uncertainty in simulated handovers. These findings provide an opportunity for medical educators to design communication courses that raise students' awareness for content-dependent implicit expressions of uncertainty and provide strategies to communicate uncertainty explicitly.
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Affiliation(s)
- Julia Gärtner
- III. Department of Internal Medicine, University Medical Centre Hamburg-Eppendorf, Germany
| | - Sarah Prediger
- III. Department of Internal Medicine, University Medical Centre Hamburg-Eppendorf, Germany
| | - Pascal O. Berberat
- TUM Medical Education Centre, School of Medicine, Technical University of Munich, Germany
| | - Martina Kadmon
- Faculty of Medicine, University of Augsburg, Deanery, Augsburg, Germany
| | - Sigrid Harendza
- III. Department of Internal Medicine, University Medical Centre Hamburg-Eppendorf, Germany
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22
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Heimbach M, Holzmann K, Stein P, Stief L, Berberat PO, Dirmeier M. How to... train your skills goes digital! A project report on the development and implementation of practice-oriented digital student tutorials. GMS J Med Educ 2022; 39:Doc5. [PMID: 35368843 PMCID: PMC8953196 DOI: 10.3205/zma001526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/10/2021] [Accepted: 10/20/2021] [Indexed: 06/14/2023]
Abstract
Objective: This project report outlines the development and implementation of digital tutorials ("How to... train your skills goes digital!") by peer tutors (TUTs) based on previously established in-person tutorials, as well as the subsequent combination of both approaches. The TUTs' objective, in spite of corona-related restrictions and strict hygiene requirements during the pandemic, was to provide fellow students with the opportunity to learn, practice and reflect on clinical-practical skills. Methodology: In a collaborative undertaking, the TUTs first analyzed the learning objectives of the in-person tutorials in order to be able to design content-matched digital tutorials without entirely abandoning the practical aspect. The Moodle learning management platform was selected as the appropriate tool for delivery of the relevant theoretical knowledge. Practical exercises are embedded in the digital tutorials during online meetings. The participants (PTs) create their own models in the sense of a home skills station based on instructions provided via Moodle. Acceptance was systematically documented via questionnaires. Results: The digital tutorials were well accepted by the PTs (n=64). Evaluation (response rate: 37.5%) outcomes were consistently positive. Both course implementation and the PTs' own progress were rated "good" to "very good". Nevertheless, the PTs do not yet feel well-prepared to carry out the various activities practiced independently. In the winter semester of 2020/21, the in-person tutorials were also reintroduced in a combined format. The marked demand for the tutorials may indicate the PT preference for practice on the simulation center models. Conclusion: The systematic combination of digital and in-person tutorials using the flipped classroom approach would appear to make sense in the long run. The effectiveness and sustainability of this approach in comparison with in-person tutorials only should be further investigated.
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Affiliation(s)
- Maria Heimbach
- Technische Universität München, Fakultät für Medizin – Klinikum rechts der Isar, TUM Medical Education Center (TUM MEC), Lehrstuhl für Medizindidaktik, medizinische Lehrentwicklung und Bildungsforschung, München, Germany
| | - Katharina Holzmann
- Technische Universität München, Fakultät für Medizin – Klinikum rechts der Isar, TUM Medical Education Center (TUM MEC), Lehrstuhl für Medizindidaktik, medizinische Lehrentwicklung und Bildungsforschung, München, Germany
| | - Philipp Stein
- Technische Universität München, Fakultät für Medizin – Klinikum rechts der Isar, TUM Medical Education Center (TUM MEC), Lehrstuhl für Medizindidaktik, medizinische Lehrentwicklung und Bildungsforschung, München, Germany
| | - Lea Stief
- Technische Universität München, Fakultät für Medizin – Klinikum rechts der Isar, TUM Medical Education Center (TUM MEC), Lehrstuhl für Medizindidaktik, medizinische Lehrentwicklung und Bildungsforschung, München, Germany
| | - Pascal O. Berberat
- Technische Universität München, Fakultät für Medizin – Klinikum rechts der Isar, TUM Medical Education Center (TUM MEC), Lehrstuhl für Medizindidaktik, medizinische Lehrentwicklung und Bildungsforschung, München, Germany
| | - Meike Dirmeier
- Technische Universität München, Fakultät für Medizin – Klinikum rechts der Isar, TUM Medical Education Center (TUM MEC), Lehrstuhl für Medizindidaktik, medizinische Lehrentwicklung und Bildungsforschung, München, Germany
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23
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Olm M, Roos M, Hapfelmeier A, Schneider D, Gensichen J, Berberat PO, Schneider A. [The importance of the learning environment and reduction of burnout in clinical training: an analysis of the Competence Centre for Residency Training in Family Medicine Bavaria (CCRTB)]. Z Evid Fortbild Qual Gesundhwes 2022; 168:88-95. [PMID: 35144910 DOI: 10.1016/j.zefq.2021.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/29/2021] [Accepted: 12/01/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The Competence Centre for Residency Training in Family Medicine Bavaria (CCRTB) was established to improve the quality of postgraduate medical training by offering additional seminars and mentoring programmes as well as regular 'train-the-trainer' courses for educating physicians. In addition, residents have the opportunity to participate in a regional training network. OBJECTIVE The aim was to assess the burden of burnout and the importance of the learning environment in the clinical training phase. METHODS We conducted a cross-sectional study. Burnout was assessed using the Maslach Burnout Inventory (MBI), which comprises the scales "Emotional Exhaustion", "Depersonalisation" and "Personal Accomplishment". The quality of the learning environment was recorded using the German version of the Dutch Residency Educational Climate Test (D-RECT German). In addition, multivariable linear regressions were performed to estimate the impact of learning environment, year of training and participation in a regional network on the level of burnout. RESULTS 129 clinical residents enrolled in the CCRTB were invited to participate in the study, 78 (61%) of whom submitted a response. 76 (59%) of these residents were included in the analyses. The present study discloses an increased burden of burnout among residents in the clinical training phase, with approx. 40% reaching a critical burnout score. A higher quality of the learning environment was associated with significantly milder burnout symptoms on the majority of the D-RECT scales. CONCLUSION Family medicine residents in the clinical training phase show a high burden of burnout. Therefore, increasing the quality of the learning environment appears to be an effective key element in achieving a reduction of burnout in clinical training. This might contribute to an increase in professional satisfaction, which finally may also prevent migration from the medical profession.
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Affiliation(s)
- Michaela Olm
- Institut für Allgemeinmedizin und Versorgungsforschung, Universitätsklinikum rechts der Isar der Technischen Universität München, München, Deutschland
| | - Marco Roos
- Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Deutschland; Allgemeinmedizinisches Institut, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland
| | - Alexander Hapfelmeier
- Institut für Allgemeinmedizin und Versorgungsforschung, Universitätsklinikum rechts der Isar der Technischen Universität München, München, Deutschland; Institut für KI und Informatik in der Medizin, Universitätsklinikum rechts der Isar der Technischen Universität München, München, Deutschland
| | - Dagmar Schneider
- Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Deutschland; Koordinierungsstelle Allgemeinmedizin, München, Deutschland
| | - Jochen Gensichen
- Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Deutschland; Institut für Allgemeinmedizin, LMU Klinikum, Ludwig-Maximilians-Universität München, München, Deutschland
| | - Pascal O Berberat
- Medizindidaktisches Zentrum für Ausbildungsforschung und Lehre, Fakultät für Medizin, Technische Universität München, München, Deutschland
| | - Antonius Schneider
- Institut für Allgemeinmedizin und Versorgungsforschung, Universitätsklinikum rechts der Isar der Technischen Universität München, München, Deutschland; Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Deutschland.
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24
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Olm M, Roos M, Hapfelmeier A, Schneider D, Gensichen J, Berberat PO, Schneider A. Increased professionalization and lower burnout scores were associated with structured residency training program: results of a cross sectional survey. Med Educ Online 2021; 26:1959284. [PMID: 34323662 PMCID: PMC8330728 DOI: 10.1080/10872981.2021.1959284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/13/2021] [Accepted: 07/20/2021] [Indexed: 06/13/2023]
Abstract
The competence centre for Residency Training in Family Medicine Bavaria (CCRTB) was established to improve the quality of postgraduate medical education by offering training and mentoring programmes for residents, and by providing train-the-trainer and mentoring courses for supervisors. Beyond that, regional Residency Training Networks (RTN) on avoluntary basis were developed to facilitate structured and efficient clinical rotation programs. Primary aim was to investigate the burden of burnout and the development of professionalism among CCRTB-residencies within a cross-sectional study. Secondary aim was to evaluate differences between CCRTB-residents with and without participation in aregional RTN. Burnout was determined with the Maslach Burnout Inventory (MBI), comprising the scales emotional exhaustion, depersonalization, and personal accomplishment. Ambulatory professionalization was evaluated using the German Professional Scale (Pro-D), comprising the scales professionalism towards the patient, towards other professionals, towards society, and towards oneself. Statistical significance of group differences was calculated by nonparametric tests. Multivariable linear regression modelling was performed to estimate the independent impact of professionalization and RTN participation on burnout scores. 347 CRRTB residents in ambulatory postgraduate training were invited, 212 (61.1%) participated, and 197 (92.9%) were included in our analyses. Lower emotional exhaustion and depersonalization, and increased personal accomplishment was associated with increased professionalisation, which was significant for nearly all Pro-D scales (p ≤ 0.05). RTN residents showed higher professionalism towards the patient (p = 0.031), other professionals (p = 0.012), and towards the society (p = 0.007) than residents of unstructured programs, and higher levels of personal accomplishment (p < 0.05). Early and efficient professionalization might be akey to reduce burnout and to establish asatisfying career in family medicine. Train-the-trainer and mentoring concepts should be implemented regularly for the training of residents. Thus, increased engagement in medical didactics should be aprerequisite for accreditation as atraining practice for residents.
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Affiliation(s)
- Michaela Olm
- TUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany
| | - Marco Roos
- Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Germany
- Institute of General Practice, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Alexander Hapfelmeier
- TUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany
- TUM School of Medicine, Institute of Medical Informatics, Statistics and Epidemiology, Technical University Munich, Munich, Germany
| | - Dagmar Schneider
- Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Germany
- Koordinierungsstelle Allgemeinmedizin, Munich, Germany
| | - Jochen Gensichen
- Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Germany
- Institute of General Practice and Family Medicine, University Hospital of the Ludwig-Maximilians University of Munich, Munich, Germany
| | - Pascal O. Berberat
- TUM Medical Education Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Antonius Schneider
- TUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany
- Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Germany
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25
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Mühlbauer L, Huber J, Fischer MR, Berberat PO, Gartmeier M. Medical students' engagement in the context of the SARS-CoV-2 pandemic: The influence of psychological factors on readiness to volunteer. GMS J Med Educ 2021; 38:Doc110. [PMID: 34651068 PMCID: PMC8493846 DOI: 10.3205/zma001506] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/12/2021] [Accepted: 04/26/2021] [Indexed: 06/13/2023]
Abstract
Objective: To avert staff shortages during the first wave of the SARS-CoV-2 pandemic in spring 2020, the medical faculties of the Technical University of Munich (TUM) and the Ludwig Maximilian University of Munich (LMU) appealed to their students to volunteer for relief work. In this study, we examine the influence of psychological factors on the students' decisions to respond to this call or not. Methodology: We report on a cross-sectional study based on an online survey among medical students at the TUM and LMU. The survey consisted of a questionnaire containing items on motivation and other factors related to the decision for or against volunteering. Questions were also asked about anxieties regarding COVID-19 and the occurrence of depressive symptoms, as well as about resilience. Results: Responses from 244 participants were analysed. Students' decisions to volunteer revealed both altruistic and introjected motivations. For those students who did not volunteer, time overlaps and workload related to other activities played an important role. Between the two groups, no significant difference was detected in terms of their resilience and COVID-19-related anxieties. However, the non-volunteering students reported a significantly higher prevalence of depressive symptoms. Conclusion: Sense of duty and the desire to help were, according to the students, the most important reasons for volunteering. Depressive symptoms and lack of time made volunteering less likely. Resilience and COVID-19-related anxieties do not seem to have had any influence on the decision to volunteer or not.
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Affiliation(s)
- Luisa Mühlbauer
- Technische Universität München, Fakultät für Medizin, Klinikum rechts der Isar, TUM Medical Education Center, München, Germany
| | - Johanna Huber
- LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin (DAM) am LMU Klinikum, München, Germany
| | - Martin R. Fischer
- LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin (DAM) am LMU Klinikum, München, Germany
| | - Pascal O. Berberat
- Technische Universität München, Fakultät für Medizin, Klinikum rechts der Isar, TUM Medical Education Center, München, Germany
| | - Martin Gartmeier
- Technische Universität München, Fakultät für Medizin, Klinikum rechts der Isar, TUM Medical Education Center, München, Germany
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26
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Heininger SK, Baumgartner M, Zehner F, Burgkart R, Söllner N, Berberat PO, Gartmeier M. Correction to: Measuring hygiene competence: the picture-based situational judgement test HygiKo. BMC Med Educ 2021; 21:440. [PMID: 34412600 PMCID: PMC8377828 DOI: 10.1186/s12909-021-02877-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Susanne Katharina Heininger
- Klinikum rechts der Isar, TUM Medical Education Center, Fakultät für Medizin, TU München, Ismaninger Straße 22, D-81675, Munich, Germany.
| | - Maria Baumgartner
- Klinikum rechts der Isar, TUM Medical Education Center, Fakultät für Medizin, TU München, Ismaninger Straße 22, D-81675, Munich, Germany
| | - Fabian Zehner
- DIPF | Leibniz-Institut für Bildungsforschung und Bildungsinformation, Frankfurt, Germany
| | - Rainer Burgkart
- Klinik und Poliklinik für Orthopädie und Sportorthopädie, Fakultät für Medizin, Klinikum rechts der Isar, TU München, Munich, Germany
| | - Nina Söllner
- Klinikum rechts der Isar, TUM Medical Education Center, Fakultät für Medizin, TU München, Ismaninger Straße 22, D-81675, Munich, Germany
| | - Pascal O Berberat
- Klinikum rechts der Isar, TUM Medical Education Center, Fakultät für Medizin, TU München, Ismaninger Straße 22, D-81675, Munich, Germany
| | - Martin Gartmeier
- Klinikum rechts der Isar, TUM Medical Education Center, Fakultät für Medizin, TU München, Ismaninger Straße 22, D-81675, Munich, Germany
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27
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Heininger SK, Baumgartner M, Zehner F, Burgkart R, Söllner N, Berberat PO, Gartmeier M. Measuring hygiene competence: the picture-based situational judgement test HygiKo. BMC Med Educ 2021; 21:410. [PMID: 34330263 PMCID: PMC8323094 DOI: 10.1186/s12909-021-02829-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 07/14/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND With the onset of the COVID-19 pandemic at the beginning of 2020, the crucial role of hygiene in healthcare settings has once again become very clear. For diagnostic and for didactic purposes, standardized and reliable tests suitable to assess the competencies involved in "working hygienically" are required. However, existing tests usually use self-report questionnaires, which are suboptimal for this purpose. In the present study, we introduce the newly developed, competence-oriented HygiKo test instrument focusing health-care professionals' hygiene competence and report empirical evidence regarding its psychometric properties. METHODS HygiKo is a Situational Judgement Test (SJT) to assess hygiene competence. The HygiKo-test consists of twenty pictures (items), each item presents only one unambiguous hygiene lapse. For each item, test respondents are asked (1) whether they recognize a problem in the picture with respect to hygiene guidelines and, (2) if yes, to describe the problem in a short verbal response. Our sample comprised n = 149 health care professionals (79.1 % female; age: M = 26.7 years, SD = 7.3 years) working as clinicians or nurses. The written responses were rated by two independent raters with high agreement (α > 0.80), indicating high reliability of the measurement. We used Item Response Theory (IRT) for further data analysis. RESULTS We report IRT analyses that show that the HygiKo-test is suitable to assess hygiene competence and that it allows to distinguish between persons demonstrating different levels of ability for seventeen of the twenty items), especially for the range of low to medium person abilities. Hence, the HygiKo-SJT is suitable to get a reliable and competence-oriented measure for hygiene-competence. CONCLUSIONS In its present form, the HygiKo-test can be used to assess the hygiene competence of medical students, medical doctors, nurses and trainee nurses in cross-sectional measurements. In order to broaden the difficulty spectrum of the current test, additional test items with higher difficulty should be developed. The Situational Judgement Test designed to assess hygiene competence can be helpful in testing and teaching the ability of working hygienically. Further research for validity is needed.
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Affiliation(s)
- Susanne Katharina Heininger
- Klinikum rechts der Isar, TUM Medical Education Center, Fakultät für Medizin, TU München, Ismaninger Straße 22, D-81675 München, Germany
| | - Maria Baumgartner
- Klinikum rechts der Isar, TUM Medical Education Center, Fakultät für Medizin, TU München, Ismaninger Straße 22, D-81675 München, Germany
| | - Fabian Zehner
- DIPF | Leibniz-Institut für Bildungsforschung und Bildungsinformation, Frankfurt, Germany
| | - Rainer Burgkart
- Klinik und Poliklinik für Orthopädie und Sportorthopädie, Fakultät für Medizin, Klinikum rechts der Isar, TU München, München, Germany
| | - Nina Söllner
- Klinikum rechts der Isar, TUM Medical Education Center, Fakultät für Medizin, TU München, Ismaninger Straße 22, D-81675 München, Germany
| | - Pascal O. Berberat
- Klinikum rechts der Isar, TUM Medical Education Center, Fakultät für Medizin, TU München, Ismaninger Straße 22, D-81675 München, Germany
| | - Martin Gartmeier
- Klinikum rechts der Isar, TUM Medical Education Center, Fakultät für Medizin, TU München, Ismaninger Straße 22, D-81675 München, Germany
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28
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Schneider A, Bühner M, Herzog T, Laverty S, Ziehfreund S, Hapfelmeier A, Schneider D, Berberat PO, Roos M. Educational Intervention Reduced Family Medicine Residents' Intention to Request Diagnostic Tests: Results of a Controlled Trial. Med Decis Making 2021; 41:329-339. [PMID: 33629614 DOI: 10.1177/0272989x21989692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Dealing with uncertainty is a core competence for physicians. To evaluate the impact of an educational intervention on family medicine residents' (FMRs') intention to request diagnostic tests and their attitudes toward uncertainty. METHODS Nonrandomized controlled trial. Intervention group (IG) FMRs participated in interactive "dealing with uncertainty" seminars comprising statistical lessons and diagnostic reasoning. Control group (CG) FMRs participated in seminars without in-depth diagnostic lessons. FMRs completed the Dealing with Uncertainty Questionnaire (DUQ), comprising the Diagnostic Action and Diagnostic Reasoning scales. The Physicians' Reaction to Uncertainty (PRU) questionnaire, comprising 4 scales (Anxiety Due to Uncertainty, Concern about Bad Outcomes, Reluctance to Disclose Uncertainty to Patients, and Reluctance to Disclose Mistakes to Physicians) was also completed. Follow-up was performed 3 months later. Differences were calculated with repeated-measures analysis of variance. RESULTS In total, 107 FMRs of the IG and 102 FMRs of the CG participated at baseline and follow-up. The mean (SD) Diagnostic Action scale score decreased from 24.0 (4.8) to 22.9 (5.1) in the IG and increased in the CG from 23.7 (5.4) to 24.1 (5.4), showing significant group difference (P = 0.006). The Diagnostic Reasoning scale increased significantly (P = 0.025) without a significant group difference (P = 0.616), from 19.2 (2.6) to 19.7 (2.4) in the IG and from 18.1 (3.3) to 18.8 (3.2) in the CG. The PRU scale Anxiety Due to Uncertainty decreased significantly (P = 0.029) without a significant group difference (P = 0.116), from 20.5 (4.8) to 18.5 (5.5) in the IG and from 19.9 (5.5) to 19.0 (6.0) in the CG. CONCLUSION The structured seminar reduced self-rated diagnostic test requisition. The change in Anxiety Due to Uncertainty and Diagnostic Reasoning might be due to an unspecific accompanying effect of the extra-occupational seminars for residents.
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Affiliation(s)
- Antonius Schneider
- TUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany.,Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Germany
| | - Markus Bühner
- Institute of Psychological Methods and Diagnostics, Department of Psychology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Therese Herzog
- TUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany.,Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Germany
| | - Siona Laverty
- TUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany.,Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Germany
| | - Stefanie Ziehfreund
- TUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany.,Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Germany
| | - Alexander Hapfelmeier
- TUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany.,TUM School of Medicine, Institute of Medical Informatics, Statistics and Epidemiology, Technical University Munich, Munich, Germany
| | - Dagmar Schneider
- Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Germany.,Koordinierungsstelle Allgemeinmedizin, Munich, Germany
| | - Pascal O Berberat
- TUM Medical Education Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Marco Roos
- Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Germany.,Institute of General Practice, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
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Kidess M, Schmid SC, Pollak S, Gschwend JE, Berberat PO, Autenrieth ME. [Virtual skills-training in urology : Teaching at the Technical University of Munich during the COVID-19-pandemic]. Urologe A 2021; 60:484-490. [PMID: 33433661 PMCID: PMC7801874 DOI: 10.1007/s00120-020-01431-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2020] [Indexed: 11/29/2022]
Abstract
Hintergrund und Einleitung Die COVID-19-Pandemie stellte die Universitätskliniken vor eine große Herausforderung: Wie kann eine praktische Ausbildung angehender Mediziner ohne deren Präsenz in der Klinik erfolgen? Als Alternative zum regulären Praktikumstag haben wir innerhalb kurzer Zeit ein virtuelles Ersatzangebot mittels Lehrvideos zu unterschiedlichen urologischen Themen auf einer universitären Online-Plattform geschaffen. Ziel der Videos war die Vermittlung des Fachs Urologie in Theorie und Praxis. Material und Methoden Die Videos wurden durch Mitarbeiter der Klinik anhand eines ausgearbeiteten Konzepts gefilmt und bearbeitet. Anschließend wurden diese Videos auf der universitären Online-Lehrplattform Moodle zur Verfügung gestellt. Zur Erfolgskontrolle mussten die Studierenden zu jedem Themenkomplex eine Frage beantworten. Eine Teilnahmebescheinigung wurde generiert, sobald die Studierenden mindestens 60 % aller Fragen richtig beantwortet hatten und an einer abschließenden Evaluation teilgenommen haben. Ergebnisse Der virtuelle Praktikumstag wurde von 164 Teilnehmern absolviert. Die Evaluationen sind mit einem sehr positiven Gesamturteil ausgefallen – mit einer Schulnote von 1,2. Insgesamt war die Akzeptanz des Ersatzangebotes hoch. Diskussion Das virtuelle Format als Alternative zum Präsenzunterricht wurde von den Studierenden sehr gut angenommen. Mit dem virtuellen Praktikumstag wurde eine schnelle und kontaktlose Alternative zum Präsenzunterricht geschaffen.
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Affiliation(s)
- Marc Kidess
- Klinik und Poliklinik für Urologie, Universitätsklinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland
| | - Sebastian C Schmid
- Klinik und Poliklinik für Urologie, Universitätsklinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland
| | - Sebastian Pollak
- Klinik und Poliklinik für Urologie, Universitätsklinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland
| | - Jürgen E Gschwend
- Klinik und Poliklinik für Urologie, Universitätsklinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland
| | - Pascal O Berberat
- TUM Medical Education Center, Fakultät für Medizin, Universitätsklinikum rechts der Isar, Technische Universität München, München, Deutschland
| | - Michael E Autenrieth
- Klinik und Poliklinik für Urologie, Universitätsklinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland.
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Zottmann JM, Horrer A, Chouchane A, Huber J, Heuser S, Iwaki L, Kowalski C, Gartmeier M, Berberat PO, Fischer MR, Weidenbusch M. Isn't here just there without a "t" - to what extent can digital Clinical Case Discussions compensate for the absence of face-to-face teaching? GMS J Med Educ 2020; 37:Doc99. [PMID: 33364378 PMCID: PMC7740012 DOI: 10.3205/zma001392] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/19/2020] [Accepted: 10/23/2020] [Indexed: 06/01/2023]
Abstract
Objective: COVID-19 challenges curriculum managers worldwide to create digital substitutes for classroom teaching. Case-based teaching formats under expert supervision can be used as a substitute for practical bedside teaching, where the focus is on teaching clinical reasoning skills. Methods: For medical students of LMU and TU Munich, the interactive, case-based, and supervised teaching format of Clinical Case Discussion (CCD) was digitised and implemented as dCCD in their respective curricula. Case discussions were realised as videoconferences, led by a student moderator, and took place under the supervision of a board-certified clinician. To prevent passive participation, additional cognitive activations were implemented. Acceptance, usability, and subjective learning outcomes were assessed in dCCDs by means of a special evaluation concept. Results: With regard to acceptance, students were of the opinion that they had learned effectively by participating in dCCDs (M=4.31; SD=1.37). The majority of students also stated that they would recommend the course to others (M=4.23; SD=1.62). The technical implementation of the teaching format was judged positively overall, but findings for usability were heterogeneous. Students rated their clinical reasoning skills at the end of the dCCDs (M=4.43; SD=0.66) as being significantly higher than at the beginning (M=4.33; SD=0.69), with low effect size, t(181)=-2.352, p=.020, d=0.15. Conclusion: Our evaluation data shows that the dCCD format is well-accepted by students as a substitute for face-to-face teaching. In the next step, we plan to examine the extent to which participation in dCCDs leads to an increase in objectively measured clinical reasoning skills, analogous to a face-to-face CCD with on-site attendance.
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Affiliation(s)
- Jan M. Zottmann
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
| | - Anna Horrer
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
| | - Amir Chouchane
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Johanna Huber
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
| | - Sonja Heuser
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
| | - Lica Iwaki
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
| | - Christian Kowalski
- LMU Munich, University Hospital, Department of Anesthesiology, Munich, Germany
| | - Martin Gartmeier
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Pascal O. Berberat
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Martin R. Fischer
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
| | - Marc Weidenbusch
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
- LMU Munich, University Hospital, Department of Internal Medicine IV, Munich, Germany
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Dapper H, Wijnen-Meijer M, Rathfelder S, Mosene K, von Kirchbauer I, Bernhardt D, Berberat PO, Combs SE. Radiation oncology as part of medical education-current status and possible digital future prospects. Strahlenther Onkol 2020; 197:528-536. [PMID: 33230568 PMCID: PMC7682521 DOI: 10.1007/s00066-020-01712-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 11/02/2020] [Indexed: 11/29/2022]
Abstract
Purpose Education as part of medical education is currently changing rapidly. Not least because of the corona crisis, more and more digital teaching formats and innovative teaching concepts such as the flipped classroom model are finding their way into teaching. We analyzed the acceptance and effectiveness of traditional teaching methods as well as the interest in innovative e‑learning methods among medical students in the field of radiation oncology at the medical school of the Technical University of Munich. Methods We carried out an online-based survey as well as a knowledge test on all students from two terms who had completed the seminar series of radiation oncology. The survey comprised seven questions on the frequency of participation, acceptance, and judgment of the effectiveness in terms of learning and on a potential use of e‑learning methods using a six-point Likert scale. The test consisted of 10 multiple-choice questions. Results Traditional teaching methods are largely accepted by students and most students consider the current learning format to be effective in terms of the teaching effect in the field of radiation oncology. However, only about 50% of all knowledge questions were answered correctly. The possible use of e‑learning methods was judged critically or desired in roughly equal parts among the students. Conclusion Traditional seminars enjoy a high level of acceptance among students. Effectiveness with regard to the internalization of content taught, however, should be increased. After all, the future seems to lie in the integration of e‑learning in the form of educational videos and practical seminars.
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Affiliation(s)
- Hendrik Dapper
- Department of Radiation Oncology, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Marjo Wijnen-Meijer
- School of Medicine, TUM Medical Education Center, Technical University Munich, Nigerstraße 3, 81675, Munich, Germany
| | - Salome Rathfelder
- DRF Stiftung Luftrettung gAG, Rita-Maiburg-Straße 2, 70794, Filderstadt, Germany
| | - Katharina Mosene
- School of Medicine, TUM Medical Education Center, Technical University Munich, Nigerstraße 3, 81675, Munich, Germany
| | - Isabelle von Kirchbauer
- School of Medicine, TUM Medical Education Center, Technical University Munich, Nigerstraße 3, 81675, Munich, Germany
| | - Denise Bernhardt
- Department of Radiation Oncology, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Pascal O Berberat
- School of Medicine, TUM Medical Education Center, Technical University Munich, Nigerstraße 3, 81675, Munich, Germany
| | - Stephanie E Combs
- Department of Radiation Oncology, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany.,Institute for Radiation Medicine (IRM), Helmholtz Zentrum München (HMGU), Ingolstädter Landstr. 1, Neuherberg, Germany.,Partner Site Munich, Deutsches Konsortium für Translationale Krebsforschung (DKTK), Munich, Germany
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Fürstenberg S, Helm T, Prediger S, Kadmon M, Berberat PO, Harendza S. Assessing clinical reasoning in undergraduate medical students during history taking with an empirically derived scale for clinical reasoning indicators. BMC Med Educ 2020; 20:368. [PMID: 33076879 PMCID: PMC7574202 DOI: 10.1186/s12909-020-02260-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 09/28/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The clinical reasoning process, which requires biomedical knowledge, knowledge about problem-solving strategies, and knowledge about reasons for diagnostic procedures, is a key element of physicians' daily practice but difficult to assess. The aim of this study was to empirically develop a Clinical Reasoning Indicators-History Taking-Scale (CRI-HT-S) and to assess the clinical reasoning ability of advanced medical students during a simulation involving history taking. METHODS The Clinical Reasoning Indictors-History Taking-Scale (CRI-HT-S) including a 5-point Likert scale for assessment was designed from clinical reasoning indicators identified in a qualitative study in 2017. To assess indicators of clinical reasoning ability, 65 advanced medical students (semester 10, n = 25 versus final year, n = 40) from three medical schools participated in a 360-degree competence assessment in the role of beginning residents during a simulated first workday in hospital. This assessment included a consultation hour with five simulated patients which was videotaped. Videos of 325 patient consultations were assessed using the CRI-HT-S. A factor analysis was conducted and the students' results were compared according to their advancement in undergraduate medical training. RESULTS The clinical reasoning indicators of the CRI-HT-S loaded on three factors relevant for clinical reasoning: 1) focusing questions, 2) creating context, and 3) securing information. Students reached significantly different scores (p < .001) for the three factors (factor 1: 4.07 ± .47, factor 2: 3.72 ± .43, factor 3: 2.79 ± .83). Students in semester 10 reached significantly lower scores for factor 3 than students in their final year (p < .05). CONCLUSIONS The newly developed CRI-HT-S worked well for quantitative assessment of clinical reasoning indicators during history taking. Its three-factored structure helped to explore different aspects of clinical reasoning. Whether the CRI-HT-S has the potential to be used as a scale in objective structured clinical examinations (OCSEs) or in workplace-based assessments of clinical reasoning has to be investigated in further studies with larger student cohorts.
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Affiliation(s)
- Sophie Fürstenberg
- Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, III Medizinische Klinik, Martinistr. 52, D-20246 Hamburg, Germany
| | - Tillmann Helm
- Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, III Medizinische Klinik, Martinistr. 52, D-20246 Hamburg, Germany
| | - Sarah Prediger
- Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, III Medizinische Klinik, Martinistr. 52, D-20246 Hamburg, Germany
| | - Martina Kadmon
- Faculty of Medicine, University of Augsburg, Deanery, Augsburg, Germany
| | - Pascal O. Berberat
- TUM Medical Education Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Sigrid Harendza
- Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, III Medizinische Klinik, Martinistr. 52, D-20246 Hamburg, Germany
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Scheide L, Teufel D, Wijnen-Meijer M, Berberat PO. (Self-)Reflexion and training of professional skills in the context of "being a doctor" in the future - a qualitative analysis of medical students' experience in LET ME ... keep you real! GMS J Med Educ 2020; 37:Doc47. [PMID: 32984506 PMCID: PMC7499461 DOI: 10.3205/zma001340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 03/26/2020] [Accepted: 06/22/2020] [Indexed: 06/11/2023]
Abstract
Objective: This paper seeks to assess how medical students can be trained in medical studies seminars to examine their own professional role as doctors. The LET ME ... keep you real! university seminar was developed and conducted at the Technical University of Munich. In this context, the following questions will be addressed: How can we assess the contribution of a university seminar to a medical student's own examination of being a doctor? And: What skills are developed in LET ME ... keep you real! that foster medical students' (self-)reflexion? Methods: The source data is statements made by medical students who took part in the LET ME….keep you real! seminar from 2016-2018. Student perspectives were analyzed after five focus group discussions with a total of 26 medical student participants and two individual interviews. Based on the interpretative paradigm and following the credo of a methodological exploration of medical students' lifeworld, their specific learning experience as well as their ability for (self-)reflexion were mapped out. Results: The research questions guiding the assessment of the seminar can be answered as follows: From the students' perspective, the (self-)reflexion triggered and organized by LET ME ... keep you real! can be seen as rehearsing a meta-view. From the students' standpoint, five skills can be identified that make this behavior possible: questioning and doubting,recognizing relevant perspectives, classifying viewpoints, maintaining communal exchanges and deciding on a (different) position. Situatively, these skills are often used in combination and challenge students on an intellectual, communicative and emotional level. Conclusion: The ability to (self-)reflect should be more strongly integrated in university medical training by providing appropriate support, especially since it presents students with specific challenges to (self-)reflexively approach their own future as doctors. The skills mapped out here can be used as orientation to develop seminars on professional (self-)reflexive identity development for medical students.
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Fincke F, Prediger S, Schick K, Fürstenberg S, Spychala N, Berberat PO, Harendza S, Kadmon M. Entrustable professional activities and facets of competence in a simulated workplace-based assessment for advanced medical students. Med Teach 2020; 42:1019-1026. [PMID: 32579039 DOI: 10.1080/0142159x.2020.1779204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Background: Competence-based assessment formats in medical education usually focus on individual facets of competence (FOCs). The concept of 'Entrustable Professional Activities' (EPAs) encompasses supervisors' decisions on which level of supervision a trainee requires to perform a professional activity including several FOCs. How the different FOCs as perceived by clinician raters contribute to entrustment decisions is yet unclear.Objective: How do FOC perceptions relate to entrustment-decisions?Methods: Sixty-seven advanced medical students participated in an assessment simulating the first day of a resident physician. Participants were rated by supervisors for seven FOCs and twelve EPAs.Results: There was a positive correlation between FOC and EPA scores. Each EPA displayed a different correlation pattern with FOC ratings.Discussion: For most EPAs high levels of entrustment were associated with high ratings for selected FOCs. The results are in alignment with the assumption that each EPA encompasses a different set of FOCs.Conclusions: In our simulated workplace-based assessment, entrustment decisions for EPAs reflect the FOCs observed in a trainee. Thus, assessment of FOCs alongside with EPA ratings could add to the understanding of factors contributing to entrustment decisions.
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Affiliation(s)
- Fabian Fincke
- Department of Medical Education and Educational Research, Faculty of Medicine and Health Science, University of Oldenburg, Oldenburg, Germany
| | - Sarah Prediger
- Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kristina Schick
- TUM Medical Education Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Sophie Fürstenberg
- Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nadine Spychala
- Department of Medical Education and Educational Research, Faculty of Medicine and Health Science, University of Oldenburg, Oldenburg, Germany
| | - Pascal O Berberat
- TUM Medical Education Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Sigrid Harendza
- Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martina Kadmon
- Department of Medical Education Augsburg, Faculty of Medicine, University of Augsburg, Augsburg, Germany
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Abstract
Medical education is a relatively young field of research that has been characterized by many innovations over the last 20 years. The main topics were the preparation of students for their medical work and imparting of profound knowledge about scientific contexts in medicine. For a long time, the main focus was on learning the necessary knowledge and skills; however, this is no longer considered sufficient. In order to carry out the work as a physician well, other qualities are also necessary, such as communication, collaboration, professionalism, science and reflectivity. Worldwide these aspects are being increasingly integrated into the learning objectives of medical schools and residency programs. The structure of medical studies at many universities has also changed. So-called vertical integration strengthens the integration of theoretical preclinical training and the clinical phase. This means that in the preclinical phase training is more practice-oriented and in the clinical phase a more structured form of training takes place. In the first years of study, students are prepared for the clinical phase by discussing patient cases and practicing skills in simulation centers. In addition, the clinical working environment is increasingly used as a learning environment. Developments have also been made regarding examinations: in addition to knowledge and skills, students and residents are now also assessed regarding performance in practice. Using more realistic assessments, e.g., Objective Structured Clinical Examinations and Workplace-based Assessments, students are evaluated more on their actual performance in practice. By means of the Entrustable Professional Activities method, students are gradually given more responsibility in order to prepare them for their future tasks.
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Affiliation(s)
- M Wijnen-Meijer
- TUM Medical Education Center, Fakultät für Medizin, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland.
| | - M Gartmeier
- TUM Medical Education Center, Fakultät für Medizin, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland
| | - P O Berberat
- TUM Medical Education Center, Fakultät für Medizin, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland
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Grünewald M, Klein E, Hapfelmeier A, Wuensch A, Berberat PO, Gartmeier M. Improving physicians' surgical ward round competence through simulation-based training. Patient Educ Couns 2020; 103:971-977. [PMID: 31810763 DOI: 10.1016/j.pec.2019.11.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 11/25/2019] [Accepted: 11/27/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Ward rounds are an essential part of physicians' daily routine. Existing studies suggest that their practical implementation is inconsistent. Therefore, developing interventions to train ward round competence and assessing if they are effective educational tools are crucial goals for research. METHODS We analysed a simulation-based tutorial dedicated to fourth-year medical students, including casework and ward round simulation. We investigated the effectiveness of this intervention regarding ward round competence through a randomized controlled trial. Performance was assessed with the modified/validated surgical ward round assessment tool by two blinded and trained raters. Supplementary, motivation during the ward round tutorial was assessed for all students at different time points. RESULTS Analysis of the ratings show that, in contrast to the control group (pre: 66.1 vs. post: 64.8 points, p = 0.72), the ward round competence of the intervention group (pre: 62.6 vs. post: 69.6 points, p = 0.0169) improved significantly after participating in the ward round tutorial. CONCLUSION The results show that our simulation-based training is an effective way to improve competence of medical students in conducting surgical ward rounds. PRACTICE IMPLICATIONS Participation in ward round trainings is a valuable tool to prepare students for their future professional practise.
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Affiliation(s)
- Marc Grünewald
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Nigerstr. 3, 81675 Munich, Germany.
| | - Evelyn Klein
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Nigerstr. 3, 81675 Munich, Germany; Department of Obstetrics and Gynecology, University Hospital rechts der Isar, Technical University of Munich, Ismaningerstrasse 22, 81675 Munich, Germany.
| | - Alexander Hapfelmeier
- Technical University of Munich, Institute of Medical Informatics, Statistics and Epidemiology, Ismaninger Str. 22, 81675 Munich, Germany.
| | - Alexander Wuensch
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Nigerstr. 3, 81675 Munich, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 5a, 79104 Freiburg, Germany.
| | - Pascal O Berberat
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Nigerstr. 3, 81675 Munich, Germany.
| | - Martin Gartmeier
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Nigerstr. 3, 81675 Munich, Germany.
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Gartmeier M, Reimer M, Huber J, Epstein N, Fischer MR, Berberat PO. International mobility of students in the medical disciplines from a comparative perspective. GMS J Med Educ 2020; 37:Doc34. [PMID: 32566736 PMCID: PMC7291386 DOI: 10.3205/zma001327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 01/15/2020] [Accepted: 02/19/2020] [Indexed: 05/28/2023]
Abstract
Objective: We analyze the extent to which students of human, veterinary and dental medicine complete study-related stays abroad (frequency, type and duration of stays abroad and countries visited). Furthermore, we investigate the possible correlations between completed stays abroad and the duration of studies, the completion of a doctorate and entering professional life. Methods: The data come from a written cross-sectional survey of 742 graduates of their respective study programs at Bavarian universities. The evaluation was carried out using descriptive and inferential statistical methods. Results: Slightly more than half of the surveyed students completed study-associated stays abroad, with notable differences between the three study programs. The students most frequently completed internships abroad lasting an average of nine weeks. Switzerland was the most common country of destination for the stays abroad. Furthermore, there were no or only weak correlations between stays abroad, the duration of studies and progress towards a doctorate or the commencement of professional employment abroad. There were no correlations with the stress experienced as part of initial employment after graduation. Conclusion: The results clearly indicate that stays abroad are quite usual for students in the medical disciplines and are almost standard in the study of human medicine. The selection of the countries visited indicates that the primary goal of the students' stays abroad is to deepen their competence with a view to later employment in their home country.
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Affiliation(s)
- Martin Gartmeier
- Technical University of Munich, Faculty of Medicine, Hospital rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Maike Reimer
- Bayrisches Staatsinstitut für Hochschulforschung und Hochschulplanung, Munich, Germany
| | - Johanna Huber
- LMU Munich, Hospital University Munich, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
| | - Nurith Epstein
- LMU Munich, Hospital University Munich, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
| | - Martin R. Fischer
- LMU Munich, Hospital University Munich, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
| | - Pascal O. Berberat
- Technical University of Munich, Faculty of Medicine, Hospital rechts der Isar, TUM Medical Education Center, Munich, Germany
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Gärtner J, Berberat PO, Kadmon M, Harendza S. Implicit expression of uncertainty - suggestion of an empirically derived framework. BMC Med Educ 2020; 20:83. [PMID: 32197608 PMCID: PMC7082979 DOI: 10.1186/s12909-020-1990-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 03/02/2020] [Indexed: 06/01/2023]
Abstract
BACKGROUND Uncertainty occurs in physicians' daily work in almost every clinical context and is also present in the clinical reasoning process. The way physicians communicate uncertainty in their thinking process during handoffs is crucial for patient safety because uncertainty has diverse effects on individuals involved in patient care. Dealing with uncertainty and expressing uncertainty are important processes in the development of professional identity of undergraduate medical students. Many studies focused on how to deal with uncertainty and whether uncertainty is explicitly expressed. Hardly any research has been done regarding implicit expression of uncertainty. Therefore, we studied the ways in which medical students in the role of beginning residents implicitly express uncertainty during simulated handoffs. METHODS Sixty-seven advanced undergraduate medical students participated in a simulated first day of residency including a consultation hour, a patient management phase with interprofessional interaction, and a patient handoff. We transcribed the videographed handoffs verbatim and extracted language with respect to expression of uncertainty using a grounded theory approach. Text sequences expressing patient related information were analyzed and coded with respect to language aspects which implicitly modified plain information with respect to increasing or decreasing uncertainty. Concepts and categories were developed and discussed until saturation of all aspects was reached. RESULTS We discovered a framework of implicit expressions of uncertainty regarding diagnostic and treatment-related decisions within four categories: "Statement", "Assessment", "Consideration", and "Implication". Each category was related to either the subcategory "Actions" or "Results" within the diagnostic or therapeutic decisions. Within each category and subcategory, we found a subset of expressions, which implicitly attenuated or strengthened plain information thereby increasing uncertainty or certainty, respectively. Language that implicitly attenuated plain information belonged to the categories questionable, incomplete, alterable, and unreliable while we could ascribe implicit strengtheners to the categories assertive, adequate, focused, and reliable. CONCLUSIONS Our suggested framework of implicit expression of uncertainty may help to raise the awareness for expression of uncertainty in the clinical reasoning process and provide support for making uncertainty explicit in the teaching process. This may lead to more transparent communication processes among health care professionals and eventually to improved patient safety.
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Affiliation(s)
- Julia Gärtner
- III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Pascal O. Berberat
- TUM Medical Education Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Martina Kadmon
- Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Sigrid Harendza
- III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Prediger S, Schick K, Fincke F, Fürstenberg S, Oubaid V, Kadmon M, Berberat PO, Harendza S. Validation of a competence-based assessment of medical students' performance in the physician's role. BMC Med Educ 2020; 20:6. [PMID: 31910843 PMCID: PMC6947905 DOI: 10.1186/s12909-019-1919-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 12/22/2019] [Indexed: 05/04/2023]
Abstract
BACKGROUND Assessing competence of advanced undergraduate medical students based on performance in the clinical context is the ultimate, yet challenging goal for medical educators to provide constructive alignment between undergraduate medical training and professional work of physicians. Therefore, we designed and validated a performance-based 360-degree assessment for competences of advanced undergraduate medical students. METHODS This study was conducted in three steps: 1) Ten facets of competence considered to be most important for beginning residents were determined by a ranking study with 102 internists and 100 surgeons. 2) Based on these facets of competence we developed a 360-degree assessment simulating a first day of residency. Advanced undergraduate medical students (year 5 and 6) participated in the physician's role. Additionally knowledge was assessed by a multiple-choice test. The assessment was performed twice (t1 and t2) and included three phases: a consultation hour, a patient management phase, and a patient handover. Sixty-seven (t1) and eighty-nine (t2) undergraduate medical students participated. 3) The participants completed the Group Assessment of Performance (GAP)-test for flight school applicants to assess medical students' facets of competence in a non-medical context for validation purposes. We aimed to provide a validity argument for our newly designed assessment based on Messick's six aspects of validation: (1) content validity, (2) substantive/cognitive validity, (3) structural validity, (4) generalizability, (5) external validity, and (6) consequential validity. RESULTS Our assessment proved to be well operationalised to enable undergraduate medical students to show their competences in performance on the higher levels of Bloom's taxonomy. Its generalisability was underscored by its authenticity in respect of workplace reality and its underlying facets of competence relevant for beginning residents. The moderate concordance with facets of competence of the validated GAP-test provides arguments of convergent validity for our assessment. Since five aspects of Messick's validation approach could be defended, our competence-based 360-degree assessment format shows good arguments for its validity. CONCLUSION According to these validation arguments, our assessment instrument seems to be a good option to assess competence in advanced undergraduate medical students in a summative or formative way. Developments towards assessment of postgraduate medical trainees should be explored.
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Affiliation(s)
- Sarah Prediger
- III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kristina Schick
- TUM Medical Education Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Fabian Fincke
- Department of Medical Education and Educational Research, Faculty of Medicine and Health Science, University of Oldenburg, Oldenburg, Germany
| | - Sophie Fürstenberg
- III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Martina Kadmon
- Faculty of Medicine, University of Augsburg, Deanery, Augsburg, Germany
| | - Pascal O. Berberat
- TUM Medical Education Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Sigrid Harendza
- III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Schick K, Reiser S, Mosene K, Schacht L, Janssen L, Thomm E, Dinkel A, Fleischmann A, Berberat PO, Bauer J, Gartmeier M. How can communicative competence instruction in medical studies be improved through digitalization? GMS J Med Educ 2020; 37:Doc57. [PMID: 33225049 PMCID: PMC7672381 DOI: 10.3205/zma001350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 03/29/2020] [Accepted: 05/29/2020] [Indexed: 05/10/2023]
Abstract
The teaching of communicative competence plays an increasingly important role in medical education. In addition to traditional teaching formats, such as role-plays with simulated patients, technology-based approaches become more important in medical education. Teaching materials are increasingly augmented by videos of simulated doctor-patient conversations. This combination allows the content of teaching materials to be demonstrated with video or for videos to create a basis for reflection activities. In addition, conversation videos can illustrate different qualities of clinical communication and serve as illustrative material for describing particular issues in more detail. In addition to teaching clinical communicative competence, the assessment of this competence also plays an important role in medical educational research. So far, this has mainly been conducted through direct observation using checklists or rating scales. Relatively little is known about the assessment of communicative competence using standardized online-based tests. Situational Judgement Tests (SJTs) offer a promising approach in this respect. The BMBF-funded (BMBF = Bundesministerium für Bildung und Forschung - Federal Ministry of Education and Research) joint project voLeA (Entwicklung videobasierter Lehr- und Assessmentmodule zur Gesprächskompetenz im Medizinstudium = Development of video-based teaching and assessment modules for communicative competence in medical studies) addresses these two issues. Specifically, the project is engaged in developing e-learning modules to promote communicative competence and an assessment of this competence using an SJT. The present paper focuses on the benefits of technology-based learning and assessment units for clinical communicative competence in medical studies, using the voLeA project as an example.
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Affiliation(s)
- Kristina Schick
- Technical University of Munich, TUM Medical Education Center, Munich, Germany
- *To whom correspondence should be addressed: Kristina Schick, Technical University of Munich, TUM Medical Education Center, Ismaninger Str. 22, D-81675 Munich, Germany, Phone: +49 (0)89/4140-6311, E-mail:
| | - Sabine Reiser
- University Erfurt, Professur für Bildungsforschung und Methodenlehre, Erfurt, Germany
| | - Katharina Mosene
- Technical University of Munich, TUM Medical Education Center, Munich, Germany
| | - Laura Schacht
- University Erfurt, Professur für Bildungsforschung und Methodenlehre, Erfurt, Germany
| | - Laura Janssen
- Technical University of Munich, TUM Medical Education Center, Munich, Germany
| | - Eva Thomm
- University Erfurt, Professur für Bildungsforschung und Methodenlehre, Erfurt, Germany
| | - Andreas Dinkel
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Munich, Germany
| | - Andreas Fleischmann
- Technical University of Munich, Pro Lehre, Medien und Didaktik, Munich, Germany
| | - Pascal O. Berberat
- Technical University of Munich, TUM Medical Education Center, Munich, Germany
| | - Johannes Bauer
- University Erfurt, Professur für Bildungsforschung und Methodenlehre, Erfurt, Germany
| | - Martin Gartmeier
- Technical University of Munich, TUM Medical Education Center, Munich, Germany
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Gartmeier M, Pfurtscheller T, Hapfelmeier A, Grünewald M, Häusler J, Seidel T, Berberat PO. Teacher questions and student responses in case-based learning: outcomes of a video study in medical education. BMC Med Educ 2019; 19:455. [PMID: 31805913 PMCID: PMC6896701 DOI: 10.1186/s12909-019-1895-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/29/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND Case-based learning (CBL) is a highly interactive instructional format widely used in medical education. One goal of CBL is to integrate basic biomedical knowledge and its application to concrete patient cases and their clinical management. In this context, we focus the role of teacher questions as triggers for reproductive vs. elaborative student responses. Specifically, our research questions concern the kinds of questions posed by clinical teachers, the kinds of responses given by students, the prediction of student responses based upon teacher questions, and the differences between the two medical disciplines in focus of our study, internal medicine and surgery. METHODS We analyse 19 videotaped seminars (nine internal medicine, ten surgery) taught by clinicians and attended by advanced medical students. Multiple raters performed a low-inference rating process using a theory-based categorical scheme with satisfactory interrater-reliability. RESULTS We found that medical teachers mostly posed initial (instead of follow-up) questions and that their questions were more often closed (instead of open). Also, more reasoning (than reproductive) questions were posed. A high rate of student non-response was observed while elaborative and reproductive student responses had a similar prevalence. In the prediction context, follow-up reasoning questions were associated with low non-response and many elaborative answers. In contrast, the highest student non-response rate followed open reproduction questions and initial reasoning questions. Most reproductive statements by students were made following closed reproduction questions. CONCLUSIONS These results deepen our understanding of interactive, questions-driven medical teaching and provide an empirical basis for clinical teachers to use questions in didactically fruitful ways.
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Affiliation(s)
- Martin Gartmeier
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Munich, Germany.
| | - Theresa Pfurtscheller
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Alexander Hapfelmeier
- Institute of Medical Informatics, Statistics and Epidemiology, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Marc Grünewald
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Janina Häusler
- Institute of Medical Informatics, Statistics and Epidemiology, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Tina Seidel
- TUM School of Education, Friedl Schöller Endowed Chair for Educational Psychology, Technical University of Munich, Munich, Germany
| | - Pascal O Berberat
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Munich, Germany
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Schick K, Eissner A, Wijnen-Meijer M, Johannink J, Huenges B, Ehrhardt M, Kadmon M, Berberat PO, Rotthoff T. Implementing a logbook on entrustable professional activities in the final year of undergraduate medical education in Germany - a multicentric pilot study. GMS J Med Educ 2019; 36:Doc69. [PMID: 31844641 PMCID: PMC6905372 DOI: 10.3205/zma001277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/19/2019] [Accepted: 09/20/2019] [Indexed: 06/10/2023]
Abstract
Objectives: The final year of undergraduate medical education (practical year) should foster the transition from undergraduate medical education to graduate medical education. Medical students in the practical year should be able to assume professional tasks, and supervisors should assign these tasks to them. In this pilot study, a curriculum based on the concept of entrustable professional activities (EPAs) was implemented and evaluated in the disciplines of internal medicine, surgery and general practice at four university hospitals. Methods:n=37 medical students and n=17 supervising physicians at four German university hospitals participated in the implementation study for one trimester. For evaluation purposes, we conducted focus group discussions and telephone interviews and analyzed them following qualitative content analysis. Results: We identified five different aspects as important for implementing the EPA curriculum in undergraduate medical education in the German context: Implementation process of the EPA curriculum and required resources, Entrustment process, Feedback sessions with supervisors, Students' and supervisors' role perceptionOverall impact of EPAs on training conditions in the practical year. Conclusion: The study presents a practical implementation of the EPA curriculum in Germany's undergraduate medical education. Besides the need for time and resources, the concept shows good feasibility and fosters a competence-oriented undergraduate medical education in the practical year.
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Affiliation(s)
- Kristina Schick
- Technical University of Munich, School of Medicine, Medical Education Center, Munich, Germany
| | - Alexander Eissner
- Heinrich Heine University Düsseldorf, Medical Faculty, Dean's Office, Düsseldorf, Germany
| | - Marjo Wijnen-Meijer
- Technical University of Munich, School of Medicine, Medical Education Center, Munich, Germany
| | - Jonas Johannink
- Eberhard Karls University of Tübingen, University Department of General, Visceral and Transplant Surgery, Tübingen, Germany
| | - Bert Huenges
- RUB, Faculty of Medicine, Institute of General Practice and Family Medicine, Bochum, Germany
| | - Maren Ehrhardt
- Hamburg University Medical School, Department of General Practice/Primary Care, Hamburg, Germany
| | - Martina Kadmon
- Augsburg University, Faculty of Medicine, Dean, Augsburg, Germany
| | - Pascal O. Berberat
- Technical University of Munich, School of Medicine, Medical Education Center, Munich, Germany
| | - Thomas Rotthoff
- Augsburg University, Faculty of Medicine, Department for Medical Education and Educational Research, Augsburg, Germany
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Kühbeck F, Berberat PO, Engelhardt S, Sarikas A. Correlation of online assessment parameters with summative exam performance in undergraduate medical education of pharmacology: a prospective cohort study. BMC Med Educ 2019; 19:412. [PMID: 31703687 PMCID: PMC6842254 DOI: 10.1186/s12909-019-1814-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 09/20/2019] [Indexed: 05/27/2023]
Abstract
BACKGROUND Learning analytics aims to improve learning outcomes through the systematic measurement and analysis of learning-related data. However, which parameters have the highest predictive power for academic performance remains to be elucidated. The aim of this study was to investigate the correlation of different online assessment parameters with summative exam performance in undergraduate medical education of pharmacology. METHODS A prospective study was conducted with a cohort of undergraduate medical students enrolled in a pharmacology course at Technical University of Munich, Germany. After a four-week teaching and learning period, students were given access to an online assessment platform consisting of 440 multiple choice (MC) questions. After 12 days, a final written summative exam was performed. Bivariate correlation and multiple regression analyses were performed for different online assessment parameters as predictors and summative exam performance as dependent variable. Self-perceived pharmacology competence was measured by questionnaires pre- and postintervention. RESULTS A total of 224 out of 393 (57%) students participated in the study and were included in the analysis. There was no significant correlation for the parameters "number of logins" (r = 0.01, p = 0.893), "number of MC-questions answered" (r = 0.02, p = 0.813) and "time spent on the assessment platform" (r = - 0.05, p = 0.459) with exam performance. The variable "time per question" was statistically significant (p = 0.006), but correlated negatively (r = - 0.18) with academic performance of study participants. Only "total score" (r = 0.71, p < 0.001) and the "score of first attempt" (r = 0.72, p < 0.001) were significantly correlated with final grades. In a multiple regression analysis, "score first attempt" accounted for 52% of the variation of "score final exam", and "time per question" and "total score" for additional 5 and 1.4%, respectively. No gender-specific differences were observed. Finally, online assessments resulted in improved self-perceived pharmacology competence of students. CONCLUSION In this prospective cohort study, we systematically assessed the correlation of different online assessments parameters with exam performance and their gender-neutrality. Our findings may help to improve predictive models of academic performance in undergraduate medical education of pharmacology.
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Affiliation(s)
- Felizian Kühbeck
- Technical University of Munich, Institute of Pharmacology and Toxicology, Biedersteiner Str. 29, 80802 Munich, Germany
| | - Pascal O. Berberat
- Technical University of Munich, School of Medicine, Center of Medical Education, Ismaninger Str. 22, 81675 Munich, Germany
| | - Stefan Engelhardt
- Technical University of Munich, Institute of Pharmacology and Toxicology, Biedersteiner Str. 29, 80802 Munich, Germany
| | - Antonio Sarikas
- Paracelsus Medical University, Institute of Pharmacology and Toxicology, Strubergasse 21, 5020 Salzburg, Austria
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Gartmeier M, Baumgartner M, Burgkart R, Heiniger S, Berberat PO. Why hand hygiene is not sufficient: modeling hygiene competence of clinical staff as a basis for its development and assessment. GMS J Med Educ 2019; 36:Doc39. [PMID: 31544139 PMCID: PMC6737265 DOI: 10.3205/zma001247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 05/06/2019] [Accepted: 05/28/2019] [Indexed: 06/10/2023]
Abstract
Adhering to hygiene standards in daily clinical work is an important characteristic of qualitatively high-value medical care. In this regards, hand hygiene is often focused on in the literature. From the viewpoint of medical education research, we argue that this focus is too narrow to explain how staff who are working clinically with patients implement and adhere to standards of hygiene across a wide variety of tasks of their daily clinical routine. We present basic features of a differentiated concept of hygiene competence, which includes specialized knowledge, corresponding inner attitudes, and action routines that are customized to the needs of specific situations. Building on that, we present a current simulation-based course concept aimed at developing hygiene competence in medical education. Furthermore, we describe a test instrument that is designed according to the principle of a situational judgment test and that appears promising for the assessment of hygiene competence. The course and the measurement instrument are discussed in regards to their fit to the competence model and the related perspectives for research and teaching.
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Affiliation(s)
- Martin Gartmeier
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Maria Baumgartner
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Rainer Burgkart
- Technical University of Munich, Klinikum rechts der Isar, Department of Orthopedics and Sports Orthopedics, Munich, Germany
| | - Susanne Heiniger
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Pascal O. Berberat
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany
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Schick K, Berberat PO, Kadmon M, Harendza S, Gartmeier M. German Language Adaptation of the Kalamazoo Communication Skills Assessment Form (KCSAF): A Multi-Method Study of Two Cohorts of Medical Students. Zeitschrift für Pädagogische Psychologie 2019. [DOI: 10.1024/1010-0652/a000241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract. This work investigates the German version of the Kalamazoo Communication Skills Assessment Form (KCSAFd) for three assessment methods: students' self-assessment (KCSAFd-self), assessment by standardised patients (KCSAFd-sPat) and video-assessment by trained raters (KCSAFd-video). Videotaped simulated patient consultations of N = 163 medical students from the first ( n = 97) and the final clinical years ( n = 66) were rated using the KCSAFd. Investigating the psychometric properties of the instrument, we found a two factor-construct with interpersonal and conversational competence. All methods showed good internal consistency and acceptable model fit values. Additionally, we found plausible relationships between the three methods and meaningful differences between the two groups of students.
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Abstract
This study investigates medical trainees' experiences with dying and death, by means of semistructured interviews. Nine medical students and nine residents reported a total of 114 experiences. The great majority of these experiences took place during the final year of medical school. The authors identified the latent characteristics, which illustrate an in-depth understanding of the significance of the described experiences. Three main themes emerged: circumstances of death, personal relationship, and one's own role. The age of the dying person, the extent of suffering, time frame and setting, and the patients' behaviors were factors that influence the perceptions of the experiences. The interviewees reported powerful emotional consternation by the patients' deaths with whom they had developed a close relationship. Failure, helplessness, and guilt were negatively associated perceptions of one's own role. This study illustrates the tension between emotional concern and professional detachment. It highlights the continuing existence of a physician image, in which control represents the key issue.
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Affiliation(s)
- Nana Jedlicska
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany.,Dagmara Srnová is now at Urological Clinic, Munich-Planegg, Germany. *Both the authors would like to share the role of first author as they contributed equally to the present work
| | - Dagmara Srnová
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany.,Dagmara Srnová is now at Urological Clinic, Munich-Planegg, Germany. *Both the authors would like to share the role of first author as they contributed equally to the present work
| | - Laura Scheide
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Marjo Wijnen-Meijer
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Martin Gartmeier
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Pascal O Berberat
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
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Scheide L, Huber T, Bette S, Nest A, Zimmer C, Berberat PO, Kreiser K. "Imagine Neuro-Oncology"- a one week course with medical and technical students: students' reflections about multidisciplinarity and its practical relevance. J Interprof Care 2019; 34:202-210. [PMID: 30977421 DOI: 10.1080/13561820.2019.1600477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Modern medicine requires tight multidisciplinary collaboration and communication among several technical disciplines. Nevertheless, multidisciplinary medical courses are rare and even less often scientifically evaluated. The aim was to evaluate an innovative neuro-oncology course for medical students (MED) and students of science, technology, engineering, and mathematics (STEM) so that they learn and practice mutual understanding, communication and cooperation. 10 MED and 9 STEM were trained together during a one-week-course on the topic of "brain tumor" in imaging, surgical planning, surgery, pathological diagnosis, and adjuvant therapy. Evaluation was undertaken via focus groups and accompanying questionnaires about motivation, course acceptance, and multidisciplinary attitude. Students evaluated course structure, content, and multidisciplinary setting positively and showed high intrinsic motivation. However, the students sensed an "artificial dividing line" between both groups, which was conceptually encouraged by the deliberate temporary subdivision into "monodisciplinary" seminars and during the preparation of presentations. Students' opinion of the concept was generally positive as they learned about the challenges in finding a "common scientific language". Nevertheless, some criticisms were raised concerning the dividing line between the disciplines, which in part led to organizational changes. Even though the current reality may be reflected here, the goal of future interprofessional courses should definitely be to dissolve this dividing line.
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Affiliation(s)
- Laura Scheide
- Klinikum rechts der Isar, TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, München, Germany
| | - Thomas Huber
- Klinikum der Universität München, Department of Radiology, Ludwig-Maximilian-University Munich, München, Germany
| | - Stefanie Bette
- Klinikum rechts der Isar, Department of Diagnostic and Interventional Neuroradiology, Technical University of Munich, München, Germany
| | - Alexandra Nest
- Klinikum der Universität München, Dr. von Hauner University Children's Hospital, Ludwig-Maximilian-University Munich, München, Germany
| | - Claus Zimmer
- Klinikum rechts der Isar, Department of Diagnostic and Interventional Neuroradiology, Technical University of Munich, München, Germany
| | - Pascal O Berberat
- Klinikum rechts der Isar, TUM Medical Education Center, TUM School of Medicine, Technical University of Munich, München, Germany
| | - Kornelia Kreiser
- Klinikum rechts der Isar, Department of Diagnostic and Interventional Neuroradiology, Technical University of Munich, München, Germany
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Engerer C, Berberat PO, Dinkel A, Rudolph B, Sattel H, Wuensch A. Specific feedback makes medical students better communicators. BMC Med Educ 2019; 19:51. [PMID: 30736764 PMCID: PMC6368801 DOI: 10.1186/s12909-019-1470-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 01/21/2019] [Indexed: 05/21/2023]
Abstract
BACKGROUND Feedback is regarded a key element in teaching communication skills. However, specific aspects of feedback have not been systematically investigated in this context. Therefore, the aim of this study was to investigate the effectiveness of communication skills training (CST) integrating specific, structured and behavioral feedback. METHODS We condensed best practice recommendations for feedback in a CST for undergraduate medical students and compared the effect of specific, structured and behavior-orientated feedback (intervention group CST-behav) to general, experience-orientated feedback (CST- exp. as our control group) in a randomized controlled trial (RCT). We investigated changes on communication skills evaluated by independent raters, and evaluated by standardized patients (SP). To do that, every student was video-recorded in a pre and post assessment. RESULTS Sixty-six undergraduate medical students participated voluntarily in our study. Randomization did not result in equally skilled groups at baseline, so valid inter-group comparisons were not possible. Therefore, we analyzed the results of 34 students of our intervention group (CST-behav). Five out of seven domains in communication skills as evaluated by independent raters improved significantly, and there was a significant change in the global evaluation by SP. CONCLUSIONS Although we were unable to make between-group comparisons, the results of the within group pre-post evaluation suggest that specific feedback helps improve communication skills.
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Affiliation(s)
- Cosima Engerer
- TUM Medical Education Center, TUM School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Pascal O. Berberat
- TUM Medical Education Center, TUM School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Bärbel Rudolph
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- CIP-Tagesklinik, Private Clinic for Psychotherapy, Munich, Germany
| | - Heribert Sattel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Alexander Wuensch
- TUM Medical Education Center, TUM School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Clinic for Psychosomatic Medicine and Psychotherapy Medical Center Freiburg, Faculty of Medicine, University Freiburg, in cooperation with Outpatient Support for Cancer Patients Comprehensive Cancer Center Freiburg, Medical Center Freiburg, Freiburg, Germany
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Prediger S, Fürstenberg S, Berberat PO, Kadmon M, Harendza S. Interprofessional assessment of medical students' competences with an instrument suitable for physicians and nurses. BMC Med Educ 2019; 19:46. [PMID: 30728006 PMCID: PMC6364398 DOI: 10.1186/s12909-019-1473-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 01/24/2019] [Indexed: 05/09/2023]
Abstract
BACKGROUND Physicians need a set of specific competences to perform well in interprofessional teams in their first year of residency. These competences should be achieved with graduation from medical school. Assessments during undergraduate medical studies are mostly rated by supervisors only. The aim of our study was to compare the rating of core facets of competence of medical students late in their undergraduate training as well as the rating confidence between three different groups of assessors (supervisors, residents, and nurses) in an assessment simulating the first day of residency. METHODS Sixty-seven advanced medical students from three different medical schools (Hamburg, Oldenburg and Munich) participated in a 360-degree assessment simulating the first working day of a resident. Each participant was rated by three assessors - a supervisor, a resident and a nurse - in seven facets of competence relevant for the first year of residency: (1) responsibility, (2) teamwork and collegiality, (3) knowing and maintaining own personal bounds and possibilities, (4) structure, work planning and priorities, (5) coping with mistakes, (6) scientifically and empirically grounded method of working, and (7) verbal communication with colleagues and supervisors. Means of all assessed competences and confidences of judgement of the three rating groups were compared. Additionally, correlations between assessed competences and confidence of judgement within each group of raters were computed. RESULTS All rating groups showed consistent assessment decisions (Cronbach's α: supervisors = .90, residents = .80, nurses = .78). Nurses assessed the participants significantly higher in all competences compared to supervisors and residents (all p ≤ .05) with moderate and high effect sizes (d = .667-1.068). While supervisors' and residents' ratings were highest for "teamwork and collegiality", participants received the highest rating by nurses for "responsibility". Competences assessed by nurses were strongly positively correlated with their confidence of judgment while supervisors' assessments correlated only moderately with their confidence of judgment in two competences. CONCLUSIONS Different professional perspectives provide differentiated competence ratings for medical students in the role of a beginning resident. Rating confidence should be enhanced by empirically derived behavior checklists with anchors, which need to be included in rater training to decrease raters' subjectivity.
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Affiliation(s)
- Sarah Prediger
- Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany
| | - Sophie Fürstenberg
- Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany
| | - Pascal O. Berberat
- TUM Medical Education Center, School of Medicine, Technical University of Munich, München, Germany
| | - Martina Kadmon
- Faculty of Medicine, III. Medizinische Klinik, University of Augsburg, Deanery, Augsburg, Germany
| | - Sigrid Harendza
- Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany
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Harendza S, Soll H, Prediger S, Kadmon M, Berberat PO, Oubaid V. Assessing core competences of medical students with a test for flight school applicants. BMC Med Educ 2019; 19:9. [PMID: 30616684 PMCID: PMC6322305 DOI: 10.1186/s12909-018-1438-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 12/26/2018] [Indexed: 05/21/2023]
Abstract
BACKGROUND Important competences of physicians regarding patient safety include communication, leadership, stress resistance, adherence to procedures, awareness, and teamwork. Similarly, while selected, prospective flight school applicants are tested for the same set of skills. The aim of our study was to assess these core competences in advanced undergraduate medical students from different medical schools. METHODS In 2017, 67 medical students (year 5 and 6) from the universities of Hamburg, Oldenburg, and TU Munich, Germany, participated in the verified Group Assessment Performance (GAP)-Test at the German Aerospace Center (DLR) in Hamburg. All participants were rated by DLR assessment observers with a set of empirically derived behavioural checklists. This lists consisted of 6-point rating scales (1: very low occurrence to 6: very high occurrence) and included the competences leadership, teamwork, stress resistance, communication, awareness, and adherence to procedures. Medical students' scores were compared with the results of 117 admitted flight school applicants. RESULTS Medical students showed significantly higher scores than admitted flight school applicants for adherence to procedures (p < .001, d = .63) and communication (p < .01, d = .62). They reached significantly lower ratings for teamwork (p < .001, d = .77), stress resistance (p < 0.001, d = .70), and awareness (p < .001, d = 1.31). Students in semester 10 showed significantly (p < .02, d = .58) higher scores in domain awareness compared to the final year students. On average, flight school entrance level was not reached by either group for this domain. CONCLUSIONS Advanced medical students' low results for awareness are alarming as awareness is essential and integrative for clinical reasoning and patient safety. Further studies should elucidate and discuss whether awareness needs to be included in medical student selection or integrated into the curriculum in training units.
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Affiliation(s)
- Sigrid Harendza
- III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- III. Medizinische Klinik, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany
| | | | - Sarah Prediger
- III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martina Kadmon
- Medical Faculty, Deanery, University of Augsburg, Augsburg, Germany
| | - Pascal O. Berberat
- TUM Medical Education Center, School of Medicine, Technical University of Munich, Munich, Germany
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