[Who Stays Loyal to Orthopaedics and Trauma Surgery? Results of a Nationwide Survey]. / Wer bleibt nach einer Famulatur in Orthopädie und Unfallchirurgie dem Fachbereich treu? Ergebnisse einer bundesweiten Umfrage.

INTRODUCTION: The general shortage of medical doctors in Germany can also be felt in the area of trauma and orthopaedics. Medical elective placements, in Germany known as "Famulatur", are sensitive interfaces between the theoretical university studies and the practical medical workplace. In this research project, the aim was to study how medical students perceive these types of placements and if it alters their decision making when planning their further career. METHODS: During the summer term of 2012, 9079 medical students answered an online questionnaire. Of these, the subgroup was evaluated that had had a placement of at least 4 weeks in the field of trauma and orthopaedics. Overall, 37 test items about this placement and further career steps were included in this study. Groups were evaluated separately by the item "I am considering a career in trauma and orthopaedics" (PJ-Ja) versus "I am not considering a career in trauma and orthopaedics" (PJ-Nein). RESULTS: Overall 397 students were included in this study; 55 % were female. 267 (67.3 %) stated: "I am considering a career in trauma and orthopaedics"; 130 (32.7 %) were not. There was no significant difference in age or sex between these groups (sex: χ²= 2.50, p = 0.114; age: F[1.93]< 1, p = 0.764). Specific and statistically significant differences between those groups were found in the items team integration, ward climate, qualification of teaching, training for specific knowledge in the field, practical aspects of the tasks performed, general planning and structure of the elective achievement of the teaching goals. DISCUSSION: Knowledge of satisfaction during medical elective placements is essential if one aims to inspire students for a specific medical profession. Instructors who can identify weaknesses and deficits in their training regime can therefore in the future increase the number of medical doctors who choose their speciality. The foundation of personal development has to be laid very early in the career of medical students.

[Logbook of learning targets for special educational skills in orthopaedic and trauma surgery for undergraduate medical training]. / Logbuch der erreichbaren Lehrziele für die speziellen Wahlfachinhalte Orthopädie/Unfallchirurgie im Praktischen Jahr (PJ) des Medizinstudiums.

INTRODUCTION: The changes in medical licensing regulations introduced in Germany in 2012 require the development of specific catalogues, termed logbooks, that define the practical skills medical students should acquire in different specialties. In conjunction with another change in medical education, which allows medical students to freely select any German university hospital or academic teaching hospital for their one-year internship, these catalogues are a prerequisite for ensuring comparable training standards throughout Germany. The German licensing regulations provide no details regarding the contents or form of the logbooks but only mention a "training programme" in very general terms. A logbook is commonly understood to define clear learning objectives to be accomplished during a specified interval (4 months). The conference of German medical faculties proposed a basic logbook for compulsory training modules (surgery and internal medicine) that is intended to serve as a model (formally and contentwise) for those who develop similar catalogues for elective training modules. Here we present our logbook for an elective training module in orthopaedic surgery and traumatology. MATERIAL AND METHOD: The logbook presented here is based on the catalogue of learning outcomes in orthopaedic surgery and traumatology developed by an expert board of the medical teaching study group of the German Society of Orthopaedic Surgery and Traumatology (DGOU) in 2011. The objectives defined for the one-year internship are of necessity divided into orthopaedic surgery and traumatology skills that must be acquired by all medical students and those that are optional (compulsory and elective modules). Using a set of predefined criteria, the authors developed the catalogue of learning outcomes (logbook) presented here. The catalogue outlines the competencies to be acquired in an elective orthopaedic surgery and traumatology module, leaving it to each medical faculty to work out the details. Where applicable, comprehensive skills across a number of (compulsory and elective modules) learning objectives are arranged in such a way that they can be taught at different levels of complexity. RESULTS: The logbook covers 15 skill domains from different specific components of orthopaedic surgery and traumatology. Where these skills overlap with those also required in compulsory modules (e.g., surgery), the required level of complexity may be lower for students in the elective module. The text is supplemented by figures with synopses of the major issues and summaries for easy reference. CONCLUSION: With the recent changes in German licensing regulations for physicians, it has become necessary to set up a logbook of uniform learning outcomes to assist medical students and their teachers alike. The authors have developed such a logbook of elective training modules in orthopaedic surgery and traumatology to be taught during the one-year undergraduate internship of German medical students.

[An educational skills programme for undergraduate training in orthopaedic and trauma surgery]. / Lehrzielkatalog im Pflicht- und Wahlbereich des Praktischen Jahres für die Inhalte des Faches "Orthopädie und Unfallchirurgie"

INTRODUCTION: Practical training on clinical cases and work with patients is one of the most important steps within the educational programme of undergraduates. Until now a general programme with specific learning targets for undergraduate training in orthopedic and trauma surgery is lacking. MATERIAL AND METHOD: In this article we present an educational skills programme developed by a national committee composed of specialists in the field of orthopaedic and trauma surgery. This programme is based on existing guidelines of German medical universities. RESULTS: The facultative and obligatory guidelines developed by the national committee are presented. CONCLUSION: The presented learning programme contains chapters regarding the increasing requirements within the field of orthopaedic and trauma surgery and provides reproducible contents with the possibility for learning control.

Force-time characteristics of the rowing stroke and corresponding physiological muscle adaptations.

The force-time characteristics of the rowing stroke was examined in a coxless pair. Sixteen highly trained rowers were evaluated in their usual training positions (stroke or bow). Stroke rowers had higher stroke speed and stroke force in the first part of the stroke than bow rowers. This finding was more prominent during competition speed rowing than during endurance training. Higher blood lactate levels and lower base excess were found at both speeds in stroke rowers. During and incremental ergometer rowing test, lactate performance curves were shifted to the left in the stroke rowers. Analysis of morphometric data in the left deltoid muscle demonstrated higher FT fiber content and lower oxidative fiber capacity and fiber areas in the stroke rowers. The results demonstrate adaptation to years of training in a specific boat position.

[Minimal invasive lumbar sympathectomy--technique and outcome, retroperitoneoscopic approach]]. / Die minimal-invasive lumbale Sympathektomie--Technik und Ergebnisse, retroperitoneoskopischer Zugang.

Peripheral vascular obliteration of the leg provides an indication for a retroperitoneoscopic lumbal sympathectomy initially using a balloon dilator to create a transitional retroperitoneal cavity. After introducing carbon dioxide and two 5-mm instruments, we perform the resection and extirpation of the lumbal sympathetic nerve from L 2 to L 4. No complications occurred in 29 patients except conversion to open surgery in two cases because of gas loss into the peritoneum after causing peritoneal lesions.