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A novel peer-led communication seminar for medical students and for students of the Interprofessional Health Care B.Sc. degree programme at the Medical Faculty of Heidelberg is currently being developed to address the increasing need for interprofessional collaborative competencies in health care professionals. The core elements of this course include role plays in interprofessional communication situations, patient-centred professional practice, and reflections on underlying attitudes. Each seminar will be conducted by a team of two senior students from both undergraduate programmes, practising their new roles as interprofessional tutors and, at the same time, serving as competent role models for interprofessional collaboration. To provide tutors with the necessary didactic preparation, an interprofessional tutor training was developed and implemented. It was positively evaluated and well accepted by participants. The seminar and tutor training concept presented in this paper aims to foster (inter-)professional ethics and communication competency development in medical students., (Copyright © 2017. Published by Elsevier GmbH.)

Issue: In 2012 the German medical licensure regulations (Approbationsordnung) made teaching and assessing the conduction of medical consultations a mandatory part of medical education. A catalogue of learning objectives (LO) based on existing references was developed to assist medical schools in meeting this requirement., Methods: A body of relevant material was compiled using literature research and surveying experts. Then, in a multiphase Delphi process, this was evaluated and condensed by an interdisciplinary working group in dialogue with external (clinical) experts. Competence levels and examples of clinical application were assigned to enhance implementation. The catalogue was revised by the medical faculties, professional associations and the BVMD., Results: This learning catalogue comprised 116 learning objectives for the specific skills necessary to conducting medical consultations as well as exemplary application contexts. The catalogue proved to be practical in terms of developing curricula and networking at medical schools., Discussion: This catalogue of learning objectives can serve as the basis for developing a sample communication curriculum for use by medical faculties.

Background: Objective Structured Clinical Examinations (OSCEs) often involve a considerable amount of resources in terms of materials and organization since the scores are often recorded on paper. Computer-assisted administration is an alternative with which the need for material resources can be reduced. In particular, the use of tablets seems sensible because these are easy to transport and flexible to use., Aim: User acceptance concerning the use of tablets during OSCEs has not yet been extensively investigated. The aim of this study was to evaluate tablet-based OSCEs from the perspective of the user (examiner) and the student examinee., Method: For two OSCEs in Internal Medicine at the University of Heidelberg, user acceptance was analyzed regarding tablet-based administration (satisfaction with functionality) and the subjective amount of effort as perceived by the examiners. Standardized questionnaires and semi-standardized interviews were conducted (complete survey of all participating examiners). In addition, for one OSCE, the subjective evaluation of this mode of assessment was gathered from a random sample of participating students in semi-standardized interviews., Results: Overall, the examiners were very satisfied with using tablets during the assessment. The subjective amount of effort to use the tablet was found on average to be "hardly difficult". The examiners identified the advantages of this mode of administration as being in particular the ease of use and low rate of error. During the interviews of the examinees, acceptance for the use of tablets during the assessment was also detected., Discussion: Overall, it was found that the use of tablets during OSCEs was well accepted by both examiners and examinees. We expect that this mode of assessment also offers advantages regarding assessment documentation, use of resources, and rate of error in comparison with paper-based assessments; all of these aspects should be followed up on in further studies.

Aim: This paper describes the theory-based development of a standardized training model for peer tutors. The aim is to qualify tutors to teach communication skills integrated with practical clinical skills, to medical students in the pre-clinical curriculum. As a result, students are encouraged to form a basic understanding of the biopsychosocial model of diseases early in their studies., Method: The training model's design is based on the Kern model for curriculum development as adapted by McLean et al., who outlined the following steps: planning, implementation, and evaluation/feedback. Our focus is on development, review of feasibility, and evaluation as measured by the subjectively perceived effectiveness of the implemented training model. 2 target groups were considered: the peer tutors and the student tutees., Results: In 2009, a 3-step training model consisting of 12 units was developed, based on the theory of patient-centered communication and the biopsychosocial model. The training was rated very positively on a 5-point Likert scale by all tutors at 2 points in time: t1 (directly after training) and t2 (after conducting 2 tutorials) (t1: M=1.67; SD=±0.86; t2: M=1.75; SD=±0.71). On a 6-point Likert scale, the tutees also evaluated their communication and clinical skills as being significantly better after completing the 10 tutorials (t2: scale for interaction and communication: M=4.81; SD: 1.09; scale for clinical examination: M=4.99; SD: 0.85) than before the tutorials (t0: scale for communication and interaction: M=3.18; SD=1.15; scale for clinical examination: M=2.88; SD: 1.09)., Conclusions: By implementing a standardized tutor training model, one can qualify peer tutors to teach communication skills integrated with practical clinical skills during the pre-clinical phase. Practice teaching of the curricular material via role playing, tutorial simulation and an extensive feedback session, along with the definition of clinical standards for recording case histories and performing examinations, have proven themselves to be core elements of effective tutor training., (© Georg Thieme Verlag KG Stuttgart · New York.)

Dilated cardiomyopathies (DCM) show remarkable variability in their age of onset, phenotypic presentation, and clinical course. Hence, disease mechanisms must exist that modify the occurrence and progression of DCM, either by genetic or epigenetic factors that may interact with environmental stimuli. In the present study, we examined genome-wide cardiac DNA methylation in patients with idiopathic DCM and controls. We detected methylation differences in pathways related to heart disease, but also in genes with yet unknown function in DCM or heart failure, namely Lymphocyte antigen 75 (LY75), Tyrosine kinase-type cell surface receptor HER3 (ERBB3), Homeobox B13 (HOXB13) and Adenosine receptor A2A (ADORA2A). Mass-spectrometric analysis and bisulphite-sequencing enabled confirmation of the observed DNA methylation changes in independent cohorts. Aberrant DNA methylation in DCM patients was associated with significant changes in LY75 and ADORA2A mRNA expression, but not in ERBB3 and HOXB13. In vivo studies of orthologous ly75 and adora2a in zebrafish demonstrate a functional role of these genes in adaptive or maladaptive pathways in heart failure., (Copyright © 2013 The Authors. Published by John Wiley and Sons, Ltd on behalf of EMBO.)

Background: Empathy is a central element in daily patient care. The burnout syndrome seems to be a potential factor influencing physicians' empathic behavior negatively. In Germany up to 20 % of practicing physicians experience burnout. So far, there have been no studies measuring empathy and the degree of burnout among final-year medical students in Germany. The aim of the current study was to investigate final-year students' self-reported empathy, burnout and the association of job satisfaction and occupational self-efficacy with regard to potential gender differences., Methods: 127 medical students at the end of their final year (82 f, 45 m; 26.8 years of age) were surveyed using the Jefferson Scale of Physician Empathy (JSPE), the Maslach Burnout Inventory (MBI) and items addressing job satisfaction and occupational self-efficacy., Results: The mean JSPE score of all final-year students was 113.25 ± 10.21 (20=lowest possible empathy score, 140=highest possible empathy score). Based on the three dimensions of burnout, the students fell in the moderate burnout category in all subscales of the MBI. There was an association between a lower empathy score and a higher burnout score. Also, the MBI correlated negatively with final-year students' job satisfaction and occupational self-efficacy., Conclusion: Despite high self-rated empathy scores, the experience of burnout symptoms in medical students may begin as early as their final year of studies, where higher levels of burnout are associated with lower self-rated empathy scores. The number of final-year medical students affected by clinically significant burnout (up to 20 %) was just as high as among practicing physicians. Female students were found to be particularly affected. Given the rising numbers of female graduates, this shows that urgent action is required., (Copyright © 2012. Published by Elsevier GmbH.)

Quality management of assessment in medical education plays a key role in Germany--owing to, among other factors, the new medical licensing regulations ("Approbationsordnung"). OSCE (Objective Structured Clinical Examination) is a widespread tool to assess clinical competencies. However, the quality of OSCE in terms of reliability as a criterion of a good test is highly debated in the current literature. To improve the reliability of the OSCE three accompanying measures have been implemented at the Faculty of Medicine of the University of Heidelberg since the summer of 2006: 1. the application of a checklist for pre- and post-reviews of OSCEs, 2. a specific training of OSCE examiners, 3. an advanced psychometric OSCE test report giving feedback to the item developer. The reliability of the Internal Medicine OSCE at the University of Heidelberg has increased since. Currently Cronbach's alpha of the final OSCE in the summer of 2007 was 0.829.

Recent studies showed that the Ca(2+)-independent transient outward current (I (to)) is very small or even not detectable in the porcine left ventricle. We investigated whether an altered molecular expression or function of voltage-dependent potassium channels belonging to the Kv4 sub-family and their ancillary Ca(2+)-binding beta sub-unit KChIP2, which contribute to the major fraction of I (to )in other species, may underlie this lack of a significant I (to) in the porcine left ventricle. RT-PCR analysis with degenerate primers showed that both Kv4 mRNA and KChIP2 mRNA are expressed in porcine left ventricular tissue and in isolated ventricular myocytes. PCR cloning and sequence analysis predicted proteins with >98% identity to rat and human Kv4.2 and >99% identity to rat and human KChIP2. Heterologous expression of porcine Kv4.2 in Xenopus laevis oocytes gave rise to currents with characteristic properties of rat and human Kv4.2, and co-expression with its KChIP2 sub-unit increased current density (tenfold), slowed inactivation (twofold) and accelerated recovery from inactivation (tenfold). Kv4.2 immunohistochemistry in porcine left ventricular tissue revealed a predominant membrane-bound signal. Relative quantification of gene expression indicated that Kv4.2 and KChIP2 mRNA and protein are expressed at comparable ratios in porcine and rat left ventricular tissues, which displays a large I (to). Collectively, these data demonstrate that the lack of a significant I (to) in the porcine left ventricle does not result from dysfunctional or insufficiently expressed Kv4.2 and KChIP2 sub-units.

Introduction: Following the recent amendment to the Medical Education Act in Germany (Approbationsordnung 2002) and the abolition of the preliminary approbation for early residency (AiP), the discussion increasingly focuses on the restructuring of German post-graduate medical training. The training should include well-defined learning objectives and an educational concept with a central emphasis on communication skills training. In the German-speaking countries there has as yet been no publication of a structured training course for the improvement of communication skills in the context of post-graduate education., Methods: Jointly designed by the University of Heidelberg's Clinic of Internal Medicine and Clinic of Paediatrics, this study aimed to measure the effect of a training programme for handling problems and difficult situations arising in the communication with parents and patients. 28 paediatric residents took part in a randomised controlled trial using standardized patients and video-feedback (intervention group: N = 14; control group: N = 14). Upon completion of the study, the control group also received training and was subsequently evaluated. The training course consisted of four units, lasting 90 minutes each. Both the acceptance of the training units and the self-evaluation of communication skills in dealing with parents were subject to assessment., Results: The participating residents acknowledged the training course to be an extremely useful tool for improving their communication skills and confidence in dealing with the parents of ill children. A pre-post comparison of self-assessed communication skills revealed a significant increase in the intervention group, but not in the control group., Discussion: The structured training course presented in the current study proved highly effective and should serve as a model for a compulsory component of a post-graduate training.