Workforce strategies during the first wave of the COVID-19 pandemic: a retrospective online survey at intensive care units in Germany.

BACKGROUND: As the COVID-19 pandemic swept across the globe at the beginning of 2020, healthcare systems were forced to rapidly adapt and expand to meet the sudden surge in demand for intensive care services. This study is the first systematic analysis of the strategies employed by German hospitals to recruit personnel and expand bed capacities during the first wave of the pandemic, and to evaluate the effectiveness of those recruitment measures. METHODS: 152 German hospitals with intensive care capacities were selected and invited to participate in an online-based retrospective survey. Factors like the geographic distribution, individual COVID burden and level of care were considered for inclusion in the sample. The data were analyzed descriptively. RESULTS: A total of 41 hospitals participated in the survey. The additional demand for intensive care beds was met primarily by activating intensive care beds that were previously considered as non-operational in existing intensive care units (81% of respondents) and by upgrading recovery rooms (73%). The physician staffing requirements were met at approximately 75%, while the nursing staffing requirements were only met by about 45%. Staffing needs were met through reallocations/transfers (85%), staff recruitment from parental leave or retirement (49%), increased hours worked by internal staff (49%), new staff hiring (44%) and increased use of temporary staff (32%). Staff reallocations/transfers to critical care within a hospital were rated as the most effective measure. In this context, specialized personnel mostly from anesthesiology departments were appointed to intensive care medicine. CONCLUSIONS: Despite multiple recruitment efforts, the pandemic has exacerbated the nursing staff shortage. The reallocation of existing staff within hospitals was a key element in covering the staffing needs. However, additional measures and efforts are required in order to ensure that critically ill patients can be cared for without compromise. The results of this study may have important implications for healthcare providers and policymakers, offering an evidence-based foundation for responding to future public health emergencies with agility, efficiency, and success.

The role of research competence as an influencing factor for the careers of young academics. Findings and implications from studies on doctorates in medicine and life sciences in Germany.

Background: When viewed internationally, Germany boasts a high rate of doctoral candidates. Fields such as medicine and life sciences have a notably high proportion of doctoral students, a trend rooted in historical factors. Despite this, comprehensive empirical studies concerning the doctoral phase and early-career researchers, especially in relation to the rise of structured doctoral programmes, have only recently gained traction. Methods: We present findings from a project investigating young scientists in medicine and life sciences. Postdoctoral graduates from these disciplines were examined both quantitatively and qualitatively within the E-Prom projects, emphasizing the primary domain of research. Results: Our analysis indicates some benefits of structured doctoral programmes over traditional individual doctorates. However, the disparities between these doctoral approaches are less pronounced than anticipated. We also identified discrepancies between the programme descriptions and their actual execution. Integration into the scientific community and research-related self-efficacy are potential indicators of publication output and inclination towards a scientific career. Physicians exhibited lower research-related self-efficacy and a lesser tendency towards a scientific career than biologists. Notably, we found gender disparities disadvantaging female graduates, with these disparities being more marked in medicine. Conclusions: There is evidence to suggest that official representations of structured doctoral programmes do not always align with their practical applications, limiting their potential effectiveness. Therefore, resources should be allocated to ensure the consistent execution of these programmes. Given the empirical evidence supporting the benefits of community integration for junior researchers, efforts should be made to facilitate their networking. Additionally, our findings emphasize the necessity of providing enhanced support for young female scientists.

International mobility of students in the medical disciplines from a comparative perspective.

Objective: We analyze the extent to which students of human, veterinary and dental medicine complete study-related stays abroad (frequency, type and duration of stays abroad and countries visited). Furthermore, we investigate the possible correlations between completed stays abroad and the duration of studies, the completion of a doctorate and entering professional life. Methods: The data come from a written cross-sectional survey of 742 graduates of their respective study programs at Bavarian universities. The evaluation was carried out using descriptive and inferential statistical methods. Results: Slightly more than half of the surveyed students completed study-associated stays abroad, with notable differences between the three study programs. The students most frequently completed internships abroad lasting an average of nine weeks. Switzerland was the most common country of destination for the stays abroad. Furthermore, there were no or only weak correlations between stays abroad, the duration of studies and progress towards a doctorate or the commencement of professional employment abroad. There were no correlations with the stress experienced as part of initial employment after graduation. Conclusion: The results clearly indicate that stays abroad are quite usual for students in the medical disciplines and are almost standard in the study of human medicine. The selection of the countries visited indicates that the primary goal of the students' stays abroad is to deepen their competence with a view to later employment in their home country.

[The specialist examination in internal medicine: a qualitative and quantitative analysis of minutes from memory]. / Die Facharztprüfung Innere Medizin: Eine qualitative und quantitative Analyse von Gedächtnisprotokollen.

BACKGROUND: The specialist examination entitles to independent professional conduct and is therefore of great significance for the quality of medical care. It should cover the contents of the continuing education regulations. So far, little is known about the actual content of the exam. In this study, the question was, which content and which structural characteristics do specialist examinations in internal medicine in Germany contain. METHODS: 100 randomly selected protocols from nationwide specialist examinations from the years 2013-2016 were quantitatively recorded and descriptively evaluated with regards to their main content as well as the various types of questions. The results were compared with the blueprints of the medical examinations in Switzerland and the USA. RESULTS: In each exam, an average of 27 (SD = 10) questions are asked. The questions can be categorized into three categories: (1) subject-specific questions, (2) case-related questions, and (3) diagnostic-oriented questions with visual material. Cardiology and Gastroenterology, each with 17 %, and Endocrinology with 11 % are the most frequently requested internal medical topics. For 50 % of the questions, the examinee must reproduce knowledge, while for the other 50 %, concepts and procedures must be understood and used. In comparison with the American and Swiss blueprints, a similar percentual distribution of question contents was found. With regards to the American blueprint, it is noticeable that there are more questions from other specialist areas such as Urology, Neurology and Psychiatry in comparison to Germany. The Swiss blueprint covers a wide range of interdisciplinary aspects such as ethics, prevention and economics which are not subject to examination in the German specialist examination. CONCLUSION: In the oral specialist examination in internal medicine in Germany as many topics as in foreign specialist examinations are examined. However, the variance between the individual exams is relatively large. A standardization of the exam is important to create equal exam conditions for all candidates.

Investigation on the acquisition of scientific competences during medical studies and the medical doctoral thesis.

Background: Not only the amount of research related contents in German medical studies are objects of criticism, but also the medical doctoral thesis. However, the question which research competences are truly acquired within medical school and the doctoral phase is empirically open, and is thus pursued in the following research study. Methods: We used data from the Bavarian Medical Graduate Panel Survey (MediBAP) (N=455), where respondents assessed their own research competences. To consolidate the data, we analysed qualitative interviews with doctoral medical graduates and students from the E-Prom study (N=14). Results: The quantitative analyses show that medical graduates evaluate the medical curriculum's research contents and their acquired competences as rather low. Doctoral graduates rate their competence of pursuing research independently higher than medical graduates who have not finished their doctorate. The qualitative analyses are in line with these results, as they point to the predominant development of competences during the doctoral phase. Despite this clearly positive trend, the majority of the respondents don't feel confident enough to undertake research independently also after attaining their doctoral degree. Conclusion: The results of this study emphasize the need for a more systematic and targeted mediation and review of research competences within the regular medical curriculum.

Academic career intentions in the life sciences: Can research self-efficacy beliefs explain low numbers of aspiring physician and female scientists?

A lack of physician scientists as well as a high female dropout rate from academic medicine and basic life sciences is a concern in many countries. The current study analyzes academic career intentions within a sample of recent doctoral graduates from medicine and basic life sciences (N = 1109), focusing on research self-efficacy beliefs as explanatory variable of gender and disciplinary differences. To ensure that differences in research self-efficacy could not be attributed solely to objective scientific performance, we controlled for number of publications and dissertation grade. The results of multivariate analyses pointed to a strong and significant association between research self-efficacy and academic career intentions (ß = 0.49, p<0.001). The lower academic career intentions of medical doctoral graduates were no longer significant when controlling for research self-efficacy. Within the field of medicine, female doctoral graduates expressed lower research self-efficacy beliefs and academic career intentions. When controlling for research self-efficacy, the correlation between gender and academic career intention was no longer significant. In contrast, no gender differences were found within the basic life sciences with respect to neither academic career intentions nor research self-efficacy.

The power of the pen: how to make physicians more friendly and patients more attractive.

CONTEXT: Studies have shown that patients' subjective perceptions of physicians' competence and friendliness are relevant aspects of a successful treatment, influencing patients' well-being and trust in the physician. Psychological research has repeatedly shown that unconsciously contracting muscles that are usually used to smile can intensify and even elicit positive feelings (known as facial feedback). Empirical evidence also suggests that a smiling person is favourably judged by others with respect to attractiveness and trustworthiness. AIM: This study's purpose was to investigate how an induced muscle contraction, similar to that of a smile, affects physicians' interactions with a standardised patient. It was expected that the 'smile intervention' would affect physicians' and patients' perceptions, resulting in higher ratings of the friendliness and attractiveness of physicians in the intervention group. METHODS: Twenty physicians participated in the randomised controlled study (10 male, 10 female). Physicians were randomly assigned to one of two conditions: an intervention group (performing an easy cognitive task while smiling; n = 11) or a control group (performing an easy cognitive task without smiling; n = 9). Afterwards, physicians had a 5-minute consultation with a standardised patient. This consultation was subsequently rated by physicians, the patient and an external rater using 10-point Likert scales. RESULTS: Physicians in the intervention group were rated as significantly friendlier by the external rater (mean 7.81 versus 7.11; p = 0.097, η2  = 0.15). In addition, physicians in the intervention group rated the patient as significantly more attractive (mean 6.91 versus 4.78; p = 0.017; η2  = 0.28). CONCLUSIONS: Our results suggest that physicians can influence their friendliness and their perception of patients' attractiveness. Thereby the 'power of pen' can be an efficient method for making the hospital a friendlier place.