Maria Lammerding-Köppel

Peer‐assisted versus faculty staff‐led skills laboratory training: a randomised controlled trial

Objectives  Although peer‐assisted learning (PAL) is widely employed throughout medical education, its effectiveness for training in technical procedures in skills laboratories has been subject to little systematic investigation. We conducted a prospective, randomised trial to evaluate the hypotheses that PAL is effective in technical skills training in a skills laboratory setting, and PAL is as effective as faculty staff‐led training.

Development and implementation of a technical and didactical training program for student tutors in the dissection course.

BACKGROUND student tutors have a long tradition in gross anatomy instruction. However, the full potential of the tutors is generally not tapped, since little attention is paid to their technical and didactical training. The aim of this paper is to report a systematic approach to the development, didactic reasoning and implementation of a curriculum for training student tutors in gross anatomy. METHODS the training program was developed using the six-step approach of Kerns curriculum development model. For needs assessment, the literature research was amended by a survey among the 1st and 2nd year students of the dissection course (n=167) and two independent 90 min focus group interviews with the tutors who supervised these students (n=15). Protocols were transcribed and analyzed by margin coding. The training curriculum was setup on the basis of these data. RESULTS corresponding to the literature, the students want student tutors with good teaching competence as well as adequate content knowledge and technical competence. Supporting that, the tutors request a training program enhancing their didactic skills as well as their knowledge of content and working using relevant methods. Thus, a combined didactic and professional training program has been developed. Six professional and 11 didactic learning objectives were defined. A 3 weeks training curriculum was implemented, using microteaching and group exercises for didactics and active dissection for technical training. Both parts were interlocked on a contextual and practical level. CONCLUSION our focus group analyses revealed that a specific training program for student tutors in the dissection course is necessary. We describe a feasible task-oriented training curriculum combining didactic and professional objectives.

Problem-based training for medical students reduces common prescription errors: a randomised controlled trial

Context  Avoidable drug‐related problems (DRPs) cause substantial morbidity, mortality and costs. As most prescription errors are committed by recently graduated doctors, undergraduate training should specifically address DRPs.

Sea urchin development: an alternative model for mechanistic understanding of neurodevelopment and neurotoxicity.

Echinoderm early developmental stages might supply a good tool for toxicity testing in different fields, ranging from environment to food contamination, and in full respect of the 3Rs objectives (reduction, refinement, and replacement of animal experiments) that will eventually lead to the replacement of high vertebrate animal testing in toxicology. Sea urchin is one of the few organismic models considered by the European Agency for Alternative models. Actually, sea urchin embryonic development has been studied for over a century, and the complex nets of intercellular communications leading to the different events are well known, as well the possibility for environmental molecules and their residuals to interfere with such communications, causing developmental anomalies. In particular, the main goal of toxicologists since several years has been to establish a correlation between the cell-to-cell communications occurring during different developmental events and the signals occurring during neurogenesis, with the aim to pursue a mechanistic understanding of these processes and their deviations caused by stressors from different sources.

Student tutors for hands-on training in focused emergency echocardiography – a randomized controlled trial

BackgroundFocused emergency echocardiography performed by non-cardiologists has been shown to be feasible and effective in emergency situations. During resuscitation a short focused emergency echocardiography has been shown to narrow down potential differential diagnoses and to improve patient survival. Quite a large proportion of physicians are eligible to learn focused emergency echocardiography. Training in focused emergency echocardiography usually comprises a lecture, hands-on trainings in very small groups, and a practice phase. There is a shortage of experienced echocardiographers who can supervise the second step, the hands-on training. We thus investigated whether student tutors can perform the hands-on training for focused emergency echocardiography.MethodsA total of 30 volunteer 4th and 5th year students were randomly assigned to a twelve-hour basic echocardiography course comprising a lecture followed by a hands-on training in small groups taught either by an expert cardiographer (EC) or by a student tutor (ST). Using a pre-post-design, the students were evaluated by an OSCE. The students had to generate two still frames with the apical five-chamber view and the parasternal long axis in five minutes and to correctly mark twelve anatomical cardiac structures. Two blinded expert cardiographers rated the students’ performance using a standardized checklist. Students could achieve a maximum of 25 points.ResultsBoth groups showed significant improvement after the training (p < .0001). In the group taught by EC the average increased from 2.3±3.4 to 17.1±3.0 points, and in the group taught by ST from 2.7±3.0 to 13.9±2.7 points. The difference in improvement between the groups was also significant (p = .03).ConclusionsHands-on training by student tutors led to a significant gain in echocardiography skills, although inferior to teaching by an expert cardiographer.

Immunohistochemical localization of ecdysteroid receptor and ultraspiracle in the epithelial cell line from Chironomus tentans (Insecta, Diptera)

Ecdysteroid receptor (EcR) and its heterodimerization partner, ultraspiracle (USP), were demonstrated in the epithelial cell line from Chironomus tentans by immunohistochemistry. In untreated cells both proteins are present in nuclei as well as in granular compartments of the cytosol. At 1 day after addition of 1-microM 20-OH-ecdysone (20E) total immunofluorescence had increased in the nuclei, whereas the cytoplasmic staining had disappeared. At the 2nd and 3rd days all cells within a vesicle appear identical according to morphological criteria, but the EcR and USP immunoreactivity becomes restricted into patches of neighbouring cells. The hormonally induced changes in the pattern of localization of functional ecdysteroid receptor, the heterodimer of EcR and USP, are discussed in relation to similar effects of 20E on acetylcholinesterase and muscarinic acetylcholine receptor distribution in this cell line.

Focused didactic training for skills lab student tutors - which techniques are considered helpful?

Objective: Peer-assisted learning is widely used in medical education. However, little is known about an appropriate didactic preparation for peer tutors. We herein describe the development of a focused didactic training for skills lab tutors in Internal Medicine and report on a retrospective survey about the student tutors’ acceptance and the perceived transferability of attended didactic training modules. Methods: The course consisted of five training modules: ‘How to present and explain effectively’: the student tutors had to give a short presentation with subsequent video analysis and feedback in order to learn methods of effective presentation. ‘How to explain precisely’: Precise explanation techniques were trained by exercises of exact description of geometric figures and group feedback. ‘How to explain on impulse’: Spontaneous teaching presentations were simulated and feedback was given. ‘Peyton’s 4 Step Approach’: Peyton‘s Method for explanation of practical skills was introduced and trained by the participants. ‘How to deal with critical incidents’: Possibilities to deal with critical teaching situations were worked out in group sessions. Twenty-three student tutors participated in the retrospective survey by filling out an electronic questionnaire, after at least 6 months of teaching experience. Results: The exercise ‘How to present and explain effectively’ received the student tutors’ highest rating for their improvement of didactic qualification and was seen to be most easily transferable into the skills lab environment. This module was rated as the most effective module by nearly half of the participants. It was followed by ‘Peyton’s 4 Step Approach’ , though it was also seen to be the most delicate method in regard to its transfer into the skills lab owing to time concerns. However, it was considered to be highly effective. The other modules received lesser votes by the tutors as the most helpful exercise in improving their didactic qualification for skills lab teaching. Conclusion: We herein present a pilot concept for a focused didactic training of peer tutors and present results of a retrospective survey among our skills lab tutors about the distinct training modules. This report might help other faculties to design didactic courses for skills lab student tutors.

20-OH-Ecdysone-induced morphogenetic movements in a Chironomus cell line are accompanied by expression of an embryonic muscarinic system

The permanent epithelial insect cell line used was derived from Chironomus tentans embryos. Cells are maintained in suspension culture, where they grow as single-layered vesicles. On treatment with the moulting hormone 20-OH-ecdysone cell division ceases. Patches of cuboidal epithelium appear in the vesicles which finally become multilayered and form bud-like protrusions at the outside. In the present study, we localized cholinesterase activity in the cell protrusions by histochemistry and demonstrated coexpression of cholinergic muscarinic receptors by immunofluorescence. Muscarinic receptors were visualized with the monoclonal antibody M35. Six hours after treatment with 20-OH-ecdysone, muscarinic receptors appeared in a few individual cells of the epithelial vesicles before morphological changes became visible. After 24 h, immunofluorescence was concentrated in multilayered patches which now also showed cholinesterase activity. After 3 days, muscarinic receptors and cholinesterase activity were localized in the epithelium protrusions. The results are discussed in the context of an embryonic cholinergic muscarinic system the expression of which has been described in vertebrate and non-vertebrate embryos and is correlated with phases of morphogenesis.

Core Competencies for Medical Teachers (KLM) – A Position Paper of the GMA Committee on Personal and Organizational Development in Teaching

Recent developments in medical education have created increasing challenges for medical teachers which is why the majority of German medical schools already offer educational and instructional skills trainings for their teaching staff. However, to date no framework for educational core competencies for medical teachers exists that might serve as guidance for the qualification of the teaching faculty. Against the background of the discussion about competency based medical education and based upon the international literature, the GMA Committee for Faculty and Organizational Development in Teaching developed a model of core teaching competencies for medical teachers. This framework is designed not only to provide guidance with regard to individual qualification profiles but also to support further advancement of the content, training formats and evaluation of faculty development initiatives and thus, to establish uniform quality criteria for such initiatives in German-speaking medical schools. The model comprises a framework of six competency fields, subdivided into competency components and learning objectives. Additional examples of their use in medical teaching scenarios illustrate and clarify each specific teaching competency. The model has been designed for routine application in medical schools and is thought to be complemented consecutively by additional competencies for teachers with special duties and responsibilities in a future step.

Auch Lehrende lernen dazu: Grundkonzepte der Didaktik

Uberall an den deutschsprachigen medizinischen Fakultaten ist ein neues Bewusstsein fur die Notwendigkeit einer verbesserten praxisorientierten Ausbildung entstanden, nicht zuletzt deswegen, weil man mit alternativen Konzepten im angloamerikanischen Raum gute Erfahrungen gemacht hat. Jedoch ist eine Reihe von Lernmethoden aus dem englischsprachigen Bereich bei uns nur begrenzt einsetzbar. Ein entscheidendes Hindernis fur die Einfuhrung stellt dabei die grose Zahl der Studenten dar, die pro Jahr mit den gegebenen Ressourcen und Bedingungen auszubilden sind. Kritiker stellen klassische Lehrformen wie Vorlesung, Seminar, Praktikum als uberholt in Frage. Um deren Potential besser auszuschopfen, mussen klassische Lehrformate auf der Basis der Lernpsychologie neu beleuchtet werden.