Does the 'Educational Alliance' conceptualize the student - supervisor relationship when conducting a master thesis in medicine? An interview study.

BACKGROUND: Completing a master thesis (MT) is mandatory in many undergraduate curricula in medicine but a specific educational framework to guide the supervisor-student relationship during the MT has not been published. This could be helpful to facilitate the MT process and to more effectively reach the learning objectives related to science education in medicine. An attractive model for this purpose is the 'Educational Alliance' (EA), which focusses on the three components 'clarity and agreement on (a) goals, (b) tasks and (c) relationship & roles'. This study investigated factors that can either facilitate or hinder the process of MTs, and related these to the components of the EA. METHODS: We conducted semi-structured face-to-face interviews with 20 students and - separately - with their 20 corresponding supervisors, after the MT had been accepted. The interviews included open questions on factors facilitating or hindering the success of the MT. Audio recordings of the interviews were anonymized and transcribed, and then analysed by qualitative content analysis. Also, quantitative data were gathered on satisfaction with the MT process and the supervisory quality (using Likert-type questions). RESULTS: We were able to analyse all 40 interviews, related to 20 MTs. From the transcripts, we extracted 469 comments related to the research question and categorized these into the four main categories (a) 'Preparation', (b) 'Process', (c) 'Atmosphere', (d) 'Value of the MT'. Interviewees highlighted the importance of a careful preparation phase, clear expectations, a clear research plan, thorough and timely feedback, mutual agreement on timelines, and a positive working atmosphere. Each of these factors could be brought in line with the three components of the EA framework: agreement and clarity of goals, tasks, relationships & roles. Satisfaction with the MT process was rated 8.75 ± 1.22 SD (of 10) points by supervisors, and 7.80 ± 1.61 SD points by students, while supervision quality was rated + 1.51 ± 0.63 SD (scale from - 2 to + 2) by supervisors, and + 1.26 ± 0.93 SD by students. CONCLUSION: We propose the EA framework as a useful guidance for students, supervisors, and the university towards conducting successful MTs in medicine. Based on the findings, we provide specific recommendations for students, supervisors, and university.

[Hospital Infections, Antibiotics and the Emergence of Resistance in English Hospitals, 1930-1960]. / Krankenhausinfektionen und Antibiotikaresistenzen in englischen Krankenhäusern 1930 - 1960.

This paper examines the history of hospital infections, the clinical introduction of antibiotics and the emergence of antibiotic resistant disease strains in English hospitals between 1930 and 1960. It argues that infection has been an almost constant problem for the modern, curative hospital. The arrival first of sulphonamides and later of antibiotics provided a cost-effective, readily available counter-measure which proved to be highly effective in the short term. The longer term consequence, however, was the emergence of antibiotic resistant strains. Calls for a rational use of antibiotics, voiced from 1952, remained unheard. The problem culminated in the crisis around Staph 80/81, a strain of Staphyloccocus Aureus resistant to all available antibiotics at the time. The development of methicillin and the implementation of stricter infection control regimes allowed the problem to recede around 1960 after an intense period of historical change from the end of the war onwards.

Negotiating hospital infections: the debate between ecological balance and eradication strategies in British hospitals, 1947-1969.

This paper reviews and contrasts two strategies of infection control that emerged in response to the growing use of antibiotics within British hospitals, c. 1946-1969. At this time, we argue, the hospital became an arena within which representatives of the medical sciences and clinical practices contested not so much the content of knowledge but the way that knowledge translated into practice. Key to our story are the conceptual assumptions about antibiotics put forward by clinicians, on the one hand, and microbiologists on the other. The former embraced antibiotics as the latest weapon in their fight to eradicate disease. For clinicians, the use of antibiotics were utilised within a conceptual frame that prioritised the value of the individual patient before them. Microbiologists, in contrast, understood antibiotics quite differently. They adopted a complex understanding of the way antibiotics functioned within the hospital environment that emphasised the relational and ecological aspects of their use. Despite their broader environmental focus, microbiologists focus on the ways in which bacteria travelled led to ever greater emphasis to be placed on the "healthy" body which, having been exposed to antibiotics, became a dangerous carrier of resistant staphylococcal strains. The surrounding debate regarding the appropriate use of antibiotics reveals the complex relationship between hospital, the medical sciences and clinical practice. We conclude that the history of hospital infections invites a more fundamental reflection on global hospital cultures, antibiotic prescription practices, and the fostering of an interdisciplinary spirit among the professional groups living and working in the hospital.