Development of a strategy for the expansion of online teaching at the University of Würzburg based on the experiences of lecturers and students in the pandemic years 2020/21.

Background: Owing to the COVID-19 pandemic, the summer of 2020 saw face-to-face teaching replaced by online teaching. The question arose as to how digitalisation may be implemented meaningfully. The views of lecturers and students on past online programmes were gathered in order to identify potential and future prospects. Project description: An exploratory, guidelines-based interview study was conducted during the clinical phase of the medicine degree at the Faculty of Medicine in Würzburg. Five lecturers and five students were interviewed in the winter semester of 2020/21. This was followed by a content analysis evaluation according to Kuckartz, with the help of MAXQDA. Results: Online teaching offers more flexibility and security for the future. Hybrid formats (e.g., blended learning) are in demand. While theoretical knowledge can be taught online, face-to-face teaching remains essential in practical training. Digital elements must be developed didactically and anchored in the curriculum. Interaction and direct feedback between students and lecturers are key aspects of this. Discussion: Online teaching in medicine offers numerous potentials and didactic design options that can improve the degree programme in a competency-based manner. Combined teaching formats are particularly effective in this regard. Fittingly conceived, multimedia teaching formats enable students to approach their studies in a focused manner. The points raised during the interviews correspond with the fundamental principles of the ARCS model, which was developed to strengthen continuous motivation in students. Conclusion: Well-thought-out design and integration of online teaching can contribute to attractive, efficient, and future-oriented teaching/learning activities. Decisive factors are the collaboration of everyone involved and adequate provision of both time and financial resources.

Neuroenhancement and mental health in students from four faculties - a cross-sectional questionnaire study.

Background: Students face great challenges at the beginning of and during their studies. Competitive experience, exam anxiety, and especially the new performance requirements often cause test anxiety and stressful experiences. The extent of substance use in terms of neuroenhancement (NE) is unclear. Evidence shows associations between NE, increased stress levels, and mental health. Objectives: We aim to determine the prevalence of NE and alcohol and tobacco use among college students. We also investigate the associations between NE and ADHD, anxiety, depression, and stress experience. Methods: In spring 2021, an anonymous online cross-sectional survey was conducted among students of medicine, dentistry, business economics, and business informatics in Würzburg. The survey included the instruments ASRS (ADHD), PSS-10 (stress), PHQ-4 (depression and anxiety), and AUDIT-C (alcohol comsumption), as well as questions about consumption patterns, prior knowledge, and reasons for NE. Results: Of the 5564 students who were invited to participate, 1010 completed the questionnaire (18.2%). Of these, 12.4% indicated NE for the studied period. NE was used in particular during preparations for exams, to enhance performance, and/or to regulate emotions, most commonly through caffeine tablets, cannabis, and methylphenidate. NE was associated with risky use of alcohol or tobacco, and to a lesser extent with ADHD symptoms and stress experience.Conclusions: Students are at risk of substance abuse and NE. Effective stress management and prevention approaches as well as low-threshold services are needed to identify and support students with risk profiles.

Teaching alcohol and smoking counselling in times of COVID-19 to 6th-semester medical students: experiences with a digital-only and a blended learning teaching approach using role-play and feedback.

Objectives: Digital teaching formats have seen increased use, and not just since the beginning of the pandemic. They can also be used to teach cognitive, practical and communicative learning objectives effectively. We describe the implementation of an online-only course on alcohol/smoking counselling in the COVID-19 summer semester (SS) 2020 and an inverted classroom (IC) concept in the winter semester (WS) 2020/21 at the University Hospital of Würzburg. Methodology: The interdisciplinary subject of "prevention" teaches students about high-risk alcohol consumption/smoking and how to conduct a brief verbal intervention. All 143 (SS) and 131 (WS) 6th-semester medical students completed a 90-minute course: module 1 included a Prezi® presentation on alcohol/smoking basics. Module 2 introduced a counselling concept (alcohol or smoking) online or classroom-based (WS only), depending on the participants' choice. In the online practical component, each student created a counselling video and reflections at home, and later received written feedback from lecturers/tutors. Supervised role-playing was used in the classroom-based format in the WS. There were 2 exam questions on module 1 at the end of each semester. Results: The students surveyed (11%) were satisfied with module 1. Practical exercises and feedback received praise in the evaluation of the classroom-based format (response: 97%). It was not possible for all students to perform counselling due to time constraints. A majority of participants filmed live role-playing in the online practical component. The exam questions were answered correctly by 31% (SS) and 36% (WS) respectively. Conclusions: Counselling can also be taught digitally: creating one's own videos with delayed written feedback is an innovative form of teaching. We are now aiming for a mix of both aspects as an IC with 90 minutes of classroom-based practical exercises.

Management of Common Infections in German Primary Care: A Cross-Sectional Survey of Knowledge and Confidence among General Practitioners and Outpatient Pediatricians.

Outpatient antibiotic use is closely related to antimicrobial resistance and in Germany, almost 70% of antibiotic prescriptions in human health are issued by primary care physicians (PCPs). The aim of this study was to explore PCPs, namely General Practitioners' (GPs) and outpatient pediatricians' (PDs) knowledge of guideline recommendations on rational antimicrobial treatment, the determinants of confidence in treatment decisions and the perceived need for training in this topic in a large sample of PCPs from southern Germany. Out of 3753 reachable PCPs, 1311 completed the survey (overall response rate = 34.9%). Knowledge of guideline recommendations and perceived confidence in making treatment decisions were high in both GPs and PDs. The two highest rated influencing factors on prescribing decisions were reported to be guideline recommendations and own clinical experiences, hence patients' demands and expectations were judged as not influencing treatment decisions. The majority of physicians declared to have attended at least one specific training course on antibiotic use, yet almost all the participating PCPs declared to need more training on this topic. More studies are needed to explore how consultation-related and context-specific factors could influence antibiotic prescriptions in general and pediatric primary care in Germany beyond knowledge. Moreover, efforts should be undertaken to explore the training needs of PCPs in Germany, as this would serve the development of evidence-based educational interventions targeted to the improvement of antibiotic prescribing decisions rather than being focused solely on knowledge of guidelines.

Which teaching method is more effective in a communication course - role-playing versus simulated patients, taught by tutors or faculty staff? A randomized trial.

Aim: Communicative skills can be taught and trained as part of medical training. In these courses, lecturers or tutors serve as instructors, and students perform interviews with simulated patients (SP) or role-play (RP) with fellow students. The present study was conducted to identify the combination of applied teaching methods that is most effective. Method: n=144 third-year (5th semester) medical students attended a medical history-taking course that consisted of three separate sessions (90 minutes each). Students were randomized into three groups. Groups 1 and 2 received training with SP in sessions one and two, followed by RP training in session three; (teaching by lecturer = SP-Lecturer group vs. teaching by tutor = SP-Tutor group). Group 3 received two sessions of RP training and a SP-based training in session three (teaching by tutor = RP-Tutor group). After completing the course, students had to rate their learning success using a short questionnaire, pass an SP-OSCE station and were supposed to answer exam questions. Results: The OSCE performance of both the SP-Lecturer group (n=28) and the RP-Tutor group (n=44) was significantly better than that of the SP-Tutor group (n=26; p=.018 and p=.041, respectively). All groups reported an increase in self-rated history-taking skills (p<.001). There was no difference between groups in the results achieved on the final exam. Conclusions: Students receiving SP-based teaching benefit more from a lecturer-taught course, while students instructed by tutors benefit more from RP-based teaching. The significant learning progress highlights the great advantage of taking the course as part of medical studies. Further research should aim to determine at which time each teaching method improves learning progress most effectively.

Can smoking cessation be taught online? A prospective study comparing e-learning and role-playing in medical education.

OBJECTIVES: We compared the effect of different didactic formats - e - learning and role-playing - on medical students' knowledge and counselling skills in smoking cessation training. METHODS: At a German medical school, 145 third-year students were randomly allocated to attend an online course with video examples or an attendance course with role-playing. Students were trained in smoking cessation counselling according to the 5A's (ask, advise, assess, assist, arrange) for approximately 90 minutes. Practical skills were measured in an objective structured clinical examination (OSCE) and represent the primary endpoint of this prospective comparative study. Additionally, changes in theoretic knowledge were assessed by pre - and post - interventional questionnaires and a final written exam. RESULTS: In the OSCE, overall scores were higher in the attendance group (Mdn=70.8 % vs. 62.8 %; U=119; p=.087, n=36), but a statistical advantage was only found in one single counselling sequence ("Assist": Mdn=66.7 % vs. 51.4 %; p = .049) and the rating of the standardised patients (M=4.7 vs. 4.2 out of 5 points, t(27.836)=2.0, p=.028). Students' results (n=130) from self-assessment and written exams suggest that both approaches are equally well suited to increase theoretical knowledge. The online course was more time efficient (90 vs. 73 minutes). CONCLUSIONS: Seminar and web-based training seem equally well suited for transferring knowledge and skills on tobacco cessation counselling. Considering their particular strengths, these two teaching approaches could be combined.