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      Overview of digital health teaching courses in medical education in Germany in 2020 Translated title: Erste Übersicht der Lehrveranstaltungen mit dem Inhalt „Digitale Kompetenzen“ an den medizinischen Universitäten in Deutschland 2020

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          Abstract

          Objective: The digitalization of the healthcare system poses new challenges for physicians. Thus, the relevance of learning digital competencies (DiCo), such as dealing with data sets, apply telemedicine or using apps, is already growing in medical education. DiCo should be clearly separated from digitized teaching formats, which have been increasingly used since the COVID 19 pandemic. This article outlines the faculties in Germany where DiCo are already integrated into medical education.

          Methods: Courses with DiCo as teaching content were collected by a literature research on Pubmed and Google as well as by contacting all dean's offices and other persons responsible for teaching at German medical faculties. The courses were summarized in a table.

          Results: In a first survey, 16 universities were identified that offer courses on DiCo. In the elective area at the universities, 17 courses and in the compulsory area eight courses could be identified. The scope and content of the courses diverged between compulsory curricula, integrated courses of different lengths, and elective courses that are one-time or longitudinally integrated. The topics taught are heterogeneous and include fundamentals of medical informatics such as data management on the one hand and a collection of e.g. ethics, law, apps, artificial intelligence, telemedicine and robotics on the other hand.

          Conclusion: Currently, only some German medical faculties offer courses on DiCo. These courses vary in scope and design. They are frequently part of the elective curriculum and only reach some of the students. The possibility of embedding DiCo in the already existing cross-sectional area appears limited. In view of the ongoing digitalization of healthcare, it is necessary to make future courses on DiCo accessible to all medical students. In order to drive this expansion forward, the implementation of the new learning objectives catalogue, in which DiCo are integrated, a network formation, a teaching qualification as well as the involvement of students is recommended.

          Zusammenfassung

          Zielsetzung: Die Digitalisierung des Gesundheitswesens stellt Ärztinnen und Ärzte vor neue Herausforderungen. Somit wächst die Relevanz des Erlernens von Digitalen Kompetenzen (DiKo), wie z.B. Kenntnisse im Umgang mit Datenmengen, Telemedizin oder Apps, bereits im Medizinstudium. DiKo sind hierbei klar zu trennen von digitalisierten Lehrformaten, die seit der COVID 19-Pandemie vermehrt eingesetzt wurden. Dieser Artikel beschreibt, an welchen Fakultäten in Deutschland digitale Kompetenzen bereits in die Medizinische Ausbildung integriert sind.

          Methodik: Über eine Literaturrecherche auf Pubmed und Google sowie durch den Kontakt zu allen Dekanaten und weiteren Lehrverantwortlichen deutscher medizinischer Fakultäten wurden Lehrveranstaltungen, die DiKo als Lehrinhalt aufweisen, gesammelt und in einer Tabelle zusammengefasst.

          Ergebnisse: In einer ersten stichprobenartigen Übersicht wurden 16 Universitäten identifiziert, die Lehrveranstaltungen zu DiKo anbieten. Im Wahlpflichtbereich konnten 17 Universitäten und im Pflichtbereich acht Universitäten identifiziert werden. Der Umfang und die inhaltliche Ausgestaltung der Lehrveranstaltungen divergiert zwischen Pflichtcurricula, integrierten Lehrveranstaltungen verschiedener Größe und Wahlpflichtveranstaltungen, die einmalig oder longitudinal integriert sind. Die gelehrten Themen sind heterogen und umfassen einerseits Grundlagen der medizinischen Informatik, wie z.B. Datenmanagement und andererseits eine Sammlung aus z.B. Ethik, Recht, Apps, Künstlicher Intelligenz, Telemedizin und Robotik.

          Schlussfolgerung: Aktuell werden nur an einem Teil der deutschen medizinischen Fakultäten Lehrveranstaltungen zu DiKo angeboten. Diese Veranstaltungen divergieren in Umfang und Ausgestaltung. Sie sind häufig im Wahlpflichtbereich angesiedelt und erreichen nur einen Teil der Studierenden. Eine Verankerung von DiKo im bereits vorhandenen Querschnittsbereich erscheint begrenzt. Angesichts der fortschreitenden Digitalisierung des Gesundheitswesens ist es notwendig, zukünftige Lehrveranstaltungen zu DiKo allen Medizinstudierenden zugänglich zu machen. Um diesen Ausbau zügig voranzutreiben wird die Umsetzung des neuen Lernzielkatalog, in den DiKo integriert sind, eine Netzwerkbildung, eine Lehrendenqualifikation sowie die Einbindung Studierender empfohlen.

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          Proposing a Transactional Model of eHealth Literacy: Concept Analysis

          Background Electronic health (eHealth) literacy was conceptualized in 2006 as the ability of internet users to locate, evaluate, and act upon web-based health information. Now, advances in eHealth technology have cultivated transactional opportunities for patients to access, share, and monitor health information. However, empirical evidence shows that existing models and measures of eHealth literacy have limited theoretical underpinnings that reflect the transactional capabilities of eHealth. This paper describes a conceptual model based on the Transactional Model of Communication (TMC), in which eHealth literacy is described as an intrapersonal skillset hypothesized as being dynamic; reciprocal; and shaped by social, relational, and cultural contexts. Objective The objective of our study was to systematically examine eHealth literacy definitions, models, and measures to propose a refined conceptual and operational definition based on the TMC. Methods Walker and Avant’s concept analysis method was used to guide the systematic review of eHealth literacy definitions (n=10), rating scales (n=6), models (n=4), and peer-reviewed model applications (n=16). Subsequent cluster analyses showed salient themes across definitions. Dimensions, antecedents, and consequences reflected in models and measures were extracted and deductively analyzed based on codes consistent with the TMC. Results Systematic review evidence revealed incongruity between operational eHealth literacy included in definitions compared with literacies included within models and measures. Theoretical underpinnings of eHealth literacy also remain dismal. Despite the transactional capabilities of eHealth, the role of “communication” in eHealth literacy remains underdeveloped and does not account for physical and cognitive processing abilities necessary for multiway transactions. Conclusions The Transactional Model of eHealth Literacy and a corresponding definition are proposed. In this novel model, eHealth literacy comprises a hierarchical intrapersonal skillset that mediates the reciprocal effect of contextual factors (ie, user oriented and task oriented) on patient engagement in health care. More specifically, the intrapersonal skillset counteracts the negative effect of “noise” (or impediments) produced by social and relational contexts. Cutting across health and technology literacies, the intrapersonal skillset of eHealth literacy is operationalized through four literacies that correspond with discrete operative skills: (1) functional (ie, locate and understand); (2) communicative (ie, exchange); (3) critical (ie, evaluate); and (4) translational (ie, apply).
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            Digitale Lehr- und Lernangebote in der medizinischen Ausbildung

            The current choice of digital teaching and learning formats in medicine is very heterogeneous. In addition to the widely used classical static formats, social communication tools, audio/video-based media, interactive formats, and electronic testing systems enrich the learning environment.For medical students, the private use of digital media is not necessarily linked to their meaningful use in the study. Many gain their experience of digital learning in the sense of "assessment drives learning", especially by taking online exams in a passive, consuming role. About half of all medical students can be referred to as "e-examinees" whose handling of digital learning is primarily focused on online exam preparation. Essentially, they do not actively influence their digital environment. Only a quarter can be identified as a "digital all-rounder", who compiles their individual learning portfolio from the broad range of digital media.At present, the use of digital media is not yet an integral and comprehensive component of the teaching framework of medical studies in Germany, but is rather used in the sense of a punctual teaching enrichment. Current trends in digital teaching and learning offerings are mobile, interactive, and personalized platforms as well as increasing the relevance of learning platforms. Furthermore, didactical concepts targeting the changed learning habits of the students are more successful regarding the acceptance and learning outcomes. In addition, digitalization is currently gaining importance as a component in the medical school curricula.
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              The Rise of the Empowered Physician in the Digital Health Era: Viewpoint

              Being a 21st-century health care provider is extremely demanding. The growing number of chronic diseases, lack of medical workforce, increasing amounts of administrative tasks, the cost of medical treatment, and rising life expectancy result in an immense challenge for medical professionals. This transformation has been triggered by the growing presence of digital health. Digital health does not only refer to technological transformation; it also fundamentally reshapes the physician-patient relationship and treatment circumstances. We argue that patient empowerment, the spread of digital health, the biopsychosocial-digital approach, and the disappearance of the ivory tower of medicine lead to a new role for physicians. Digital health allows the job of being a medical professional to become more rewarding and creative. The characteristics of a physician-as-idol could shift from self-confident to curious, from rule follower to creative, and from lone hero to team worker. Empowered physicians (e-physicians) can be described as “electronic,” where they use digital technologies in their practice with ease; “enabled,” where they are enabled by regulations and guidelines; and “empowered,” where they are empowered by technologies that support their job and their empowered patients (e-patients). They can be described as “experts” in the use of technologies in their practice or in knowing the best, most reliable, and trustworthy digital health sources and technologies. They can also be described as “engaged,” when understanding the feelings and points of view of their patients, giving relevant feedback, and involving them throughout the whole healing process. The skills and approaches that characterize this era of e-physicians, such as face-to-face communication skills, digital literacy, interdisciplinarity, knowing where to find information, translating large amounts of data into insights for patients, among others, should always have been at the core of practicing medicine. However, the economical, technological, and administrative burden of the profession has not made it possible for most physicians to enjoy the benefits of their training, individual capabilities, and creativity. By understanding how digital health technologies can support or augment their capabilities, physicians would have the chance to practice the art of medicine like never before.
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                Author and article information

                Journal
                GMS J Med Educ
                GMS J Med Educ
                GMS J Med Educ
                GMS Journal for Medical Education
                German Medical Science GMS Publishing House
                2366-5017
                15 April 2021
                2021
                : 38
                : 4
                : Doc80
                Affiliations
                [1 ]Universitätsklinikum Essen, Klinik für Anästhesiologie und Intensivmedizin, Essen, Germany
                [2 ]Medizinische Hochschule Hannover, Hannover, Germany
                [3 ]Eberhard-Karls Universität Tübingen, Tübingen, Germany
                [4 ]Bundesvertretung der Medizinstudierenden in Deutschland, Berlin, Germany
                [5 ]Ruprecht-Karls-Universität Heidelberg, Heidelberg, Germany
                Author notes
                *To whom correspondence should be addressed: Jana Aulenkamp, Universitätsklinikum Essen, Klinik für Anästhesiologie und Intensivmedizin, Hufelandstr. 55, D-45147 Essen, Germany, E-mail: jana.aulenkamp@ 123456uk-essen.de
                Article
                zma001476 Doc80 urn:nbn:de:0183-zma0014762
                10.3205/zma001476
                8136344
                34056069
                ac200b4a-694d-41da-909b-02fdcbc5abb9
                Copyright © 2021 Aulenkamp et al.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

                History
                : 30 November 2019
                : 09 January 2021
                : 20 November 2020
                Categories
                Article

                education,digital health,digital competencies,digital medicine,digital teaching,elearning,medical informatics

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