Götz Fabry

Communication and social competencies in medical education in German-speaking countries: the Basel consensus statement. Results of a Delphi survey.

OBJECTIVE To propose a comprehensive set of competencies and educational objectives for communication and social competencies in undergraduate medical education and to support the nationwide implementation of these issues in all medical schools. METHODS Thirty experts from different medical and psychosocial disciplines participated in a 2-day workshop using the Nominal Group Technique (NGT) to develop an initial set of educational objectives. These were refined, structured, and rated according to their importance by means of a two-step Delphi Survey involving additional experts in medical education. RESULTS The initial workshop resulted in 188 educational objectives assigned to 26 different topics. After the Delphi Survey, 131 objectives remained, assigned to 19 different topics. Some objectives that could be assigned to more than one topic were subsumed under a new more general category. CONCLUSION The described consensus process proved successful as one method to develop a set of educational objectives. PRACTICAL IMPLICATIONS The Basel consensus statement can be used to orientate curriculum reform and development in medical education.

Student perceptions of evaluation in undergraduate medical education: A qualitative study from one medical school.

BackgroundEvaluation is an integral part of medical education. Despite a wide use of various evaluation tools, little is known about student perceptions regarding the purpose and desired consequences of evaluation. Such knowledge is important to facilitate interpretation of evaluation results. The aims of this study were to elicit student views on the purpose of evaluation, indicators of teaching quality, evaluation tools and possible consequences drawn from evaluation data.MethodsThis qualitative study involved 17 undergraduate medical students in Years 3 and 4 participating in 3 focus group interviews. Content analysis was conducted by two different researchers.ResultsEvaluation was viewed as a means to facilitate improvements within medical education. Teaching quality was believed to be dependent on content, process, teacher and student characteristics as well as learning outcome, with an emphasis on the latter. Students preferred online evaluations over paper-and-pencil forms and suggested circulating results among all faculty and students. Students strongly favoured the allocation of rewards and incentives for good teaching to individual teachers.ConclusionsIn addition to assessing structural aspects of teaching, evaluation tools need to adequately address learning outcome. The use of reliable and valid evaluation methods is a prerequisite for resource allocation to individual teachers based on evaluation results.

Development of a questionnaire to assess medical competencies: Reliability and validity of the Questionnaire.

Introduction: While preparing a graduate survey for medical education in 2008 we realized that no instrument existed that would be suitable to evaluate whether the learning outcomes outlined in the Medical Licensure Act (ÄAppO) would be met. Therefore we developed the Freiburg Questionnaire to Assess Competencies in Medicine (Freiburger Fragebogen zur Erfassung von Kompetenzen in der Medizin, FKM)1 which has been revised and extended several times since then. Currently the FKM includes 45 items which are assigned to nine domains that correspond to the CanMEDS roles: medical expertise, communication, team-work, health and prevention, management, professionalism, learning, scholarship, and personal competencies. Methods: In order to test the reliability and validity of the questionnaire we have repeatedly surveyed medical students and residents since May 2008. In this article we report on the results of a cross-sectional study with 698 medical students from the preclinical and clinical years. In addition, we report the results of a survey of 514 residents who were up to two years into their residency. Results and conclusions: In summary, results show that the scales of the FKM are reliable (Cronbach’s α between .68 and .97). Significant differences in means between selected groups of students support the measure’s construct validity. Furthermore, there is evidence that the FKM might be used as a screening tool e.g. in graduate surveys to identify weaknesses in the medical education curriculum.

Importance and benefits of the doctoral thesis for medical graduates

Introduction: The majority of medical graduates in Germany complete a doctorate, even though a doctoral degree is not necessary for the practice of medicine. So far, little is known about doctoral candidates’ view on the individual benefit a doctoral thesis has for them. Consequently, this is the subject of the present investigation. Method: Data from surveys with graduates of the five medical faculties of Baden-Württemberg from the graduation years 2007/2008 (N=514) and 2010/2011 (N=598) were analysed. Results: One and a half years after graduating 53% of those interviewed had completed their doctorate. When asked about their motivation for writing a doctoral thesis, participants answered most frequently “a doctorate is usual” (85%) and “improvement of job opportunities” (75%), 36% said that an academic career has been their primary motive. Less than 10% responded that they used their doctoral thesis as a means to apply for a job. The proportion of graduates working in health care is equally large among those who have completed a thesis and those who have not. Graduates who pursued a thesis due to scientific interest are also currently more interested in an academic career and recognise more opportunities for research. An implicit benefit of a medical thesis emerged with regard to the self-assessment of scientific competences as those who completed a doctorate rated their scientific competencies higher than those who have not. Discussion: Although for the majority of physicians research interest is not the primary motivation for completing a doctorate, they might nevertheless achieve some academic competencies. For graduates pursuing an academic career the benefit of completing a medical thesis is more obvious.

Novice medical students: individual patterns in the use of learning strategies and how they change during the first academic year.

Background: Adequate use of different learning strategies is one of the most important prerequisites of academic success. The actual use of learning strategies is the result of an interaction between individual and situational variables. Against this background we conducted a longitudinal study with first year medical students to investigate whether individuals show different patterns in their use of learning strategies and whether these patterns change during the first academic year. Methods: Medical students (N=175, 58% female) were surveyed three times in their first academic year regarding their use of learning strategies. A hierarchical cluster analysis (Ward) was conducted in order to identify groups of students with different patterns of learning strategies. Results: We identified four different patterns in approaches to learning among novice medical students (“easy-going”, “flexible”, “problematic” and “hardworking” learners). Compared to their peers, the problematic learners had the worst final school grades. In addition changes in the use of learning strategies were identified, most of them occurred during the first term. Conclusion: Students start their academic studies with different patterns of learning strategies; the characteristics of these patterns change during the first academic year. Further research is necessary to better understand how individual and situational variables determine students’ learning.

Replication--The ugly duckling of science?

This August “Science” published a much-noticed paper by a collective of authors demonstrating that the results of many studies in the field of psychology could not be replicated [1]. With great methodological effort the Open Science Collaboration that incorporates 270 scientists from all over the world selected 100 up-to-date experimental studies from three top-ranked psychological journals in order to assign them for replication to designated and qualified research groups. In these replication studiesmaterial and instruments from the original studies were used and the authors of these studies were also consulted during the preparation phase. The results are sobering: While 97% of the original studies reported significant results only 36% of the replication studies did so. Furthermore, the reported effect sizes of the replication studies were only half as large as the original ones and even when the original data and the replicated data were analyzed conjointly only 68% of the results turned out to be significant. What do these findings mean? First of all the problem itself is known for a long time and is not restricted to psychology. Quite recently, wewitnessed a sometimes heated discussion circled around the question whether toomuch “research waste” is produced in the biomedical sciences [2]. As a matter of fact, the replication of many studies in this field fails, even if they are published in top-ranked journals. It is estimated that the proportion of non-replicable studies within the biomedical domain is actually larger than in psychology (approximately 75–90%) and even frequently cited studies make no exception [3].

Self-regulated learning and critical reflection in an e-learning on patient safety for third-year medical students

Objectives To explore the influence of critical thinking, self-regulated learning and system usability on the acceptance of e-learning on patient safety. Methods A cross-sectional study was conducted, using a 32-question online survey. One hundred ninety-three (n=193 medical students participated in the study and were asked to rate levels of reflective thinking, self-regulated learning and attitudes towards patient safety using scales from the Questionnaire for Reflective Thinking, the Attitudes to Patient Safety Questionnaire and the System Usability Scale. Differences between reflection levels were calculated using paired t-tests, associations between critical thinking and self-regulated learning were calculated using linear correlations. We performed linear multiple regression analysis to identify predictors for student acceptance of the e-learning. Results Students (n=193) engaged in intermediate levels of reflection (5-point Likert, M=3.62, SD=0.73) and significantly (t(143)=15.15, p<0.001, d=1.57) lower levels (M=2.35, SD=0.87) of critical reflection. Most students showed high (≥ 4; 44.1%) or intermediate (<4 level > 2; 29.4 %) levels of self-regulated learning. A regression model indicated that 5 predictors (Reflection, critical reflection, self-regulated learning, relevance, usability) explained 65.3% of the variance (R²=0.653, F(5, 96)=39.02, p<0.01) of perceived total quality. Conclusions This study shows that reflection and learning skills are important factors for e-learning acceptance, but perceived relevance and system usability play a more important role. From a didactic perspective, it is indispensable to provide the students with sufficient examples and links to professional practice to enhance the perception of relevance and to improve system usability permanently.

Acknowledgement to the Reviewers of GMS Zeitschrift für Medizinische Ausbildung

• Olaf Ahlers, Berlin • Matthias Angstwurm, München • Sebastian Arlt, Berlin • Katrin Balzer, Lübeck • Daniel Bauer, München • Johannes Bauer, München • Nicola Bauer, Bochum • Erika Baum, Marburg • Jan Becker, Münster • Stefan Beckers, Aachen • Katrin Bekes, Wien • Pascal Berberat, München • Christoph Berendonk, Bern • Mathias Berger, Freiburg i. Br. • Sarah Berger, Heidelberg • Mathias Bertram, Witten • Silke Biller, Basel • Mats Blohm, Heidelberg • Martin Boeker, Freiburg i. Br. • Klaus Böhme, Freiburg • Markus Bolzer, München • Hans Martin Bosse, Düsseldorf • Claudia Bozzaro, Freiburg i. Br. • Jan Breckwoldt, Zürich • Beate Brem, Bern • Georg Breuer, Erlangen • Irene Brunk, Berlin • Heinz Bruppacher, Zürich • Andreas Burger, Bochum • Rainer Büscher, Essen • Jean-Francois Chenot, Greifswald • Alexander Damanakis, Marburg • Katja Anne Dannenberg, Berlin • Renate Deinzer, Gießen • Winand Dittrich, Essen • Jörg Eberhard, Hannover • Jan P. Ehlers, Witten • Maren Ehrhardt, Hamburg • Michael Ewers, Berlin • Götz Fabry, Freiburg i. Br.

The Effort and Reward of Teaching Medical Psychology in Germany: an Online Survey.

Background: The increasing significance of university teaching also leads to higher demands for academic teachers. Against this background this study inquires how teachers in the field of medical pychology experience and evaluate their various activities and how their efforts on the one hand and gratifications on the other hand relate to each other (as conceptualized by the effort-reward-imbalance, ERI). Methods: A cross-sectional online survey was conducted in 2012 among the academic staff of departments of medical psychology in Germany. The questionnaire was answered by 188 participants (return rate: 39.2%), of whom 62% were women. Work stress was measured according to Siegrist’s effort–reward-imbalance (ERI) model. Further questions referred to the distribution of academic activities and meaningfulness. Results: Among all participants, 67.3% were satisfied with the portion of their workload devoted to teaching, while 63% wanted more time for research. The ERI-coefficient was on average M=0.76 (SD=0.45), thus indicating a shift towards reward. There were no associations with gender, age, or fixed-term work contracts. Meaningfulness was associated negatively with the ERI (r=-.21, p=.012), and positively with overcommitment (r=.52, p<.001) and the desire for less administrative tasks (r=.24, p=.017). Conclusions: Teaching medical psychology is evaluated as positive and meaningful by a majority of respondents. In general, the rewarding aspects seem to outweigh the stressful factors. Thus, teaching might be a protective factor with regard to coping with work related burden.

German Medical Science--Journal for Medical Education: respectable and very much in motion.

The first issue of a new volume, which is the 32 of our Journal for Medical Education, is a good opportunity to take a look on what we have achieved during the last year, and what lies ahead of us as there are some innovations coming up that document the development of our journal. First of all some data: We published 35 articles in 2014. A good half of them (16) are research articles, almost a third are project reports (11), the remaining ones are reviews (1), position papers (3), and comments (4). These numbers illustrate that our journal lives up to its self-declared mission i.e. to promote the scientific discourse within the entire domain of education and professional development in medicine, dentistry and veterinary medicine as well as in the health professions overall. However, there is still room for improvement. From an editorial perspective we would wish to havemore review articles since we consider the integration of insights from individual studies of utmost importance as these become increasingly difficult to keep track of in many domains. That we are also on the right track for our readers is documented by the growing access of our sites: Both on our “home” platformGMS [http://www.egms.de/dynamic/ en/index.htm] and on PubMedwhere our articles are also available as full text we enjoy growing popularity (see Figure 1). In 2014 we counted almost 100.000 hits on GMS. On PubMed where our journal is listed only since 2011 we still had almost 50.000 hits. Both measures are corrected for automated queries. Although we are really excited about this response we still want to develop the proliferation of our journal without making any compromises in terms of the quality of our articles. To achieve this and to come closer to the Impact Factor as an important milestone for our journal, we introduce three innovations that we hope will generate positive impetus for this development: