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1.
Front Med (Lausanne) ; 9: 538398, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35391878

RESUMO

Introduction: In ever changing conditions, medical faculties must face the challenge of preparing their medical students as best as possible for the demands of their future work. This requires involving all stakeholders, especially medical students in the constant redefinition of medical curricula. Using the idea of "Communities of Practice" as conceptual framework, this study looks at semester spokespeople as an example for participatory quality management. Methods: We conducted focus-group interviews with semester spokespeople at a German Medical Faculty. Data was recorded, transcribed, and analysed using MAXQDA. The interviews were analysed using meaning condensation method. Results: Eleven out of 48 semester spokespeople took part. We found seven topics that fell within three main categories: (1) role of the semester spokesperson, (2) role of the fixed meeting, and (3) contact and commitment. Communities of Practice principles could be aligned to topics and categories. Discussion: The idea of semester spokespeople based on the concept of Communities of Practice are useful in the quality management processes of a medical school and lead to greater involvement of medical students, identifying their needs. The reciprocal commitment among all stakeholders fosters mutual understanding and collaboration. Future studies could investigate the underlying motivational factors of dedicated students and how to transfer these characteristics to a larger cohort.

2.
PLoS One ; 15(6): e0233400, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32502213

RESUMO

The teaching of professional roles in medical education is an interdisciplinary concern. However, surgeons require specific standards of professionalism for certain context-based situations. In addition to communication, studies require collaboration, leadership, error-/conflict-management, patient-safety and decision-making as essential competencies for surgeons. Standards for corresponding competencies are defined in special chapters of the German National Competency-based Learning Objectives for Undergraduate Medical Education (NKLM; chapter 8, 10). The current study asks whether these chapters are adequately taught in surgical curricula. Eight German faculties contributed to analysing mapping data considering surgical courses of undergraduate programs. All faculties used the MERlin mapping platform and agreed on procedures for data collection and processing. Sub-competency and objective coverage, as well as the achievement of the competency level were mapped. Overall counts of explicit citations were used for analysis. Collaboration within the medical team is a strongly represented topic. In contrast, interprofessional cooperation, particularly in healthcare sector issues is less represented. Patient safety and dealing with errors and complications is most emphasized for the Manager/Leader, while time management, career planning and leadership are not addressed. Overall, the involvement of surgery in teaching the competencies of the Collaborator and Manager/Leader is currently low. However, there are indications of a curricular development towards explicit teaching of these roles in surgery. Moreover, implicitly taught roles are numerous, which indicates a beginning awareness of professional roles.


Assuntos
Competência Clínica/normas , Educação de Graduação em Medicina/métodos , Ensino/normas , Currículo/tendências , Educação de Graduação em Medicina/tendências , Docentes de Medicina/psicologia , Docentes de Medicina/tendências , Alemanha , Humanos , Liderança , Aprendizagem , Segurança do Paciente , Comportamento Social , Cirurgiões/psicologia
3.
BMC Med Educ ; 20(1): 35, 2020 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-32019523

RESUMO

BACKGROUND: The Collaborator, Health Advocate and Leader/Manager roles are highly relevant for safe patient management and optimization of healthcare system in rehabilitation and prevention. They are defined in competency-based frameworks and incorporate competencies empowering physicians to master typical daily tasks in interdisciplinary, interprofessional and institutional collaboration. However, appropriate implementation of roles remains difficult in undergraduate medical education (UME) and needs to be closely monitored. The aim of this cross-institutional mapping study was to examine for the roles of Collaborator, Health Advocate and Leader/Manager: (1) To what extent do German UME programs explicitly meet the given standards after 5 years of study? (2) Which information may be obtained from multi-site mapping data for evidence-based reflection on curricula and framework? METHODS: In a joint project of eight German UME programs, 80 to 100% of courses were mapped from teachers' perspective against given national standards: (sub-)competency coverage, competency level attainment and assessment. All faculties used a common tool and consented procedures for data collection and processing. The roles' representation was characterized by the curricular weighting of each role content expressed by the percentage of courses referring to it (citations). Data were visualized in a benchmarking approach related to a general mean of the intrinsic roles as reference line. RESULTS: (Sub-)competencies of the Health Advocate are consistently well-integrated in curricula with a wide range of generally high curricular weightings. The Collaborator reveals average curricular representation, but also signs of ongoing curricular development in relevant parts and clear weaknesses regarding assessment and achieved outcomes. The Leader/Manager displays consistently lowest curricular weightings with several substantial deficiencies in curricular representation, constructive alignment and/or outcome level. Our data allow identifying challenges to be considered by local curriculum developers or framework reviewers (e.g. non-achievement of competency levels, potential underrepresentation, lacking constructive alignment). CONCLUSION: Our non-normative, process-related benchmarking approach provides a differentiated crosscut snapshot to compare programs in the field of others, thus revealing shortcomings in role implementation, especially for Leader/Manager and Collaborator. The synopsis of multi-site data may serve as an external reference for program self-assessment and goal-oriented curriculum development. It may also provide practical data for framework review.


Assuntos
Comportamento Cooperativo , Currículo , Educação de Graduação em Medicina , Liderança , Educação Baseada em Competências , Conjuntos de Dados como Assunto , Educação de Graduação em Medicina/métodos , Alemanha , Humanos , Equipe de Assistência ao Paciente , Competência Profissional
4.
Anat Sci Educ ; 13(3): 320-332, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31509334

RESUMO

The professional behavior of future doctors is increasingly important in medical education. One of the first subjects in the curriculum to address this issue is gross anatomy. The Tuebingen Medical Faculty implemented a learning portfolio and a seminar on medical professionalism during the dissection course. The aims of this research project are to get an overview of how students form a professional identity in the dissection course and to compare the content of both their oral and written reflections on the course. A qualitative analysis was conducted of the oral and written reflections on the dissection laboratory experience. This study was conducted during winter term 2013/2014 with a cohort of 163 participants in the regular dissection course. Written reflection texts (from n = 96 students) and audio recordings from four oral reflection seminar discussions (with n = 11 students) were transcribed and deductively categorized with Mayring's qualitative content analysis method. Both qualitative analyses show that students reflected on many topics relevant to professional development, including empathy, respect, altruism, compassion, teamwork, and self-regulation. Quantitative analysis reveals that students who attended the oral reflection wrote significantly more in their written reflection than students who did not. There is, however, no difference in the reflection categories. Reflection content from students corresponds with categories derived from existing competency frameworks. Both the seminar (oral reflections) and the learning portfolio (written reflections) present excellent opportunities to foster professional development during anatomy education; the key is using them in conjunction with the dissection course.


Assuntos
Anatomia/educação , Dissecação , Educação de Graduação em Medicina/métodos , Profissionalismo/educação , Estudantes de Medicina/psicologia , Adolescente , Altruísmo , Cadáver , Currículo , Empatia , Feminino , Humanos , Masculino , Autonomia Profissional , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa , Adulto Jovem
5.
BMC Med Educ ; 19(1): 237, 2019 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-31248391

RESUMO

BACKGROUND: The implementation of competency-based intrinsic roles in undergraduate medical education remains a challenge. Faculties in transition need to be provided with generalizable curricular data in order to facilitate orientation on curricular roles' representation and to decide on steps of curriculum development. Explicit and implicit representation of objectives and multi-site agreement can be viewed as status indicators for the adoption of roles. Our aim was to develop a pragmatic cross-locational approach to capture roles' developmental status in an overview and prioritize strategic recommendations. METHODS: Based on the mapping data from six German medical faculties, the relationship between explicit and implicit curricular representation of role' objectives (weighting) and extent of programs' consent (agreement) was calculated. Data was visualized in a role-specific Matrix Map to analyse roles' implicit-explicit relation and risk-value potential. The matrix was combined with Roger's stages of innovation diffusion for differentiated interpretation of the developmental role status. RESULTS: Entangling multi-site agreement and curricular weighting, the 4-Field-Matrix allows to assess objectives based on their current localization in a quadrant: "Disregard" (lower left) and "Progress" quadrant (upper left) reveal the diffusion period; "Potential" (lower right) and "Emphasis" quadrant (upper right) indicate the adoption period. The role patterns differ in curricular representation, progression and clarity: (1) Scholar: explicit/implicit - scattered across the matrix; most explicit objectives in "Progress". (2) Health Advocate: explicit - primarily in "Emphasis"; only role in which the explicit representation significantly exceeds the implicit. (3) Collaborator: explicit - mainly "Potential"; implicit - "Progress" or "Emphasis". (4) Professional: explicit - primarily "Potential" but also "Emphasis"; implicit - "Progress" and "Emphasis"; appears better adopted but scattered in weighting; high hidden curricula. (5) Manager: explicit and implicit - exclusively in "Potential", without signs of development. Role patterns correspond to evidences from literature. Exemplified with roles, quadrant-specific strategies and measures are suggested. Framework reviewers may gain information for discussion of critical content. CONCLUSION: The Matrix Map enables to catch intuitively the status of intrinsic roles' profiles regarding role pattern, implicit-explicit relation and programs agreement. Thus, interpretation and informed discussions are fostered. Further target-oriented analyses and strategic developments can be conducted to enhance transparency and resource-efficiency.


Assuntos
Educação Baseada em Competências , Currículo , Educação de Graduação em Medicina , Docentes de Medicina , Modelos Educacionais , Competência Clínica , Educação de Graduação em Medicina/métodos , Alemanha
6.
Med Teach ; 41(4): 422-432, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30058428

RESUMO

Objectives: Transition to competency-based medical education is a highly challenging endeavor. Students, teachers and institutions need curricular transparency for understanding the build-up of competencies in terms of coverage, sequence and consistence of learning objectives and assessment. The project aim was to develop and implement a web-based interactive platform for curriculum mapping, diagnostics, and development. The tool should be transferable to other faculties and allow description and visualization of medical curricula in comparison to given national competency-based standards. Methods: In a design-based multi-center approach, four German medical faculties cooperated and developed a standardized, common mapping tool (MERlin database). Implemented are techniques for big data handling and visual analytics. Results: The platform profile is adapted closely to user needs. Intuitive data entry and comfortable quality maintenance support teacher engagement. Individual navigation for curricular diagnostics is guided by practice-oriented questions. Sophisticated, easy-understandable visualizations show curricular strengths and weaknesses. Transparency in contributing departments facilitates goal-oriented dialogs. Currently, 14 of 38 German faculties use the platform. Conclusions: In view of huge amounts of data and complex curricular structures, the MERlin database facilitates effective curriculum mapping, goal-oriented curriculum development, comparison to national competency-based standards, effective data sharing and benchmarking across faculties with different curriculum management systems.


Assuntos
Educação Baseada em Competências/organização & administração , Currículo/normas , Educação de Graduação em Medicina/organização & administração , Objetivos , Competência Clínica , Educação Baseada em Competências/normas , Educação de Graduação em Medicina/normas , Docentes de Medicina/organização & administração , Alemanha , Humanos , Internet , Aprendizagem , Modelos Educacionais , Motivação
7.
Med Teach ; 40(2): 164-173, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29141480

RESUMO

OBJECTIVES: Internationally, scientific and research-related competencies need to be sufficiently targeted as core outcomes in many undergraduate medical curricula. Since 2015, standards have been recommended for Germany in the National Competency-based Learning Objective Catalogue in Medicine (NKLM). The aim of this study is to develop a multi-center mapping approach for curricular benchmarking against national standards and against other medical faculties. METHOD: A total of 277 faculty members from four German medical faculties have mapped the local curriculum against the scientific and research-related NKLM objectives, using consented procedures, metrics, and tools. The amount of mapping citations of each objective is used as indicator for its weighting in the local curriculum. Achieved competency levels after five-year education are compared. RESULTS: All four programs fulfill the NKLM standards, with each emphasizing different sub-competencies explicitly in writing (Scholar: 17-41% of all courses; Medical Scientific Skills: 14-37% of all courses). Faculties show major or full agreement in objective weighting: Scholar 44%, scientific skills 79%. The given NKLM competency level is met or even outperformed in 78-100% of the courses. CONCLUSIONS: The multi-center mapping approach provides an informative dataset allowing curricular diagnosis by external benchmarking and guidance for optimization of local curricula.


Assuntos
Benchmarking , Currículo , Docentes de Medicina , Competência Profissional/normas , Pesquisa , Educação de Graduação em Medicina , Alemanha , Humanos
8.
GMS J Med Educ ; 34(4): Doc44, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29085888

RESUMO

Objectives: Competency-based medical education (CBME) requires factual knowledge to be practically applied together with skills and attitudes. With the National Competence-Based Learning Objectives for Undergraduate Medical Education (NKLM) representing a strong official demand for competence-orientation, it is generally important to explicitly outline its characteristics and review its realisation in teacher trainings. Further requirements are given by the core competencies for medical teachers (KLM). As an example the MQ programme ("Medizindidaktische Qualifikation") in Baden-Wuerttemberg, a long established and well-accepted training, has been critically revised on this basis, concerning its suitability for the demands of CBME, its needs for adjustment and the efforts to be undertaken for its implementation. Methods: In a systematic quality management process the MQ curriculum and its organisational framing were analysed and further developed in a step-wise comprehensive approach, using the six-step cycle by Kern. The procedures included a thorough needs assessment (e.g. literature research, programme mapping), strategic decisions on structure and content, piloting and evaluation. During the process essential elements of project and change management were considered. Results: The experiences of the MQ example revealed helpful information for key factors to be considered in the pending change process any training provider will be confronted with. Guiding questions were developed related to the process phases. Our analyses showed persistent key points of proven value as stable foundation for change, as well as components needing special consideration to foster competence-oriented aims and transfer into practice: reflection, feedback, application-oriented methods and transparent competence development. These aspects have to be consciously perceived and experienced by participants. Taking this into account, we re-designed the course evidence-based. Besides visualising competencies and their progress, the occasions for reflection and feedback as well as the number of typical, practice-oriented tasks were extended to facilitate self-directed learning, critical self-reflection and individualised solutions. It is shown at what point, in what form and with which purpose these aspects were integrated in the MQ programme. Piloting showed good acceptance by participants, trainers. Preliminary assessment of the outcome is promising. Conclusion: Respecting the high workload, most likely medical teachers will not put CBME concepts into practice without impulses and support. Therefore, in didactical trainings, medical teachers should practice in a competency-based teaching setting and reflect themselves in different professional roles to be able to transfer the experiences to their own educational approach. Trainers and training can serve as models for CBME realisation.


Assuntos
Educação Baseada em Competências , Educação de Graduação em Medicina , Capacitação de Professores , Competência Clínica , Currículo , Docentes de Medicina
9.
GMS J Med Educ ; 34(1): Doc7, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28293674

RESUMO

Objective: After passing of the National Competency-based Learning Objectives Catalogue in Medicine (Nationaler Kompetenzbasierter Lernzielkatalog Medizin, [NKLM, retrieved on 22.03.2016]), the German medical faculties must take inventory and develop their curricula. NKLM contents are expected to be present, but not linked well or sensibly enough in locally grown curricula. Learning and examination formats must be reviewed for appropriateness and coverage of the competences. The necessary curricular transparency is best achieved by systematic curriculum mapping, combined with effective change management. Mapping a complex existing curriculum and convincing a faculty that this will have benefits is not easy. Headed by Tübingen, the faculties of Freiburg, Heidelberg, Mannheim and Tübingen take inventory by mapping their curricula in comparison to the NKLM, using the dedicated web-based MERLIN-database. This two-part article analyses and summarises how NKLM curriculum mapping could be successful in spite of resistance at the faculties. The target is conveying the widest possible overview of beneficial framework conditions, strategies and results. Part I of the article shows the beneficial resources and structures required for implementation of curriculum mapping at the faculties. Part II describes key factors relevant for motivating faculties and teachers during the mapping process. Method: The network project was systematically planned in advance according to steps of project and change management, regularly reflected on and adjusted together in workshops and semi-annual project meetings. From the beginning of the project, a grounded-theory approach was used to systematically collect detailed information on structures, measures and developments at the faculties using various sources and methods, to continually analyse them and to draw a final conclusion (sources: surveys among the project participants with questionnaires, semi-structured group interviews and discussions, guideline-supported individual interviews, informal surveys, evaluation of target agreements and protocols, openly discernible local, regional or over-regional structure-relevant events). Results: The following resources and structures support implementation of curriculum mapping at a faculty: Setting up a coordination agency (≥50% of a full position; support by student assistants), systematic project management, and development of organisation and communication structures with integration of the dean of study and teaching and pilot departments, as well as development of a user-friendly web-based mapping instrument. Acceptance of the mapping was increased particularly by visualisation of the results and early insight into indicative results relevant for the department. Conclusion: Successful NKLM curriculum mapping requires trained staff for coordination, resilient communication structures and a user-oriented mapping database. In alignment with literature, recommendations can be derived to support other faculties that want to map their curriculum.


Assuntos
Competência Clínica , Currículo , Educação de Graduação em Medicina , Docentes de Medicina , Alemanha , Aprendizagem
10.
GMS J Med Educ ; 34(1): Doc6, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28293673

RESUMO

Objective: After adoption of the National Competency-based Learning Objectives Catalogue in Medicine [Nationaler Kompetenzbasierter Lernzielkatalog Medizin, NKLM], the German medical faculties are asked to test the learning obejctives recorded in it and evaluate them critically. The faculties require curricular transparency for competence-oriented transition of present curricula, which is best achieved by systematic curriculum mapping in comparison to the NKLM. Based on this inventory, curricula can be further developed target-oriented. Considerable resistance has to be expected when a complex existing curriculum is to be mapped for the first time and a faculty must be convinced of its usefulness. Headed by Tübingen, the faculties of Freiburg, Heidelberg, Mannheim and Tübingen rose to this task. This two-part article analyses and summarises how NKLM curriculum mapping was successful at the locations despite resistance. Part I presented the resources and structures that supported implementation. Part II focuses on factors that motivate individuals and groups of persons to cooperate in the faculties. Method: Both parts used the same method. In short, the joint project was systematically planned following the steps of project and change management and adjusted in the course of the process. From the beginning of the project, a Grounded-Theory approach was used to systematically collect detailed information on measures and developments at the faculties, to continually analyse them and to draw final conclusions. Results: At all sites, faculties, teachers, students and administrative staff were not per se willing to deal with the NKLM and its contents, and even less to map their present curricula. Analysis of the development reflected a number of factors that had either a negative effect on the willingness to cooperate when missing, or a positive one when present. These were: clear top-down and bottom-up management; continuous information of the faculty; user-oriented support in the mapping process by reduction of the mapping categories, portioning and condensation of the NKLM via student pre-mapping (blueprint) and visibility of growing consent. Apart from that, there were a series of frequent questions, objections and concerns that could be countered strategically and by argumentation. They particularly referred to relevance, benefit, feasibility and effort of curriculum mapping. Conclusion: An overview of beneficial framework conditions, strategies and results from different points of view is achieved and interrelations are made visible. Based on literature results, the motivating factors as well as their implementation and effects in the faculties involved are critically reflected on. Recommendations can be derived that can support other faculties in practice.


Assuntos
Competência Clínica , Educação de Graduação em Medicina , Docentes de Medicina , Currículo , Humanos , Aprendizagem
11.
GMS J Med Educ ; 34(1): Doc9, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28293676

RESUMO

Background: The German National Competence-Based Learning Objectives for Undergraduate Medical Education (NKLM) being adopted in 2015 is designed to contribute to improve the quality of teaching and learning in medicine with respect to competence orientation. For departments, the coherence between teaching, assessment and the content of the catalogues of exam-relevant topics (GK) is a crucial factor. Before making use of the NKLM seriously in curricular development, many faculties demand more transparency regarding the representation in the NKLM of GK topics and in what aspects the NKLM exceeds the GK. Therefore, the aim of the study was to assign the NKLM competencies and objectives to the systematic GK terms, to reveal gaps in their congruence and to determine the percentage of agreement between GK and NKLM. Additionally, the distribution among the NKLM chapters (chap.), of GK content and further competencies relevant for medical practice were analysed. Methods: The textual comparison of GK and NKLM was done by advanced students that were familiar with the NKLM from previous analyses. The comparison was done independently (keyword search, face validity), afterwards consented and matched with independent ratings of GK-2 and chapter 21 done by experts as well as with cross-references to the GK indicated in chapter 12, 13 and 15 of the NKLM. Detailed data is available online: www.merlin-bw.de/gk-nklm-abgleich.html. Results: The degree of correspondence of the GK's six preclinical parts with the NKLM ranges between 94% and 98%, with the clinical GK the degree of correspondence ranging between 84% and 88%. This demonstrates a consistently very high congruence of content. Only 6-16% of the content per GK part could not be assigned to NKLM equivalents. Regarding the distribution of GK content among NKLM chapters, the chapters with classic medical expertise (chapters 12, 13, 16, 17 as well as 20 and 21) show the highest correspondences. Practical medical skills (chapter 14b) can be found in the clinical GK "Health Disorders". Doctor-patient interaction (chapter 14c) and medical scientific skills (chapter 14a) are represented only marginally in the GK. As expected, there were no equivalents to be found in the GK for the new professional roles for medical doctors (chapter 06-11). Discussion: The results presented provide faculties with a useful and detailed data base to evaluate the NKLM more reliably, especially with respect to its relevance for exams. The increased transparency supports the implementation process of the NKLM by reducing content-related uncertainties of departments, invalidating sweeping arguments against the NKLM resulting from uncertainties and thereby minimizing resistance. At the same time a critical review process of the NKLM is encouraged.


Assuntos
Competência Clínica , Educação de Graduação em Medicina , Currículo , Docentes , Alemanha , Humanos , Aprendizagem
12.
Med Teach ; 38(11): 1157-1165, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27075989

RESUMO

BACKGROUND: Based on CanMEDS and others, the German National Competence-Based Learning Objectives for Undergraduate Medical Education (NKLM) were recently consented. International studies recommend integrating national and cultural context when transferring a professional roles framework in different countries. Teachers' misconceptions may establish barriers in role understanding and implementation. OBJECTIVES: The aim is to analyze medical teachers' rating and perception of NKLM roles in order to reveal differences to official definitions. METHODS: A two-step sequential mixed methods design was used including a survey and focus groups with N = 80 medical teachers from four German universities. RESULTS: Most of the teachers highly valued the importance of the role "Medical Expert" and understood comprehensively. The Communicator and the Collaborator were rated fairly and perceived to a large extent. Other intrinsic roles like Health Advocate and Scholar showed more deficits in perception and less importance by the participants. This was seen generally problematic and should be considered carefully. Manager and professional showed one-sided weaknesses either in importance or perception. CONCLUSION: Medical teachers considered NKLM roles relevant for medical practice, although their role perception differed considerably. The value and risk matrix visualizes the specific role profile and offers strategic implications for NKLM communication and handling, thus supporting change management.


Assuntos
Competência Clínica , Educação de Graduação em Medicina/organização & administração , Docentes de Medicina/psicologia , Papel do Médico , Adulto , Comunicação , Educação Baseada em Competências , Comportamento Cooperativo , Educação de Graduação em Medicina/normas , Feminino , Grupos Focais , Alemanha , Humanos , Aprendizagem , Masculino , Percepção
14.
Med Teach ; 38(6): 564-9, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26841068

RESUMO

BACKGROUND: Logbooks are widely used to set learning outcomes and to structure and standardize teaching in clinical settings. Experience shows that logbooks are not always optimally employed in clinical training. In this article, we have summarized our own experiences as well as results of studies into twelve tips on how to successfully implement logbooks into clinical settings. METHODS: We conducted both a workshop concerning the importance of logbook training to exchange experiences in teaching practice, organization, didactic knowledge and a literature research to compare our own experiences and add additional aspects. RESULTS: Tips include the process of developing the logbook itself, the change-management process, conditions of training and the integration of logbooks into the curriculum. CONCLUSIONS: Logbooks can be a valuable tool for training in clinical settings, especially when multiple sites are involved, when you take our tips into consideration.


Assuntos
Documentação/métodos , Educação Médica/métodos , Competência Clínica , Comunicação , Currículo , Objetivos , Humanos , Aprendizagem , Ensino/organização & administração
15.
J Med Internet Res ; 17(11): e268, 2015 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-26607233

RESUMO

BACKGROUND: Medical expert forums on the Internet play an increasing role in patient counseling. Therefore, it is important to understand how doctor-patient communication is influenced in such forums both by features of the patients or advice seekers, as expressed in their forum queries, and by characteristics of the medical experts involved. OBJECTIVE: In this experimental study, we aimed to examine in what way (1) the particular wording of patient queries and (2) medical experts' therapeutic health concepts (for example, beliefs around adhering to a distinctly scientific understanding of diagnosis and treatment and a clear focus on evidence-based medicine) impact communication behavior of the medical experts in an Internet forum. METHODS: Advanced medical students (in their ninth semester of medical training) were recruited as participants. Participation in the online forum was part of a communication training embedded in a gynecology course. We first measured their biomedical therapeutic health concept (hereinafter called "biomedical concept"). Then they participated in an online forum where they answered fictitious patient queries about mammography screening that either included scientific or emotional wording in a between-group design. We analyzed participants' replies with regard to the following dimensions: their use of scientific or emotional wording, the amount of communicated information, and their attempt to build a positive doctor-patient relationship. RESULTS: This study was carried out with 117 medical students (73 women, 41 men, 3 did not indicate their sex). We found evidence that both the wording of patient queries and the participants' biomedical concept influenced participants' response behavior. They answered emotional patient queries in a more emotional way (mean 0.92, SD 1.02) than scientific patient queries (mean 0.26, SD 0.55; t74=3.48, P<.001, d=0.81). We also found a significant interaction effect between participants' use of scientific or emotional wording and type of patient query (F2,74=10.29, P<.01, partial η(2)=0.12) indicating that participants used scientific wording independently of the type of patient query, whereas they used emotional wording particularly when replying to emotional patient queries. In addition, the more pronounced the medical experts' biomedical concept was, the more scientifically (adjusted ß=.20; F1,75=2.95, P=.045) and the less emotionally (adjusted ß=-.22; F1,74=3.66, P=.03) they replied to patient queries. Finally, we found that participants' biomedical concept predicted their engagement in relationship building (adjusted ß=-.26): The more pronounced their biomedical concept was, the less they attempted to build a positive doctor-patient relationship (F1,74=5.39, P=.02). CONCLUSIONS: Communication training for medical experts could aim to address this issue of recognizing patients' communication styles and needs in certain situations in order to teach medical experts how to take those aspects adequately into account. In addition, communication training should also make medical experts aware of their individual therapeutic health concepts and the consequential implications in communication situations.


Assuntos
Aconselhamento/estatística & dados numéricos , Educação Médica/métodos , Internet/estatística & dados numéricos , Estudantes de Medicina/psicologia , Adulto , Comunicação , Feminino , Humanos , Masculino , Relações Médico-Paciente , Inquéritos e Questionários
16.
Ann Anat ; 192(6): 361-5, 2010 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-21036569

RESUMO

BACKGROUND: student tutors in the dissection course are expected to meet high demands on their job. We developed a combined technical and didactical training on the basis of literature review and needs assessment. The three-week training program comprised dissection as well as presentation techniques, group dynamics and activating teaching methods. A randomized, controlled, single-blind study was set up to test whether there is a difference between the tutee's perception of the tutor competences, comparing trained and untrained tutors. METHODS: a total of 10 trained and 10 untrained tutors (control group) were enlisted in the study. The acceptance of the training program was measured with a questionnaire (11 items, 5-point Likert scale) where the tutees rated the competences of the tutors. The tutees were assigned randomly to their tutor and blinded to his/her training. RESULTS: the tutees assessed the trained tutors better in all categories compared to the untrained tutors. A significantly better score (p<0.05) was stated for the categories "conveying basic dissection techniques" (4.31 ± 0.86 vs. 3.89 ± 1.05), "positive group atmosphere" (4.69 ± 0.73 vs. 4.44 ± 0.88), "learning support" (4.24 ± 1.03 vs. 3.79 ± 1.16) and "visualisation" (3.99 ± 1.11 vs. 3.56 ± 1.17). In self-assessment, the trained tutors rated themselves significantly better after the training compared to before in all categories. CONCLUSION: The specific training curriculum for tutors in the dissection course, focusing on the improvement of content knowledge, technical and didactical competencies, is well accepted by the tutees and tutors.


Assuntos
Anatomia/educação , Dissecação/educação , Docentes/normas , Estudantes de Medicina , Adulto , Currículo/normas , Avaliação Educacional/métodos , Feminino , Alemanha , Humanos , Masculino , Mentores/educação , Grupo Associado , Competência Profissional , Avaliação de Programas e Projetos de Saúde/métodos , Autoavaliação (Psicologia) , Método Simples-Cego , Inquéritos e Questionários , Adulto Jovem
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