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Background: The MAAS Global () is an internationally widely-used instrument in under- and postgraduate medical education. The focus is on the assessment of medical communication and clinical skills. The assessment tool, which has also been used in Germany since 2015, has a high-quality design (e.g. comprehensible structure, appropriate complexity), good psychometric properties and is very user-friendly. An update of MAAS Global, MAAS 2.0, was published in March 2021 with a new and greater focus on context and the formative.Method: The revised version of the MAAS 2.0 assessment sheet was translated into German with the authors’ permission. Open questions were discussed with the revision process project manager. Results: The revision was carried out with a view to focusing on the patient’s frame of reference, removing ambiguities identified previously while using MAAS Global, and closer alignment with the underlying Calgary-Cambridge model. Furthermore, the scale used for the evaluation was modified and now uses a formative evaluation range without grade-related classification. Conclusion: With the content reorientation of MAAS Global to MAAS 2.0, and the associated focus on frame of reference, context, the formative, the revision presented here sets new priorities for future evaluations in the context of under- and postgraduate medical education and the assessment of medical patient communication in general.

Aim: In Germany there is an increasing shortage of physicians, especially in rural areas. Strategies that make use of medical doctors from non-EU member states could effectively counteract this problem more rapidly than other strategies, including those that focus on education. Physicians from third countries must first demonstrate evidence of their professional qualifications on an exam. The failure rate in Schleswig-Holstein is approximately 50%.The specific aim of the 80-hour training course is to prepare third-country physicians for the practice of medicine in Germany and to provide exposure to the rural setting, regardless of whether or not these physicians have already taken an exam to receive formal recognition of their professional qualifications.Method: The need for post-licensure training courses was discerned in interviews with third-country physicians and examiners. The course was also evaluated using different instruments and then revised accordingly.Results: The training program has been held four times with a total of 52 third-country physicians; the program was given the very good rating of 1.4 on the traditional German academic grading scale. In addition to the 10-day training course, the participants had access to an online medical learning platform. Moreover, information on working in rural setting and a field trip to a variety of medical institutions in a rural region was integrated into the course. The majority of the participants used the course as additional preparation for the exam. Their willingness to later practice medicine in a rural setting was high with 89% of participants.Conclusion: The evaluation results suggest that such an intensive training program is suitable to prepare third-country physicians for medical practice in Germany and in particular in rural regions.

Background: In face of the looming shortage of general practitioners, primary healthcare providers and post-graduate training in general practice are increasingly becoming part of the political agenda in Germany. In 2009 the program “Verbundweiterbildung Baden-Württemberg” (VWB BW) was developed by the Competence Center for General Practice in Baden-Wuerttemberg to ensure primary healthcare in the future by enhancing the attractiveness of general medicine. This paper describes the experiences that have been gathered in developing a post-graduate training-program for physicians undergoing specialist training in general practice.Project description: The Competence Center for General Practice in Baden-Wuerttemberg supports the organization of regional networks dedicated to post-graduate medical education. First core element of the VWB BW program is a special seminar series for physicians pursuing post-graduate training. This seminar program is aligned with the German competency-based curriculum in general medicine and is meant to promote medical expertise and other related competencies, such as business and medical practice management and communication skills. Mentoring and advising the physicians regarding professional and personal planning form the second core element. The third core element is seen in the train-the-trainer seminars that address the competencies of the trainers. In order to focus the program’s content closely on the needs of the target groups, scientifically based evaluations and research are carried out.Results: Since starting in 2009, 685 physicians have entered the program and 141 have passed the examination to become medical specialists (as of December 2016). In total, 31 networks, 60 hospitals and 211 general practices have participated. The seminar sessions have been rated on average with 1.43 on a six-point Likert scale by the physician trainees (1=extremely satisfied, 6=extremely dissatisfied). Alongside the medical training, these physicians viewed the exchange of information and experiences with other physicians as very positive and important. In 185 seminars lasting 90 minutes each, the seminar program has presently covered 250 out of 320 units in the competency-based curriculum for general medicine. A total of 281 trainers have been trained in 13 train-the-trainer courses and have rated this course on average with 1.36 on a six-point Likert scale. Above all, the trainers emphasized the exchange of information and experiences with other trainers as very positive. In 2013 the DEGAM concept for its Verbundweiterbildung program was developed based on that of the VWB BW. Since 2008 over 40 articles on the topic of post-graduate medical education have been published.Conclusion: The steadily increasing number of participants over the years demonstrates that the VWB BW is relevant for recent medical graduates and contributes to the attractiveness of general practice. The consistently excellent evaluations of the training program and the train-the-trainer course affirm the focus on the needs of the target groups. The post-graduate VWB BW program advances structured, competency-based and quality-oriented specialist training and fosters professional sharing between physicians – something that could also be relevant for other fields. The increasing numbers of participating physicians and specialists in general practice in Baden-Württemberg lead to the conclusion that the VWB BW program positively influences the number of general practitioners.

Introduction: In different German regions, seminar programs have been conducted for General practice residents. In each region, selection and teaching of learning content is conducted in a different manner. So far, no structured, standardized curriculum has been implemented nationwide. We have investigated, if the development of a common 5-year program of learning topics is conceivable between the different university departments of General practice in Germany.Method: The seminar program working group of the DEGAM (German College of General Practitioners and Family Physicians) has conducted an online survey based on information gathered via preliminary telephone conference (n=7; physicians with postgraduate teaching experience) among all German university departments of General Practice and two non-university teaching institutions, identified via the internet. 884 topics were extracted from 14 Seminar programs. The topics were entered in a database, discussed and categorized: Practice management/practice work flow/standardized documentation forms/quality management (n=33 topics), common acute and chronic diseases, including disease management programs (n=29 topics), communication, neurological, psychological and psychiatric consultations (n=24 topics), common medical problems, including eye, ear, nose, throat, skin and pediatric problems (n=99 Topics) family physicians general approach, including epidemiology, shared decision making, test of time (n=42 Topics). These topics have been rated for priority and desirable number of teaching-units.Results: A catalogue of 111 topics was designed, encompassing 160 teaching units. There is a suggestion of wide topics collections plus an add-on catalogue.Conclusion: A proposal for a 5-year-thematic catalogue for postgraduate training of general practice residents in Germany has been developed. This newly developed curriculum has the potential to improve knowledge and skills that have not been covered during in-house and ambulatory general practice residencies.

Background: Although demands on family physicians (FP) are to a large extent similar in the European Union, uniform assessment standards for family medicine (FM) specialty training and assessment do not exist. Aim of this pilot study was to elicit and compare the different modalities and assessment methods of FM specialty training in five European countries.Methods: A semi structured survey was undertaken based on a convenient sample in five European countries (Denmark, Germany, Poland, the Netherlands and the United Kingdom). The respondents were asked to respond to ten items about aspects of FM specialty training and assessment methods in their respective countries. If available, this data was completed with information from official websites of the countries involved.Results: FM specialty training is performed heterogeneously in the surveyed countries. Training time periods range from three to five years, in some countries requiring a foundation program of up to two years. Most countries perform longitudinal assessment during FM specialty training using a combination of competence-based approach with additional formative and summative assessment. There is some evidence on the assessments methods used, however the assessment method used and costs of assessment differs remarkably between the participating countries.Conclusions: Longitudinal and competence-based assessment is the presently preferred approach for FM specialty training. Countries which use less multifaceted methods for assessment could learn from best practice. Potential changes have significant cost implications.

[english] Background: Since 2008 the Verbundweiterbildung programme of the Competence Centre General Practice Baden-Wuerttemberg offers continual improvement with regards to content and structure of general practice training. The programme uses the didactical concept of the CanMEDs competencies, which were developed in Canada, as a postgraduate medical training framework. Train the trainer (TTT)-programmes are an additional important element of these contentual optimisations of postgraduate training. Within this article we describe the conception and evaluation of the first TTT-workshop within the programme Verbundweiterbildung. Methods: The conception of the first TTT-workshop was influenced by results of a survey of general practitioner (GP) trainers and by experiences with teaching GP trainers involved in medical undergraduate teaching. A questionnaire was designed to get a self-assessment about organisational and didactic aspects oriented on the CanMEDs competencies of postgraduate medical training. In addition, the workshop was evaluated by the participants.Results: The workshop lasted 12 teaching units and included the following elements: introduction into the CanMEDs competencies, feedback training, fault management, legal and organisational aspects of post graduate training. From the 29 participating trainers 76% were male and on average 57 years old. The evaluation showed a good to very good acceptance of the workshop. Initial self-rating showed the need of improving in the fields of determining learning objectives, providing formative feedback and incorporation of a trainee. Most trainers rated themselves as very good in procure CanMEDs competencies with the exclusion of the competencies “Manager“ and “Scholar“. Conclusion: A TTT-programme is an important method to improve GP training which has not been used in Germany so far. Such a GP TTT-programme should highlight especially training in providing feedback and teaching in management aspects. Results of this article add information that can be used for developing TTT-programmes also in other specialties.[german] Zielsetzung: Das Programm Verbundweiterbildung des Kompetenzzentrums Allgemeinmedizin Baden Württemberg bietet seit 2008 strukturelle und inhaltliche Optimierungen für die Weiterbildung Allgemeinmedizin an. Das Programm orientiert sich am didaktischen Konzept der in Kanada entwickelten Kompetenzfelder der CanMEDs. Schulungen für Weiterbildungsbefugte, sogenannte „Train the Trainer (TTT) -Programme“, sind ein ergänzendes wesentliches Element einer inhaltlichen Optimierung der Weiterbildung. Der vorliegende Artikel beschreibt die Konzeption und Evaluation des ersten TTT-Workshops im Rahmen der Verbundweiterbildung. Methodik: Für die Konzeption des TTT-Workshops wurden Ergebnisse einer Umfrage bei Weiterbildungsbefugten sowie Erfahrungen aus Schulungen allgemeinmedizinischer Lehrpraxen herangezogen. Ferner wurde ein Fragebogen konzipiert, mit dem die Vorgehensweisen der Weiterbilder sowie deren Selbsteinschätzung, bestimmte Kompetenzen (orientiert am CanMEDs Modell) vermitteln zu können, abgefragt wurden. Ergänzend wurde die Veranstaltung evaluiert.Ergebnisse: Der Workshop war mit 12 Unterrichtseinheiten konzipiert und enthielt folgende Elemente: Einführung in die Kompetenzfelder der CanMEDs, Feedbacktraining, Fehlermanagement, rechtliche und organisatorische Aspekte der Weiterbildung. Es nahmen 29 Weiterbildungsbefugte (im Mittel 57 Jahre, 76% männlich) teil. Die Evaluationsergebnisse zeigen eine gute bis sehr gute Akzeptanz der Veranstaltung. Die eingangs durchgeführte Fragebogenerhebung zu den aktuellen Vorgehensweisen der Weiterbilder zeigt Optimierungsbedarf bei der Vereinbarung von Lernzielen, Feedbackgabe und der strukturierten Einarbeitung eines Arztes in Weiterbildung. Der überwiegende Teil der Weiterbildungsbefugten schätzt sich insgesamt als sehr gut in der Vermittlung von CanMEDs Kompetenzen ein, lediglich bei den Kompetenzfeldern „Praxismanagement“ und „Lehren und Lernen“ ist die Selbsteinschätzung etwas schwächer. Schlussfolgerungen: Für die Allgemeinmedizin können TTT-Programme eine wichtige, bisher in Deutschland ungenutzte Maßnahme darstellen, um die Weiterbildung zu optimieren. Ein TTT-Programm für Allgemeinmedizin sollte schwerpunktmäßig aus Feedbacktraining sowie Schulung in Aspekten des „Praxismanagements“ und „Lehren und Lernen“ bestehen. Die vorliegenden Ergebnisse können auch für die Entwicklung von TTT-Programmen für andere Gebiete genutzt werden.