[Participatory Design of Health Technologies - Challenges and Requirements for Action from the Perspective of Health Services Research]. / Partizipatives Design im Kontext gesundheitsbezogener Technologien ­ Herausforderungen und Handlungserfordernisse aus Perspektive der Versorgungsforschung.

The use of participatory design (PD) provides a framework for involving users in the process of developing healthcare technologies. Within PD, theoretical and methodological decisions need to be made. However, these decisions are often not adequately described or justified. This can lead to limited interpretability of the results. This paper has three objectives: First, to provide an overview of the key theoretical and methodological decisions that must be made in PD from the perspective of health services research; second, to describe the associated challenges and third, to describe action requirements for the future development of PD in health services research.

[Child and Career, but When? Mixed Methods Research on Starting a Family During Student Years vs. after Graduation from Medical School]. / Kind und Karriere, aber wann? ­ Mixed Methods Research zum Thema Medizinstudium als alternativer Zeitpunkt für die Familiengründung.

BACKGROUND: More and more women are studying medicine these days. They often face a conflict between having children and pursuing a career. Thus, a challenging question arises for a new generation of young doctors: How can children and career be reconciled? Also, the right time to start a family plays an important role. At the University Witten/Herdecke, students with and without children were asked to what extent their time when they were students of medicine proved to be a convenient time to start a family. METHODS: A questionnaire survey was carried out in which a total of 423 medical students took part. A further 12 medical students with children were also interviewed about their situation using a guided interview. Results were evaluated using a qualitative content analysis. RESULTS: Medical students with children saw that there were advantages in terms of family and career to starting a family during their studies, but noted the disadvantages in terms of studies and the financial situation. The majority of medical students without children were undecided about the ideal time to start a family, but only 18% considered the student years to be the ideal time for this. Among medical students with children, on the other hand, 50% considered the student years as the ideal time to start a family and only five percent perceived the time after their studies as ideal. CONCLUSION: In order to facilitate combining children and career across the entire career path as a medical doctor, political and university policy concepts should be developed that take into consideration financial relief and flexible study organization.

Digital Competencies and Attitudes Toward Digital Adherence Solutions Among Elderly Patients Treated With Novel Anticoagulants: Qualitative Study.

BACKGROUND: Nonadherence to medication is a driver of morbidity and mortality, and complex medication regimens in patients with chronic diseases foster the problem. Digital technology might help, but despite numerous solutions being developed, none are currently widely used, and acceptance rates remain low, especially among the elderly. OBJECTIVE: This study aimed to better understand and operationalize how new digital solutions can be evaluated. Particularly, the goal was to identify factors that help digital approaches targeting adherence to become more widely accepted. METHODS: A qualitative study using a conceptual grounded theory approach was conducted. We included patients aged 65 years and older who routinely took new oral anticoagulants. To generate theses about the digital competencies of the target group with daily medication intake, face-to-face interviews were conducted, recorded, and anonymized. After coding the interviews, categories were generated, discussed, and combined with several theses until saturation of the statements was reached. RESULTS: The methodological approach led to the finding that after interviews in 20 of 77 potentially available patients, a saturation of statements was reached. The average patient's age was 75 years, and 50% (10/20) of the subjects were female. The data identified five main coding categories-Diseases and medicine, Technology, Autonomy, Patient narrative, and Attitude toward technologies-each including positive and negative subcategories. Main categories and subcategories were summarized as Adherence Radar, which can be considered as a framework to assess the potential of adherence solutions in the process of prototyping and can be applied to all adherence tools in a holistic manner. CONCLUSIONS: The Adherence Radar can be used to increase the acceptance rate of digital solutions targeting adherence. For a patient-centric design, an app should be adapted to the individual patient's needs. According to our results, this application should be based on gender and educational background as well as the individual physician-patient relationship. If used in a proper, individualized manner, digital adherence solutions could become a new cornerstone for the treatment of chronically ill individuals.

TiHoVideos: veterinary students' utilization of instructional videos on clinical skills.

BACKGROUND: The YouTube channel "TiHoVideos" was created by the University of Veterinary Medicine Hannover, Foundation (TiHo) to enable easy, public access to the university's instructional videos as an additional support for learning clinical skills. Video production is expensive and time-consuming. To be able to optimize video production and aligning content to student needs we wanted to know if and how our students use these videos. RESULTS: Results show that the participating students primarily prepared for learning stations in the Clinical Skills Lab (CSL) by watching TiHoVideos at home on tablets or laptops and then concentrated at the CSL on learning the practical skills hands on. The videos available on TiHoVideos are rated as being a "very helpful" educational tool when preparing for CSL learning stations. CONCLUSIONS: Instructional videos represent an unquestionably suitable medium to aid veterinary students learn practical skills and a contribution to animal welfare by reducing the use of live animals in undergraduate veterinary education. The university's production of educational video material proves to be worth the effort because the videos are being used, appreciated and well-rated by TiHo students for their learning experience.

Digital Transformation and Disruption of the Health Care Sector: Internet-Based Observational Study.

BACKGROUND: Digital innovation, introduced across many industries, is a strong force of transformation. Some industries have seen faster transformation, whereas the health care sector only recently came into focus. A context where digital corporations move into health care, payers strive to keep rising costs at bay, and longer-living patients desire continuously improved quality of care points to a digital and value-based transformation with drastic implications for the health care sector. OBJECTIVE: We tried to operationalize the discussion within the health care sector around digital and disruptive innovation to identify what type of technological enablers, business models, and value networks seem to be emerging from different groups of innovators with respect to their digital transformational efforts. METHODS: From the Forbes 2000 and CBinsights databases, we identified 100 leading technology, life science, and start-up companies active in the health care sector. Further analysis identified projects from these companies within a digital context that were subsequently evaluated using the following criteria: delivery of patient value, presence of a comprehensive and distinctive underlying business model, solutions provided, and customer needs addressed. RESULTS: Our methodological approach recorded more than 400 projects and collaborations. We identified patterns that show established corporations rely more on incremental innovation that supports their current business models, while start-ups engage their flexibility to explore new market segments with notable transformations of established business models. Thereby, start-ups offer higher promises of disruptive innovation. Additionally, start-ups offer more diversified value propositions addressing broader areas of the health care sector. CONCLUSIONS: Digital transformation is an opportunity to accelerate health care performance by lowering cost and improving quality of care. At an economic scale, business models can be strengthened and disruptive innovation models enabled. Corporations should look for collaborations with start-up companies to keep investment costs at bay and off the balance sheet. At the same time, the regulatory knowledge of established corporations might help start-ups to kick off digital disruption in the health care sector.

Impact of Virtual Patients as Optional Learning Material in Veterinary Biochemistry Education.

Biochemistry and physiology teachers from veterinary faculties in Hannover, Budapest, and Lublin prepared innovative, computer-based, integrative clinical case scenarios as optional learning materials for teaching and learning in basic sciences. These learning materials were designed to enhance attention and increase interest and intrinsic motivation for learning, thus strengthening autonomous, active, and self-directed learning. We investigated learning progress and success by administering a pre-test before exposure to the virtual patients (vetVIP) cases, offered vetVIP cases alongside regular biochemistry courses, and then administered a complementary post-test. We analyzed improvement in cohort performance and level of confidence in rating questions. Results of the performance in biochemistry examinations in 2014, 2015, and 2016 were correlated with the use of and performance in vetVIP cases throughout biochemistry courses in Hannover. Surveys of students reflected that interactive cases helped them understand the relevance of basic sciences in veterinary education. Differences between identical pre- and post-tests revealed knowledge improvement (correct answers: +28% in Hannover, +9% in Lublin) and enhanced confidence in decision making ("I don't know" answers: -20% in Hannover, -7.5% in Lublin). High case usage and voluntary participation (use of vetVIP cases in Hannover and Lublin >70%, Budapest <1%; response rates in pre-test 72% and post-test 48%) indicated a good increase in motivation for the subject of biochemistry. Despite increased motivation, there was only a weak correlation between performance in final exams and performance in the vetVIP cases. Case-based e-learning could be extended and generated cases should be shared across veterinary faculties.

Development of learning objectives for neurology in a veterinary curriculum: part I: undergraduates.

BACKGROUND: With an increasing caseload of veterinary neurology patients in first opinion practice, there is a requirement to establish relevant learning objectives for veterinary neurology encompassing knowledge, skills and attitudes for veterinary undergraduate students in Europe. With help of experts in veterinary neurology from the European College of Veterinary Neurology (ECVN) and the European Society of Veterinary Neurology (ESVN) a survey of veterinary neurologic learning objectives using a modified Delphi method was conducted. The first phase comprised the development of a draft job description and learning objectives by a working group established by the ECVN. In the second phase, a quantitative questionnaire (multiple choice, Likert scale and free text) covering 140 learning objectives and subdivided into 8 categories was sent to 341 ESVN and ECVN members and a return rate of 62% (n = 213/341) was achieved. RESULTS: Of these 140 learning objectives ECVN Diplomates and ESVN members considered 42 (30%) objectives as not necessary for standard clinical veterinary neurology training, 94 (67%) were graded to be learned at a beginner level and 4 (3%) at an advanced level. The following objectives were interpreted as the most important day one skills: interpret laboratory tests, perform a neurological examination and establish a neuroanatomical localization. In this survey the three most important diseases of the central nervous system included epilepsy, intervertebral disc disease and inflammatory diseases. The three most important diseases of the peripheral nervous system included polyradiculoneuritis, myasthenia gravis and toxic neuropathies. CONCLUSIONS: The results of this study should help to reform the veterinary curriculum regarding neurology and may reduce the phenomenon of "Neurophobia".

Development of learning objectives for neurology in a veterinary curriculum: part II: postgraduates.

BACKGROUND: Specialization in veterinary medicine in Europe is organized through the Colleges of the European Board of Veterinary Specialization. To inform updating of the curriculum for residents of the European College of Veterinary Neurology (ECVN) job analysis was used. Defining job competencies of diploma holders in veterinary neurology can be used as references for curriculum design of resident training. With the support of the diplomates of the ECVN and the members of the European Society of Veterinary Neurology (ESVN) a mixed-method research, including a qualitative search of objectives and quantitative ranking with 149 Likert scale questions and 48 free text questions in 9 categories in a survey was conducted. In addition, opinions of different groups were subjected to statistical analysis and the result compared. RESULTS: A return rate of 62% (n = 213/341) was achieved. Of the competencies identified by the Delphi process, 75% objectives were expected to attain expert level; 24% attain advanced level; 1% entry level. In addition, the exercise described the 11 highly ranked competencies, the 3 most frequently seen diseases of the central and peripheral nervous systems and the most frequently used immunosuppressive, antiepileptic and chemotherapeutic drugs. CONCLUSION: The outcomes of this "Delphi job analysis" provide a powerful tool to align the curriculum for ECVN resident training and can be adapted to the required job competencies, based on expectations. The expectation is that for majority of these competencies diplomates should attain an expert level. Besides knowledge and clinical skills, residents and diplomates are expected to demonstrate high standards in teaching and communication. The results of this study will help to create a European curriculum for postgraduate education in veterinary neurology.

Clinical skills of veterinary students - a cross-sectional study of the self-concept and exposure to skills training in Hannover, Germany.

BACKGROUND: Students of veterinary medicine should achieve basic professional competences required to practise their profession. A main focus of veterinary education is on developing clinical skills. The present study used the guidelines of the "Day-One Skills" list of European Association of Establishments for Veterinary Education (EAEVE) to create an online questionnaire for assessing the skills acquired by students at the University of Veterinary Medicine Hannover (TiHo). The theoretical and practical veterinary knowledge levels of the students and postgraduates are determined and compared. RESULTS: In two batches, 607 people responded (response batch 1, 23.78%; response batch 2, 23.83%). From 49 defined skills, 28 are actually practised during training at the university and 21 activities are known only theoretically. Furthermore, the students showed great willingness to use simulators and models in a clinical skills lab. CONCLUSIONS: The results of this survey highlight that the opening of a clinical skills lab at the University of Veterinary Medicine Hannover and its incorporation into the study programme are ideal tools to promote practical competences and foster the motivation to learn.

Use of key feature questions in summative assessment of veterinary medicine students.

PURPOSE: To prove the hypothesis that procedural knowledge might be tested using Key Feature (KF) questions in written exams, the University of Veterinary Medicine Hannover Foundation (TiHo) pioneered this format in summative assessment of veterinary medicine students. Exams in veterinary medicine are either tested orally, practically, in written form or digitally in written form. The only question formats which were previously used in the written e-exams were Type A Single-choice Questions, Image Analysis and Short Answer Questions. E-exams are held at the TiHo using the electronic exam system Q [kju:] by CODIPLAN GmbH. METHODS: In order to examine less factual knowledge and more procedural knowledge and thus the decision-making skills of the students, a new question format was integrated into the exam regulations by the TiHo and some examiner used this for the first time in the computer based assessment. Following a successful pilot phase in formative e-exams for students, KF questions were also introduced in summative exams. A number of multiple choice questions were replaced by KF questions in four computer based assessment in veterinary medicine. The subjects were internal medicine, surgery, reproductive medicine and dairy science. RESULTS: The integration and linking of KF questions into the computer based assessment system Q [kju:] went without any complications. The new question format was well received both by the students and the teaching staff who formulated the questions. CONCLUSION: The hypothesis could be proven that Key Feature questions represent a practicable addition to the existing e-exam question formats for testing procedural knowledge. The number of KF questions will be therefore further increased in examinations in veterinary medicine at the TiHo.

[Multimodal selection of medical students: The predictive power of individual process components in the two-stage selection process at Witten/Herdecke University (UW/H)]. / Multimodale Auswahl von Medizinstudierenden: Vorhersagekraft einzelner Verfahrensbestandteile im zweistufigen Auswahlverfahren an der Universität Witten/Herdecke (UW/H).

OBJECTIVE: According to the legislator's ideas, the selection of medical students in Germany should no longer be based on the Abitur grade alone. This approach has already been implemented in the two-stage selection process at Witten/Herdecke University (UW/H) using several criteria. On the one hand, the present study aims to determine the prognostic value of the procedural components for the overall performance on the selection day. On the other hand, the different strategies of the applicants in processing the written task (phase 1) will be examined with regard to their application success. METHODOLOGY: Data on applications for the summer semester 2020 (N = 819 phase 1; N = 233 phase 2) were available retrospectively. A stepwise regression analysis was conducted to determine the predictive power of each procedural component. Using a summary content analysis, the four essays from the applicants' motivation letters were structured and categories were identified, and an extreme group comparison (Group 1: Not invited; Group 2: University acceptance; N = 60 essays) was conducted. RESULTS: As the stepwise regression analysis shows, the individual biographical interview emerged as the strongest predictor in terms of overall performance, followed by lecture, group interview, and multiple mini interviews. Content analysis extracted content and scaling categories for the individual essays, as well as an additional meta-category (Impression Management, IM). Successful applicants demonstrated, among other things, better judgment skills, more sophisticated reasoning skills, and an internalized role model as a physician. In addition, they used defensive IM strategies, e.g., subjectification and self-deprecation, more frequently. CONCLUSION: Biographical interview is considered the strongest predictor of overall performance. The dimensions of impression management, reasoning quality and judgment proved to be reliable predictors of successful performance in the selection process. In addition, role image as a physician and professional commitment had a favorable effect on the selection decision.

Teaching Digital Medicine in a Virtual Classroom: Impacts on Student Mindset and Competencies.

Digital competencies, as well as knowledge about digital medicine, are becoming increasingly relevant but are rarely reflected in teaching concepts at universities. One reason for this is probably the fact that they are not yet part of the curricula in many areas or countries (such as medicine in Germany). Therefore, courses that address digital competencies and intend to impart knowledge about digital medicine are not subject to any curricular specifications and have a correspondingly broad range of possible designs. This article reports findings from an investigation on an interdisciplinary and cross-faculty course on digital medicine. An online questionnaire was used to assess student attitudes toward digital medicine topics and conduct self-assessments of their digital competencies before and after the course. The aim of this study was to test whether such a course could influence students' attitudes and competencies. Group comparisons revealed statistically significant changes. They proved that the described course and its content regarding digital transformation in healthcare and digital medicine had an impact on digital competencies and participant opinions on digital topics. In order to teach students important competencies for the 21st century, universities should offer more courses that address digital transformation and support students in improving their competencies.

[How important is an academic career in medicine today? A survey among medical students in Germany: Results of study arm XIII of the KARiMED study]. / Wie wichtig ist heute noch eine akademische Karriere in der Medizin? Eine Befragung von Medizinstudierenden in Deutschland: Ergebnisse des Studienarms XIII der KARiMED-Studie.

OBJECTIVE: Academic careers still play a significant role in medicine. Although the doctorate remains interesting for many students, there are no data available from medical students, for example, with regard to the interest in habilitation. In parallel, a good work-life/family balance is a key career element for young medical professionals. The aim was to obtain an up-to-date opinion on the academic career of medical students. METHODOLOGY: Using an online survey, medical students of all semesters in Germany were questioned on the topics of academic career, mentoring, and work-life balance from October 2017 to December 2018. For this purpose, the medical students were invited by e-mail to participate and answer an anonymized online questionnaire. RESULTS: A total of 1,775 participants from all 38 German medical faculties (68.3% female; age 23.3 ±â€¯4.0 years) were included. Almost half of the participants could envision working in a branch office after graduation. While a professional career appeared important to a clear majority (70.8%), leisure time was rated as even more important (84.3%), and work-life balance clearly prioritized personal life (41.2%) over career (9.6%). Acquiring a title was rated as important to one's career by 53.6%. However, while the acquisition of a doctorate was still an option for 88.0% of the respondents, the situation is significantly different for academic titles following a successful habilitation. Although the significance of a habilitation is rated as high to very high (66.1%), the titles of assistant professor ("yes": 13.0%), associate professor (6.0%) or university professor (7.0%) are much less likely to be considered by medical students and are therefore rated as "maybe" and "no". Nevertheless, almost 60% wished for better information and advice in their future field of work. CONCLUSION: Careers in medicine are undergoing a transformation where better compatibility of leisure/family and work is no longer the sole focus. On the contrary, work-life blending is sought, as a connection between work and life. Changes are therefore necessary for professional and especially academic careers in order to make working in science and research attractive again.

Involving Health Care Professionals in the Development of Electronic Health Records: Scoping Review.

BACKGROUND: Electronic health records (EHRs) are a promising approach to document and map (complex) health information gathered in health care worldwide. However, possible unintended consequences during use, which can occur owing to low usability or the lack of adaption to existing workflows (eg, high cognitive load), may pose a challenge. To prevent this, the involvement of users in the development of EHRs is crucial and growing. Overall, involvement is designed to be very multifaceted, for example, in terms of the timing, frequency, or even methods used to capture user preferences. OBJECTIVE: Setting, users and their needs, and the context and practice of health care must be considered in the design and subsequent implementation of EHRs. Many different approaches to user involvement exist, each requiring a variety of methodological choices. The aim of the study was to provide an overview of the existing forms of user involvement and the circumstances they need and to provide support for the planning of new involvement processes. METHODS: We conducted a scoping review to provide a database for future projects on which design of inclusion is worthwhile and to show the diversity of reporting. Using a very broad search string, we searched the PubMed, CINAHL, and Scopus databases. In addition, we searched Google Scholar. Hits were screened according to scoping review methodology and then examined, focusing on methods and materials, participants, frequency and design of the development, and competencies of the researchers involved. RESULTS: In total, 70 articles were included in the final analysis. There was a wide range of methods of involvement. Physicians and nurses were the most frequently included groups and, in most cases, were involved only once in the process. The approach of involvement (eg, co-design) was not specified in most of the studies (44/70, 63%). Further qualitative deficiencies in the reporting were evident in the presentation of the competences of members of the research and development teams. Think-aloud sessions, interviews, and prototypes were frequently used. CONCLUSIONS: This review provides insights into the diversity of health care professionals' involvement in the development of EHRs. It provides an overview of the different approaches in various fields of health care. However, it also shows the necessity of considering quality standards in the development of EHRs together with future users and the need for reporting this in future studies.

Non-Invasive Wearable Devices for Monitoring Vital Signs in Patients with Type 2 Diabetes Mellitus: A Systematic Review.

Type 2 diabetes mellitus (T2D) poses a significant global health challenge and demands effective self-management strategies, including continuous blood glucose monitoring (CGM) and lifestyle adaptations. While CGM offers real-time glucose level assessment, the quest for minimizing trauma and enhancing convenience has spurred the need to explore non-invasive alternatives for monitoring vital signs in patients with T2D. Objective: This systematic review is the first that explores the current literature and critically evaluates the use and reporting of non-invasive wearable devices for monitoring vital signs in patients with T2D. Methods: Employing the PRISMA and PICOS guidelines, we conducted a comprehensive search to incorporate evidence from relevant studies, focusing on randomized controlled trials (RCTs), systematic reviews, and meta-analyses published since 2017. Of the 437 publications identified, seven were selected based on predetermined criteria. Results: The seven studies included in this review used various sensing technologies, such as heart rate monitors, accelerometers, and other wearable devices. Primary health outcomes included blood pressure measurements, heart rate, body fat percentage, and cardiorespiratory endurance. Non-invasive wearable devices demonstrated potential for aiding T2D management, albeit with variations in efficacy across studies. Conclusions: Based on the low number of studies with higher evidence levels (i.e., RCTs) that we were able to find and the significant differences in design between these studies, we conclude that further evidence is required to validate the application, efficacy, and real-world impact of these wearable devices. Emphasizing transparency in bias reporting and conducting in-depth research is crucial for fully understanding the implications and benefits of wearable devices in T2D management.

Can online conference systems improve veterinary education? A study about the capability of online conferencing and its acceptance.

In veterinary medicine, there is an ongoing need for students, educators, and veterinarians to exchange the latest knowledge in their respective fields and to learn about unusual cases, emerging diseases, and treatment. Networking among veterinary faculties is developing rapidly, but conferences and meetings can be difficult to attend because of time limitations and travel costs. The current study examines acceptance of synchronous online conferences, seminars, meetings, and lectures by veterinarians and students. First, an online survey on the use of communication technology in veterinary medicine was made available for 15 weeks to every German-speaking veterinary university and via professional journals and an online veterinary forum. A total of 1,776 persons (620 veterinarians and 1,156 students) participated. Most reported using the Internet at least once per day; more than half reported using instant messengers. Most participants used the Internet for communication, but less than half used Skype. Second, to test the spectrum of tools for online conferences, a variety of "virtual classroom" systems (netucate systems iLinc, Adobe Acrobat Connect Pro, Cisco WebEx, Skype) were used to deliver student lectures, veterinary continuing-education courses, and academic conferences at the University of Veterinary Medicine, Hannover (TiHo). Of 591 participants in 63 online events, 99.4% rated the virtual events as enjoyable, 96.1% found them useful, and 92.4% said that they learned a lot. Participants noted that the courses were not tied to a certain place, and thus saved time and travel costs. Online conference systems thus offer new opportunities to provide information in veterinary medicine.

Digitalization in Medicine: Are German Medical Students Well Prepared for the Future?

The German healthcare system is facing a major transformation towards digitalized medicine. The aim was to find out the attitude and the degree of preparation of upcoming medical professionals for digital medicine. By means of an online survey, medical students from 38 German faculties were asked about different topics concerning digitalization. Most students (70.0%) indicated that they had not had any university courses on digital topics. Thus, only 22.2% feel prepared for the technical reality of digitalized medicine. Most fear losing patient contact because of digitalized medicine and assume that the medical profession will not be endangered by digitalization. Security systems, data protection, infrastructure and inadequate training are cited as the top problems of digitalization in medicine. Medical students have major concerns about incorrect decisions and the consecutive medicolegal aspects of using digital support as part their treatment plans. Digitalization in medicine is progressing faster than it can currently be implemented in the practical work. The generations involved have different understandings of technology, and there is a lack of curricular training in medical schools. There must be a significant improvement in training in digital medical skills so that the current and future healthcare professionals are better prepared for digitalized medicine.

Clothes Make the Man-What Impact Does the Dress of Interprofessional Teams Have on Patients?

Physicians' attire seems to play an important role in the success of patient treatment. The classic doctor's white coat initiates a strong signal to the patient and can have a determining effect on a successful doctor-patient relationship. In a quantitative online questionnaire study comprising 52 questions, participants were shown four photos of an interprofessional German family medicine team in varying attire. One important study feature relating to the ongoing coronavirus pandemic was that the team was portrayed wearing FFP2 masks in one photo. We measured core values regarding the team's perception in terms of sympathy, competence, trust, choosing the practice as a personal health care provider, and wanting to participate in the team. The questionnaire was posted online between March and May 2021. It was accessed 1435 times and 906 sheets were qualified for statistical analysis. For the first time in this field of research, a practice team's attire was investigated. We found a significant influence of different clothing on the perception of sympathy, competence, trust, elective practice, and team participation. Wearing an FFP2 mask promotes feelings of security and competence. The study shows that in times of fast social changes due to rapid digitalization and an ongoing pandemic, we should present ourselves in different ways as a medical team depending on the patient groups we are targeting and the feelings we want to evoke.

Millennials Medical Students Generation at the Crosswalks: Motivations and Attitudes Towards Study and Future Career - A Mixed-Method Study.

Background and Objectives: The aim of this study was to investigate in the millennium medical student generation the influence of the curriculum (problem-based curriculum [PBC] vs science-based curriculum [SBC]), gender and semester level on medical students' motives to study medicine, their attitudes toward their career and in this regard their view about their study condition in university. Methods: Semi-structured qualitative interviews with 28 medical students were performed and analyzed using Mayring's content analysis. Based on these results, a quantitative questionnaire for a nationwide survey was developed using a mixed-method-approach and send to most medical faculties in Germany. Data from n=1053 students entered statistical analysis. Results: Humanistic ideals prevailed in the choice to enter medical school and to become a physician. PBC students were found to be significantly (p<0.001) more idealistic and patient oriented, and they regard their curriculum more competitive than SBC-students (p<0.001). A balanced work and family life is essential for all students but particularly important for the PBC - group, male and undergraduate students. The majority of students wanted to work with patients and omitted patient-distant line of work. Undergraduate SBC-students saw their studies as old-fashioned citing lack of patient contact (p<0.001 compared to PBC), which eased in the graduate study part. Conclusion: This study found major differences in student's perceptions depending on curriculum type. PBC-students were more idealistic, and humanistic ideals prevailed in comparison to SBC. For both, close patient contact is essential in their training. Particularly for female students, lifestyle factors and a balanced work-life-integration outweigh career ambitiousness. This study offers an important insight to policy makers and educators to understand the motivation and perceptions of the millennial student generation regarding their studies and future career plans, which should be considered in educational policies.

Quantitative Analysis of the Acceptance and Learning Success Instead of Flipped Classroom Teaching in a Caries Diagnosis Course for Undergraduate Students.

This pilot study aimed to investigate the effectiveness of a flipped classroom for undergraduate students in dentistry. The main objective was to compare the knowledge level of students before and after lectures and practice. All second-year dental students (n = 44) at Witten/Herdecke University participated in this pilot study. They took four knowledge assessments, i.e., T0: the baseline, T2a: after the online lecture (two weeks after T0), T2b: immediately after the face-to-face session, and T3: after the practical session (three weeks after T2). The students' satisfaction and self-assessment of their abilities were determined immediately after the practical session in an anonymous online questionnaire using LimeSurvey. To assess the level of knowledge, we used the Friedman and Wilcoxon-signed-rank tests with the Bonferroni correction to analyze the correct answer by comparing the results from different sessions. The students' satisfaction and self-assessment of their abilities were determined descriptively, presenting the mean and standard deviation. A significance level of p ≤ 0.05 was applied. Data from thirty-nine students regarding the level of knowledge were analyzed. There were statistically significant differences in the level of knowledge of the students at different times (p = 0.001). A total of 19.5% of students reported a problem with the flipped classroom method, and 80.5% reported no problem with this educational method. Ninety-four percent of students would like further flipped classrooms in dental education. Within the limitations of this pilot study, the results suggest that dental students benefit from the flipped classroom method and that this mode of education can be effective in introducing caries diagnosis education for undergraduate students.