Competency-based Learning Objectives Research Articles

Update of the competence-based catalog of learning objectives in nuclear medicine for the study of human medicine in Germany.

To update the subject-specific, competence-based catalog of learning objectives for medical studies in Germany published by the German Society of Nuclear Medicine (DGN) in 2018, prioritizing relevant learning objectives. Based on the previous catalog, the writing group compiled nuclear medicine topics and formulated competence-based learning objectives, including medical developments, device innovations and new radiopharmaceutical approvals. These were presented for prioritization to the 180 habilitated DGN members as an expert group in a Delphi process. The first round of voting assessed firstly the topics in terms of necessity or dispensability, and secondly the detailed learning objectives of the topics were assessed for their relevance to academic teaching in nuclear medicine. The results of the first survey were used to draft a catalog of learning objectives with final approval by the expert group in a second survey. The time available for teaching nuclear medicine was also recorded. The writing group developed 240 competence-based learning objectives from 41 topics. After a first Delphi round, 73 detailed competence-based learning objectives from 15 topics were compiled. The mean teaching time was 8.4 h for lectures, 3.7 h for seminars and 3.6 h for practical courses. In a second Delphi round, the agreement of the expert group was at least 95% for the selected topics and at least 90% for the detailed learning objectives. The catalog of subject-specific learning objectives, updated by expert consensus, provides basic knowledge, skills and competences related to the most relevant diagnostic and therapeutic procedures in nuclear medicine, taking into account both long-established topics and recently introduced innovations.

Infection prevention in medical education - results of a descriptive cross-sectional study in Germany.

The aim of the study was to assess the current curricular status of content on infection prevention in hospitals during medical education prior to the development of a serious game on infection prevention in hospitals. In addition, the data collected was to be contrasted with the training for a specialist nurse in hygiene and infection prevention (FKHI). In an online survey, persons in charge of medical degree programs and continuing education centers for FKHI, SkillsLabs and professional associations in Germany were asked to answer 28 questions on framework conditions, teaching, examinations, and gamification. Data was collected for 22 medical degree programs and 5 FKHI continuing education centers. Due to the low response rate, the data for the FKHI was only analyzed in summary form. On average, 13.5 teaching units (median) are available in medical studies. Six degree programs have a longitudinal curriculum. In 7 of the 22 degree programs, teaching is based on the National Competency-Based Learning Objectives Catalogue (NKLM). Almost all locations teach this content in lectures (n=18) and/or in internships (n=13). Teaching and examinations are most common in the third year of study (n=12). In addition to practical OSCE examinations (n=5), written (n=12) and computer-based (n=8) examinations are used in particular. Gamification is known as a didactic approach to some extent but is not used for teaching infection prevention. Infection prevention in hospitals is given relatively low priority in medical education. Teaching and examinations are based on traditional knowledge-oriented formats, although practical teaching and practical examinations are established at some locations. In contrast to the FKHI, learning objectives currently appear to be less standardized. Further interprofessional development of teaching would be desirable in the future.

Teaching communication skills in medical education : Best practice example of an interdisciplinary seminar in radiation oncology.

Communication with patients is challenging, especially in radiation oncology. Therefore, radiation oncology is particularly suited to sensitize medical students for this topic and to train them competently. We report on experiences with an innovative teaching project for fourth- and fifth-year medical students. The course, funded as an innovative teaching project by the medical faculty, was offered as an optional course for medical students in 2019 and again in 2022 after apandemic-related break. The curriculum and evaluation form were developed through atwo-stage Delphi process. The course consisted of, first, participation during counselling of patients prior to radiotherapy, mainly on topics with shared decision-making, and, second, a1-week interdisciplinary block seminar with practical exercises. The topics covered abroad spectrum of the competence areas defined in the National Competence-Based Learning Objectives Catalog for Medicine (NKLM). The number of participants was limited to approximately 15students because of the practical components. So far, 30students (all at least in the seventh semester or higher) have participated in the teaching project. The most frequent reasons for participation were the desire to acquire competence in breaking bad news and confidence in talking to patients. The overall evaluation of the course was very positive, with agrade of 1.08 + 0.28 (on ascale of 1 = totally agree to 5 = totally disagree) plus German grade1 (very good) to6 (very bad). Notably, participants' expectations regarding specific competencies (e.g., breaking bad news) were also met. Although the evaluation results cannot be generalized to the entirety of medical students due to the limited number of voluntary participants, the very positive evaluation shows the need for such projects among students and can also be seen as an indication that radiation oncology as apatient-centered discipline is particularly well suited to teach medical communication.

Exercisable Learning-Theory and Evidence-Based Andragogy for Training Effectiveness using XR (ELEVATE-XR): Elevating the ROI of Immersive Technologies

eXtended Reality (XR) promises to provide a powerful capability to disseminate a vast array of instructional content appropriate for all types and levels of learners, ultimately revolutionizing education and training. Yet, while XR presents an opportunity for a powerful paradigm shift in education, a scientifically grounded andragogy for harnessing the didactic power of XR has yet to emerge. Herein, a unified framework of research-based instructional strategies for guiding the design of proficiency-based XR educational and training content is proposed, along with an associated naval maintenance use case. While this work draws on relevant pedagogical and andragogical theories, as well as fundamental learning theories applicable to learners of all ages, the framework specifically targets adult learners and training of complex skills applicable to various professional domains. Within the framework, learning theories have been aligned with learner proficiency level to specify competency-based learning objectives and activities, XR form factors, and learning loops that are anticipated to boost XR training efficacy. The proposed framework—the Exercisable Learning-theory and EVidence-based Andragogy for Training Effectiveness using XR (ELEVATE-XR)—is meant to serve as a guide to drive effective and efficient design of XR applications that enhance adult learning.

Competence-based catalog of learning objectives for the subject area of quality management in medical studies - position paper of the working group Quality Management in Education, Training and Continuing Education of the Society for Quality Management in Health Care (GQMG).

Traditionally, direct medical competences are taught in medical studies, whereas leadership and quality management competences are hardly taught, although graduates are already confronted with management tasks at the beginning of their clinical work. With the upcoming amendment of the Medical Licensing Regulations, this topic area will probably be addressed and must be adequately taught by the faculties. The learning objectives in the area of quality management listed in the current working version of the German National Catalogue of Learning Objectives in Medicine (NKLM) 2.0 have so far been formulated in rather general terms and need to be concretized. To develop a competence-based learning objectives catalog for the topic area of quality management in medical studies as a structured framework recommendation for the design of faculty teaching-learning programs and as a suggestion for further development of the NKLM. The competence-based learning objectives catalog was developed by an eight-member working group "Quality Management in Education, Training and Continuing Education" of the Gesellschaft für Qualitätsmanagement in der Gesundheitsversorgung e.V. (GQMG) within the framework of a critical synthesis of central publications. The members of the project group have many years of project experience in quality management in health care as well as in university didactics. Six basic competence goals as well as 10 specific competence goals could be formulated and consented upon. These are each flanked by a list of essential basic concepts and examples. These focus on quality improvements, including patient safety and treatment success against the background of a physician leadership role in an interprofessional context. A competency-based set of learning objectives has been compiled that encompasses the necessary concepts and basic knowledge of quality management required for those entering the profession to understand and actively participate in quality management after completing medical school. To the authors' knowledge, no comparable learning objectives catalog is currently available for medical studies, even internationally.

Pity as pain: Narrative Medicine and Melville's "Bartleby"

Narrative Medicine is an interdisciplinary concept that joins literary texts and theory on the one hand with medical education on the other. It suggests that specific skills can be practiced by reflecting about literature and the arts, which represent existential human experiences. These skills are narrative competence, tolerance for ambiguity, changing one's perspective, empathy, and self-care. This article describes aNarrative Medicine course and focuses on one unit in which Herman Melville's short story "Bartleby, the Scrivener: AStory of Wall Street" was discussed. In combining participant observation and aclose reading of the short story, the article describes how students responded to the text and how "Bartleby" speaks to central topics in medical practice, such as pain management and the significance (and limits) of pity and empathy. Melville's text represents pain and empathy in complex and ambiguous ways. In presenting acompassionate narrator who ultimately fails to empathize with the pain he perceives in his employee, the story challenges readers to reflect on the complexities of dealing with the suffering of others and invites adiscussion about professionalism, personal values, and expectations. Literary texts in amedical classroom can be aproductive resource to practice and critically discuss competences identified in the National Competency-Based Learning Objective Catalogue for Medicine2.0.

Modelling the Effect of Age, Semester of Study and Its Interaction on Self-Reflection of Competencies in Medical Students.

Objectives: Accurate self-assessment and -reflection of competencies are crucial skills for all health professions. The National Competence-Based Learning Objectives Catalogue (NKLM) guiding medical faculties in Germany points out reflection as a non-technical skill and competency-based medical education (CBME) as important approaches. In this context, the role and structure of curricula and skills labs evolved. Especially in peer-assisted trainings, reflection of competencies is important to improve self-regulated learning. Traditionally, we assume self-reflection skills to evolve automatically with learners’ experience. This approach aims to find empirical evidence for this assumption and implements self-reflection of competencies in clinical skills education. Here, we quantify the influence of age and semester of study and its interaction on the concordant self-reflection of students’ own competencies. Methods: Investigation was based on a retrospective analysis of evaluation data from peer-assisted “first aid” and “physical examination” courses in the skills labs of the medical faculty at the Ruhr-University Bochum, Germany. Participants were asked for self-assessed competencies before (pre) and after (post) the course. Additionally, they were asked to retrospectively re-rate their “before” competencies after completing the course (post-pre). Differences between pre and post-pre competencies were assessed as the concordant self-reflection in a moderated regression analysis. Group means and standard deviation were depicted using univariate analysis of variance (ANOVA) with post-hoc Tukey HSD testing in IBM SPSS Statistics V.28. Moderated regression and simple slope analyses were conducted to calculate interaction effects of age and semester of study on the concordant self-reflection. Results: As expected, participants (n = 168) showed significant progress in subjective self-assessment (pre vs. post) in all 18 assessed domains in the course (all p < 0.001). Additionally, participants self-assessed their previous competencies after the course (post-pre) differently than before the course (pre) in 11 out of 18 domains. Hereby, the interaction of age and semester of study explained a significant part of variance in the first aid course (∆R2 = 0.008, ∆F (1;1020) = 8.53, p < 0.005) and in the physical examination course (ΔR2 = 0.03, ΔF (1;10,280) = 10.72, p < 0.001). Conclusions: We quantified that interaction of age and semester has a significant influence on concordant self-reflection skills using a moderated regression analysis. Assumed as an indicator, we conclude that advanced and older students show less differences in pre- vs. post-pre-ratings. This has implications for curriculum development, postulating that an exposure to self-reflection as a metacognitive process should be introduced early in order to train competencies in health professionals. Prospective studies with competency-based assessments are necessary to validate findings.

An undergraduate medical education framework for refugee and migrant health: Curriculum development and conceptual approaches

BackgroundInternational migration, especially forced migration, highlights important medical training needs including cross-cultural communication, human rights, as well as global health competencies for physical and mental healthcare. This paper responds to the call for a ‘trauma informed’ refugee health curriculum framework from medical students and global health faculty.MethodsWe used a mixed-methods approach to develop a guiding medical undergraduate refugee and migrant health curriculum framework. We conducted a scoping review, key informant interviews with global health faculty with follow-up e-surveys, and then, integrated our results into a competency-based curriculum framework with values and principles, learning objectives and curriculum delivery methods and evaluation.ResultsThe majority of our Canadian medical faculty respondents reported some refugee health learning objectives within their undergraduate medical curriculum. The most prevalent learning objective topics included access to care barriers, social determinants of health for refugees, cross-cultural communication skills, global health epidemiology, challenges and pitfalls of providing care and mental health. We proposed a curriculum framework that incorporates values and principles, competency-based learning objectives, curriculum delivery (i.e., community service learning), and evaluation methods.ConclusionsThe results of this study informed the development of a curriculum framework that integrates cross-cultural communication skills, exploration of barriers towards accessing care for newcomers, and system approaches to improve refugee and migrant healthcare. Programs should also consider social determinants of health, community service learning and the development of links to community resettlement and refugee organizations.

Everybody is able to reflect, or aren't they? Evaluating the development of medical professionalism via a longitudinal portfolio mentoring program from a student perspective.

Introduction: Reflective competence is fundamental for responsible medical practice and must be systematically incorporated in medical training. To promote this, a longitudinal portfolio-based mentoring program was made mandatory at the Medical Faculty of the University of Tübingen in 2013. This study examines medical students' attitudes toward professional reflection and toward the program in general to draw conclusions about conditions as well as the needs-based design of the program.Method: In winter semester 2017/18, a retrospective questionnaire survey with free text fields was conducted (total sample: N=1.405; students S 1-9; response 37%; S 1-4 “Pre-clinic”: n=231; S 5-9 “Clinic”: n=241). Opinion trends of semester groups were identified through seven semi-structured interviews with semester speaker and peer tutors.Results: Differences in understanding and attitudes resulted in three positions: 1=approval, 2=ambivalence, 3=rejection. All three groups included individuals from pre-clinical and clinical settings with varying levels of experience. Prior experience and hidden curriculum influenced the position. Opinion trends confirmed the feedback.Conclusion: Although reflection appears in the National Competence-based Learning Objectives Catalogue for Medicine (NKLM), reflective competence is not regarded as equivalent to other study content. Motivation, commitment on the part of the mentors, and a trusting mentor-mentee relationship are effective. The flexibility of the portfolio in terms of content and methodology, as well as the curricular integration of the program are also beneficial.

White Paper: Radiology Curriculum for Undergraduate Medical Education in Germany and Integration into the NKLM 2.0.

The aim was to develop a new curriculum for radiology in medical studies, to reach a national consensus and to integrate it into the new national competence-based learning objectives catalog (NKLM 2.0). In this statement of the German Radiological Society (DRG), the process of curriculum development is described and the new curriculum is presented together with suggestions for practical implementation. The DRG has developed a new curriculum for radiology. This was coordinated nationally among faculty via an online survey and the result was incorporated into the NKLM 2.0. Furthermore, possibilities for the practical implementation of the competency-based content are shown and different teaching concepts are presented. The developed curriculum is competency-based and aims to provide students with important skills and abilities for their future medical practice. The general part of the curriculum is divided into the topics "Radiation Protection", "Radiological Methods" and radiologically-relevant "Digital Skills". Furthermore, there is a special part on the individual organ systems and the specific diseases. In order to implement this in a resource-saving way, new innovative teaching concepts are needed that combine the advantages of face-to-face teaching in small groups for practical and case-based learning with digital teaching offers for resource-saving teaching of theoretical content. We have created a uniform radiology curriculum for medical studies in Germany, coordinated it nationally and integrated it into the NKLM 2.0. The curriculum forms the basis of a uniform mandatory radiology teaching and should be the basis for the individual curriculum development of each faculty and strengthen the position of radiology in the interdisciplinary context. · A radiology curriculum for undergraduate medical education was developed.. · The curriculum was brought into agreement among the faculties in Germany and integrated into the NKLM 2.0.. · This curriculum is intended to be the basis for curriculum development and to strengthen the position of radiology.. · In order to implement the competence-based teaching, new innovative teaching concepts are necessary.. · Dettmer S, Barkhausen J, Volmer E et al. White Paper: Radiology Curriculum for Undergraduate Medical Education in Germany and Integration into the NKLM 2.0. Fortschr Röntgenstr 2021; 193: 1294 - 1303.

Ethik First - extracurricular support for medical students and young physicians facing moral dilemmas in hospital routine.

Introduction: Moral value conflicts play an increasingly central role in everyday hospital life. Clinical ethics, however, is only marginally represented in the compulsory curriculum for human medicine and the additional education regulations. The aim of the Ethik First project at the University Medical Center Schleswig-Holstein, Campus Kiel is to close this gap with an extracurricular offer and to support medical students from the fifth clinical semester onward and during their practical year as well as assistant doctors in dealing with moral dilemmas in everyday hospital life. The project has taken the concomitant learning objectives from the national competency-based learning objective catalog for medicine. According to the target group, the address in particular, showed higher taxonomy levels. Project description: The multimodal concept is based on three pillars: In monthly principle-based case conferences, participants practice ethical reflection and moral judgment primarily on the basis of concrete cases introduced by them using the methods of problem-based learning and consideration-based deliberation. If participants do not bring forth a case, they discuss ethical aspects of current political relevance. Moreover, there is an annual public speaker event.Results: Since the project began in 2017, ~20 students and interns have taken part in Ethik First one or more times. In a web-based interim evaluation (N=13), all respondents fully agreed that they considered the format helpful for dealing with ethical questions at the clinic. They rated the relevance for their later profession as high. There is evidence for support in moral dilemma situations.Discussion: The first evaluation results of the voluntary extracurricular offer show the acceptance of the selected format, which goes beyond pure teaching in its conception in that it addresses moral stress as well and strengthens the participants’ individual resilience.Conclusion: Ethik First reinforces the role of ethical aspects in the training of (prospective) doctors and focuses on reflecting on cases they have experienced firsthand. We formulate a desideratum for appropriate advanced training concepts both in medical studies and in advanced medical training such that the training and development of comparable projects at medical faculties and at medical associations with student participation can be discussed.

Developing Core Competency-Based Learning Objectives for Postgraduate Curricula for Postanesthesia Nurses—A Delphi Study

PurposePostanesthesia care unit (PACU) nurse competencies involve the ability to care for patients receiving complex treatment. Well-educated PACU nurses are required to provide safe patient care, and accordingly, they require investment in their education. However, core competencies for PACU nurses that are based on systematic methods for curriculum development and consensus have not been established. The purpose of this study was to develop a nationwide consensus on core competency–based learning objectives for a postgraduate PACU nursing curriculum. DesignNationwide Delphi Study using Kern's six steps of curriculum development as a framework. MethodsForty-one anesthesiologists and 38 PACU nurses from 37 Danish departments of anesthesiology were invited to participate. In Delphi round 1, the participants listed core competencies for PACU nurses within 12 predefined categories. We analyzed the responses using an inductive and manifest approach to content analysis and developed learning objectives in accordance with the Structure of Observed Learning Outcomes and Simpson taxonomies. In Delphi round 2 and 3, the participants rated and rerated the learning objectives on a 7-point Likert scale, measuring statements of agreement. Consensus was predefined as a median score of 6 and or greater. The main outcome was a prioritized list of competency-based learning objectives for a postgraduate PACU nurse curriculum. FindingsTwenty-six nurses and 14 anesthesiologists (51%) completed all Delphi rounds, representing 22 (60%) departments of anesthesiology. Consensus was reached on 180 learning objectives. The learning objectives described competencies ranging from basic to complex nursing tasks and emphasized the knowledge and skills needed to identify and initiate treatment of postoperative complications. ConclusionsNationwide consensus on core competencies for postgraduate curricula for PACU nurses was achieved through the Delphi method. Our study exemplifies the range of complex knowledge and skills needed to work as a PACU nurse. The learning objectives are applicable in postgraduate curricula designed for PACU nurses.

Implementation of self-directed learning within clinical clerkships.

Background: The main aim of medical curricula is to prepare students for the first day at the work place. While teaching clinical competence is pivotal, clinical clerkships are often the last chance to close knowledge gaps with the help of clinical teachers. Self-directed learning is a dynamic field for research within medical education, though its curricular implementation is rare. This study focuses on the needs assessment of clinical clerkships using the concept of self-directed learning. Methods: The study comprised an educational experience at the Ludwig-Maximilians Universität (LMU) Munich. Medical students (n=1446, 59% female) in their second clinical year were instructed to specify learning objectives (LOs) by Doran`s SMART criteria and to gauge the probability of their fulfilment prior to the mandatory clerkship. In a second questionnaire one week later, the students rated the actual subjective fulfilment of the LOs. Data was coded with regards to the German National Catalogue of Competence-Based Learning Objectives for Undergraduate Medical Education (NKLM) and investigated qualitatively. Factors that determine goal achievement were collected and coded binary (barrier vs. enabler). Univariate analysis was used when appropriate. Results: The acquisition of “clinically practical abilities” (29%), “diagnostic methods” (21%) and “professional communication” (13%) were the LOs mentioned most. Throughout the week, subjective fulfilment diminished. Rich (vs. poor) availability to “practical exercise” (31%), “engagement of the physicians and other medical staff” (27%) and “personal initiative” (23%) resulted in higher subjective fulfilment. Conclusions: The self-chosen LOs reflect the needs of students for which the clinical teacher should be prepared. Considering these findings, it seems possible to close practical training gaps. We support the consideration of establishing curricular anchored self-directed learning in clinical clerkships. Further empirical studies would be beneficial in revealing its positive effects on the learning progress.

Fit for the Future - Entwicklung eines Seminars zu Aspekten der Digitalisierung im Gesundheitswesen als Beitrag der Lehre im Fach Medizinische Soziologie

IntroductionTopics regarding the digitization of the healthcare system are hardly being addressed during the undergraduate training of medical students, even though the promotion of skills in this area has been defined as a learning goal in the German National Competence-Based Learning Objectives for Undergraduate Medical Education (NKLM) since 2015. At the same time, telemedicine as one part of digitization is becoming increasingly important in the public perception as a tool supplementing access to care. Therefore, the aim was to give medical students in the fourth pre-clinical semester a first insight into topics of telemedicine and other aspects of digitization in the healthcare sector as part of a seminar. MethodsOn the basis of the existing literature, we developed the content and a didactic concept for the seminar “The doctor-patient relationship in the field of technological developments” in the Medical Sociology course for undergraduate medical students in their second year at the University of Lübeck. Inspired by Kirkpatrick's four-level model, the students were asked for topics they wished to cover regarding the digitization of healthcare and telemedicine at the start and their attitudes towards and experiences with telemedicine at the end of the seminar. ResultsA total of 184 students from the fourth pre-clinical semester attended the seminar. The survey response rate was 32%. The topics most frequently requested by students were “Legal Framework”, “Electronic Patient Record” and “Tele-consultation”. 85% of the students rated the topic “digitization of healthcare” as highly relevant for their future profession. Also 85% of the students wished for easy-to-use telemedicine equipment. A third or more of the students reported considerable uncertainty about their ability to evaluate the benefits of health apps. ConclusionsThe contents of the seminar met the students’ demands. In the future, topics relating to the digitization of the health system should be increasingly integrated into undergraduate training; also, the students’ feeling uncertain about their ability to assess various telemedical applications should be addressed.

The Importance of Different Topics in Medical Psychology/Sociology from Physicians' and Medical Students' View: Similarities and Differences

The subject of "Medical Psychology/Sociology" is facing various content changes as a result of the currently pending study reforms within the framework of the "Master Plan Medical Studies 2020". These include the further development of the catalogues of exam-relevant topics (GK) and the National Competence-Based Learning Objectives Catalogue for Undergraduate Medical Education (NKLM) as well as the Medical Licensing Regulations (ÄApprO). In this context, the question arises as to which training contents of "medical psychology/sociology", that medical students are confronted with, are of particular importance for their future medical work. 332 physicians and 265 students evaluated different contents of the catalogue of exam-relevant topics of medical psychology/sociology (GK-MPS) according to their importance regarding their education or respectively their daily work. In addition, the physicians indicated in free text fields of the questionnaire which situations in their daily work they would have liked to have been better prepared for during medical school. In a combined quantitative-qualitative analysis approach, differences between the 2 groups were identified by t-tests for independent samples with unequal variances (Welch test) and free text information was assigned to the various topics of the GK-MPS and evaluated in terms of content by 3 raters within the framework of a qualitatively oriented category-based text analysis. Both physicians and students considered those topics of the GK-MPS, that involve communication between physician and patient, to be the most important. In addition, physicians rated the topics of physician-patient communication, statistics and prevention as more important than the students did. The physicians would have liked to have been better prepared for special and challenging medical situations in physician-patient interaction. The topics of physician-patient communication are still considered to be of particular importance for the medical training of physicians and students, but physicians consider them to be more important than students. The study results support the current study reforms towards a stronger emphasis on physician-patient communication and scientific basics as well as the linking of pre-clinical and clinical study contents.

Surgeons' participation in the development of collaboration and management competencies in undergraduate medical education.

The teaching of professional roles in medical education is an interdisciplinary concern. However, surgeons require specific standards of professionalism for certain context-based situations. In addition to communication, studies require collaboration, leadership, error-/conflict-management, patient-safety and decision-making as essential competencies for surgeons. Standards for corresponding competencies are defined in special chapters of the German National Competency-based Learning Objectives for Undergraduate Medical Education (NKLM; chapter 8, 10). The current study asks whether these chapters are adequately taught in surgical curricula. Eight German faculties contributed to analysing mapping data considering surgical courses of undergraduate programs. All faculties used the MERlin mapping platform and agreed on procedures for data collection and processing. Sub-competency and objective coverage, as well as the achievement of the competency level were mapped. Overall counts of explicit citations were used for analysis. Collaboration within the medical team is a strongly represented topic. In contrast, interprofessional cooperation, particularly in healthcare sector issues is less represented. Patient safety and dealing with errors and complications is most emphasized for the Manager/Leader, while time management, career planning and leadership are not addressed. Overall, the involvement of surgery in teaching the competencies of the Collaborator and Manager/Leader is currently low. However, there are indications of a curricular development towards explicit teaching of these roles in surgery. Moreover, implicitly taught roles are numerous, which indicates a beginning awareness of professional roles.

Quality of teaching radiation oncology in Germany\u2014where do we stand?

PurposeMedical students’ knowledge of radiation oncology (RO) is of increasing importance with a rising prevalence of malignancies. However, RO teaching in medical schools is heterogeneous and has not been analyzed at a federal level yet. Therefore, the following survey aims to provide a national overview of RO teaching in Germany.MethodsA questionnaire containing multiple-choice and free-text questions covering the extent and topics of RO teaching was sent to RO departments of all university hospitals in Germany and was answered by the heads of department/main lecturers.Results24/35 (68.6%) RO departments returned completed forms. Most faculties employ lectures (91.7%), seminars (87.5%), and practical/bedside training (75.0%), whereas training in radiation biology and medical physics are rare (25% and 33.3%, respectively). Main topics covered are general RO (100%), radiation biology (91.7%), and side effects (87.5%). Regarding RO techniques and concepts, image-guided and intensity-modulated radiotherapy are taught at all faculties, followed by palliative and stereotactic techniques (87.5% each). Notably, all departments offered at least a partial rotation in RO in conjunction with radiology and/or nuclear medicine departments in the last year of medical school, while only 70.8% provided a complete rotation in RO. In addition, 57.1% of the departments have taken measures concerning the upcoming National Competence-Based Learning Objectives Catalogue (NKLM) for medical education.ConclusionRO plays an integral but underrepresented role in clinical medical education in Germany, but faces new challenges in the development of practical and competence-based education, which will require further innovative and interdisciplinary concepts.

Development and implementation of a comprehensive ultrasound curriculum for undergraduate medical students \u2013 a feasibility study

BackgroundUltrasound is one of the most important imaging techniques in clinical medicine with unique advantages. Skills in ultrasound imaging are very usefull for physicians including novices and thus also mandated by the Task Force “National Competence-Based Learning Objectives for Undergraduate Medical Education” (NKLM) in Germany and as well as by the German Ultrasound Society (Deutsche Gesellschaft für Ultraschall in der Medizin, DEGUM). Since ultrasound is best learned hands-on in very small supervised groups, we developed and implemented a comprehensive ultrasound-curriculum for all undergraduate medical students of our faculty using a peer-teaching concept.MethodsWe used Kern‘s six-step model of curricular development comprising (1) problem identification and general needs assessment, (2) needs assessment of the targeted learners, (3) goals and objectives, (4) educational stategies, (5) implementation, and (6) evaluation and feedback.ResultsThe developed curriculum covers basic ultrasound of the abdomen and the throat, eFAST (Extended Focused Assessment with Sonography for Trauma), lung-ultrasound, FEEL (Focused Echocardiography in Emergency Life Support) and compression duplex sonography of the thigh deep vein system. All 5th year medical students receive a 90 min lecture on ultrasound basics by a faculty member and then a 12.5 h hands-on course divided into three sessions with one student tutor for every 4 students. The students are provided with a script (PDF-File) that covers all the learning goals, including example images of pathologies. The student tutors are trained during a 1 week ultrasound course and a 21-day rotation through seven different ultrasound laboratories. In addition, they undergo a standardized 1.5 day didactical training. Prior to the implementation for all students, the overall course was tested on 27 volunteer students. These students rated (on a 6-point Likert scale from 1 = excellent to 6 = very poor) the satisfaction with the student tutors and the faculty members as 1.4 ± .9 (mean ± stddev) and 1.3 ± .5 respectively.ConclusionA comprehensive ultrasound curriculum for all undergraduate medical students using a peer-teaching concept is feasible. Further studies are needed to evaluate in detail the learning outcomes for students and student tutors.

Improving the Pharmacology Curriculum at a German Medical School: A Structured Plan Based on a Student-Guided Large-Scale Study.

With rapid progress in medicine, a thorough understanding of pharmacology remains crucial. Currently, lecturers are implementing competency-based learning objectives in medical curricula around the world. Advancing teaching modalities need to be integrated into pharmacology courses in a reasonable way. At Ludwig-Maximilians-Universität (LMU) Munich Medical Faculty, a systematic evidence-based approach was used to modernize pharmacology classes. The needs assessment was conducted by final-year students. It included focus groups and a large-scale online survey, which was distributed among all medical students at LMU, with 1018 students participating (response rate 20%). Survey results showed that most of the students (92%) aimed to become pharmacology-adept doctors. Also, a majority (88%) stated that their goal was to understand the material most critical to application of pharmacology concepts as well as prescribing practice. Only 38% of the students reported satisfaction with the current curriculum, and 93% supported modernization. Thus far, pharmacology teaching at LMU Munich had mainly consisted of lectures attended by 200 students. Now, students advocated for a stronger integration of clinical pharmacology teaching into clinical subjects in the last 2 years of medical school. Specifically, they called for classes with smaller groups of students including problem-based learning as well as video podcasts. These results provided the foundation for change in curriculum at the LMU medical school. In conclusion, a structured approach for curriculum development that considers students' views is feasible and can reveal their actual goals and demands. The approach has proven successful at LMU Munich and is transferrable to other universities.

Development of a Rehab-Wiki for rehabilitation-Related Educational Materials Assigned to Competence-Based Learning Objectives

For adequate rehabilitative care, it is indispensable to impart appropriate competences in medical education based on learning objectives. In addition to the "National Competence-Based Learning Objectives Catalogue for Medicine (NKLM)", a competence-based learning objectives catalogue for the field of rehabilitation in the interdisciplinary subject "Rehabilitation, Physical Medicine, Naturopathy" (RPMN) was recently presented. These learning objectives were to be assigned to a wide variety of teaching materials of different media types and made easily accessible to university lecturers in a free online database. The database should also contain flexible teaching and learning modules as well as information on didactic methods. Teaching materials from six university locations were assigned to the rehabilitation-related learning objective sections of the competence-based learning objective catalogue for RPMN and the NKLM. Presentation slides and text-based material were integrated in PDF-format. Educational films were embedded in a non-public channel on the video platform "YouTube". As a result, they could be referenced in the online database designed as a MediaWiki. The contents of this "rehab-wiki" (www.rehawiki.uni-halle.de) were structured using four thematic portals: The "Teaching and Learning Objectives Portal" contains the competence-based learning objectives and keywords for the content to be taught along with links to suitable didactic methods and available teaching materials. The "Teaching and Learning Methods Portal" contains didactic methods with detailed instructions. In the "Teaching Materials Portal" the teaching materials are grouped according to media type and the "Glossary" portal contains definitions and links to important rehabilitation medicine terms based on the "Social Medicine Glossary" published by the Federal German Pension Insurance. Just 6 months after implementation and presentation of the platform at a congress, 53 interdisciplinary users with teaching positions at German universities have registered. The "rehab-wiki" provides an intuitive online database. It contains teaching materials of various media types, which are assigned to competence-based learning objective sections, and suitable didactic methods. Teachers are supported in designing learning goal-oriented, didactically advanced and appealing rehabilitation courses. The MediaWiki-system enables constant further development by the teaching community requiring low long-term supervision effort. The "rehab-wiki" also offers a starting-point for continuing education and advanced training as well as for other occupational groups involved in rehabilitation.