Chronic stress, work-related daily challenges and medicolegal investigations: a cross-sectional study among German general practitioners.

BACKGROUND: The prevalence of chronic stress among German general practitioners (GPs) was shown to be twice as high as in the general population. Because chronic stress negatively influences well-being and poor physician well-being is associated with poor patient outcomes, targeted strategies are needed. This analysis focuses on work-related factors associated with high chronic stress in GPs. METHODS: This cross-sectional study measured chronic stress among German GPs using the validated and standardized Trier Inventory for the Assessment of Chronic Stress (TICS-SSCS). Based on the TICS, GPs were categorized as either having low strain (≤ 25th percentile) or high strain (≥ 75th percentile) due to chronic stress. Questions on work-related challenges assessed the frequency and the subjectively perceived strain of single challenges. For exploratory analyses, these items were combined to dichotomous variables reflecting challenges that are common and that cause high strain. Variables significant in bivariate analyses were included in a multivariate logistic regression model analyzing their association with high chronic stress. RESULTS: Data of 109 GPs categorized as having low strain (n = 53) or high strain (n = 56) due to chronic stress were analyzed. Based on bivariate analyses, challenges regarding personnel matters, practice software, complexity of patients, difficult patients, care facilities, scheduling of appointments, keeping medical records up-to-date, fee structures, and expectations versus reality of care were included in the regression model. Keeping medical records up-to-date had the strongest association with high chronic stress (odds ratio 4.95, 95% confidence interval 1.29-19.06). A non-significant trend showed that medicolegal investigations were more common among GPs with high chronic stress. CONCLUSIONS: This exploratory research shows that chronic stress is predominantly associated with administrative challenges. Treatment documentation, which represents a legal safeguard and is closely linked to existential concerns, has the strongest influence.

Digital studying in times of COVID-19: teacher- and student-related aspects of learning success in german higher education.

In the wake of COVID-19, study conditions in Europe have changed dramatically. To limit contact between students and teachers, since March 2020 teaching has largely taken place digitally (remotely via digital means) and in private. Because the success of digital learning likely relies on many factors beyond good digital infrastructure conditions, this article focuses on which aspects, at both the teacher and the student levels, promote digital learning success. The large-scale student survey "Studying in Times of the Corona Pandemic" conducted at German universities and universities of applied sciences in the summer semester of 2020 offers data on how COVID-19 has affected several aspects of university studying in Germany. Here, we consider this data within the theoretical framework "theory of transactional distance" introduced by Moore (in: Moore (ed) Handbook of distance education, Routledge, 2018), according to which the success of digital teaching is influenced by dialogue, structure, and learner autonomy. Based on various regression analyses, our results show that several (digital) framework conditions must be created on both the teacher and student levels to achieve sufficient digital learning success. In this sense, our findings provide guidance on which aspects institutions of higher education should focus on when developing or updating their digitalization strategies. In accordance with collaborative learning approaches a key factor for learning success appears to be enabling peer-to-peer interactions. This finding supports our prediction that the possibility of engaging in interactive learning activities is crucial for students' learning experience, as it might reduce the perception of transactional distance and allow for social exchange. The strongest predictor of students' learning success turned out to be the (perceived) digital competencies of the teachers. This finding clearly emphasizes that teachers must be qualified to address the very specific challenges of teaching in digital contexts and indicates that universities may need to implement more teacher qualification programs. Supplementary Information: The online version contains supplementary material available at 10.1186/s41239-023-00382-w.