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The final year offers students the opportunity to explore their future role as a physician in different environments. Learning success depends in large part on how students experience these assignments. The aim of this study is to analyze students' self-reported experiences to derive factors that promote experience-based learning in the transition phase during the final year of medical school in order to optimally prepare students for professional practice. Data were collected from 2013 to 2019 via written survey after each assignment in the final year. Students were asked to report their pleasant and unpleasant experiences in free-text fields. The text material was analyzed using quantitative content analysis. The authors included 1762 questionnaires for analysis. They formed 12 main categories from the text material, equally covering pleasant and unpleasant experiences. Supervisors and teamwork played a central role in both questions, responsibility and working areas frequently led to positive experiences, and working conditions to negative ones. This study confirms the great importance of supervision. Above all, successful collaboration serves as a door opener into a feeling of security which students need to take on responsibility. The authors adapted Dornan's model of experience-based learning to the transition phase to help medical schools establish tailored conditions for students' successful entry into professional practice. [ABSTRACT FROM AUTHOR]

Background: Meta-analyses indicate a high prevalence of burnout among medical students. Although studies have investigated different coping strategies and health interventions to prevent burnout, professional experience's influence on burnout resilience as seldom been explored. Therefore, in our study we aimed to examine the self-efficacy's mediating role in the relationship between past vocational training and burnout resilience. In the process, we also analysed the associations between study-related variables and burnout resilience., Methods: In our cross-sectional study, we analysed the data of 2217 medical students at different stages of their university education (i.e. 1st, 3rd, 6th, 10th semester, and final year) at five medical faculties in Germany. The questionnaire included items addressing variables related to medical school, previous professional and academic qualifications, and validated instruments for measuring burnout and self-efficacy., Results: The overall prevalence of burnout was 19.7%, as defined by high scores for emotional exhaustion and notable values in at least one of the other two dimensions (cynicism or academic efficacy). Higher levels for self-efficacy (p < .001), having children (p = .004), and financing education with personal earnings (p = .03) were positively associated with burnout resilience, whereas having education financed by a partner or spouse (p = .04) had a negative association. In a mediation analysis, self-efficacy exerted a suppressor effect on the relationship between vocational training and burnout resilience (indirect effect = 0.11, 95% CI [0.04, 0.19])., Conclusions: Self-efficacy's suppressor effect suggests that the positive association between vocational training and burnout resilience identified in the mediation analysis disappears for students who have completed vocational training but do not feel efficacious. Those and other findings provide important insights into the psychological mechanisms underlying the development of burnout resilience in medical students and suggest the promotion of self-efficacy in medical education., (© 2024. The Author(s).)

Objectives: Surgical undergraduate training takes place in a male-dominated work environment that struggles with recruitment problems. Experiences of cultural and sex/gender-specific barriers of women in surgery have been reported worldwide. Overall, the experiences that students have in coping with the emotional impact of surgery as a profession are thought to be crucial to their subsequent career choices. We investigated whether students' self-reported experiences differed by sex/gender in terms of frequency and content, and whether they were related to their career aspirations., Methods: In Germany, the final year represents the last part of the undergraduate medical study program. At the Mannheim Medical Faculty, a 12-week surgical training is mandatory. After completing their surgical training, the students were asked about their experiences and their later career aspirations. These experiences were analysed using quantitative content analysis. The relationship between the quality of experience and career aspirations as well as sex/gender differences were statistically measured., Results: In the 475 questionnaires analysed (response rate 52%), the number of positive and negative mentions does not differ by sex/gender. However, male students feel more actively involved and female students feel poorly briefed and think that supervisors are less interested in their training. A significant influence on career aspirations was found in the performance category for female and male students, and in the supervision category for female students., Conclusion: The positive experiences that students gain while performing surgical activities have an impact on their subsequent career choices. In particular, a good settling-in period and encouragement to actively participate could help to attract more women to surgery., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2024 Homberg et al.)

In Germany, about two thirds of students and doctoral candidates in medicine are female. The proportion is only about 35% for post-doctoral degrees and much lower for many leadership positions at medical schools and on medical education committees. Although reasons for this have long been known, changes are slow in coming. Therefore, with this commentary, we would like to shed light on the current situation regarding gender equality in Germany in medical education and identify and discuss measures. These include, for example, mentoring and networking programs as well as greater consideration of women in committees., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2022 Hege et al.)

Low stakes assessment without grading the performance of students in educational systems has received increasing attention in recent years. It is used in formative assessments to guide the learning process as well as in large-scales assessments to monitor educational programs. Yet, such assessments suffer from high variation in students' test-taking effort. We aimed to identify institutional strategies related to serious test-taking behavior in low stakes assessment to provide medical schools with practical recommendations on how test-taking effort might be increased. First, we identified strategies that were already used by medical schools to increase the serious test-taking behavior on the low stakes Berlin Progress Test (BPT). Strategies which could be assigned to self-determination theory of Ryan and Deci were chosen for analysis. We conducted the study at nine medical schools in Germany and Austria with a total of 108,140 observations in an established low stakes assessment. A generalized linear-mixed effects model was used to assess the association between institutional strategies and the odds that students will take the BPT seriously. Overall, two institutional strategies were found to be positively related to more serious test-taking behavior: discussing low test performance with the mentor and consequences for not participating. Giving choice was negatively related to more serious test-taking behavior. At medical schools that presented the BPT as evaluation, this effect was larger in comparison to medical schools that presented the BPT as assessment.

Objectives: Feedback is one of the most important methods for competency-based teaching. A survey was conducted to learn more about the use of feedback methods at five medical faculties. Methods: In the 2017 summer semester, teachers at Baden-Wurttemberg's medical schools in Freiburg, Heidelberg, Mannheim, Tuebingen and Ulm were invited to participate in the survey. The link to the questionnaire was sent to the teaching coordinators at the various departments at each of the five medical schools. The teaching coordinators were asked to forward the link to the questionnaire to all instructors in their department. At one location, all instructors were directly addressed. The data were collected online. Results: A total of 464 instructors participated in the survey. Most consider feedback in medical education as important (23%) or very important (72%). However, some feedback methods are hardly used. The reason for this is, in particular, that some of the feedback methods are unfamiliar, e.g. checklists (56%), or not considered necessary by the instructors, e.g. written feedback (31%). Fifty-five percent of the instructors would like to receive further education or information on feedback. Conclusion: The results show that the use of feedback methods in medical teaching is expandable and that teachers find feedback to be important. Accordingly, nothing should stand in the way of a greater use of feedback methods in teaching. However, in order for this to happen, it is important that instructors are made more familiar with feedback methods., Competing Interests: The authors declare that they have no competing interests.

Background: Although the need for hand hygiene (HH) is generally accepted, studies continue to document inadequate compliance. Medical students are taught about the importance of HH to prevent nosocomial infections, and receive training in the correct procedures for HH. However, personality traits (social orientation and achievement orientation) may influence HH compliance. People with high social orientation feel socially responsible and act cooperatively, and people with high achievement orientation are ambitious and competitive., Aim: To evaluate the relationship between HH compliance and personality traits of medical students., Methods: The HH compliance of 155 students was observed during objective standardized clinical examinations (OSCEs). Social orientation and achievement orientation were measured using the corresponding scales of the Freiburg Personality Inventory - Revised., Findings: Social orientation did not differ between students with high HH compliance and students with low HH compliance [F(1) = 3.87, P = 0.052, η(2) = 0.045]. For achievement orientation, a moderate effect was found between low and high HH compliance [F(1) = 11.242, P = 0.001, η(2) = 0.119], and students with high HH compliance were found to be more achievement orientated than students with low HH compliance., Conclusion: Achievement orientation plays a major role during OSCEs, while social orientation is less emphasized. To the authors' knowledge, this is the first study to show that HH compliance is associated with achievement orientation in achievement situations., (Copyright © 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.)

Unlabelled: CONSTRUCT: In this study, we examine the differences in test performance between the paper-based and the computer-based version of the Berlin formative Progress Test. In this context it is the first study that allows controlling for students' prior performance., Background: Computer-based tests make possible a more efficient examination procedure for test administration and review. Although university staff will benefit largely from computer-based tests, the question arises if computer-based tests influence students' test performance., Approach: A total of 266 German students from the 9th and 10th semester of medicine (comparable with the 4th-year North American medical school schedule) participated in the study (paper = 132, computer = 134). The allocation of the test format was conducted as a randomized matched-pair design in which students were first sorted according to their prior test results. The organizational procedure, the examination conditions, the room, and seating arrangements, as well as the order of questions and answers, were identical in both groups., Results: The sociodemographic variables and pretest scores of both groups were comparable. The test results from the paper and computer versions did not differ. The groups remained within the allotted time, but students using the computer version (particularly the high performers) needed significantly less time to complete the test. In addition, we found significant differences in guessing behavior. Low performers using the computer version guess significantly more than low-performing students in the paper-pencil version., Conclusions: Participants in computer-based tests are not at a disadvantage in terms of their test results. The computer-based test required less processing time. The reason for the longer processing time when using the paper-pencil version might be due to the time needed to write the answer down, controlling for transferring the answer correctly. It is still not known why students using the computer version (particularly low-performing students) guess at a higher rate. Further studies are necessary to understand this finding.

Patient safety in hospitals is difficult to define and is not measurable by operational safety parameters as in other fields. So-called adverse events (AE) are a collective of complications, failures, mistakes, errors and violations. Estimations of at least 9.2 % AEs in surgery with 0.1 % fatalities are given worldwide but there are no correlations between objective quantification of AEs and subjective or public perception of safety during the perioperative period. Patient safety during this period is mostly endangered by wound infections (safety 98 %) and nosocomial infections (safety 97 %). In spite of these facts, safety parameters for problems in anesthesia, blood transfusion, in retaining surgical instruments and so-called index events, such as patient and side identification errors are much higher. Patient safety is maintained in hospitals by objective means (surgical). Checklists have been proven to improve safety and critical incidence reporting, training and changing of attitudes could have further advantages but they are difficult to measure.

Background: Students' motivation to participate is one of the main challenges in formative assessment. The utility framework identifies potential points of intervention for improving the acceptance of formative assessment [Van Der Vleuten C. 1996. The assessment of professional competence: Developments, research and practical implications. Adv Health Sci Educ 1(1):41-67]. At the Medical Faculty of the University of Cologne, the paper-based version of the Berlin Progress Test has been transformed into computer-based version providing immediate feedback., Aim: To investigate whether the introduction of computer-based assessment (CBA) enhances the acceptance of formative assessment relative to paper-based assessment (PBA)., Methods: In a retrospective cohort study (PBA: N = 2597, CBA: N = 2712), students' overall acceptance of the two forms of assessment was surveyed, their comments were analyzed, and we analyzed their test behavior and categorized students into "serious" or "non-serious" test takers., Results: In the preclinical phase of medical education, no differences were found in overall acceptance of the two forms of assessment (p > 0.05). In the clinical phase, differences in favor of CBA were found in overall acceptance (p < 0.05), the proportion of positive comments (p < 0.001), and the proportion of serious participants (p < 0.001)., Conclusions: Introduction of immediate feedback via CBA can enhance the acceptance and therefore the utility of formative assessment.