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ABSTRACT: BACKGROUND: Informed consent talks are mandatory before invasive interventions. However, the patients' information recall has been shown to be rather poor. We investigated, whether medical laypersons recalled more information items from a simulated informed consent talk after advanced medical students participated in a communication training aiming to reduce a layperson's cognitive load. METHODS: Using a randomized, controlled, prospective cross-over-design, 30 5th and 6th year medical students were randomized into two groups. One group received communication training, followed by a comparison intervention (early intervention group, EI); the other group first received the comparison intervention and then communication training (late intervention group, LI). Before and after the interventions, the 30 medical students performed simulated informed consent talks with 30 blinded medical laypersons using a standardized set of information. We then recorded the number of information items the medical laypersons recalled. RESULTS: After the communication training both groups of medical laypersons recalled significantly more information items (EI: 41 +/- 9% vs. 23 +/- 9%, p < .0001, LI 49 +/- 10% vs. 35 +/- 6%, p < .0001). After the comparison intervention the improvement was modest and significant only in the LI (EI: 42 +/- 9% vs. 40 +/- 9%, p = .41, LI 35 +/- 6% vs. 29 +/- 9%, p = .016). CONCLUSION: Short communication training for advanced medical students improves information recall of medical laypersons in simulated informed consent talks.
BMC Medical Education 02/2013; 13(1):15. · 1.15 Impact Factor
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Medical Teacher 08/2012; · 1.22 Impact Factor
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ABSTRACT: 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.
GMS Zeitschrift für medizinische Ausbildung. 01/2012; 29(5):Doc70.
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ABSTRACT: The effectiveness of skills laboratory training is widely recognized. Yet, the transfer of procedural skills acquired in skills laboratories into clinical practice has rarely been investigated. We conducted a prospective, randomised, double-blind, controlled trial to evaluate, if students having trained intravenous (IV) cannulation in a skills laboratory are rated as more professional regarding technical and communication skills compared to students who underwent bedside teaching when assessed objectively by independent video assessors and subjectively by patients.
84 volunteer first-year medical students were randomly assigned to one of two groups. Three drop-outs occurred. The intervention group (IG; n = 41) trained IV cannulation in a skills laboratory receiving instruction after Peyton's 'Four-Step Approach'. The control group (CG; n = 40) received a bedside teaching session with volunteer students acting as patients. Afterwards, performance of IV cannulation of both groups in a clinical setting with students acting as patients was video-recorded. Two independent, blinded video assessors scored students' performance using binary checklists (BC) and the Integrated Procedural Protocol Instrument (IPPI). Patients assessed students' performance with the Communication Assessment Tool (CAT) and a modified IPPI. IG required significantly shorter time needed for the performance on a patient (IG: 595.4 SD(188.1)s; CG: 692.7 SD(247.8)s; 95%CI 23.5 s to 45.1 s; p = 0.049) and completed significantly more single steps of the procedure correctly (IG: 64% SD(14) for BC items; CG: 53% SD(18); 95%CI 10.25% to 11.75%; p = 0.004). IG also scored significantly better on IPPI ratings (median: IG: 3.1; CG: 3.6; p = 0.015;). Rated by patients, students' performance and patient-physician communication did not significantly differ between groups.
Transfer of IV cannulation-related skills acquired in a skills laboratory is superior to bedside teaching when rated by independent video raters by means of IPPI and BC. It enables students to perform IV cannulation more professionally on volunteer students acting as patients.
PLoS ONE 01/2012; 7(3):e32831. · 4.09 Impact Factor
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Medical Education 07/2011; 45(7):656-8. · 3.18 Impact Factor
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ABSTRACT: student tutors in the dissection course are expected to meet high demands on their job. We developed a combined technical and didactical training on the basis of literature review and needs assessment. The three-week training program comprised dissection as well as presentation techniques, group dynamics and activating teaching methods. A randomized, controlled, single-blind study was set up to test whether there is a difference between the tutee's perception of the tutor competences, comparing trained and untrained tutors.
a total of 10 trained and 10 untrained tutors (control group) were enlisted in the study. The acceptance of the training program was measured with a questionnaire (11 items, 5-point Likert scale) where the tutees rated the competences of the tutors. The tutees were assigned randomly to their tutor and blinded to his/her training.
the tutees assessed the trained tutors better in all categories compared to the untrained tutors. A significantly better score (p<0.05) was stated for the categories "conveying basic dissection techniques" (4.31 ± 0.86 vs. 3.89 ± 1.05), "positive group atmosphere" (4.69 ± 0.73 vs. 4.44 ± 0.88), "learning support" (4.24 ± 1.03 vs. 3.79 ± 1.16) and "visualisation" (3.99 ± 1.11 vs. 3.56 ± 1.17). In self-assessment, the trained tutors rated themselves significantly better after the training compared to before in all categories.
The specific training curriculum for tutors in the dissection course, focusing on the improvement of content knowledge, technical and didactical competencies, is well accepted by the tutees and tutors.
Annals of anatomy = Anatomischer Anzeiger: official organ of the Anatomische Gesellschaft 10/2010; 192(6):361-5. · 0.88 Impact Factor
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ABSTRACT: Research regarding the experience of stress during medical training scenarios using standardised patients (SPs) has been primarily qualitative and has focused on the SPs. The purpose of this study was to quantitatively evaluate stress and motivation in both students and SPs during these scenarios by measuring heart rate variability (HRV) and administering the German version of the Questionnaire on Current Motivation (QCM).
A total of 44 medical students (23 women, 21 men) participated in two medical history-taking training scenarios. In one scenario the SP role-played a patient with a somatic disease; in the other the SP played a patient with a psychosomatic disease, creating easy and difficult scenarios, respectively, for the student. Each student interviewed one of 11 SPs (five women, six men), using the same SP in both scenarios. Heart rate variability was measured during baseline periods and during the training scenarios in both students and SPs. Motivation was assessed before each training scenario.
Heart rate variability was lower in both students and SPs during the scenarios compared with baseline values, but did not differ by scenario type. For students, motivation increased when the first scenario involved psychosomatic illness, but decreased when the first condition was somatic. For SPs motivation was consistent over time for scenarios involving psychosomatic disease, but decreased for somatic disease-related scenarios.
The training scenarios induced stress in both students and SPs, as indicated by decreased HRV. Student motivation was high, indicating that SP scenarios represent a valid teaching method. Further studies in the natural setting of SP examinations are needed.
Medical Education 07/2009; 43(6):553-6. · 3.18 Impact Factor
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ABSTRACT: Due to the new licensing regulations for physicians, social and communicative aspects have attained a central position within medical education. In developing self-reflexive, empathetic and communicative skills, medical students are influenced on the one hand by encounters with real physicians in the role of supervisor or colleague, and on the other by their intra-psychic ideals and role stereotypes. The present study aimed to contrast the self-evaluations of modern medical students with their role stereotypes and ideals, and to further relate these to the evaluations, stereotypes and ideals of medical students in 1981.
696 medical students were surveyed with respect to their self-image, their image of a physician and their image of the ideal physician using Osgood and Hofstätter's polarity profile.
Over the past 25 years, medical students' image of the ideal physician has remained surprisingly constant, comprising expectations with regard to aptitude, trustworthiness, reliability, friendliness, confidence, thoroughness and congeniality. Encountered physicians were described as negatively deviating from this ideal; self-evaluations lay predominantly in between these two extremes. Self-images were characterized by feelings of powerlessness and uncertainty.
Medical students possess differentiated images of self, future colleagues and the ideal physician. Surveyed students appeared to develop feelings of powerlessness and uncertainty, as well as tendencies to overestimate themselves within self-evaluations. Dealing with the conflict-charged domain between idealism and realism within the occupational reality toward which medical students aspire thus appears to be complicated. These problem areas, which have so far received little attention, require urgent consideration in the development of future medical curricula, in particular in the psychosocial fields.
PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie 04/2009; 59(12):446-53. · 1.02 Impact Factor
