Search

Contains fulltext : 238674.pdf (Publisher’s version ) (Open Access), OBJECTIVES: The individual course of disease in idiopathic pulmonary fibrosis (IPF) is highly variable. Assessment of disease activity and prospective estimation of disease progression might have the potential to improve therapy management and indicate the onset of treatment at an earlier stage. The aim of this study was to evaluate whether regional ventilation, lung perfusion, and late enhancement can serve as early imaging markers for disease progression in patients with IPF. METHODS: In this retrospective study, contrast-enhanced dual-energy CT scans of 32 patients in inspiration and delayed expiration were performed at two time points with a mean interval of 15.4 months. The pulmonary blood volume (PBV) images obtained in the arterial and delayed perfusion phase served as a surrogate for arterial lung perfusion and parenchymal late enhancement. The virtual non-contrast (VNC) images in inspiration and expiration were non-linearly registered to provide regional ventilation images. Image-derived parameters were correlated with longitudinal changes of lung function (FVC%, DLCO%), mean lung density in CT, and CT-derived lung volume. RESULTS: Regional ventilation and late enhancement at baseline preceded future change in lung volume (R - 0.474, p 0.006/R - 0.422, p 0.016, respectively) and mean lung density (R - 0.469, p 0.007/R - 0.402, p 0.022, respectively). Regional ventilation also correlated with a future change in FVC% (R - 0.398, p 0.024). CONCLUSION: CT-derived functional parameters of regional ventilation and parenchymal late enhancement are potential early imaging markers for idiopathic pulmonary fibrosis progression. KEY POINTS: * Functional CT parameters at baseline (regional ventilation and late enhancement) correlate with future structural changes of the lung as measured with loss of lung volume and increase in lung density in serial CT scans of patients with idiopathic pulmonary fibrosis. * Functional CT parameter measurements in high-attenuation areas

Background: Diversity issues play a key role in medical practice and have recently been more explicitly integrated into undergraduate medical curricula in Europe and worldwide. However, research on students´ perspectives on the relevance and curricular integration of diversity issues, such as sex/gender and culture-sensitive competencies, is still limited.Methods: The Charité Berlin (Germany) ran in parallel a traditional and a competency-based medical program. Diversity perspectives, especially sex and gender aspects, were systematically integrated into the new curriculum. In 2016, an online questionnaire was sent to all medical students in their final clerkship year of both programs. Students provided diversity-related information (sex/gender, age, number of children, migration background or disability) and rated the relevance of sex/gender and culture-sensitive competencies and the integration into their study program. They also rated their preparedness for the final year clerkships and for working as a physician.Results: The included 184 students considered sex/gender and culture-sensitive competencies to be very relevant or relevant (62%; 73%). The ratings of the relevance are independent of the curriculum and significantly higher in female students. Regarding curricular integration, 69% of the students of the traditional curriculum evaluated the degree of implementation as minor, whereas 83% students of the new curriculum rated the degree of implementation as extensive. Degrees of preparedness for the workplace were significantly higher in students from the new curriculum, with no significant effects by sex/gender. Age group, having a child, migration background or a disability had separate effects on the students' ratings.Conclusions: Medical students in their final clerkship year rated sex/gender and culture-sensitive competencies as relevant; this was independent from their study program. Their ratings provide complementary evidence that our systematic appr, Hintergrund: Diversitätsaspekte spielen in der medizinischen Versorgung eine wichtige Rolle und werden vermehrt in medizinische Curricula in Europa und weltweit integriert. Forschung zur Sichtweise der Studierenden hinsichtlich der Relevanz und der Integration von Diversitätsaspekten wie geschlechter- und kultursensible Kompetenzen ist jedoch noch begrenzt. Methodik: An der Charité - Universitätsmedizin Berlin wurden parallel ein Regel- und ein Modellstudiengang angeboten. Diversitätsperspektiven, insbesondere Geschlechteraspekte, wurden systematisch in den Modellstudiengang integriert. Im Jahr 2016 wurde ein Online- Fragebogen an alle Medizinstudierenden im letzten Studienjahr beider Studiengänge verschickt. Die Studierenden machten diversitätsbezogene Angaben (Geschlecht, Alter, Anzahl der Kinder, Migrationshintergrund, körperliche Beeinträchtigungen / Behinderung) und beurteilten die Relevanz von geschlechter- und kultursensiblen Kompetenzen und deren Integration in ihren Studiengang. Sie beurteilten auch ihren Grad der Vorbereitung auf das Praktische Jahr und auf ihre ärztliche Tätigkeit.Ergebnisse: Die befragten 184 Studierenden betrachteten geschlechter- und kultursensible Kompetenzen als sehr relevant oder relevant (62%; 73%). Die Beurteilung der Relevanz war dabei unabhängig vom Studiengang und signifikant höher bei Studentinnen. Von den Studierenden des Regelstudiengangs bewerteten 69% das Ausmaß der Integration als gering, wobei 83% der Studierenden des Modellstudiengangs das Ausmaß der Integration als groß beurteilten. Die Studierenden des Modellstudiengangs fühlten sich signifikant besser auf die ärztliche Tätigkeit vorbereitet. Dabei waren keine signifikanten Geschlechterunterschiede zu verzeichnen. Alter, Anzahl der Kinder, Migrationshintergrund oder körperliche Beeinträchtigungen / Behinderung hatten separate Effekte auf die Beurteilungen der Studierenden.Schlussfolgerung: Medizinstudierende im letzten Studienjahr beurteilten geschlechtersensible und

Aim: The introduction of a reform clause into the German licensing laws for medical doctors has enabled German faculties to pilot alternative designs for medical degree programmes. The aim of this project report is to outline the curricular features of the modular curriculum of medicine (MCM) at the Charité and to assess the results of its implementation based on a student evaluation across semesters.Project outline: The MCM was planned and implemented in a competency- and outcome-based manner from 2010-2016 in a faculty-wide process. The curriculum is characterised by a modular structure, longitudinal teaching formats and the integration of basic and clinical science. In the winter semester 2017, evaluations by students in semesters 1-10 were carried out. The results were analysed descriptively, and the coverage of overarching learning outcomes was compared to the results of a survey carried out amongst students on the traditional regular curriculum of medicine track in 2016.Results: A total of 1,047 students participated in the across-semester evaluation (return rate 35%). A high percentage of the respondents positively rated the achieved curricular integration and longitudinal teaching formats. The majority of the respondents agreed with the relevance of the overarching learning outcomes. Students' evaluations of the coverage of learning outcomes showed a differentiated picture for the MCM. Compared to the regular curriculum track, the coverage in the MCM programme showed substantial improvements in all aspects. Students found themselves to be better prepared for the M2 state examination and the practical year. The students' overall satisfaction with their decisions to study in the MCM was high.Conclusions: The results of the student evaluation show that a significant improvement in medical education has been achieved at the Charité with the new integrated, outcome-oriented design and the implementation of the MCM. At the same time, ongoing weaknesses have been r, Zielsetzung: Die Einführung der sogenannten "Modellklausel" gibt den deutschen Fakultäten die Möglichkeit, alternative Konzepte für das Medizinstudium zu erproben. Ziel dieser Projektbeschreibung ist es, die curricularen Kennzeichen des Modellstudiengang Medizin (MSM) der Charité zu skizzieren und das Ergebnis seiner Implementation auf Basis einer semesterübergreifenden Studierendenevaluation zu bewerten. Projektbeschreibung: Der MSM wurde kompetenzbasiert und outcome-orientiert in einem fakultätsweiten Prozess von 2010-2016 geplant und implementiert. Seine Struktur ist charakterisiert durch einen modularen Aufbau, longitudinale Unterrichtsformate und der Integration von Grundlagen und Klinik. Im Wintersemester 2017 wurde eine Studierendenevaluation der MSM-Semester 1-10 durchgeführt. Die Ergebnisse wurden deskriptiv analysiert und bezüglich der Outcome-Erreichung mit Ergebnissen einer Umfrage mit Studierenden des Regelstudiengangs (RSG) von 2016 verglichen.Ergebnisse: An der semesterübergreifenden Studierendenevaluation haben 1047 Studierende teilgenommen (Rücklauf 35%). Ein Großteil bewertet die erreichte curriculare Integration und die longitudinalen Lehrformate positiv. Der Relevanz der übergeordneten Ausbildungsziele wird mehrheitlich zugestimmt. Ihre Vermittlung im MSM zeigt ein differenziertes Bild. Im Vergleich zu Erhebungen zum RSG gibt es in allen Bereichen substanzielle Zugewinne. Verbesserungen finden sich auch beim Vorbereitsein auf die M2-Prüfung und das Praktische Jahr. Die Gesamtzufriedenheit mit der Entscheidung, im MSM zu studieren, ist hoch.Schlussfolgerungen: Die Ergebnisse der Evaluation zeigen, dass aus studentischer Sicht mit der integrierten, outcome-orientierten Konzeption und Implementation des MSM eine deutliche Verbesserung des Medizinstudiengangs an der Charité erreicht wurde. Gleichzeitig werden fortbestehende Defizite aufgezeigt, die als Grundlage für die kontinuierliche Weiterentwicklung des Studiengangs dienen. Dieser Bericht soll zu

Aim: The introduction of a reform clause into the German licensing laws for medical doctors has enabled German faculties to pilot alternative designs for medical degree programmes. The aim of this project report is to outline the curricular features of the modular curriculum of medicine (MCM) at the Charité and to assess the results of its implementation based on a student evaluation across semesters. Project outline: The MCM was planned and implemented in a competency- and outcome-based manner from 2010-2016 in a faculty-wide process. The curriculum is characterised by a modular structure, longitudinal teaching formats and the integration of basic and clinical science. In the winter semester 2017, evaluations by students in semesters 1-10 were carried out. The results were analysed descriptively, and the coverage of overarching learning outcomes was compared to the results of a survey carried out amongst students on the traditional regular curriculum of medicine track in 2016. Results: A total of 1,047 students participated in the across-semester evaluation (return rate 35%). A high percentage of the respondents positively rated the achieved curricular integration and longitudinal teaching formats. The majority of the respondents agreed with the relevance of the overarching learning outcomes. Students’ evaluations of the coverage of learning outcomes showed a differentiated picture for the MCM. Compared to the regular curriculum track, the coverage in the MCM programme showed substantial improvements in all aspects. Students found themselves to be better prepared for the M2 state examination and the practical year. The students’ overall satisfaction with their decisions to study in the MCM was high. Conclusions: The results of the student evaluation show that a significant improvement in medical education has been achieved at the Charité with the new integrated, outcome-oriented design and the implementation of the MCM. At the same time, ongoing weaknesses have bee