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      Projektbericht zur Förderung wissenschaftlicher Kompetenzen im Fach Schmerzmedizin im Rahmen der curricularen Lehre Translated title: Project report on fostering scientific competencies in pain medicine in the context of student education

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          Abstract

          Zielsetzung

          Die Vermittlung von Wissenschaftskompetenzen ist ein unverzichtbares Charakteristikum eines akademischen Medizinstudiums. Im Rahmen des Modellstudiengangs Mannheimer Reformiertes Curriculum für Medizin (MaReCuM) wurde die Lehrveranstaltung Wissenschaftliches Arbeiten im Fach Schmerzmedizin in das 5. Studienjahr implementiert. Die Ziele der Arbeit umfassen die Beschreibung dieser kompetenzorientierten Lehrveranstaltung sowie eine Evaluation der Lerneffekte der Lehrveranstaltung.

          Methodik

          114 Studierende haben sich an einer Fragebogenerhebung beteiligt. Die historische Kontrollgruppe absolvierte das 5. Studienjahr vor Einführung der Lehrveranstaltung. Die Interventionsgruppe nahm verpflichtend an der Lehrveranstaltung sowie an der realen Versorgungsforschungsstudie Case-Management-Programm Kreuzschmerzteil. In beiden Gruppen erfolgte eine Fragebogenerhebung zu schmerzmedizinischem Vorwissen und Interesse sowie zur Akzeptanz der Lehrveranstaltung und dem subjektiv wahrgenommenen Lernerfolg.

          Ergebnisse

          Die innovative und kompetenzorientierte Lehrveranstaltung konnte erfolgreich in das Curriculum des Modellstudiengangs implementiert und mit den Partnern in der Allgemeinmedizin und dem Mannheim Institute of Public Health wie geplant durchgeführt werden. Die Lehrveranstaltung wurde von den teilnehmenden Studierenden akzeptiert. In der begleitenden Evaluation hatte die Teilnahme an der Lehrintervention an und für sich keinen messbaren Einfluss auf den subjektiven Lernerfolg.

          Diskussion

          Unseres Wissens nach wurde dieser didaktische Ansatz in der curricularen Lehre bislang noch nicht verfolgt. Die vorgestellte Lehrveranstaltung eröffnet eine weitere Option zur Vermittlung von Wissenschaftskompetenzen im Rahmen des Medizinstudiums. Ein Effekt der Lehrveranstaltung auf den subjektiven Lernerfolg war in der untersuchten Form und am Ende des Moduls nicht messbar. Gründe dafür könnten in den vielfältigen und umfangreichen Vorerfahrungen der Studierenden des Modellstudiengangs MaReCuM sowie in Limitationen bei der Teilnahme an der realen Versorgungsforschungsstudie liegen. Durch die Verknüpfung der Lehrintervention mit anderen Lehrveranstaltungen zu einem longitudinalen Wissenschaftsmodul kann eine zusätzliche Lerngelegenheit im Bereich der Arztrolle des Gelehrten geschaffen werden. Die Implementierung der Lehrveranstaltung bietet darüber hinaus die Gelegenheit für vergleichende Untersuchungen zum Erwerb von Wissenschaftskompetenzen der Studierenden im Fach Humanmedizin.

          Translated abstract

          Aim

          The training of scientific skills and competencies is an essential part of academic medical studies. As part of the MaReCuM model study program at Heidelberg University’s Mannheim Medical School, a fifth-year rotation on scientific skills in the field of pain medicine was implemented. This paper describes this competence-oriented rotation as well as the investigation of the educational effect.

          Method

          A total of 114 fifth-year medical students participated in the survey (response rate: 83%). The control group completed the fifth year prior to the implementation of the rotation. The experimental group was required to participate in the rotation and the real healthcare research study “Case management program: low back pain”. A survey of both groups was conducted on the first day of the rotation and at the end of the module.

          Results

          The innovative and competency-based learning unit was successfully implemented as part of the MaReCuM model study program and carried out with partners in general practice as well as the Mannheim Institute of Public Health. The participating students accepted the rotation well. There was no measurable effect on the subjective learning success of the rotation in the evaluation.

          Discussion

          To the authorsʼ knowledge, this educational approach has never been tested before in a German study program. The presented rotation offers an additional option for the training of scientific competencies as part of medical studies. The missing of a measurable effect could be due to the extensive experience of the medical students as well as the limitations on participation in a real healthcare study. An additional learning opportunity could be created by connecting the preexisting lectures to a longitudinal module on scholarly competencies. The implementation of the program also offers a unique opportunity for educational research on the acquisition of scientific competencies in medical students.

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          Most cited references13

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          Developing research skills in medical students: AMEE Guide No. 69.

          This Guide has been written to provide guidance for individuals involved in curriculum design who wish to develop research skills and foster the attributes in medical undergraduates that help develop research. The Guide will provoke debate on an important subject, and although written specifically with undergraduate medical education in mind, we hope that it will be of interest to all those involved with other health professionals' education. Initially, the Guide describes why research skills and its related attributes are important to those pursuing a medical career. It also explores the reasons why research skills and an ethos of research should be instilled into professionals of the future. The Guide also tries to define what these skills and attributes should be for medical students and lays out the case for providing opportunities to develop research expertise in the undergraduate curriculum. Potential methods to encourage the development of research-related attributes are explored as are some suggestions as to how research skills could be taught and assessed within already busy curricula. This publication also discusses the real and potential barriers to developing research skills in undergraduate students, and suggests strategies to overcome or circumvent these. Whilst we anticipate that this Guide will appeal to all levels of expertise in terms of student research, we hope that, through the use of case studies, we will provide practical advice to those currently developing this area within their curriculum.
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            Publication practices of medical students at British medical schools: experience, attitudes and barriers to publish.

            With research playing a vital role in improving clinical practice, it is important that medical students understand the role of research and submitting articles for publication. Therefore, the aim of this study was to ascertain the experience, motivation and attitude of publishing of medical students. A cross-sectional survey of British medical students from seven medical schools in the United Kingdom. Seventy-two of 515 had submitted an article for publication with a total of 124 articles being submitted. The main motivation to publish was for career progression. For the students that had not published, not having an opportunity to perform research was felt to be the main barrier. Only 49% of students had taken part in a research or audit project. Sixty-two percent of students stated they were not encouraged by the seniors to participate in research projects. From 515 medical students, only 88 students had submitted an article for a scientific meeting. Students have a positive attitude towards publishing and they feel it is important. However, it is clear that students require and would welcome education in writing papers and abstracts, skills that they will need in their postgraduate careers.
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              Finally finished! National Competence Based Catalogues of Learning Objectives for Undergraduate Medical Education (NKLM) and Dental Education (NKLZ) ready for trial

              Note Finally finished! Earlier this June, the National Competence Based Catalogues of Learning Objectives for Undergraduate Medical Education (NKLM) and Dental Education (NKLZ) were passed with overwhelming agreement at the annual meeting of the Association of Medical Faculties in Germany (MFT) [http://www.mft-online.de/files/pm_nklm-nklz_2015-07-27.pdf, cited 2015-08-03] after nearly six years of development. The catalogues describe the competencies students of medical or dental degrees in Germany should have acquired by the time they graduate. They were made freely available online not long ago at www.nklm.de (www.nklz.de respectively). What were the starting points for the development process? On the one hand the institute tasked with the execution of the written licensing examinations (Institut für Medizinische und Pharmazeutische Prüfungsfragen, IMPP) has long provided catalogues which list topics to be assessed via multiple choice tests. But much remained unclear. They list diseases and leading symptoms relevant for the clinical subjects but without elucidating what knowledge and which abilities a newly licensed physician should have exactly – i.e. listing diabetes without mentioning interdisciplinary tasks in secondary prevention, communication with patients and relatives, and collaboration with diabetes educators. The NKLM does not order its content by subject or organ; subjects associated with an item are considered suggestions, leaving the mapping of competencies and local departments responsible for their mediation to the individual faculties. To what extent should doctor-patient communication be mastered and in which contexts? Working in professional teams? Skills of scholarship and critical appraisal of studies? Experience in conducting research including literature searches, developing research questions and hypotheses? All this content and competencies indeed had already been identified by faculties and were being conveyed to a certain extent. Many countries already provide competence-based descriptions of medical programs - most notably Canada, the Netherlands and Switzerland. These served as reference and a basis for discussion in the development of NKLM. In 2009, the Society for Medical Education (Gesellschaft für Medizinische Ausbildung, GMA) and the Association of Medical Faculties in Germany (Medizinischer Fakultätentag, MFT) were commissioned by the Standing Conference of Ministers of Education and Cultural Affairs’s Higher Education Committee (Hochschulausschuss der Kultusministerkonferenz der Länder) to develop a competence-based catalogue of learning objectives for medicine to aid faculties in the advancement and modernization of their curricula [1]. The NKLM was to define the foundations for students moving on to postgraduate clinical education. The road to completion was longer and more complicated than originally anticipated though. 21 teams incorporating over 200 medical experts worked out a draft, then presented to a steering committee that included all major stakeholders in medical education and postgraduate training, in particular the German Medical Association (Bundesärztekammer), the National Association of Medical Students in Germany (Bundesvereinigung der Medizinstudierenden Deutschlands, bvmd), and the Association of the Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen medizinischen Fachgesellschaften, AWMF). The draft was discussed and a version agreed upon which then underwent systematic revision by all scientific medical societies of the AWMF (over 160) via an online platform. Over two years, 98 societies participated in a two-step Delphi consensus process continuously improving and commenting the drafts (with over 4000 comments submitted in the first Delphi round alone). With success. Eventually, all 234 competencies and 281 sub-competencies reached strong agreement or consensus and were included in the catalogue’s final version. Just two of the proposed 1958 learning objectives that further operationalize and describe the competencies could not be agreed upon. The NKLM office at the GMA coordinated this process (with the kind support of the Robert Bosch Foundation) and compiled the catalogue’s final version in close cooperation with the MFT. Competencies and sub-competencies listed in the catalogues in their present form have the status of recommendations for medical faculties while the library of learning objectives provided will have to be trialed. It can be assumed that with time the catalogue’s volume will decrease – based on the Swiss experience, where the Swiss Catalogue of Learning Objectives’ content was reduced by 30% from the first to the revised second edition [http://sclo.smifk.ch/, cited 2015-08-04]. From IT infrastructure to concept design for competence-based assessment, challenges remain and will have to be faced. Time will show what kind of support faculties and individual teachers will need in the implementation of the NKLM. An expert group has been set up by the MFT to support this implementation process. Until 2020 the faculties’ experiences with the catalogues are to be regularly exchanged and discussed, and will give insights into what future revisions and developments should address. It will be interesting to see to what extent medical education in Germany will turn competence-based and what impact this will have on the federal government’s Master Plan 2020 on Medical Education (Masterplan Medizinstudium 2020). Published in 2014, the Science Council (Wissenschaftsrat)’s much-discussed paper on the advancement of medical education in Germany, based on experiences from reformed medical programs, prominently and repeatedly points at the NKLM as an important basis for future medical education in Germany [http://www.wissenschaftsrat.de/download/archiv/4017-14.pdf, cited 2015-08-04]. The path to completion of NKLM and NKLZ was tedious and accompanied by controversy over the desirability and feasibility of competency-based medical education. Indeed the catalogues’ implementation and real-life trials at the medical faculties will not be less arduous but point the way to the future of medical education in Germany. It is about nothing less than ensuring future doctors are trained as well as humanly possible to face the health system’s challenges and to adequately carry out their various professional roles for the benefit of their patients. Many thanks to all who contributed to the critical discussion and development of NKLM and NKLZ! Competing interests The authors declare that they have no competing interests.
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                Author and article information

                Contributors
                dusch.martin@mh-hannover.de
                Journal
                Schmerz
                Schmerz
                Schmerz (Berlin, Germany)
                Springer Medizin (Heidelberg )
                0932-433X
                1432-2129
                4 March 2022
                4 March 2022
                2022
                : 36
                : 6
                : 398-405
                Affiliations
                [1 ]GRID grid.10423.34, ISNI 0000 0000 9529 9877, Klinik für Anästhesiologie und Intensivmedizin, , Medizinische Hochschule Hannover, ; Carl-Neuberg-Str. 1, 30625 Hannover, Deutschland
                [2 ]GRID grid.7700.0, ISNI 0000 0001 2190 4373, Mannheim Institute of Public Health, Medizinische Fakultät Mannheim, , Ruprecht-Karls-Universität Heidelberg, ; Mannheim, Deutschland
                [3 ]GRID grid.7700.0, ISNI 0000 0001 2190 4373, Centrum für Biomedizin und Medizintechnik Mannheim, Medizinische Fakultät Mannheim, , Ruprecht-Karls-Universität Heidelberg, ; Mannheim, Deutschland
                [4 ]GRID grid.5252.0, ISNI 0000 0004 1936 973X, Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Universität München, , LMU München, ; München, Deutschland
                Article
                628
                10.1007/s00482-022-00628-y
                9674719
                35244773
                27a8d05a-55f8-4bd0-85a0-abd07b0cd24c
                © The Author(s) 2022

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                History
                : 21 January 2022
                Funding
                Funded by: Medizinische Hochschule Hannover (MHH) (3118)
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                © Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2022

                kompetenzbasierte lehre,arztrolle des gelehrten,wissenschaftsmodul,nklm,competence-based teaching,scholar,research module

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