[The situation of education in ENT-residency-training in Germany].
Ontology highlight
ABSTRACT: Background
As a starting point for developing concrete suggestions for optimizing specialty training in German ENT departments, the present study analysed the current status of residency training in order to identify weaknesses.Methods
Residents at German ENT departments were invited to participate in an online survey. The questionnaire comprised 78 individual questions.Results
The questionnaire was answered by 223 ENT residents. Educational deficits such as a lack of regular feedback from supervisors, only moderately rated mediation of specialist competencies, capriciousness of the trainers in charge regarding the organisation of training, and time and personnel shortages were identified. Some of the mandatory recommendations of the specialty training regulations, including determination of concrete training goals during regular meetings or the use of a logbook, have only been implemented in limited cases. Demands for development of more external training opportunities (job shadowing/rotation) and an external objective review of the residency training (e.g., by a representative of the German Society of Otorhinolaryngology, Head and Neck Surgery, DGHNOKHC) in the sense of quality assurance are discussed.Conclusion
Implementation of structured and standardized ENT residency training in Germany, for which DGHNOKHC reviewal is also possible, can generate a basis for more effective compulsory residency training.
SUBMITTER: Linke J
PROVIDER: S-EPMC8233243 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:To meet the demand by residents and to provide knowledge and skills important to the developing physician, global health (GH) training opportunities are increasingly being developed by United States (U.S.) residency training programs. However, many residency programs face common challenges of developing GH curricula, offering safe and mentored international rotations, and creating GH experiences that are of service to resource-limiting settings. Academic GH partnerships allow for the opportunity to collaborate on education and research and improve health care and health systems, but must ensure mutual benefit to U.S. and international partners. This article provides guidance for incorporating GH education into U.S. residency programs in an ethically sound and sustainable manner, and gives examples and solutions for common challenges encountered when developing GH education programs.
| S-EPMC5400750 | biostudies-literature
Project description:IntroductionSurgery and the training of young surgeons face various challenges. Work hour restrictions, demographic changes, medicolegal demands, as well as economic constraints have led to changes in patient care and thus changed surgical residency. In addition to the daily training at work, several theoretical and practical courses are offered to surgical residents. The aim of this manuscript is to provide an overview of the existing courses and programs for surgical residents in Germany. It describes the current structure of surgical training in Germany for 10 subspecialties and sets out existing approaches to implement structured surgical training by professional associations as well as by commercial providers.Materials and methodsThe official homepages of 10 surgical associations were analyzed for information on structured surgical training and a Google search for surgical training programs was conducted. Then, the websites of two commercial providers were searched for information in courses. In addition, the members of the German Young Surgeons Association were asked open questions about the existence of structured resident training and additional training opportunities in their specialty. The courses were analyzed for structural characteristics such as the price and type of course (single course, exam preparatory course, and structured program). A structured program was defined as a set of courses based on learning objectives that are designed to cover all aspects of the specialty and include some form of summative or formative assessment.ResultsSeveral courses are offered by varied providers; some of them associated with surgical associations and some commercial. Seven of 10 professional associations offer single courses and six of them offer exam preparatory courses. Commercial providers only offer single courses. All of these courses are optional; there is no requirement to take part in any of them. None of them is free of charge, but most offer discounts for members of surgical societies. Only one structured program exists for orthopedics and trauma surgery. A fixed schedule does not exist for any surgical subspecialty, but it is rather the responsibility of the trainee or his/her supervisor to pick or suggest a course that suits their personal state of knowledge.DiscussionUntil now, it depends on personal motivation and the generosity of hospitals whether or not surgical residents will receive training outside of their training hospital. Various external courses are offered in all surgical subspecialties to complement on-the-job training. It is unknown how many residents take part in them. The implementation of new, competence-based specialist training regulations in Germany in 2018 may facilitate a change in surgical education. Simulation-based education can promote the acquisition and consolidation of surgical skills. Additional training possibilities and structured programs should be implemented in surgical resident training to foster competence-based education and surgical proficiency.
| S-EPMC6754064 | biostudies-literature
Project description:The Integrative Medicine in Residency (IMR) program, a 200-hour Internet-based, collaborative educational initiative was implemented in 8 family medicine residency programs and has shown a potential to serve as a national model for incorporating training in integrative/complementary/alternative medicine in graduate medical education.The curriculum content was designed based on a needs assessment and a set of competencies for graduate medical education developed following the Accreditation Council for Graduate Medical Education outcome project guidelines. The content was delivered through distributed online learning and included onsite activities. A modular format allowed for a flexible implementation in different residency settings.TO ASSESS THE FEASIBILITY OF IMPLEMENTING THE CURRICULUM, A MULTIMODAL EVALUATION WAS UTILIZED, INCLUDING: (1) residents' evaluation of the curriculum; (2) residents' competencies evaluation through medical knowledge testing, self-assessment, direct observations, and reflections; and (3) residents' wellness and well-being through behavioral assessments.The class of 2011 (n = 61) had a high rate of curriculum completion in the first and second year (98.7% and 84.2%) and course evaluations on meeting objectives, clinical utility, and functioning of the technology were highly rated. There was a statistically significant improvement in medical knowledge test scores for questions aligned with content for both the PGY-1 and PGY-2 courses.The IMR program is an advance in the national effort to make training in integrative medicine available to physicians on a broad scale and is a success in terms of online education. Evaluation suggests that this program is feasible for implementation and acceptable to residents despite the many pressures of residency.
| S-EPMC3312539 | biostudies-other
Project description:Virtual patients (VPs) are a one-of-a-kind e-learning resource, fostering clinical reasoning skills through clinical case examples. The combination with face-to-face teaching is important for their successful integration, which is referred to as "blended learning". So far little is known about the use of VPs in the field of continuing medical education and residency training. The pilot study presented here inquired the application of VPs in the framework of a pediatric residency revision course.Around 200 participants of a pediatric nephology lecture ('nephrotic and nephritic syndrome in children') were offered two VPs as a wrap-up session at the revision course of the German Society for Pediatrics and Adolescent Medicine (DGKJ) 2009 in Heidelberg, Germany. Using a web-based survey form, different aspects were evaluated concerning the learning experiences with VPs, the combination with the lecture, and the use of VPs for residency training in general.N=40 evaluable survey forms were returned (approximately 21%). The return rate was impaired by a technical problem with the local Wi-Fi firewall. The participants perceived the work-up of the VPs as a worthwhile learning experience, with proper preparation for diagnosing and treating real patients with similar complaints. Case presentations, interactivity, and locally and timely independent repetitive practices were, in particular, pointed out. On being asked about the use of VPs in general for residency training, there was a distinct demand for more such offers.VPs may reasonably complement existing learning activities in residency training.
| S-EPMC4647158 | biostudies-other
Project description:BACKGROUND:Graduate medical education is shifting from the traditional apprenticeship model to a competency-driven model. Here we describe the design and implementation of competency-based medical education (CBME) in an internal medicine residency program, and report satisfaction survey results. METHODS:We redesigned the residency curriculum as CBME to be resident-centred, systematic, focused on general internal medicine, to provide experience in various care setting, and work-based assessment. In the second year of this CBME transition, we surveyed residents' overall satisfaction using 5-point Likert scale. Feedback on their training program was also analysed. RESULTS:The overall satisfaction score was 3.24 and thirteen residents (61.9%) answered that the preceptor's practical training in an educational atmosphere and improvement through training were the merits of the training program. However, residents complained about the working condition such as work overload. CONCLUSION:With the CBME implementation, most residents expressed satisfaction with the hospital's educational environment but they suffered from overwork. Further efforts to improve the educational program and environment are warranted.
| S-EPMC6660321 | biostudies-other
Project description:Both Germany and the United States of America have a long tradition of science and medical excellence reaching back as far as the nineteenth century. The same tribute must be paid to the medical educational system in both countries. Despite significant initial similarities and cross-inspiration, the paths from enrolling in a medical university to graduating as a medical doctor in Germany and the US seem to have become much different. To fill a void in literature, the authors' objective therefore is to delineate both structures of medical education in an up-to-date review and examine their current differences and similarities. Recent medical publications, legal guidelines of governmental or official organizations, articles in media, as well as the authors' personal experiences are used as sources of this report. Tuition loans of over $200,000 are not uncommon for students in the US after graduating from medical schools, which are often private institutions. In Germany, however, the vast majority of medical universities are tax-funded and, for this reason, free of tuition. Significant differences and surprisingly multiple similarities exist between these two systems, despite one depending on government and the other on private organizations. Germany currently employs an integrated medical curriculum that typically begins right after high school and consists of a 2-year long pre-clinical segment teaching basic sciences and a 4-year clinical segment leading medical students to the practical aspects of medicine. On the other hand, the US education is a two-stage process. After successful completion of a Bachelor's degree in college, an American student goes through a 4-year medical program encompassing 2 years of basic science and 2 years of clinical training. In this review, we will address some of these similarities and major differences.
| S-EPMC5617919 | biostudies-other
Project description:BackgroundAbortion has been decriminalized in Canada since 1988 and is considered an essential medical service. There is concern that decreasing numbers of abortion providers may impair access to abortion. This study examined the quantity of exposure and education that Canadian family medicine residents receive on abortion during training and their preparation to provide abortions. In addition, the study assessed residents' attitudes, intention and expressed competency to provide abortion in future practice and the association between medical training and changes in these factors.MethodsThe authors developed a 21-item survey in consultation with experts in medical education. The survey was distributed online in 2016. A total of 1517 family medicine residents in their first, second and third year of training attending 8 English language schools across Canada were invited to participate. Associations between attitudes, education, exposure and intention were assessed using relative risks based on bivariate analysis of self-reported measures and odds ratios from ordered logistic regression.ResultsThe response rate was 28.7% (436/1517). The majority of residents, 79%, reported never observing or assisting with an abortion during training. Similarly, 80% of residents reported receiving less than 1 hour of formal education on abortion. Residents strongly supported receiving abortion education. Self reported exposure to a single abortion during training was associated with an increase in residents' intention (RR?=?1.95, 95% CI 1.54-2.47) and self-rated competency to provide a medical abortion (RR?=?2.16, 95% CI 1.60-2.93). Twenty five percent of residents were unaware of ethical and legal requirements towards abortion provision and referral.ConclusionsCanadian family medicine residents receive little education or exposure to abortion during training most do not feel competent to provide abortion services. Residents expressed strong support for receiving abortion training. The Canadian College of Family Physicians curriculum does not currently include abortion as a training objective. The authors argue there is a need for family medicine training programs to increase education and exposure to abortion during residency, while respecting residents' rights to opt out of such training. Failure to do so may impair future access to abortion provision.
| S-EPMC5984743 | biostudies-literature
Project description:Residency training in medicine lays the foundation for future medical doctors. In real-world settings, training centers face challenges in trying to create balanced residency programs, with cases encountered by residents not always being fairly distributed among them. In recent years, there has been a tremendous advancement in developing artificial intelligence (AI)-based algorithms with human expert guidance for medical imaging segmentation, classification, and prediction. In this paper, we turned our attention from training machines to letting them train us and developed an AI framework for personalised case-based ophthalmology residency training. The framework is built on two components: (1) a deep learning (DL) model and (2) an expert-system-powered case allocation algorithm. The DL model is trained on publicly available datasets by means of contrastive learning and can classify retinal diseases from color fundus photographs (CFPs). Patients visiting the retina clinic will have a CFP performed and afterward, the image will be interpreted by the DL model, which will give a presumptive diagnosis. This diagnosis is then passed to a case allocation algorithm which selects the resident who would most benefit from the specific case, based on their case history and performance. At the end of each case, the attending expert physician assesses the resident's performance based on standardised examination files, and the results are immediately updated in their portfolio. Our approach provides a structure for future precision medical education in ophthalmology.
| S-EPMC10002549 | biostudies-literature
Project description:The purpose of this article is to give international readers an overview of the organisation, structure and curriculum, together with important advances and problems, of undergraduate medical education in Germany. Interest in medical education in Germany has been relatively low but has gained momentum with the new "Regulation of the Licensing of Doctors" which came into effect in 2003. Medical education had required substantial reform, particularly with respect to improving the links between theoretical and clinical teaching and the extension of interdisciplinary and topic-related instruction. It takes six years and three months to complete the curriculum and training is divided into three sections: basic science (2 years), clinical science (3 years) and final clinical year. While the reorganisation of graduate medical education required by the new "Regulation of the Licensing of Doctors" has stimulated multiple excellent teaching projects, there is evidence that some of the stipulated changes have not been implemented. Indeed, whether the medical schools have complied with this regulation and its overall success remains to be assessed systematically. Mandatory external accreditation and periodic reaccreditation of medical faculties need to be established in Germany.
| S-EPMC2716556 | biostudies-literature
Project description:During government-implemented restrictions in the wake of the COVID-19 pandemic, people's everyday lives changed profoundly. However, there is to date little research chronicling how people perceived their changed everyday lives and which consequences this had. In a two-wave study, we examined the psychological characteristics of people's situations and their correlates during shutdown in a large German sample (NT1 = 1,353; NT2 = 446). First, we compared characteristics during government-issued restrictions with retrospective accounts from before and with a follow-up assessment 6 to 7 months later when many restrictions had been lifted. We found that mean levels were lower and variances were higher for most characteristics during the shutdown. Second, the experience of certain situation characteristics was associated in meaningful and theoretically expected ways with people's traits, appraisals of the COVID-19 crisis, and subjective well-being. Lastly, situation characteristics often substantially explained the associations of traits with appraisals and well-being. Our findings highlight the importance of considering perceived situations as these contribute to people's functioning during crises.
| S-EPMC7880467 | biostudies-literature