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Aim: Boor et al developed and validated the questionnaire D-RECT (Dutch Residency Educational Climate Test ) to measure the clinical learning environment within the medical specialist training. In this study, a German version of this questionnaire (D-RECT German) is analyzed regarding testtheoretical properties.Problem: Are the results of Boor et al replicable as a proof for validity of the questionnaire D-RECT?Material & Methods: The study was performed as online survey using the questionnaire D-RECT German (50 items in 11 subscales). To determine item characteristics and internal consistency (Cronbach’s α), item- and reliability analyses were performed. Furthermore, a confirmatory factor analysis was performed using a model for maximum-likelihood estimation to evaluate validity.Results: This replication study on the psychometric properties of the D-RECT with 255 residents at 17 German hospitals revealed heterogeneous discriminatory power for all items and an internal consistency of Cronbach’s α between 0.57 and 0.85. Within the confirmatory factor analysis, 6 items showed standardized regression coeffizients 0.7) were found between the subscales “Supervision”, “Coaching” and “Attendings role”.Conclusion: The present replication study with the D-RECT German showed structural differences with respect to factorial validity underpinning the need of further validation studies.

Objective: The purpose of formative examinations is that students and lecturers receive an early feedback regarding the success of learning behavior and teaching methods. These also serve as practice for later summative exams. The aim of this paper is to investigate to what extent the result of the formative MEQ* at the end of the first semester at Witten/Herdecke University (UW/H) in the study program human medicine can be used as a predictor for the summative MEQ-1 at the end of the second semester which is part of the equivalence examination replacing the state examination. Methodology: The predictive value of the score achieved in the MEQ* on the MEQ-1 score, as well as the potential influence of the variables gender, age, high school graduation grade (German Abiturnote), professional background, and self-efficacy expectancy, was determined for students of human medicine.Results: Data from two cohorts of UW/H with a total of 88 students were included. Scores on the formative MEQ* correlate with those on the summative MEQ-1 in both cohorts. In regression analyses, only the score on the MEQ* proves to be a significant predictor of performance on the MEQ-1 (40.5% variance explanation). Particularly significant predictors are the scores in the subjects anatomy and clinical reasoning. Vocational training or pre-study only appear to contribute to higher scores in the MEQ* after the first semester, but have no further significance in predicting scores in the MEQ-1. Conclusion: The MEQ* was confirmed to be a good predictor of the MEQ-1. Thus, it serves as a formative exam to inform students about their current state of knowledge with regard to the summative exam MEQ-1, so that they can adequately adapt their learning strategies in the course of the second semester.

Introduction: For the selection of students for the winter semester 2020/21, the established selection procedure of the University of Witten/Herdecke (UW/H) was adapted to the virtual space in view of the current contact ban and recommended keeping of distance. The three stations in the second step of the procedure, the biographical one-on-one interview, presentation and discussion on a subject-specific topic as well as multiple mini interviews (MMI) on the social skills of the applicants were audiovisual and in real time in zoom meetings. Project description: The medical, psychological and student reviewers were prepared for the virtual selection procedure in training sessions. Three weeks before the selection days, the applicants received information on the technical requirements for the interviews and on data protection for the persons affected by the collection of personal data. The evaluation of the virtual selection procedure was carried out by the reviewers using an online questionnaire with 8 socio-demographic, 5 organizational, 8 content and 3 open questions.Results: The 108 reviewers conducted selection interviews in tandems (medical/psychological and student reviewers) with 178 applicants for human medicine and 105 applicants for psychology. The online evaluation by 58 reviewers (response rate 53.7%) showed a positive agreement with the virtual selection procedure, with a more favorable assessment of organization and content by the medical and psychological reviewers compared to the student reviewers.Discussion: The adequate adaptation of the selection procedure of the UW/H to the virtual zoom room as well as its acceptance are confirmed by the successful execution of the selection days for the students for the winter semester 2020/21 and the evaluation of the reviewers.Conclusion: The results and analysis of this exceptional situation will be used to also conduct the upcoming selection procedure for the summer semester 2021 in the virtual space. A valid assessment for the future use of a virtual selection procedure as a possible supplement to the personal selection interviews at the University of Witten/Herdecke remains to be made.

Background: General practitioners and general internists occupy a key position in German and Austrian healthcare systems. They provide primary care and act as gatekeepers between medical disciplines and sectors of care. Their explicit medical knowledge levels, however, can be quite disparate. Objective: This study analyses whether general practitioners’ performances on a standardised knowledge test changes with four relevant socio-demographic variables.Design: The survey was based on the Progress Test Medicine (PTM), a standardised 200 item knowledge test on graduate level. After formal blueprinting and item analysis, 60 items of PTM were selected (“PTM-GP”) for our study. Participants: PTM-GP was presented ad hoc to general practitioners and internists from Germany and Austria at a number of professional meetings in 2011. 161 volunteers completed the survey. Main measures: For evaluation, correlation analysis (Spearman), Kruskal Wallis-tests for non-parametric data and an analysis of covariance (ANCOVA) were calculated.Results: Overall, four indicators turned out to be slightly significant for the performance on the PTM-GP, namely: Conclusions: Recent graduates performed better in the PTM-GP; a doctor’s licensing examination grade as well as training at a university hospital correlated positively with PTM-GP performance.A general doctor’s knowledge level is moderately influenced by exam grades, time since graduation, the institutional affiliation of postgraduate training and medical specialisation. Individual changes in knowledge over time have to be deliberately considered in lifelong learning. In consequence, the on-going teaching of medical knowledge should be integrated mandatory and verifiable into general doctors’ everyday practices, e.g. through repetitive knowledge tests with individual feedback and recommendations for further continuing medical education (CME).

Introduction: Both formative and summative assessments have their place in medical curricula: formative assessment to accompany the learning process and summative assessment to ensure that minimum standards are achieved. Depending on the conditions of undergraduate training, assessment and feedback, students place more or less importance on formative assessment, and thus the fulfilment of its function may be questionable. This study describes how the low-stakes formative Berlin Progress Test (BPT) is embedded at two medical faculties with partially different framework conditions and what effects these have on the students' testing efforts and the evaluation of the test, especially the perception of its benefits and (intangible) costs, such as non-participation in contemporaneous activities and emotional impairments. Methods: In this study, the proportion of non-serious BPT participants at two medical faculties (total sample: N=1,410, N=1,176) in winter term 2015/16 was determined both by the number of unanswered questions on the test itself and in a survey using a standardized instrument (N=415, N=234). Furthermore, open questions were asked in this survey about perceived benefits and perceived costs, which were analyzed with qualitative and quantitative methods. Results: The BPT is generally better accepted at Faculty 2. This can be seen in the higher proportion of serious test takers, the lower perceived costs and the higher reported benefit, as well as the higher proportion of constructive comments. Faculty 2 students better understood the principle of formative testing and used the results of the BPT as feedback on their own knowledge progress, motivation to learn and reduction of exam fear.Discussion: When medical faculties integrate formative assessments into the curriculum, they have to provide a framework in which these assessments are perceived as an important part of the curriculum. Otherwise, it is questionable whether they can fulfil their function of accompanying the learning process.

Objective: The individualized two-stage selection procedure for medical studies at Witten/Herdecke University (UW/H) has been in use for more than 30 years and comprises explicit and implicit selection criteria. This analysis aims at identifying the implicit criteria and answering the question whether an internal consistency of these implicit criteria may be verified for the different phases of the selection procedure (when evaluating the statements of purpose, during the selection weekend and during the concluding discussions of assessors). Methodology: Three qualitative studies on all phases of the selection procedure at UW/H have been conducted for determining the implicit assessment criteria of assessors: Results: The content analysis of the statements of purpose yielded 14 main categories with significant deviations between extreme groups in the categories school career, reasons for application and reflections as well as regarding the higher education entrance qualification grade. Based on the expert interviews, three main categories could be identified: intellectual ability, motivation and social competence, and the ability to reflect as a cross-content category. The focus group analysis yielded four main categories: performance, personality, personal growth potential and ability to reflect. Most frequently, the ability to reflect was mentioned as an assessment criterion. Conclusion: The main assessment categories are: motivation for the medical profession and starting studies at UW/H; performance and scholastic aptitude; personality, personal growth potential and social competence, as well as the ability to reflect as the most important basic competence and general category. Assessors consider the ability to reflect as a predictor of lifelong professional development as a physician.

[english] Introduction: The aim of the study was to examine the effect of an elaborate feedback and an audience response system (ARS) on learning success. Methods: Students of the 1 clinical semester were randomly assigned to a study and a control group. The randomization was carried out considering the factors of age, gender and power spectrum during preliminary dental examination. Within 10 lectures 5 multiple-choice questions were asked about the learning objectives and answered by the students using an ARS. Only the study group received an immediate comprehensive feedback on the results. A final exam at the end was carried out in order to evaluate whether the elaborate feedback leads to a successful learning. Furthermore the effect of the ARS on the lecture atmosphere was investigated. Result: The results of the final exams showed no significant difference between the study and the control group regarding the learning success. Conclusion: Although no significant effect on learning success was found, the ARS creates a more interactive, positive learning environment.[german] Einleitung: Die Studie soll die Frage klären, ob sich durch Anwendung von elaboriertem Feedback und einem Audience-Response-Systems (ARS) der Lernerfolg im Studienfach Zahnerhaltung signifikant verbessert. Methodik: Die Studierenden des 1. klinischen Semesters wurden in eine Studien- und eine Kontrollgruppe randomisiert eingeteilt. Die Randomisierung erfolgte unter Berücksichtigung der Faktoren Alter, Geschlecht und Note im Physikum. Im Verlauf von 10 Vorlesungen wurden pro Vorlesung 5 Multiple-Choice-Fragen zu den formulierten Lernzielen gestellt. Diese wurden unter Anwendung eines ARS von den Studierenden beantwortet. Nur die Studiengruppe erhielt sofort ein elaboriertes Feedback zu den Ergebnissen. Die am Ende durchgeführte Abschlussklausur und Evaluation sollten ermitteln, ob das elaborierte Feedback zu einem Lernerfolg führt und welchen Effekt das ARS auf die Vorlesungsatmosphäre hat. Ergebnisse: Die Ergebnisse der Abschlussklausuren ergaben keinen signifikanten Unterschied zwischen dem Lernerfolg der Studien- und der Kontrollgruppe. Schlussfolgerung: Durch das elaborierte Feedback zeigte sich in dieser Untersuchung kein Unterschied im Lernerfolg. Mit dem ARS ließ sich jedoch eine interaktivere, positivere Lernatmosphäre schaffen.

[english] The current challenges of educational policy seem to be associated to changes of the health care system, to counteract concerns regarding the lack of physicians, supply shortage and migration of specialists. Therefore, expectations, wishes and concerns relevant to the anticipated everyday life as a physician of medical students at the Witten/Herdecke University (UWH) were acquired with an online questionnaire. Useful for a direct comparison the results of the online survey ‘Medical Study and Future’ throughout Germany have been used. Findings from this survey are common characteristics regarding the choice of the profession and planning of an establishment as a general practitioner and clear differences in reflecting on future issues in the occupational field.[german] Die aktuellen bildungspolitischen Herausforderungen scheinen sich als direkte Reaktion auf Änderungen im Gesundheitssystem zu manifestieren, um den Befürchtungen von Ärztemangel, Versorgungsengpass und Abwanderung von qualifizierten Fachärzten entgegen zu wirken. Deshalb wurden mit einer Online-Befragung die Erwartungen, Wünsche und Befürchtungen von Wittener Medizinstudierenden bzgl. des antizipierten beruflichen Alltags als Ärztin oder Arzt erfasst. Zum direkten Vergleich standen die Ergebnisse einer bundesweiten Online-Umfrage zur Zukunft von Medizinstudierenden zur Verfügung. Dabei zeigen sich Gemeinsamkeiten zwischen den beiden Gruppen bzgl. der angestrebten Fachrichtung und der Planung einer Niederlassung, aber auch deutliche Unterschiede in der Einschätzung zukünftiger beruflicher Problemfelder.

[english] Aims: Evaluation of the effectiveness of clinical teaching is an important contribution for the quality control of medical teaching. This should be evaluated using a reliable instrument in order to be able to both gauge the status quo and the effects of instruction. In the Stanford Faculty Development Program (SFDP), seven categories have proven to be appropriate: Since 1998, the SFDP26 questionnaire has established itself as an evaluation tool in English speaking countries. To date there is no equivalent German-language questionnaire available which evaluates the overall effectiveness of teaching.Question: Methods: 19 anaesthetists (7 female, 12 male) from the University of Lübeck were evaluated at the end of a teaching seminar on emergency medical care using SFDP-German. The sample consisted of 173 medical students (119 female (68.8%) and 54 male (31.2%), mostly from the fifth semester (6.6%) and sixth semester (80.3%). The mean age of the students was 23±3 years. Results: The discriminatory power of all items ranged between good and excellent (r=0.48-0.75). All subscales displayed good internal consistency (α=0.69-0.92) and significant positive inter-scale correlations (r=0.40-0.70). The subscales and “overall effectiveness of teaching” showed significant correlation, with the highest correlation for the subscale “communication of goals (p< 0.001; r = 0.61).Conclusion: The analysis of SFDP26-German confirms high internal consistency. Future research should investigate the effectiveness of the individual categories on the overall effectiveness of teaching and validate according to external criteria. [german] Zielsetzung: Die Evaluation klinischer Lehrkompetenz ist ein wichtiger Beitrag zur Qualitätssicherung medizinischer Lehrveranstaltungen. Die Evaluation sollte mit einem verlässlichen Instrument durchgeführt werden, um Status quo sowie Effekte von medizindidaktischen Schulungsmaßnahmen beurteilen zu können. Im „Stanford Faculty Development Program“ (SFDP) haben sich folgende Aspekte als sinnvoll erwiesen: Als Evaluationsinstrument ist seit 1998 der Fragebogen „SFDP26“ im englischsprachigen Raum zur Erfassung dieser Kategorien etabliert. Bisher existiert kein gleichwertiges deutschsprachiges Instrument zur Überprüfung von Lehrkompetenz im klinischen Kontext.Fragestellung: Methodik: 19 Ärzte (w=7, m=12) der Klinik für Anästhesiologie an der Universität zu Lübeck wurden am Ende ihrer Lehrveranstaltungen zur Notfallmedizin durch Studierende mittels SFDP26-German evaluiert. Die Stichprobe setzte sich aus 173 Medizinstudierenden (w=119, bzw. 68.8%; m=54, 31.2%) des überwiegend fünften (6.6%) und sechsten Fachsemesters (80.3%) zusammen. Das durchschnittliche Alter der Studierenden betrug 23±3 Jahre. Ergebnisse: Die Trennschärfen der Items lagen alle in einem guten bis sehr guten Bereich (r=0.48-0.75). Alle Subskalen zeigten gute interne Konsistenzen (α=0.69-0.92) sowie signifikante positive Korrelationen (r=0.40-0.70) untereinander. Subskalen und „Gesamtlehreffektivität“ korrelierten signifikant (p

The development of media-supported learning scenarios should fulfil a number of criteria to adequately support collaborative learning in medicine. These criteria should be based on cognitive psychology and determine the match between the media used and the processing parameters of the learner. The design also should take personal and medial context criteria of the group into consideration. In addition to these criteria on the micro level implementation criteria on the macro level for a sustainable integration of learning scenarios need to be realized.

Adrian Gillissen,1 Tonja Kochanek,1 Michaela Zupanic,2 Jan P Ehlers1 1Institute for Didactics and Educational Research in Health Care, Department of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany; 2Interprofessional and Collaborative Didactics in Medicine- and Health professions, Department of Medicine, Faculty of Health, Witten/Herdecke University, Witten, GermanyCorrespondence: Adrian Gillissen, Institute for Didactics and Educational Research in Health Care, Department of Medicine, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, Witten, 58455, Germany, Email adrian.gillissen@uni-wh.deBackground and Objectives: The aim of this study was to investigate in the millennium medical student generation the influence of the curriculum (problem-based curriculum [PBC] vs science-based curriculum [SBC]), gender and semester level on medical students’ motives to study medicine, their attitudes toward their career and in this regard their view about their study condition in university.Methods: Semi-structured qualitative interviews with 28 medical students were performed and analyzed using Mayring’s content analysis. Based on these results, a quantitative questionnaire for a nationwide survey was developed using a mixed-method-approach and send to most medical faculties in Germany. Data from n=1053 students entered statistical analysis.Results: Humanistic ideals prevailed in the choice to enter medical school and to become a physician. PBC students were found to be significantly (p< 0.001) more idealistic and patient oriented, and they regard their curriculum more competitive than SBC-students (p< 0.001). A balanced work and family life is essential for all students but particularly important for the PBC – group, male and undergraduate students. The majority of students wanted to work with patients and omitted patient-distant line of work. Undergraduate SBC-students saw their studies as old-fashioned citing lack of patient contact (p< 0.001 compared to PBC), which eased in the graduate study part.Conclusion: This study found major differences in student’s perceptions depending on curriculum type. PBC-students were more idealistic, and humanistic ideals prevailed in comparison to SBC. For both, close patient contact is essential in their training. Particularly for female students, lifestyle factors and a balanced work-life-integration outweigh career ambitiousness. This study offers an important insight to policy makers and educators to understand the motivation and perceptions of the millennial student generation regarding their studies and future career plans, which should be considered in educational policies.Keywords: medical students, career expectations, perceptions