ZusammenfassungDer Nationale Kompetenzbasierte Lernzielkatalog Zahnmedizin (NKLZ) wurde 2015 verabschiedet und definiert die Lernziele für die zahnmedizinische Ausbildung in Deutschland. Er legt fest, welche Kompetenzen Studierende erwerben sollen, und dient als Grundlage für die curriculare Gestaltung des Studiums, der Prüfungen und der Unterrichtsmaterialien. Der NKLZ fördert eine umfassende Ausbildung, die neben fachlichem Wissen auch klinische Fähigkeiten und Fertigkeiten, professionelles Verhalten und kommunikative Kompetenzen einschließt. Er trägt zur Vorbereitung angehender Zahnmediziner:innen auf ihren Beruf bei und standardisiert die Ausbildung, um Qualität und Vergleichbarkeit sicherzustellen.Der vorliegende Artikel beschreibt Hintergründe, Geschichte, Aufbau und die Weiterentwicklung des NKLZ. Derzeit wird der NKLZ zur Version 2.0 in einem mehrstufigen Prozess weiterentwickelt. Seine Struktur orientiert sich am NKLM 2.0, dem Nationalen Kompetenzbasierten Lernzielkatalog Medizin. Ziel ist es, die Anforderungen für die Zahnärztliche Approbationsordnung umfassend abzubilden.Eine wichtige Voraussetzung für die offizielle Anerkennung des NKLZ als grundlegender Leitfaden für die Ausbildung von Zahnmediziner:innen ist die Verankerung in einer zeitnah zu reformierenden Approbationsordnung Zahnmedizin. Dadurch werden Klarheit und Verbindlichkeit für Lehrende und Studierende geschaffen. Eine solche Verankerung ermöglicht zudem eine bessere Abstimmung zwischen Ausbildungszielen und den Anforderungen der Berufspraxis. Da die Approbationsordnung weniger häufig angepasst wird, bietet die Einbindung des NKLZ die Möglichkeit, Aktualisierungen und Anpassungen des Lernzielkatalogs strukturiert und reguliert vorzunehmen. Dies gewährleistet, dass die Ausbildung den aktuellen Standards und Entwicklungen entspricht.

Background: Due to the coronavirus pandemic, the medical faculties in the Federal Republic of Germany converted their curricula to digital formats on a large scale and very quickly in spring 2020 as an emergency measure. At the same time, a start was made on the nationwide exchange of digital teaching/learning materials via the online platform “LOOOP share” in order to save local resources. Among other things, virtual patient cases (VP) were shared across faculties for case-based learning, through which students can acquire clinical decision-making skills.Objectives: Within the framework of the cooperation project “National Learning Platforms for Digital Patient-Related Learning in Medical Studies” (DigiPaL), the usability of VPs for students and teachers should be improved, and the spectrum of disease patterns that are covered by VPs should be systematically expanded. Results: With the participation of many locations, a total of 150 VPs were developed by 96 case authors from 16 faculties, in addition to the existing 403 VPs. The thematic selection was made on the basis of criteria oriented to the National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM). After completion, these VPs were also made available to all faculties for free use via “LOOOP share” and the CASUS learning platform.Discussion: Even after the pandemic, these developed VPs should be available to the faculties and thus make a lasting contribution to improve medical training in Germany – especially in light of digital teaching formats being expressly advocated on the basis of the adapted current Medical Licensure Act (ÄApprO). A possible application is interdisciplinary learning of clinical decision-making with the help of blended learning formats within the framework of a longitudinal curriculum. The large number of involved colleagues and faculties shows that the nationally coordinated development of VPs across faculties was commonly seen as useful.

ZusammenfassungIn den letzten Jahren hat sich ein breites Angebot an medizinischen Studiengängen in privater Trägerschaft in Deutschland etabliert. Nur wenige davon unterliegen der deutschen Approbationsordnung für Ärzte und damit einer Qualitätssicherung in Deutschland. Die Mehrzahl der Angebote findet im Rahmen von Kooperationen deutscher Kliniken mit Universitäten im EU-Ausland statt. Die Zulassung, Studieninhalte und Prüfungen unterliegen somit den jeweiligen Regulierungen im Sitzland der ausländischen Universität. Dieser Artikel fasst die wesentlichen Unterschiede zwischen staatlicher und privater Medizinerausbildung in Deutschland zusammen und gibt einen Überblick über die derzeitigen Angebote. Neben den Chancen, die eine nichtstaatliche Medizinerausbildung bietet, werden auch ihre Herausforderungen und Risiken angesprochen. Daraus werden die Grundsätze zur Finanzierung und Qualitätssicherung privater Medizinstudiengänge abgeleitet, die national wie international zu fordern sind. Unabhängig von der Art der Trägerschaft muss dabei gelten, dass das Medizinstudium auch zukünftig zur Weiterbildung qualifizierte Ärzte ausbildet, die eine größtmögliche Qualität der Patientenversorgung, der klinischen Forschung sowie der Lehre sicherstellen.

There is high need for more research in the field of rare diseases. Not only must the causes and mechanisms of the numerous and often heterogeneous diseases be delineated, but criteria must also be defined for optimal stratification of patients for individualized therapies. In this context, research and innovative diagnostics are linked together more closely than in other fields of medicine. The early stages of disease-oriented research can be performed in individual institutions but, due to low numbers of patients, late translation and transfer into clinics requires multicentric and international collaboration. In Germany research on rare diseases takes place mostly in faculties of medicine at universities. Since the institutional financial support is very low, research grants have substantial significance. The German Research Foundation (DFG) and the Federal Ministry of Education and Research (BMBF) are the main grant agencies for national projects, but foundations and patient advocacy groups also finance research to acertain extent. The ERA-Net "E-Rare" and the programs of the EU target primarily international cross-border projects and patient trials. All of these programs need to be adapted more efficiently to the particular needs of rare disease research. For national and international research projects on rare diseases, sufficient funds are needed but also sustainable interdisciplinary platforms and centers must be established in order to share expert knowledge and to implement complex programs such as proof-of-concept studies in humans.

Of all the measures to ensure family-friendliness for students and doctors of both genders in professional development at medical universities, the best solution is a guarantee of full-time studies and full time training because it does not unnecessarily extend the already long 12-year educational and training phase. The most effective measure to prevent a career break is the massive expansion of all-day childcare (7am to 7pm), creches (from age 8 weeks or more ideally over 6 months), kindergartens (3-6 years) and school care (from age 6 at primary school age). This childcare must be accompanied by holiday care and emergency care. It’s nothing but a drop in the ocean to off a university kindergarten which does not meet the needs of the medical school in any shape or form. Medical schools and university hospitals, including medical students, have a separate demand level which by far outstrips current supply. Financing construction projects must be approached with an element of creativity, including the program allowance for research infrastructure, supporting young talent in teaching, doctorals and professional development are all part of this equation. Any other measures for family-friendliness are good but clearly secondary.

The aim of this study was to gather, against the background of a long-discussed deficit in academic teaching, data on the current activities of medical faculties with regard to teaching, and to analyse these findings. Another aim was to obtain suggestions for establishing a consensus on indicators that could be used to assess the quality of teaching. In March 2000, a written inquiry was addressed to the deans of all 37 medical faculties in Germany. The questionnaire, arranged so that responses could be entered into a data-base, consisted of ten items in three parts. Part 1 concerned the evaluation of teaching, parts 2 and 3 dealt with the place of specific assessment of teaching in the process of choosing lecturers ("habilitation") and appointing senior professors. In addition to providing alternative answers (in some instances, allowing a choice of several alternatives) there was also space for written comments. The answers were analysed by descriptive statistics. All questionnaires were returned in a usable form (response rate 100%). 36 faculties had, at the time of receiving the questionnaire, already instituted teaching assessments, of clinical teaching sessions more often than preclinical ones (97% vs 89%). The most widespread method of assessment consisted of obtaining students' opinion and of using the centralized written examinations of the institute for Medical and Pharmaceutical Examination Questions. In more than half of the faculties (57%) an above-average teaching performance by teachers was acknowledged in special ways (honours/prizes). In 31 faculties (84%) teaching experience counted as an absolute prerequisite for obtaining a lectureship, but as a rule without employing any defined standards. With regard to the selection of senior professors, 27 faculties (73%) explicitly took teaching competence into account. Defined criteria for assessing teaching ability were largely absent. The assessment of teaching quality can be considered as well established at medical faculties in Germany. However, the methods and models used are highly heterogeneous. Furthermore, numerous activities exist in the various faculties to increase the importance attached to academic teaching. However, despite using diverse indicators of quality, the central problems for assessing teaching ability remain unsolved.