Development and implementation of digital peer mentoring in small groups for first-year medical students.

Introduction: Mentoring has become an important educational strategy in medical training. Peer mentoring (PM) can enhance student experience and support transition to higher education. This article documents the implementation of an online peer mentoring program for first year medical students at a newly founded medical school in Germany during the COVID-19 pandemic and its development into in-person PM. Project description: We developed the program in close collaboration between students and teachers. Students were invited to apply as peer mentors via email; they received instructions and reflected on their role and experiences in meetings before, during and after the semester. One or more peer mentors were assigned randomly to a student group. We evaluated the program with an online survey inspired by the "Modified Mentorship Effectiveness Scale". After successful piloting PM was implemented into the core curriculum. Results: In 2020 we assigned 17 peer mentors to 14 groups of 6-7 students. Groups met 3 or more times via Zoom®. Overall satisfaction was high. Both student groups reported benefits for their personal and professional identity formation. Atmosphere in online meetings was excellent. Most important topics were exams/learning strategies. In 2021 meetings were held in person. Overall satisfaction, perceived benefits and learning atmosphere were again rated very positively. Most students preferred many-to-many PM and random matching. Conclusion: The implementation of PM was successful and beneficial for the participating students. PM can help first-year medical students reduce anxiety, improve self-organization and orientation at university. It fosters identity formation and has positive effects on peer mentees as well as on peer mentors.

Motivation and Experience Matters: What Veterinary Mentors Think About Learning Communication Skills: A Qualitative Study.

Communication skills are a core competence in veterinary medicine. These skills play a pivotal role in professional success in the animal health professions. Over the last few decades, there has been an increased focus on communication skills in veterinary curricula. Conversely, we know less about the knowledge and motivation behind the communication skills of those veterinarians in different work domains who are acting as mentors outside the university. In 2016, semi-structured interviews (n = 16) were conducted with German practitioners in workplaces ranging from companion to farm animal practice, and throughout the veterinary industry, veterinary research, and government service. We combined two qualitative methods: a thematic analysis approach and the generation of types to identify characteristics associated with the acquisition of communication skills. In the current study, three main themes were developed: "Motivation," "Experiences with the acquisition of communication skills," and "Communication skills training during formal education." Within the identified themes, we recognized three types of communicators: "self-experienced," "extrinsic-experienced," and "unexperienced." We found that acquisition of communication skills was closely linked to motivation; therefore, motivation must be considered when developing communication skills curricula for learners and educators. By extrapolating the findings of this explorative study, we determined that intrinsically motivated mentors from the field should be a main source of veterinary education to promote further development in communication training. This qualitative study also determined that most non-university veterinary mentors had only a basic knowledge of teaching and learning communication skills, leading us to recommend formal training. Interchange between practicing veterinarians and veterinary educators and curriculum coordinators can foster relevant curricular modifications.

Blended learning: ten tips on how to implement it into a curriculum in healthcare education.

Blended learning is a meaningful combination of online and face-to-face teaching and learning. In this article we summarize relevant aspects of this format and provide ten tips for educators and curriculum developers on implementing a blended learning curriculum in healthcare education. These general tips are derived from our experience and the available literature and cover the planning and implementation process.

Feedback in medical education - a workshop report with practical examples and recommendations.

Background: As a teaching method, feedback is an integral part of medical education. However, there is a lack of a uniform theoretical basis or generally recognized guidelines for its specific design. Against this background, the aim of this article is to discuss conceptual considerations and empirical findings regarding feedback using various practical examples. Procedure and conceptual considerations: Building on the results of a workshop of the Committee for Communicative and Social Competences of the Society for Medical Education (GMA), this article first explains central conceptual considerations and empirical results on the topic of feedback. A particular focus is on various variables that influence the effect of feedback. This includes the feedback source, the frequency of feedback, starting points of feedback, the connection between feedback and reflection as well as the motivation and meta-cognitive skills of the feedback recipient. Practical examples: The implementation of feedback in practice is illustrated using eight examples from the field of medical and dental education. They stem from various settings and the focus is on formative oral feedback. It will become evident that the focus is more on the givers of feedback than the recipients of feedback. Instructions for recipients of feedback on how to reflect on it is still the exception. Discussion: Many of the relevant aspects for the effect of feedback described in the literature are already taken into account in the practical examples discussed. In conclusion, seven recommendations are made for implementing feedback in practice.

The influence of prompts on final year medical students' learning process and achievement in ECG interpretation.

Objective: ECG interpretation is prone to errors that can lead to relevant misdiagnoses and incorrect treatment. Prompts are one way in lectures to encourage learning from one's own mistakes and to reduce error rates. Prompts are measures such as questions, hints, and suggestions of content-related or metacognitive nature, which can lead to self-explanation in the learner and thus to a deeper understanding of an issue. The aim of the study was therefore to investigate whether the use of prompts can reduce the error rate in ECG interpretation among students. Method: In a 2x2 experimental test and control group design, N=100 final year medical students carried out ECG interpretation tasks in the form of online case vignettes in CASUS®. In these tasks, justification prompts (B) and error analysis prompts (F) were systematically varied in four groups and the learning success was measured using a knowledge test. In addition, prior knowledge in ECG interpretation, motivation, interest in the topic, subjective confidence in ECG interpretation, and cognitive load was collected. Results: Neither error analysis prompts nor justification prompts had a significant effect on the correct ECG interpretation by students, F(1,96)=1.03, p=.31. Justification prompts seemed to have a positive effect on the confidence of answering the questions, F(1,96)=10.15, p=.002, partial η2 =.10; and a negative effect on student motivation, F(1,96)=8.13 , p=.005, partial η2 =.08; but both with comparable diagnostic accuracy. Conclusion: The present study could not confirm the positive effects of prompts on the error rate in ECG interpretation reported in the literature but showed significant effects on subjective confidence and motivation which should be investigated in further studies.

What works best in a general practice specific OSCE for medical students: Mini-CEX or content-related checklists?

Aim: To develop and pilot a General Practice (GPr) OSCE assessing medical students dealing with patient encounters, which are typical for GPr and to compare different measurement instruments (global ratings, content-specific checklists).Methods: A blueprint based on Entrusted Professional Activities was used to develop prototypical OSCE stations. Four stations were tested with voluntary medical students. Students were videotaped and assessed with self-developed content-specific checklists, a global rating for communication skills, and mini-CEX. Results were compared according to students' phases of studies.Results: All three measurements were able to discriminate between clinical and pre-clinical students. Clearest results were achieved by using mini-CEX. Content-specific checklists were not able to differentiate between those groups for the more difficult stations. Inter-station reliability for the global ratings was sufficient for high-stakes exams. Students enjoyed the OSCE-setting simulating GPr consultation hours. They would prefer feedback from GPs after the OSCE and from simulated patients after each encounter.Discussion and conclusion: Although the OSCE was short, results indicate advantages for using a global rating instead of checklists. Further research should include validating these results with a larger group of students and to find the threshold during the phases of education for switching from checklists to global ratings.

[Learning from Mistakes using a Case-based Curriculum in Medical Education for Health Systems/health Economics and Public Health Care]. / Lernen aus Fehlern anhand eines fallbasierten Curriculums im medizinischen Querschnittsbereich Gesundheitssysteme/Gesundheitsökonomie und öffentliche Gesundheitspflege.

AIM OF THE STUDY: There are hardly any concepts on how to impart knowledge about the own health system to students and to clarify the importance and practical relevance of the topic. The case-based approach and the errors described therein should highlight the relevance of the topic to the medical profession. METHODOLOGY: A course concept was developed with focus on the practical relevance of the content to students. This was based on a method mix of game-based learning, case-based and cooperative learning. The seminar describes the path of a cancer patient through health care, an issue which, due to a lack of agreements and other interface problems, is dealt with unsatisfactorily. RESULTS: Analyses showed that students (n=1162) had moderate interest in the topic of the seminar during both survey periods. However, they found the method of case-based learning to be good and rated the relevance of the topic as high. CONCLUSIONS: The relevance of the topic complex GGG for later professional activity was apparently recognized by the students. The low motivation of the students to engage with this topic could be reduced, as confirmed by reports of the lecturers.

Communication identity in veterinary medicine: a grounded theory approach.

It is well established that communication skills are a core competence in veterinary medicine. Most studies in the field of veterinary medicine have focused on communication as an interpersonal skill. Much less is known about communication in the context of professional identity formation. Semistructured interviews with practitioners from companion and farm animal practice, veterinary industry, veterinary research and government service were conducted in Germany in 2016. A grounded theory approach as described by Strauss and Corbin was used to identify characteristics associated with professional communication identity formation in veterinarians. According to the current study, the identity formation process occurs in three steps: existing personal communication identity, socialisation and professional communication identity. Essentials of interpersonal communication, communication interaction experiences at work, acquisition of communication skills and subjective clarification of veterinary communication ability and skills are the key factors associated with this formation process. Since communication skills are of uttermost importance for all fields of veterinary medicine, communication education, and supporting undergraduate students in the process of communication identity formation, should be an important part of the veterinary curriculum. Furthermore, integrating communication skills training in continuing education courses could foster professionalism in veterinary medicine.

Development of the competency-based medical curriculum for the new Augsburg University Medical School.

Aim: With the resolution from April 28, 2014, the Bavarian state government in Germany decided to found a new medical school at Augsburg University, thereby requiring the development of a competency-based medical curriculum. Methods: Two interdisciplinary groups developed a spiral curriculum (following Harden) employing the model of Thumser-Dauth & Öchsner. The curriculum focuses on specifically defined competencies: medical expertise, independent scientific reasoning, argumentation and scholarship, as well as communication skills. Results: The spiral curriculum was developed as a hybrid curriculum. Its modular structure incorporates the mandatory subjects required by the German regulations for medical licensure (Approbationsordnung) into organ- and system-centered blocks which are integrated both horizontally and vertically. Basic preclinical sciences are covered in the blocks "Movement," "Balance" and "Contact." The clinical sciences are organized according to six pillars (conservative medicine, surgical medicine, men's-women's-children's medicine, the senses, the nervous system and the mind, and general medicine) which students revisit three times each over the course of the program. A longitudinal clinical course incorporates interdisciplinary education. A particular focus is on scientific education encompassing a longitudinal course in the sciences (including interdisciplinary classes with other university departments), block practicums, and two scientific projects. Conclusion: It is not only the degree of integration und intensity of the Augsburg University undergraduate medical degree program, but also its targeted advancement of academic, social and communication skills that have not yet been realized to such an extent elsewhere in Germany. On July 8, 2016, the German Council of Science and Humanities unanimously gave this concept a positive evaluation. Future research will examine and evaluate the Augsburg medical curriculum and the impact of the new medical school on the hospital and university in Augsburg.

Communication in Health Professions: A European consensus on inter- and multi-professional learning objectives in German.

BACKGROUND AND AIM: Communication is object of increasing attention in the health professions. Teaching communication competencies should already begin in undergraduate education or pre-registration training. The aim of this project was to translate the Health Professions Core Communication Curriculum (HPCCC), an English catalogue of learning objectives, into German to make its content widely accessible in the German-speaking countries. This catalogue lists 61 educational objectives and was agreed on by 121 international communication experts. A European reference framework for inter- and multi-professional curriculum development for communication in the health professions in German-speaking countries should be provided. METHOD: The German version of the HPCCC was drafted by six academics and went through multiple revisions until consensus was reached. The learning objectives were paired with appropriate teaching and assessment tools drawn from the database of the teaching Committee of the European Association for Communication Health Care (tEACH). RESULTS: The HPCCC learning objectives are now available in German and can be applied for curriculum planning and development in the different German-speaking health professions, the educational objectives can also be used for inter-professional purposes. Examples for teaching methods and assessment tools are given for using and implementing the objectives. CONCLUSION: The German version of the HPCCC with learning objectives for communication in health professions can contribute significantly to inter- and multi-professional curriculum development in the health care professions in the German-speaking countries. Examples for teaching methods and assessment tools from the materials compiled by tEACH supplement the curricular content and provide suggestions for practical implementation of the learning objectives in teaching and assessment. The relevance of the German HPCCC to the processes of curriculum development for the various health professions and inter-professional approaches should be the subject of further evaluation.

Desire and reality--teaching and assessing communicative competencies in undergraduate medical education in German-speaking Europe--a survey.

OBJECTIVES: Increasingly, communicative competencies are becoming a permanent feature of training and assessment in German-speaking medical schools (n=43; Germany, Austria, Switzerland - "D-A-CH"). In support of further curricular development of communicative competencies, the survey by the "Communicative and Social Competencies" (KusK) committee of the German Society for Medical Education (GMA) systematically appraises the scope of and form in which teaching and assessment take place. METHODS: The iterative online questionnaire, developed in cooperation with KusK, comprises 70 questions regarding instruction (n=14), assessment (n=48), local conditions (n=5), with three fields for further remarks. Per location, two to three individuals who were familiar with the respective institute's curriculum were invited to take part in the survey. RESULTS: Thirty-nine medical schools (40 degree programmes) took part in the survey. Communicative competencies are taught in all of the programmes. Ten degree programmes have a longitudinal curriculum for communicative competencies; 25 programmes offer this in part. Sixteen of the 40 programmes use the Basler Consensus Statement for orientation. In over 80% of the degree programmes, communicative competencies are taught in the second and third year of studies. Almost all of the programmes work with simulated patients (n=38) and feedback (n=37). Exams are exclusively summative (n=11), exclusively formative (n=3), or both summative and formative (n=16) and usually take place in the fifth or sixth year of studies (n=22 and n=20). Apart from written examinations (n=15) and presentations (n=9), practical examinations are primarily administered (OSCE, n=31); WPA (n=8), usually with self-developed scales (OSCE, n=19). With regards to the examiners' training and the manner of results-reporting to the students, there is a high variance. CONCLUSIONS: Instruction in communicative competencies has been implemented at all 39 of the participating medical schools. For the most part, communicative competencies instruction in the D-A-C-H region takes place in small groups and is tested using the OSCE. The challenges for further curricular development lie in the expansion of feedback, the critical evaluation of appropriate assessment strategies, and in the quality assurance of exams.