German Medical Schools Research Articles

Abstract 4138484: Exploring medical students’ clinical preparedness to provide cardiovascular care for sexual and gender minorities

Sexual and gender minorities (SGM) have unique risk factors for cardiovascular disease (CVD). A higher likelihood of tobacco use, inadequate exercise, diabetes, dyslipidemia, hypertension, and obesity have been found, driven by increased psychosocial stressors across the lifespan. Specific treatments, especially gender-affirming hormone therapy, can also increase the CVD risk. Even though SGM-related issues have been introduced into medical education, students’ expertise regarding cardiovascular care for SGM populations has not been studied. The present study examines the clinical preparedness, attitudes, and basic knowledge of medical students regarding cardiovascular care for SGM populations. Medical students from Germany were recruited to take part in an online survey. Additionally, medical students from the UK and the USA will be recruited in the future. We used a variety of channels for recruitment (e.g., mailing lists of student councils, social medical groups). The LGBT-DOCSS was used to assess SGM-related clinical competency. Based on prior work of our research group, we developed items to assess the knowledge of SGM-related cardiovascular care and educational needs. We calculated descriptive statistics to describe the outcomes of interest. Currently, 217 medical students (20% final-year) from 5 German medical schools participated in the study. Regarding general SGM-related clinical competency, participants scored below average on clinical preparedness (3.4/7.0), above average on basic knowledge about SGM-specific healthcare (5.1/7.0), and low on explicit bias and prejudice towards SGM individuals (6.4/7.0). 84 % of the participants reported not feeling appropriately prepared to deliver cardiovascular care for SGM populations. Most participants (72 %) only knew about one or two SGM-specific CVD risk factors. There was a high interest in learning about cardiovascular care for SGM populations (96%) and a preference to implement the issue in medical school curricula (93%). Additional data from Germany, the USA, and the UK will be presented at the time of the conference presentation. The present study provides insights into the clinical preparedness of medical students regarding cardiovascular care for SGM populations. Despite showing a high interest in learning about SGM-specific cardiovascular care, most medical students feel underprepared on the issue. Implementing SGM-specific cardiovascular health into medical school curricula could close this gap.

Medical students’ AI literacy and attitudes towards AI: a cross-sectional two-center study using pre-validated assessment instruments

BackgroundArtificial intelligence (AI) is becoming increasingly important in healthcare. It is therefore crucial that today’s medical students have certain basic AI skills that enable them to use AI applications successfully. These basic skills are often referred to as “AI literacy”. Previous research projects that aimed to investigate medical students’ AI literacy and attitudes towards AI have not used reliable and validated assessment instruments.MethodsWe used two validated self-assessment scales to measure AI literacy (31 Likert-type items) and attitudes towards AI (5 Likert-type items) at two German medical schools. The scales were distributed to the medical students through an online questionnaire. The final sample consisted of a total of 377 medical students. We conducted a confirmatory factor analysis and calculated the internal consistency of the scales to check whether the scales were sufficiently reliable to be used in our sample. In addition, we calculated t-tests to determine group differences and Pearson’s and Kendall’s correlation coefficients to examine associations between individual variables.ResultsThe model fit and internal consistency of the scales were satisfactory. Within the concept of AI literacy, we found that medical students at both medical schools rated their technical understanding of AI significantly lower (MMS1 = 2.85 and MMS2 = 2.50) than their ability to critically appraise (MMS1 = 4.99 and MMS2 = 4.83) or practically use AI (MMS1 = 4.52 and MMS2 = 4.32), which reveals a discrepancy of skills. In addition, female medical students rated their overall AI literacy significantly lower than male medical students, t(217.96) = -3.65, p <.001. Students in both samples seemed to be more accepting of AI than fearful of the technology, t(745.42) = 11.72, p <.001. Furthermore, we discovered a strong positive correlation between AI literacy and positive attitudes towards AI and a weak negative correlation between AI literacy and negative attitudes. Finally, we found that prior AI education and interest in AI is positively correlated with medical students’ AI literacy.ConclusionsCourses to increase the AI literacy of medical students should focus more on technical aspects. There also appears to be a correlation between AI literacy and attitudes towards AI, which should be considered when planning AI courses.

Uncovering heterogeneity in mental health changes among first-year medical students

ABSTRACT Introduction The initial year of medical school is linked to a decline in mental health. To assess mental health comprehensively, the dual-factor model posits the consideration of both psychopathology (e.g., depression) and positive mental health (e.g., well-being). Previous mental health research among medical students has primarily examined these two factors independently. This study uses the dual-factor approach for a deeper understanding of mental health changes during the first year of medical school. Methods Students from eight German medical schools (N = 450) were surveyed three times (T0 = entering medical school, T1 = end of the first semester, T2 = end of the second semester) regarding depression (PHQ-9), well-being (subscale of FAHW-12), and general life satisfaction (German Single-Item Scale L1). Latent profile analysis was used to identify distinct mental health groups based on their combinations of psychopathology and positive mental health. We then analysed trajectories descriptively by examining the longitudinal stability and dynamics of mental health group membership during the first year of medical school. Results We identified five mental health groups: (1) complete mental health, (2) moderately mentally healthy, (3) symptomatic but content, (4) vulnerable, and (5) troubled. The examination of change trajectories unveiled diverse paths pointing towards both recovery and deterioration. In comparison to the other groups, students belonging to the complete mental health group exhibited greater stability and a higher potential to recover after initial deteriorations in the first semester. Conclusions Our study uncovers distinct mental health trajectories in the first year of medical school, emphasizing the crucial role of initial mental health status. Our findings stress the diverse nature of mental health changes in medical students, underscoring the need for tailored prevention strategies. The implications for research and practice are discussed.

Gaston Labat, the Mayo Clinic, and the Introduction of Regional Anesthesia to the United States

Abstract Throughout the nineteenth century, transatlantic medical research and training was largely dominated by Western European hospitals. Americans trained in German, Austrian, French, and British medical schools and hospitals, and then returned to work in relatively subpar hospitals and medical schools in the U.S. This relationship was reversed after wwi, with European doctors seeking transition to a comparatively well-funded and respected medical community in the U.S. Recruited in 1920 from a French hospital system to the Mayo Clinic in Rochester, Minnesota, the young surgeon Gaston Labat (1897–1934) became a pioneer in the development of regional anesthesiology and pain management practices in America, establishing the Mayo Clinic as a leader in this nascent field. Published in the U.S. in 1922, Labat’s textbook Regional Anesthesia was based upon his earlier years of work in Paris and came to define the field over the subsequent decades. Labat moved to Bellevue Hospital in New York City, and in 1923 founded the American Society of Regional Anesthesia (asra). The asra acted as an engine of transformation in the professionalization of the field of anesthesia in the U.S. and formed part of the organized response to the opioid crises that emerged in the early twentieth century. Labat’s story serves as a window into this period of transition in global medical leadership and the introduction of regional anesthesiology and acute pain management, based upon European medical practice.

Students' perspectives regarding needs for and opportunities with mixed-reality education in neurosurgery at German medical schools.

Despite mixed reality being an emerging tool for tailored neurosurgical treatment and safety enhancement, the use of mixed reality in the education of German medical students is not established in the field of neurosurgery. The present study aimed to investigate medical students' perspectives on the use of mixed reality in neurosurgical medical education. Between July 3, 2023, and August 31, 2023, an online survey was completed by German medical students through their affiliated student associations and educational institutions. The survey included 16 items related to mixed reality in neurosurgery, with participants providing ratings on a 4-point Likert scale to indicate their level of agreement with these statements. A total of 150 students from 27 medical schools in Germany took part in the survey. A significant majority comprising 131 (87.3%) students expressed strong to intense interest in mixed-reality courses in neurosurgery, and 108 (72%) reported an interest in incorporating mixed reality into their curriculum. Furthermore, 94.7% agreed that mixed reality may enhance their understanding of operative neuroanatomy and 72.7% agreed with the idea that teaching via mixed-reality methods may increase the probability of the use of mixed reality in their future career. The majority (116/150 [77.3%]) reported that the preferred optimum timepoint for teaching with mixed reality might be within the first 3 years of medical school. In particular, more students in the first 2 years preferred to start mixed-reality courses in the first 2 years of medical school compared to students in their 3rd to 6th years of medical school (71.9% vs 41.5%, p = 0.003). Residents and attending specialists were believed to be appropriate teachers by 118 students (78.7%). German medical students exhibited significant interest and willingness to engage in mixed reality in neurosurgery. Evidently, there is a high demand for medical schools to provide mixed-reality courses. Students seem to prefer the courses as early as possible in their medical school education in order to transfer preclinical neuroanatomical knowledge into operative neurosurgical anatomy by using this promising technique.

Comparison of Effectiveness regarding a Culinary Medicine Elective for Medical Students in Germany Delivered Virtually versus In-Person.

(1) Background: The Culinary Medicine elective at the German medical schools of the universities of Göttingen, Giessen, and Brandenburg is a teaching kitchen-based elective aimed at training medical students on how to improve patient counselling on nutrition and lifestyle medicine topics. This curriculum was either delivered virtually (2021) or in-person (2022/2023). Changes in teaching effectiveness were evaluated. (2) Methods: The elective included seven modules in the teaching kitchen for 3 h each. It consisted of a short introduction and a hands-on interactive cooking part illustrating important dietary principles in different disease groups. The elective was conducted virtually in 2021 in a fully interactive setup using videoconference tools. Students in this cohort attended from their private kitchens whereas students in the in-person cohort (2022/2023) attended the same classes in the teaching kitchen. Standardized comparative self-assessment questionnaires on counselling competencies, nutrition knowledge, eating habits, and mental well-being (WHO-5) before and after the elective were used to determine teaching effectiveness. Paired and unpaired t-tests were performed to evaluate results. (3) Results: A total of 70 students (mean semester 6.3) were included in the virtual cohort, and 80 students (mean semester 6.3) were in the in-person cohort. In both, counselling competencies on 25 nutrition and lifestyle medicine topics increased significantly. Significant changes also occurred in most nutrition knowledge categories. Subjective well-being as well as personal attitudes towards nutrition counselling in medical practice improved significantly during the elective. Healthy eating habits improved in both groups as students ate significantly less unfavourable foods. There were no significant differences between the two groups apart from minor differences in nutrition knowledge. (4) Conclusions: The elective in Culinary Medicine improved students counselling competencies, nutrition knowledge, attitudes, well-being, and eating habits with no relevant difference between virtual and in-person teaching.

How we achieve satisfaction in training - A German-wide survey on preferred training conditions among trainers and trainees for board certification in gastroenterology.

a majority of resident physicians in Germany are not satisfied with their training conditions. However, training satisfaction is important for physician retention and patient care. Although federal and state laws define the general training regulations and conditions, considerable variability still exists concerning their implementation in the healthcare units. Little is known about the expectations concerning training for gastroenterology board certification by trainers and trainees in Germany. This lack of data hinders discussion on and improvement of training in gastroenterology in Germany. assessment of preferred training conditions among trainers and trainees for board certification in gastroenterology in Germany. an anonymous, voluntary survey consisting of single- and multiple-choice questions utilizing the Likert scale and fill-in responses was circulated to all members of the German Society for Digestive and Metabolic Diseases (DGVS - Deutsche Gesellschaft für Gastroenterologie, Verdauungs und Stoffwechselerkrankungen), as well as through the student council mailing lists of all German medical schools. The survey aimed to assess the consent regarding the ideal implementation of training regulations for gastroenterology board certification. Department heads, senior physicians, board-certified physicians, and outpatient-care physicians were classified as trainers and residents and students as trainees. Subgroups defined by place of work, age, gender, professional position, employment status, and parental status were investigated. 958 responses were included in the final analysis. We found a broad consensus among trainers and trainees on most aspects of our survey. Considerable differences were seen in items on part-time work, overtime, protected time for research, and advanced endoscopy training. the broad consensus seen in this survey is indicative of a shared vision for training conditions among trainers and trainees. However, the areas of dissent identified in this survey may assist trainers to better understand the expectations of trainees. Furthermore, this survey creates a sound basis upon which training conditions for board certification in gastroenterology in Germany can be discussed and improved.

Implementing nutritional medicine into medical curricula: A student-initiated course improves knowledge and attitudes

Although the risks and opportunities of nutrition in health trajectories are well known, it is rarely addressed in doctors' daily routine. This is partly related to physicians' lack of confidence in their ability to provide nutritional counselling, possibly due to insufficient training in medical school. Our study aimed at assessing the status quo of nutrition in the German medical curricula and the impact of a recently implemented, student-initiated online teaching initiative on perceived competence, knowledge and attitudes. "Eat This!" was the first Germany-wide initiative for online nutritional medicine (NM) education, consisting of 11 digital lectures on nutrition basics, nutrition medicine and public health nutrition. The contact time with NM during studies as well as the effects on students' attitudes towards NM, their self-perceived competence in NM and their nutrition knowledge were assessed from October 2020 to February 2021 in a cross-sectional as well as a prospective study using online questionnaires. Over 1500 medical students from 42 German faculties participated in the lecture series and the online survey. One hundred and twenty-two students formed a control group. Although considering the topic relevant, students rated their training in NM as insufficient, in terms of both quality and quantity. Initially, they did not feel able to counsel patients and rated their knowledge as low. However, self-ratings and the score in a 33-item multiple-choice test knowledge improved by participating in Eat This! as did their attitude towards nutrition and planetary health. No such changes were observed in the control group of 122 students not attending the course. Our results show that education in NM at German medical schools is perceived insufficient despite high student interest. But even low-threshold educational options like "Eat This!" can improve students' perceived competence, knowledge, and attitudes, and thus be an efficient and cost-effective way to address related deficits.

Ten characteristics of high-quality planetary health education-Results from a qualitative study with educators, students as educators and study deans at medical schools in Germany.

The climate and ecological crises are considered fundamental threats to human health. Healthcare workers in general and doctors in particular can contribute as change agents in mitigation and adaptation. Planetary health education (PHE) aims to harness this potential. This study explores perspectives among stakeholders involved in PHE at German medical schools on the characteristics of high-quality PHE and compares them to existing PHE frameworks. In 2021, we conducted a qualitative interview study with stakeholders from German medical schools involved in PHE. Three different groups were eligible: faculty members, medical students actively involved in PHE, and study deans of medical schools. Recruitment was performed through national PHE networks and snowball sampling. Thematic qualitative text analysis according to Kuckartz was used for the analysis. Results were systematically compared to three existing PHE frameworks. A total of 20 participants (13 female) from 15 different medical schools were interviewed. Participants covered a wide range of professional backgrounds and experience in PHE education. The analysis revealed ten key themes: (1) Complexity and systems thinking, (2) inter- and transdisciplinarity, (3) ethical dimension, (4) responsibility of health professionals, (5) transformative competencies including practical skills, (6) space for reflection and resilience building, (7) special role of students, (8) need for curricular integration, (9) innovative and proven didactic methods, and (10) education as a driver of innovation. Six of our themes showed substantial overlap with existing PHE frameworks. Two of our themes were only mentioned in one of the frameworks, and two others were not explicitly mentioned. Few important elements of the frameworks did not emerge from our data. In the light of increased attention regarding the connections of the climate and ecological crises and health, our results can be useful for anyone working toward the integration of planetary health into medical schools' and any health professions' curricula and should be considered when designing and implementing new educational activities.

How to: Success factors for the implementation and establishment of the "longitudinal curriculum" on communicative competencies at the Medical Faculty Mannheim.

Communicative competencies are of great importance to the medical profession, hence the teaching of them has been continuously expanded in recent years at many German medical schools. While individual courses on communicative competencies have already been established in the curricula, there remains, in part, a lack of longitudinal anchoring over the entire course of medical study. In 2008 the Medical Faculty Mannheim began implementing a longitudinal curriculum for communicative competencies. This paper outlines the general and phase-specific success factors in this process and gives practical recommendations and tips based on the personal experiences of the authors and the existing literature.

The large part German medicine has played in the development of experimental pharmacology in Japan.

The history of hitherto existing pharmacology in Japan presented here is authored in commemoration of the 150th anniversary of Naunyn-Schmiedeberg's Archives of Pharmacology. After the publication of the new book of anatomy "Anatomische Tabellen" translated into Japanese in 1774, the foundation of understanding the medical science was gradually formed in Japan under seclusion policy, and, since the Meiji Restoration of 1868, the modernization of Japanese medicine was rapidly fostered on the basis of German medicine. Thus, the Japanese government officially adopted German medicine, and the philosophy and practice of German medical schools were incorporated. Most of the medical texts used in Japan were of German origins, often in Dutch translations, and many Japanese physicians and medical researchers studied abroad in Germany. The start of experimental pharmacology in Japan was also made up by Japanese disciples of Oswald Schmiedeberg, who was the one of founders of the Archives in 1873. Additionally, it was customary for professor candidates in charge of pharmacology in medical faculties in Japan to go to Germany and study pharmacology. Through such historical circumstances, the Japanese Pharmacology Society has been established to fulfill the responsibility for contributing internationally to world-class research achievements in the field of medical sciences by supplying numerous talented pharmacologists. During the course of the development of experimental pharmacology in Japan, the Archives has provided an excellent stage for many Japanese pharmacologists to publish their research outcomes to proliferate them internationally. Without German medicine influence, Japanese pharmacology would not have been what it is today.

Considering vocational training as selection criterion for medical students: evidence for predictive validity

Prior work experience in a relevant medical profession is an important admission criterion currently used at many German medical schools in addition to cognitive criteria. In other countries, work experience is often considered in later admission stages (e.g., interviews with pre-selected subgroups of applicants). However, evidence for its predictive validity for study success in addition to cognitive admission criteria is currently lacking. We therefore assessed whether completed vocational training in a relevant medical profession can predict study performance in the first two years of study in addition to cognitive admission criteria. Admission and study performance data of all currently enrolled medical students at two German medical schools (Göttingen and Heidelberg) beginning with the 2013/14 cohort were retrospectively analyzed. Cognitive admission criteria in our sample were GPA grades and a cognitive test (“Test für Medizinische Studiengänge”, TMS). We defined the study outcome parameter as the mean percentile rank over all performance data points over the first two years of study for each location, respectively. A multi-level model with varying intercepts by location, GPA, TMS, vocational training, and sex as predictors accounted for 14.5% of the variance in study outcome. A positive predictive association with study outcome was found for vocational training (ß = 0.33, p = .008) beyond GPA (ß = 0.38, p < .001) and TMS (ß = 0.26, p < .001). Our results support the use of prior vocational training as a selection criterion for medical studies potentially adding predictive validity to cognitive criteria.

A Needs-Based Analysis of Teaching on Vaccinations and COVID-19 in German Medical Schools.

The COVID-19 pandemic highlights the need for improving public confidence in vaccines. Academic gaps and redundancies on vaccinations must be identified to revise the medical curriculum for up-to-date training of medical students. This cross-sectional survey assessed the status of vaccine-related teaching in general and specific to COVID-19 in medical schools across Germany. A total of 4313 medical students completed a questionnaire comprising items on national learning goals and perceived needs for teaching on vaccinations. Mixed methods were used to analyse data quantitatively for relative frequencies (%) and correlations between teaching items and semesters (Spearman’s rho), and qualitatively (content analysis). Our findings showed that 38.92% of the students were dissatisfied with teaching on vaccine-preventable diseases, but the perceived satisfaction increased in later semesters (r = 0.46, p < 0.001). Moreover, 75.84% and 68.15% of the students were dissatisfied with teaching related to vaccine scepticism and vaccine-related communication strategies, respectively. Furthermore, 63.79% reported dissatisfaction with teaching on COVID-19 disease and 72.93% with teaching on COVID-19 vaccines. A total of 79.12% stated they educated others on COVID-19 and its vaccines and 75.14% felt responsible to do so. A majority of the medical students were dissatisfied with teaching on dealing with vaccine scepticism, communication strategies and COVID-19 vaccines. We recommend practice-oriented vaccine education, especially for teaching communication skills to medical students.

Artificial Intelligence in Undergraduate Medical Education.

AI will take on an increasingly important role in medicine. Therefore, AI competencies should be taught in medical school. We investigated the inventory of AI-related courses at German medical schools. The majority of faculty offer courses on AI, but mainly at the elective and introductory levels. Regarding the topic of AI, there is a gap in German medical education that should be closed.

Students' Perspectives on Curricular Ultrasound Education at German Medical Schools.

Background: Despite ultrasound being an inherent part of medical education, only a few German medical schools have established a comprehensive ultrasound curriculum. This study aimed to explore medical students' perspectives on ultrasound in medical education (USMed).Results: Between January 1st, 2019 und June 30th, 2019, an online survey was conducted among German medical students via the students' associations and their respective teaching facilities. The survey consisted of 17 items regarding USMed. Statements were rated on a 4-point Likert scale for agreement. In total, 1040 students from 31 German medical faculties participated. The majority (1021, 98.2%) reported a very high to high interest in curricular USMed. Students agreed (n = 945, 90.9%) that USMed would be helpful along their entire course of medical studies. Considering the best starting time for USMed, the opinions of German medical students diverged: students studying in a model curriculum preferred to start in the second year (40.7%) while 49% of the students studying in a traditional curriculum preferred to start in the third year (p ≤ 0.001). An insufficient allotment of time for USMed in the planned curriculum (675, 65%) and a lack of courses run by medical faculty (305, 29.4%) were listed as perceived significant barriers to the participation in USMed. Peer teaching was regarded as an effective method in realizing USMed by 731 (70.3%) students.Conclusion: German medical students are very interested and willing to participate in USMed. There appears to be a high demand for US courses offered by medical schools.

How to increase the attractiveness of undergraduate rural clerkships? A cross-sectional study among medical students at two German medical schools

ObjectivesWhile literature provides substantial evidence that undergraduate rural clerkships may contribute to attract medical students to rural careers, so far little is known about how to convince medical students to...

How good are medical students at communicating risk? An implementation study at three German medical schools

ObjectiveTo assess the objective and subjective risk communication skills of medical students in three universities in Germany MethodsWe developed a risk communication skills Objective Structured Clinical Examination (OSCE) station and implemented it in three medical schools in Germany. 596 students contributed data to a risk communication checklist and a risk communication self-assessment. Multiple linear regression models were used to identify factors associated with the risk communication OSCE performance. ResultsParticipants in our study achieved on average 73.5% of the total risk communication skills score, which did not differ between locations (F(2-595) = 1.96; p = 0.142). The mean objective performance of students who assessed their skills as poor was significantly worse than the performance of students who assessed their skills as good (t(520) = −5.01, p < 0.001). The risk communication skills score was associated with native language but not with gender nor General Point Average (p < 0.001). ConclusionsMedical students demonstrated acceptable risk communication skills scores and were able to self-assess their performance. However, selected communication techniques should be re-emphasised in the undergraduate medical curriculum. Practice implicationsOur research identified shortcomings in particular subgroups that can be addressed through tailored curriculum interventions.

Implementation of disaster medicine education in German medical schools - a nationwide survey.

Objectives: Floods, earthquakes and terror attacks in recent years emphasize the importance of disaster preparedness for the medical community. To best prepare doctors for providing optimal care in disaster situations, specific education and training should start at the medical school level. This study containes an online survey among German medical schools to evaluate the status quo of teaching disaster medicine and to reveal potential obstacles.Methods: The dean’s offices of 36 German medical schools were contacted from April 2016 to May 2017. Via an e-mail link, recipients could anonymously and voluntarily access an online questionnaire (74 items, 42 with a four-point “Likert-like” scale, 12 yes/no questions and 20 with listed items to choose from). The answers were analyzed by descriptive statistics. Results: A total of 25 medical schools participated in the survey. Twenty respondents were in favor of expanding disaster medicine teaching at their institutions. Incorporating single topics ranging from triage (n=21) to accidents involving radioactive materials (n=4) into the curriculum varied widely. Only two schools had established a teaching coordinator for disaster medicine and only one e-learning course had been established. Twenty-one respondents regarded funding issues and 18 regarded organizational matters to be major hurdles in the future. Conclusion: Though most faculty representatives indicated that they favor expanding and implementing disaster medicine education, German medical schools still have a lot of room for enhancement in this field. The incorporation of e-learning tools could facilitate the expansion of disaster medicine teaching while simultaneously addressing the expressed concerns of the survey’s participants and guarantee nationwide standardization.

Semantic fluency including task switching predicts academic success in medical school.

The future state treaty on the admission of students to German medical schools calls for a variety of selection criteria among which at least two are required to be independent of school leaving grades. Against this background, the present study investigated achievement motivation and executive functions as predictors of academic success in medical school. Second year medical students were assessed for executive functioning by using the Tower of London Test (ToL), a German version of the Controlled Oral Word Association Test (COWAT), the Trail Making Test (TMT-A) and for motivation by using the Achievement Motivation Inventory (AMI). Academic success was evaluated twofold, i) whether the first state exam (M1) was passed at the earliest possible, after completion of the second year and ii) via the grades obtained. 81 out of 226 students enrolled participated in our study. Passing the M1 was best explained by semantic fluency including task switching. Moreover, academically successful students achieved significantly higher levels in the AMI-facets "compensatory effort" and "engagement". All students scored above average in the TMT-A and average in the ToL. Alternating semantic fluency-requiring simultaneously inhibition, updating and task shifting-turned out highly predictive of academic success in medical school. Moreover, higher levels in "compensatory effort" and "engagement" suggested that both, increased energy expenditure as response to fear of failure and elevated readiness to exert effort also impacted positively on success.

Quantity and quality of conflict of interest policies at German medical schools: a cross-sectional study and survey

ObjectivesTo assess the quantity and evaluate the quality of policies and curricula focusing on conflicts of interests (COI) at medical schools across Germany.DesignCross-sectional study, survey of medical schools, standardised web search.SettingMedical schools, Germany.Participants38 German medical schools.InterventionsWe collected relevant COI policies, including teaching activities, by conducting a search of the websites of all 38 German medical schools using standardised keywords for COI policies and teaching. Further, we surveyed all medical schools’ dean’s offices. Finally, we adapted a scoring system for results we obtained with 13 categories based on prior similar studies.Main outcomes and measuresPresence or absence of COI-related policies, including teaching activities at medical school. The secondary outcome was the achieved score on a scale from 0 to 26, with high scores representing restrictive policies and sufficient teaching activities.ResultsWe identified relevant policies for one medical school via the web search. The response rate of the deans’ survey was 16 of 38 (42.1%). In total, we identified COI-related policies for 2 of 38 (5.3%) German medical schools, yet no policy was sufficient to address all COI-related categories that were assessed in this study. The maximum score achieved was 12 of 26. 36 (94.7%) schools scored 0. No medical school reported curricular teaching on COI.ConclusionsOur results indicate a low level of action by medical schools to protect students from undue commercial influence. No participating dean was aware of any curriculum or instruction on COI at the respective school and only two schools had policies in place. The German Medical Students Association and international counterparts have called for a stronger focus on COI in the classroom. We conclude that for German medical schools, there is still a long way to go.