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Objective: The purpose of this study was to find applicable clusters for the development of different treatment pathways in an inpatient multimodal pain-therapy setting based on the multifaceted nature of CLBP.Methods: Based on data of questionnaires (Hospital Anxiety and Depression Scale (HADS), Marburg Questionnaire on Habitual Health Findings (MFHW), quality of life assessment using the Short-Form 12 (SF 12)), a retrospective two-step cluster analysis involving a sample of chronic low back pain (CLBP) patients (N=320) was calculated. Subsequently, the clusters were precisely described and compared on the basis of further data collected during the patients' standard care: pain characteristics, socio-demographic data and the general state of health, psychological variables, therapy intensity, and Diagnosis Related Groups (DRG) data.Results: We found a three-cluster solution: little psychological interference but marginal physical and mental quality of life (Cluster 1); poor well-being, low physical quality of life, and marginal mental quality of life (Cluster 2); and heavy mental strain and marginal physical quality of life (Cluster 3).Conclusions: Similar to previous studies, our results suggest that patients suffering from CLBP differ with regard to the magnitude of mental burden and the presence of physical impairment. These differences ascertain the need for precise targeting of treatment for CLBP. Inpatient pain centers therefore should offer different multimodal therapy pathways and integrate a meaningful triage, taking into account the multifaceted nature of CLBP based on sophisticated knowledge about forms, differences, and relationships among the biopsychosocial components of CLBP., Hintergrund: Die vorliegende Studie soll als Grundlage für die gezielte Entwicklung von Cluster-basierten Behandlungspfaden im stationären Therapiesetting mit multimodaler Schmerztherapie für Patienten mit chronischen Rückenschmerzen dienen.Methoden: Basierend auf Daten aus Fragebögen (Hospital Anxiety and Depression Scale (HADS), Marburger Fragebogen zum habituellen Wohlbefinden (MFHW), Messung der Lebensqualität per Short-Form 12 (SF 12)) haben wir retrospektiv eine Two-step-Clusteranalyse unter Einbezug von N=320 Patienten mit chronischen Schmerzen berechnet. Zur anschließenden näheren Beschreibung sowie für Vergleiche zwischen den Clustern wurden Daten verwendet, die im Rahmen der stationären Regelversorgung gewonnen wurden: Schmerzcharakteristika, sozio-demografische Daten sowie Daten zum allgemeinen Gesundheitszustand, psychologische Variablen, Therapieintensität und Diagnosis Related Groups (DRG) Daten.Ergebnisse: Letztendlich wurde eine Lösung mit drei Clustern gefunden: geringe psychische Beeinträchtigung, leichte Auffälligkeiten hinsichtlich körperlicher und mentaler Lebensqualität (Cluster 1); geringes allgemeines Wohlbefinden verbunden mit schlechter physischer Lebensqualität und grenzwertiger mentaler Lebensqualität (Cluster 2); und starke psychische Belastung verbunden mit grenzwertiger physischer Lebensqualität (Cluster 3).Schlussfolgerungen: Ähnlich wie in früheren Studien bestätigt unsere Untersuchung, dass sich Patienten mit chronischen Rückenschmerzen hinsichtlich der psychischen Belastung und ihrer körperlichen Beeinträchtigung durchaus unterscheiden. Eben diese Unterschiede erfordern eine möglichst maßgeschneiderte Therapie für chronische Rückenschmerzen. Im Rahmen der stationären Schmerztherapie sollten daher verschiedene multimodale Behandlungspfade angeboten werden. Die Patienten könnten durch eine einfach gehaltene und gleichzeitig sinnvolle Triage, die die Vielschichtigkeit von chronischen Rückenschmerzen sowie die Unterschiede und Beziehun

In 2009 palliative medicine was integrated into the undergraduate curriculum as cross-disciplinary subject 13 and is now part of mandatory education in German medical faculties (MF). Surveys across German MFs have shown an inhomogeneous development of this cross-disciplinary subject. The aim of this study was to assess the current state and the needs in terms of assessments in the cross-disciplinary subject 13 at German MFs. Palliative care coordinators at German MFs were surveyed by using a standardized telephone interview. Closed-ended questions were analyzed by descriptive analysis and open-ended questions by content analysis. A total of 34 out of 36 MFs participated. Multiple choice tests were the major form of assessment (94.1 %) and 9 MFs planned to implement another form of assessment, mainly an objective structured clinical examination (OSCE) station (55.5 %). The majority of the MFs (91.2 %) had no blueprint to develop assessments but conducted a review (78.8 %) afterwards. A successful implementation of the assessment was mostly achieved when the concept of the assessment was felt to be suitable. The lack of human resources was found to be the most relevant obstacle for the implementation of a practical assessment format. The major form of assessment in palliative care is still a written examination, especially multiple choice tests. This format is considered to be of limited value for assessing communicative competencies and attitudes in palliative medical care. Further steps should include the development of a competence-based assessment that is also feasible for smaller MFs with limited resources.

In 2009 palliative medicine was integrated into the undergraduate curriculum as cross-disciplinary subject 13 and is now part of mandatory education in German medical faculties (MF). Surveys across German MFs have shown an inhomogeneous development of this cross-disciplinary subject. The aim of this study was to assess the current state and the needs in terms of assessments in the cross-disciplinary subject 13 at German MFs. Palliative care coordinators at German MFs were surveyed by using a standardized telephone interview. Closed-ended questions were analyzed by descriptive analysis and open-ended questions by content analysis. A total of 34 out of 36 MFs participated. Multiple choice tests were the major form of assessment (94.1 %) and 9 MFs planned to implement another form of assessment, mainly an objective structured clinical examination (OSCE) station (55.5 %). The majority of the MFs (91.2 %) had no blueprint to develop assessments but conducted a review (78.8 %) afterwards. A successful implementation of the assessment was mostly achieved when the concept of the assessment was felt to be suitable. The lack of human resources was found to be the most relevant obstacle for the implementation of a practical assessment format. The major form of assessment in palliative care is still a written examination, especially multiple choice tests. This format is considered to be of limited value for assessing communicative competencies and attitudes in palliative medical care. Further steps should include the development of a competence-based assessment that is also feasible for smaller MFs with limited resources.

Objective: Simulations of doctor-patient interactions have become a popular method for the training of medical skills, primarily communication skills. A new questionnaire for the measurement of students' satisfaction with medical courses using this technique is presented, the Student Evaluation Scale for Medical Courses with Simulations of the Doctor-Patient Interaction (SES-Sim).Method: A set of items focusing on the course quality and the core elements of simulations was created and presented to 220 medical students who had been trained with this method.Results: Based on factor-analyses 18 items were selected for the final version of the scale, which represent five dimensions: learning success, actors, premises, tutors and students. The five dimensions are all significantly correlated with a 1-item-measure of the general satisfaction with the course.Conclusion: The SES-Sim enables tutors to assess in an economic way whether the course has met the students' needs and what can be done better., Zielsetzung: Simulationen von Arzt-Patient-Interaktionen sind zu einer beliebten Methode für das Training medizinischer Kompetenzen, insbesondere kommunikativer Fähigkeiten, geworden. Ein neuer Fragebogen zur Erfassung der studentischen Zufriedenheit mit Lehrveranstaltungen, in denen diese Methode eingesetzt wird, wird vorgestellt, die Studentische Evaluations-Skala für Lehrveranstaltungen mit Simulationen der Arzt-Patient-Interaktion (SES-Sim).Methodik: Eine Zusammenstellung von Items, die inhaltlich auf die Qualität des Kurses und die zentralen Elemente von Simulationen abzielen, wurde gebildet und 220 Medizinstudierenden vorgelegt, die mit dieser Methode trainiert worden waren.Ergebnisse: Auf der Basis von Faktorenanalysen wurden 18 Items für die Endversion der Skala ausgewählt, die fünf Dimensionen repräsentieren: Lernerfolg, Schauspielpatienten, Räumlichkeiten, Dozenten und Studierende. Die fünf Dimensionen korrelieren alle bedeutsam mit einer 1-Item-Messung der generellen Zufriedenheit mit dem Kurs.Schlussfolgerung: Die SES-Sim ermöglicht es Lehrenden, auf ökonomische Weise einschätzen zu können, ob der Kurs den Bedürfnissen der Studierenden entsprach und was verbessert werden kann.