[Graduates of the Model Study Courses in the Health Professions in North Rhine-Westphalia: Employment Characteristics and Competencies in Professional Practice]. / Verbleib der Absolventinnen und Absolventen der Modellstudiengänge in den Gesundheitsfachberufen in Nordrhein-Westfalen: Ergebnisse zu Beschäftigungsmerkmalen und Kompetenzen in der Berufspraxis.

AIM: The aim of this article was to present key results of the graduates' survey VAMOS. The study examined the professional status of the graduates of 12 model study courses in the health professions in North Rhine-Westphalia. The focus of the article was on the employment characteristics of the current main jobs and the application of the academic competencies in everyday professional life. METHODS: In the early summer of 2018 (April to June), 515 graduates of the model study courses in nursing (N=244), physiotherapy (N=97), speech therapy (N=95), occupational therapy (N=47), and midwifery (N=32) were included in an online cross-sectional survey. Graduating classes between the winter semester 2013/2014 and the summer semester 2017 were included. In addition, employers (N=109) were interviewed who hired graduates from the model study courses. RESULTS: The main jobs of the graduates were mostly located in hospitals and outpatient therapy practices. Eight out of ten graduates (84%) performed tasks in direct contact with patients as the main part of their employment. In 71% of these cases, the regular tasks were combined with extended activities in comparison to colleagues without an academic degree. On average, the graduates felt confident in all competency dimensions examined in this study. In all dimensions, employers perceived a "competence advantage" for graduates compared to colleagues without an academic degree. CONCLUSION: The results of this graduate survey support the current recommendation to have the study programs in the five health care professions governed by professional laws and to enable the programs to be carried out at universities.

Randomised clinical trial of pilonidal sinus operations performed in the prone position under spinal anaesthesia with hyperbaric bupivacaine 0.5 % versus total intravenous anaesthesia.

PURPOSE: The aim of this randomised clinical trial was to determine whether spinal anaesthesia (SPA) is superior to total intravenous anaesthesia (TIVA) in patients undergoing pilonidal sinus (PS) operations in the prone position. METHODS: After approval of the local ethics committee, suitable patients aged 19-49 years were randomised to SPA (7.5 mg hyperbaric bupivacaine) or TIVA (Propofol and Fentanyl). Cumulative consumption of analgesics, postoperative recovery, complications and patient satisfaction were evaluated. RESULTS: A total of 50 patients were randomised within a 24-month period. Median monitoring time in the recovery room was 0 (0-11) min for SPA versus 40 (5-145) min for TIVA (p < 0.0001). Patients in the SPA group were able to drink (40.5 (0-327) min versus TIVA 171 (72-280) min, p < 0.0001) and eat (55 (0-333) min versus TIVA 220 (85-358), p < 0.0001) earlier. More patients with a TIVA needed analgesics in the recovery room (SPA n = 0 versus TIVA n = 6, p = 0.0023) and suffered more frequently from a sore throat (SPA n = 0 versus TIVA n = 11, p = 0.0001). Two patients with a TIVA suffered from nausea and vomiting. Patients of both groups were equally satisfied with the anaesthesia technique offered. CONCLUSIONS: SPA with 7.5 mg hyperbaric bupivacaine is superior to TIVA in patients undergoing PS operations in the prone position in terms of analgesia consumption in the recovery room, recovery times and postoperative complications.