Hendrik Friederichs

Teaching ultrasound in a curricular course according to certified EFSUMB standards during undergraduate medical education: a prospective study

BackgroundAs a non-invasive and readily available diagnostic tool, ultrasound is one of the most important imaging techniques in medicine. Ultrasound is usually trained during residency preferable according to German Society of Ultrasound in Medicine (DEGUM) standards. Our curriculum calls for undergraduate training in ultrasound of medical students in their 4th year of undergraduate education. An explorative pilot study evaluated the acceptance of this teaching method, and compared it to other practical activities in medical education at Muenster University.Methods240 medical students in their 4th year of undergraduate medical education participated in the training and completed a pre- and post-questionnaire for self-assessment of technical knowledge, self-assurance of the procedure, and motivation in performing ultrasound using a Likert scale. Moreover, students were asked about their interest in pursuing a career in internal medicine. To compare this training to other educational activities a standardized online evaluation tool was used. A direct observation of procedural skills assessment (DOPS) for the first time applied on ultrasound aimed to independently assess the success of our teaching method.ResultsThere was a significant increase in technical knowledge and self-assurance (p < 0.001) of the students’ self-assessments. The clinical relevance and self-motivation of the teaching were evaluated positively. The students’ DOPS results demonstrated proficiency in the understanding of anatomic structures shown in ultrasonographic images, including terminology, machine settings, and transducer frequencies.ConclusionsTraining ultrasound according to certified DEGUM standards was successful and should be offered in undergraduate medical education. The evaluation of the course affirmed the necessity, quality and clinical relevance of the course with a top ranking score of hands-on training courses within the educational activities of the Medical Faculty of Muenster.

Measuring the ambiguity tolerance of medical students: a cross-sectional study from the first to sixth academic years

BackgroundTolerance of ambiguity, or the extent to which ambiguous situations are perceived as desirable, is an important component of the attitudes and behaviors of medical students. However, few studies have compared this trait across the years of medical school. General practitioners are considered to have a higher ambiguity tolerance than specialists. We compared ambiguity tolerance between general practitioners and medical students.MethodsWe designed a cross-sectional study to evaluate the ambiguity tolerance of 622 medical students in the first to sixth academic years. We compared this with the ambiguity tolerance of 30 general practitioners. We used the inventory for measuring ambiguity tolerance (IMA) developed by Reis (1997), which includes three measures of ambiguity tolerance: openness to new experiences, social conflicts, and perception of insoluble problems.ResultsWe obtained a total of 564 complete data sets (return rate 90.1%) from medical students and 29 questionnaires (return rate 96.7%) from general practitioners. In relation to the reference groups defined by Reis (1997), medical students had poor ambiguity tolerance on all three scales. No differences were found between those in the first and the sixth academic years, although we did observe gender-specific differences in ambiguity tolerance. We found no differences in ambiguity tolerance between general practitioners and medical students.ConclusionsThe ambiguity tolerance of the students that we assessed was below average, and appeared to be stable throughout the course of their studies. In contrast to our expectations, the general practitioners did not have a higher level of ambiguity tolerance than the students did.

Practicing evidence based medicine at the bedside: a randomized controlled pilot study in undergraduate medical students assessing the practicality of tablets, smartphones, and computers in clinical life

BackgroundPracticing evidence-based medicine is an important aspect of providing good medical care. Accessing external information through literature searches on computer-based systems can effectively achieve integration in clinical care. We conducted a pilot study using smartphones, tablets, and stationary computers as search devices at the bedside. The objective was to determine possible differences between the various devices and assess students’ internet use habits.MethodsIn a randomized controlled pilot study, 120 students were divided in three groups. One control group solved clinical problems on a computer and two intervention groups used mobile devices at the bedside. In a questionnaire, students were asked to report their internet use habits as well as their satisfaction with their respective search tool using a 5-point Likert scale.ResultsOf 120 surveys, 94 (78.3%) complete data sets were analyzed. The mobility of the tablet (3.90) and the smartphone (4.39) was seen as a significant advantage over the computer (2.38, p < .001). However, for performing an effective literature search at the bedside, the computer (3.22) was rated superior to both tablet computers (2.13) and smartphones (1.68). No significant differences were detected between tablets and smartphones except satisfaction with screen size (tablet 4.10, smartphone 2.00, p < .001).ConclusionsUsing a mobile device at the bedside to perform an extensive search is not suitable for students who prefer using computers. However, mobility is regarded as a substantial advantage, and therefore future applications might facilitate quick and simple searches at the bedside.

Using Tree Diagrams without Numerical Values in Addition to Relative Numbers Improves Students’ Numeracy Skills A Randomized Study in Medical Education

Background. Physicians and medical students may lack sufficient numeracy skills to make treatment decisions, interpret test results, and practice evidence-based medicine. We evaluated whether the use of a tree diagram without numerical values as an aid for numerical processing might improve students’ test results when dealing with percentages. Methods. A prospective randomized study was carried out with 102 third-year students. Participants received 3 diagnostic test problems and were asked to determine positive predictive values. The information in these tests was expressed either in (1) natural frequencies, (2) conditional probabilities, or (3) conditional probabilities with a tree diagram without numbers. Results. Ninety-eight (96.1%) complete data sets could be obtained. The group working with natural frequencies achieved significantly higher test results (n = 29, mean score: 1.1, P = 0.045) than the group working with conditional probabilities (n = 34, mean score: 0.56). The students who were given a tree diagram in addition to conditional probabilities (n = 35, mean score: 1.26) also achieved significantly better scores than the group with conditional probabilities alone (P = 0.008). The difference between the group who had received natural frequencies and the group working with conditional probabilities and the tree diagram was not significant. Conclusions. We suggest the use of a tree diagram as a visual aid when dealing with diagnostic tests expressed in conditional probabilities.

Mastery learning improves students skills in inserting intravenous access: a pre-post-study.

Objective: Inserting peripheral venous catheters (PVCs) has been identified as a core competency for medical students. Because the performance – even of hygienic standards – of both students and novice physicians is frequently inadequate, medical faculties must focus on competence-based learning objectives and deliberate practice, features that are combined in mastery learning. Our aim was to determine the competency of students in inserting PVCs before and after an educational intervention. Design: This study comprised a skills assessment with pre- and post-tests of a group of third-year students who received a simulation-based intervention. A newly established curriculum involved one hour of practice at inserting PVCs on simulators. Students were required to pass a test (total 21 points, pass mark 20 points) developed on the concept of mastery learning. An unannounced follow-up test was performed one week (8 days) after the intervention. Setting: The simulation center of the medical faculty in Muenster. Participants: Third-year students who received the intervention. Results: One hundred and nine complete data sets were obtained from 133 students (82.5%). Most students (97.2%) passed the test after the intervention (mean score increase from 15.56 to 20.50, P<0.001). There was a significant decrease in students’ performance after one week (8 days): only 74.5% of participants passed this retest (mean score reduction from 20.50 to 20.06, P<0.001). Conclusion: Mastery learning is an effective form of teaching practical skills to medical students, allowing a thorough preparation for the challenges of daily clinical practice.

Assessment of Risk Literacy Among German Medical Students: A Cross-Sectional Study Evaluating Numeracy Skills

ABSTRACT For successful communication of risk-related disease and treatment modalities, sufficient competence in risk literacy is important. Medical students who will soon be in the responsible role of physicians need to comprehend numeric estimates of probability in order to explain them understandably to patients. Therefore, we have examined the risk literacy among German medical students in a cross-sectional study with 600 participants from the first to the sixth year. Four hundred thirty-four complete datasets (72.35%) could be retrieved. The measuring instrument was the Berlin Numeracy Test, in which a maximum of 4 points could be obtained. Participants achieved an average score of 2.03 points, which is significantly higher than the score defined by the Berlin Numeracy Test (1.6 points). A slight increase from the first (2.00 points) to the sixth academic year (2.38) was detected, which was not significant. In addition, participants who made notes achieved significantly higher test results (2.45) than students who did mental arithmetic (1.77). Male participants showed a significantly higher performance (2.36) than their female colleagues (1.72). Medical students possess a good basis in their risk literacy skills; however, more exercise in dealing with practical case studies is needed.