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Copyright of Wiener Medizinische Wochenschrift is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background A new competency-based blended-learning Family Medicine curriculum was implemented at Saarland University in 2020. Based on self-determination theory, this study aims to measure and compare the motivation of medical students to study within medical school in general and within the Family Medicine curriculum. Methods This explorative study consists of two quantitative questionnaires that were given to one cohort of medical students in a time interval of two months. The first questionnaire focuses on motivation to study medicine in general and the second questionnaire focuses on students' motivation regarding the Family Medicine curriculum at Saarland University. Students' motivation was compared between both settings. Separately, sociodemographic background, self-efficacy, perceived competence and perceived autonomy were correlated to autonomous motivation to figure out specific motivators for Family Medicine education. Results Out of 92 students enrolled during the winter semester 2020/21, 86 students participated in the first and 55 students participated in the second survey. Students showed higher scores of autonomous motivation for medical school in general compared to the Family Medicine curriculum (p = 0.015). For Family Medicine perceived competence showed a strong correlation with autonomous motivation (p < 0.001). Conclusions Students' motivational setup towards medical school differs from their motivational setup towards the individual Family Medicine subject. Perceived competence of students appears to play an important role in fostering autonomous motivation for Family Medicine as a subject. Competency-based medical education in Family Medicine might be an option to purposefully foster perceived competence in medical students. This might align well with the changes suggested by the National Competency-Based Learning Outcome Catalogue for Medicine. [ABSTRACT FROM AUTHOR]

Background: Coding diagnoses is part of a physician's daily routine. Good coding quality has several functions; it is, for example, the basis for the remuneration of contract doctors. In the field of general medicine, this process can, however, pose a particular challenge, as diagnoses are naturally more often excluded than made. In addition, the process of diagnosing informs treatment., Methods: 23 semi-structured interviews were conducted with general practitioners from Schleswig-Holstein. The interviews were recorded with a dictaphone, pseudonymized, transcribed and then analyzed by content analysis according to Mayring., Results: 87 % (N = 20) of the participants were male, the mean age was 57 years, and the mean duration of work experience was 23 years. The ICD-10 (International Classification of Diseases) coding system was often criticized for not representing general medical practice and placing an increased administrative and time burden on physicians. At the same time, diagnostic pressure from external economic interests was perceived. Specifications of practice management systems or their additional programming options were used, among other things, to search for a code. Particular challenges arose in this context, e.g., complex clinical pictures and lack of time. Prescriptions without indication, among other things, have been made at the request of patients, due to a lack of time and concerns about doctor switching. In these cases, a diagnosis in the ICD-10 code that justified the therapy was sometimes used., Conclusions: The path leading from clinical findings to therapy and finally to the appropriate diagnostic code is a complex one, and it involves various influencing factors, including non-medical factors. These influencing factors must be taken into account in future secondary data analyses. The ICD-10 is not the ideal choice for mapping these processes in general medicine., (Copyright © 2024. Published by Elsevier GmbH.)

Introduction: Starting in 2013, a five-year, competence-based postgraduate programme, the "Seminartage Weiterbildung Allgemeinmedizin" (SemiWAM®) for continuing education in general practice, was developed and offered in Bavaria. This evaluation reports on the experiences of SemiWAM® after a first cycle. Material and methods: Process reflection based on the cycle of Kern: In addition to qualitative findings, results of the evaluation forms (mean values with standard deviation) are presented. The evaluation form contained questions on organisational issues, content of presentation, didactic preparation of the supervisor, transfer to real life practice as well as demographic variables. All questions were voted on a six-point Likert scale from "1=very satisfied" to "6=very dissatisfied". Results: The reflection showed three crucial entry points: Choosing "reason for encounter" as a content precondition to ensure target audience needs, the close didactic supervision of supervisor, and the continuous growth of supervisor team with newly qualified GP. The evaluation results for the overall assessment (MW 1.11-1.60), the didactic concept (MW 1.30-1.87), as well as the transfer into daily life practice (MW 1.48-2.35) reflect the high quality of the SemiWAM®. Discussion: The SemiWAM® curriculum presented can be easily transferred to comparable structures in Germany that accompany specialty training, such as the competence centres for residency training in general practice. The process evaluation based on the core cycle also provides important support for the agile implementation of these or similar programmes. [ABSTRACT FROM AUTHOR]

Background: 2020 was the year with the most cases of early tick-borne encephalitis (TBE) in Germany. The number of cases fluctuates annually, mainly depending on the weather. Because it is a poten tially serious and sometimes fatal disease, individuals exposed to ticks should be informed about the possibility of disease prevention through active vaccination. Search Methods: Pragmatic search (no language limit) in divers data banks. Main messages: The risk of disease after tick bite cannot be reliably calculated due to the high variability of tick infection rates with TBE virus and the lack of prospective studies on clinical manifestation rates. In individual cases, a single tick bite is sufficient to cause severe illness and to impair the quality of life in the long term or permanently. Causal treatment options are not available. Conclusions: Vaccination against TBE is generally well tolerated and offers a high level of protection against the corresponding disease. The indication for immunization is based on the risk of tick exposure, and the benefit is individual only for the vaccinated persons. [ABSTRACT FROM AUTHOR]

Background: Digital health applications (DiGA) can be reimbursed by the statutory health insurance as an „app on prescription" since the Digital Health Care Act (DVG) came into force. Currently, it is unclear how family physicians should be actively involved in the use of DiGAs in order to increase the health literacy of their patients, but at the same time ensure a long-term doctor-patient relationship. The aim of this work was to assess the involvement of GPs in the use of DiGAs based on publicly available information. Methods: We performed a descriptive analysis of cross-sectional data available from the DiGA directory as of 19th of October 2021. We extracted information on the apps, as well as their respective indication and intervention. We also investigated the involvement of family physicians in the use of DiGAs. Results: At the time of the evaluation, 24 DiGAs were included in the register. Available DiGAs offered a wide range of indications with a focus on mental illnesses. The role of the DiGAs were mainly complementary to existing treatment and in the majority of cases designed to be used independently by the patients. Conclusions: DiGAs have the potential to strengthen the resources of patients, but can influence the doctor-patient relationship. Advantages and disadvantages of the different roles of the practitioners should be taken into account when using specific DiGAs in patient care. [ABSTRACT FROM AUTHOR]

Objectives: The extent of university teaching in general practice is increasing and is in part realised with attachments in resident general practices. The selection and quality management of these teaching practices pose challenges for general practice institutes; appropriate instruments are required. The question of the present study is whether the student evaluation of an attachment in previously poorly evaluated practices improves after teaching physicians have received feedback from a colleague. Methods: Students in study years 1, 2, 3 and 5 evaluated their experiences in general practice attachments with two 4-point items (professional competence and recommendation for other students). Particularly poorly evaluated teaching practices were identified. A practising physician with experience in teaching and research conducted a personal feedback of the evaluation results with these (peer feedback), mainly in the form of individual discussions in the practice (peer visit). After this intervention, further attachments took place in these practices. The influence of the intervention (pre/post) on student evaluations was calculated in generalised estimating equations (cluster variable practice). Results: Of 264 teaching practices, 83 had a suboptimal rating. Of these, 27 practices with particularly negative ratings were selected for the intervention, of which 24 got the intervention so far. There were no post-evaluations for 5 of these practices, so that data from 19 practices (n=9 male teaching physicians, n=10 female teaching physicians) were included in the present evaluation. The evaluations of these practices were significantly more positive after the intervention (by n=78 students) than before (by n=82 students): odds ratio 1.20 (95% confidence interval 1.10-1.31; p<.001). Conclusion: The results suggest that university institutes of general practice can improve student evaluation of their teaching practices via individual collegial feedback. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, psychotrauma and its potential sequelae, such as posttraumatic stress disorder (PTSD), are of increased concern to family medicine. Trauma exposure and PTSD both increase the risks of a broad range of physical diseases. The knowledge of these diseases supports targeted prevention and early diagnosis. This paper provides a brief overview of diseases associated with psychotrauma and PTSD. The identified diseases include inadequate immune response, infectious diseases, dermatoses, cardiovascular and pulmonary diseases, cancer, metabolic dysfunction, traumatic brain injury, pain disorders, and musculoskeletal, gastrointestinal, and urogenital disorders. Various possible relationships between trauma exposure, PTSD, and somatic disorders are highlighted. Not only can trauma exposure and PTSD increase the risk for or be a consequence of illnesses, but also affect the course of sequelae or comorbid diseases and their treatment. Family physicians play an essential role in the health care of patients with traumatic experiences or PTSD. Knowledge of the associations between trauma exposure, PTSD, and somatic diseases can facilitate targeted prevention of somatic diseases, early diagnosis, and structured treatment planning for multimorbid patients. [ABSTRACT FROM AUTHOR]

Background: One of the aims of the German student selection network (Studierendenauswahl-Verbund, stav) is to review existing procedures for selecting medical students and to relate their effectiveness to students' career aspirations as well as to their further careers. Against the background of changes in the selection procedures and the introduction of the rural doctor quota (Landarztquote), the study conducted here aims at contributing to the current discussion on the future of GP (general practitioners) care, especially in rural areas. Methods: In 2019 and 2020, the stav conducted a German nationwide online survey among medical students towards the end of their "Practical Year" (Praktisches Jahr, final-year medical students in practical training). The associations between selection parameters and students' interest in later working as a GP as well as students' preference to later work in a place with a low population density were investigated. Furthermore, socio-demographic variables and variables related to medical studies were taken into account. Statistical comparisons were carried out using Chi2- and Mann-Whitney U tests. Results: A total of 1,055 students in their Practical Year (65.4% female, 27 years) completed the survey. As their final professional position, 12.1% aspired to own a GP practice or work as employed GP after completing medical specialist training in general medicine (interested students: 9.9%) or general internal medicine (interested students: 9.5%). Compared to their fellow students, those interested in working as a GP had been more often admitted to medical school via the waiting time quota and had more often already completed vocational training in a medical-related field. 39.1% of those interested in working as a GP wanted to work in a place with a low population density. Coming from a place with a low population density as well as completing the medical internship (Famulatur) for GP care in such a place turned out to be positive influencing factors. Discussion: The observed associations between waiting time quota and interest in working as a GP as well as between origin from a place with a low population density and preferring to later work in such a place go hand in hand with changes in the access regulations for medical studies, which concern both the waiting time quota (abolition of the latter) and a regulation of the number of rural doctors (rural doctor quota). In order to evaluate the current changes in the access regulations for medical studies, longitudinal studies are desirable that cover the time from the application to study up to the medical specialist examination and further career. [ABSTRACT FROM AUTHOR]

We are on the threshold of an electronic patient file being introduced in Germany. At the same time, we are already encountering challenges in integrating image files from our ultrasound equipment into our own practice information system (PIS). Part of the challenges is caused by a lack of technical knowledge that is helpful for a deeper understanding and by the terminology used in this context. Taking into account the intended standardization of interfaces in the medical environment of a general practice, such as by the National Association of Statutory Health Insurance Physicians (Kassenärztliche Bundesvereinigung) or Gematik, this article aims to present the terminology for the necessary network components of a practice, so that it is possible to speak more at eye level with the diverse service providers in this area. [ABSTRACT FROM AUTHOR]

Background Family physicians largely ensure end of life care for elderly people. The present study examines how using a structured decision aid might support family physicians in identifying palliative needs and which palliative interventions they initiate. Methods Within an explorative intervention study, the German version of the Supportive and Palliative Care Indicators Tool (SPICTDE™) was applied by family physicians. By using SPICT-DE™ family physicians estimated to what extent older patients (70+) with chronic progressive diseases might benefit from palliative care and decided which palliative interventions seem reasonable (t0). A revaluation on patients and initiated interventions was conducted after 6 months (t1). In addition, family physicians were asked about their experiences using SPICTDETM. The data were analysed descriptively. Results 13 family physicians participated in the study. Between February and August 2019 they identified palliative needs in 111 patients (61 women; median age 83 years, 70 to 96 years). The majority were patients with non-malignant diseases (87 %). According to the family physicians' assessment, it was particularly important to examine the drug and non-drug therapy and to clarify patients' and their relatives? support needs (t0). After 6 months (t1), primarily an examination of therapy was reported. The family physicians evaluated SPICT-DE™ positively and emphasised the clear structure and ease of use. Conclusions A structured decision aid (SPICT-DE™) can support family physicians to identify older patients in palliative situations at an early stage, to initiate palliative interventions and to manage end-of-life care proactively. [ABSTRACT FROM AUTHOR]

Background In order to strengthen the coordination by family physicians, a copayment was introduced in 2004. Due to a perceived lack of efficacy in comparison to high bureaucratic efforts, this copayment was abolished in 2012. This paper is a summary of the most relevant results of two internationally published articles that analysed the change of coordination after the abolition of the copayment. Methods A retrospective analysis of anonymized claims data of the Bavarian Association of Statutory Health Insurance Physicians from 2011-2016 (2011/2012 with, 2013-2016 without copayment). The analysis included all statutory health insurance with a minimum age of 18 years and with residential address in Bavaria. A patient was considered to be 'coordinated' if every ambulatory specialist contact within a quarter occurred as a result of a family physicians' referral. Results After the abolition, there was a substantial decrease in coordinated primary care in Bavaria, from 49.6 % (2011) to 15.5 % (2016). Comparing regional characteristics, urban areas showed higher decreases than rural areas. In terms of morbidity, the proportions of chronic and mental diseases increased in the group of uncoordinated patients. Conclusions The results suggest that the copayment was a partly effective instrument to support coordinated primary care. After the abolition, alternative approaches are required to support coordinated primary care by family physicians. [ABSTRACT FROM AUTHOR]

Since 2014 the 'Koordinierungsstelle Allgemeinmedizin (KoStA)' has performed one-day courses - called SemiWAM® - for postgraduate education. The topics of the courses follow a five-year curriculum, which is linked to the Competence-Based Curriculum Family Practice of DEGAM (German College of General Practitioners and Family Physicians). From 2017 on, the 'Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB)', a Bavarian residency training scheme, provides the SemiWAM®. This paper reports the teaching concept and shows the working result of the course "Stomach pain as a reason for consulting a doctor" in 2016. Participants developed a clinical guideline how to manage patients with stomach pain in family practice. Participants evaluated the course with high grades in matters of practical feasibility. This contribution should foster the discussion on postgraduate education. [ABSTRACT FROM AUTHOR]

Objective: A competency-based training of medical students that is adapted to the realities of care is required internationally and is being intended in Germany with the Master Plan for Medical Studies 2020. In order to test these competencies, the German National Institute for state examinations in Medicine, Pharmacy and Psychotherapy (IMPP) has developed a concept for the redesign of the final part of the medical licensing examination in Germany. It focuses on general and interprofessional healthcare in the examination with outpatients. The aim of this work is to assess the feasibility of the new final examination on the basis of pilot examinations in family practices and to derive further steps for the national implementation. Methods: Fourteen medical students in their internship year completed a full examination with patients aged 42 to 84 years. Examiners evaluated the examination performance using standardised evaluation forms. Feasibility was qualitatively assessed in terms of compliance with content and time limits, examination results, patient reflections, and implementation in the practice. Results: Students were able to complete all tasks within the given time frame. Based on the evaluation forms, the examiners assessed the performance of the students. Patients appreciated the structured course of the examination in the familiar location of their family practice. For the nationwide implementation of the examination, 2,500 examination practices are required for about 10,000 examinees per year. Four students can then be examined on two days per year in each practice. Conclusions: Oral-practical examinations with outpatients in general medical practices can be carried out successfully throughout the nation. An implementation of the examinations throughout Germany requires that medical studies are restructured and that this new curriculum is implemented as intended by the Master Plan for Medical Studies 2020. Furthermore, training and remuneration of examiners together with a legal framework for the new examination must be established. [ABSTRACT FROM AUTHOR]

Background* In Germany, 5 % of the population is suffering from Asthma which is, alongside COPD, the most common chronic respiratory disease encountered in family medicine and the most common chronic disease in pediatric practice. Search methods This continuing educational article is based on the National Disease Guideline for Asthma and the addendum of 2020, which are supplemented by findings from special investigations and past publications by the author who is an expert for respiratory diseases working in family medicine. Key messages Based on a careful medical history and considering a thoughtful differential diagnosis, the diagnosis for asthma can be established in a relatively safe manner and confirmed by pulmonary function testing including a bronchodilator test. Alternatively, and in exceptional cases, peak-flow measurement and/or the measuring of exhaled nitrogen oxide can be helpful. First and foremost, the therapy consists of an inhalation of a corticosteroid taken alone or in combination with a long-acting betaagonist. This anti-inflammatory therapy is able to prevent a remodeling, i.e., the destruction of the mucous membrane, a thickening of the basal membrane or a hypertrophy of the bronchial muscles and the development of a functional obstruction. In case of an insufficient effect, long-acting muscarinic antagonists or leukotriene antagonists can be added; also, if necessary, biologicals can be contemplated. A long-term treatment with oral corticosteroids should be avoided, if possible. Conclusions Given an early diagnosis and correct treatment, the vast majority of asthmatics can lead a life without symptoms or, at worst, experience temporary mild symptoms. A prerequisite is a sufficiently assessed anti-inflammatory therapy, which must be regularly adapted to the current severity and which the patient carries out regularly and correctly. [ABSTRACT FROM AUTHOR]

Background The Competence Center for Residency Training in Family Medicine in Bavaria introduced a one-to-one mentoring in 2019. For this purpose, family physicians from all over Bavaria were recruited and trained as mentors. In addition to „giving feedback“, „dealing with critical situations in a general practitioner's work routine“ was a major topic of the training. This article describes the structure, content, and evaluation results of the training course. Methods Trainings were held in presence at four Bavarian Family Medicine University Departments and immediately evaluated anonymously in written form using EvaSys®. The questionnaire was designed by the head of the LMU's Evaluation and Teaching Qualification Working Group and was based on questionnaires used in teaching, supplemented by the special aspects of the mentoring programme. The evaluation covered content-related aspects and the overall assessment of the event (6 closed, 6 open questions) and was analysed descriptively by two authors. Free texts were thematically clustered using main and subcategories. Results In 2019, four training sessions were held with a total of 48 mentors, 43 completely filled in the evaluation forms. The majority of mentors are male, between 50 and 60 years old, and work in rural practices. Participants assessed both format and content of the training very positively. Over 90 % of mentors were „satisfied“ or „very satisfied“ with the contents and presentations provided. The module on ethical decision-making was rated as particularly relevant and the overall appreciative and open character of the event was highlighted. Conclusions Both participants and organizers were very motivated and benefited greatly from their collegial exchange. Slightly modified, the training has been converted to an online format. [ABSTRACT FROM AUTHOR]

Core principles of family medicine include continuity of care and long-lasting doctor patient relationships whereas the younger generation seeks for work-family balance as well as work-life balance. This results in limited working time and thus in an area of conflict. The aim of this report is to find solution-oriented approaches to secure high quality of care in family medicine in face of part-time work. Methods We conducted a workshop with the above mentioned objective at the DEGAM congress. With two working groups, one gathered best practice models in a moderated group exercise, the other conducted a SWOT analysis of part-time work. The results were collected, notecards were fixed on a pin board and discussed in the plenum. Results Of the 18 participants (n = 14 female) n = 10 were physicians (n = 7 family physicians) and n = 6 medical students. Besides the balancing of family and work itself the SWOT analysis recognized the compatibility with scientific work and a higher degree of satisfaction as strengths, due to more diverse fields of activity. Other strengths with regards to quality of patient care included an integrated second opinion and more patience. Weaknesses included the increasing lack of physicians, the loss of information and a decline in continuity were mentioned as well. Examples of best practice models included the distribution of working time to a least two days a week, appointment-based office hours or the accessibility of part-time workers out of official working-time. Conclusions The results could serve as an impulse to integrate the themes work-family balance and work-life balance in the further development of the DEGAM future positions. The search for successful working models in family medicine needs to be enhanced. [ABSTRACT FROM AUTHOR]

Background New antihyperglycemic agents have expanded therapeutic options for the treatment of diabetes. At the same time, routine data point to overdiagnosis and overtreatment. The last national recommendations for diagnosis and therapy of type 2 diabetes (NVL-Diabetes) were from 2013 and needed revision. Search Methods The main results of the updated German National Guideline for Type 2 Diabetes are presented. Background is a systematic evidence review conducted by the Medical Center for Quality. Main Messages 1. The NVL recommends metformin as the first-line blood glucose-lowering drug. 2. Two new substance groups, SGLT2 inhibitors and GLP-1 analogues, are given their own status. 3. Incompatible points of view between the individual professional societies are no longer presented side by side, but are explained by the professional societies elsewhere. 4. The DEGAM user version recommends the combination with glibenclamide in cardiovascular healthy patients. 5. DPP4 inhibitors and insulin analogues should be used only in a few exceptional situations. 6. Empagliflozin and liraglutide are recommended in cardiovascular pre-disease patients when the individual HbA1c target is not achieved. Conclusions The new German National Guideline on Diabetes and especially the DEGAM user version provide an opportunity to reduce overuse, underuse and misuse. [ABSTRACT FROM AUTHOR]

Background Previous pandemics such as SARS in 2002 revealed an especially high psychological burden of frontline healthcare professionals in hospitals directly involved in the treatment of confirmed cases. As family physicians are among the first exposed to the SARS-CoV-2 virus, assessing their psychological burden and needs for support is important. Methods A web-based survey was distributed among family physicians of a German university teaching practice network. The questionnaire consisted of validated instruments to evaluate symptoms of psychological distress, i.e., the patient health questionnaire (PHQ-9), generalized anxiety disorder 7 (GAD-7), peritraumatic distress inventory (PDI), and insomnia severity index (ISI). Additional self-developed items addressed sociodemographic and professional characteristics including professional duties and protective equipment available. Effects between the symptoms were examined using bivariate Pearson correlation. Results The participation rate was 31 % (36 of 116) with 33 valid cases. About 47 % (n = 17) of the respondents were 56 years old or more. 66.7 % (n = 22) physicians reported moderate to severe depressive symptoms (PHQ-9 ≥ 10) and 51.5 % (n = 17) moderate to severe signs of anxiety (GAD-7 ≥ 10). Physicians with depressive symptoms showed more signs of anxiety (p < .001) and insomnia (p < .001). There is a negative correlation between age and severity of depressive symptoms (p = .041) and insomnia (p = .002). The regression analysis showed that younger participants were more likely to show depressive symptoms (β = -.358, p = .046), even after correcting for gender (R2 = .402). Conclusions Depressive symptoms were frequent among family physicians, especially in younger physicians who were also more likely to report symptoms of insomnia. The symptoms of psychological distress are unlikely to be explained by a lack of protective equipment, because the majority had sufficient supplies. [ABSTRACT FROM AUTHOR]

Copyright of Zeitschrift für Gerontologie und Geriatrie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Type 2 diabetes is frequently diagnosed in Germany with a prevalence of over 7 %, although there are indications of a declining incidence. The majority of people with diabetes who are cared for by family doctors are over 65 years old, and one third of those affected are over 75 years old. New antihyperglycemic agents have expanded therapeutic options. At the same time, routine data point to overdiagnosis and overtreatment. The last national recommendations for diagnosis and therapy of type 2 diabetes (NVL-Diabetes) were from 2013 and needed revision. Search Methods The main results of the updated German National Guideline for Type 2 Diabetes are presented. Background is a systematic evidence review conducted by the Medical Center for Quality. Main Messages The NVL emphasizes the following points in particular: 1) regardless of laboratory values, the reality of the patient's life should be included in decisions on antihyperglycemic therapy. 2) In certain situations, a de-escalation of therapy should be considered. 3) A HbA1c corridor between 6.5 and 8.5 % is recommended. Points of view not compatible between the different scientific societies are no longer presented side by side - as in the previous version from 2013 - but are specified and explained by the professional societies in additional user versions. 4) The DEGAM user version recommends lowering HbA1c with medication only to 7.0-8.0 %; in people over 70 years of age, values should not permanently exceed 8.5 %. In contrast, DEGAM recommends a drug-induced HbA1c reduction only to 7.0-8.0 %, and not permanently above 8.5 % in those over 70 years of age. Conclusions The new German National Guideline on Diabetes and especially the DEGAM user version provide an opportunity to reduce overuse, underuse and misuse. [ABSTRACT FROM AUTHOR]

Background Like almost all courses at higher education institutions in Germany, family medicine teaching had to be switched to online learning formats from the summer semester of 2020 on due to the SARS-CoV-2 pandemic. At Lübeck University, these formats consisted of web-seminars, digital learning material, homework assignments and, from the winter semester of 2020/21 on, practice seminars in very small groups. These formats are now evaluated and adjusted for the following, still pandemicinfluenced, semesters. We aim to provide adequate family medicine teaching under special circumstances. Methods Via the semester evaluations of both semesters, supplemented by questions regarding the digital teaching, we collected feedback from the students and analyzed it. Additionally, we analyzed field reports from the teachers (collected in team meetings) and data on the usage behavior of students on a family medicine knowledge platform. Results Teachers reported a mostly trouble-free realization of digital teaching. The overall rating of the semester evaluation remained unchanged when compared to the previous year's figure. Most of the students perceived the digital teaching to be an adequate substitute for the traditional in-person teaching considering the circumstances. Practical aspects and personal interactions were missed the most in the summer semester of 2020 and were especially valued in the winter semester of 2020/21. The recommended knowledge platform was used actively by a high proportion of the students. Conclusions Parts of the family medicine syllabus could be taught digitally without significant problems. Recommended digital learning material was used specifically. For the teaching and assessment of higher-level learning objectives, inter alia, practical skills, the in-person teaching is still a necessary requirement. [ABSTRACT FROM AUTHOR]

Digital tools enable practical patient-based family medicine training for students without constituting the risk of a SARSCoV-2 infection. This has been tested in a preparatory remote internship. Over a period of four months, we provided practical training in which a student accompanied virtual consultations as well as theoretical lessons. This paper describes details and examples of the implementation and gained competencies among teachers and students. In addition, the limitations of telemedical education and the restricted possibilities compared to face-to-face teaching are reported. The remote internship in family medicine is presented here as a model which could be used and improved in the future. [ABSTRACT FROM AUTHOR]

Hintergrund Train-the-Trainer-Seminare (TtT-Seminare) für Weiterbildungsbefugte (WBB) sind Bestandteile der nach § 75 SGB V eingerichteten Kompetenzzentren Weiterbildung Allgemeinmedizin (KW). Ziele der vorliegenden Studie waren die Analyse der bestehenden TtT-Angebote in Deutschland und die darauf aufbauende Überarbeitung der Checkliste TtT der Sektion Weiterbildung der DEGAM. Methoden In einer interprofessionellen Arbeitsgruppe wurde ein an der Checkliste TtT (Version 1, 2017) orientierter, strukturierter Interviewleitfaden konzipiert, konsentiert und mit zwei Testinterviews pilotiert. Über vier Monate (1.3.-30.6.2019) wurden alle KW mehrfach via E-Mail und telefonisch zur Teilnahme eingeladen. Die Auswertung der Ergebnisse der Befragung erfolgte deskriptiv und wurde durch Vertreter*innen der KW auf dem Jahreskongress der DEGAM inhaltlich bestätigt. Ergebnisse 15 von 16 KW (94 %) nahmen an der Befragung teil. An 13 KW (81 %) sind TtT-Seminare implementiert. 2018 starteten acht (53 %) KW mit dem Angebot, drei KW (20 %) führten schon vor 2017 Seminare durch. Die Zahl der Durchführungsorte schwankte von eins bis sieben, die Anzahl der bisherigen Seminare zwischen eins und 17. Die maximale Teilnahmezahl variierte von 12-40. Zusätzlich zu WBB der Allgemeinmedizin ermöglichten elf KW (78 %) WBB anderer Gebiete die Teilnahme. Die Dozierendenteams waren interdisziplinär zusammengesetzt. Die Checkliste TtT wurde unter Beteiligung von 13 KW angepasst und im Dezember 2019 konsentiert. Schlussfolgerungen Die meisten KW boten im Befragungszeitraum TtT-Programme an, die Inhalte orientieren sich an der Checkliste TtT. Die didaktische Ausgestaltung und der zeitl. Umfang der Seminare sind heterogen. Die Implementierung von TtT-Seminaren in den KW Allgemeinmedizin ist erfolgreich umgesetzt. Die überarbeitete DEGAM-Checkliste TtT kann zur Sicherstellung von Mindeststandards genutzt werden. Der nächste Schritt ist die Anbindung der WBB durch eine breite Implementierung von TtT-Folgetreffen. Background Train the Trainer (TtT)-courses for trainers in family medicine (TFM) form a mandatory component of German competence centers for post-graduate medical education (CC) in regard to legal requirements. Aims of this study were to analyse the current status of TtTcourses in Germany and to revise the TtT-checklist of the German College of General Practitioners and Family Physicians. Methods An interprofessional working group developed a structured interview-guideline which incorporated items of the TtT checklist (version no. 1, 2017). After group consensus, it was piloted in two test-interviews. In between four months (March 1st-June 30th 2019) all CC were invited to participate, multiple times via e-mail and telephone. Data was analysed descriptively by an interprofessional team and validated during the annual meeting of the German College of General Practitioners and Family Physicians. Results 15 of 16 CC participated in the study (response rate 94 %). 81 % (n = 13) of CC offered TtT-courses. 53 % (n = 8) had initiated TtT-courses in 2018, 20 % (n = 3) had started previously. Locations of regional TtT-courses varied from one to seven per CC. Experience differed from one up to 17 TtTcourses performed. The range of attendants was from twelve to 40. 78 % (n = 11) offered the courses to TFM as well as of other specialties. Lecturers mainly operated interprofessional. Checklist TtT was adopted and revised by the help of 13 CC and consensus was found in December 2019. Conclusions At time of the study, the majority of CC offered TtT-courses, predominantly in accordance with the TtT-checklist. Length of time as well as teaching techniques of TtT-courses differed in between the CC. In summary, implementation of TtT-courses in CC for family medicine has been completed. The revised TtT-checklist could proof useful to ensure minimum standard. The next steps include stable integration of TFM by broad implementation of iterative TtT-courses. [ABSTRACT FROM AUTHOR]

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Digitization is capturing all parts of social life. The use of digital, social, and mobile technologies (DSMT) in daily routine is obvious, including the professional aspects as a physician. This paper presents a narrative description of four typical milestones in a physicians' biography (clerkship, internship, vocational training and continuing medical education). Within these four scenarios, we describe situations of daily practice in which DSMT is used. The manuscript is not comprehensive, nor do the descriptions aim to cover all aspects of DSMT. However, usage of DSMT is present at all timepoints of professional life but appears random and unsystematic with no critical appraisal of selection and quality of sources. We aim to develop recommendations for evidence-based usage of DSMT in family practice. This article should stimulate the discussion on future concepts to embed DSMT in professional education and health care. [ABSTRACT FROM AUTHOR]

Background Fever is one of the most common acute presenting complaints in infancy and childhood in primary medical care. A pragmatic approach to the diagnosis, therapy and education of parents is therefore indispensable in daily family practice. This article provides instructions for action on the basis of an up-to-date literature research. Search methods Pragmatic search in the database Pubmed (with the language filters set to English and German) under the keywords „pediatric fever" „management" „< 18years of age". Articles relevant to the outpatient setting were taken into account if they aimed at the care of otherwise healthy infants older than three months and infants. Main messages The task of a family physician when examining a feverish child is to detect any serious illness, avertable dangerous courses of disease, to identify the most probable cause of the fever, and to initiate treatment or referral/hospitalization. The indications for the use of antibiotics and antipyretics should be weighed critically. Furthermore, providing parents with sufficient information about the underlying disease and the symptom „fever" is important in order to reduce anxiety and prevent excessive drug use. Conclusions Primary care of the feverish child is daily routine in many family practices. The main causes of fever are usually self-limiting viral or focal bacterial infections. Severe, life-threatening infectious diseases have become rare in recent decades due to modern vaccines. Extensive and expensive diagnostics are almost never necessary. It is very important to involve and educate the parents about the care provided. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the study was to explore the subjective views of general practitioners on the applicability of the Adult ADHD Self-Report Screening Scale for DSM-5 (ASRS-5) as a screening tool for attention-deficit/hyperactivity disorder (ADHD) in adults in general practice., Method: Eleven general practitioners, who had participated in the validation study of the German version of the ASRS-5, were interviewed. For this purpose, a semi-structured interview guide was designed using the Consolidated Framework for Implementation Research (CFIR). The interviews were audio-recorded, transcribed, and analyzed using qualitative content analysis according to Kuckartz., Results: The ASRS-5 seems to work well in general medical practice. But there is evidence for a lack of knowledge about ADHD in adults among general practitioners and a demand for further training in this area. Moreover, insufficient possibilities for subsequent treatment after a positive ADHD screening were claimed., Discussion: In general medicine, the introduction of a screening using ASRS-5 in cases of clinical suspicion could be the first step towards improving the management of adult patients with ADHD., Conclusion: Optimizing the management of adults with ADHD requires additional information and training initiatives to support early diagnosis especially in the primary care setting, and to reveal treatment options and care concepts for adults with ADHD., (Copyright © 2024. Published by Elsevier GmbH.)

Aim: The Masterplan Medizinstudium 2020 (Masterplan for Medical Studies 2020) focuses on practice-oriented undergraduate training with increased involvement of rural teaching practices. The demand for teaching practices for the final year will increase at all medical faculties in Germany. The project medPJplus at the University Medical Center Göttingen (UMG) presents an approach for successfully acquiring general medical teaching practices in local rural areas. Project outline: The project medPJplus implemented eight measures in cooperation with medical students, interested general practitioners, and regional players in the surrounding districts to attract new teaching practices: we established public relations, accredited practices, organized the didactic training of participating general practitioners, created a digital platform for students that is linked to the nationwide PJ-Portal, and organized information events, workshops, and feedback reports to regional actors. Results: Within one year, a total of 40 new teaching practices with 57 new teachers in the local rural area joined the project in southern Lower Saxony. A three-stage didactic training concept for general practitioners was established at the UMG. A digital platform enhances the visibility of general practitioners and their activities for students. The teaching practices can now be found on the nationwide PJ-Portal. Fourteen students have currently completed their period of the final year in family medicine there. Conclusions: It is possible to acquire rural general medical teaching practices for the final year. This depends on four core elements: addressing and didactic training of interested general practitioners, networking of medical students with teaching physicians and regional actors, digitally presenting teaching practices, and developing solutions for mobility and living space during the final year. [ABSTRACT FROM AUTHOR]

Aim: The seminar program of the KWBW Verbundweiterbildungplus® is offered by the Competence Center for Postgraduate Medical Education in Baden-Württemberg (KWBW) for physicians specializing in general practice (GP trainees). Attendance is a voluntary one comprised of 48 curricular units of 45 minutes each per GP trainee. This seminar program is meant to be attended in parallel to the postgraduate medical education in clinic or practice. The intention behind this project was to develop objectives, topics and a feasible structure for a seminar curriculum while taking time and financial constraints into account. Method: The Kern cycle was applied in an open, modified nominal group consensus technique in the form of an iterative process. Participating were 17 experts from the departments of general practice at the universities in Freiburg, Heidelberg, Tuebingen and Ulm, plus a pediatrician. Results: The main objective was defined as empowering GP trainees to independently provide high-quality primary care, including in rural areas. A basic curriculum was defined based on relevant frameworks, such as the 2018 Model Regulation for Postgraduate Medical Training (Musterweiterbildungsordnung/MWBO) and the Competency-based Curriculum General Practice (KCA). Overall, the seminar curriculum has 62 basic modules with 2 curricular units each (e.g. Basic Principles of General Practice, Chest Pain, Billing) and another 58 two-unit modules on variable topics (e.g. digitalization, travel medicine) adding up to 240 (124+116) curricular units. A blueprint with a rotation schedule for all of the teaching sites in Baden-Württemberg allows regular attendance by n=400 GP trainees over a period of five years, with individual variability in terms of program length. Conclusion: The model entails a five-year, flexible program to accompany the postgraduate medical education in general practice which can also be implemented in multicenter programs and those with high enrollments. The model's focus is on acquisition of core competencies for general practice. Despite the current shift to eLearning seminars due to SARS-CoV, the program's implementation is being continued, constantly evaluated, and used to further develop the KWBW Verbundweiterbildungplus® program. [ABSTRACT FROM AUTHOR]

Background: The corona pandemic is changing the framework conditions for medical studies and continuing education as well as the work with patients and within teams. Systematic reflection and communication about experiences and ways of dealing with them forms the basis for successful learning in and out of the crisis. Therefore, we designed a 90-minute workshop "Corona-Debriefing" for students and physicians in specialist-training in family medicine (ÄiW) using three successive moderated interaction phases: Questionnaire survey via tele-dialogue voting (TED) with immediate presentation of results and discussion, moderated experience reports on the categories risk/assessment/support/coping and finally moderated group discussions in small groups to collect "best practice" examples of crisis management. Objective: We tested "Corona-Debriefing" as a pilot test with 48 participants (TN) in July 2020 (30 present, 14 online) in order to assess mental stress and risk perception of participants plus formative/brief summative evaluation of the workshop. Methods: The PHQ-4 with its subscales GAD-2 (anxiety) and PHQ-2 (depression) was used to assess mental stress; risk assessments were made by means of self-constructed 5-point Likert-scales for the dimensions person/society/health/economy. A formative evaluation was carried out by means of a questionnaire at the end of the event; the brief summative assessment was asked for by means of a school grading scale. Results: 37 complete TED questionnaires and 22 evaluations were obtained. TN showed a low personal risk assessment, but considerable fears about social and economic developments. Needs are seen mainly in improvements regarding organization, protective equipment and technical communication (e.g. official recommendations for action). The workshop was rated "good" or "very good" in 95% of the evaluations. Criticism was directed at the limited time available, the narrowing of topics by moderators and the desire for (even) more room for the exchange of personal experiences. Conclusion: The workshop "Corona-Debriefing" is a relatively easy way to use crisis experiences for learning processes. "Corona-Debriefing" can be used by changing the focus of moderation in various courses, years or fields of study, whereby the participants' own personal and clinical crisis experiences remain a prerequisite for a meaningful "debriefing". [ABSTRACT FROM AUTHOR]

Background: The SARS-CoV-2 pandemic had a strong impact on academic teaching and could change it sustainably. Ad hoc digitization of teaching had to be carried out. General practice teaching situation: Education in general practice at the Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) offers, in addition to the main lecture, various elective courses, clinical traineeships, internship as well as the elective part in the final practical year. The main lecture and one clinical elective course were offered digitally in the summer term 2020. Digital methods: In the main lecture, an adapted inverted-classroom concept was used. Podcasts and audio annotated videos were provided. Teaching materials were reflected via a weekly, 1hr video consultation and in a forum. An asynchronous learning module was developed for the elective course "Smart Decision-making in Clinical Practice". Each module consisted of course preparation, podcasts and follow-ups as well as a supervised forum. Results: The main lecture (response rate n=115/170; 67.6%) was rated "very good" on average. The same applies to the commented videos. The forum, reflective video consultation and teaching materials were rated "good" on average. The predominantly desired forms of presence were "Focus on virtual with in-depth presence phases" (n=54) and "Focus on presence phases, virtual support only" (n=37). Discussion and implications: The digital restructuring enables students to work on the course contents independently. This requires self-regulation strategies, which in future shall be taught through portfolio work. The teaching focus shifts from a passive teaching format to an interactive one. First evaluation results showed a very good acceptance by the students. [ABSTRACT FROM AUTHOR]

Background: The task of the Competence Centers for vocational training (KW) is to increase the attractiveness and quality of vocational (=post-graduate) training in general practice. For this purpose, they offer, among other things, a structured seminar program for post-graduate trainees in general practice (GP-trainees). During the Covid-19 pandemic the seminar program of the KWBW-Verbundweiterbildungplus® in Baden-Württemberg was converted to digital formats. The goal of the paper is to evaluate the acceptance by the GP-trainees and lecturers, to describe experiences with the conversion to e-learning and to derive recommendations with regard to the future orientation of seminar programs in post-graduate as well as continuing medical education. The implementation was based on a modified Kern-cycle and aimed at offering eight teaching units of 45 minutes each to a large number of GP-trainees. It tried to maintain the high quality of content and education as well as the interactive character of the previous seminars. For this purpose, the events were designed as synchronous webinars (six units) with asynchronous preparation and post-processing (two units) according to the flipped classroom method. The evaluation by the participating GP-trainees and lecturers was performed online using a multi-center developed and pre-piloted questionnaire. Results and discussion: N=101 GP-trainees participated in the evaluation of five individual seminar days in the second quarter of 2020 (response rate 97%). 58% (N=59) of the trainees were satisfied or very satisfied with the implementation. 82% (n=83) rated pre-tasks as helpful. 99% (n=100) would participate in an online seminar again. For 52% (n=53) of the trainees, the attitude towards e-learning had changed positively. The main advantages mentioned were no travel, save in time and costs as well as increased flexibility. The main disadvantages mentioned were less personal interaction and technical obstacles. The high acceptance of the new digital format showed the fundamental potential of e-learning in continuing medical education. The experiences can be a source of inspiration for other departments and KW. However, it also shows that important goals of KW, such as the personal interaction of the peer group, could not be achieved. In the future, it is important to develop a suitable mix of presence and digital formats with the aim to improve the attractiveness as well as sustainability of continuing medical education. [ABSTRACT FROM AUTHOR]

The CanMEDS roles has conveyed through a digital videoconference supported teaching format in which the students develop their own case-based, interactive e-learning units. The learning forms used are problem-based learning and peer-teaching. After a quality check by the lecturer the e-learning units are made available to further general medicine lessons. [ABSTRACT FROM AUTHOR]

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Copyright of GMS Journal for Medical Education is the property of German Medical Science Publishing House gGmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: This article reports on the conceptual development and subsequent implementation of a targeted and attractive general practice teaching program in a rural area for students of human medicine at the medical faculty of Goethe University, Frankfurt am Main. Project description: Since the 2016/2017 winter semester, usually up to 15 interested students a year have had the opportunity to participate in the longitudinal priority program "Landpartie 2.0". The program runs for six semesters during the clinical stage of medical studies and consists of regular internships during which the students receive one-to-one support in a family practice, and participate in a series of seminars and an annual one-day excursion. The aim is to enable students, early on in their studies and without any obligations, to gain uninterrupted experience of providing patient care, and to find out what it means to pursue a career in family medicine. Results: Since the beginning of the annual program, 62 students have been included in it. The initial results show that the different elements of the program fulfil the expectations and requirements of participants and that their overall level of satisfaction is high. Almost 95% of students reported that they felt their knowledge had increased as a result of the internships, and they rated them as a useful part of their medical education. Despite the rural focus of the program, around half of the participants were of urban origin. Conclusion: The "Landpartie 2.0" provides students with the opportunity to familiarize themselves with family health care in a rural area. Further studies should investigate to what extent the program encourages students to continue their training with a view to pursuing a career in family medicine. [ABSTRACT FROM AUTHOR]

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At the 55th Congress for General Medicine and Family Medicine (DEGAM) in Lübeck, the German Armed Forces (Bundeswehr) medical service was represented for the first time with several contributions at a DEGAM congress. Family physicians form the largest group of specialists in the Bundeswehr. In speciality training as well as in provided care there are large overlaps between civilian family physicians and those in the armed forces. The aim of this article is to report on the workshop "Learning together and from one another - synergy potentials in speciality training and care between the medical services of the Bundeswehr and civilian family medicine". Brief lectures and presentations of the current postgraduate training and care models from both "worlds" on the subjects of postgraduate training to become a family physician in the armed forces, the competence-based general medicine curriculum and the German network of competence centers in postgraduate training formed starting points for a joint discussion. The first very specific plan that emerged was participation in and use of the competence centers for postgraduate training by trainers and trainees in the armed forces, in order to promote exchange at this level as well. [ABSTRACT FROM AUTHOR]

Background: The 2002 Medical Licensure Act gave German universities certain freedoms for reforming their medical degree courses. The Medical Faculty of the University of Cologne took advantage of this opportunity and introduced a model study course in the winter semester 2003/04 through §41 of the Medical Licensure Act. One of the main reasons for this was that back then there was an increasing shortage of doctors in clinical curative medicine and GP primary care. This study investigates whether the introduction of the Cologne Model Study Course (MSG) can show stronger interest in curative medical work (especially General Practice) compared to students of the standard degree course (RSG). Methodology: The proof of added value was examined through graduate surveys conducted at the University of Cologne and through the proportion of students who completed the PY elective rotation "General Practice". The students of the standard degree course (start of studies prior to winter semester 2003/2004) were compared with students of the model study course (start of studies from winter semester 2003/04 onwards). Measurements were carried out using descriptive frequency tables and correlation analyzes according to Spearman. Results: The students' interest in curative medicine was already high (91%) even before the model study course was introduced and increased only slightly (to 91.9%). There is also only a slight increase in specialization in General Practice (RSG=5.9% vs. MSG=9.2%). However, selection of rotations in General Practice was significantly increased (RSG=1.9% vs. MSG=3.4%, r=0.046 **, p<0.005). Conclusion: The Cologne Model Study Course in Human Medicine has increased awareness of the subject of General Practice among students through a large number of curricular changes. The fact that only marginal effects can be demonstrated shows once more the strong dependence of choosing General Medicine as a career path on other factors (such as gender or the presence of positive role models) and emphasizes the necessity of promoting General Practice student education not only through increased curricular mapping but by additional innovative concepts to maximize the status of General Practice from the perspective of students. [ABSTRACT FROM AUTHOR]

The Brandenburg Medical School "Theodor Fontane" (MHB) was founded in 2014 by municipal and non-profit institutions in Bernau, Brandenburg an der Havel and Neuruppin to train more physicians for the non-metropolitan region of Brandenburg. Since the 2015 summer term, 48 medical students have been enrolled each year, accepted through the university's own selection process in which the score on the German school-leaving exam (Abitur) and time spent on the waiting list play subordinate roles. Tuition fees can be partially financed through scholarship agreements with regional hospitals if the applicants commit themselves to medical specialist training (Facharztweiterbildung) at a particular hospital. The main places of study are Neuruppin and Brandenburg an der Havel; there is a decentralized study phase from the eighth to tenth semester of study. The Brandenburg Reformed Medical Curriculum (BMM) complies with the model clause contained in the German regulations governing the licensing of medical doctors (ÄAppO). The curriculum is based on problem-based learning (PBL) and focused on competencies and consists of integrated interdisciplinary modules that combine, from the very beginning, basic sciences with clinical and theoretical medical subjects. The focus on general practice is visible in the regularly held "Practical Days" (Praxistag) during which second-year students and above have the opportunity to observe at participating medical practices and familiarize themselves with primary care in Brandenburg. A special focus of BMM is on the acquisition and development of communication and interpersonal skills. These are imparted through a longitudinal curriculum referred to as "Teamwork, Reflection, Interaction, Communication" (TRIK). High value is placed on critical thinking and scientific scholarship and this is reflected in an eight-week academic placement in which the students independently write a research paper. Several different teaching formats ensure that, along with learning specific subjects, sustained personal development can also take place. BMM's decentralized study phase starting in the eighth semester represents a special part of the curriculum in which students complete their clinical training in small groups at selected cooperating hospitals in Brandenburg. This phase encompasses not only hospital placements and other local patient-centered courses, but also centralized instruction via video conferencing to assure that basic sciences and clinical theory continue to be covered. Knowledge- and performance-based semester assessments, in particular OSCEs, reinforce the practical aspects of the training. These replace the M1 state medical examination in the first study phase. The first medical students are now in their ninth semester as of April 2019, making it still too early for final evaluations. The curriculum, successfully implemented to date, already satisfies core requirements of the Master Plan 2020 for undergraduate medical education (Masterplan Medizinstudium 2020) with the curriculum's organization and structure, curricular content, assessment formats and student admission process. With its decentralized structure, BMM specifically addresses the social and health policy challenges facing rural regions of Brandenburg. This is the first curriculum that has taken on the improvement of healthcare in rural regions as its central aim. [ABSTRACT FROM AUTHOR]

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Aim: Following changes in licensing regulations for doctors ("Approbationsordnung") in 2012, a 4-week clinical attachment ("Famulatur") in primary care is now mandatory for all medical students in Germany. To date, it has not been studied how the Famulatur in primary care is perceived by the learner or the teacher. The aim of this study was to explore the experiences of both medical students and primary care physicians (PCPs) with regard to the teaching and learning situation in the Famulatur in primary care. Methods: A qualitative analysis of semi-structured interviews with 12 students from the medical faculty in Tübingen, Germany, and 17 PCPs from this region, was performed. Interview material was analyzed following content analysis according to Mayring. Results: In addition to considering the variety of tasks expected of the students and the optimal time for the Famulatur during the medical curriculum, the main themes of the interviews were the strengths, weaknesses and suggestions for improvement of the Famulatur. The Famulatur was predominantly perceived positively, although it being obligatory was criticized. In particular, the 1:1 supervision and the extended duration (compared to the first curricular primary care placement ("Blockpraktikum")) were positively evaluated. PCPs and students were critical of the lack of a learning and educational Famulatur framework, which would have enabled earlier orientation and alignment of each party. Conclusion: The Famulatur offers good learning opportunities for medical students and provides an insight into primary care, which is typically seen positively; it appears to heighten enthusiasm for primary care within budding doctors. Even if the obligation should cease in "The Master Plan for Medical Studies 2020" (Masterplan Medizinstudium 2020), it would be beneficial to optimize the primary care Famulatur; the development of a student logbook and learning objectives could be helpful, for example in the form of portfolios. [ABSTRACT FROM AUTHOR]