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The CanMEDS roles were adapted in Denmark more than ten years ago. The complexity of the professional role is discussed from various aspects and put into perspective of the Danish culture and the Danish ethical rules for medical doctors. Redefinition of the role professional according to these aspects is recommended.

This state of the art article explores what is known from the international and Danish literature on admission criteria as predictors of success in medical education. Previous academic performance is the best known predictor of medical students' grades. Poorer entry qualifications, broadly defined, are associated with dropout in medical education. Admission interviews may have a small additive explanatory effect on medical students' grades, but the effect on dropout has barely been investigated. Admission interviews are a challenge for the feasibility, reliability and validity of medical student selection. Admission variables in use should be supported by predictive validity.

In this paper we describe the first four phases of a curriculum reform covering the three clinical years of medical school at Aarhus University. The reform intends to ease students' transition from medical school to the foundation year, increase focus on communication, create more coherence between subjects, increase students' active participation, and align learning outcomes and assessments. More than 80 stakeholders participated in the first phases and five task forces gave their recommendations on how to achieve the intentions. The next phases are initiated on the basis of this solid work.

Peer-led training has been identified as a useful tool for delivering undergraduate healthcare training. In this paper we describe the implementation of the European Resuscitation Council BLS/AED Course as a peer-led training program for medical students.

Lecturing is one of the oldest forms of teaching. The lecture is as effective as other teaching formats for transmitting information. One of the major defects of the lecture method is that it tends to induce passive learning. In order to lecture effectively, the lecturer must gain and hold the attention of the audience. Also, the audience should be given a chance to elaborate on the information presented. The list of expedient lecturing skills is long. In this paper we focus on how to effectively open and close a lecture. In addition, we give suggestions to how an audience may be actively engaged.

In 2007 the Faculty of Health Sciences, Aarhus University, took a first step towards outcome-based education. During an educational development process, all courses developed clear, consistent descriptions of learning outcomes and extensive, template-based course descriptions. This enabled the Faculty to implement a new national grading system and to prepare for Aarhus University's application for an ECTS label. Furthermore, the process created the basis for alignment of outcomes, assessment and teaching. In this paper, we share results, problems encountered and lessons learned.

The University of Aarhus and Further Training Region North (Danish: Videreuddannelsesregion Nord) arranged a 24-hour experimental course in research training for junior physicians. Previously, the course has been imparted as three course days with daytime training, but this time it had the form of one 24-hour session. The idea behind the new concept is to combine a high professional content with considerable change in the form of the course. The response from course participants was very positive, and the course organisers are most satisfied with the achieved results.

Introduction: The medical profession and hospital practice have changed over the last decades without a concomitant change in Danish clerkships. Therefore, the aim of this study was to analyze learning and supervision in clerkships and to discuss how traditional clerkship learning matches a modern effective hospital environment., Material and Methods: A qualitative field study based on 38 days of observations ( asymptotically equal to 135 hours) with 6 students in 8th Semester in 2 internal medical and 3 surgical wards at 2 teaching hospitals in Aarhus County during 2003. The 6 students were interviewed prior to and following clerkship. Data were coded using Ethnograph and analyzed qualitatively., Results: The students typically participated in 6 learning activities: morning reports, ward rounds, out-patient clinics, on call, clerking, and operating theatres. A common feature for the first 3 activities was the students' observational role in contrast to their more active role in the latter 3 activities. Supervision was primarily indirect as the doctors worked and thereby served as tacit role models. When direct, the supervision was didactic and characterized by information transfer., Conclusion: A clerkship offers important learning opportunities for students. They are exposed to many patients and faced with various clinical problems. However, the benefit of students learning in authentic environments is not fully utilized, and the didactic supervision used by doctors hardly matches the learning conditions in a busy hospital. Consequently, we need to reassess the students' roles and doctors' supervisory methods.

Introduction: The purpose of this study was to do a quantitative description of how medical students spend their time during their clerkship in the eighth semester of study. We examined to what degree students have the possibility to learn both from the doctors and other staff and through active participation in daily work routines., Subjects and Methods: Time registration was carried out through observation of six medical students spread over 32 observation days, corresponding to 6,674 minutes. The observations cover surgical and medical clerkships in two hospitals in Aarhus, Denmark., Results: The study revealed that the students (1) were present in the clinic about four hours a day; (2) spent about two-thirds of their time with doctors; (3) received guidance to a limited degree when they spent time with doctors; (4) carried out specific and visible actions in relation to patients to a limited degree; (5) practically did not co-operate with the nursing staff., Conclusion: Recent learning theories recommend that students should work actively on a subject or a task and that they should receive guidance to ensure their reflection on the tasks performed. We observed that students have plenty of opportunity to learn through watching experienced practitioners. However, the limited amount of guidance and the students' role as observers indicate that the learning potential of being with doctors and patients is not being exploited sufficiently.

Introduction: We compared and contrasted the learned and intended practical clinical skills of the three Danish medical schools., Material and Methods: An anonymous questionnaire listing 210 practical clinical skills was posted to 226 newly qualified Danish physicians. They were asked if they could meet the minimum level for each of the skills, which had earlier been identified by a Delphi study., Results: The response rate was 80%. None of the responders met the minimum of all the 210 skills. Only 8% (14) met the minimum level for at least 90% (189) of the skills. On average, the responders met the minimum for 74% (155) of the skills. More than 90% of the responders could take medical histories and carry out examinations. The responders did not meet 28 medical emergency procedures., Discussion: We found that the clinical skills learned constituted 75% of those intended. Those responsible for pre- and postgraduate medical training should be aware of the discrepancy between expected and learned skills. We discuss the role of experts in the process of defining the core curriculum.

Introduction: In the new medical curriculum at the University of Aarhus, a third term, 20-week course focussing on early patient contact was launched., Material and Methods: Nine prototypical and clinically important disease entities each formed the basis of one-week courses covering an introductory clinical lecture, presentation of "paper" cases, and formalised training of pertinent clinical skills. This was integrated with plenaries and group work in physiology pertaining to the disease and the patient cases. In addition, seminars were held in patient-doctor relationships, and environmental and social medicine. Introductory lectures were given on topics, such as medical ethics, taxonomy of diseases, the organisation of hospital-based health care. At the end of the term, the students resided for eight weeks at county hospitals, which do not traditionally participate in pregraduate teaching. Each student followed one particular patient, which formed the basis of a written essay., Results: Early clinical lectures (87 +/- 8%, mean +/- SD) and use of clinical cases (73 +/- 8%) were well received by third term students, and 87% found that the "paper" cases facilitated their understanding of physiology. The evaluation of the hospital training was very positive (rated excellent or good by > 95%)., Discussion: We conclude that early introduction to clinical practice is feasible and well received by the students.

Introduction: The aim of the present study was to use the Delphi technique to identify standards of quality for the curriculum of basic clinical skills in the pre-registration internship., Method: The Delphi method was used with a selected panel of 52 experts to set a level of competence for 213 practical clinical skills in a series of three questionnaires., Results: For the pre-registration internship, the panel reached a 75% level of consensus for 80% of the basic clinical skills. A total of 47 basic clinical skills were identified (97% level of consensus) as core skills that should be mastered by the time of registration., Discussion: The study suggests that further investigations should be performed to identify a core curriculum of basic clinical skills common to all pre-registration internists. In addition, a curriculum of electives should be based on the special characteristics of each training department.

Introduction: The necessity of defining standards in medical education is increasingly recognised. The aim of the present study was to adapt the Delphi method in establishing a consensus about competence levels of basic clinical skills in the undergraduate medical curriculum., Method: We used a Delphi design with two postal rounds. An expert panel of 52 physicians was selected on the criteria of knowledge and practical engagement in medical education. Questionnaires were set up with lists of 213 practical skills based on literature studies. Six levels of competence were identified. The task of the panel was to select the competence level for each skill., Results: The panel reached a 75% level of consensus in 212 of the 213 skills. A core curriculum of basic clinical skills in the medical education of Danish undergraduates is proposed., Discussion: The Delphi method was found applicable to qualify the process of identifying goals in a medical curriculum design.

Clean intermittent catheterization (CIC) is a well-established method for treatment of bladder emptying failure. There have been many reports on the therapeutical benefits of CIC as well as on its complications. However, no reports have appeared on the impact of CIC on urodynamic parameters. We therefore investigated 18 women with urinary retention on the basis of a hypocontractile detrusor muscle and performed uroflowmetry and cystometry and recorded residual urine. The women were treated with CIC for an average of 26 months (1-62 months). At the time of investigation five had stopped because residual urine was reduced to below 50 ml. These patients were young and infrequent voiders. Two had stopped because of complications. In 11 patients there were still significant amounts of residual urine. When bladder capacity was measured cystometrically, there was a reduction in bladder capacity in ten patients but an increment in 8 cases. Patient compliance was high despite a high frequency of symptomatic urinary infections (16/18). On the basis of this study we suggest that CIC is efficient in normalizing mild cases of large bladders with emptying failure only.