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Objective: This position paper of the Committee on Methodology in Educational Research sets out the criteria for the acceptance, revision, or rejection of manuscripts of the article types and in the GMS Journal for Medical Education, as well as outlining the development of these criteria.Methods: In a workshop with writers, reviewers, and editors, we formulated and discussed common core elements for articles. We did this by consulting the journal’s editorial board on the basis of guidelines for authors and reviewers from other journals and by using examples of articles considered less or more successful. From this, we derived specific aspects to be addressed and rejection criteria for the respective article types.Results: We have identified the target group, relevance, justification, and implication as the common core elements for both article types. We have also derived specific aspects to be addressed and rejection criteria from these core elements for each article type.Conclusion: A manuscript lacking core elements will be rejected. If aspects are not described sufficiently or are not clearly comprehensible, the manuscript must be revised.

Background: Due to the corona pandemic, we conducted the Heidelberg module of the Master of Medical Education (MME) study program, which focuses on teaching and assessment of communicative and interpofessional skills, digitally for the first time.Method: We outsourced the teaching to a pre-module phase in the weeks upfront. During the module week, the lecturers picked up again and deepened the topics and the participants created, revised and simulated a virtual OSCE course. Results/Conclusion: Evaluation and reflection of the module showed that the digital implementation including an OSCE examination can be an appropriate alternative to a classroom-based training. However, important elements of the MME program that provide networking possibilities and personal exchange can only be replicated in the digital environment to a limited extent. In the future, sensibly applied digital components can be used to enrich the study program.

Background: Objective Structured Clinical Examinations (OSCEs) have become an established examination format at German medical faculties. Medical experts routinely use a summative assessment to evaluate practical and communicative skills, while the use of the OSCE format by student examiners, as a formative examination, remains rather limited.Objective: The formative OSCE program of the Department of General Practice and Implementation Research at the Heidelberg Medical Faculty, which is conducted and evaluated by peer tutors, is examined with regard to its quality criteria and compared with summative OSCEs from other departments. Methods: Difficulties and discriminatory power of individual testing stations were determined for the summative, as well as the formative OSCE, and compared with each other. To assess the reliability of the measurements, an analysis of the data was carried out using the Generalizability theory. In addition, a comparison is made between the assessments of student examiners and second assessments by medical experts.Results: The stations of the formative OSCE show similar difficulties as those of the summative comparison OSCEs (P=0.882; P=0.845 – 0.902). With respect to measurement reliability, there are no differences between the OSCE in General Medicine and the other subjects. The assessments of student examiners and medical experts correlate highly (r=0.888).Conclusion: The formative OSCE in General Medicine is comparable to the summative comparison formats in terms of its quality criteria. The use of student examiners can be a reliable alternative to medical experts in formative OSCEs.

Background: Since 2013 a competency-oriented student progress test (SKPT) has been administered at a number of German medical schools. The questions are generated on the basis of a two-dimensional blueprint, on which one axis contains the five competency domains – communicative competence (CO), practical clinical competence (CP), theoretical clinical competence (CT), scientific competence (SC), and professional decision-making competence (PR) – that form part of the competency model of the National Competency-based Catalogue of Learning Objectives for Undergraduate Medicine (NKLM). The feedback for students is structured in part according to these domains. The aim of our study is to examine if Methods: The SKPTs for the years 2013 to 2017, taken by a total of 3,027 students, were examined. The measurement accuracy was determined using the coefficient glb (greatest bound to reliability) and the standard error of measurement; discriminant analysis of the principal components was carried out to demonstrate differentiation between the competency domains.Results: The reliability of the competency domains was above 0.8 for all SKPTs; exceptions to this were seen in two of the tests for CO and PR that had a reliability of 0.7–0.8. The results for all of the individual competency domains differed in their informational content compared to the overall of the other domains; the same applies for all pairwise comparisons, with the exceptions of CP and CT.Discussion: The SKPT feedback for students that is differentiated by competency domains basically fulfills the requirements for measurement reliability and distinctness. An improvement of the measurement quality for CO and PR and a better differentiation between CP and CT is desirable.

Background: The increasing significance of didactic aspects in medical education has also led to the development of special postgraduate programs. Completion rates represent an important outcome criterion for these programs of study. Up to today, detailed studies on what factors influence these completion rates have been lacking.Methods: Within the framework of outcomes research, a semi-structured online survey of students was conducted in the Master of Medical Education Germany program. Of the 90 items, 21 referred to the master's thesis that is required for graduation. Results: 157 out of 246 (63.8%) of students from classes 1-10 of the program (study period 2004-2014) participated in the survey. 109 participants had submitted a master's thesis, whereas 45 participants had not completed their studies by submitting a master's thesis. Influencing factors of successful completion were, among other things, little difficulty in choosing the topic, retention of the originally chosen topic, general support by the program administration in the modules and ensuring timely feedback from the advisor, and the provision of temporal, staff and financial resources by the home faculty. The failure to turn in the project report and a lengthy interruption of master thesi's work could be identified as critical parameters.Conclusion: Taking into account these results can contribute to increasing completion rates in medical education graduate programs. Systematic outcomes research leads, moreover, to quality assurance. Such studies should be conducted in a standardized manner in the future, in order to facilitate comparisons between medical education programs.

In the written part of German state exams, multiple choice questions which inherit a flaw are not always excluded but taken into consideration when awarding a grade to any individual candidate, if this is advantageous to the candidate. This process of elimination and compensation of disadvantage in flawed questions, as applied by the Institut für medizinische und pharmazeutische Prüfungsfragen (IMPP), can lead to being taken into consideration in the grading and to the application of .This procedure is applied here to examinations containing items with partial credit scoring. A simple numerical rule can be applied which can be used to decide whether a flawed item has be taken into account in the grading procedure in order to achieve a pass or a particular grade for a candidate. This rule – as in the state examinations – must take account of the individual number of scores achieved in the flawed item and, if the relative pass threshold ("automatic adjustment clause") is applied, the average score achieved in the item by all candidates. In addition, however, it also includes the grade boundaries.

Introduction: The aim of the study presented here was to evaluate the reliability of an OSPE end-of-semester exam in the phantom course for operative dentistry in Frankfurt am Main taking into consideration different modes of evaluation (examiner’s checklist versus instructor’s manual) and number of examiners (three versus four).Methods: In an historic, monocentric, comparative study, two different methods of evaluation were examined in a real end-of-semester setting held in OSPE form (Group I: exclusive use of an examiner’s checklist versus Group II: use of an examiner’s checklist including an instructor’s manual). For the analysis of interrater reliability, the generalisability theory was applied that contains a generalisation of the concept of internal consistency (Cronbach’s alpha). Results: The results show that the exclusive use of the examiner’s checklist led to higher interrater reliability values than the in-depth instructor’s manual used in addition to the list.Conclusion: In summary it can be said that the examiner’s checklists used in the present study, without the instructor’s manual, resulted in the highest interrater reliability in combination with three evaluators within the context of the completed OSPE.

Introduction: Progress tests provide students feedback on their level of proficiency over the course of their medical studies. Peer-assisted learning and competency-based education have become increasingly important in medical education. Although progress tests have been proven to be useful as a longitudinal feedback instrument, there are currently no progress tests that have been created in cooperation with students or that focus on competency in medical education.In this study, we investigated the extent to which students can be included in the development of a progress test and demonstrated that aspects of knowledge related to competency can be represented on a competency-based progress test.Methods: A two-dimensional blueprint for 144 multiple-choice questions (MCQs) covering groups of medical subjects and groups of competency areas was generated by three expert groups for developing the competency-based progress test. A total of 31 students from seven medical schools in Germany actively participated in this exercise. After completing an intensive and comprehensive training programme, the students generated and reviewed the test questions for the competency-based progress test using a separate platform of the ItemManagementSystem (IMS). This test was administered as a formative test to 469 students in a pilot study in November 2013 at eight medical schools in Germany. The scores were analysed for the overall test and differentiated according to the subject groups and competency areas.Results: A pool of more than 200 MCQs was compiled by the students for pilot use, of which 118 student-generated MCQs were used in the progress test. University instructors supplemented this pool with 26 MCQs, which primarily addressed the area of scientific skills. The post-review showed that student-generated MCQs were of high quality with regard to test statistic criteria and content. Overall, the progress test displayed a very high reliability. When the academic years were compared, the progress test mapped out over the course of study not only by the overall test but also in terms of the subject groups and competency areas.Outlook: Further development in cooperation with students will be continued. Focus will be on compiling additional questions and test formats that can represent competency at a higher skill level, such as key feature questions, situational judgement test questions and OSCE. In addition, the feedback formats will be successively expanded. The intention is also to offer the formative competency-based progress test online.

Background: Objective Structured Clinical Examinations (OSCEs) often involve a considerable amount of resources in terms of materials and organization since the scores are often recorded on paper. Computer-assisted administration is an alternative with which the need for material resources can be reduced. In particular, the use of tablets seems sensible because these are easy to transport and flexible to use.Aim: User acceptance concerning the use of tablets during OSCEs has not yet been extensively investigated. The aim of this study was to evaluate tablet-based OSCEs from the perspective of the user (examiner) and the student examinee.Method: For two OSCEs in Internal Medicine at the University of Heidelberg, user acceptance was analyzed regarding tablet-based administration (satisfaction with functionality) and the subjective amount of effort as perceived by the examiners. Standardized questionnaires and semi-standardized interviews were conducted (complete survey of all participating examiners). In addition, for one OSCE, the subjective evaluation of this mode of assessment was gathered from a random sample of participating students in semi-standardized interviews.Results: Overall, the examiners were very satisfied with using tablets during the assessment. The subjective amount of effort to use the tablet was found on average to be “hardly difficult”. The examiners identified the advantages of this mode of administration as being in particular the ease of use and low rate of error. During the interviews of the examinees, acceptance for the use of tablets during the assessment was also detected.Discussion: Overall, it was found that the use of tablets during OSCEs was well accepted by both examiners and examinees. We expect that this mode of assessment also offers advantages regarding assessment documentation, use of resources, and rate of error in comparison with paper-based assessments; all of these aspects should be followed up on in further studies.

Objective: The decision having the most serious consequences for a student taking an assessment is the one to pass or fail that student. For this reason, the reliability of the pass/fail decision must be determined for high quality assessments, just as the measurement reliability of the point values.Assessments in a particular subject (graded course credit) are often composed of multiple components that must be passed independently of each other. When “conjunctively” combining separate pass/fail decisions, as with other complex decision rules for passing, adequate methods of analysis are necessary for estimating the accuracy and consistency of these classifications. To date, very few papers have addressed this issue; a generally applicable procedure was published by Douglas and Mislevy in 2010.Using the example of an assessment comprised of several parts that must be passed separately, this study analyzes the reliability underlying the decision to pass or fail students and discusses the impact of an improved method for identifying those who do not fulfill the minimum requirements.Method: The accuracy and consistency of the decision to pass or fail an examinee in the subject cluster Internal Medicine/General Medicine/Clinical Chemistry at the University of Heidelberg’s Faculty of Medicine was investigated. This cluster requires students to separately pass three components (two written exams and an OSCE), whereby students may reattempt to pass each component twice. Our analysis was carried out using the method described by Douglas and Mislevy.Results: Frequently, when complex logical connections exist between the individual pass/fail decisions in the case of low failure rates, only a very low reliability for the overall decision to grant graded course credit can be achieved, even if high reliabilities exist for the various components. For the example analyzed here, the classification accuracy and consistency when conjunctively combining the three individual parts is relatively low with κ=0.49 or κ=0.47, despite the good reliability of over 0.75 for each of the three components. The option to repeat each component twice leads to a situation in which only about half of the candidates who do not satisfy the minimum requirements would fail the overall assessment, while the other half is able to continue their studies despite having deficient knowledge and skills.Conclusion: The method put forth by Douglas and Mislevy allows the analysis of the decision accuracy and consistency for complex combinations of scores from different components. Even in the case of highly reliable components, it is not necessarily so that a reliable pass/fail decision has been reached – for instance in the case of low failure rates. Assessments must be administered with the explicit goal of identifying examinees that do not fulfill the minimum requirements.

Objectives: The point of departure for the present work is the observation that, in comparison with Anglo-American countries or the Netherlands, Germany was responsible for only a marginal number of international publications in the field of medical education research before 2004. Recent years, however, have seen an increase in the importance of medical education research in Germany. The objective of this article is to evaluate the extent to which this trend can be substantiated by increased German publishing activity since the year 2004 in international, English-language journals in the subject area of “medical education research”. Methods: In the framework of a literature and content analysis, German-author articles from the years 2004 to 2013 in six international, English-language medical education research journals were evaluated. In order to obtain an overview of German research activity in this area, all project and original works with German first and last authors were identified and subjected to a more in-depth content analysis. Results: In total, 10,055 articles were examined. The evaluation shows that between the years 2004 and 2013 179 articles (of which 145 are project or original works) by German authors were published in the journals examined. Fluctuations over the course of time were evidenced. The project and original works are primarily cross-sectional studies (27.8%) and randomised control studies (25.6%) on the subject of “teaching and learning methods” (43.6%). Conclusions: In comparison with the years 2004-2008, a significant rise can be seen in the number of publications by German education researchers in international journals since the year 2009.

Background and aim: In German-speaking countries, the physicians’ roles framework of the “Canadian Medical Education Directives for Specialists” (CanMEDS) is increasingly used to conceptualize postgraduate medical education. It is however unclear, whether it may also be applied to the final year of undergraduate education within clinical clerkships, called “Practical Year” (PY).Therefore, the aim of this study was to explore how clinically active physicians at a university hospital and at associated teaching hospitals judge the relevance of the seven CanMEDS roles (and their (role-defining) key competencies) in respect to their clinical work and as learning content for PY training. Furthermore, these physicians were asked whether the key competencies were actually taught during PY training. Methods: 124 physicians from internal medicine and surgery rated the relevance of the 28 key competencies of the CanMEDS framework using a questionnaire. For each competency, following three aspects were rated: “relevance for your personal daily work”, “importance for teaching during PY”, and “implementation into actual PY teaching”.Results: In respect to the main study objective, all questionnaires could be included into analysis. All seven CanMEDS roles were rated as relevant for personal daily work, and also as important for teaching during PY. Furthermore, all roles were stated to be taught during actual PY training.The roles “Communicator”, “Medical Expert”, and “Collaborator” were rated as significantly more important than the other roles, for all three sub-questions. No differences were found between the two disciplines internal medicine and surgery, nor between the university hospital and associated teaching hospitals.Conclusion: Participating physicians rated all key competencies of the CanMEDS model to be relevant for their personal daily work, and for teaching during PY. These findings support the suitability of the CanMEDS framework as a conceptual element of PY training.

[english] Introduction: Medical students with a migration background face several specific problems during their studies. International surveys show first indications that this group of students performs worse in written, oral or practical exams. However, so far, nothing is known about the performance of international students in written pre-clinical tests as well as in pre-clinical State Examinations for German-speaking countries.Method: A descriptive, retrospective analysis of the exam performances of medical students in the pre-clinical part of their studies was conducted at the Faculty of Medicine of Heidelberg in for the year 2012. Performance in written tests of the final exams in the second (N=276), third (N=292) and fourth semester (N=285) were compared between German students, students from EU countries and students from non-EU countries. Same comparison was drawn for the performance in the oral exam of the First State Examination in the period from 2009 - 2012 (N=1137).Results: German students performed significantly better than students with a non-EU migration background both in all written exams and in the oral State Examination (all p

[english] Purpose: The acquisition of clinical-technical skills is of particular importance for the doctors of tomorrow. Procedural skills are often trained for the first time in skills laboratories, which provide a sheltered learning environment. However, costs to implement and maintain skills laboratories are considerably high. Therefore, the purpose of the present study was to investigate students’ patterns of attendance of voluntary skills-lab training sessions and thereby answer the following question: Is it possible to measure an effect of the theoretical construct related to motivational psychology described in the literature – ‘Assessment drives learning’ – reflected in patterns of attendance at voluntary skills-lab training sessions? By answering this question, design recommendations for curriculum planning and resource management should be derived.Method: A retrospective, descriptive analysis of student skills-lab attendance related to voluntary basic and voluntary advanced skills-lab sessions was conducted. The attendance patterns of a total of 340 third-year medical students in different successive year groups from the Medical Faculty at the University of Heidelberg were assessed.Results: Students showed a preference for voluntary basic skills-lab training sessions, which were relevant to clinical skills assessment, especially at the beginning and at the end of the term. Voluntary advanced skills-lab training sessions without reference to clinical skills assessment were used especially at the beginning of the term, but declined towards the end of term.Conclusion: The results show a clear influence of assessments on students’ attendance at skills-lab training sessions. First recommendations for curriculum design and resource management will be described. Nevertheless, further prospective research studies will be necessary to gain a more comprehensive understanding of the motivational factors impacting students’ utilisation of voluntary skills-lab training in order to reach a sufficient concordance between students’ requirements and faculty offers, as well as resource management.[german] Zielsetzung: Die Vermittlung klinisch-praktischer Fertigkeiten ist von entscheidender Bedeutung für die Berufsfähigkeit angehender Ärzte. Prozedurale Fertigkeiten werden dabei häufig zu allererst in sogenannten Skills-Labs trainiert, die eine geschützte Lernumgebung gewährleisten. Die Implementierung und auch Pflege von Skills-Labs stellt allerdings eine nicht geringfügige finanzielle Herausforderung dar. Aus diesem Grund hat sich die vorliegende Arbeit zum Ziel gesetzt, die Besuchsfrequenzen und –muster im Rahmen freiwilliger Skills-Lab-Unterrichtseinheiten zu untersuchen, um folgende Frage zu beantworten: Kann der in der Literatur beschriebene, motivationspsychologische Effekt des “Assessment drives learning” festgestellt werden und spiegelt sich dieser in dem Besuchsverhalten von Studierenden in freiwilligen Skills-Lab-Unterrichtseinheiten wider? Ausgehend von den Studienergebnissen sollen Empfehlungen für die Curriculumsplanung und das Ressourcenmanagement abgeleitet werden.Methode:. Eine retrospektive, deskriptive Analyse studentischen Inanspruchnahmeverhaltens sowohl von freiwilligen „Basic“- als auch „Advanced“ Skills-Lab-Unterrichtseinheiten wurde durchgeführt. Hierzu wurden Teilnahmemuster von 340 Medizinstudierenden des dritten Studienjahres verschiedener Jahrgänge an der Medizinischen Fakultät Heidelberg näher untersucht.Ergebnisse: Die Studierenden zeigten besonders zu Beginn und am Ende des Semesters eine Präferenz für die Teilnahme an freiwilligen “Basic“ Skills-Lab-Unterrichtseinheiten, die für die klinisch-praktische Prüfung relevant sind. Freiwillige “Advanced“ Skills-Lab”-Unterrichtseinheiten ohne Bezug zur klinisch-praktischen Prüfung wurden vor allem zu Beginn des Semesters genutzt, mit einem Rückgang der Besuche gegen Ende des Semesters.Fazit: Die Ergebnisse zeigen einen deutlichen Einfluss klinisch-praktischer Prüfungen auf die studentischen Teilnahmen an Skills-Lab-Unterrichtseinheiten. Empfehlungen für die Planung des Curriculums und das Ressourcenmanagement werden dargestellt. Weitere, prospektive Studien sind erforderlich, um ein umfassenderes Verständnis motivationaler Faktoren zu entwickeln, die Studierende dazu veranlassen, freiwillige Skills-Lab-Unterrichtseinheiten zu besuchen. Damit kann eine noch erfolgreichere Abstimmung zwischen studentischen Anforderungen und Fakultätsangeboten sowie ein effizientes Ressourcenmanagement erzielt werden.

[english] With the introduction of the new medical licensing regulation [1] in 2002, a reform process was initiated nationwide that aimed to redesign medical degree programs at universities to make them more practice-oriented and to establish quality assurance in teaching. Five centers of excellence were set up at the medical schools in Baden-Württemberg that merged to form the Network for Excellence in Medical Education.The Network for Excellence in Medical Education carried out a survey among the five medical schools in Baden-Württemberg on the implementation of the requirements set down in the GMA guidelines for university-specific, high-quality assessments during the clinical phase of medical studies. The network’s next steps for improving the quality of assessments at medical schools were prioritized in order to determine the urgency of support to be given to Baden-Württemberg’s faculties of medicine in implementing the GMA requirements.It became apparent that essential parts of the requirements formulated in the guidelines had already been fulfilled or at least could be fulfilled in the near future. It was observed that establishing structured review processes during assessment preparation and in particular the follow-up presented considerable difficulties. A focus group analysis identified the following objectives for the network: supporting medical schools in their review processes; compiling a comprehensive assessment program and assessment reports with statistical analysis. Training the people responsible for assessment is another priority.The results largely correspond to those from a similar survey carried out among medical schools in Bavaria and show that organizational structures, such as those that have been established in the centers of excellence in education and assessment in Baden-Württemberg and Bavaria, can offer essential support in the quality assurance of assessment.[german] Mit der Einführung der novellierten Ärztlichen Approbationsordnung im Jahr 2002 wurde bundesweit ein Reformprozess in Gang gesetzt, mit dem Ziel, das Medizinstudium an den Universitäten praxisorientierter zu gestalten und eine Qualitätssicherung im Bereich der Lehre zu etablieren. Um hierbei die medizinischen Fakultäten Baden-Württembergs zu unterstützen, wurden fünf Kompetenzzentren an den medizinischen Fakultäten des Landes gegründet, die sich zum Kompetenznetz Lehre Baden-Württemberg zusammengeschlossen haben.Das Kompetenznetz Lehre hat an den fünf medizinischen Fakultäten Baden-Württembergs eine Befragung zum Umsetzungsstatus der in der GMA-Leitlinie für fakultätsinterne Leistungsnachweise dargelegten Anforderungen an qualitativ hochwertige Prüfungen im klinischen Abschnitt des Medizinstudiums durchgeführt. Um den vordringlichen Bedarf für die Unterstützung der medizinischen Fakultäten des Landes Baden-Württemberg bei der Umsetzung der Leitlinien durch das Kompetenznetz Lehre zu ermitteln, wurde eine Priorisierung der nächsten Aufgaben bei der Verbesserung der Qualität der universitären medizinischen Prüfungen vorgenommen.Es zeigte sich, dass wesentliche Teile des in den Leitlinien formulierten Anforderungskatalogs bereits erfüllt wurden oder wenigstens mittelfristig an den Fakultäten umsetzbar sind. Festgestellt wurde aber, dass die Etablierung strukturierter Reviewprozesse bei der Prüfungsvorbereitung und insbesondere der Nachbereitung noch auf deutliche Schwierigkeiten stößt. Im Rahmen einer Fokusgruppenanalyse wurden als vorrangige Arbeitsziele für das Kompetenznetz Lehre die Unterstützung der medizinischen Fakultäten für den Begutachtungsprozess der Prüfungsaufgaben („Review“), die Erstellung eines Gesamtprüfungsprogramms und von Prüfungsberichten mit statistischer Auswertung definiert. Einen weiteren Schwerpunkt bildet die Qualifizierung von Prüfungsverantwortlichen zum Thema Prüfungen.Die Ergebnisse decken sich im Wesentlichen mit einer ähnlichen Befragung der medizinischen Fakultäten in Bayern und zeigen, dass organisatorische Strukturen, wie sie mit den Kompetenzzentren für Lehre und Prüfungen in Baden-Württemberg und Bayern geschaffen wurden, eine wesentliche Hilfestellung bei der Qualitätssicherung von Prüfungen bieten können.

[english] The 2002 licensing regulation for doctors significantly increased the importance of school-specific assessment during the clinical phase of medical education. School-specific assessment should strengthen the practical element of medical training; due to the licensing reform, students now obtain individual grades for each clinical subject, which then count toward the final degree. In order to gain an overview of how the assessment procedure has evolved in light of this reform, a survey was carried out in all medical schools in Germany in autumn 2007. The dean of each school received a questionnaire containing questions on central organization. The questionnaire inquired about and recorded information on the format of all graded assessments and whether a structured appraisal and a statistical analysis were carried out for exam questions. Thirty-one out of 36 medical schools responded. Twenty-eight schools provided information on the 15 graded assessments taken during the pre-clinical phase of medical training, and all 31 provided information on the 38 subjects that comprise the clinical phase of the degree course. Multiple choice examinations dominate in both phases of medical training. Structured practical assessments are seldom used. Regulated evaluation procedures and statistical analysis of the questions take place in approximately 40% of all assessments, whereby differences between the individual schools of medicine do exist. In summary, the results show that although considerable effort has been made to carry out high-quality assessments, overall a stronger focus on practical elements within medical education has not yet been achieved. Often, assessment has not yet become an integral part of studies and it is doubtful that international minimum standards on assessment quality are being maintained. Necessary measures to improve the quality of assessments include training courses and cooperation between universities to help with content and organizational aspects of establishing assessment forms with strong practical components; the specification of adequate quality standards; and the creation of examination boards. [german] Mit der im Jahr 2002 novellierten Ärztlichen Approbationsordnung gewannen die fakultätsinternen Prüfungen im klinischen Studienabschnitt erheblich an Bedeutung. Sie sollen die Stärkung des Praxisbezugs der medizinischen Ausbildung abbilden und sind Teil des Abschlusszeugnisses. Um eine Übersicht zu gewinnen, wie sich dadurch die „Prüfungskultur“ an den medizinischen Fakultäten entwickelt hat, wurde im Herbst 2007 eine Umfrage an allen medizinischen Fakultäten in Deutschland durchgeführt. Allen Studiendekanaten wurde ein Fragebogen zugesandt, welcher Fragen zur zentralen Organisation enthielt. Für alle Leistungsnachweise wurde das Prüfungsformat erfragt und erhoben, ob für die Prüfungsaufgaben eine strukturierte Begutachtung und eine statistische Auswertung der Ergebnisse erfolgt. Von den 36 medizinischen Fakultäten antworteten 31 Fakultäten. Zu den 15 Leistungsnachweisen im vorklinischen Abschnitt des Studiums machten 28 Fakultäten Angaben, zu den 38 Fächern im klinischen Abschnitt alle 31 Fakultäten. In beiden Abschnitten des Studiums dominieren Klausuren mit Mehrfachauswahlfragen. Strukturierte praktische Prüfungen werden selten eingesetzt. Geregelte Begutachtungsverfahren der Aufgaben und statistische Auswertungen erfolgen bei etwa 40 % der Prüfungen, wobei sich hier charakteristische Unterschiede zwischen Fakultäten zeigen. Zusammenfassend folgt aus den Ergebnissen, dass zwar erhebliche Anstrengungen zur Durchführung qualitativ hochwertiger Prüfungen unternommen werden, sich insgesamt aber die angestrebte höhere Praxisorientierung des Studiums noch nicht hinreichend abbildet, die Integration von Prüfungen als wesentlicher Bestandteil der Lehre häufig noch nicht erfolgt und die Einhaltung internationaler Mindeststandards an die Qualität der Leistungsmessung zweifelhaft ist. Als Maßnahmen zur qualitativen Verbesserung der Prüfungen werden Schulungen und universitäre Kooperationen zur logistischen und inhaltlichen Etablierung praxisnaher Prüfungsformen, die Festlegung adäquater Qualitätsstandards sowie die Bildung von Prüfungsverbünden als notwendig erachtet.

[english] Aims: Interactive, student-centered teaching methods have replaced traditional teacher-centered didactic formats in many modern medical curricula in the past few years. However, in the natural sciences such as biochemistry, interactive teaching methods are not well proven. The present study was conducted to compare the effect of the teaching format on the performance of undergraduate students in biochemistry and their evaluation of the respective format. Methods: A total of 421 second-year students were randomized into two groups: The control group was taught in a traditional lecture-like format, whereas the study group dealt with the same topic in an interactive group discussion. At the end of each lesson, students performed a multiple-choice test and completed a questionnaire. The same MCQ test was repeated 4–6 weeks after the last lesson. Results: Students who were taught in a lecture-like format performed significantly better in the first MCQ test immediately after the lesson than students taught in the interactive format. However, in the second MCQ test, there was no difference between the two groups. In the questionnaire, students rated the lecture-based course significantly better than the interactive group discussion. Conclusion: One reason why students prefer a didactic lecture to an interactive group discussion might be due to the subject biochemistry, which is strongly knowledge-based. Students perceived that the transfer of knowledge by a professional lecturer was more effective than the knowledge obtained in a student-centered discussion group. Other reasons might be the method of assessment and the overall design of the curriculum. [german] Zielsetzung: Interaktive, Lerner-orientierte Unterrichtsmethoden werden vielfach mit moderner und guter Lehre in Verbindung gebracht und ersetzen zunehmend konventionellen, Lehrer-zentrierten Frontalunterricht. In naturwissenschaftlichen Fächern, wie Biochemie, sind interaktive Unterrichtsformen bisher nur wenig erprobt. Die vorliegende Studie wurde mit dem Ziel durchgeführt, herauszufinden, welchen Einfluss die Unterrichtsform auf den Wissenszuwachs und die studentische Beurteilung des Biochemie-Unterrichts hat. Methodik: Studierende des 4. Fachsemesters (n=421) wurden für eine Seminarveranstaltung in zwei Gruppen randomisiert. Die Kontrollgruppe erhielt konventionellen Frontalunterricht, die Studiengruppe erarbeitete sich dieselben Lerninhalte anhand konkreter Fragestellungen in interaktiven Arbeitsgruppen. Als Messinstrument zur Beurteilung des kognitiven Erfolges diente ein Wissenstest unmittelbar nach der Veranstaltung und nach 4-6 Wochen. Die Beurteilung der beiden Unterrichtsformen durch die Studierenden erfolgte anhand eines Fragebogens. Ergebnisse: Studierende, die Frontalunterricht erhielten, schnitten in einem ersten Wissenstest, direkt nach der Veranstaltung, signifikant besser ab als Studierende, die sich die Inhalte in interaktiven Gruppen selbst erarbeiteten. Im Wiederholungstest waren keine signifikanten Wissensunterschiede mehr messbar. In der Evaluation beurteilten Studierende, die Frontalunterricht erhielten, die Veranstaltung signifikant besser als diejenigen, die in Gruppen arbeiteten. Schlussfolgerung: Die schlechtere studentische Bewertung der interaktiven Unterrichtsform gegenüber Frontalunterricht in einem Biochemieseminar kann verschiedene Ursachen haben. Eine Ursache könnte die starke Orientierung des Faches an Faktenwissen sein. Dieses Wissen wurde nach Meinung der Studierenden - in dem in dieser Studie gegebenen Rahmen – vom Dozenten besser vermittelt als es in einer interaktiven Gruppenarbeit von Studierenden selbst erarbeitet werden konnte. Andere Ursachen könnten Prüfungsmethoden und curriculare Vorgaben sein.

[english] After assigning the different examination formats to the diverse terms of Miller's pyramide of knowledge, this paper provides a short presentation of the key feature approach by giving the definition and an example for clarification. Afterwards, a practical guide to writing key feature problems is given consisting of the following steps: define the domain, choose a clinical situation, define the key features, develop a test case scenario, write questions, select a preferred response format, define the scoring key, and validation. Finally, we present the evaluation results of this practical guide. In sum, the participants were very pleased with it. The differences between the estimations of their knowledge before and after the workshop concerning key features were significant. The key feature approach is an innovative tool for assessing clinical decision-making skills, also for electronical examinations. Substituting the write-in format for the long-menu format allows an automatic data analysis. [german] Im vorliegenden Beitrag wird - nach der Zuordnung unterschiedlicher Prüfungsformen zu den verschiedenen Wissensarten der Wissenspyramide von Miller - der Key-Feature (KF) Ansatz vorgestellt. Nachdem anhand der Definition und einem Beispiel erklärt wurde, was ein KF ist, wird im Anschluss eine Anleitung für die Erstellung eines KF-Problems gegeben. Diese besteht aus folgenden Schritten: Definition des Kontextes, Wahl der klinischen Situation, Identifikation der KFs des klinischen Problems, Schreiben des klinischen Szenarios (Fallvignette), Schreiben der einzelnen KF-Fragen, Auswahl des Antwortformates, Bewertungsverfahren und Inhaltsvalidierung. Am Ende werden die Ergebnisse einer Evaluation dieser Anleitung, die im Rahmen eines KF-Workshops gewonnen wurden, präsentiert. Die Teilnehmer waren mit dieser Workshopeinheit sehr zufrieden und gaben an, sehr viel gelernt zu haben. Die subjektive Einschätzung ihres Wissensstands vor und nach dem Workshop zeigte signifikante Unterschiede. Mit dem KF-Format steht ein innovativer Ansatz zur Überprüfung von Entscheidungskompetenz zur Verfügung, das auch sehr gut elektronisch eingesetzt werden kann. Durch den Einsatz eines Long-Menu Formats anstelle eines Write-In Formats wird eine automatische Auswertung möglich.

[english] The evaluation steps are described which are necessary for an elementary test-theoretic analysis of an exam and sufficient as a basis of item-revisions, improvements of the composition of tests and feedback to teaching coordinators and curriculum developers. These steps include the evaluation of the results, the analysis of item difficulty and discrimination and - where appropriate - the corresponding evaluation of single answers. To complete the procedure, the internal consistency is determined, which makes an estimate of the reliability and significance of the examination. [german] Es werden die Auswertungsschritte beschrieben, die für eine einfache testtheoretische Analyse einer Prüfung notwendig sowie als Grundlage von Aufgabenrevisionen, Verbesserungen von Prüfungszusammenstellungen und Rückmeldung an Lehrbeauftragte und Curriculumsentwickler ausreichend sind. Diese Schritte umfassen die Ergebnisauswertung, die Analyse der Aufgabenschwierigkeiten und der Trennschärfen, sowie - wo angebracht - die entsprechenden Auswertungen der Einzelantworten. Vervollständigt wird das Vorgehen durch die Bestimmung der internen Konsistenz, durch die die Zuverlässigkeit und Aussagekraft (Reliabilität) der Prüfung abgeschätzt wird.

Introduction: The present study aims to evaluate the role of sense of coherence and self-efficacy in relation to mental health and well-being, with and without social restrictions due to the COVID-19 pandemic. Additionally, this study seeks to investigate the differences in sense of coherence, self-efficacy, mental health and well-being depending on the manner in which the pandemic is being handled. Methods: A total of 27,162 students at Heidelberg University were surveyed via email at two measurement points, once with and once without social restrictions. The survey assessed sense of coherence, self-efficacy, mental health and well-being. To this end, the questionnaires Sense of Coherence Scale, Patient Health Questionnaire, WHO-Well-being-Index and the General Self-Efficacy Scale were employed. A total of 2,398 individuals participated in the initial measurement, while 701 individuals participated in the subsequent measurement. Results: The lifting of social restrictions has been associated with a notable improvement in well-being and mental health, particularly in the context of depressive syndromes. Further analysis demonstrated a positive correlation between the sense of coherence and self-efficacy at both measurement points, as well as between these two constructs and mental health and well-being. Furthermore, the sense of coherence and self-efficacy were found to account for a notable proportion of the observed variability in mental health and well-being values. Self-efficacy exhibited a significantly higher mean value at the initial measurement time point compared to the subsequent time point. In contrast, no significant difference was observed in the sense of coherence between the two measurement points. Discussion: The findings presented here illustrate the significance of social interaction, sense of coherence and self-efficacy for mental health and well-being. [ABSTRACT FROM AUTHOR]

Introduction: Radiographic diagnostic competences are a primary focus of dental education. This study assessed two feedback methods to enhance learning outcomes and explored the feasibility of artificial intelligence (AI) to support education. Materials and Methods: Fourth‐year dental students had access to 16 virtual radiological example cases for 8 weeks. They were randomly assigned to either elaborated feedback (eF) or knowledge of results feedback (KOR) based on expert consensus. Students´ diagnostic competences were tested on bitewing/periapical radiographs for detection of caries, apical periodontitis, accuracy for all radiological findings and image quality. We additionally assessed the accuracy of an AI system (dentalXrai Pro 3.0), where applicable. Data were analysed descriptively and using ROC analysis (accuracy, sensitivity, specificity, AUC). Groups were compared with Welch's t‐test. Results: Among 55 students, the eF group by large performed significantly better than the KOR group in detecting enamel caries (accuracy 0.840 ± 0.041, p =.196; sensitivity 0.638 ± 0.204, p =.037; specificity 0.859 ± 0.050, p =.410; ROC AUC 0.748 ± 0.094, p =.020), apical periodontitis (accuracy 0.813 ± 0.095, p =.011; sensitivity 0.476 ± 0.230, p =.003; specificity 0.914 ± 0.108, p =.292; ROC AUC 0.695 ± 0.123, p =.001) and in assessing the image quality of periapical images (p =.031). No significant differences were observed for the other outcomes. The AI showed almost perfect diagnostic performance (enamel caries: accuracy 0.964, sensitivity 0.857, specificity 0.074; dentin caries: accuracy 0.988, sensitivity 0.941, specificity 1.0; overall: accuracy 0.976, sensitivity 0.958, specificity 0.983). Conclusion: Elaborated feedback can improve student's radiographic diagnostic competences, particularly in detecting enamel caries and apical periodontitis. Using an AI may constitute an alternative to expert labelling of radiographs. [ABSTRACT FROM AUTHOR]