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Zusammenfassung Hintergrund Während Grenzverletzungen in Psychotherapien in den letzten Jahren zunehmend in den Fokus gerückt sind, waren die Besonderheiten der Grenzverletzungen in Lehrtherapien und Lehranalysen bislang kaum Gegenstand der wissenschaftlichen Untersuchungen. Ziel Die vorliegende Arbeit beschreibt spezifische Kontextmerkmale einer Ausbildungssituation, die mit dem Auftreten, dem Verlauf und den Folgen von Schweigepflichtverletzungen verbunden sind. Methode Es werden 18 anonymisierte Beratungsdokumentationen des Ethikvereins e. V., in denen Schweigepflichtverletzungen im Rahmen einer Psychotherapie-Ausbildung beobachtet werden, qualitativ im Sinne der „Grounded-theory“-Methodologie, angelehnt an Charmaz, ausgewertet. Dazu wird die Software „MAXQDA“ (von VERBI, Berlin) benutzt. Ergebnis Die untersuchten Lehrtherapien hatten schädigende Auswirkungen auf die betroffenen Aus- und Weiterbildungskandidaten und -kandidatinnen (AWT). Die Variablen „Eignungszweifel“, „multiple Rollen des Lehrtherapeuten“ und „institutionelle Verleugnung der Grenzverletzung“ waren bedeutsame ausbildungsspezifische Charakteristika der untersuchten Schweigepflichtverletzungen. Die Destruktivität der entgleisten dyadischen Beziehung wurde in den ungünstigen Verläufen durch eine Wiederholung der gestörten Beziehung zwischen AWT und dem Institut potenziert. Schlussfolgerungen Schweigepflichtverletzungen können schädigende Grenzverletzungen sein, die im Ausbildungskontext auf weitere Grenzverluste in der Dyade und in der Institution hinweisen können. Es werden verschiedene autonomiefördernde Maßnahmen vorgeschlagen, die Ausbildungsteilnehmende vor Grenzverletzungen besser schützen können.

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

Digital competencies, as well as knowledge about digital medicine, are becoming increasingly relevant but are rarely reflected in teaching concepts at universities. One reason for this is probably the fact that they are not yet part of the curricula in many areas or countries (such as medicine in Germany). Therefore, courses that address digital competencies and intend to impart knowledge about digital medicine are not subject to any curricular specifications and have a correspondingly broad range of possible designs. This article reports findings from an investigation on an interdisciplinary and cross-faculty course on digital medicine. An online questionnaire was used to assess student attitudes toward digital medicine topics and conduct self-assessments of their digital competencies before and after the course. The aim of this study was to test whether such a course could influence students’ attitudes and competencies. Group comparisons revealed statistically significant changes. They proved that the described course and its content regarding digital transformation in healthcare and digital medicine had an impact on digital competencies and participant opinions on digital topics. In order to teach students important competencies for the 21st century, universities should offer more courses that address digital transformation and support students in improving their competencies.

Background: The aim of nursing education in Germany is the development of different competences, including professional identity. To promote this, the use of collegial consultation in the form of collegial advice is recommended. How collegial advice affects the development of competences and professional identity, and which didactic and organizational framework conditions are favorable for this have not yet been conclusively clarified. Objectives: The aim of the study is to determine how collegial consultation affects the development of competence and professional identity of student nurses. Enabling and hindering factors for the success of collegial advice will be identified. Design/ Participants: A mixed-methods study with 25 student nurses who completed training in collegial advice and then regularly engaged in collegial advice for one year. Methods: A content analysis from four focus group interviews using a category system developed for this purpose. Results: This article reports the development of the category system necessary for the content analysis with examples. The resulting categories are presented. Conclusions: The category system has high objectivity, reliability, and validity. It contains links to competence and identity research in the care sector. A suitable instrument has been developed for further evaluation of the focus group interviews.

Physicians’ attire seems to play an important role in the success of patient treatment. The classic doctor’s white coat initiates a strong signal to the patient and can have a determining effect on a successful doctor–patient relationship. In a quantitative online questionnaire study comprising 52 questions, participants were shown four photos of an interprofessional German family medicine team in varying attire. One important study feature relating to the ongoing coronavirus pandemic was that the team was portrayed wearing FFP2 masks in one photo. We measured core values regarding the team’s perception in terms of sympathy, competence, trust, choosing the practice as a personal health care provider, and wanting to participate in the team. The questionnaire was posted online between March and May 2021. It was accessed 1435 times and 906 sheets were qualified for statistical analysis. For the first time in this field of research, a practice team’s attire was investigated. We found a significant influence of different clothing on the perception of sympathy, competence, trust, elective practice, and team participation. Wearing an FFP2 mask promotes feelings of security and competence. The study shows that in times of fast social changes due to rapid digitalization and an ongoing pandemic, we should present ourselves in different ways as a medical team depending on the patient groups we are targeting and the feelings we want to evoke.

ZusammenfassungViele digitale Interventionen sind auf die Mitwirkung ihrer Nutzer*innen angewiesen, damit sie eine positive Wirkung erzielen können. In verschiedenen Bereichen ist zu beobachten, dass die Anwendung digitaler Interventionen durch Nutzer*innen oftmals nach einer kurzen Zeit reduziert oder in Gänze eingestellt wird. Dies wird als einer der wesentlichen Faktoren angesehen, der die Wirksamkeit digitaler Interventionen einschränken kann. In diesem Zusammenhang gewinnt das Konzept der Adhärenz (Einhalten therapeutischer Vorgaben) bei digitalen Interventionen zunehmend an Bedeutung. Definiert wird Adhärenz bei digitalen Interventionen etwa als „the degree to which the user followed the program as it was designed“ („Ausmaß, in dem die Nutzer*innen die Software so verwenden, wie sie konzipiert wurde“). Dies wird auch oftmals mit „intended use“ oder „use as it is designed“ umschrieben („bestimmungsgemäße Verwendung“ bzw. „Verwendung, wie es konzipiert wurde“). Jedoch finden sowohl die theoretisch-konzeptionelle als auch die praktische Auseinandersetzung hinsichtlich der Adhärenz bei digitalen Interventionen noch eine zu geringe Berücksichtigung in der Forschung.Ziel dieses narrativen Übersichtsartikels ist es, das Konzept der Adhärenz bei digitalen Interventionen näher zu beleuchten und von verwandten Konzepten abzugrenzen. Zudem wird diskutiert, mit welchen Methoden und Messgrößen die Adhärenz operationalisiert werden kann und welche Prädiktoren die Adhärenz positiv beeinflussen. Weiterhin wird auf die Dosis-Wirkungs-Beziehung bei der Anwendung digitaler Interventionen eingegangen und auf Faktoren, die die Adhärenz positiv beeinflussen können. Abgeschlossen wird mit einer ethischen Betrachtung der Thematik.

Background: Because of the COVID-19 pandemic, students had to interrupt their regular studies, and universities changed their teaching formats. The aim of this study was to analyze medical students’ stress perception, wellbeing, life and work satisfaction, and cool down reactions, and to compare the survey data of online and hybrid semesters with pre-pandemic education formats in-person. Methods: Cross-sectional surveys at three time points enrolling 1061 medical students (58% women; 24.4 ± 3.4 years); 30.8% from pre-pandemic formats in-person, 22.8% from pandemic online semesters, and 46.1% from pandemic hybrid semesters. Results: Both students’ stress perception and psychological wellbeing decreased during the pandemic semesters. Their satisfaction with the university support was at its lowest during the hybrid semesters. Regression analyses indicated that students’ stress perception can be explained only to some extent by their general dissatisfaction with their medical studies or teaching formats. Conclusions: The lockdowns affected students in more ways than simply their teaching formats. Students require individual support to adjust to difficult situations, and particularly medical students in their preclinical phase compared to students in their clinical phases. These are challenges for the medical education system, which must find ways to be prepared for future times of crisis and insecurity.

Learning digital competencies can be successful if the information is also tried out immediately using interactive elements. However, interactive teaching poses a particular challenge, especially in large group formats. Various strategies are used to promote interaction, but there is little known about the results. This article shows different strategies and evaluates their influence on the interaction rate in a large group course over two terms that teaches digital medicine. Log files and participation in surveys as well as participation in chat were quantitatively evaluated. In addition, the chat messages themselves were evaluated qualitatively. For the evaluation, relation to the total number of participants was particularly relevant in order to be able to determine an interaction rate in the individual course sessions. A maximum average interaction rate of 90.97% could be determined over the entire term while the participants wrote an average of 3.96 comments during a session in the chat. In summary, this research could show that interactive elements should be well planned and used at regular intervals in order to reap the benefits.

Zusammenfassung Hintergrund Die Medizin wird immer weiblicher. Vor dem Hintergrund des häufig Frauen betreffenden Konflikts zwischen Kind und Karriere, stellt sich für eine neue Generation junger Ärztinnen und Ärzten die schwierige Frage nach der Vereinbarkeit. Dabei spielt auch der richtige Zeitpunkt der Familiengründung eine große Rolle. An der privaten Universität Witten/Herdecke wurden Studierende mit und ohne Kind dazu befragt, inwiefern sich das Medizinstudium als geeigneter Zeitpunkt erweist. Methodik Es wurde eine Fragebogenerhebung durchgeführt, an der insgesamt 423 Medizinstudierende teilnahmen. Weitere 12 Medizinstudierende mit Kind wurden zudem mittels leitfadengestütztem Interview zu ihrer Situation befragt und die Ergebnisse mittels qualitativer Inhaltsanalyse ausgewertet. Ergebnisse Medizinstudierende mit Kind sehen die Vorteile der Familiengründung im Studium v. a. für Familie und Karriere, die Nachteile hingegen für das Studium an sich und die Finanzen. Die Medizinstudierenden ohne Kind sind mehrheitlich unentschlossen bezüglich des idealen Zeitpunktes der Familiengründung, das Studium sehen jedoch nur 18% als idealen Zeitpunkt an. Dem gegenüber stehen die Medizinstudierenden mit Kind, welche zu 50% das Studium als idealen Zeitpunkt für die Familiengründung sehen, den Zeitpunkt nach dem Studium hingegen nur zu 5%. Schlussfolgerung Es sollten Konzepte auf politischer und hochschulpolitischer geschaffen werden, die es ermöglichen, über den gesamten Karriereweg als Mediziner/in Kind und Karriere zu vereinen. Diese Konzepte sollten finanzielle Entlastungsmöglichkeiten und eine flexible Studienorganisation berücksichtigen.

The skills, knowledge and resources to search for, find, understand, evaluate and apply health information is defined as health literacy (HL). If individuals want to use health information from the Internet, they need Digital Health Literacy (eHL), which in addition to HL also includes, for example, media literacy. If information cannot be found or understood by patients due to low (e)HL, patients will not have the opportunity to make informed decisions. In addition, many health apps for self-management or prevention also require (e)HL. Thus, it follows that active participation in healthcare, in terms of Person-Centered Care (PCC) is only possible through (e)HL. Currently, there is a great need to strengthen these competencies in society to achieve increased empowerment of patients and their health. However, at the same time, there is a need to train and improve competencies in the field of healthcare professionals so that they can counsel and guide patients. This article provides an overview with a focus on HL and eHL in healthcare, shows the opportunities to adapt services and describes the possible handling of patients with low (e)HL. In addition, the opportunities for patients and healthcare professionals to improve (e)HL are highlighted.

Zusammenfassung Hintergrund In Deutschland gilt die Habilitation als Nachweis der Qualifikation zur selbstständigen Forschung und Lehre und ist die Voraussetzung zur Erlangung der Lehrbefähigung im jeweiligen Fachgebiet. Die Voraussetzungen sind in den Habilitationsordnungen der Universitäten und gleichgestellten Institutionen festgelegt. Dieser Übersichtsartikel verfolgt das Ziel, die Anforderungen an die Habilitation der medizinischen Fakultäten aufzuzeigen und Verbesserungsvorschläge hinsichtlich dessen darzulegen. Methoden Die gültigen Habilitationsordnungen und Ausführungsbestimmungen aller 39 deutschen medizinischen Fakultäten wurden auf folgende Zielkriterien analysiert: Gesamtpublikationen (n), Erst- und Letztautorenschaften (n), Lehrleistungen, Berücksichtigung von Drittmitteleinwerbung, Patentrechte, Abstracts auf Kongressen, Teilnahme an didaktischen Fortbildungen, kumulative Habilitation, Voraussetzung von Promotion oder äquivalenten Leistungen, Gutachter (n) und deren Zugehörigkeit, Abhaltung eines hochschulöffentlichen und wissenschaftlichen Vortrags sowie einer Lehrprobe. Ergebnisse Insgesamt wurden 37 Habilitationsordnungen in die Analyse einbezogen. Die Habilitationsanforderungen unterscheiden sich in mehreren zentralen Punkten, vor allem in der Zahl der geforderten Erst- und Letztautorenschaften, Gesamtanzahl der Publikationen und Bewertung der Publikationsleistung. Eine kumulative Habilitation ist an 97 % (n = 36) der Universitäten möglich. Deutliche Unterschiede bestehen auch in Bezug auf die Auswahl der Gutachtenden (nur Interne, Interne und Externe, nur Externe). Schlussfolgerung Die quantitativen und qualitativen Anforderungen und deren Gewichtung sind zwischen den Ordnungen häufig uneinheitlich. Zur Steigerung der Transparenz und Würdigung der erbrachten wissenschaftlichen Leistung erscheint eine Vereinheitlichung der Anforderungen zielführend.

Mobile health apps (MHAs) and medical apps (MAs) are becoming increasingly popular as digital interventions in a wide range of health-related applications in almost all sectors of healthcare. The surge in demand for digital medical solutions has been accelerated by the need for new diagnostic and therapeutic methods in the current coronavirus disease 2019 pandemic. This also applies to clinical practice in gastroenterology, which has, in many respects, undergone a recent digital transformation with numerous consequences that will impact patients and health care professionals in the near future. MHAs and MAs are considered to have great potential, especially for chronic diseases, as they can support the self-management of patients in many ways. Despite the great potential associated with the application of MHAs and MAs in gastroenterology and health care in general, there are numerous challenges to be met in the future, including both the ethical and legal aspects of applying this technology. The aim of this article is to provide an overview of the current status of MHA and MA use in the field of gastroenterology, describe the future perspectives in this field and point out some of the challenges that need to be addressed.

Background Mobile health applications and their subset digital therapeutics—defined as evidence-based software interventions to prevent, manage, or treat a medical condition—offer great potential to improve patient care. However, such solutions often struggle to reach widespread adoption. Objective This study seeks to explore healthcare stakeholders’ roles and potential for fostering patient access and adherence to evidence-based digital therapeutics and thereby improve health outcomes from the perspective of digital therapeutics developers and distributors. Methods Semi-structured qualitative and semiquantitative interviews were conducted with 19 experts from developers and distributors of digital therapeutics in Germany to discuss their perceived relevance of different healthcare stakeholders and strategies in promoting patient access and adherence to digital therapeutics. Results Healthcare professionals were found to have the greatest potential to promote both access and patient adherence to digital therapeutics, followed by health insurers, pharmaceutical companies, and patients themselves. In terms of patient access, healthcare professionals have potential due to their ability to prescribe digital therapeutics. Other stakeholders’ potential stems from their capacity to influence healthcare professionals prescription decision. In terms of patient adherence, only healthcare professionals are of high relevance by onboarding patients and monitoring digital therapeutics use. Most healthcare stakeholders currently do not fully leverage their potential. Further educating healthcare professionals and simplifying processes for them, empowering patients to seek treatment with digital therapeutics, and designing digital therapeutics’ product features for better adherence can help improve patient access and adherence. Conclusions Established healthcare stakeholders and digital therapeutics developers both need to take action to improve patient access and adherence to digital therapeutics. Several macro-level changes can support these efforts, including broader information dissemination, improved financial incentives, simplified prescription and activation processes, and a wider adoption of blended care and pay-for-performance payment models.

Background: Pediatric palliative care (PPC) patients experience years of multisectoral and professional care. An electronic cross-facility health record (ECHR) system can support the immediate exchange of information among PPC professionals. Based on a needs assessment, a prototype ECHR system was developed. Methods: To evaluate potential users’ perspective regarding the system, a qualitative observational study was conducted consisting of a concurrent think-aloud session and a semi-structured qualitative interview. Results: Twenty PPC professionals (nurses, physicians) from specialized outpatient PPC teams, a PPC unit, and medical offices rated the ECHR system as a helpful tool to improve the exchange and collection of information, communication between PPC professionals, and treatment planning. From the user’s point of view, the basic logic of the ECHR system should be further adapted to improve the interaction of data remirrored from patient records of outpatient and inpatient care with those entered via the system. The users wished for further functions (text search) and content (information on therapies). Some content, such as the treatment process, needs to be further adapted. Conclusion: The developed ECHR system needs to be more specific in some features by offering all available information, while for other features, be less specific to offer a quick overview. The ability to share information promptly and automatically was seen as a tremendous improvement to the quality of care for PPC patients.

BACKGROUND In October 2020, Germany became the first country, worldwide, to approve certain mobile health (mHealth) apps, referred to as DiGA (Digitale Gesundheitsanwendungen, in German, meaning digital health applications), for prescription with costs covered by standard statutory health insurance. Yet, this option has only been used to a limited extent so far. OBJECTIVE The aim of this study was to investigate physicians’ and psychotherapists’ current attitudes toward mHealth apps, barriers to adoption, and potential remedies. METHODS We conducted a two-stage sequential mixed methods study. In phase one, semistructured interviews were conducted with physicians and psychotherapists for questionnaire design. In phase two, an online survey was conducted among general practitioners, physicians, and psychotherapists. RESULTS A total of 1308 survey responses by mostly outpatient-care general practitioners, physicians, and psychotherapists from across Germany who could prescribe DiGA were recorded, making this the largest study on mHealth prescriptions to date. A total of 62.1% (807/1299) of respondents supported the opportunity to prescribe DiGA. Improved adherence (997/1294, 77.0%), health literacy (842/1294, 65.1%), and disease management (783/1294, 60.5%) were most frequently seen as benefits of DiGA. However, only 30.3% (393/1299) of respondents planned to prescribe DiGA, varying greatly by medical specialty. Professionals are still facing substantial barriers, such as insufficient information (1135/1295, 87.6%), reimbursement for DiGA-related medical services (716/1299, 55.1%), medical evidence (712/1298, 54.9%), legal uncertainties (680/1299, 52.3%), and technological uncertainties (658/1299, 50.7%). To support professionals who are unsure of prescribing DiGA, extended information campaigns (1104/1297, 85.1%) as well as recommendations from medical associations (1041/1297, 80.3%) and medical colleagues (1024/1297, 79.0%) were seen as the most impactful remedies. CONCLUSIONS To realize the benefits from DiGA through increased adoption, additional information sharing about DiGA from trusted bodies, reimbursement for DiGA-related medical services, and further medical evidence are recommended.

Background In October 2020, Germany became the first country, worldwide, to approve certain mobile health (mHealth) apps, referred to as DiGA (Digitale Gesundheitsanwendungen, in German, meaning digital health applications), for prescription with costs covered by standard statutory health insurance. Yet, this option has only been used to a limited extent so far. Objective The aim of this study was to investigate physicians’ and psychotherapists’ current attitudes toward mHealth apps, barriers to adoption, and potential remedies. Methods We conducted a two-stage sequential mixed methods study. In phase one, semistructured interviews were conducted with physicians and psychotherapists for questionnaire design. In phase two, an online survey was conducted among general practitioners, physicians, and psychotherapists. Results A total of 1308 survey responses by mostly outpatient-care general practitioners, physicians, and psychotherapists from across Germany who could prescribe DiGA were recorded, making this the largest study on mHealth prescriptions to date. A total of 62.1% (807/1299) of respondents supported the opportunity to prescribe DiGA. Improved adherence (997/1294, 77.0%), health literacy (842/1294, 65.1%), and disease management (783/1294, 60.5%) were most frequently seen as benefits of DiGA. However, only 30.3% (393/1299) of respondents planned to prescribe DiGA, varying greatly by medical specialty. Professionals are still facing substantial barriers, such as insufficient information (1135/1295, 87.6%), reimbursement for DiGA-related medical services (716/1299, 55.1%), medical evidence (712/1298, 54.9%), legal uncertainties (680/1299, 52.3%), and technological uncertainties (658/1299, 50.7%). To support professionals who are unsure of prescribing DiGA, extended information campaigns (1104/1297, 85.1%) as well as recommendations from medical associations (1041/1297, 80.3%) and medical colleagues (1024/1297, 79.0%) were seen as the most impactful remedies. Conclusions To realize the benefits from DiGA through increased adoption, additional information sharing about DiGA from trusted bodies, reimbursement for DiGA-related medical services, and further medical evidence are recommended.

Innovative pharmaceutical companies have started to explore quantum computing (QC). In this article, we provide a collective industry perspective from QC domain leaders at leading pharmaceutical companies. There are immediate nonfinancial benefits in engaging with QC, some likely financial returns in the short term in drug development, manufacturing, and supply chain, and potentially large scientific benefits in drug discovery long term. We discuss the required activities for institutionalizing QC: how to create an understanding of QC among researchers and management, which and how to deploy external resources, and how to identify the problems to be addressed with QC. If (and once) deployable, QC will likely have a similar trajectory to that of computer-aided drug design (CADD) and artificial intelligence (AI) during the 1990s and 2010s, respectively.

Background: Pediatric palliative care (PPC) is characterized by years of multisectoral and multi-professional care. Sharing information between PPC professionals is, therefore, essential for quality care. The evidence shows that electronic cross-facility health records (ECHRs) provide useful support in this context. To our knowledge, no ECHRs have been developed through a user-centered approach for this specific setting in Germany. Methods: Guided by design thinking, first, qualitative interviews were conducted to assess the needs of PPC professionals. Second, the elicited needs were specified in focus groups (FGs). Based on the needs stated in the interviews, prototypes of the ECHR were developed and discussed in the FGs. The indicated needs were supplemented and specified in an iterative process. The prototypes were further adapted according to these results. The unified theory of acceptance and use of technology was the basic model in the evaluation of needs. Results: Across seven main categories, past and current medication, emergency view, and messaging functions were identified as the participants’ desired core components of an ECHR. Utilizing design thinking facilitated the explicit articulation of user needs. Conclusions: Developing an ECHR with the content identified would allow for real-time data during emergencies, tracking what other PPC professionals have done, and making the applied treatments visible to others. This would offer a broader picture of the complex conditions common to PPC.

Background Professional intrapersonal and interpersonal competences (IICs) form an important part of medical expertise but are given little attention during clinical training. In other professional fields such as psychotherapy, education and aviation, training in IICs is an integral part of education and practice. In medicine, IICs tend to actually decline during studies. To date it is unclear why IICs are given less attention in medicine, despite evidence for their importance in the treatment process. In view of this, the study examined the role of IICs in the treatment process, the current situation of IIC training in medicine and, most importantly, the reasons for the comparatively low focus on IICs in the clinical training of medical students. Methods Semi-structured interviews were carried out with 21 experts from a variety of medical specialties and non-medical professions that provide a training with a stronger focus on IIC development. The interviews were evaluated using grounded theory. Results The experts confirmed the idea that IICs are an equally important component in the treatment process, along with medical knowledge and technical skills. They also described large differences between the IICs possessed by physicians but noted a general developmental need. The key shortcoming was perceived to be a deep-seated defensiveness towards learning from mistakes and deficits e.g. through reflection and feedback. The interaction of different factors that seem to be reasons for this defensiveness and perpetuate it were identified: lack of support in dealing with insecurities in the face of responsibility; the notion of medicine as a science with the categories of right and wrong answers; and a range of pressures arising from the setting, such as hierarchical, economic and competition pressures. Conclusion Our study showed, that the defensive attitude towards learning from mistakes and deficits especially in the field of IICs appears to be a subtle but powerful obstacle for implementing IICs in medical training, in contrast to other professional fields. This obstacle is sustained by various underlying barrier factors. We therefore propose that changes should be made within a cultural transformation targeting this defensive mindset and culture and its presumed reasons. Electronic supplementary material The online version of this article (10.1186/s12909-019-1748-y) contains supplementary material, which is available to authorized users.

BACKGROUND Pediatric palliative care (PPC) is characterized by years of multisectoral and multiprofessional care. The exchange of information through effective communication between various PPC professionals is essential for high-quality care. Evidence shows that electronic cross-facility health records (ECHRs) provide useful support in this context. Given the specific needs of and content exchanged within PPC, the use of specific ECHRs in this area is necessary. To our knowledge, no ECHRs have been developed through a user-centered approach for this specific setting in Germany. OBJECTIVE The aim was to record PPC professionals’ needs (nurses, physicians, and secretaries) regarding ECHRs, as they may represent future users in inpatient and outpatient PPC as well as general practitioners and pediatrists from medical offices. METHODS Guided by design thinking, this study consisted of six steps: (1) empathize, (2) define, (3) ideate, (4) prototype, (5) test, and (6) iteration. First, qualitative interviews were conducted to assess the needs of PPC professionals. Second, the elicited needs were specified in focus groups (FGs). Prototypes of the ECHR (mock-ups) were then developed according to the needs mentioned in the interviews and were discussed in the FGs. Finally, the indicated needs were supplemented and specified in an iterative process. The mock-ups were further adapted according to these results. RESULTS Across seven main categories, medical history, actual medication, the emergency view with the most critical data, and messaging functions were identified as some participants’ desired core components of an ECHR. Utilizing design thinking facilitated an explicit articulation of user needs. The mock-ups clearly aligned the research and development team’s ideas with the simulated work in the ECHR for the users. CONCLUSIONS Developing an ECHR with the content that participants identified, which is currently being shared, that integrates overarching new views and functionality would make it possible to obtain real-time data during emergencies, to track what other PPC professionals have done, and to make the applied treatments visible to others. Moreover, it would give all providers with a more comprehensive picture of the complex conditions that are common in PPC. Concerning relevant content and functionality, user-centered design, and sensitivity to the various sectors regarding the needs of PPC professionals employed in those sectors emerged as strengths of the design thinking approach. An ECHR that directly addresses user needs will foster pediatric palliative care across sectors.

More and more women are studying medicine these days. They often face a conflict between having children and pursuing a career. Thus, a challenging question arises for a new generation of young doctors: How can children and career be reconciled? Also, the right time to start a family plays an important role. At the University Witten/Herdecke, students with and without children were asked to what extent their time when they were students of medicine proved to be a convenient time to start a family.A questionnaire survey was carried out in which a total of 423 medical students took part. A further 12 medical students with children were also interviewed about their situation using a guided interview. Results were evaluated using a qualitative content analysis.Medical students with children saw that there were advantages in terms of family and career to starting a family during their studies, but noted the disadvantages in terms of studies and the financial situation. The majority of medical students without children were undecided about the ideal time to start a family, but only 18% considered the student years to be the ideal time for this. Among medical students with children, on the other hand, 50% considered the student years as the ideal time to start a family and only five percent perceived the time after their studies as ideal.In order to facilitate combining children and career across the entire career path as a medical doctor, political and university policy concepts should be developed that take into consideration financial relief and flexible study organization.Die Medizin wird immer weiblicher. Vor dem Hintergrund des häufig Frauen betreffenden Konflikts zwischen Kind und Karriere, stellt sich für eine neue Generation junger Ärztinnen und Ärzten die schwierige Frage nach der Vereinbarkeit. Dabei spielt auch der richtige Zeitpunkt der Familiengründung eine große Rolle. An der privaten Universität Witten/Herdecke wurden Studierende mit und ohne Kind dazu befragt, inwiefern sich das Medizinstudium als geeigneter Zeitpunkt erweist.Es wurde eine Fragebogenerhebung durchgeführt, an der insgesamt 423 Medizinstudierende teilnahmen. Weitere 12 Medizinstudierende mit Kind wurden zudem mittels leitfadengestütztem Interview zu ihrer Situation befragt und die Ergebnisse mittels qualitativer Inhaltsanalyse ausgewertet.Medizinstudierende mit Kind sehen die Vorteile der Familiengründung im Studium v. a. für Familie und Karriere, die Nachteile hingegen für das Studium an sich und die Finanzen. Die Medizinstudierenden ohne Kind sind mehrheitlich unentschlossen bezüglich des idealen Zeitpunktes der Familiengründung, das Studium sehen jedoch nur 18% als idealen Zeitpunkt an. Dem gegenüber stehen die Medizinstudierenden mit Kind, welche zu 50% das Studium als idealen Zeitpunkt für die Familiengründung sehen, den Zeitpunkt nach dem Studium hingegen nur zu 5%.Es sollten Konzepte auf politischer und hochschulpolitischer geschaffen werden, die es ermöglichen, über den gesamten Karriereweg als Mediziner/in Kind und Karriere zu vereinen. Diese Konzepte sollten finanzielle Entlastungsmöglichkeiten und eine flexible Studienorganisation berücksichtigen.

Background: Currently, to the best of our knowledge, no findings exist concerning the needs of professionals in specialized pediatric palliative care (PPC) regarding electronic health records (EHRs). Several studies have highlighted benefits concerning the use of EHRs in pediatrics. However, usability is strongly affected by the degree of adaptivity to the context of application. The aim of this study is to examine the needs of professionals concerning an EHR in the specialized PPC inpatient and outpatient settings. Methods: A qualitative research design was chosen to address the complex aspects of user demands. Focus group interviews and semi-structured one-on-one interviews were conducted with PPC professionals. N = 23 participants from inpatient and N = 11 participants from outpatient settings of specialized PPC representing various professions took part in the study. Results: The findings could be grouped into four categories: (1) attitude towards the current methods of documentation, (2) attitude towards electronic documentation in general, (3) general requirements for an EHR, and (4) content requirements for an EHR. Conclusions: Professionals in specialized PPC expect and experience many benefits of using electronic documentation. Their requirements for an EHR for inpatient and outpatient settings of PPC are largely consistent with EHRs for pediatrics. However, individual specifications and adaptations are necessary for this particular setting.

Medical training in Germany is in a state of flux. Medical education must be adapted to fit the changing health care needs of future societies. This study aims to gain the patients' perspective on the education of medical students to improve future curricula.Using a semi-structured interview guide, 17 interviews were conducted with patients undergoing inpatient (N=9) or outpatient (N=8) medical treatment. The interviews were subjected to computer-assisted analysis guided by Grounded Theory.480 codings were condensed into seven main categories: Science Fiction Medicine, Society and the Patient, Professional Environment and Health Care System, Medical Curriculum and Continuing Education, Value System and Motivation, Psychosocial Competence and Medical Professional Competence. The largest main categories are Psychosocial Competence (114 codings) and Professional Environment and Health Care System (105 codings).There is a need for psychosocial education in addition to medical knowledge. A future-focused curriculum should entail practice-oriented education to ensure the training of motivated physicians who possess strengthened digital skills and act on ethical principles and values. Assessment of the patients' perspective should play a crucial role in medical education research.

Quantum computing (QC) is expected to revolutionize drug research by performing tasks classical supercomputers are not capable of. However, practically useful quantum computation is not yet a reality, and thus it is still unclear when and whether QC will be capable of solving real-world issues in drug discovery. By identifying the QC-related activities of pharmaceutical companies, startups, and academia in the field of drug discovery and development, we show that QC has gained traction across all of these stakeholder groups, that there is focus on developing utilities related to lead optimization and compound screening, and that there is a need for collaboration in the highly dynamic QC ecosystem.

As part of a study on competence-based assessment, students of the University of Veterinary Medicine, Hannover (TiHo), were asked to fill in an online questionnaire regarding their exam preparation and common examination formats. The aim of this investigation was to attain the students' opinion on different exam formats as well as the intensity and method of their preparation in order to further improve and develop the assessment formats.Data was collected using an online questionnaire developed in LimeSurveyA total of 215 questionnaires were completed and entered the evaluation. It was shown that the duration of the exam preparation depended on the specific exam format. Students' preparation time for an oral exam was longer than for a written-electronic exam. In the students' view, the assessment contents of oral examinations appeared to be more "relevant for later professional life". Electronic exams, on the other hand, were perceived as being more "fair" and less stressful. 30.3 % of respondents indicated to be suffering from test anxiety.Based on these findings, new recommendations for the development of teaching/learning materials may be derived. The opinions of students collected in this investigation provide an up-to-date insight into their perception of examinations. These results may serve as a valuable contribution to the optimization of examination scenarios in veterinary education. In addition, such surveys contribute to university-wide quality management of the examination systems.Im Rahmen einer Studie zur Kompetenzorientierung in Prüfungen wurde an der Stiftung Tierärztliche Hochschule Hannover (TiHo) eine Befragung der Studierenden zur Prüfungsvorbereitung und zu den Prüfungsformaten vorgenommen. Das Ziel dieser Studie war die Bewertung der eingesetzten Prüfungsformate. Erfasst wurden auch die Intensität und Art der Vorbereitung auf die Prüfungen, um aus den gewonnenen Daten eine Weiterentwicklung von Prüfungsformaten umsetzen zu können.Die Datenerhebung erfolgte mithilfe eines mit LimeSurveyFür die Auswertung standen insgesamt 215 vollständig ausgefüllte Fragebögen zur Verfügung. Es zeigte sich, dass die Dauer der Prüfungsvorbereitung vom Prüfungsformat abhängt. So bereiten sich Studierende deutlich länger auf eine mündliche Prüfung vor als auf eine schriftlich-elektronische Prüfung. Die Prüfungsinhalte mündlicher Prüfungen erscheinen den Studierenden „berufsrelevant“, während elektronische Prüfungen als „gerechter“ und weniger belastend empfunden werden. 30,2 % der Befragten gaben an, unter Prüfungsangst zu leiden.Aus den Erkenntnissen können neue Handlungsempfehlungen zur Erstellung von Lehr-/Lernmaterialien abgeleitet werden. Das erhobene Meinungsbild der Studierenden bietet einen aktuellen Einblick in die Wahrnehmung von Prüfungen. Dies kann als wertvoller Beitrag zur Optimierung von Prüfungsszenarien in der tiermedizinischen Ausbildung dienen. Gleichzeitig stellen solche Umfragen einen Beitrag für das hochschulweite Qualitätsmanagement im Prüfungswesen dar.

This article was migrated. The article was not marked as recommended. Background: In Germany academic degree programs for non-medical health care professions (nursing, physical, occupational and speech language therapy, midwifery) have been established only recently, even if they play a key role in today´s complex patient-centered health care. The aim of this study was to evaluate the development and current state of German education research in these professions as well as to conduct a comparison to international research activities in this field. Method: To achieve these objectives a bibliometric and content-related publication analysis was performed from 2008 to 2017 in four international high-impact journals. Based on appropriate inclusion criteria (bibliographical and biographical criteria, focus on first and last author, original study) and their development into a coding scheme, articles were recorded systematically and results analyzed quantitatively and content-wise. Group comparisons between German and international health care professions as well as interdisciplinary comparisons between the individual professions were performed. Results: On the whole, 11.891 articles were analyzed for participation of the respective target groups, either as first or as last author. Of these, 164 original studies met the inclusion criteria with 157 publications pertaining to international and only seven to German health care professionals. The majority of authors belonged to the discipline of nursing science (n=138). North America (36.63%), Australia (18.32%) and Asia (14.85%) rank among the regions that publish most frequently. Publications by German health care professionals are rare but showed an overall high level of quality. Conclusion: International publication activities by non-medical health care professionals have been on the rise in recent years. Specific funding measures as well as transnational and interdisciplinary collaborations may be potential ways of strengthening and expanding education research in countries with only young academic experiences.

Progress testing is an assessment tool for longitudinal measurement of increase in knowledge of a specific group, e.g., students, which is well-known in medical education. This article gives an overview of progress testing in veterinary education with a focus on the progress test of the German-speaking countries. The "progress test veterinary medicine" (PTT) was developed in 2013 as part of a project by the Competence Centre for E-Learning, Didactics and Educational Research in Veterinary Medicine-a project cooperation of all German-speaking institutes for veterinary medicine in Germany, Austria, and Switzerland. After the end of the project, the PTT was still continued at six locations, at each of the five German schools for veterinary medicine and additionally in Austria. Further changes to the PTT platform and the analysis were carried out to optimize the PTT for continuing to offer the test from 2017 to 2019. The PTT is an interdisciplinary, formative electronic online test. It is taken annually and is composed of 136 multiple-choice single best answer questions. In addition, a "don't know" option is given. The content of the PTT refers to the day 1 competencies described by the European Association of Establishments for Veterinary Education. The platform Q-Exam (R) Institutions (IQuL GmbH, Bergisch Gladbach, Germany) is used for creating and administrating the PTT questions, the review processes and organizing of the online question database. After compiling the test by means of a blueprint, the PTT file is made available at every location. After the last PTT in 2018, the link to an evaluation was sent to the students from four out of these six partner Universities. The 450 analyzed questionnaires showed that the students mainly use the PTT to compare their individual results with those of fellow students in the respective semester. To conclude our study, a checklist with our main findings for implementing progress testing was created.

Biochemistry and physiology teachers from veterinary faculties in Hannover, Budapest, and Lublin prepared innovative, computer-based, integrative clinical case scenarios as optional learning materials for teaching and learning in basic sciences. These learning materials were designed to enhance attention and increase interest and intrinsic motivation for learning, thus strengthening autonomous, active, and self-directed learning. We investigated learning progress and success by administering a pre-test before exposure to the virtual patients (vetVIP) cases, offered vetVIP cases alongside regular biochemistry courses, and then administered a complementary post-test. We analyzed improvement in cohort performance and level of confidence in rating questions. Results of the performance in biochemistry examinations in 2014, 2015, and 2016 were correlated with the use of and performance in vetVIP cases throughout biochemistry courses in Hannover. Surveys of students reflected that interactive cases helped them understand the relevance of basic sciences in veterinary education. Differences between identical pre- and post-tests revealed knowledge improvement (correct answers: +28% in Hannover, +9% in Lublin) and enhanced confidence in decision making (“I don't know” answers: −20% in Hannover, −7.5% in Lublin). High case usage and voluntary participation (use of vetVIP cases in Hannover and Lublin >70%, Budapest

Background Interest in digital technologies in the health care sector is growing and can be a way to reduce the burden on professional caregivers while helping people to become more independent. Social robots are regarded as a special form of technology that can be usefully applied in professional caregiving with the potential to focus on interpersonal contact. While implementation is progressing slowly, a debate on the concepts and applications of social robots in future care is necessary. Objective In addition to existing studies with a focus on societal attitudes toward social robots, there is a need to understand the views of professional caregivers and patients. This study used desired future scenarios to collate the perspectives of experts and analyze the significance for developing the place of social robots in care. Methods In February 2020, an expert workshop was held with 88 participants (health professionals and educators; [PhD] students of medicine, health care, professional care, and technology; patient advocates; software developers; government representatives; and research fellows) from Austria, Germany, and Switzerland. Using the scenario methodology, the possibilities of analog professional care (Analog Care), fully robotic professional care (Robotic Care), teams of robots and professional caregivers (Deep Care), and professional caregivers supported by robots (Smart Care) were discussed. The scenarios were used as a stimulus for the development of ideas about future professional caregiving. The discussion was evaluated using qualitative content analysis. Results The majority of the experts were in favor of care in which people are supported by technology (Deep Care) and developed similar scenarios with a focus on dignity-centeredness. The discussions then focused on the steps necessary for its implementation, highlighting a strong need for the development of eHealth competence in society, a change in the training of professional caregivers, and cross-sectoral concepts. The experts also saw user acceptance as crucial to the use of robotics. This involves the acceptance of both professional caregivers and care recipients. Conclusions The literature review and subsequent workshop revealed how decision-making about the value of social robots depends on personal characteristics related to experience and values. There is therefore a strong need to recognize individual perspectives of care before social robots become an integrated part of care in the future.

ZusammenfassungGegenstand und Ziel: In dem 5,5-jährigen Studium der Tiermedizin soll den angehenden Tierärzten neben theoretischem Fachwissen eine Vielzahl an praktischen Fertigkeiten vermittelt werden. Bei der großen Anzahl an Studierenden pro Semester ist die Ausbildung am lebenden Patienten unter Berücksichtigung des Tierschutzes und tierethischer Standpunkte nur begrenzt möglich. Das seit 2013 etablierte tiermedizinische Clinical Skills Lab an der Stiftung Tierärztliche Hochschule Hannover (TiHo) bietet allen Studierenden die Möglichkeit, klinischpraktische Fertigkeiten an Simulatoren und Modellen zu erlernen, zu trainieren und beliebig oft zu wiederholen, bis diese routiniert durchgeführt werden können. Anschließend sollen die Fertigkeiten auf das lebende Tier übertragen und angewendet werden. In der Studie wurde der Erfolg eines Skills-Lab-Trainings am Beispiel der Klinik für Kleintiere der TiHo untersucht. Material und Methoden: Verglichen wurden zwei Gruppen an Studierenden: ohne (Gruppe K) bzw. mit Skills-Lab-Training (Gruppe I). Am Ende des Trainings bzw. der rotierenden Ausbildung in verschiedenen Bereichen der Klinik erfolgte eine objektive strukturierte klinische Prüfung der praktischen Fertigkeiten an 15 Stationen. Ein vor und nach der klinischen Rotation durchgeführter Multiple-Choice-Test diente zur Evaluierung des Zuwachses an medizinischtheoretischem Wissen. Ergebnisse: Studierende der Gruppe I schnitten bei der Prüfung von acht der 15 Fertigkeiten signifikant (p 0,05) besser ab als Studierende der Gruppe K. Der Multiple-Choice-Test belegte in beiden Gruppen einen signifikanten (p 0,05) Wissenszuwachs während der klinischen Rotation ohne Unterschied zwischen den Gruppen. Die Studierenden zeigten eine hohe Akzeptanz des Clinical Skills Labs. Schlussfolgerung: Die Vermittlung praktischer Fertigkeiten mittels Einsatz von Simulatoren und Modellen sollte verstetigt und in das Curriculum integriert werden.

The implementation of lecture recordings at the University of Veterinary Medicine Hannover, Foundation, was accompanied by the current study investigating students' and teachers' acceptance of and requirements for this teaching format.Data were collected using questionnaires and guideline-based focus group surveys with students and teachers at the University of Veterinary Medicine Hannover, Foundation.Despite skepticism, teachers at the University are prepared to have their lectures recorded and prefer the option to provide the students with a short version of their lectures. All interviewed focus groups identified similar requirements for lecture recordings, including updating and editing options. Students wish to expand the lecture recording offer in veterinary medicine, while the teachers expressed their desire for support measures, including instructions and training.The present study will contribute to the optimization of lecture recording for students and teachers of veterinary medicine. The lecture recording offer can be adapted to the indicated requirements. Teachers who were skeptical of lecture recording have already been convinced to record. The use of mobile technology enables the expansion of the lecture recording possibilities. With the continuation of digitization, teaching material and didactics in veterinary medicine can be further enriched.Diese Studie wurde im Rahmen der Einführung von Vorlesungsaufzeichnungen an der Stiftung Tierärztliche Hochschule Hannover (TiHo) durchgeführt, um die Akzeptanz und speziellen Anforderungen von Dozierenden und Studierenden an Vorlesungsaufzeichnungen zu erheben.Die Datenerhebung erfolgte mithilfe von Fragebögen und leitfadengestützten Fokusgruppenbefragungen mit Studierenden und Dozierenden der TiHo.Dozierende der TiHo sind trotz Skepsis bereit, ihre Vorlesungen aufzeichnen zu lassen und präferieren die Option, den Studierenden eine Kurzversion zur Verfügung zu stellen. Alle befragten Fokusgruppen nannten ähnliche Anforderungen an Vorlesungsaufzeichnungen, beispielsweise Möglichkeiten zur Aktualisierung und Bearbeitung. Studierende wünschen sich den Ausbau des Angebots an Vorlesungsaufzeichnungen in der Tiermedizin, während die Dozierenden den Wunsch nach Unterstützungsmaßnahmen wie Anleitungen und Schulungen äußerten.Die Studie wird zur Optimierung der Vorlesungsaufzeichnungen für Studierende und Dozierende der Tiermedizin beitragen und das Angebot an Vorlesungsaufzeichnungen lässt sich an die genannten Anforderungen anpassen. Erste zuvor skeptische eingestellte Dozierende konnten bereits gewonnen und überzeugt werden, Aufzeichnungen durchzuführen. Der Einsatz mobiler Technik ermöglicht den Ausbau des Angebots. Mit der Fortführung der Digitalisierung der Lehre kann die tiermedizinische Hochschuldidaktik weiter bereichert werden.