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[english] Aims: Interactive, student-centered teaching methods have replaced traditional teacher-centered didactic formats in many modern medical curricula in the past few years. However, in the natural sciences such as biochemistry, interactive teaching methods are not well proven. The present study was conducted to compare the effect of the teaching format on the performance of undergraduate students in biochemistry and their evaluation of the respective format. Methods: A total of 421 second-year students were randomized into two groups: The control group was taught in a traditional lecture-like format, whereas the study group dealt with the same topic in an interactive group discussion. At the end of each lesson, students performed a multiple-choice test and completed a questionnaire. The same MCQ test was repeated 4–6 weeks after the last lesson. Results: Students who were taught in a lecture-like format performed significantly better in the first MCQ test immediately after the lesson than students taught in the interactive format. However, in the second MCQ test, there was no difference between the two groups. In the questionnaire, students rated the lecture-based course significantly better than the interactive group discussion. Conclusion: One reason why students prefer a didactic lecture to an interactive group discussion might be due to the subject biochemistry, which is strongly knowledge-based. Students perceived that the transfer of knowledge by a professional lecturer was more effective than the knowledge obtained in a student-centered discussion group. Other reasons might be the method of assessment and the overall design of the curriculum. [german] Zielsetzung: Interaktive, Lerner-orientierte Unterrichtsmethoden werden vielfach mit moderner und guter Lehre in Verbindung gebracht und ersetzen zunehmend konventionellen, Lehrer-zentrierten Frontalunterricht. In naturwissenschaftlichen Fächern, wie Biochemie, sind interaktive Unterrichtsformen bisher nur wenig erprobt. Die vorliegende Studie wurde mit dem Ziel durchgeführt, herauszufinden, welchen Einfluss die Unterrichtsform auf den Wissenszuwachs und die studentische Beurteilung des Biochemie-Unterrichts hat. Methodik: Studierende des 4. Fachsemesters (n=421) wurden für eine Seminarveranstaltung in zwei Gruppen randomisiert. Die Kontrollgruppe erhielt konventionellen Frontalunterricht, die Studiengruppe erarbeitete sich dieselben Lerninhalte anhand konkreter Fragestellungen in interaktiven Arbeitsgruppen. Als Messinstrument zur Beurteilung des kognitiven Erfolges diente ein Wissenstest unmittelbar nach der Veranstaltung und nach 4-6 Wochen. Die Beurteilung der beiden Unterrichtsformen durch die Studierenden erfolgte anhand eines Fragebogens. Ergebnisse: Studierende, die Frontalunterricht erhielten, schnitten in einem ersten Wissenstest, direkt nach der Veranstaltung, signifikant besser ab als Studierende, die sich die Inhalte in interaktiven Gruppen selbst erarbeiteten. Im Wiederholungstest waren keine signifikanten Wissensunterschiede mehr messbar. In der Evaluation beurteilten Studierende, die Frontalunterricht erhielten, die Veranstaltung signifikant besser als diejenigen, die in Gruppen arbeiteten. Schlussfolgerung: Die schlechtere studentische Bewertung der interaktiven Unterrichtsform gegenüber Frontalunterricht in einem Biochemieseminar kann verschiedene Ursachen haben. Eine Ursache könnte die starke Orientierung des Faches an Faktenwissen sein. Dieses Wissen wurde nach Meinung der Studierenden - in dem in dieser Studie gegebenen Rahmen – vom Dozenten besser vermittelt als es in einer interaktiven Gruppenarbeit von Studierenden selbst erarbeitet werden konnte. Andere Ursachen könnten Prüfungsmethoden und curriculare Vorgaben sein.

[english] Overestimating one's clinical competence can be dangerous to patient's safety. Therefore the goal of this study was to identify students with high confidence in their own clinical competence but low performance in objective assessment. 171 students in the 14 week course in internal medicine completed the clinical skills-related self-assessment expectations (SE) and were tested in a 12 station OSCE. Both measures were obtained within three days. In total we identified 16% of students who overestimated their performance in clinical skills compared to their OSCE-results. Male students significantly more oversestimated their clinical compltence (31%) than female students. One possible cause may be the lack of corrective experiences during clinical traineeship leading to the misconception of own performance. Further validation and the integration of a counselling program for these students seem necessary. [german] Die Selbstüberschätzung ärztlicher Kompetenzen kann weitereichende Konsequenzen für die Patientensicherheit haben. Aus diesem Grunde initiierten wir eine Studie zur Identifizierung von Studierenden, die ihre klinische Kompetenz als sehr gut einschätzen, jedoch eine unzufriedenstellende objektive klinisch-praktische Performanz aufweisen. 171 Studierende des 14-wöchigen Blockes Innere Medizin an der Medizinischen Universitätsklinik Heidelberg füllten einen Selbsteinschätzungsfragebogen zur klinischen Kompetenz aus und wurden in einem 12-Stationen OSCE evaluiert. Beide Messungen wurden innerhalb von drei Tagen vollzogen. Insgesamt konnten 16% der Studierenden identifiziert werden, die sich verglichen mit den OSCE-Ergebnissen, bezüglich ihrer klinisch-praktischen Fertigkeit selbst überschätzen. Dabei überschätzen sich signifikant mehr männliche (31%) als weibliche (8%) Studierende. Eine mögliche Erklärung für den Sachverhalt der studentischen Fehleinschätzung klinischer Kompetenzen könnte in fehlenden korrigierenden Rückmeldungen im Rahmen des Studiums zu sehen sein. Die systematische Integration von Beratungsprogrammen für Studierende scheint hier sinnvoll.

[english] The evaluation steps are described which are necessary for an elementary test-theoretic analysis of an exam and sufficient as a basis of item-revisions, improvements of the composition of tests and feedback to teaching coordinators and curriculum developers. These steps include the evaluation of the results, the analysis of item difficulty and discrimination and - where appropriate - the corresponding evaluation of single answers. To complete the procedure, the internal consistency is determined, which makes an estimate of the reliability and significance of the examination. [german] Es werden die Auswertungsschritte beschrieben, die für eine einfache testtheoretische Analyse einer Prüfung notwendig sowie als Grundlage von Aufgabenrevisionen, Verbesserungen von Prüfungszusammenstellungen und Rückmeldung an Lehrbeauftragte und Curriculumsentwickler ausreichend sind. Diese Schritte umfassen die Ergebnisauswertung, die Analyse der Aufgabenschwierigkeiten und der Trennschärfen, sowie - wo angebracht - die entsprechenden Auswertungen der Einzelantworten. Vervollständigt wird das Vorgehen durch die Bestimmung der internen Konsistenz, durch die die Zuverlässigkeit und Aussagekraft (Reliabilität) der Prüfung abgeschätzt wird.

The results of a 12-year follow-up study of occurrence and timing of first recovery in 69 hospitalized patients with severe anorexia nervosa (AN) are presented. For the first time discrete-time survival analysis methods were used to determine the likelihood of recovery in AN patients. Furthermore, predictors gleaned from pretreatment-posttreatment studies of long-term outcome in AN could be evaluated as to their effect on a change in the time course structure of the likelihood of first recovery. Results show that AN condition did not improve until after 6 years after the first inpatient treatment in 50% of patients. However, a restricter-type AN and low serum creatinine levels were predictors for earlier recovery. One specific effect was that AN patients who show purging behavior in combination with additional social disturbances have a lower chance of recovering. The use of discrete-time survival analysis methodology in further prospective studies will contribute to the development of more tailored treatment of AN, which also takes the individual phase of illness and specific aspects of the symptomatology into account.

Objective: The aim of this randomized controlled trial (RCT) was to assess the efficacy of a short intervention targeting psychosomatic care in older adults with complex health care needs.Methods: Participants were recruited in the frame of the 11-year follow-up of a large population-based study by means of the INTERMED interview. The INTERMED interview is an integrative assessment method to identify bio-psycho-social health care needs. Persons with high health care needs (interview score ≥ 17) were invited to take part. Participants were randomized with a 1:1 ratio to a control and an intervention group. The intervention group received a home visit conducted by a doctor trained in psychosomatic medicine. The primary hypothesis stated that the intervention group would have a better outcome with respect to health related quality of life (HRQOL) measured by the 12-item short-form health survey (mental component score, MCS) 6 months after randomization (T1). Secondary outcomes were physical HRQOL, health care needs, depression, anxiety, and somatic symptom severity.Results: In total, 175 participants were included. At the three-year follow-up (T2), 97 participants (55.4%) were included. At T1, we did not find a difference regarding MCS between the intervention and control groups. At T2, the intervention group showed significantly lower health care needs compared with the control group. Regarding HRQOL, depression, and somatic symptom severity the two groups did not differ at T2.Conclusions: The primary hypothesis was not confirmed. However, results indicate that a short intervention with complex patients could lead to reduced bio-psycho-social health care needs. [ABSTRACT FROM AUTHOR]