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      Die Weiterbildungssituation in der HNO-Heilkunde in Deutschland Translated title: The situation of education in ENT-residency-training in Germany

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          Abstract

          Hintergrund

          Als Ansatzpunkt zur Entwicklung konkreter Optimierungsvorschläge für das HNO-ärztliche Weiterbildungssystem wurde zunächst die Ausbildungssituation an deutschen HNO-Kliniken analysiert, um existierende Schwachstellen der Weiterbildung identifizieren zu können.

          Methodik

          HNO-Weiterbildungsassistenten an deutschen HNO-Kliniken wurden eingeladen, an einer Online-Befragung teilzunehmen. Der Fragebogen bestand dabei aus 78 Einzelfragen.

          Ergebnisse

          An der Umfrage nahmen 223 Weiterbildungsassistenten der HNO-Heilkunde teil. Defizite der Ausbildung wie ein fehlendes regelmäßiges Feedback zwischen Weiterbildungsberechtigten und Weiterbildungsassistenten/-innen, eine nur mittelmäßig bewertete Vermittlung von Fachkompetenz sowie eine in den Freitextkommentaren genannte „Willkür“ der Weiterbildungsbeauftragten hinsichtlich der Gestaltung des Weiterbildungsverlaufs sowie Zeit- und Personalmangel treten in den Fokus unserer Auswertung. Einige der verbindlich aufgeführten Empfehlungen der Weiterbildungsordnung wie die Festlegung von konkreten Weiterbildungszielen im Rahmen eines regelmäßigen Gesprächs oder der Einsatz eines Log-Buchs werden bislang nur vereinzelt umgesetzt. Forderungen zum Ausbau von externen Fortbildungsmöglichkeiten (Hospitation/Rotation) und einer externen objektiven Überprüfung der klinikinternen Durchführung der Weiterbildung im Sinne einer Qualitätssicherung beispielsweise durch Fachvertreter der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Halschirurgie (DGHNOKHC) werden diskutiert.

          Schlussfolgerung

          Die Umsetzung einer strukturierten und standardisierten Weiterbildung in Deutschland, welche im Sinne einer freiwilligen Eigeninitiative auch durch die DGHNOKHC in ihrer Umsetzung überprüft wird, kann eine Basis für eine effektivere verbindliche Weiterbildung schaffen.

          Zusatzmaterial online

          Die Online-Version dieses Beitrags (10.1007/s00106-020-00838-9) enthält eine Tabelle, die Ergebnisse einer Fragenauswahl gegliedert nach Themenkomplexen darstellt. Beitrag und Zusatzmaterial stehen Ihnen auf www.springermedizin.de zur Verfügung. Bitte geben Sie dort den Beitragstitel in die Suche ein, das Zusatzmaterial finden Sie beim Beitrag unter „Ergänzende Inhalte“.

          Translated abstract

          Background

          As a starting point for developing concrete suggestions for optimizing specialty training in German ENT departments, the present study analysed the current status of residency training in order to identify weaknesses.

          Methods

          Residents at German ENT departments were invited to participate in an online survey. The questionnaire comprised 78 individual questions.

          Results

          The questionnaire was answered by 223 ENT residents. Educational deficits such as a lack of regular feedback from supervisors, only moderately rated mediation of specialist competencies, capriciousness of the trainers in charge regarding the organisation of training, and time and personnel shortages were identified. Some of the mandatory recommendations of the specialty training regulations, including determination of concrete training goals during regular meetings or the use of a logbook, have only been implemented in limited cases. Demands for development of more external training opportunities (job shadowing/rotation) and an external objective review of the residency training (e.g., by a representative of the German Society of Otorhinolaryngology, Head and Neck Surgery, DGHNOKHC) in the sense of quality assurance are discussed.

          Conclusion

          Implementation of structured and standardized ENT residency training in Germany, for which DGHNOKHC reviewal is also possible, can generate a basis for more effective compulsory residency training.

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          Most cited references10

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          [The shortage of qualified staff in Germany: a survey on head physicians' expectations of young doctors].

          The shortage of medical specialists in Germany has led to increased competition between hospitals, particularly in the recruitment of young skilled doctors. The quality of training appears to be the critical factor in a clinic's recruiting process. At the same time, the suitability of candidates is decreasing. There is currently no data on the suitability of candidates for otorhinolaryngology, nor are there any forecasts about the labor shortage in this speciality.
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            European otorhinolaryngology training programs: results of a European survey about training satisfaction, work environment and conditions in six countries.

            ORL-students and residents have an ongoing debate about the "best" programme in Europe. Aim of this study was to comparatively assess differences among programmes in training, satisfaction, quality of life (QoL) of residents and recent otorhinolaryngologist (ORL) specialists in France, Germany, Spain, Italy, Austria, and Belgium. A self-administered anonymous questionnaire, structured in ten sections including general information, provided guidance, working environment, training structure, teaching of medical students, publication work, QoL, and satisfaction with training, were emailed to residents and recent ORL specialists. 476 returned questionnaires from 6 countries revealed that daily work hours were the highest in France and Belgium with 11 and 10.4 h on average, respectively. QoL, work conditions, and salary were best in Germany followed by Austria in terms of possibility of part-time contracts, better respect for post-duty day off, and compensation for overtime. Satisfaction with training including support and guidance of seniors was lowest in Italy, but, on the other hand, the publication work and support had a more important place than in other countries. In Belgium, there was some gap between the quality of teaching and feedback from seniors as well as apprenticeship. The highest satisfaction with training was in France and Spain followed by Austria. The study results provide guidance before choosing an ORL training programme in Europe. Country-specific strengths could be included into future harmonization efforts to improve all programmes, facilitate professional exchange and, finally, establish standards-of-care carried out by well-trained doctors also looking after a satisfying work-life balance.
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              Training satisfaction and work environment in Otorhinolaryngology, Head and Neck surgery: a comparison between France and Germany.

              With the coalescing of Europe, increased mobility of professionals emerges. Initiatives to harmonize medical education were launched. In Otolaryngology, Head and Neck surgery (ORL) an European board examination was created to ensure standards. Quality of training, satisfaction and quality of life of residents and recent ORL specialists were compared to assess different aspects of work and hierarchical relationships in France (FRA) and Germany (GER) by means of an anonymous questionnaire. 120 FRA and 125 GER questionnaires were included. 78 % of respondents were residents. 86 % would choose the same training again. In both countries, a majority felt well considered with responsibilities adapted to their level of training and with supportive supervisors. Germans reported average daily work hours of 9.6 versus 11 in FRA with compensated overtime (76 %) and a possibility of part-time work (62 %), both nearly inexistent in FRA. In GER, the day-off after duty was more often respected. French attributed their seniors better pedagogic skills, taking time for explanations and providing better teaching. Offering a good training was a more important objective in French training centers (77 vs. 51 %). In both countries, surgical training relied on coaching. Research activities were comparable. The overall satisfaction with ORL training was high. Differences concerned structure of training, guidance by senior doctors and the working conditions. The study results provide guidance before choosing a program and may help to improve current training by identifying positive aspects that, if combined could lead to a convergence of programs. However, present high standards of education must be maintained.
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                Author and article information

                Contributors
                jana.linke@uniklinikum-dresden.de
                Journal
                HNO
                HNO
                Hno
                Springer Medizin (Heidelberg )
                0017-6192
                1433-0458
                4 March 2020
                4 March 2020
                2021
                : 69
                : 7
                : 534-543
                Affiliations
                [1 ]GRID grid.412282.f, ISNI 0000 0001 1091 2917, Klinik für Hals‑, Nasen- und Ohrenheilkunde, , Universitätsklinikum Carl Gustav Carus Dresden, ; Fetscher Str. 74, 01307 Dresden, Deutschland
                [2 ]GRID grid.460801.b, ISNI 0000 0004 0558 2150, Emeritus HNO-Klinik Carl-Thiem-Klinikum, ; Cottbus, Deutschland
                Article
                838
                10.1007/s00106-020-00838-9
                8233243
                32130454
                503ab042-e0b4-4ea3-b18f-e7dfd555e9d8
                © The Author(s) 2020, korrigierte Publikation 2021

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                History
                Funding
                Funded by: Universitätsklinikum Carl Gustav Carus Dresden
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                Originalien
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                © Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2021

                hno-facharztweiterbildung,hals-nasen-ohren-heilkunde,evaluation der weiterbildung,assistenzarztausbildung,weiterbildungsstruktur,ent residency training,otorhinolaryngology,evaluation of residency training,ent resident,residency training structure

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