[Effects of examinations on learning and the curriculum: A position from Switzerland]. / Lern- und curriculumsteuernde Effekte von Prüfungen: Eine Standortbestimmung aus der Schweiz.

The federal law for higher academic medical professions (MedBG) constitutes a program accreditation as well as a federal licensing exam in medicine; both instruments influence the curricula and their further development.Parallel to the Bologna reform in Switzerland for all university degrees the federal licensing exam in medicine has been revised. The swiss catalogue of learning objectives (SCLO, 2nd edition 2008) served as mandatory content reference for the exam and initiated numerous curricular developments. The new federal licencing exam has been implemented in 2011 comprising a MCQ-Part and a structured clinical practical exam in the OSCE format. Particularly this exam triggered the introduction of OSCEs in Zürich as well as in other Swiss universities.The latest national initiative to increase the number of medical students and the introduction of the new edition of the catalogue of learning objectives in 2017 will have relevant effects on curricular developments in Switzerland.

Development and alignment of undergraduate medical curricula in a web-based, dynamic Learning Opportunities, Objectives and Outcome Platform (LOOOP).

INTRODUCTION: This study presents a web-based method and its interface ensuring alignment of all parts of a curriculum map including competencies, objectives, teaching and assessment methods, workload and patient availability. Needs, acceptance and effectiveness are shown through a nine-year study. METHODS: After a comprehensive needs assessment, the curriculum map and a web-based interface "Learning Opportunities, Objectives and Outcome Platform" (LOOOP) were developed according to Harden's conceptual framework of 10-steps for curriculum mapping. The outcome was measured by surveys and results of interdisciplinary MCQ-assessments. The usage rates and functionalities were analysed. RESULTS: The implementation of LOOOP was significantly associated with improved perception of the curriculum structure by teachers and students, quality of defined objectives and their alignment with teaching and assessment, usage by students to prepare examinations and their scores in interdisciplinary MCQ-assessment. Additionally, LOOOP improved the curriculum coordination by faculty, and assisted departments for identifying patient availability for clinical training. CONCLUSION: LOOOP is well accepted among students and teachers, has positive effect on curriculum development, facilitates effective utilisation of educational resources and improves student's outcomes. Currently, LOOOP is used in five undergraduate medical curricula including 85,000 mapped learning opportunities (lectures, seminars), 5000 registered users (students, teachers) and 380,000 yearly page-visits.

Progress testing in German speaking countries.

Progress testing was introduced in 1999 at the Charité-Universitätsmedizin Berlin. This Berlin progress test medizin (PTM) started to cooperate with other Medical Schools in 2000. The cooperation grew continuously and now 13 Medical schools in Germany and Austria take part, including more than 8500 Students. This article focuses on the concept and quality of the PTM and the benefits for students and medical schools. It shows how an initial small student initiative has developed into a successful international cooperation of formative testing in medical education.

Medical students' attitudes towards science and involvement in research activities: a comparative study with students from a reformed and a traditional curriculum.

BACKGROUND AND AIMS: Little is known about medical students' attitudes towards science and scientific methodology. We aimed to evaluate these attitudes and students' involvement in research activities. METHODS: Cross-sectional study comparing fifth-year medical students from the reformed and the traditional curriculum of the Charité University Medical Centre Berlin, Germany. Students filled out a standardised questionnaire containing three domains: research project for a dissertation; self-reported behaviour, knowledge/attitudes towards evidence-based medicine (EBM) and scientific methodology; and attitudes towards science. RESULTS: Two-thirds of the students had already started research for their dissertation and 70% agreed that reading articles and conducting research was challenging. Reformed curriculum students showed a higher involvement in scientific activities and felt more secure about their own scientific competencies. The odds for involvement in different research activities were significantly higher (odds ratios from 1.8 to 2.4) for students who agreed that 'science enables medical progress' or who felt 'secure in understanding medical articles and statistics' compared with students without these attitudes. CONCLUSION: The general attitude towards science and scientific methodology was positive among students from both the traditional and the reformed medical curriculum. Specific attitudes predicted involvement in research activities; however, they should be examined in other settings and student populations.

Do they know too little? An inter-institutional study on the anatomical knowledge of upper-year medical students based on multiple choice questions of a progress test.

The depth of medical students' knowledge of human anatomy is often controversially discussed. In particular, members of surgical disciplines raise concerns regarding deficits in the factual anatomical and topographical knowledge of upper-year students. The question often raised is whether or not medical students have sufficient anatomical and topographical knowledge when they graduate from medical school. Indeed, this question is highly relevant for curricular planners. Therefore, we have addressed it by evaluating the performance of students in the 5th and 6th years of their studies on anatomical multiple choice questions from the Berlin Progress Test Medicine performed at 10 German university medical schools. Results were compared to a reference based on a standard setting (modified Angoff-procedure). The reference was established independently by 5 panels of anatomists at different universities across Germany. As the ratings were independent of university affiliation, teaching-experience or training of the anatomists, an overall cut off score could be calculated which corresponded to 60.4% correct answers for the question set used in this study. In the progress test, on average only 29.9% of the students' answers were correct, reflecting that the performance was significantly below the expected standard. On the basis of the test results it remained unclear whether acquisition or retention of anatomical information was insufficient. Further evaluation by item characteristics revealed that the students had major difficulty in applying their theoretical knowledge to practical problems in the context of a clinical setting. Thus, our results reveal deficits in the anatomical knowledge of medical students in their final years. Therefore medical curricula should not only focus on enhancing the acquisition and retention of core anatomical knowledge, but aim at improving skills applying this in a clinical setting.