Sören Huwendiek

The effect of using standardized patients or peer role play on ratings of undergraduate communication training: A randomized controlled trial

OBJECTIVESnConsidering the expense of standardized patients (SP) for training communication skills and the convenience of peer role playing (RP) there is a surprising lack of studies directly comparing the two methods.nnnMETHODSnFifth year medical students (N=103) were assigned to three groups receiving a training in counseling parents of sick children with RP (N=34) or SP (N=35) or to a control group (CG, N=34). We assessed self-efficacy, as well as objective performance in parent-physician communication using questionnaires and the Calgary-Cambridge-Observation-Guide Checklist in a six-station OSCE, respectively.nnnRESULTSnThe training led to an increase in self-efficacy ratings and in the post-intervention OSCE score after RP (p<.021 and p<.001 respectively) and SP-training (p<.007 and p<.006 respectively) compared to controls. Surprisingly, this benefit was higher after RP than after SP-training (p<.021) due to significantly higher performance in the domain understanding of parentsperspective (p<.001).nnnCONCLUSIONnBoth RP and SP are valuable tools for training specific communication skills. RP offer a methodological advantage in fostering empathy for patient perspectives.nnnPRACTICE IMPLICATIONSnBoth peer-role-play and standardized patients hold specific benefits for communication training. Peer-role-play seems to foster a more empathic approach towards patients concerns justifying its prominent role in medical curricula.

New directions in e-learning research in health professions education: Report of two symposia

Background: The use of Computer Assisted Instruction (CAI) is rising across health professions education. Research to date is of limited use in guiding the implementation and selection of CAI innovations. Aims: In the context of two symposia, systemic reviews were discussed that evaluate literature in Internet-based learning, Virtual Patients, and animations. Each session included a debate with the goal of reaching consensus on best current practices and future research. Methods: Thematic analysis of the discussions was performed to arrange the questions by theme, eliminate redundancy, and craft them into a cohesive narrative. Results: The question analysis revealed that there are clear advantages to the use of CAI, and that established educational theories should certainly inform the future development and selection of CAI tools. Schools adopting CAI need to carefully consider the benefits, cost, available resources, and capacity for teachers and learners to accept change in their practice of education. Potential areas for future research should focus on the effectiveness of CAI instructional features, integration of e-learning into existing curricula and with other modalities like simulation, and the use of CAI in assessment of higher-level outcomes. Conclusions: There are numerous opportunities for future research and it will be important to achieve consensus on important themes.

Applying the Verona coding definitions of emotional sequences (VR-CoDES) to code medical students’ written responses to written case scenarios: Some methodological and practical considerations

OBJECTIVEnTo investigate whether the Verona Coding Definitions of Emotional Sequences to code health providers responses (VR-CoDES-P) can be used for assessment of medical students responses to patients cues and concerns provided in written case vignettes.nnnMETHODSnStudent responses in direct speech to patient cues and concerns were analysed in 21 different case scenarios using VR-CoDES-P.nnnRESULTSnA total of 977 student responses were available for coding, and 857 responses were codable with the VR-CoDES-P. In 74.6% of responses, the students used either a reducing space statement only or a providing space statement immediately followed by a reducing space statement. Overall, the most frequent response was explicit information advice (ERIa) followed by content exploring (EPCEx) and content acknowledgement (EPCAc).nnnDISCUSSIONnVR-CoDES-P were applicable to written responses of medical students when they were phrased in direct speech. The application of VR-CoDES-P is reliable and feasible when using the differentiation of providing and reducing space responses. Communication strategies described by students in non-direct speech were difficult to code and produced many missings.nnnPRACTICE IMPLICATIONSnVR-CoDES-P are useful for analysis of medical students written responses when focusing on emotional issues. Students need precise instructions for their response in the given test format.

Challenges for medical educators: Results of a survey among members of the German association for medical education

Background: Despite the increasing interest in medical education in the German-speaking countries, there is currently no information available on the challenges which medical educators face. To address this problem, we carried out a web-based survey among the members of the Association for Medical Education (Gesellschaft für medizinische Ausbildung, GMA). Methods: A comprehensive survey was carried out on the need for further qualifications, expertise and the general conditions of medical educators in Germany. As part of this study, the educators were asked to list the three main challenges which they faced and which required urgent improvement. The results were analysed by means of qualitative content analysis. Results: The questionnaire was completed by 147 of the 373 members on the GMA mailing list (response rate: 39%). The educators named a total of 346 challenges and emphasised the following areas: limited academic recognition for engagement in teaching (53.5% of educators), insufficient institutional (31.5%) and financial support (28.4%), a curriculum in need of reform (22.8%), insufficient time for teaching assignments (18,9%), inadequate teacher competence in teaching methods (18.1%), restricted faculty development programmes (18.1%), limited networking within the institution (11.0%), lack of teaching staff (10.2%), varying preconditions of students (8.7%), insufficient recognition and promotion of medical educational research (5.5%), extensive assessment requirements (4.7%), and the lack of role models within medical education (3.2%). Conclusion: The medical educators found the biggest challenges which they faced to be limited academic recognition and insufficient institutional and financial support. Consequently, improvements should be implemented to address these issues.

Virtual Patients in continuing medical education and residency training: a pilot project for acceptance analysis in the framework of a residency revision course in pediatrics.

Aim: Virtual patients (VPs) are a one-of-a-kind e-learning resource, fostering clinical reasoning skills through clinical case examples. The combination with face-to-face teaching is important for their successful integration, which is referred to as “blended learning”. So far little is known about the use of VPs in the field of continuing medical education and residency training. The pilot study presented here inquired the application of VPs in the framework of a pediatric residency revision course. Methods: Around 200 participants of a pediatric nephology lecture (‘nephrotic and nephritic syndrome in children’) were offered two VPs as a wrap-up session at the revision course of the German Society for Pediatrics and Adolescent Medicine (DGKJ) 2009 in Heidelberg, Germany. Using a web-based survey form, different aspects were evaluated concerning the learning experiences with VPs, the combination with the lecture, and the use of VPs for residency training in general. Results: N=40 evaluable survey forms were returned (approximately 21%). The return rate was impaired by a technical problem with the local Wi-Fi firewall. The participants perceived the work-up of the VPs as a worthwhile learning experience, with proper preparation for diagnosing and treating real patients with similar complaints. Case presentations, interactivity, and locally and timely independent repetitive practices were, in particular, pointed out. On being asked about the use of VPs in general for residency training, there was a distinct demand for more such offers. Conclusion: VPs may reasonably complement existing learning activities in residency training.

Virtuelle Patienten für Kinderärzte : an der Universität Heidelberg geht man neue Wege in der Medizinerausbildung

Uber ein neues Schulungskonzept fur die Versorgung von Kindern in Notfallsituationen, das jetzt am Universitatsklinikum Heidelberg gestartet wurde, berichtet die Mai-Sendung von Campus-TV. Das bisher einmalige Schulungskonzept fur Arzte und Pflegepersonal trainiert in Simulationsszenarien an realistisch gestalteten Puppen Notfalle in der Kinder- und Jugendmedizin. Beide Berufsgruppen lernen, wie man im Ernstfall zusammen schnell und effektiv handelt und kommuniziert. Das neue Weiterbildungskonzept, das die Experten des Zentrums fur Kinder- und Jugendmedizin sowie des Zentrums fur Virtuelle Patienten am Universitatsklinikum Heidelberg ausarbeiteten und nun auch wissenschaftlich begleiten, wurde von der Klaus Tschira Stiftung unterstutzt.

Recommendations for reviewing a manuscript for the GMS Zeitschrift für Medizinische Ausbildung.

The aim of this paper, written by the committee of educational research methodology of the “Society for Medical Education” of the German-speaking countries, will give recommendations for the review process of scientific papers in medical education. The recommendations are based on the results of a workshop in 2007 and on a survey among reviewers of the journal GMS Z Med Ausbild. It reflects on international standards and research in medical education in Germany. The paper describes reviewer’s function concerning the journal of GMS Z Med Ausbild and specifies criteria for the review process with regard to the editors and reviewers; it also gives proposals for a feedback to the author. The catalogue of criteria for the reviewers is pictured in a checklist. The present recommendations shall help to increase the quality of the review process and to improve the national and international acceptance of the journal GMS Z Med Ausbild. Additionally, transparency of the review processes will support authors to submit a scientific article of high quality.