Search

Objectives: As part of the further development of an existing training program on scientific skills for health services research at the University Hospital Tübingen, the aim of the study is to determine the level of knowledge, utilization and needs for continuing education among staff.Methods: In 2022, a semi standardized anonymous cross-sectional survey was conducted at the University Hospital Tübingen. The content of the questionnaire survey was the level of knowledge and utilization of various research methods, the need for continuing education on these and other healthcare research-related topics and the preferred training concept. The data analysis was carried out descriptively based on absolute and relative frequencies overall and grouped according to the scientific experience of the participants.Results: Participants’ self-assessment indicated that a proportion of them had research skills. However, the level of knowledge and utilization varied greatly with regard to different research methods. The 222 participants most frequently expressed a desire for continuing education in the preparation of meta-analyses (56%), questionnaire validation (43%) and -development (42%). There was also great interest in continuing education in the fields of project coordination (57%), third-party funded projects (46%) and science communication (45%).Conclusion: The survey highlights existing research skills and the need for methodological qualification in the field of healthcare research among the staff of the University Hospital Tübingen. The focus appears to be on evidence generation, methods of empirical social research and general research-related skills. The results will be used to design new training courses with a focus on health services research.

Background: A large part of the population in Germany makes use of naturopathic, complementary and integrative medical treatments. There are now numerous scientific studies that provide evidence of efficacy for certain indications. At German medical faculties, selected procedures and their application are taught within the cross-sectoral unit called and some elective courses, with a focus on specific aspects are offered. So far, however, there has been no structured curriculum that longitudinally anchors teaching across medical studies and enables all students to consider naturopathic and complementary medical options for patient care later on and to integrate them effectively into the diagnostic and treatment process.Objective: The aim of this position paper is to show the relevance of this topic for medical education, to clarify terminology and to present core competencies and possible implementation options for training.Method: The Integrative Medicine and Perspective Pluralism Committee of the German Association for Medical Education developed this position paper in a multi-stage consensual process, in cooperation with the Forum of University Work Groups on Naturopathic Treatment and Complementary Medicine.Results: First, different umbrella terms were discussed and an existing definition of integrative medicine and health was chosen for subsequent use. Building on this step, the status of education and its scientific foundation in Germany was considered in an international context. In the next step, a competency profile for medical training, consisting of seven areas of competency, was developed and described in detail with regard to naturopathic, complementary and integrative medicine. Implementation options were identified using possible starting points in the curriculum and using established examples of best practice.Conclusion: Despite different priorities at each faculty, it was possible to find an agreement on the development of competencies and anchoring them in medical education on the basis of a common definition of terms. Currently, the implementation in the mandatory and elective areas is very heterogeneous. As part of the current revision of the Medical Licensure Act, there are many possible starting points for the integration of naturopathic and complementary medical teaching content, especially in interprofessional and general practice courses. The implementation and accompanying research of targeted teaching settings should lay the foundations for a long-term and binding integration into medical education. Overall, it is clear that medical education in the field of naturopathy and complementary and integrative medicine has the potential to develop comprehensive core medical competencies.

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 Verbundweiterbildung® program.

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-Verbundweiterbildung 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.

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.

Background: In face of the looming shortage of general practitioners, primary healthcare providers and post-graduate training in general practice are increasingly becoming part of the political agenda in Germany. In 2009 the program “Verbundweiterbildung Baden-Württemberg” (VWB BW) was developed by the Competence Center for General Practice in Baden-Wuerttemberg to ensure primary healthcare in the future by enhancing the attractiveness of general medicine. This paper describes the experiences that have been gathered in developing a post-graduate training-program for physicians undergoing specialist training in general practice.Project description: The Competence Center for General Practice in Baden-Wuerttemberg supports the organization of regional networks dedicated to post-graduate medical education. First core element of the VWB BW program is a special seminar series for physicians pursuing post-graduate training. This seminar program is aligned with the German competency-based curriculum in general medicine and is meant to promote medical expertise and other related competencies, such as business and medical practice management and communication skills. Mentoring and advising the physicians regarding professional and personal planning form the second core element. The third core element is seen in the train-the-trainer seminars that address the competencies of the trainers. In order to focus the program’s content closely on the needs of the target groups, scientifically based evaluations and research are carried out.Results: Since starting in 2009, 685 physicians have entered the program and 141 have passed the examination to become medical specialists (as of December 2016). In total, 31 networks, 60 hospitals and 211 general practices have participated. The seminar sessions have been rated on average with 1.43 on a six-point Likert scale by the physician trainees (1=extremely satisfied, 6=extremely dissatisfied). Alongside the medical training, these physicians viewed the exchange of information and experiences with other physicians as very positive and important. In 185 seminars lasting 90 minutes each, the seminar program has presently covered 250 out of 320 units in the competency-based curriculum for general medicine. A total of 281 trainers have been trained in 13 train-the-trainer courses and have rated this course on average with 1.36 on a six-point Likert scale. Above all, the trainers emphasized the exchange of information and experiences with other trainers as very positive. In 2013 the DEGAM concept for its Verbundweiterbildung program was developed based on that of the VWB BW. Since 2008 over 40 articles on the topic of post-graduate medical education have been published.Conclusion: The steadily increasing number of participants over the years demonstrates that the VWB BW is relevant for recent medical graduates and contributes to the attractiveness of general practice. The consistently excellent evaluations of the training program and the train-the-trainer course affirm the focus on the needs of the target groups. The post-graduate VWB BW program advances structured, competency-based and quality-oriented specialist training and fosters professional sharing between physicians – something that could also be relevant for other fields. The increasing numbers of participating physicians and specialists in general practice in Baden-Württemberg lead to the conclusion that the VWB BW program positively influences the number of general practitioners.

Introduction: After the reform of the German Medical Licensure Act of 2003, Rehabilitation, Naturopathy and Physical Medicine were integrated into one discipline to be taught in Medical University. The aim of this survey is to determine the outcome of this change by evaluating the current status of education of these three disciplines based on the experience and satisfaction reported by lecturers responsible for teaching these subjects to medical students. Methods: A questionnaire-based survey. A paper version of the questionnaire for each discipline was posted to each Medical University in Germany. The first part asked about the current status of teaching; the second part asked about facilities and requirements; the third part asked respondents to give information on their career and teaching experience in this subjectResults: The response rate was 51.5% for Rehabilitation, 48.5% for Physical Medicine and 60.6% for Naturopathy. A vast range of people and faculties were involved in the curricula. The percentage of each discipline taught was unevenly distributed: the major proportion being rehabilitation (38%), then naturopathy 34% lastly physical medicine with less than a third (28%). The main delivery of these disciplines was through lectures in plenary sessions. Modern teaching methods were not in evidence. Lecturers were generally pleased to be working with the combination of the three disciplines. Conclusion: Future medical education should improve upon teaching coordination and aim towards a common curriculum for these three disciplines. Expected future changes to medical curricula will provide opportunities to improve the implementation of Rehabilitation, Physical Medicine and Naturopathy in teaching and research.

[english] Objectives: Interprofessional collaboration leads to an improvement in health care. This call for increased interprofessional collaboration has led to national and international recommendations for interprofessional learning and education. The GMA has taken up this challenge and has implemented a working group on “interprofessional education in the health professions” to address this topic. The terminology used to describe collaboration among the health professions seems to vary and does not reflect any clear consensus. The aim of this paper is to identify the different terms used to describe collaboration between health professions and to analyse their use in German journals.Methods: The terms frequently used to describe collaboration between health professionals were identified and defined. German medical journals were then pragmatically analyzed regarding the use of the terms interprof* and interdiszip*.Results: The German terms for interprofessional and interdisciplinary were not used consistently in the journals reviewed.Conclusion: There seems to be no agreement on the use of terms to describe the collaboration between health professions. Consistent terminology should be used as a basis for promoting collaboration and improving understanding among the parties involved.

[english] Background: Since 2008 the Verbundweiterbildung programme of the Competence Centre General Practice Baden-Wuerttemberg offers continual improvement with regards to content and structure of general practice training. The programme uses the didactical concept of the CanMEDs competencies, which were developed in Canada, as a postgraduate medical training framework. Train the trainer (TTT)-programmes are an additional important element of these contentual optimisations of postgraduate training. Within this article we describe the conception and evaluation of the first TTT-workshop within the programme Verbundweiterbildung. Methods: The conception of the first TTT-workshop was influenced by results of a survey of general practitioner (GP) trainers and by experiences with teaching GP trainers involved in medical undergraduate teaching. A questionnaire was designed to get a self-assessment about organisational and didactic aspects oriented on the CanMEDs competencies of postgraduate medical training. In addition, the workshop was evaluated by the participants.Results: The workshop lasted 12 teaching units and included the following elements: introduction into the CanMEDs competencies, feedback training, fault management, legal and organisational aspects of post graduate training. From the 29 participating trainers 76% were male and on average 57 years old. The evaluation showed a good to very good acceptance of the workshop. Initial self-rating showed the need of improving in the fields of determining learning objectives, providing formative feedback and incorporation of a trainee. Most trainers rated themselves as very good in procure CanMEDs competencies with the exclusion of the competencies “Manager“ and “Scholar“. Conclusion: A TTT-programme is an important method to improve GP training which has not been used in Germany so far. Such a GP TTT-programme should highlight especially training in providing feedback and teaching in management aspects. Results of this article add information that can be used for developing TTT-programmes also in other specialties.[german] Zielsetzung: Das Programm Verbundweiterbildung des Kompetenzzentrums Allgemeinmedizin Baden Württemberg bietet seit 2008 strukturelle und inhaltliche Optimierungen für die Weiterbildung Allgemeinmedizin an. Das Programm orientiert sich am didaktischen Konzept der in Kanada entwickelten Kompetenzfelder der CanMEDs. Schulungen für Weiterbildungsbefugte, sogenannte „Train the Trainer (TTT) -Programme“, sind ein ergänzendes wesentliches Element einer inhaltlichen Optimierung der Weiterbildung. Der vorliegende Artikel beschreibt die Konzeption und Evaluation des ersten TTT-Workshops im Rahmen der Verbundweiterbildung. Methodik: Für die Konzeption des TTT-Workshops wurden Ergebnisse einer Umfrage bei Weiterbildungsbefugten sowie Erfahrungen aus Schulungen allgemeinmedizinischer Lehrpraxen herangezogen. Ferner wurde ein Fragebogen konzipiert, mit dem die Vorgehensweisen der Weiterbilder sowie deren Selbsteinschätzung, bestimmte Kompetenzen (orientiert am CanMEDs Modell) vermitteln zu können, abgefragt wurden. Ergänzend wurde die Veranstaltung evaluiert.Ergebnisse: Der Workshop war mit 12 Unterrichtseinheiten konzipiert und enthielt folgende Elemente: Einführung in die Kompetenzfelder der CanMEDs, Feedbacktraining, Fehlermanagement, rechtliche und organisatorische Aspekte der Weiterbildung. Es nahmen 29 Weiterbildungsbefugte (im Mittel 57 Jahre, 76% männlich) teil. Die Evaluationsergebnisse zeigen eine gute bis sehr gute Akzeptanz der Veranstaltung. Die eingangs durchgeführte Fragebogenerhebung zu den aktuellen Vorgehensweisen der Weiterbilder zeigt Optimierungsbedarf bei der Vereinbarung von Lernzielen, Feedbackgabe und der strukturierten Einarbeitung eines Arztes in Weiterbildung. Der überwiegende Teil der Weiterbildungsbefugten schätzt sich insgesamt als sehr gut in der Vermittlung von CanMEDs Kompetenzen ein, lediglich bei den Kompetenzfeldern „Praxismanagement“ und „Lehren und Lernen“ ist die Selbsteinschätzung etwas schwächer. Schlussfolgerungen: Für die Allgemeinmedizin können TTT-Programme eine wichtige, bisher in Deutschland ungenutzte Maßnahme darstellen, um die Weiterbildung zu optimieren. Ein TTT-Programm für Allgemeinmedizin sollte schwerpunktmäßig aus Feedbacktraining sowie Schulung in Aspekten des „Praxismanagements“ und „Lehren und Lernen“ bestehen. Die vorliegenden Ergebnisse können auch für die Entwicklung von TTT-Programmen für andere Gebiete genutzt werden.

[english] Background: Future physicians should be educated in evidence-based medicine. So it is of growing importance for medical students to acquire both practical medical and basic research competencies. However, possibilities and concepts focusing on the acquisition of basic practical research competencies during undergraduate medical studies in Germany are rare. Therefore the aim of this article is to develop a didactic and methodological concept for research-based teaching and learning based on the initial results from the block placement in general practice.Methods: Connecting medical didactic approaches with classic educational control measures (knowledge, acceptance and transfer evaluation, process evaluation, and outcome evaluation).Results: We describe the steps for implementing a research task into the block placement in general practice. Also stressed is the need to develop didactic material and the introduction of structural changes. Furthermore, these steps are integrated with the individual educational control measures. A summary serves to illustrate the learning and teaching concept (Block Placement Plus).Conclusion: The conceptualisation of the Block Placement Plus leads to changes in the daily life routine of medical education during the undergraduate block placement in general practice. The concept can in principle be transferred to other courses. It may serve as an instrument for teachers within the framework of a longitudinal curriculum for the scientific qualification of medical students.[german] Hintergrund: Zukünftige Ärzte sollen zu Evidenz-basierter Medizin (EbM) ausgebildet werden. Deswegen ist neben der Ausbildung von medizinischen Kompetenzen auch zunehmend eine wissenschaftliche Basisausbildung wichtig. Möglichkeiten und Konzepte, die auf die Entwicklung von Forschungskompetenzen und wissenschaftlicher Qualifizierung von Studierenden abzielen, sind jedoch bisher spärlich. Ziel des vorliegenden Artikels ist es, aus ersten Erfahrungen im Blockpraktikum Allgemeinmedizin ein didaktisch-methodologisches Konzept abzuleiten für forschungsorientiertes Lernen und Lehren.Methoden: Verknüpfung von Bausteinen medizin-didaktischer Methodologie mit jenen des klassischen Bildungscontrolling (Wissens-, Akzeptanz- und Transferevaluation, Prozessevaluation und Ergebnisevaluation).Ergebnisse: Vorgestellt werden die Schritte zur Implementierung einer Forschungsaufgabe in das Blockpraktikum. Gleichzeitig wird auf die Notwendigkeit der Entwicklung von lehrdidaktischem Material und der Einführung von strukturellen Veränderungen abgehoben. Des Weiteren findet die Verzahnung mit den einzelnen Bildungscontrolling-Schritten statt. Eine Übersicht dient der Veranschaulichung des Lehr- und Lernkonzepts (Blockpraktikum plus).Schlussfolgerung: Die Konzeptionalisierung des „Blockpraktikum plus“ in Allgemeinmedizin stellt eine Veränderung des Lehr- und Lernalltags dar. Das Konzept ist prinzipiell übertragbar auf andere Lehrveranstaltungen und kann als Instrument für Lehrende im Rahmen einer longitudinalen Kompetenzvermittlung wissenschaftlicher Basisfertigkeiten eingesetzt werden.

Some patients develop multiple protracted sequelae after infection with SARS- CoV-2, collectively known as post-COVID syndrome or long COVID. To date, there is no evidence showing benefit of specific therapies for this condition, and patients likely resort to self-initiated therapies. We aimed to obtain information about therapies used by and needs of this population via inductive crowdsourcing research. Patients completed an online questionnaire about their symptoms and experiences with therapeutic approaches. Responses of 499 participants suggested few approaches (eg, mind-body medicine, respiratory therapy) had positive effects and showed a great need for patient-centered communication (eg, more recognition of this syndrome). Our findings can help design clinical studies and underscore the importance of the holistic approach to care provided by family medicine. Key words: COVID-19/complications; long COVID; COVID-19/therapy; chronic disease/therapy; family medicine; crowdsourcing research; surveys and questionnaires; patient needs; self-management; self-medication; patient-centered communication; holistic care, INTRODUCTION After surviving an infection with SARS-CoV-2, about one-half of patients report long-term sequelae, collectively called post-COVID syndrome or long COVID. In a population-based study, the most common symptoms were [...]

Medical guidelines recommend actively addressing patients' information needs regarding complementary and integrative healthcare (CIH). Within the CCC-Integrativ study, an interprofessional counseling program on CIH was developed and implemented at four comprehensive cancer centers (CCCs) in Germany. As part of the process evaluation, this study examines cancer patients' experiences with interprofessional CIH counseling sessions conducted by a physician and a nurse. Forty problem-centered interviews were conducted using a semi-structured interview guide. All interviews were audio-recorded, transcribed verbatim, and analyzed using deductive–inductive content analysis based on Kuckartz and Rädiker's approach. Findings revealed that most participants had prior experience with CIH approaches and were burdened by physiological and psychological symptoms. Counseling sessions focused on cancer- and treatment-related symptoms and appropriate CIH recommendations (e.g., herbal poultice against anxieties and acupressure against nausea). Participants appreciated the mutual exchange and integration of perspectives from different healthcare professions within the interprofessional approach. They noted that the counseling team comprehensively addressed their healthcare and CIH information needs. Suggestions for improvement included the specificity of the CIH recommendations. As the participants only received counseling and no CIH treatments, information about reputable CIH providers was particularly important to many seeking advice. Patients with cancer receiving tailored CIH counseling from two healthcare professionals experienced benefits in CIH counseling for symptom management. The interprofessional teams offered a comprehensive perspective on patients' needs, proposing personalized recommendations for symptom control. These insights may foster collaboration between healthcare professionals interested in CIH counseling, enabling them to expand and consolidate their counseling services. [ABSTRACT FROM AUTHOR]