Digital transfer in radiation oncology education for medical students-single-center data and systemic review of the literature.

PURPOSE: Modern medical education demands innovative, competence-orientated concepts. The forced digital transfer of teaching due to the coronavirus pandemic also affected radiation oncology (RO). The following analysis investigates whether the attractivity of RO teaching at our faculty could be maintained during the pandemic and which possibilities exist to involve students (in active learning). The latter aspect is further elaborated on a broader scale by a systemic review of the literature on competence-orientated digital education. METHODS: Evaluation results and participation rates of clinical lectures in radiation oncology (RO) were analyzed between the winter semester 2018/2019 and the summer semester 2021. A systemic review of the literature on digital education in RO for medical students was conducted. RESULTS: Concerning evaluation results, a significant improvement for the 7th and 9th semesters was observed in comparison between the pre-pandemic and pandemic semesters (p = 0.046 and p = 0.05, respectively). Overall participation rates did not differ. However, the number of students attending > 75% of classes in the respective semester increased significantly between the pre-pandemic and pandemic period (median values: 38 vs. 79%, p = 0.046; 44 vs. 73%, p = 0.05; 45 vs. 64%, p = 0.05; 41 vs. 77%, p = 0.05; 41 vs. 71%, p = 0.05, for the 6th to 10th semester, respectively). CONCLUSION: The analysis demonstrates the possibility of efficient digital transfer of a core curriculum in RO to the digital era, with a more continuous participation of students. This transfer may enable amelioration of teaching quality and the introduction of innovative and interactive concepts in accordance with the literature.

[Competence-based assessment in the national licensing examination in Germany]. / Kompetenzorientiert prüfen im Staatsexamen Medizin.

In Germany, future physicians have to pass a national licensing examination at the end of their medical studies. Passing this examination is the requirement for the license to practice medicine. The Masterplan Medizinstudium 2020 with its 41 measures aims to shift the paradigm in medical education and medical licensing examinations.The main goals of the Masterplan include the development towards competency-based and practical medical education and examination as well as the strengthening of general medicine. The healthcare policy takes into account social developments, which are very important for the medical education and licensing examination.Seven measures of the Masterplan relate to the realignment of the licensing examinations. Their function to drive learning should better support students in achieving the study goal defined in the German Medical Licensure Act: to educate a medical doctor scientifically and practically who is qualified for autonomous and independent professional practice, postgraduate education and continuous training.

[Selection of medical students : Measurement of cognitive abilities and psychosocial competencies]. / Medizinstudierendenauswahl in Deutschland : Messung kognitiver Fähigkeiten und psychosozialer Kompetenzen.

The German Constitutional Court is currently reviewing whether the actual study admission process in medicine is compatible with the constitutional right of freedom of profession, since applicants without an excellent GPA usually have to wait for seven years. If the admission system is changed, politicians would like to increase the influence of psychosocial criteria on selection as specified by the Masterplan Medizinstudium 2020.What experiences have been made with the actual selection procedures? How could Situational Judgement Tests contribute to the validity of future selection procedures to German medical schools?High school GPA is the best predictor of study performance, but is more and more under discussion due to the lack of comparability between states and schools and the growing number of applicants with top grades. Aptitude and knowledge tests, especially in the natural sciences, show incremental validity in predicting study performance. The measurement of psychosocial competencies with traditional interviews shows rather low reliability and validity. The more reliable multiple mini-interviews are superior in predicting practical study performance. Situational judgement tests (SJTs) used abroad are regarded as reliable and valid; the correlation of a German SJT piloted in Hamburg with the multiple mini-interview is cautiously encouraging.A model proposed by the Medizinischer Fakultätentag and the Bundesvertretung der Medizinstudierenden considers these results. Student selection is proposed to be based on a combination of high school GPA (40%) and a cognitive test (40%) as well as an SJT (10%) and job experience (10%). Furthermore, the faculties still have the option to carry out specific selection procedures.

[Planetary Health in the mandatory undergraduate medical curriculum - A qualitative study to evaluate a teaching/learning intervention]. / Planetary Health in der curricularen Lehre im Fach Humanmedizin ­ eine qualitative Studie zur Evaluation einer Lehr-/Lernintervention.

INTRODUCTION: Climate change is the greatest threat to human health and therefore has a direct impact on the work of physicians. At the same time, the health sector is also an originator of pollutants that burden the climate. The concept of Planetary Health describes, among other things, ways in which the health sector can counter the effects of climate change. Nevertheless, the inclusion of contents on sustainable action in the education of health professionals has not been made mandatory to date. The aim of this study is to answer the question of how an intervention has to be designed so that medical students specifically develop an interest in dealing with the topic on their own. METHODS: The intervention consisted ofFor evaluation purposes, a qualitative study with guided focus group interviews of attendees was conducted. The fully transcribed focus group transcripts were analysed using Mayring's structuring qualitative content analysis. Additionally, we checked the semester evaluation for feedback on the intervention. RESULTS: Four focus groups comprising n = 14 medical students (11 female, 3 male) were conducted. Dealing with Planetary Health as a topic during medical education was considered relevant. The partially restrained to negative reaction of the teaching practice staff involved to the checklist had a demotivating effect. A lack of time was given as a further reason for not dealing with the topic independently. Participants suggested integrating specific Planetary Health content in mandatory courses and considered environmental medicine to be especially suited. As a didactic method, case-based working in small groups seemed to be particularly appropriate. In the semester evaluation, we found both approving and critical commentaries. DISCUSSION: Participants considered Planetary Health a relevant topic in the context of medical education. The intervention proved to be of limited use in motivating students to deal with the topic independently. A longitudinal integration of the topic in the medical curriculum seems to be appropriate. CONCLUSIONS: From the students' perspective, it is important to teach and acquire knowledge and skills regarding to Planetary Health in the future. Despite a high level of interest, additional offers are not being utilised due to a lack of time and should therefore be made part of the mandatory curriculum, where possible.

[Emergency Ultrasound Training for and with Medical Students]. / Notfallsonografie für Studierende.

Emergency Ultrasound Training for and with Medical Students Abstract. Practical basic skills in sonography are a mandatory part of Swiss medical schools since 2018. The universities of Basel and Bern teach students the content of the POCUS component "Basic Emergency Sonography" of the SGUM and have developed the e-learning tool "POCUS Emergency Sonography" for this purpose in cooperation. By using this innovative blend- ed learning concept, students acquire basic skills in sonography and can build upon this know-how in their further education.

[Depth and integration of science modules in medical studies at recognized public and private faculties in Germany: A cross-sectional study]. / Ausmaß und Integration von Wissenschaftsmodulen in das Medizinstudium an den staatlichen Fakultäten und den privaten staatlich anerkannten Fakultäten in Deutschland: eine Querschnittsstudie.

BACKGROUND: At the end of November 2020, four years after the adoption of the Masterplan Medizinstudium 2020, the Federal Ministry of Health presented the draft bill for the revision of the medical licensing regulations. This was adapted in August 2021 and stipulates, among other things, the completion of a mandatory scientific project up to the second stage of the medical examination, which is to be conducted within twelve weeks and based on the structured teaching of scientific skills using longitudinal courses. This study examines to what extent the mentioned aspects of the draft bill are already included in the current compulsory curricula in German medical study programs. METHODS: In a cross-sectional study, we conducted a document analysis and an online survey of the student deaneries of state and private, state-recognized faculties of medicine in Germany. The objective was to assess the integration of curricular science projects and longitudinal science modules. The data was analyzed descriptively. RESULTS: In total, 40 (93%) of 43 faculties were included in the document analysis. 26 (60.5%) of 43 academic deans responded to the online questionnaire. Only twelve (30%) of the faculties offer a mandatory science project according to the document analysis and eight (30.8%) according to the evaluation of the online survey. In relative terms, a mandatory science project is already a curricular component in the majority of model and reform degree programs (document analysis: 83.3%, n=10 / N=12; questionnaire: 87.5%, n=7 / N=8). This contrasts with a significantly smaller number of regular degree programs that currently offer a science project as a mandatory component (document analysis: 16.7%, n=2 / N=12; questionnaire: 12.5%, n=1 / N=8). In the majority of the model and reform courses, a compulsory (longitudinal) science module has already been integrated into the curriculum (document analysis: 75%, n=12 / N=16; questionnaire: 55.5%, n=6 / N=11). This is only true for 25% (n=4 / N=12; document analysis) and 44.5% (n=5 / N=11; questionnaire) of the regular courses. DISCUSSION: The results of the surveys indicate that the regular study programs, in particular, need to be restructured in order to integrate the intended time frame of twelve weeks for an obligatory science project into the current curriculum. How this is to be achieved without reducing the existing study content seems to be still unclear. Regardless of the current draft bill, however, this step appears to be necessary in order to strengthen the acquisition of scientific competencies in medical studies and to adapt it to international medical education. CONCLUSION: The majority of the current model and reformed medical study courses already fulfill the requirements of the draft bill for the new licensing regulations with regard to the curricular integration of an obligatory scientific project and longitudinal strand on scientific work, which offer hints on design possibilities for further faculties.

[Selection interviews at Hanover Medical School (MHH): determinants of student selection in medical studies]. / Auswahlgespräche an der Medizinischen Hochschule Hannover: Determinanten der Studierendenauswahl im Studiengang Medizin.

INTRODUCTION: In order to incorporate social and communicative skills in its student admissions process, Hanover Medical School (MHH) has conducted selection interviews (in combination with the high-school GPA) to choose 60 % of its freshmen in medical studies. The present article analyses if applicants' performances in the interviews were the determining criterion of student selection, despite a higher weighting of school grades in the admission process. Furthermore, this article checks whether the grading of the interviews was independent of the applicants' gender, age, origin and educational background. METHODS: For a sample of more than 3,000 successful and unsuccessful participants in the MHH student admission process in the years 2010-2017, we employ variance analysis and logistic regression analysis to determine those factors that have contributed to the chances of being offered a place at the MHH after a successful interview. RESULTS: The scores received in the selection interview were the sole determinant of being offered a place at the MHH; neither the applicants'age nor their gender or origin biased the decisions of the selection committees. The grading of the interview was also not affected by school GPAs. DISCUSSION: The selection interviews at the MHH have been costly in terms of both financial and human resources. However, this selection method has been popular among students and lecturers alike, not least because its elements fit the MHH's focus on early bedside teaching and social skills of prospective physicians. However, there is no evidence that selection interviews are effective in predicting academic success. CONCLUSIONS: The present article has shown that the selection interviews acted up to the principles defined by the MHH: very homogenous high school GPAs were complemented by differentiated interview assessments that did not discriminate by sociodemographic characteristics. It is, however, unclear if the MHH will resume the interviews after the end of a federally mandated halt to stand-alone selection methods at medical schools in Germany.

["Flipped classroom"-A future concept for student teaching in ophthalmology?] / "Flipped classroom" ­ Ein Zukunftskonzept für die studentische Lehre in der Augenheilkunde?

BACKGROUND: "Flipped classroom" is a didactic teaching concept in which learning contents are prepared by self-study with arranged tools before the classroom session. The concept offers the advantage of a uniform knowledge base for the students at the beginning of the course and also the advantage of a greater theoretical knowledge, which creates more opportunities for practical exercises, application and consolidation in the subsequent joint teaching units. This study describes the establishment and application of such a model in student teaching in ophthalmology and analyzes the student's evaluation. METHODOLOGY: For the winter term 2018/2019, a new teaching module was designed and established in a cooperation between the department of ophthalmology and the Institute for Education and Study Affairs (IfAS) at the medical faculty of the University of Münster. A uniform training of the lecturers as well as a preparation of the students for the restructuring took place. After the course the evaluation of the students was recorded and evaluated using a standardized online evaluation. RESULTS: Between the winter semester 2018/2019 and the winter semester 2019/2020, an average of 112.3 ± 4.0 students were taught with the "flipped classroom" model. Of these 93.7% were able to give an assessment. In the previous semesters with the old teaching concept (summer semester 2015 to summer semester 2018), the average number of students was 115.4 ± 15.1 with an assessment rate of 93.3%. The new teaching concept achieved on average a better assessment than the old module. CONCLUSION: With a "flipped classroom" space and flexibility can be generated for a more individual course preparation and at the same time a higher practical part. Further studies are needed to analyze whether this also enables a sustainable transfer of knowledge.

[How does a patient-centered, future-oriented medical curriculum look like? The patients' view]. / Wie sieht ein patientenzentriertes, zukunftsgerichtetes Curriculum im Humanmedizinstudium aus? Die Sicht der Patient*innen.

AIM OF THE STUDY: Medical training in Germany is in a state of flux. Medical education must be adapted to fit the changing health care needs of future societies. This study aims to gain the patients' perspective on the education of medical students to improve future curricula. METHODOLOGY: Using a semi-structured interview guide, 17 interviews were conducted with patients undergoing inpatient (N=9) or outpatient (N=8) medical treatment. The interviews were subjected to computer-assisted analysis guided by Grounded Theory. RESULTS: 480 codings were condensed into seven main categories: Science Fiction Medicine, Society and the Patient, Professional Environment and Health Care System, Medical Curriculum and Continuing Education, Value System and Motivation, Psychosocial Competence and Medical Professional Competence. The largest main categories are Psychosocial Competence (114 codings) and Professional Environment and Health Care System (105 codings). CONCLUSION: There is a need for psychosocial education in addition to medical knowledge. A future-focused curriculum should entail practice-oriented education to ensure the training of motivated physicians who possess strengthened digital skills and act on ethical principles and values. Assessment of the patients' perspective should play a crucial role in medical education research.

Comparing Blended Learning with Faculty-Led Ultrasound Training: Protocol for a Randomised Controlled Trial (The SIGNATURE Trial).

Background: Ultrasound is increasingly used in clinical practice as a bedside tool. As medical graduates first encounter the technique in early residency, ultrasound training needs to be integrated into the undergraduate curriculum. In Switzerland, abdominal ultrasound skills have been taught by a faculty-led, 21-hour course. However, this course does not have sufficient capacity to meet the increasing demand, and there have been doubts about its effectiveness as a teaching method. We therefore developed a 21-hour blended-learning course, comprising five hours of e-learning and 16 hours of near-peer tutoring. This study investigates whether this new teaching format is as good as, or superior to, the faculty-led method. Methods: The SIGNATURE study is an investigator-initiated, two-arm, randomised controlled trial, enrolling 152 medical students at the Universities of Bern, Fribourg and Zurich. Stratified by study site, students are 1:1 randomised to either the blended-learning course or the faculty-led 2.5-day ultrasound course. Students undergo a six-station objective structured clinical examination (OSCE) and complete an online questionnaire immediately after the course and 6 months later. Discussion: If demonstrated to be effective, the blended-learning course would allow an increase in the number of undergraduate medical students that can acquire ultrasound skills before starting their residencies.

[Reflections on Trends in the Undergraduate Curricula of Human Medicine at the Universities in Switzerland]. / Betrachtungen zu den Veränderungen in den Humanmedizinstudiengängen in der Schweiz.

Reflections on Trends in the Undergraduate Curricula of Human Medicine at the Universities in Switzerland Abstract. Reflections on current trends and progressions in the undergraduate curricula of Human Medicine of the universities in Switzerland. Both updated modern learning objectives and the politically intended higher number of graduated swiss physicians will make an impact on clinical skills training and offers opportunities in focusing as well as in coordinating the curricula.

[Project Report: Evaluation of the Practical Year (PY) at the Charité Medical School, University Medicine Berlin]. / Evaluation des Medizinischen Praktischen Jahres (PJ) an der Charité­Universitätsmedizin Berlin.

BACKGROUND: In Germany, the final year of medical school consists of a series of clinical externships termed "Practical Year" (PY). Logbooks have been introduced to document the clinical experience and the value of the teaching program (First Ordinance amending the Licensing Regulations for Physicians, July 14, 2012). However, little is known about how PY education is experienced by students, what problems they face, what support they seek to manage their problems, and how the logbooks contribute to training. OBJECTIVE: We assessed the PY education at the Charité Medical School (University Medicine Berlin) in terms of the requirement profile, quality of training, logbooks, satisfaction, and general conditions. MATERIAL AND METHODS: We developed a questionnaire to assess PY education by relying on medical students' experiences. This tool was developed in parallel with the introduction of the logbooks. We contacted 6,068 students between May 2014 to September 2017 via e-mail. The students were asked to participate in the evaluation on a voluntary basis and answer 39 questions. The questionnaire was completed using an anonymous online form, taking into account legal data protection regulations. RESULTS: We evaluated 1,957 questionnaires (31.1 %). The students were mostly satisfied (67.6 %) with their supervision. Patient encounters were, for the most part (85.5 %), perceived as informative, and the quality of continuing education as high (91.3 %), and most students (76.1 %) were directly involved in patient care. The students (87.8 %) felt that they had made progress during the PY teaching period, although the logbooks were rarely (14 %) used and apparently not reviewed by the teaching staff. The students judged some rotations harshly when they were dissatisfied with both teaching and supervision. CONCLUSIONS: In general, the PY experience at the Charité was rated positively. Some rotations receiving poor evaluations desperately need to be reviewed. The role of the logbook seems to be imperfectly defined. The survey results suggest that further evaluation of our program is needed with ongoing participation of students and their representatives.

[Practical Ultrasound Skills in Medical School]. / Universitäre Ultraschall- ausbildung in Deutschland.

Practical Ultrasound Skills in Medical School Abstract. A more competency-based medical education is addressed in the German National Competence Based Catalogue of Learning Objectives (NKLM) for Undergraduate Medical Education. This catalogue defines a wide range of competencies in communication, knowledge and skills that enable a medical professional to act effectively and responsibly for the benefit of individual patients and the community. Currently, the cataloque has the status of recommendations for restructuring medical curricula. Medical faculties are called upon to gain practical experience over the next years. Ultrasound is implemented in the preclinical and clinical parts of the NKLM. However, the acquisition of practical ultrasound skills for students is not addressed.

[Patient handoffs in undergraduate medical education: A systematic analysis of training needs]. / Patientenübergaben in der Ausbildung? Eine systematische Analyse des Trainingsbedarfs unter Medizinstudierenden.

BACKGROUND: Insufficient handoffs lead to an increase in the risk of complications and malpractice, treatment delays, prolonged hospital stays, costs and patient complaints. The German Society for Anesthesiology and Intensive Care (DGAI) and the European Resuscitation Council (ERC) recommend the implementation of a communication procedure according to the SBAR concept. So far, there have been few curricular requirements in Germany regarding handoffs. METHODS: As part of the EU-funded PATIENT project an online-based cross-sectional needs analysis was conducted in three countries. In Aachen, 237 medical students answered 45 items concerning handoffs in three sections: A: skills (relevance and self-assessment), B: clinical experience (agreement), C: curricula content (presence and relevance). Data was recorded using a Likert scale (0-7). RESULTS: The students rated an adequate handoff performance as highly important (M=6.8; SD: ±0.6) and their own expertise as low (M=4.0; SD: ±1.3). A high training need was identified for writing discharge letters and performing accurate handoffs. The students were aware of the link between adequate handoffs and patient safety (M=6.5; SD: ±0.9). They considered standardized handoff procedures as an important curricular component (M=6.1; SD: ±1.1). From their point of view, the handling of medical errors is underrepresented in the curriculum (61.7 %). CONCLUSION: A need for handoff training was revealed, especially regarding transfers and discharges. Accordingly, learning objectives were determined and training modules developed and integrated into the curriculum in Aachen.

[Choosing Wisely in medical education]. / Klug entscheiden in der Lehre.

Choosing Wisely recommendations address situations where physicians will have to make decisions about further diagnostic and therapeutic steps. Undergraduate medical education needs to equip students with the foundations on which clinical reasoning skills can be acquired and fostered throughout their clinical career. Teaching these skills usually involves patients (e.g., bedside teaching, electives, clinical attachments) but it can also be delivered in the format of formalised small-group, case-based learning. Case-based key feature tests have been developed to facilitate the assessment of learning outcomes related to clinical reasoning. Repeated testing with key feature cases yields better medium-term retention than repeatedly studying the same material (without questions). The project 'Choosing Wisely in medical education', which was funded by the German Association for Internal Medicine, involves the creation of key feature cases with reference to the German set of Choosing Wisely recommendations. This article presents the results of the first pilot study using these new cases.

[General practitioners' commitment to treating excessive alcohol consumption: A question of role security in treating affected patients?]. / Hausärztliche Bereitschaft zur Intervention bei zu hohem Alkoholkonsum: Eine Frage der Sicherheit im Umgang mit betroffenen Patienten?

Only a few general practitioners (GPs) are committed to screen their patients for alcohol consumption and, in case of excessive alcohol consumption conduct by a brief intervention according to WHO recommendations. Apart from inadequate compensation and work load, another barrier identified by the GPs was their uncertainty about how to deal with affected patients. Most German universities presently spend no more than 90minutes lecture time on addiction medicine teaching. Our research aims to investigate the question whether medical studies and advanced medical education increases the role security of medical students and physicians and their commitment to implementing alcohol screening and brief intervention. Moreover, we will explore whether lack of therapeutic commitment can be related to lack of role security. Questionnaires were administered to pre-clinical and clinical medical students as well as senior house officers. Role security and therapeutic commitment of students and senior house officers were assessed using the Alcohol and Alcohol Problems Questionnaire (SAAPPQ) subscales "Role Security" and "Therapeutic Commitment". Analysis was based on 367 questionnaires. As expected, senior house officers reported more Role Security than clinical medical students who showed a higher level of Role Security than pre-clinical medical students. No differences could be found for Therapeutic Commitment. An association between Role Security and Therapeutic Commitment was only revealed for clinical medical students. Medical studies and advanced medical education can increase students' and senior house officers' Role Security to treat patients with excessive alcohol consumption, but not Therapeutic Commitment. Moreover, no association between Role Security and Therapeutic Commitment could be found for senior house officers. Hence, it may be assumed that educational activities aiming to increase Role Security do not promote the development of motivational aspects such as Therapeutic Commitment to the management of patients with excessive alcohol intake.

[Medical school admission test at the University of Goettingen - which applicants will benefit?]. / Das neue Göttinger Auswahlverfahren für Medizin - welche Bewerber können profitieren?

Medical schools in Germany may select 60% of the student applicants through their own admission tests. The influence of the school-leaving examination grades (EGs) in each of the procedural steps is controversial. At Goettingen Medical School, we combine a structured interview and a communicative skills assessment. We analysed how many applicants succeeded in our admission test, compared to a model which only takes EGs into account. Admission scores were transferred into SPSS-21. Sociodemographic data were submitted by the Stiftung Hochschulstart. Besides descriptive statistics, we used Pearson-correlation and means comparisons (t-test, analysis of variance). 221 applicants (EGs 1.0-1.9) were invited in the winter semester 2013/14 and 222 applicants (EGs 1.1-1.8) in the summer semester 2014. The proportion of women was 68% (winter) and 74% (summer). Sixteen and 37 applicants had a medical vocational training and performed slightly better. The analysis showed that our test was gender neutral. EGs did not correlate with interviews or skills assessment. Despite a two-fold impact of EGs, 26 (winter) and 44 (summer) of the overall 181 applicants had EGs of 1.4 -1.9, which would have been too low for admission otherwise. If EGs were only considered once, 40 (winter) and 59 (summer) applicants would have succeeded.