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Evaluation of the current status of Rehabilitation, Physical Medicine and Naturopathy education 10 years after the reform of the Medical Licensure Act - a nationwide survey of German Medical Universities.

ABSTRACT: 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 subject Results: 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.

SUBMITTER: Stock-Schroer B

PROVIDER: S-EPMC5327655 | biostudies-other | 2017

REPOSITORIES: biostudies-other

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Evaluation of the current status of Rehabilitation, Physical Medicine and Naturopathy education 10 years after the reform of the Medical Licensure Act - a nationwide survey of German Medical Universities.

Stock-Schröer Beate B Huber Roman R Joos Stefanie S Klose Petra P

GMS journal for medical education 20170215 1

<b>Introduction:</b> 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. <b>Methods:</b> A questionnaire- ...[more]

PMID: 28293670

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Project description:BackgroundSince June 2002, revised regulations in Germany have required "Emergency Medical Care" as an interdisciplinary subject, and state that emergency treatment should be of increasing importance within the curriculum. A survey of the current status of undergraduate medical education in emergency medical care establishes the basis for further committee work.MethodsUsing a standardized questionnaire, all medical faculties in Germany were asked to answer questions concerning the structure of their curriculum, representation of disciplines, instructors' qualifications, teaching and assessment methods, as well as evaluation procedures.ResultsData from 35 of the 38 medical schools in Germany were analysed. In 32 of 35 medical faculties, the local Department of Anaesthesiology is responsible for the teaching of emergency medical care; in two faculties, emergency medicine is taught mainly by the Department of Surgery and in another by Internal Medicine. Lectures, seminars and practical training units are scheduled in varying composition at 97% of the locations. Simulation technology is integrated at 60% (n = 21); problem-based learning at 29% (n = 10), e-learning at 3% (n = 1), and internship in ambulance service is mandatory at 11% (n = 4). In terms of assessment methods, multiple-choice exams (15 to 70 questions) are favoured (89%, n = 31), partially supplemented by open questions (31%, n = 11). Some faculties also perform single practical tests (43%, n = 15), objective structured clinical examination (OSCE; 29%, n = 10) or oral examinations (17%, n = 6).ConclusionEmergency Medical Care in undergraduate medical education in Germany has a practical orientation, but is very inconsistently structured. The innovative options of simulation technology or state-of-the-art assessment methods are not consistently utilized. Therefore, an exchange of experiences and concepts between faculties and disciplines should be promoted to guarantee a standard level of education in emergency medical care.

Project description:Background: Recent decades have seen controversial discussions on the validity of dissection courses in medical education, with alternative programs tested for various reasons. On April 1, 2015 the classification of formaldehyde as a hazardous substance was upgraded by the EU, leding to some universities precluding the participation of pregnant and breastfeeding students in dissection course. However, the revision to the Maternity Protection Act, implemented in Germany on January 1, 2018, now protects student mothers from being disadvantaged in their studies as a consequence of their pregnancy or breastfeeding. Therefore, universities must offer alternatives to dissection courses using formaldehyde to these female students. Project description: As an alternative to regular dissection courses, which use the abovementioned chemical, the Centre for Anatomy at Charité has opted for developing dedicated courses for student mothers. These new courses use plastinated prosection material instead of formalin-treated cadavers of body donors. As the core of the anatomical education takes place during the third and fourth semester in the current curriculum of human medicine at Charité the alternative courses are limited to those two semesters. Additionally, alternative exams at the end of both semesters had to be developed. The alternative courses were designed to offer pregnant and breastfeeding students a study program as close as possible to the one in which their peers learn human anatomy. Results: For the new courses, plastinates had to be produced and further specimens are still needed. Additionally required sets of bones, models and radiological images were readily available at the Centre for Anatomy. The planning and conceptualization of the courses took half a year of intense preparation. The courses for the third and fourth semester were first running during summer semester 2017. There is a clear demand for courses among pregnant and breastfeeding students. At least 5 student participants per course were registered, corresponding to every fortieth female student in their semester cohorts. The highest number of student participants was 13 in one course so far. The performances of the participants in the anatomical examinations were matching that of students attending the regular courses. Discussion: The alternative macroscopic anatomy courses enable the implementation of the revised Maternity Protection Act. The targeted student group is highly satisfied with the offered alternative courses. Considering the number of participants and their examination performance so far, the Centre for Anatomy regards the efforts involved in planning and implementing the courses as justified. The courses allow pregnant and breastfeeding students to address the same anatomical themes at the same time as their fellow students. However, due to restricted flexibility of plastinates and because students cannot prepare specific anatomical structures independently the scope of topographic learning is limited. That being said, well-produced plastinates can display anatomical structures which often cannot be dissected in regular courses. The alternative macroscopic anatomy courses using plastinates constitute suitable alternatives to the regular dissection courses with formalin-treated cadavers for pregnant and breastfeeding students.

Project description:Objective: In order to evaluate the quality of postgraduate medical education in Germany, we examined how the learning of theoretical and practical competencies is conceptualized and how the learning process takes place in real terms. The training conditions, as perceived by medical residents, are compared with the learning objectives, as stated by the Federal Chamber of Physicians in its regulation on postgraduate education. The analysis is based on the data of the "KarMed" study (abbreviation of "career progression and career breaks among physicians during postgraduate education"), a multicentre cohort study of medical school graduates from seven universities who arre followed until they receive their licenses as specialist physicians. The study was conducted by the Institute of Primary Medical Care of the University Medical Center Hamburg-Eppendorf starting in 2008. Methodology: The KarMed study is based on annual, standardized surveys of the population described above. 48% responded in the initial survey (n=1012) and 85% or more in each of the following surveys. Descriptive statistics and logistical regressions were used for analysis. Gender-specific analyses were performed where possible in order to highlight the differences in the professional objectives and workloads between female and male physicians. Results: The study shows that both the practical and the theoretical components of postgraduate medical education in Germany are insufficient. There is a lack of a curriculum with precise learning objectives and descriptions of the corresponding educational settings. In fact, the act of learning is identical to daily clinical work. There is no structuring of the work process with regard to learning; for example, documentation procedures and feedback discussions are prescribed but largely omitted. Evidence-based medicine is not a systematic part of the training, nor is the evaluation of residents' progress. The summative final oral examination pretends that the necessary specialist competencies can be evaluated within 30 minutes. Many factors indicate that female doctors, especially those with children, have fewer learning opportunities than male doctors. Conclusion: The quality of postgraduate medical education in Germany has become inadequate, especially in an international comparison. The deficits are well known. The responsible institutions are called upon to implement sustainable reforms in the sense of postgraduate education that is structured according to educational principles and whose quality is assured.

Project description:Background: The purpose of this study was twofold: to assess the status of undergraduate medical ultrasound (US) education in the German-speaking area and to suggest a possible framework for a longitudinal undergraduate medical US curriculum based on the study results and a literature review. Methods: The survey included 44 medical faculties in the German-speaking area: 37 in Germany, four in Austria and three in German-speaking Switzerland. A standardized questionnaire focused on the following aspects of undergraduate medical US education: general information, organization, resources, assessment methods and evaluation. Results: Data from 28 medical faculties were analysed. 26 out of 28 medical faculties offered US courses, 21 offered compulsory as well as elective courses, four offered compulsory and one elective courses only. 27 medical faculties supported US skills implementation. Abdominal US (n=25) was most common in teaching basic US skills. A learning objective catalogue was provided at 15 medical faculties. At 22 medical faculties, medical specialists were involved in undergraduate medical US education. 24 out of 26 medical faculties thought that peer-teaching is important to convey US skills. Medical faculties used the following methods to assess US skills: objective structured clinical examination (OSCE, n=7), non-standardized practical exams (n=4), non-standardized combined oral-practical exams (n=2) or direct observation of procedural skills (DOPS, n=1). 25 out of 26 medical faculties evaluated their US courses and 19 made suggestions for improvements in undergraduate medical US education. Conclusion: Medical faculty members in the German-speaking area have recognized the relevance of undergraduate medical US education. So far, courses are offered heterogeneously with rather short hands-on scanning time and high student-instructor ratio. Based on the results of this study and a literature review we suggest a possible framework and milestones on the way to a longitudinal undergraduate medical US curriculum.

Project description:ObjectivesApproximately 10 years ago, China introduced an education plan to improve the overall quality of medical education and to better serve the population's health needs. Many medical schools were then recognised and financed by China's Ministry of Education to develop and operationalise new pilot programmes (PPs) aligned with this plan. These ran in parallel with the traditional programmes (TPs). One way to achieve the plan's first aim, improving the quality of medical education, is to select academically stronger candidates. We, thus, examined and compared who were selected into PPs and TPs.DesignCross-sectional study.SettingData were collected from 123 medical schools across China via the 2021 China Medical Student Survey.ParticipantsParticipants were undergraduate clinical medicine students across all year groups.Primary and secondary outcome measuresMedical school selection was via the National College Entrance Examination (NCEE). Medical students' NCEE performance and their sociodemographics were used as the primary and secondary outcome measures. Mann-Whitney or χ2 tests were used to compare the means between educational programmes (PPs vs TPs) and various selection outcomes. Multilevel mixed-effects regressions were employed to account for school idiosyncratic selection results.ResultsOf the 204 817 respondents, 194 163 (94.8%) were in a TP and 10 654 (5.2%) a PP. PP respondents (median=75.2, IQR=69.5-78.8) had significantly higher NCEE scores than their TP counterparts (median=73.9, IQR=68.5-78.7). Holding constant their NCEE score, PP respondents were significantly more likely to come from urban areas, not be first-generation college students, and have parents with higher occupational status and income.ConclusionsAssuming quality can be indicated by prior academic achievement at the point of selection, PPs achieved this mission. However, doing so limited medical students' diversity. This may be unhelpful in achieving the Education Plan's goal to better serve China's health needs.

Dataset Information

Evaluation of the current status of Rehabilitation, Physical Medicine and Naturopathy education 10 years after the reform of the Medical Licensure Act - a nationwide survey of German Medical Universities.

Publications

Evaluation of the current status of Rehabilitation, Physical Medicine and Naturopathy education 10 years after the reform of the Medical Licensure Act - a nationwide survey of German Medical Universities.

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