[The new medical licensing regulations (ÄApprO) : Status and expected challenges]. / Die neue Ärztliche Approbationsordnung ÄApprO : Aktueller Stand und zu erwartende Herausforderungen.

BackgroundThe amendment to the medical licensing regulations (ÄApprO) was decided at the federal level in the version of the "Master Plan for Medical Studies 2020" passed in 2017. In addition to the organizational effort involved in redesigning the curricular teaching, the expected costs associated with the implementation of the new licensing regulations due to the necessary additional time and, therefore, personnel expenditure are of particular importance. Taking into account the different forms of study and the 20% scope for study-design provided to the individual faculties, the process of transferring the teaching content to the new modules confronts us with an enormous organizational challenge.Significance of O&UDiseases of the musculoskeletal system are of particular medical, social and economic importance. Therefore, the training of future physicians in the field of orthopedics and traumatology must be taken into account. The visibility of the field of orthopedics and traumatology must not be lost with the introduction of the new medical licensing regulations (ÄApprO).ImplementationThe implementation of the new medical licensing regulations at German universities will be costly and necessitates an increased number of staff. However, there is a great opportunity to position orthopedics and traumatology as a "central player" in the modular, interdisciplinary and interprofessional course landscape. It is, therefore, important to take on concrete responsibility for the design of the new teaching programs and to bring in our specialist and interdisciplinary skills wherever sensible and possible.

The Case for Advocacy Curricula and Opportunities in Medical Education: Past Examples to Inform Future Instruction.

ABSTRACT: With recent advances in understanding racial, socioeconomic, and mental health issues in medicine and their relation to policy and legislation, medical professionals are increasingly involved in local and national advocacy efforts. At the frontlines of these initiatives are medical students who, in addition to completing required coursework and clinical training, devote themselves to serving patients through civic participation. The burgeoning evidence concerning health care disparities and inequity, along with greater awareness of racial and socioeconomic discrimination, have made advocacy an essential aspect of many students' medical training. Every year, thousands of medical students join national medical advocacy organizations, in addition to regional, state, and local groups. Despite the rich history of medical student involvement in advocacy, there remains much speculation and skepticism about the practice as an essential component of the medical profession. From early initiatives pushing for national health insurance after World War II to encouraging antidiscrimination policies and practices, medical students have been collectively working to create change for themselves and their patients. Through efforts such as banning smoking on airplanes, creating safe syringe programs, and protesting against police brutality, many medical students work tirelessly in advocacy despite minimal educational support or guidance about the advocacy process. Given that medical student advocacy continues to grow and has shown measurable successes in the past, the authors believe that these efforts should be rewarded and expanded upon. The authors examine historical examples of medical student advocacy to suggest ways in which advocacy can be integrated into core medical school curricula and activities. They call attention to opportunities to support students' development of knowledge and skills to facilitate legislative change, expansion of interprofessional collaborations and credit, and curricular updates to promote social and health equity.

The Metamorphosing Professor: Adapting Teaching to Fulfill the Promise of Biology Education.

Teaching students at all levels of education has undergone extensive changes, particularly in the past decade. Our present student population has transformed dramatically in the 21st century due to the changing demographics of the nation, an increasing use of technology both inside and outside the classroom, along with an expectation to have information instantaneously available to peruse and utilize as a source of material. Today's instructors also need to adapt to these changes by assessing how well students are learning new concepts, as well as how much material students retain for future coursework. Here, we explore the recent history of science education, and the progress that has been made to overcome multiple learning obstacles, particularly relevant to PEERs (persons excluded because of their ethnicity or race) in STEM (science, technology, engineering, and mathematics). We hope to provide insight into how educators are restructuring the way they design their teaching portfolios to provide better outcomes for the students of today's educational system.

Implementing and optimizing a communication curriculum in medical teaching: Stakeholders' perspectives.

OBJECTIVE: The relevance of communication in medical education is continuously increasing. At the Medical Faculty of Hamburg, the communication curriculum was further developed and optimized during this project. This article aims to describe the stakeholders' perceived challenges and supporting factors in the implementation and optimization processes. METHODS: The initial communication curriculum and its development after a one-year optimization process were assessed with a curricular mapping. A SWOT analysis and group discussions were carried out to provide information on the need for optimization and on challenges the different stakeholders faced. RESULTS: The curricular mapping showed that the communication curriculum is comprehensive, coherent, integrated and longitudinal. In both the implementation and the project-related optimization processes, support from the dean, cooperation among all stakeholders and structural prerequisites were deemed the most critical factors for successfully integrating communication content into the curriculum. CONCLUSION: The initiative and support of all stakeholders, including the dean, teachers and students, were crucial for the project's success. PRACTICE IMPLICATIONS: Although the implementation of a communication curriculum is recommended for all medical faculties, their actual implementation processes may differ. In a "top-down" and "bottom-up" approach, all stakeholders should be continuously involved in the process to ensure successful integration.

Qué hay detrás de LinkedIn? Midiendo a través de rúbricas las LinkedIn Big Four Dimensions / What’s behind LinkedIn? Measuring the LinkedIn Big Four Dimensions through rubrics

LinkedIn es la red social más utilizada en el ámbito profesional para funciones de reclutamiento y selección de personal. Aunque los profesiona-les de Recursos Humanos realizan inferencias sobre los candidatos en base a la información contenida en el perfil de LinkedIn, estas inferenciasno se realizan de forma sistematizada y objetiva. En esta investigación se proponen rúbricas, basadas en el modelo LinkedIn Big Four, como he-rramienta para hacer más sistemáticas y objetivas las inferencias de los profesionales de selección. Para el análisis se utilizó una muestra de pro-fesionales del sector IT (n = 105). Los resultados muestran unos resultados de fiabilidad adecuados a los estándares al uso y una evidencia inicialde validez que relaciona las puntuaciones en las rúbricas con las competencias genéricas de los profesionales.(AU)

LinkedIn is the most used social network in the professional field for recruitment and selection. Although human resources professionals makeinferences about candidates based on the information contained in the LinkedIn profile, these inferences are not made in a systematized or objectiveway. In this research, rubrics, based on the LinkedIn Big Four model, are proposed as a tool to make the inferences of selection professionals moresystematic and objective. A sample of professionals from the IT sector (n = 105) was used. Results show adequate reliability and initial evidence ofvalidity by means of correlation between the rubrics and generic competencies scores.(AU)

Reconocimiento docente de los valores éticos y morales en la formación curricular de la carrera de odontología de la Universidad de Viña del Mar, Chile / Teaching recognition of ethical and moral values in the curriculum training of the dentistry career of the Universidad de Viña del Mar, Chile

El objetivo de esta investigación es determinar la coherencia entre lo declarado por los programas de estudios de pregrado en la carrera de Odontología de la Universidad de Viña del Mar, en relación a los valores éticos y morales y, cómo son reconocidos efectivamente por los docentes en los estudiantes. El diseño de investigación corresponde a un estudio descriptivo y transversal. Para esto se adaptaron dos instrumentos, el primero: "cuestionario sobre percepción en la categorización de valores" que busca determinar la importancia que le dan los docentes a los valores. Mientras que en el segundo: "Encuesta sobre valores en estudiantes de odontología" solicita que cada docente evalúe la frecuencia con que se manifiestan ciertos valores éticos y morales en sus estudiantes. Se consideraron los 28 académicos que constituyen la totalidad del universo de docentes clínicos de los cursos de 4to y 5to años de la carrera de odontología en el año 2019. Se discuten los resultados comparándolos con experiencias similares en otras instituciones. Los resultados muestran la percepción y el reconocimiento de los valores por parte del cuerpo docente en los estudiantes, donde se identificó que los valores incorporados de mejor manera son la dignidad, el trato humano y el dialogo; mientras que la autocrítica y el conocimiento fueron los menos incorporados, estos son clave para establecer reflexión y mejoras en los planes de estudio. Se marca el punto de inicio para la generación de futuras líneas de investigación que incorporen otros aspectos como la perspectiva de los pacientes, los estudiantes, así como también continuar recabando información para utilizar metodologías que puedan contribuir a la integración de valores y poner en debate la importancia de ellos en la formación de pregrado.

The aim of this article is to determine the coherence between what is declared by the undergraduate study programs in the Dentistry career at the University of Viña del Mar, in relation to ethical and moral values and how they are effectively recognized by teachers in the students. The research design corresponds to a descriptive and cross-sectional study. Two instruments were adapted for this, the first: "questionnaire on perception in the categorization of values" that seeks to determine the importance that teachers give to values. While in the second: "Survey on values in dentistry students" requests that each teacher evaluates the frequency of certain ethical and moral values which are manifested in their students. 28 academics constituting the entire universe of clinical teachers of the 4th and 5th year courses of dentistry career in 2019 were considered. The results were discussed, comparing them with similar experiences in other institutions. Results show the perception and recognition of the values by the teaching staff in the students. These values incorporated in the best way were dignity, humane treatment and dialogue; while self-criticism and knowledge were the least incorporated. These are key values to establish a reflection and subsequent improvements in the study plans. This article marks a starting point for the generation of future lines of research that incorporate other aspects such as the perspective of patients, students, as well as continuing to collect information to use methodologies that can contribute to the integration of values and put them into a debate about the importance of them in undergraduate training.

The Safe Discharge Checklist: A Standardized Discharge Planning Curriculum for Medicine Trainees.

OBJECTIVES: Hospital discharge is a challenging time for residents, requiring the completion of many tasks to ensure safe transitions for patients. Despite recognition of the importance of hospital discharge planning, formal curricula are lacking. We sought to improve medicine residents' comfort and skills with discharge planning and enhance the quality of care by introducing a standardized approach to discharge on the medicine wards. METHODS: The intervention included a didactic, a bedside rounds component, and a discharge checklist. Interns were surveyed at the end of rotations to measure confidence, attitudes, and frequency of completing discharge planning tasks. Results were compared with a control group of experienced interns from the previous academic year. Clinical outcomes included hospital readmission and emergency department return rates and patient satisfaction scores in discharge-related domains. RESULTS: Study interns reported similar confidence to control group interns with discharge planning and endorsed completing four of five discharge tasks more frequently than control interns. There were no differences in clinical outcomes. CONCLUSIONS: We did not identify changes in clinical outcomes, although this finding likely reflects the multifactorial nature of hospital readmissions. Interns exposed to the curriculum early in the academic year had a higher reported frequency of completing key discharge tasks and similar confidence around discharge, when compared with end-of-the-year interns. These improvements suggest that the curriculum led to a change in culture surrounding discharge planning and perhaps accelerated learning of skills associated with discharge best practices.

Increasing Short- and Long-Term Buprenorphine Treatment Capacity: Providing Waiver Training for Medical Students.

In the face of an ongoing opioid crisis in the United States, persistent treatment gaps exist for vulnerable populations. Among the 3 Food and Drug Administration-approved medications used to treat opioid use disorder, many patients prefer buprenorphine. But physicians are currently required to register with the Drug Enforcement Administration and complete 8 hours of qualifying training before they can receive a waiver to prescribe buprenorphine to their patients. In this article, the authors summarize the evolution of buprenorphine waiver training in undergraduate medical education and outline 2 potential paths to increase buprenorphine treatment capacity going forward: the curriculum change approach and the training module approach. As part of the 2018 Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, the Substance Abuse and Mental Health Services Administration has provided funding for medical schools to adapt their curricula to meet waiver training requirements. To date, however, only one school has had its curriculum approved for this purpose. Additionally, recent political efforts have been directed at eliminating aspects of the waiver training requirement and creating a more direct path to integrating waiver qualification into undergraduate medical education (UME). Other medical schools have adopted a more pragmatic approach involving the integration of existing online, in-person, and hybrid waiver-qualifying training modules into the curricula, generally for fourth-year students. This training module approach can be more rapidly, broadly, and cost-effectively implemented than the curriculum change approach. It can also be easily integrated into the online medical curricula that schools developed in response to the COVID-19 pandemic. Ultimately both curricular changes and support for student completion of existing training modules should be pursued in concert, but focus should not be single-mindedly on the former at the expense of the latter.

An introductory biology research-rich laboratory course shows improvements in students' research skills, confidence, and attitudes.

As part of a wider reform to scaffold quantitative and research skills throughout the biology major, we introduced course-based undergraduate research experiences (CURE) in sections of a large-enrollment introductory biology laboratory course in a mid-level, public, minority-serving institution. This initiative was undertaken as part of the in the National Science Foundation / Council for Undergraduate Research Transformations Project. Student teams performed two or three experiments, depending on semester. They designed, implemented, analyzed, revised and iterated, wrote scientific paper-style reports, and gave oral presentations. We tested the impact of CURE on student proficiency in experimental design and statistical reasoning, and student research confidence and attitudes over two semesters. We found that students in the CURE sections met the reformed learning objectives for experimental design and statistical reasoning. CURE students also showed higher levels of experimental design proficiency, research self-efficacy, and more expert-like scientific mindsets compared to students in a matched cohort with the traditional design. While students in both groups described labs as a positive experience in end-of-semester reflections, the CURE group showed a high level of engagement with the research process. Students in CURE sections identified components of the research process that were difficult, while also reporting enjoying and valuing research. This study demonstrates improved learning, confidence, and attitudes toward research in a challenging CURE laboratory course where students had significant autonomy combined with appropriate support at a diverse public university.

Learning objectives: an epiphany.

A new Bachelor-Master curriculum in Biomedical Sciences was created at the University of Geneva in 2017. As we organized the new curriculum, we discovered the usefulness of learning objectives. This goal-oriented approach of teaching proved essential to determine the overall structure of the teaching program, as well as the content of specific courses, and the nature of the examinations. It led us to include innovative elements in the program, preparing students for real-life situations. Finally, it convinced us to change our role as teachers, in order to engage students in a more active learning relationship.

A High-Value Care Curriculum Using Individual and Group Structured Reflection.

OBJECTIVE: One-third of all healthcare dollars are wasted, primarily in the form of clinician-ordered unnecessary diagnostic tests and treatments. Medical education has likely played a central role in the creation and perpetuation of this problem. We aimed to create a curriculum for medical students to promote their contribution to high-value care conversations in the clinical environment. METHODS: At a large university medical center between March 2017 and February 2018, we implemented a 3-phase curriculum combining multimodal educational initiatives with individual and group reflection for third-year medical students during their 12-week long Internal Medicine clerkship rotation. Students were asked to identify examples of clinical decision making that lacked attention to high-value care, propose solutions to the identified situation, and pinpoint barriers to the implementation of effective solutions using a structured reflection framework and then participate in a debrief debate with fellow students. To assess the curriculum, reflective narratives were coded by frequency and codes were compared with one another and with relevant high-value care literature to identify patterns and themes. RESULTS: In total, 151 medical students participated in phase 1 and 119 in phase 3. For phase 2, 126 reflective narratives (94.7% participation rate) comprised 226 problems, 280 solutions, and 179 barriers. CONCLUSIONS: When provided appropriate resources, medical students are able to identify relevant examples of low-value care, downstream solutions, and barriers to implementation through a structured reflection curriculum comprising written narratives and in-person debate.

New Warning About Treating Children with Short-Term Corticosteroid Bursts.

Long considered harmless, researchers now urge caution in prescribing the drugs.

Adapting Surgical Clerkship Curricula in Response to the COVID-19 Pandemic.

BACKGROUND: Coronavirus disease-19 (COVID-19) impacted medical education and led to the significant modification or suspension of clinical clerkships and rotations. OBJECTIVES: To describe a revised surgery clerkship curriculum, in which we divided in-person clinical teaching into smaller groups of students and adopted online-based learning to foster student and patient safety while upholding program standards. METHODS: The third-year surgery core clerkship of a 4-year international English-language program at the Medical School for International Health at Ben Gurion University of the Negev, Beer Sheva, Israel, was adapted by dividing students into smaller capsules for in-person learning and incorporating online learning tools. Specifically, students were divided evenly throughout three surgical departments, each of which followed a different clinical schedule. RESULTS: National Board of Medical Examiners clerkship scores of third-year medical students who were returning to in-person clinical clerkships after transitioning from 8 weeks of online-based learning showed no significant difference from the previous 2 years. CONCLUSIONS: To manage with the restrictions caused by COVID-19 pandemic, we designed an alternative approach to a traditional surgical clerkship that minimized the risk of exposure and used online learning tools to navigate scheduling challenges. This curriculum enabled students to complete their clinical rotation objectives and outcomes while maintaining program standards. Furthermore, this approach provided a number of benefits, which medical schools should consider adopting the model into practice even in a post-pandemic setting.