[Success factors and obstacles in the implementation of competence-oriented teaching in surgery]. / Erfolgsfaktoren und Hindernisse bei der Implementierung kompetenzorientierter Lehre in der Chirurgie.

BACKGROUND AND OBJECTIVES: For successful competence-oriented teaching at the medical faculties it is important to identify the factors that influence its implementation in order to benefit from the strengths and balance out weaknesses. The present study examined the success factors and obstacles of the implementation of competence-oriented teaching in the surgical discipline from the point of view of students and lecturers. METHODS: After implementation of competence-oriented teaching based on the teaching goals of the NKLM, in clinical examination courses (bedside teaching and block internship, BP) at two hospitals, a qualitative content analysis and quantification of the answers were performed using focus group interviews and questionnaires with students (S) and lecturers (D). RESULTS: During the summer semester 2022 a total of 31 students and 14 lecturers were interviewed in focus groups and 143 questionnaires (123 S, 20 D) were analyzed. For the students the presence of concrete competences/teaching goals, guidelines for the lesson, transparent goals and ability to demand teaching goals as well as structured lessons and mentoring were the main success factors. Lecturers on the other hand reported the presence of concrete goals, assistance for the lesson preparation and the activity of the students as success factors. The results of the questionnaires showed that the majority (88% S, 75% D) were informed about the teaching goals and considered them to be followed (84%S, 95% D). Obstacles were the factors "time", "mentoring" and "information". Factors that were between negative and positive (indifferent factors) were "uncertainty about competence-orientation" and "uncertainty how to examine the teaching success". DISCUSSION: Transparent structure and teaching goals as well as a mentoring system are the success factors for the implementation of competence-oriented lessons and should be used as strengths. Indifferent factors represent weaknesses and need to be addressed by training and instruction. Restricted time and personnel resources are the immanent problems that hamper the implementation and require fulminant structural changes.

[Portfolio-based learning in surgery : Making competencies "visible"]. / Portfoliobasiertes Lernen in der Chirurgie : Kompetenzen "sichtbar" machen.

BACKGROUND: Due to an increasing competence orientation of medical studies, surgical curricula are being adapted in many places. In addition to surgical knowledge and practical skills, these should also teach competencies in differential diagnostics and treatment. The teaching of surgical knowledge through lectures and seminars and the demonstration of practical skills, e.g., through the use of logbooks in the Bock Practical Surgery (BP), only allows limited active engagement with surgical competencies on differential diagnostics and treatment. A reflection-based portfolio allows, through the independent written elaboration of surgical topics, an active engagement with the competencies and promises a higher learning effect. In the context of the implementation of such a portfolio as part of the proof of activity in BP, the effects on the acquisition of competencies and on the way of learning were investigated. MATERIAL AND METHODS: Using a mixed methods approach, we compared competence acquisition using a reflection-based portfolio with learning using a logbook. Students conducted a self-assessment of competencies using questionnaire surveys before and after the BP. Through focus group interviews with discussions among students using a guideline, we explored the different ways of acquiring competencies. In addition, the examination and evaluation results of both cohorts were compared. RESULTS AND DISCUSSION: Students' self-assessed competency acquisition and examination and evaluation results showed no differences when comparing the two cohorts. During the focus group interviews, we were able to show that in the perception of the students, surgical competencies can be made more visible and thus more explicit with the help of a reflection-based portfolio. In addition, self-regulated learning was promoted without neglecting practical skills. Students demanded greater supervision and guidance by mentors in both groups.

A Novel Mobile Platform Enhances Motivation and Satisfaction of Academic Teachers.

With rising numbers of students, shorter hospital stays and increasing workload of academic teachers, teaching time have become a scarce resource. Thus, optimal preparation by teachers is key for good clinical teaching. Though a lot of teaching duties are performed by residents in Germany, they are not likely to have been educated in didactic techniques. We developed and evaluated a mobile teaching application using the "Learning Toolbox (LTB)" platform (Raycom BV, Utrecht, Netherlands) that was offered to academic teachers for preparation and support during curricular courses at our medical school. Courses were part of the curricula in Anaesthesiology, Emergency Medicine, and Orthopaedic and Trauma Surgery, and course length could vary up to 40 h per week. Information provided by the novel platform included logistic information, learning objectives, and curricula for the individual courses. A basic tutorial on didactic techniques, suggestions for providing feedback and for enhancing students' participation was also part of the platform. After one semester, interviews with teachers indicated an increase in overall satisfaction. Residents appreciated didactic aids and content provided for preparation, leading to higher motivation and self-confidence. The more experienced teachers were particularly satisfied with easy access to scheduling, teaching assignments and daily planning. The app increased teachers' satisfaction with their performance and enabled better integration of teaching in the daily schedule.