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Aim: During the COVID-19 pandemic, social restrictions significantly impacted post-graduate training in pediatric surgery. This paper describes the implementation and continuation of a German-language, online training program for pediatric surgery residents, named "KiWI" (Kinderchirurgische Weiterbildung im Internet), which was established during the period of social distancing. Method: "KiWI" was designed as a monthly, post-graduate online seminar course that combined practical relevance with theoretical knowledge. The teaching methods included case presentations by residents, active participant engagement through multiple-choice questions, and chat interactions. Course evaluation was conducted via an online questionnaire. The program was specifically tailored to meet the needs of the residents through close collaboration with them. Results: Between February 2021 and September 2023, an average of 53 participants (M=53; SD=20) attended each session, with no correlation observed between attendance and the level of social restrictions. Fifty-seven percent of the participants were residents, with over half being in their fifth year or beyond of post-graduate training. Evaluations indicated a high level of satisfaction with the topics and course design. Lecturers showed great willingness to participate voluntarily, and moderators facilitated the sessions to support the lecturers. Technical issues were addressed through pre-session test runs. Conclusion: The "KiWI" project demonstrates the potential of online continuing education as a resource-efficient supplement to post-graduate medical education. The program achieved high levels of acceptance and accessibility, showcasing the effectiveness of a decentralized online seminar format with interactive, case-based teaching methods. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has led to massive and aprupt changes in the training of health care professionals. Especially hands-on training can no longer take place in the usual form in everyday clinical practice. Rotations on the interprofessional training ward in Pediatrics (IPAPAED) at the University Medical Center Freiburg, had to be suspended starting March 2020. This report presents the interprofessional Covid-19 Replacement Program (I-reCovEr) as an alternative learning format for a rotation on the IPAPAED at the Center for Pediatric and Adolescent Medicine. I-reCovEr offers opportunities for pediatric nursing trainees (n=6) and medical students (n=9) to learn together, taking hygienic and distancing measures into account. Based on a case study, selected learning aspects regarding interprofessional cooperation and communication are targeted. The participants report increased knowledge about the work of the other professional group in the evaluation using the Interprofessional Socialization and Valuing Scale (ISVS) -9A. In comparison to participants of the IPAPAED, however, the self-evaluation did not reveal any self-perceived acquisition of other interprofessional skills or competences. I-reCovEr can therefore serve as an introduction to interprofessional training, but it cannot replace interprofessional learning and working on an interprofessional training ward. [ABSTRACT FROM AUTHOR]

Introduction: Auscultation skills are among the basic techniques to be learned in medical school. Such skills are achieved through supervised examination of patients often supported by simulator-based learning. The emergence of COVID-19 has disrupted and continues to hinder hands-on on-site medical training on a global scale. Project description: An effective virtual auscultation course was established in times of contact restrictions due to COVID-19 at the Medical Faculty of the Heinrich Heine University Düsseldorf. The interactive case-based webinar was designed to improve listening techniques, description and interpretation of auscultation findings in an off-site context. Clinical cases with pre-recorded auscultation sounds and additional case-based diagnostics were presented. The course focused on common heart murmurs including aortic and mitral valve stenosis and regurgitation as well as congenital heart defects (ventricular septal defect and patent ductus arteriosus). Results: The course was well received by the students and assessed as being useful and instructive. Assessment of learning effects, such as detection of pathological findings before and after training, is ongoing as part of a subsequent trial. Conclusion: Virtual interactive learning using a sound simulation lesson with clinical case presentations via video chat can well be used as a supplement to practical auscultation training. This learning format could also play a useful role in the curriculum of medical studies once contact restrictions are revoked. [ABSTRACT FROM AUTHOR]

Objective: COVID-19 challenges curriculum managers worldwide to create digital substitutes for classroom teaching. Case-based teaching formats under expert supervision can be used as a substitute for practical bedside teaching, where the focus is on teaching clinical reasoning skills. Methods: For medical students of LMU and TU Munich, the interactive, case-based, and supervised teaching format of Clinical Case Discussion (CCD) was digitised and implemented as dCCD in their respective curricula. Case discussions were realised as videoconferences, led by a student moderator, and took place under the supervision of a board-certified clinician. To prevent passive participation, additional cognitive activations were implemented. Acceptance, usability, and subjective learning outcomes were assessed in dCCDs by means of a special evaluation concept. Results: With regard to acceptance, students were of the opinion that they had learned effectively by participating in dCCDs (M=4.31; SD=1.37). The majority of students also stated that they would recommend the course to others (M=4.23; SD=1.62). The technical implementation of the teaching format was judged positively overall, but findings for usability were heterogeneous. Students rated their clinical reasoning skills at the end of the dCCDs (M=4.43; SD=0.66) as being significantly higher than at the beginning (M=4.33; SD=0.69), with low effect size, t(181)=-2.352, p=.020, d=0.15. Conclusion: Our evaluation data shows that the dCCD format is well-accepted by students as a substitute for face-to-face teaching. In the next step, we plan to examine the extent to which participation in dCCDs leads to an increase in objectively measured clinical reasoning skills, analogous to a face-to-face CCD with on-site attendance. [ABSTRACT FROM AUTHOR]

Introduction: In preparation for the state examination, many students have open questions and a need for advice. Tutors of the Skills Lab PERLE-„Praxis ERfahren und Lernen“ (experiencing and learning practical skills) have developed a new course concept to provide support and practical assistance for the examinees. Objectives: The course aims to familiarize the students with the exam situation in order to gain more confidence. This enables the students to experience a confrontation with the specific situation of the exam in a protected environment. Furthermore, soft skills are utilized and trained. Concept of the course: The course was inspired by the OSCE-model (Objective Structured Clinical Examination), an example for case-based learning and controlling. Acquired knowledge can be revised and extended through the case studies. Experienced tutors provide assistance in discipline-specific competencies, and help in organizational issues such as dress code and behaviour. Evaluation of the course: An evaluation was conducted by the attending participants after every course. Based on this assessment, the course is constantly being developed. In March, April and October 2015 six courses, with a total of 84 participants, took place. Overall 76 completed questionnaires (91%) were analysed. Discussion: Strengths of the course are a good tutor-participants-ratio with 1:4 (1 Tutor provides guidance for 4 participants), the interactivity of the course, and the high flexibility in responding to the group's needs. Weaknesses are the tight schedule, and the currently not yet performed evaluation before and after the course. Conclusion: In terms of “best practise”, this article shows an example of how to offer low-cost and low-threshold preparation for the state examination. [ABSTRACT FROM AUTHOR]

[english] Objective: The medical faculties of LMU Munich and CAU Kiel have developed a joint blended learning concept for computer-based learning and practical training of clinical skills: "CliSO – Clinical Skills Online" (). CliSO is implemented in their core curricula with the intention to foster students’ medical examination skills at the preclinical and clinical level. Methods: Both partners contributed their special competencies in the fields of case-based learning (Munich: CASUS e-learning platform) and systematic learning (Kiel: Nickels e-learning platform). The didactic concept comprises the integration of theory and practice. It combines the standardized teaching of the following three components: Clinical skills are trained and reviewed in face-to-face courses. In the e-learning environment, the well-directed combination of case-based and systematic learning together with the chosen diversity of media (video, audio, animation) facilitates situated learning as well as the intelligible presentation of clinical skills and their biomedical background. Both faculties agreed on joint learning objectives and standards. Results and prospects: It was possible to apply the concept to the different target groups at both faculties (first and second study phases) and the differently designed face-to-face courses (Kiel: students examine each other; Munich: patients are examined in addition). Evaluations and studies confirmed the success of this approach, so that a transfer of the concept to other faculties is intended. [german] Zielsetzung: Mit „KliFO – Klinische Fertigkeiten Online“ () haben die Medizinischen Fakultäten der LMU München und der CAU Kiel ein gemeinsames Blended Learning-Konzept zum computergestützten Lernen und praktischen Trainieren von klinischen Untersuchungstechniken entwickelt und in Pflichtveranstaltungen der Curricula integriert. Ziele sind die Verbesserung der Vor- und Nachbereitung von Untersuchungskursen im vorklinischen und klinischen Studienabschnitt und damit einhergehend verbesserte Untersuchungsfertigkeiten der Studierenden bei den ersten Patientenkontakten. Methodik: Beide Partner brachten ihre speziellen Kompetenzen in den Bereichen fallbasiertes Lernen (München, Lernplattform CASUS) und systematisches Lernen (Kiel, Lernplattform Nickels) ein. Das didaktische Konzept beinhaltet die Integration von Theorie und Praxis. Es kombiniert die standardisierte Vermittlung der folgenden drei Komponenten: Im Präsenzunterricht werden die Untersuchungstechniken geübt und reflektiert. Computerbasiert werden durch gezielte Kombination von fallbasiertem und systematischem Lernen zusammen mit einem vielfältigen Medieneinsatz (Video, Audio, Animation) situiertes Lernen gefördert, Untersuchungstechniken anschaulich dargestellt sowie Hintergrundwissen in inhaltlichem und zeitlichem Zusammenhang mit dessen Anwendung vermittelt. Beide Fakultäten haben sich auf gemeinsame Lernziele und Standards geeinigt. Ergebnisse und Ausblick: Das Konzept lässt sich auf die unterschiedlichen Zielgruppen an beiden Fakultäten (1. bzw. 2. Studienabschnitt) und die unterschiedlich gestalteten Präsenzphasen (Kiel: gegenseitige Untersuchung der Studierenden, München: zusätzlich Untersuchungen an realen Patienten) anwenden. Evaluationsergebnisse und Begleitstudien bestätigen den Erfolg dieses Konzepts, sodass nun ein Transfer von KliFO auf andere Fakultäten angestrebt wird.

Mit „KliFO – Klinische Fertigkeiten Online“ wurde an den medizinischen Fakultäten der CAU Kiel und der LMU München ein gemeinsames Blended Learning-Konzept zum computergestützten Lernen und praktischen Trainieren von klinischen Untersuchungstechniken für Medizinstudenten entwickelt (http://www.cliso.de). Das didaktische Konzept beinhaltet die standardisierte und Lernziel-bezogene Vermittlung klinischer Untersuchungstechniken und sensomotorischer Fertigkeiten und die Verbindung von typischen Fallbeispielen mit biomedizinischem Hintergrundwissen. Beide beteiligten Fakultäten brachten hierbei ihre speziellen Kompetenzen und Erfahrungen in den Bereichen systematisches (Kiel: Lernplattform Nickels) bzw. fallbasiertes Lernen (München: Lernplattform CASUS® ) ein. Eine Single-Sign-On-Lösung wurde durch Einsatz eines SCORM/AICC-HACP-Protokolles verwirklicht und erlaubt den direkten und gezielten Zugriff auf freigegebene Inhalte beider Lernplattformen und den Austausch der Ergebnisse der Lernzielkontrollen.KliFO wurde in das vorklinische und klinische Curriculum integriert. Evaluationen in beiden Studienabschnitten bestätigen den Erfolg des Ansatzes in inhaltlich-didaktischer und technischer Hinsicht. Ein Transfer des Konzeptes auf andere Fakultäten wird angestrebt.

[english] Introduction: Concept mapping tools have long been established in medical education as an aid for visualizing learning processes in computer-based programs. The case-based learning system CASUS with its mapping tool for visualizing the differential diagnostic reasoning process is an example. It was shown that such tools are well accepted by users and lead to an increased number of diagnostic hypotheses being visualized as maps. However, there is scarce evidence on the quality of user-generated diagnostic hypotheses. This study examines the quality of diagnostic hypotheses obtained with CASUS and whether the quality can be improved through ICD-10 coding as compared with an expert’s solution. Methods: We randomized 192 third-year medical students at the University of Munich into two groups. The students worked in groups of two on one computer. Group A was asked to code their diagnostic hypotheses with an ICD-10 coding browser before entering them into the mapping tool. Group B generated their hypotheses without prior ICD-10 coding. The differential diagnostic reasoning visualizations were analyzed quantitatively and qualitatively. An expert solution was used as reference. Results: Eighty-seven differential diagnoses were evaluated. Group A, using ICD-10 coding, made the correct and precise diagnosis of malaria tropica significantly more often than Group B (p < 0.05). For additional alternative diagnostic hypotheses, no quantitative or qualitative differences were detected. Conclusions: ICD-10 coding in connection with a mapping tool supporting the diagnostic reasoning process improved the accuracy of diagnostic performance in third-year medical students in the case of malaria tropica. [german] Einleitung: Der Einsatz von Concept-Mapping-Tools in computergestützten Lernprogrammen ist in der medizinischen Ausbildung etabliert: Es konnte gezeigt werden, dass diese Werkzeuge zur Visualisierung von Differentialdiagnosen vom Anwender akzeptiert werden und zu einer vermehrten Hypothesenbildung beitragen. Es gibt bisher jedoch wenige Erkenntnisse über die Qualität der dabei vom Anwender erstellten Hypothesen. Die vorliegende Studie untersucht die Qualität der im Netzwerk-Tool im fallbasierten Lernsystem CASUS erstellten Hypothesen und inwieweit diese durch Kodierung mittels ICD10 präzisiert werden können. Methodik: Die Lernenden bearbeiteten zu zweit einen Computerlernfall zum Thema Malaria. Wir randomisierten 192 Teilnehmer der Studie aus dem 3. Studienjahr an der Universität München in zwei Gruppen: Gruppe A wurde gebeten, die erdachten Hypothesen vor der Eingabe in das Netzwerk-Tool mittels eines ICD10-Browsers zu kodieren. Gruppe B erstellte ihre Hypothesen ohne weitere Hilfsmittel. Die Netzwerke wurden quantitativ und qualitativ evaluiert und die Ergebnisse der beiden Gruppen verglichen. Als Referenz diente das von Experten erstellte Netzwerk. Ergebnisse: 87 differentialdiagnostische Netzwerke konnten ausgewertet werden. In Gruppe A mit ICD10-Kodierung der Hypothesen, konnten die Lernenden signifikant häufiger (p

[english] Aims: The new law for medical education (ÄAppO 2002) requires the establishment of at least 98 hours of integrated seminars with inclusion of appropriate clinical subjects. The newly established curriculum committee for the reform of pre-clinical studies (Medicine I) developed a concept for these integrated seminars at Hamburg Medical School. The seminars are taught during the first four semesters every fortnight. Subjects of the seminars are related to other courses taking place at the same time. Important didactic elements of the seminars are multidisciplinarity and case based learning. Other elements are small group work, self- study and short student presentations. Representatives from the different scientific and clinical subjects developed horizontal and vertical connections within Medicine I by planning these seminars.Methods: Integrated seminars were evaluated by the first cohort of students between 2003 and 2005 for quality control. With special instruments seminars were evaluated formatively for each seminar and summatively at the end of every semester. Besides descriptive explanations data were analyzed for systematic connections and differences.Results: Evaluation of the integrated seminars at Hamburg Medical School by students from the first cohort demonstrated high acceptance of the concept. Certain aspects of the course like practical relevance of basic sciences, integration of basic sciences and individual learning progress reached high marks of satisfaction.Conclusion: The integrated seminars at Hamburg Medical School represent a coherent concept for horizontal and vertical connection of scientific and clinical aspects which is well accepted by the students. Evaluation results also indicate possibilities of improvement which will be addressed by modification of individual cases and in the faculty development program.[german] Zielsetzung: Die neue ÄAppO (2002) fordert für den ersten Studienabschnitt (Medizin I) die Einrichtung von mindestens 98 Stunden Integrierter Seminare unter Einbezug geeigneter klinischer Fächer. Das an der Medizinischen Fakultät der Universität Hamburg zur Reform des Studienabschnitts Medizin I eingesetzte Curriculum-Komitee erarbeitete ein Konzept für Integrierte Seminare, die in den ersten vier Semestern in 14-tägigem Rhythmus durchgeführt werden. Die Themen orientieren sich inhaltlich an parallel stattfindenden Unterrichtsveranstaltungen. Wichtige didaktische Elemente der Integrierten Seminare sind Interdisziplinarität und das fallbasierte Lernen. Darüber hinaus prägen die Veranstaltung Kleingruppenarbeit, Selbststudium und Kurzreferate. Vertreter naturwissenschaftlicher und medizinischer Grundlagenfächer sowie klinischer Fächer erarbeiteten durch das Seminar horizontale und vertikale inhaltliche Verknüpfungen im Abschnitt Medizin I.Methodik: Zur Qualitätskontrolle wurden die Integrierten Seminare der ersten Studierendenkohorte von Wintersemester 2003/04 bis Sommersemester 2005 wissenschaftlich begleitet. Anhand spezieller Instrumente wurde die Veranstaltung mit Terminevaluationen formativ und mit Abschlussevaluationen summativ evaluiert. Neben einer deskriptiven Darstellung wurden die Daten auf systematische Zusammenhänge und Unterschiede analysiert.Ergebnisse: Die Evaluation der Integrierten Seminare durch die erste Studierendenkohorte belegt eine große Akzeptanz des Konzepts und eine hohe Zufriedenheit mit zentralen Einzelaspekten der Veranstaltung, z. B. Verdeutlichung der Praxisrelevanz der Grundlagenfächer, Aufzeigen der Vernetzung der Grundlagenfächer und subjektiver Lernerfolg.Schlussfolgerung: Die Integrierten Seminare an der Hamburger Medizinischen Fakultät liefern ein schlüssiges und von den Studierenden akzeptiertes Konzept für horizontale und vertikale inhaltliche Verknüpfungen von Grundlagenfächern mit klinischen Fächern. Außerdem zeigen die Evaluationsergebnisse Verbesserungsmöglichkeiten auf, die u. a. durch Modifikationen einzelner Fallgeschichten und im Faculty-Development-Programm der Fakultät umgesetzt werden können.

[english] A revision of the educational law (ÄAppO) in Germany requires major reorganization of the curricula since 2002. Hamburg Medical Faculty introduced interdisciplinary education into the pre-clinical education integrating case-based and problem-based theoretical knowledge of medical preclinical subjects with practical skills. For this curricular change an independent curriculum committee was established by the faculty board. Reformation was carried out in close cooperation of the departments of medical science and basic science and was accompanied by a central evaluation organized by the office of the vice-dean of education. Curriculum contents were distributed on the basis of an interdisciplinary learning spiral with horizontal and vertical connections of basic and medical science subjects. Basic sciences are strictly focussed on medically relevant topics as required by the new ÄAppO. Case-based learning has become the major focus during "Integrated seminars" where small group discussions, self-studies, essays, and short reports form the basis for modern didactics. Electives are offered on the basis of the research profiles determined by the medical basic sciences. Training of basic medical skills is offered during the course "Introduction to clinical medicine". Students´ parcours through the curriculum are analysed by regular feedback meetings and followed by a computer programme. For better management of information the internet homepage of Hamburg medical faculty was reorganized. Positive results of evaluation and exams confirm a successful reform of the pre-clinical curriculum. [german] Die neue Approbationsordnung für Ärzte (ÄAppO) stellt die Universitäten seit 2002 vor die Aufgabe einer weit reichenden Umstrukturierung des Medizinstudiums. An der Medizinischen Fakultät in Hamburg erfolgte die Einführung einer fächerübergreifenden Ausbildung, die an den medizinischen Grundlagenfächern orientiert fallbasiert und problemorientiert theoretisches Wissen mit praktischen Fertigkeiten für den vorklinischen Studienabschnitt verknüpft. Zur Reform von Medizin I institutionalisierte der Fakultätsrat ein Curriculum-Komitee. Der Reformprozess wurde in enger Kooperation mit Vertretern der medizinischen und naturwissenschaftlichen Grundlagenfächer umgesetzt und wird von einer zentralen Evaluation durch das Prodekanat für Lehre begleitet. Auf Grundlage einer fachübergreifenden Lernspirale mit horizontaler und vertikaler Vernetzung der naturwissenschaftlichen und medizinischen Inhalte wurden die Unterrichtseinheiten nach inhaltlichen und zeitlichen Aspekten neu eingeteilt. Eine strikte Beschränkung der naturwissenschaftlichen Fächer auf medizinisch relevante Inhalte wurde, wie von der ÄAppO vorgeschrieben, umgesetzt. Die vorklinischen Studieninhalte werden in einem horizontal und vertikal vernetzten Kontext, orientiert an den Bausteinen "Grundlagen", "Die Zelle", "Systeme/Organe", gelehrt. Auf der Basis des "Fallbasierten Lernens" bilden in den "Integrierten Seminaren" Kleingruppenarbeit, Selbststudium und Kurzreferate neben Impulsvorträgen eine Grundlage für moderne lerndidaktische Ausbildungskonzepte. Das Wahlfachangebot ist durch das Forschungsprofil der medizinischen Grundlagenfächer geprägt. Das Training basisärztlicher Fertigkeiten findet im Rahmen der "Einführung in die klinische Medizin" statt. Studienverläufe werden durch regelmäßige studentische Feedbackveranstaltungen und ein Computerprogramm analysiert. Die Homepage für die Studierenden wurde zum besseren Informationsmanagement neu gestaltet. Die bislang positiven Evaluations- und Prüfungsergebnisse sprechen für einen erfolgreichen Strukturveränderungsprozess.

The medical faculties at Kiel and Munich University jointly developed the blended learning concept "CliSO - Clinical Skills Online" for computer based and practical training of physical examination skills in undergraduate medical students (http://www.cliso.de). CliSO's didactic concept is based on standardized and learning target 4 oriented mediation of physical examination and sensomotor skills and their association with biomedical basics. Both faculties realized their individual competencies and experiences in systematic (CAU Kiel: Nickels) and case based e-learning (LMU Munich: CASUS®) respectively. Direct and targeted access to contents as well as assessment data was facilitated with single sign on through SCORM/AICC-HACP protocol. CliSO has been integrated into preclinical and clinical curricula. Evaluations in both stages confirm the concept's didactic and technical approach. Transferring CliSO's concept to other faculties seems a justified goal. [ABSTRACT FROM AUTHOR]