ABSTRACT: Objective: The Master Plan for Medical Studies 2020 places additional emphasis on curricular development processes. In addition, institutes may recognize a need to optimize their courses, for example because of poor evaluations. Frequently, however, the resources required for comprehensive optimizations are not available. In the present study, we aimed to use the example of a biochemistry seminar that takes place in the preclinical part of the medical degree at Ulm University Medical School to show how a course can be successfully optimized in small steps and evaluation results can be used for quality assurance. Methods: Similar to a continuous improvement process (CIP), over the course of five years a biochemistry seminar was gradually optimized in three steps. This process used structural, methodological, and content components, such as vertical integration, the inverted classroom method, and competence orientation. For quality assurance, we analyzed the official, standardized evaluation sheets from a total of n=1248 students. We evaluated the optimization process on the basis of responses to evaluation statements that were arranged into categories such as "organization, structure, implementation" and "quality of teaching," free text information, and the results of a pilot study conducted in parallel. We then determined the usefulness of the students' evaluation results for evaluating the optimization process. Results: Each developmental step resulted in a significantly more positive overall evaluation of the seminar by the students. This result was independent of whether the development was on a structural or methodological/content-related level. In addition, the evaluations of the categories that were optimized were significantly better. For example, the vertical integration and introduction of the inverted classroom method were accompanied by a better evaluation of the "quality of teaching" and a change in the structure led to a higher score in the category "organization, structure, implementation." A comparison with the free text evaluation sheets and the results of the pilot study supports the results. Conclusion: Although optimization of a curriculum or course is a major task, it can also be successfully completed in small steps. With this approach, new learning goals, for example as required in the Master Plan for Medical Studies 2020, can be continuously integrated and student satisfaction with a course can be increased. Student evaluation results can represent a kind of quality assurance in this process and can provide important impulses for optimization.
