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Background: Due to SARS-CoV-2, the Bavarian Ministry of Health decided in April 2020 to postpone the second national board examination in human medicine and to bring forward the start of the practical year (in German: Praktisches Jahr, further abbreviated with PJ) from May to April 2020. The different tertial times made it necessary for affected students to reorganise the PJ and rendered the preparation for the national board examination that had already taken place obsolete. As a result, students had to prepare for it again after the PJ and take it together with the third national board examination.Research question: How do students affected by the early PJ differ in their perception of the practical year and in their psychological well-being from the comparison groups with a regular PJ schedule?Methodology: The study is based on quantitative data from the Dean of Studies Office of the Medical Faculty of Ludwig-Maximilians-Universität München (LMU) and an online survey. The sample consists of LMU students who started the early PJ in April 2020 (=86) and two comparison groups: The cohort of LMU students who started their PJ regularly in May 2019 (=50), and students from other German universities who started their PJ regularly in May 2020 (=98) and took the second national board examination in human medicine in spring 2020. Results: For students affected by the early PJ, there were measurable negative effects on the choice of training institutions, the quality of the PJ content, preparation for the national board examinations, and career planning. Compared to regular students from other federal states, affected students reported higher psychological stress, with comparable resilience.Conclusion: It can be assumed that the insights gained apply to the entirety of medical students in the affected federal states of Bavaria and Baden-Württemberg. As a conclusion, we make the recommendation to include the position of the students in decisions of great consequence.

Aim of the study: Test anxiety expresses itself in a variety of physical and cognitive processes. Due to its influence on test performance, the cognitive component in particular can have a negative impact on those affected. A measuring instrument for this is not yet available in the German-speaking world but does exist in the form of the “Cognitive Test Anxiety Scale” (CTAS), among other languages, in English. The aim of this work was the creation and psychometric review of a German version of the scale (G-CTAS).Methods: A German translation of the scale was created using a forward-backward procedure. Statistical investigations were then carried out on a cohort of medical students, which included an item analysis with calculation of difficulty, variance and item discrimination as well as the determination of the scale’s internal consistency. The criterion validity was examined using test performance and gender-specific differences.Results: The final version contains 26 matching items with acceptable item parameters (mean values >1.46, 0.48; part-whole-discrimination-indices >0.37). Cronbach's alpha was 0.92, the scale was therefore found to be a reliable measuring instrument. The scale validity could be confirmed by significant differences (p

Objective: The final year of undergraduate medical education in Germany is called the practical year (PY), where emphasis is placed on developing practical skills requisite of soon-to-be physicians. Many students choose to spend part of this year abroad, yet little is known about their results on the medical licensing examinations. Is there a predisposition of high-performing students to go abroad as compared to lower performers? Are international health electives during the PY followed by higher scores in the final section of the German medical licensing examination (GMLE2)?Methods: We conducted a retrospective cohort study among undergraduate medical students at the LMU Munich, who participated in the final section of the German medical licensing examination between autumn 2009 and spring 2011. Of the 1,731 eligible students, 554 (32%) participated in our study. We analyzed for statistical associations of international health electives with written test scores of both sections of the medical licensing examination as well as grades earned during medical school training. We then used multiple regression analysis to identify relevant predictors of GMLE2 scores.Results: Approximately half of study participants pursued international health electives during the PY (51.1%). The number of students going abroad increased with the scores achieved on the first section of the medical licensing examination (GMLE1, p

Introduction: The clinical examination and other practical clinical skills are fundamental to guide diagnosis and therapy. The teaching of such practical skills has gained significance through legislative changes and adjustments of the curricula of medical schools in Germany. We sought to find out how well final year undergraduate medical students master practical clinical skills.Methods: We conducted a formative 4-station objective structured clinical examination (OSCE) focused on practical clinical skills during the final year of undergraduate medical education. Participation was voluntary. Besides the examination of heart, lungs, abdomen, vascular system, lymphatic system as well as the neurological, endocrinological or orthopaedic examination we assessed other basic clinical skills (e.g. interpretation of an ECG, reading a chest X-ray). Participants filled-out a questionnaire prior to the exam, inter alia to give an estimate of their performance.Results: 214 final year students participated in our study and achieved a mean score of 72.8% of the total score obtainable. 9.3% of participants (n=20) scored insufficiently (

[english] Objectives: Amended in 2013, the current version of the German Medical Licensure Regulation contains structural specifications that are also required of non-university institutions involved in Practical Year clinical training. The criteria are worded in relatively general terms. Furthermore, not all of the structural specifications can be readily applied to every subject area. In order to ensure commensurability in Practical Year instruction in Germany, not least in light of recently introduced Practical Year mobility, it is necessary to define consistent quality criteria for Practical Year training. The authors therefore propose a catalogue of criteria for the quality management process in Practical Year instruction facilities.Methods: In January 2014, the board of directors of the German Society for Medical Education decided to establish a committee comprised of representatives from various German medical faculties. In a process similar to the Delphi methodology, the group developed criteria for structure, process and outcome quality in Practical Year training in Germany.Results: The criteria developed for structure, process and outcome quality apply to Practical Year training in academic teaching hospitals and university medical centres. Furthermore, modalities for review are proposed. Conclusions: The present catalogue of criteria is intended to contribute to the formation of a basis for the most consistent quality standards possible for Practical Year instruction in Germany.

[english] Background: Effective team performance is essential in the delivery of high-quality health-care. Leadership skills therefore are an important part of physicians’ everyday clinical life. To date, the development of leadership skills are underrepresented in medical curricula. Appropriate training methods for equipping doctors with these leadership skills are highly desirable. Objective: The review aims to summarize the findings in the current literature regarding training in leadership skills in medicine and tries to integrate the findings to guide future research and training development. Method: The PubMED, ERIC, and PsycArticles, PsycINFO, PSYNDEX and Academic search complete of EBSCOhost were searched for in German and English. Relevant articles were identified and findings were integrated and consolidated regarding the leadership principles, target group of training and number of participants, temporal resources of the training, training content and methods, the evaluation design and trainings effects. Results: Eight studies met all inclusion criteria and no exclusion criteria. The range of training programs is very broad and leadership skill components are diverse. Training designs implied theoretical reflections of leadership phenomena as well as discussions of case studies from practice. The duration of training ranged from several hours to years. Reactions of participants to trainings were positive, yet no behavioral changes through training were examined. Conclusions: More research is needed to understand the factors critical to success in the development of leadership skills in medical education and to adapt goal-oriented training methods. Requirements analysis might help to gain knowledge about the nature of leadership skills in medicine. The authors propose a stronger focus on behavioral training methods like simulation-based training for leadership skills in medical education.[german] Hintergrund: Eine effektive Zusammenarbeit in Teams ist eine wichtige Voraussetzung für qualitativ hochwertige Versorgung im Gesundheitswesen. In diesem Zusammenhang spielen auch Führungskompetenzen von Ärztinnen und Ärzten im klinischen Alltag eine wichtige Rolle. Bisher wurde die Entwicklung von Führungskompetenzen in medizinischen Curricula in der Aus- und Weiterbildung von Ärztinnen und Ärzten jedoch kaum systematisch abgebildet. Die Entwicklung adäquater und effektiver Trainingsmethoden für die Vermittlung von Führungskompetenzen ist daher wünschenswert. Ziel: Das Review soll vorliegende Ergebnisse der Literatur zu Trainings von Führungskompetenzen in der Medizin zusammenfassen und integrieren, um zukünftige Forschung und Trainingsentwicklung anzuregen. Methode: Die Datenbanken PubMED, ERIC, PsycArticles, PsycINFO, PSYNDEX und dem Academic search complete durch EBSCOhost wurden auf Deutsch und Englisch nach Trainings von Führungskompetenzen in der Medizin durchsucht. Relevante Artikel wurden identifiziert und die Studienergebnisse hinsichtlich des zugrundeliegenden Führungsverständnisses, der Zielgruppe und Teilnehmeranzahl, der zeitlichen Ressourcen, sowie der Inhalte und Methoden des Trainings, des Evaluationsdesigns und der berichteten Trainingseffekte zusammengefasst. Ergebnisse: Auf acht Studien trafen alle Einschluss- und kein Ausschlusskriterium zu. Die Trainings selbst sowie die thematisierten Führungskompetenzen differenzieren jedoch stark voneinander. Die Trainingsdesigns beinhalten im Schwerpunkt die theoretische Auseinandersetzung mit dem Thema Führung sowie die Diskussion von Fallstudien aus der Praxis. Die Dauer der Trainings reicht von mehrstündigen bis hin zu mehrjährigen Veranstaltungen. Die selbst eingeschätzte Reaktion der Teilnehmer auf alle Trainings war positiv; es fand jedoch bisher keine systematische Überprüfung des Trainingserfolgs in Bezug auf konkrete Verhaltensänderungen der Teilnehmer statt.Schlussfolgerungen: Es bedarf weiterer Forschung, um die Erfolgsfaktoren für die Vermittlung von Führungskompetenzen in der medizinischen Aus- und Weiterbildung zu verstehen und die Trainingsmethoden gezielt anzupassen. Anforderungsanalysen könnten helfen, Führungskompetenzen in der Medizin besser zu erfassen. Weiterhin schlagen die Autoren vor, den Fokus zukünftig mehr auf verhaltensnahe Trainingsmethoden wie simulationsbasierte Trainings zu legen.

[english] Aims: The Medical Curriculum Munich (MeCuM) has been implemented since 2004 and was completely established in 2007. In this study the clinical part of MeCuM was evaluated with respect to retention of the knowledge in internal medicine (learning objectives of the 6th/7th semester). Methods: In summer of 2009 and winter of 2009/2010 1065 students participated in the Progress Test Medizin (PTM) from Charité Medical School Berlin. Additionally the students answered a questionnaire regarding the acceptance and rating of the progress test and basic demographic data. Results: The knowledge of internal medicine continuously increases during the clinical part of the medical curriculum in Munich. However, significant differences between the sub-disciplines of internal medicine could be observed. The overall acceptance of the PTM was high and increased further with the study progress. Interestingly, practical experiences like clinical clerkships positively influenced the test score. Conclusions: The PTM is a useful tool for the evaluation of knowledge retention in a specific curriculum. [german] Zielsetzung: Das Medizinische Curriculum München (MeCuM) wurde seit 2004 implementiert. Seit 2007 ist MeCuM im klinischen Studienabschnitt voll etabliert (Ende der Übergangsregelungen). Aktuell sollte MeCuM bezüglich der Nachhaltigkeit des im Modul 2 „Konservative Medizin“ (6./7. Semester) vermittelten Wissens evaluiert werden.Methodik: Im Sommersemester 2009 und Wintersemester 2009/2010 absolvierten 1065 Studierende den Progress Test Medizin (PTM). Zusätzlich beantworteten die Studierenden einen Fragebogen zur Akzeptanz und Bewertung des PTM sowie zu demographischen Basisdaten.Ergebnisse: Das Wissen „Konservative Medizin“ nimmt im klinischen Studienabschnitt kontinuierlich zu, wobei sich deutliche Unterschiede in den internistischen Subdisziplinen zeigen. Die Akzeptanz des PTM ist sehr hoch und nimmt im Studienverlauf zu. Praktische Erfahrungen (Famulatur) beeinflussen das Testergebnis signifikant.Schlussfolgerung: Mit dem PTM kann die Nachhaltigkeit erworbenen Wissens im Verlauf eines klinischen Curriculums evaluiert werden.

The article reports that Sepsis is an organ malfunction, whereby the trigger of this organ damage is an immune reaction of the body in response to an infection. Topics incldue considered the occurrence of organ failure is characteristic here and it distinguishes sepsis from an uncomplicated infection and is not always present at the beginning of a localized infection.

After initiating haemostatic treatment with recombinant factor VIIa (up to 115 mg per 24 h, tapered to a minimum of 5 mg per 24 h) and immunosuppression with prednisolone, the patient was referred to the intensive care unit of our university hospital for further treatment. 4 Stemberger M, Möhnle P, Tschöp J, Ney L, Spannagl M, Reincke M. Successful bleeding control with recombinant porcine factor VIII in reduced loading doses in two patients with acquired haemophilia A and failure of bypassing agent therapy. Keywords: acquired haemophilia A; bypassing agent therapy; emicizumab; off-label EN acquired haemophilia A bypassing agent therapy emicizumab off-label e502 e505 4 07/21/21 20210701 NES 210701 Dear Editor, Acquired haemophilia A (AHA) is a serious condition resulting from the development of autoantibodies to coagulation factor VIII. [Extracted from the article]