Objective structured clinical examination to teach competency in planetary health care and management - a prospective observational study.

BACKGROUND: Health professionals are increasingly called upon and willing to engage in planetary health care and management. However, so far, this topic is rarely covered in medical curricula. As the need for professional communication is particularly high in this subject area, this study aimed to evaluate whether the objective structured clinical examination (OSCE) could be used as an accompanying teaching tool. METHODS: During the winter semester 2022/2023, 20 third- and fifth-year medical students voluntarily participated in a self-directed online course, three workshops, and a formal eight-station OSCE on planetary health care and management. Each examinee was also charged alternatingly as a shadower with the role of providing feedback. Experienced examiners rated students' performance using a scoring system supported by tablet computers. Examiners and shadowers provided timely feedback on candidates` performance in the OSCE. Immediately after the OSCE, students were asked about their experience using a nine-point Likert-scale survey and a videotaped group interview. Quantitative analysis included the presentation of the proportional distribution of student responses to the survey and of box plots showing percentages of maximum scores for the OSCE performance. The student group interview was analyzed qualitatively. RESULTS: Depending on the sub-theme, 60% -100% of students rated the subject of planetary health as likely to be useful in their professional lives. Similar proportions (57%-100%) were in favour of integrating planetary health into required courses. Students perceived learning success from OSCE experience and feedback as higher compared to that from online courses and workshops. Even shadowers learned from observation and feedback discussions. Examiners assessed students' OSCE performance at a median of 80% (interquartile range: 83%-77%) of the maximum score. CONCLUSIONS: OSCE can be used as an accompanying teaching tool for advanced students on the topic of planetary health care and management. It supports learning outcomes, particularly in terms of communication skills to sensitise and empower dialogue partners, and to initiate adaptation steps at the level of individual patients and local communities.

Motivations for body piercings and tattoos - the role of sexual abuse and the frequency of body modifications.

Though the popularity of body modification increases, psychosocial data about practitioners of body piercing and tattooing are few and controversial. Most studies used semi-structured interviews and relatively small sample sizes. The aim of this study was to explore psychosocial background information (motivation, sexual abuse) for body modification practises based on a sufficiently large sample. A core group of 432 subjects with body piercings and/or tattoos (readers of a specialised magazine on body modification; mean age: 28 years) was investigated in this study using a 55-item questionnaire. The mean number of body modifications (piercings and tattoos) was nine. Participants with a history of sexual abuse and high users with more than 10 body modifications differed from those without these features with respect to several motivations and consequences of body modification. Participants with sexual abuse often stated that they wanted to overcome certain experiences, and high users were characterised by the feeling of an addiction to continue body modification. Clinicians should include questions on body modifications and their motives in anamnestic schedules.

The Effort and Reward of Teaching Medical Psychology in Germany: an Online Survey.

Background: The increasing significance of university teaching also leads to higher demands for academic teachers. Against this background this study inquires how teachers in the field of medical pychology experience and evaluate their various activities and how their efforts on the one hand and gratifications on the other hand relate to each other (as conceptualized by the effort-reward-imbalance, ERI). Methods: A cross-sectional online survey was conducted in 2012 among the academic staff of departments of medical psychology in Germany. The questionnaire was answered by 188 participants (return rate: 39.2%), of whom 62% were women. Work stress was measured according to Siegrist's effort-reward-imbalance (ERI) model. Further questions referred to the distribution of academic activities and meaningfulness. Results: Among all participants, 67.3% were satisfied with the portion of their workload devoted to teaching, while 63% wanted more time for research. The ERI-coefficient was on average M=0.76 (SD=0.45), thus indicating a shift towards reward. There were no associations with gender, age, or fixed-term work contracts. Meaningfulness was associated negatively with the ERI (r=-.21, p=.012), and positively with overcommitment (r=.52, p<.001) and the desire for less administrative tasks (r=.24, p=.017). Conclusions: Teaching medical psychology is evaluated as positive and meaningful by a majority of respondents. In general, the rewarding aspects seem to outweigh the stressful factors. Thus, teaching might be a protective factor with regard to coping with work related burden.

Implementation of "social and communicative competencies" in medical education. The importance of curriculum, organisational and human resource development.

OBJECTIVE: With this article we want to support teachers and curriculum planners to be aware of and apply knowledge and recommendations of organisational (OD), curriculums (CD) and human resource development (HRD) ideas already in the planning phase of a project. Taking these into account can influence the process of change successfully and controlled during the introduction and establishment of curricula in the field of communication and social skills in medical education. APPROACH AND RESULTS: In the context of a multi-stage developmental process, a recommendation on CD for "Communicative and social competencies" was developed. The basis for it was made during two workshops of the GMA-committee "Communicative and social competencies" and supplemented by the available literature and the experience of communication experts. The "Undeloher Recommendation" (see attachment ) includes a compilation of recommendations and guiding questions, which is geared to the various phases of CD. Additionally, general approaches and recommendations of organisational and human resource development were integrated, which turned out to be particularly relevant in the process of CD. Thus, the "Undeloher recommendation" includes an orientation for each phase of the curriculum development process, the organisation and the staff in order to successfully implement a longitudinal curriculum. In addition to theoretical models the long-term discussion process and the personal experiences of a variety of curriculum planners and teachers have been integrated. CONCLUSION: The "Undeloher recommendation" can support the implementation processes of curricula in communication and social skills during development and realisation. Its application was reviewed in the context of workshops based on concrete examples. The participating teachers and curriculum planners assessed it to be very helpful. The recommendation goes beyond of what has been described in terms of content models in the CD so fare. In particular, the organisational and human resource development related aspects such as the formation of a steering committee and recommendations for the phase of sustainability.