A concept for adapting medical education to the next generations via three-staged digital peer teaching key feature cases.

While the core principles of medical education remain the same, the students' socioecological backgrounds, values and learning requirements are constantly changing. Bridging the generation gap between teachers and students is a key challenge of medical didactics. To meet the demands of today's classroom, we piloted a novel three-stage peer teaching and key feature concept. First, an on-demand key feature video case was presented. Second a background video was launched, followed by a self-assessment tool. Third, a live case discussion webinar focusing on clinical reasoning was held. The contents were created by near-peers experienced in medical didactics and checked by clinical experts. The elective format resonated with 652 participating graduate students and 1250 interactions per webinar, suggesting that students' strengths and weaknesses were addressed adequately. We aim to provide educators with input for creating a flexible and integrative learning environment utilising modern technological and didactic tools that shape the healthcare workers of tomorrow.

The potential of medical comics to teach palliative care skills: a cross-sectional study of 668 medical students.

BACKGROUND: Palliative care (PC) skills are important when caring for patients with advanced illness in a broad range of settings. Students need to be trained in communication and empathy, both representing essential PC skills. Therefore, creative approaches could promote the understanding of relevant PC skills. METHODS: In an online lecture about graphic medicine, different medical comics (MC) were used to introduce the field of graphic medicine and to illustrate relevant skills in PC. After the lecture, an online survey was conducted. The survey consisted of each respondent`s sociodemographic profile and a questionnaire on multiple aspects related to the field of MC. Spearman correlation coefficients and Cohen's effect sizes were used for statistical analysis. RESULTS: The survey respondents comprised 668 students, 337 female, 326 male and 5 diverse. The results showed that the students had never (27.2%) or had very rarely (31.9%) been involved in with the field of MC. The largest number would rate their interest as somewhat or very interested (58.8%). When considering the use of MC to understand different perspectives, the students mainly rated them as useful (54.6%) or very useful (23.4%). Women had a more positive attitude towards MC than men (P<0.001). Students who placed more importance on PC skills were more likely to recommend the use of MC in general medical education (r=0.11, P=0.005). The majority of the students (58.8%) moderately or strongly agreed on the use of MC as a teaching method in PC. CONCLUSIONS: After a single lecture on graphic medicine, the students were positive about using MC for teaching PC skills. Since the lecture was short and the majority of the medical students stated that they had not been previously exposed to the field of MC, this study demonstrates that it is promising to further use and evaluate a set of visual and narrative illustrations as a teaching method in PC.

May I curse a referee? Swear words and consequences.

The purpose of this study was to determine whether male and female soccer (football) referees would execute the Laws of the Game despite players' verbal abuse. Law 12 (Fouls and misconduct) instructs the referees as to how they should react when a player, substitute or substituted player expresses a swear word. The player should be issued a red card. Referees (n = 113) were presented with 28 swear words and asked how they would respond if this situation occurred in a real game (red card, yellow/blue card [blue cards are used in juvenile games, player leaves field of game for 10 minutes], admonition, no reaction). The selected words were divided into categories (such as pertaining to intelligence or sexual abuse) indicating different degrees of insult. Approximately half of the referees would have responded to players saying swear words in a game by issuing a red card (55.7% red card, 25.2% yellow/blue card, 12.1% admonition, and 7.0% no reaction). The response was independent of the referees' qualification and experience. It was found that the insulting content of a swear word determines the referee's decision. Referees would apply Law 12 only in one half of the cases, depending on the insulting content. The findings are discussed in the context of game management. Key pointsLack of consistency in referees' response to a verbal offence.Referees' qualification as well as the duration of serving as a referee did not influence the effect.The insulting content is crucial for a red card.

Using medical comics to explore challenging everyday topics in medicine: lessons learned from teaching medical humanities.

BACKGROUND: Studying medicine requires an extensive acquisition of knowledge, skills and attitudes. At the MedUni Vienna, this wide range of skills is strengthened by discussing aspects of medical humanities (MH) with medical students in their pre-clinical fifth study year. Medical comics (MCs), as a part of MH, offer the possibility to address challenging situations within medical settings through the use of graphic illustrations. Thus, patient stories as well as different perspectives of patients, caregivers, and medical staff can be addressed. METHODS: A total of 506 medical students were randomly assigned to one of three MCs within a blended learning setting via the Moodle online learning platform. The medical students were instructed to reflect on the MC by answering three questions within one week. Depending on the MC assigned, the learning objectives were to (I) comprehend demands on a young doctor during a night shift, (II) reflect on a patient examination situation, or (III) recognize patients' physical and/or emotional needs. The word counts of the answers and the time spent online answering the questions in the learning platform were analyzed. This was followed by an analysis in which the answers and their content were rated on a three-point Likert scale (insufficient, sufficient, exceptional). Subsequently, an MH and MCs lecture was held that incorporated the medical students' reflections. After the lecture, a one-minute paper (OMP) survey comprising two questions was conducted on the learning platform. RESULTS: Of the 506 medical students assigned the online task, 505 completed it. On average, each medical student wrote 110.87 words (SD: 78.54; range, 4.00-602.00) and spent 12.75 minutes (SD: 11.60) on the task. Of all the answers, 84% were rated as sufficient or exceptional. Two OMP questions: (I) "What was the most important thing you learned today?", and (II) "What questions remain unanswered?" were answered by the medical students. "What was the most important thing you learned today?" was answered by 78% (n=393) of the medical students with a profound statement. When asked "What questions remain unanswered?", 85% (n=429) of the medical students stated that nothing was left unanswered. All the answers included 154 positive and 28 negative comments on the lecture. CONCLUSIONS: The study results indicate that medical students saw great potential in the use of MCs in medical teaching in terms of addressing challenging topics and reflecting on them deeply. This kind of blended learning (a form of learning in which the advantages of face-to-face events and e-learning are combined) successfully showed that medical students can gain a deeper understanding of MH and be inspired through the use of MCs.

Diagnostic grand rounds: a new teaching concept to train diagnostic reasoning.

INTRODUCTION: Diagnostic reasoning is a core skill in teaching and learning in undergraduate curricula. Diagnostic grand rounds (DGRs) as a subform of grand rounds are intended to train the students' skills in the selection of appropriate tests and in the interpretation of test results. The aim of this study was to test DGRs for their ability to improve diagnostic reasoning by using a pre-post-test design. METHODS: During one winter term, all 398 fifth-year students (36.1% male, 63.9% female) solved 23 clinical cases presented in 8 DGRs. In an online questionnaire, a Diagnostic Thinking Inventory (DTI) with 41 items was evaluated for flexibility in thinking and structure of knowledge in memory. Results were correlated with those from a summative multiple-choice knowledge test and of the learning objectives in a logbook. RESULTS: The students' DTI scores in the post-test were significantly higher than those reported in the pre-test. DTI scores at either testing time did not correlate with medical knowledge as assessed by a multiple-choice knowledge test. Abilities acquired during clinical clerkships as documented in a logbook could only account for a small proportion of the increase in the flexibility subscale score. This effect still remained significant after accounting for potential confounders. CONCLUSION: Establishing DGRs proofed to be an effective way of successfully improving both students' diagnostic reasoning and the ability to select the appropriate test method in routine clinical practice.