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Background: During the crucial stage of the COVID-19 pandemic, face-to-face undergraduate medical education was disrupted and replaced with online teaching activities. Based on its emphasized impact on several outcomes, a deeper insight into the pandemic related effects on medical students´ motivation is aspirational. Therefore, this study aimed to assess the motivational changes that took place during the pandemic in medical students and explored, how motivation of medical students is influenced., Methods: Using a mixed method inter-cohort study design, 4th year medical students´ motivation, assessed pre- and post-pandemic were compared. In subsequent qualitative analyses underlying variables that may have contributed to both- medical students´ motivation and pandemic related changes were identified. These variables were then systematically explored- both individually and in combination. In a final step, the results were embedded within the Self-Determination Theory., Results: Students who were affected by the university lockdown reported significantly higher levels of less self-determined motivation and amotivation. The qualitative analysis identified determinants that influence medical students´ motivation. The common core of these determinants is lacking social interaction and support, with a great emphasis on the interaction with the lecturer and patients., Conclusion: This study emphasizes the crucial role of medical educators, patient contact, social interactions and personal support on students´ motivation. Students need to be strengthened in their beliefs about their abilities, the value of their task at hand and receive encouragement in their efforts. All this will result in an increased identification with the task and less detrimental outcomes., (© 2024. The Author(s).)

Background: Virtual reality (VR) is a computer-generated simulation technique which yields plenty of benefits and its application in medical education is growing. This study explored the effectiveness of a VR Basic Life Support (BLS) training compared to a web-based training during the COVID-19 pandemic, in which face-to-face trainings were disrupted or reduced., Methods: This randomised, double-blinded, controlled study, enrolled 1 st year medical students. The control group took part in web-based BLS training, the intervention group received an additional individual VR BLS training. The primary endpoint was the no-flow time-an indicator for the quality of BLS-, assessed during a structural clinical examination, in which also the overall quality of BLS (secondary outcome) was rated. The tertiary outcome was the learning gain of the undergraduates, assessed with a comparative self-assessment (CSA)., Results: Data from 88 undergraduates (n = 46 intervention- and n = 42 control group) were analysed. The intervention group had a significant lower no-flow time (p = .009) with a difference between the two groups of 28% (95%-CI [8%;43%]). The overall BLS performance of the intervention group was also significantly better than the control group with a mean difference of 15.44 points (95%-CI [21.049.83]), p < .001. In the CSA the undergraduates of the intervention group reported a significant higher learning gain., Conclusion: VR proved to be effective in enhancing process quality of BLS, therefore, the integration of VR into resuscitation trainings should be considered. Further research needs to explore which combination of instructional designs leads to deliberate practice and mastery learning of BLS., (© 2022. The Author(s).)

Objectives: To assess the effects of simulation-based education on medical students' motivation and to compare these effects with the motivational effects of a classical teaching approach (seminar)., Methods: In this cross-sectional study, motivational qualities of 164 3rd year medical students, who participated in four mandatory simulation-based training and two seminars of the department of anaesthesiology, were assessed. Comparative analysis was made to determine differences and changes of motivation towards participating in each teaching unit and each teaching format, using a one-way analysis of variance and unpaired t-tests., Results: The different motivational qualities, as well as the computed levels of autonomous and controlled motivation of students towards participating in each of the six teaching units and each teaching format did not differ significantly (F (5, 839) = 0.66, p = 0.657; F (5, 839) = 0.29, p = 0.920; (t (843) = - 0.72, p = 0.471; t (843) = -0.17, p = 0.868). Students` motivation, particularly autonomous motivation, did not enhance after participating in the first SBME, (t (264) = 1.035, p = 0.301), after participating in the second SBME, (t (254) = -0.055, p = 0.956), or after participating in the third training (t (250) = -0.881, p = 0.379)., Conclusions: Simulation-based medical education provides a valuable teaching approach but, in this study, this teaching approach did not enhance nor stimulate student motivation. Therefore, simulation-based medical education equals classical teaching approaches regarding student motivation. Further investigations are needed to identify how simulation-based medical education could enhance medical students' motivation.

Background: Many efforts of the past years aimed to build a safer health care system and hereby, non-technical skills (NTS) have been recognised to be responsible for over 70 % of preventable medical mishaps. In order to counteract those mishaps, several simulation-based trainings have been implemented in health care education to convey NTS. Still, the best and effective way to foster NTS in simulation-based training is not known. Due to the importance of NTS, this gap in knowledge needs to be filled. A possible approach to convey NTS effectively during simulation-based medical education (SBME), might be the use of the flipped learning approach. The benefits of flipped learning regarding the improvement of human factors (NTS), have not been investigated yet. Therefore, the authors introduced flipped learning as an experimental intervention into their SBME emergency trainings and aimed to analyse, whether flipped learning improved students´ NTS performance compared to lecture-based learning (LBL)., Methods: In a randomized controlled trial, 3rd year medical students participated in a SBME training and then received either a further SBME training with integrated flipped learning on NTS (intervention), or a further SBME training and an accompanying lecture on NTS (control). NTS performance was assessed on three skill dimensions with a validated behavioural marker system., Results: The authors analysed NTS performance of 102 students, prior and after their allocation to each teaching method. The baseline NTS performance of both groups did not differ, whereas the intervention group enhanced significantly on all three skill dimensions (t (44) = 5.63, p < .001; t (44) = 4.47, p < .001; t (44) = 4.94, p < .001)., Conclusion: The integration of flipped learning into SBME yields a significant improvement of NTS performance and therefore medical educators should consider the application of flipped learning to convey complex human factors and skills.

Background: Non-technical skills (NTS) are an indispensable element of emergency care and need to be prevalent alongside with good technical skills. Though, questions of how to teach (instructional design) and improve NTS effectively remain unresolved. One adjustment screw to enhance performance of NTS, which is detached from instructional designs and learning efforts might be motivation. Theoretical models and observational studies suggest that high levels of intrinsic (situational) motivation result in better performance and better learning. Therefore, this study analyzed the influence of motivation on performance of NTS, by exploring if high levels of intrinsic motivation lead to better performance of NTS in medical students., Methods: In this prospective cross-sectional cohort study, the authors assessed the correlation of situational motivation and performance of NTS within a cohort of 449 undergraduates in their 1st to 4th year of medical studies, in a total of 101 emergency simulation trainings. Situational motivation was measured with the validated Situational Motivation Scale (SIMS), which was completed by every undergraduate directly before each simulation training. The NTS were evaluated with the Anesthesiology Students´ Non-Technical skills (AS-NTS) rating tool, a validated taxonomy, especially developed to rate NTS of undergraduates., Results: Student situational motivation was weakly correlated with their performance of NTS in simulation-based emergency trainings., Conclusion: Although motivation has been emphasized as a determining factor, enhancing performance in different fields and in medicine in particular, in our study, student situational motivation was independent from their performance of NTS in simulation-based emergency trainings (SBET).

Background: Non-Technical Skills (NTS) are becoming more important in medical education. A lack of NTS was identified as a major reason for unsafe patient care, favouring adverse events and team breakdown. Therefore, the training of NTS should already be implemented in undergraduate teaching. The goal of our study was to develop and validate the Anaesthesiology Students' Non-Technical Skills (AS-NTS) as a feasible rating tool to assess students' NTS in emergency and anaesthesiology education., Methods: The development of AS-NTS was empirically grounded in expert- and focus groups, field observations and data from NTS in medical fields. Validation, reliability and usability testing was conducted in 98 simulation scenarios, during emergency and anaesthesiology training sessions., Results: AS-NTS showed an excellent interrater reliability (mean 0.89), achieved excellent content validity indexes (at least 0.8) and was rated as feasible and applicable by educators. Additionally, we could rule out the influence of the raters' anaesthesiology and emergency training and experience in education on the application of the rating tool., Conclusions: AS-NTS provides a structured approach to the assessment of NTS in undergraduates, providing accurate feedback. The findings of usability, validity and reliability indicate that AS-NTS can be used by anaesthesiologists in different year of postgraduate training, even with little experience in medical education.