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Background: "Flipped classroom" is a didactic teaching concept in which learning contents are prepared by self-study with arranged tools before the classroom session. The concept offers the advantage of a uniform knowledge base for the students at the beginning of the course and also the advantage of a greater theoretical knowledge, which creates more opportunities for practical exercises, application and consolidation in the subsequent joint teaching units. This study describes the establishment and application of such a model in student teaching in ophthalmology and analyzes the student's evaluation., Methodology: For the winter term 2018/2019, a new teaching module was designed and established in a cooperation between the department of ophthalmology and the Institute for Education and Study Affairs (IfAS) at the medical faculty of the University of Münster. A uniform training of the lecturers as well as a preparation of the students for the restructuring took place. After the course the evaluation of the students was recorded and evaluated using a standardized online evaluation., Results: Between the winter semester 2018/2019 and the winter semester 2019/2020, an average of 112.3 ± 4.0 students were taught with the "flipped classroom" model. Of these 93.7% were able to give an assessment. In the previous semesters with the old teaching concept (summer semester 2015 to summer semester 2018), the average number of students was 115.4 ± 15.1 with an assessment rate of 93.3%. The new teaching concept achieved on average a better assessment than the old module., Conclusion: With a "flipped classroom" space and flexibility can be generated for a more individual course preparation and at the same time a higher practical part. Further studies are needed to analyze whether this also enables a sustainable transfer of knowledge.

Background: At present minimum nursing staff numbers have been defined and are being implemented. In December 2019 the German Medical Association asked the German professional associations about their general experience with planning of medical personnel in hospital departments. As no structured data were available on this subject, the German Ophthalmological Society (DOG) founded a working group in March 2020 to answer this request., Method: In the course of several consensus meetings, the working group on personnel planning for physicians in hospitals of the DOG prepared a questionnaire on previous experiences in personnel planning of eye hospitals, which was sent to the heads of all university eye hospitals and departments of ophthalmology in Germany. The questionnaire consisted of individual items with fixed choices and free answers regarding the procedure and current situation of staffing as well as the range of tasks and organization of the medical service., Results: Out of 104 departments 53 (51%) responded, of which 25 were from university departments (64% response), 23 from departments of other public or non-profit ownership (46%) and 5 from departments with private hospital ownership (33%). Of these 49% stated that there was no transparent basis for calculation of the number of medical positions in their hospital. Of the surveyed departments, outpatient tasks, services and revenues were considered in the calculations in only 47%. There was a statistically significant higher ratio of full-time personnel to the numbers of beds in university departments compared to private and publicly owned non-profit institutions (p < 0.001, t‑test). All departments have to cope with multiple additional tasks in addition to clinical patient care, which are taken into account only to a limited extent in the staffing. Approximately 70% of the departments provide a 24 h/7 day (24/7) medical on-call service on site, 91% have a 24/7 surgery on-call service and 34% have a cooperation with emergency services run by the Association of Statutory Health Insurance Physicians., Conclusion: The results show how heterogeneously and nontransparent German departments of ophthalmology are staffed in terms of medical doctors. On average, university departments have higher personnel resources per hospital bed to cope with additional tasks in research and teaching. Outpatient tasks, which contribute significantly to the revenues of an eye department, and multiple other tasks are often not taken into account in the personnel calculation. A transparent and uniform basis for calculation of the medical staff of the departments is desirable in order to achieve a sufficient personnel staffing for a patient and employee-oriented working environment.

Background: The implementation of an electronic patient health record (EHR) system in the field of ophthalmology can be a challenging project for many hospitals. Although all hospitals have a hospital information systems (HIS), these systems are often not capable of managing the complexity of ophthalmological patient records., Methods: This article reports the implementation of an ophthalmological EHR into the pre-existing HIS (Agfa-ORBIS; Agfa HealthCare GmbH, Bonn, Germany). The digital record management and the connections to the peripheral examination devices are presented., Results: The EHR developed by us has been in clinical use since 2009 and is subject to continuous further development. Through close cooperation with the IT department, all examination devices could be digitally connected, enabling paperless work and avoiding the drawbacks of paper files., Discussion: The advantages of an EHR implemented into the existing HIS are manifold. Through such a system a complete, interdisciplinary and ubiquitous documentation can take place. The alternative is the acquisition of a third system, which must be connected by an interface with the main system and has significantly higher acquisition and maintenance costs.

Background: The implementation of electronic medical records (EMR) in the Department of Ophthalmology at the Saarland University Medical Center (UKS) in January 2016 was a timely response to growing documentation requirements and rapidly increasing electronic diagnostic data. The software system was primarily developed for private practices and cannot therefore meet the different requirements of various clinics out of the box. The purpose of this study was to identify features of the EMR beyond purely paper replacement that can assist in the clinical workflow and whether these features can be implemented in a running system., Methods: The EMR was specifically individualized with respect to the work processes and documentation requirements of the Department of Ophthalmology at the UKS. In addition to a seamless integration into the hospital information system (HIS) the modifications included changes in the structure and visual presentation of the EMR as well as functional extensions. An internet-based platform was set up to enable a direct exchange of appointments and patient data with specialist practices., Results: Due to the introduction of a so-called ghost list the position of patients within the hospital who are allocated to a physician, e.g. for diagnostics, can be reconstructed at any point in time. The logging of the individual treatment times enables tracking of patient flow within the clinic and a reduction of waiting times. Existing paper documents particularly for the graphic recording of findings, such as sketches, are digitalized eliminating the need to scan documents. The UKS.AUGEN.NETZ is an internet-based portal to facilitate direct organization of appointments with specialist practitioners and for the exchange of digital examination data and medical correspondence., Conclusion: The permanent close cooperation between employees of the Department of Ophthalmology at the UKS and the manufacturer of the software enables a continuous optimization of the EMR in a fully operational clinical workflow. In addition, the web-based interface improves the cooperation between the hospital and private practices.

Background: For more than 60 years patient records of the Department of Ophthalmology at the Saarland Medical Center in Homburg were documented on handwritten paper documents and filed in archives. Increasing requirements for medical documentation, exploding volumes of diagnostic data, overcrowded archives and unavailable files when needed, were the essential rationales for the implementation of an electronic patient archive (EPA)., Methods: The EPA has been specifically adapted to the requirements of the Department of Ophthalmology in order to guarantee a standardized unobstructed documentation and patient care across all sections of the department. Seamless integration into the clinic information system (KIS) and network-compatible diagnostic software were essential as well as a timely digitization of existing paper charts. Decisive factors for using FIDUS (Arztservice Wente GmbH, Darmstadt, Germany) as the EPA software were the visual layout of the EPA, user friendliness and reference installations of the software in other ophthalmology departments., Results: After one and a half years of meticulous preparation with specific adaptations to the requirements of our department, the EPA was finally implemented in January 2016 and since then we have been working on improvements. The EPA software retrieves basic patient data from the KIS and diagnostic data from electronic devices via various interfaces. Expenses for printers could be reduced but computer workplaces had to be expanded or newly created. For previous patients paper files are digitized externally and stored in an electronic archive directly accessible from the EPA., Discussion: Successful reorganization and implementation of electronic documentation during clinical routine is feasible with careful preparation and timely involvement of information technology experts, motivated physicians, nurses, research departments and the administration.

Background: The Homburger Curriculum was introduced in 2012 to enhance the medical resident education and professional satisfaction. At the same time different steps were taken to encourage applications of eligible candidates., Methods: To address candidates, the Homburger Curriculum is presented on the department's website and a short-term hospitation was introduced. The curriculum has been divided into time slots of 4 months throughout the 5 years of residency. In addition, a booklet of documented evidence of the rotations and a Resident's Compendium were introduced. Internal and external teaching programs, additional research projects and involvement of the residents in the organization of their curriculum were introduced. The paper describes the rationale behind the new structure of the curriculum and its practical outcomes for the department (e. g. a regular standby resident to fill in unexpected gaps)., Results: It is discussed in detail which steps were easy to implement and which steps were more difficult to introduce. After consolidation of the numerous steps, the number of resigning residents dropped significantly and the number of applicants increased., Conclusions: The new rotation schedule guarantees every young resident to be able to work at each work area of the Department of Ophthalmology. External training courses can be planned suitable to his/her rotations. An "internal competition" for popular rotations is no longer necessary. Clear organization and transparency in all areas provide good interpersonal climate in which much work still has to be done, but by motivated and satisfied residents.

Background: Although electronic health records (EHR) were introduced into ophthalmology practices many years ago, paper-based medical records are still common in most tertiary care eye hospitals., Material and Methods: We report on the implementation of an EHR system at the university eye hospital in Münster in the time period between January and December 2013., Results: Advantages of an EHR system in the setting of a university eye hospital include ubiquitous access to patient data, structurability as well as scientific interpretability. Data safety, personnel and financial investment and integration into existing hospital software systems represent the main challenges., Conclusion: The EHR system will replace paper-based records in the future. In view of the high need for visualization and recording of medical findings, EHR software solutions seem promising particularly in ophthalmology.