[Measuring Satisfaction with Deployment in the Final Year of Undergraduate Medical Study (Ma-FEZ-PJ) to Ensure the Quality of Training in the Final Year - Psychometrics of a Self-Evaluation Questionnaire]. / Erfassung der Zufriedenheit mit dem Einsatz im Praktischen Jahr (Ma-FEZ-PJ) zur Qualitätssicherung der Lehre im Praktischen Jahr ­ Psychometrie eines Selbsteinschätzungsfragebogens.

INTRODUCTION: One way to recruit junior physicians in surgery is to optimise the final year. Starting points for this can be gained through a standardised evaluation of the deployments in the final year. In this study, a questionnaire for the evaluation of the training conditions and satisfaction with the deployment in the final year (Ma-FEZ-PJ) underwent a test and item analysis. In addition, initial studies were carried out to analyse the construct validity of the two scales - final year training and individual attitude. A specific example will then be used to show how the Ma-FEZ-PJ can be used to optimise the final year. METHODS: 555 medical students from eight final year cohorts evaluated their deployments in the final year with the Ma-FEZ-PJ. The reliability of the two scales as well as item characteristics were calculated. To validate construct validity, a global satisfaction item was used to verify the convergent validity of the final year training scale, which captures training conditions and satisfaction with the final year, and the divergent validity of the individual attitude scale. Groups of students who voluntarily or involuntarily attended the mandatory subjects in the final year were then compared to show whether the individual attitude scale can differentiate between the two. RESULTS: The reliability of the scale final year training is very good, that of the scale individual attitude is in the acceptable range. The construct validity can be sufficiently confirmed. DISCUSSION: The Ma-FEZ-PJ can be used as a tool to evaluate training conditions and satisfaction with the final year's deployment. Comparisons with other surgical departments, oriented at the scale level and then in detail at the item level, identify deficits in final year training and therefore approaches to optimise it.

Benchmarking for research-related competencies - a curricular mapping approach at medical faculties in Germany.

OBJECTIVES: Internationally, scientific and research-related competencies need to be sufficiently targeted as core outcomes in many undergraduate medical curricula. Since 2015, standards have been recommended for Germany in the National Competency-based Learning Objective Catalogue in Medicine (NKLM). The aim of this study is to develop a multi-center mapping approach for curricular benchmarking against national standards and against other medical faculties. METHOD: A total of 277 faculty members from four German medical faculties have mapped the local curriculum against the scientific and research-related NKLM objectives, using consented procedures, metrics, and tools. The amount of mapping citations of each objective is used as indicator for its weighting in the local curriculum. Achieved competency levels after five-year education are compared. RESULTS: All four programs fulfill the NKLM standards, with each emphasizing different sub-competencies explicitly in writing (Scholar: 17-41% of all courses; Medical Scientific Skills: 14-37% of all courses). Faculties show major or full agreement in objective weighting: Scholar 44%, scientific skills 79%. The given NKLM competency level is met or even outperformed in 78-100% of the courses. CONCLUSIONS: The multi-center mapping approach provides an informative dataset allowing curricular diagnosis by external benchmarking and guidance for optimization of local curricula.

Confirmatory factor analysis of the German Readiness for Interprofessional Learning Scale (RIPLS-D).

Over the past five years, the development of interprofessional education programmes has been gaining momentum in Germany fostering the need to evaluate these with appropriate instruments. Instead of developing a new instrument for evaluation purposes, the Readiness for Interprofessional Learning Scale (RIPLS) was chosen, as it is a widespread instrument that has been used in a variety of different educational settings and countries. The German version of the RIPLS was administered in two sites to health professional students in Heidelberg and Freiburg, Germany. Cronbach's alpha was used to examine internal consistency. Confirmatory factor analysis (CFA) was performed for confirmation of the underlying factor structure of the RIPLS-D. In total, 531 questionnaires were analysed. The instrument showed overall reliability (0.81) and low reliability (< 0.7) in the subscales. The underlying factor structure could not be confirmed. These results contribute further evidence on deficits with the RIPLS. Despite known issues, the RIPLS continues to be translated and applied. This paper highlights the problematic issues in the RIPLS-D and does not recommend its use.

Psychometric survey of nursing competences illustrated with nursing students and apprentices / Psychometrische Erfassung von Kompetenzen am Beispiel von Studierenden und Auszubildenden der Pflege.

Background: The term competences is discussed differently in various disciplines of science. Furthermore there is no international or discipline comprehensive accepted definition of this term. Problem: So far, there are few practical, reliable and valid measuring instruments for a survey of general nursing skills. This article describes the adaptation process of a measuring instrument for medical skills into one for nursing competences. Method: The measurement quality of the questionnaire was audited using a sample of two different courses of studies and regular nursing apprentices. Another research question focused whether the adapted questionnaire is able to detect a change of nursing skills. For the validation of reliability and validity data from the first point of measurement was used (n = 240). The data from the second point of measurement, which was conducted two years later (n = 163), were used to validate, whether the questionnaire is able to detect a change of nursing competences. Results/Conclusions: The results indicate that the adapted version of the questionnaire is reliable and valid. Also the questionnaire was able to detect significant, partly even strong, effects of change in nursing skills (d = 0,17 ­ 1,04). It was possible to adapt the questionnaire for the measurement of nursing competences.

Oral hygiene-related self-efficacy as a predictor of oral hygiene behaviour: a prospective cohort study.

AIM: The aim of this study was to assess whether oral hygiene-related self-efficacy is correlated with current oral hygiene and might influence the outcome of oral hygiene instruction. MATERIALS AND METHODS: Hundred and twenty-six patients filled out questionnaires about oral hygiene-related self-efficacy, general self-efficacy, oral hygiene-related knowledge and demographic variables. Plaque and gingival inflammation were measured and an individual oral hygiene plan was conducted. After 6 months, oral hygiene indices were assessed again. RESULTS: Women had significantly higher scores in oral hygiene-related self-efficacy than men (women mean 60.40 ± 9.41; men mean 56.04 ± 11.55; p = 0.039) and oral hygiene-related self-efficacy was significantly correlated with general self-efficacy independent from the age of the patients (r = 0.3114, p = 0.0004). Higher scores in oral hygiene-related self-efficacy were significantly correlated with lower scores of gingival bleeding for non-smoking patients (r = -0.301, p = 0.0066), usage of a professional tooth cleaning within these 6 months (p = 0.0406), reappearance to the follow-up appointment (p = 0.0303), and higher goals in inter-dental cleaning plans (p = 0.0189). CONCLUSION: Oral hygiene-related self-efficacy is an influencing factor in the oral hygiene behaviour and has the potential to predict patients' oral hygiene outcomes.

Recommendations for reviewing manuscripts of the article types "project report" and "how to" for the GMS Journal for Medical Education.

Objective: This position paper of the Committee on Methodology in Educational Research sets out the criteria for the acceptance, revision, or rejection of manuscripts of the article types project report and how to in the GMS Journal for Medical Education, as well as outlining the development of these criteria. Methods: In a workshop with writers, reviewers, and editors, we formulated and discussed common core elements for articles. We did this by consulting the journal's editorial board on the basis of guidelines for authors and reviewers from other journals and by using examples of articles considered less or more successful. From this, we derived specific aspects to be addressed and rejection criteria for the respective article types. Results: We have identified the target group, relevance, justification, and implication as the common core elements for both article types. We have also derived specific aspects to be addressed and rejection criteria from these core elements for each article type. Conclusion: A manuscript lacking core elements will be rejected. If aspects are not described sufficiently or are not clearly comprehensible, the manuscript must be revised.

Which digital learning strategies do undergraduate dentistry students favor? A questionnaire survey at a German university.

Background: The development in teaching dental education toward ever greater digitization has gained enormous momentum in the last 2 years due to the pandemic. However, acceleration is not synonymous with improvement, especially from the learners' point of view. Therefore, the aim of this survey among students of dentistry was to determine which digital learning strategies and which media are preferred. Method: Undergraduate students of clinical semesters (6th to 9th) in dental medicine during at the University of Freiburg participated in an online-survey. Questions were asked about personal learning strategies for and experience with using digital media for private and educational reasons. Furthermore, students were asked which digital learning formats they preferred for different learning phases. Results: Students (N=148) are experienced in using digital media for learning. They prefer classical media (such as textbooks and lectures) for acquiring basic theoretical knowledge and mention digital teaching formats more in relation to practical training and complex treatment procedures. 67% prefer learning alone and 90% rate visualizations as helpful for learning. 78% report, that they feel well supported in the learning process by digital media and 83% agree that e-learning offerings are a quality factor for university teaching. 82% state e.g. that the growing range of online content allows a more flexible approach to face to face-teaching, enriches classroom teaching (78%) and helps organize one's own study (79%). Conclusion: Students have a positive attitude towards the use of digital media, especially when it comes to having more time available for practical exercises. They also see an advantage in the fact that through the use of digital media, lectures can be organized more flexibly and also the organization of their studies can be optimized. New digital teaching media should be created based on these results. It is important to consider which digital formats seem suitable for which content during different semesters.

What do hematologists and oncologists consider necessary for their career? Results of an online survey in Germany, Austria and Switzerland.

PURPOSE: This study aimed to find out more about factors that hinder physicians' careers, especially with regard to gender differences, and which future working conditions they would prefer. METHODS: In an online survey, members of the professional societies of Hematology and Oncology in Germany, Austria and Switzerland were asked to rate factors that might hinder or facilitate their professional career. Data analysis included χ2-tests, t tests and analyses of variance. RESULTS: 469 physicians participated (61% female, response rate 9.1%). 40% of the participants experience a lack of compatibility between family life and career. Female physicians with children living in their household especially feel restricted in their professional development. The most preferred conditions for improving compatibility were flexible working hours (72%), opportunities to work in home office (71%), better opportunities for specialist training (51%) and enabling managerial activities on a part-time basis (73%). Both female and male physicians would like fathers to be encouraged to take parental leave to the same extent as mothers (50%). They would, e.g., like to see more flexible drop-off and pickup times for children (71%) and more childcare options offered by their employer (61%). CONCLUSION: Results suggest various options for promoting compatibility of family life and work, e.g., by family-friendly working time models and part-time offers breaking with traditional role models. Managerial positions might be offered on a regular part-time basis. Structured qualification programs could enable the compatibility of clinical work, research and family life. Childcare services should preferably be provided in line with existing needs.

Development of a diagnostic instrument for the assessment of teaching competencies in medicine (FKM_L): First results of the test statistical verification.

Introduction: This project report describes the development of the Questionnaire for the Assessment of Teaching Competencies in Medicine (FKM_L) and the analysis of some of its psychometric properties. The design of the FKM_L is based on the model of Core Competency for Teachers in Medicine (KLM) model of the GMA Committee on Personnel and Organizational Development in Teaching. Methods: Global questions and in-depth items were formulated for each of the sub-competencies of the six core competencies of the KLM model. Depending on the number of sub-competencies, there are 3-4 subscales for each core competency, comprising 69 items in total. Data from 90 participants of medical didactic courses were analysed. Item analyses supported the hypothesized scales. Results: The internal consistencies (Cronbach's alpha: CR-α) of the 22 subscales ranged from CR-α=.70 to CR-α=.93, and the item difficulty indices of the subscales ranged from 18% to 89%. For 2 subscales, some items had a difficulty index of more than 80%, and for 3 subscales, the difficulty index of some items was less than 25%. Conclusions: The FKM_L was developed to assess individual and group profiles of teachers' competence in medicine. The results of this first psychometric analysis are promising: With the help of the FKM_L, teachers can learn about and reflect on aspects of their teaching competencies in the context of medical didactic courses. Based on their FKM_L profiles, they can decide whether they want to selectively optimize their competence characteristics. For providers, the FKM_L is suitable as a screening tool to identify, among other things, gaps in the training offered. Further analyses are necessary to check limitations identified in some scales and to improve individual items. In addition, research on the construct and criterion-related validity of the instrument is required.

Quality assurance and curricular development of medical faculties using graduate surveys: Challenges - proposal of a core questionnaire - implementation guide.

Graduate surveys provide valuable information to further improve and develop an academic study program. The aim of this project report is to point out the relevance of these surveys for medical schools and to offer guidance on planning and implementing such surveys so that comparable evaluations of medical degree programs are possible. The authors of this project report were asked by the MFT working subgroup on Quality Assurance in Education to generate quality recommendations for surveying medical graduates. To accomplish this, the questionnaires used by the medical schools to survey graduates were closely inspected and analyzed. A questionnaire containing core and optional questions was created as part of this project. A comprehensive matrix was also developed listing all of the procedural elements of graduate surveys.

["Closing the Gap": Results of a survey assessing quality assurance in medical education]. / "Closing the Gap": Ergebnisse einer Bestandsaufnahme zu Qualitätssicherungsmaßnahmen der Lehre an medizinischen Fakultäten.

OBJECTIVES: The aim of the present study was to survey the current state of quality assurance of teaching at German-speaking medical faculties. Another aim was to determine whether and how the evaluation loop is closed. METHODS: A questionnaire was sent out to 45 German-speaking faculties in the DACH countries to determine how the faculties ensure quality of teaching. Information was collected on qualification programs offered to faculty, course evaluations (LVE), evaluations during the final year (PJ-E), and on the implementation of graduate surveys (ABS-B). Evaluable data sets are available from 29 of the 40 faculties that responded. RESULTS: At almost all faculties, lecturers can take advantage of various didactic offers. Training programs for (M3) examiners (32%) and PJ supervisors (21%), on the other hand, are offered less frequently. Students at two-thirds of the faculties participate in the planning and implementation of LVEs, which are conducted at all faculties. Almost all faculties conduct PJ-E, and 72% of the faculties report interviewing graduates (ABS-B). However, the responsibility for conducting the ABS-B lies with the faculties themselves in only 48% of the cases. Twenty faculties report various additional teaching evaluations (e.g., evaluation of projects, progress tests). Indicators of teaching quality are mostly student satisfaction (LVE=93%, PJ-E=82%, ABS-B=100%), practical relevance of content (LVE=72%, ABS-B=100%) and quality of supervision (PJ-E=86%). The majority use questionnaires that are often self-developed (LVE=63%, PJ=78%). Surveys are mostly summative and either purely online (LVE=44%, PJ-E=81%, ABS-B=40%) or combined with paper (LVE=56%, ABS-B=60%). The majority of results are reported back to the academic deans in writing and/or as a presentation of results. In addition, faculties conduct results-based interviews with faculty/departments (LVE=79%, PJ=64%) and make binding goal agreements during these interviews (LVE=52%, PJ-E=50%). The survey results are often used to inform curricular development (LVE=79%, PJ-E=89%, ABS-B=80%). However, changes in the curriculum based on these results are not re-evaluated in all cases (LVE=83%, PJ-E=60%, ABS-B=63%). CONCLUSION: This study provides an overview of the evaluation practice at German-speaking medical faculties. The number of evaluations carried out in the various areas related to teaching indicates that quality assurance of teaching is taken very seriously by medical faculties. However, there is still need for optimization in some areas: training programs for examiners and PJ supervisors should be offered more frequently to ensure teaching quality. It should also be examined whether the quality indicators used can be supplemented to include, for example, the indicator "giving appropriate feedback". Very often, self-developed questionnaires are used whose reliability and validity are questionable. The use of standardized questionnaires would be desirable in order to be able to adequately classify the results. In addition, the evaluation cycle is not closed with re-evaluations in all cases after curricular changes have been implemented. This is especially true of changes initiated by the PJ-E and ABS-B. .

"Assistant physician light?" - Feedback from graduates on the practical year.

Background: As the final and longest practical phase of undergraduate medical study in Germany, the final year is essential for the acquisition and development of core medical competencies. However, studies show that the educational conditions are often not optimal. The aim of this study was to learn more about the educational conditions connected with the final year and to find out how it can be improved. To do this, written comments from graduate evaluation surveys were analyzed. Methods: Using the data from the survey of Freiburg medical students in the graduating classes of 2015/16 and 2016/17, we investigated which potential improvements were identified by students who had completed the final year and which aspects these students felt they especially benefited from in terms of beginning their medical careers. The written responses by the Freiburg graduating classes of 2015/16 (n=88; response rate: 28%) and 2016/17 (n=112; response rate: 36%) to the questions about beneficial aspects of the final year and potential improvements were qualitatively analyzed for content. As a comparison condition, the written comments of medical students graduating in the same years from the other medical schools in Baden-Württemberg were analyzed. Results: The written responses of the Freiburg graduates to these two questions could be classified according to five main categories. Comments were most frequently assigned either to the category "(more) autonomous work, like an assistant physician" or "(increased) mentoring of the final-year students as learners". In hindsight, the Freiburg medical graduates felt that they had already benefited in terms of beginning their careers from working independently under supervision during the final year, but they also saw room for improvement and wished that they had been perceived more strongly as learners and encouraged as such. The analysis of the written comments made by students in the same graduating classes at other medical schools in Baden-Württemberg showed corroborating results. Conclusion: The results of this study show how the educational conditions of final year can be optimized. For instance, more opportunities should be created for final-year students to work independently and care for patients, and the course offerings should be expanded and adjusted, if needed, to match the needs of the students. Furthermore, those teaching final year students should be better trained and released from other duties so that they can focus on teaching.

The frequency of using certain feedback methods in the teaching of medicine: a survey of teachers at the medical faculties in Baden-Wurttemberg.

Objectives: Feedback is one of the most important methods for competency-based teaching. A survey was conducted to learn more about the use of feedback methods at five medical faculties. Methods: In the 2017 summer semester, teachers at Baden-Wurttemberg's medical schools in Freiburg, Heidelberg, Mannheim, Tuebingen and Ulm were invited to participate in the survey. The link to the questionnaire was sent to the teaching coordinators at the various departments at each of the five medical schools. The teaching coordinators were asked to forward the link to the questionnaire to all instructors in their department. At one location, all instructors were directly addressed. The data were collected online. Results: A total of 464 instructors participated in the survey. Most consider feedback in medical education as important (23%) or very important (72%). However, some feedback methods are hardly used. The reason for this is, in particular, that some of the feedback methods are unfamiliar, e.g. checklists (56%), or not considered necessary by the instructors, e.g. written feedback (31%). Fifty-five percent of the instructors would like to receive further education or information on feedback. Conclusion: The results show that the use of feedback methods in medical teaching is expandable and that teachers find feedback to be important. Accordingly, nothing should stand in the way of a greater use of feedback methods in teaching. However, in order for this to happen, it is important that instructors are made more familiar with feedback methods.

Conditions for excellence in teaching in medical education: The Frankfurt Model to ensure quality in teaching and learning.

Background: There is general consensus that the organizational and administrative aspects of academic study programs exert an important influence on teaching and learning. Despite this, no comprehensive framework currently exists to describe the conditions that affect the quality of teaching and learning in medical education. The aim of this paper is to systematically and comprehensively identify these factors to offer academic administrators and decision makers interested in improving teaching a theory-based and, to an extent, empirically founded framework on the basis of which improvements in teaching quality can be identified and implemented. Method: Primarily, the issue was addressed by combining a theory-driven deductive approach with an experience based, "best evidence" one during the course of two workshops held by the GMA Committee on Personnel and Organizational Development in Academic Teaching (POiL) in Munich (2013) and Frankfurt (2014). Two models describing the conditions relevant to teaching and learning (Euler/Hahn and Rindermann) were critically appraised and synthesized into a new third model. Practical examples of teaching strategies that promote or hinder learning were compiled and added to the categories of this model and, to the extent possible, supported with empirical evidence. Based on this, a checklist with recommendations for optimizing general academic conditions was formulated. Results: The Frankfurt Model of conditions to ensure Quality in Teaching and Learning covers six categories: organizational structure/medical school culture, regulatory frameworks, curricular requirements, time constraints, material and personnel resources, and qualification of teaching staff. These categories have been supplemented by the interests, motives and abilities of the actual teachers and students in this particular setting. The categories of this model provide the structure for a checklist in which recommendations for optimizing teaching are given. Conclusions: The checklist derived from the Frankfurt Model for ensuring quality in teaching and learning can be used for quality assurance and to improve the conditions under which teaching and learning take place in medical schools.

Effects of additional team-based learning on students' clinical reasoning skills: a pilot study.

BACKGROUND: In the field of Neurology good clinical reasoning skills are essential for successful diagnosing and treatment. Team-based learning (TBL), an active learning and small group instructional strategy, is a promising method for fostering these skills. The aim of this pilot study was to examine the effects of a supplementary TBL-class on students' clinical decision-making skills. METHODS: Fourth- and fifth-year medical students participated in this pilot study (static-group comparison design). The non-treatment group (n = 15) did not receive any additional training beyond regular teaching in the neurology course. The treatment group (n = 11) took part in a supplementary TBL-class optimized for teaching clinical reasoning in addition to the regular teaching in the neurology course. Clinical decision making skills were assessed using a key-feature problem examination. Factual and conceptual knowledge was assessed by a multiple-choice question examination. RESULTS: The TBL-group performed significantly better than the non-TBL-group (p = 0.026) in the key-feature problem examination. No significant differences between the results of the multiple-choice question examination of both groups were found. CONCLUSIONS: In this pilot study participants of a supplementary TBL-class significantly improved clinical decision-making skills, indicating that TBL may be an appropriate method for teaching clinical decision making in neurology. Further research is needed for replication in larger groups and other clinical fields.

Teaching neurology to medical students with a simplified version of team-based learning.

OBJECTIVE: To compare the effect of a simplified version of team-based learning (sTBL), an active learning/small group instructional strategy, with that of the traditionally used small group interactive seminars on the acquisition of knowledge and clinical reasoning (CR) skills. METHODS: Third- and fourth-year medical students (n = 122) were randomly distributed into 2 groups. A crossover design was used in which 2 neurologic topics were taught by sTBL and 2 by small group interactive seminars. Knowledge was assessed with a multiple-choice question examination (MCQE), CR skills with a key feature problem examination (KFPE). Questionnaires were used for further methodologic evaluation. RESULTS: No group differences were found in the MCQE results. sTBL instruction of the topic "acute altered mental status" was associated with a significantly better student performance in the KFPE (p = 0.008), with no differences in the other 3 topics covered. Although both teaching methods were highly rated by the students, a clear majority voted for sTBL as their preferred future teaching method. CONCLUSIONS: sTBL served as an equivalent alternative to small group interactive seminars for imparting knowledge and teaching CR skills, and was particularly advantageous for teaching CR in the setting of a complex neurologic topic. Furthermore, students reported a strong preference for the sTBL approach, making it a promising tool for effectively teaching neurology.

Publication activity in medical education research: A descriptive analysis of submissions to the GMS Zeitschrift für Medizinische Ausbildung in 2007-2015.

Objectives: The significance of medical education research has increased internationally. In this context we investigated whether, and if so, how the quantity and quality of scientific papers reviewed and/or published by the GMS Zeitschrift für Medizinische Ausbildung (GMS Z Med Ausbild) changed. Methods: The quantity and ratio of original papers, project reports and reviews submitted to or published in the GMS Z Med Ausbild were analysed. Published scientific articles were investigated in regard to the quality features "study type" and "mode of data collection" as well as the background (university affiliation) of the last authors. The citation frequency within the first five years after PubMed listing was compared to the one of BMC Medical Education in the corresponding period. Results: The number of submitted scientific manuscripts increased steadily. Most of the submissions and publications are original papers. For publications explorative studies and prospective data collection are most common. A shift over time is not observed. 16% of the published works come from one and 36% from four of the in total 39 universities represented by the last authors. The development of the citation frequency of articles published in GMS Z Med Ausbild is similar to that of BMC Medical Education. Conclusion: The rising number of submissions indicates an increasing significance of medical education research in German-speaking countries. The development of the number of citations reflects the growing appreciation of GMS Z Med Ausbild also indicated by the increasing number of online accesses. Our findings that study type and mode of data collection did not change has to be interpreted with caution since among other things choice and correct application of adequate methods are crucial regarding a scientific work's quality, too. These aspects, however, were not investigated in this paper.

Monitoring and analysis of the change process in curriculum mapping compared to the National Competency-based Learning Objective Catalogue for Undergraduate Medical Education (NKLM) at four medical faculties. Part I: Conducive resources and structures.

Objective: After passing of the National Competency-based Learning Objectives Catalogue in Medicine (Nationaler Kompetenzbasierter Lernzielkatalog Medizin, [NKLM, retrieved on 22.03.2016]), the German medical faculties must take inventory and develop their curricula. NKLM contents are expected to be present, but not linked well or sensibly enough in locally grown curricula. Learning and examination formats must be reviewed for appropriateness and coverage of the competences. The necessary curricular transparency is best achieved by systematic curriculum mapping, combined with effective change management. Mapping a complex existing curriculum and convincing a faculty that this will have benefits is not easy. Headed by Tübingen, the faculties of Freiburg, Heidelberg, Mannheim and Tübingen take inventory by mapping their curricula in comparison to the NKLM, using the dedicated web-based MERLIN-database. This two-part article analyses and summarises how NKLM curriculum mapping could be successful in spite of resistance at the faculties. The target is conveying the widest possible overview of beneficial framework conditions, strategies and results. Part I of the article shows the beneficial resources and structures required for implementation of curriculum mapping at the faculties. Part II describes key factors relevant for motivating faculties and teachers during the mapping process. Method: The network project was systematically planned in advance according to steps of project and change management, regularly reflected on and adjusted together in workshops and semi-annual project meetings. From the beginning of the project, a grounded-theory approach was used to systematically collect detailed information on structures, measures and developments at the faculties using various sources and methods, to continually analyse them and to draw a final conclusion (sources: surveys among the project participants with questionnaires, semi-structured group interviews and discussions, guideline-supported individual interviews, informal surveys, evaluation of target agreements and protocols, openly discernible local, regional or over-regional structure-relevant events). Results: The following resources and structures support implementation of curriculum mapping at a faculty: Setting up a coordination agency (≥50% of a full position; support by student assistants), systematic project management, and development of organisation and communication structures with integration of the dean of study and teaching and pilot departments, as well as development of a user-friendly web-based mapping instrument. Acceptance of the mapping was increased particularly by visualisation of the results and early insight into indicative results relevant for the department. Conclusion: Successful NKLM curriculum mapping requires trained staff for coordination, resilient communication structures and a user-oriented mapping database. In alignment with literature, recommendations can be derived to support other faculties that want to map their curriculum.

Monitoring and analysis of the change process in curriculum mapping compared to the National Competency-based Learning Objective Catalogue for Undergraduate Medical Education (NKLM) at four medical faculties. Part II: Key factors for motivating the faculty during the process.

Objective: After adoption of the National Competency-based Learning Objectives Catalogue in Medicine [Nationaler Kompetenzbasierter Lernzielkatalog Medizin, NKLM], the German medical faculties are asked to test the learning obejctives recorded in it and evaluate them critically. The faculties require curricular transparency for competence-oriented transition of present curricula, which is best achieved by systematic curriculum mapping in comparison to the NKLM. Based on this inventory, curricula can be further developed target-oriented. Considerable resistance has to be expected when a complex existing curriculum is to be mapped for the first time and a faculty must be convinced of its usefulness. Headed by Tübingen, the faculties of Freiburg, Heidelberg, Mannheim and Tübingen rose to this task. This two-part article analyses and summarises how NKLM curriculum mapping was successful at the locations despite resistance. Part I presented the resources and structures that supported implementation. Part II focuses on factors that motivate individuals and groups of persons to cooperate in the faculties. Method: Both parts used the same method. In short, the joint project was systematically planned following the steps of project and change management and adjusted in the course of the process. From the beginning of the project, a Grounded-Theory approach was used to systematically collect detailed information on measures and developments at the faculties, to continually analyse them and to draw final conclusions. Results: At all sites, faculties, teachers, students and administrative staff were not per se willing to deal with the NKLM and its contents, and even less to map their present curricula. Analysis of the development reflected a number of factors that had either a negative effect on the willingness to cooperate when missing, or a positive one when present. These were: clear top-down and bottom-up management; continuous information of the faculty; user-oriented support in the mapping process by reduction of the mapping categories, portioning and condensation of the NKLM via student pre-mapping (blueprint) and visibility of growing consent. Apart from that, there were a series of frequent questions, objections and concerns that could be countered strategically and by argumentation. They particularly referred to relevance, benefit, feasibility and effort of curriculum mapping. Conclusion: An overview of beneficial framework conditions, strategies and results from different points of view is achieved and interrelations are made visible. Based on literature results, the motivating factors as well as their implementation and effects in the faculties involved are critically reflected on. Recommendations can be derived that can support other faculties in practice.

Importance and benefits of the doctoral thesis for medical graduates.

INTRODUCTION: The majority of medical graduates in Germany complete a doctorate, even though a doctoral degree is not necessary for the practice of medicine. So far, little is known about doctoral candidates' view on the individual benefit a doctoral thesis has for them. Consequently, this is the subject of the present investigation. METHOD: Data from surveys with graduates of the five medical faculties of Baden-Württemberg from the graduation years 2007/2008 (N=514) and 2010/2011 (N=598) were analysed. RESULTS: One and a half years after graduating 53% of those interviewed had completed their doctorate. When asked about their motivation for writing a doctoral thesis, participants answered most frequently "a doctorate is usual" (85%) and "improvement of job opportunities" (75%), 36% said that an academic career has been their primary motive. Less than 10% responded that they used their doctoral thesis as a means to apply for a job. The proportion of graduates working in health care is equally large among those who have completed a thesis and those who have not. Graduates who pursued a thesis due to scientific interest are also currently more interested in an academic career and recognise more opportunities for research. An implicit benefit of a medical thesis emerged with regard to the self-assessment of scientific competences as those who completed a doctorate rated their scientific competencies higher than those who have not. DISCUSSION: Although for the majority of physicians research interest is not the primary motivation for completing a doctorate, they might nevertheless achieve some academic competencies. For graduates pursuing an academic career the benefit of completing a medical thesis is more obvious.