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Aim: Despite having a generally positive attitude toward vaccinations, medical students show gaps in their own immunization histories and knowledge about vaccinations. Future practicing physicians will be confronted with the need to evaluate protective immunity and make vaccination recommendations. This study aims to investigate the extent to which a seminar on the topic of vaccination can improve students' attitudes, knowledge and practical skills in interpreting vaccination certificates. Project description: Two different one-hour seminars were developed and integrated into the required clinical curriculum. A third of the students attended a theory-based seminar; the other two-thirds completed a predominantly practice-based seminar. The theoretical seminar consisted of a lecture on the principles and theoretical aspects of immunization. In the practical seminar, the curricular content was case-based and taught using fictive examples of vaccination certificates. Before the seminar was held, a voluntary and anonymous survey of the students was conducted regarding their attitudes toward and knowledge of immunization. At the conclusion of the seminar, the students' ability to understand vaccination certificates was tested. After completing the seminar, all of the participants received a link to participate in a voluntary online survey to evaluate the seminar. Results: Of the 149 seminar attendees in the 2017/18 winter semester, 148 participated in the study. Attitude: Students have a positive attitude toward vaccinations. Regardless of the type of seminar attended, the agreement with statements on vaccination could be significantly increased primarily among students who already at the start of the seminar expressed a high degree of agreement. Students vaccinated against influenza showed significantly stronger agreement than unvaccinated students. Knowledge: Regardless of teaching format, students' knowledge about vaccination topics could be increased. For those vaccinated against influenza, the mean value for agreement with the statement, "The vaccination of healthcare workers prevents nosocomial transmission of diseases," saw an increase on a five-point Likert scale from 3.97 to 4.4 (p<0.001; R=0.67). For the unvaccinated students, the mean value rose from 4.04 to 4.19 (p=0.06; R=0.29). Practical skills: The students who attended the theory-based seminar tended to score higher on interpreting vaccination certificates than those who attended the practical seminar; however, this difference was not statistically significant. Seminar evaluation: The online evaluation was completed by 18% of the participants. The theoretical seminar received the grade of 2.9 based on the conventional German academic grading scale; the practical seminar received 1.9. This difference is statistically significant (p=0.02). Conclusion: Precisely for skeptical students it was only possible to minimally change existing views with a seminar that offers very brief instruction. Attendees of the theoretical seminar tended to score somewhat higher on interpreting vaccination certificates than those who took the practical seminar. The practical seminar was rated significantly better on the course evaluation than the theoretical one. The advantage that the students attending the theoretical seminar had can be explained best by the structured review of the current vaccination recommendations as part of the seminar, which should, as a consequence, be integrated into the practical seminar., Competing Interests: Sabine Wicker is a member of the Standing Committee on Vaccination. The authors declare that there are no financial or economic conflicts of interest., (Copyright © 2020 Rill et al.)

The multimodal concept of Patient Blood Management touches many aspects of in-hospital treatment. The goals are to preserve and strengthen the patients' own resources in order to avoid transfusion-associated adverse events. This can be achieved by meticulous minimization of perioperative blood loss and the enhancement and full utilization of individual anaemia tolerance. The transfusion of allogeneic blood products shall be guideline-based only. The proposed package of measures has immense potential to increase patient safety!, (© Georg Thieme Verlag Stuttgart · New York.)

Preoperative anaemia is an independent risk factor for an increase in perioperative morbidity and mortality. Patient Blood Management (PBM) aims for an early detection of anaemia in elective surgery patients. Reasons for anaemia should be detected and causally treated if possible. A multidisciplinary team of specialists aims for diagnosis and causative treatment of easily treatable and frequent causes of anaemia like iron deficiency, bleeding or (autoimmune) haemolysis using patients' specific history, examination, laboratory and technical methods. Such an outpatient PBM programme is only feasible, if anaesthesiologists, surgeons, haematologists, gastroenterologists, gynecologists, laboratory and transfusion medicine specialists work together in a PBM team using a common PBM plan. Communication within this team as well as with the patients' physicians in their private offices is key for a long lasting success of such a PBM programme., (© Georg Thieme Verlag Stuttgart · New York.)