U Obertacke

Orthopädisch-Chirurgische Zentrum, Cham Regen, Bavaria, Germany

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Publications (186)303.18 Total impact

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    ABSTRACT: Introduction: Traumatic fractures of the neck of the femur are rare injuries in younger patients between 15 and 50 years old. The short-term and long-term complications may cause substantial problems, in particular non-union and avascular necrosis (AVN) of the head of the femur. In the literature (and from some experts) the impression is occasionally given that there might be "proven" successful therapeutic procedures. Methods: For this purpose we retrospectively analysed follow-up-data from our own patients in the years 2003-2007 and compared them with the literature. We identified 23 of a total of 376 patients with a femoral neck fracture as a cohort being younger than 50 years. 17 of those 23 patients were treated with an internal fixation. We were able to collect and analyse complete clinical and radiological data of 11 of these 17 patients 4.2 years after surgery. Results: The mean interval between accident and surgery was 22 hours. Only one of the patients developed an AVN after internal fixation of the fracture and was implanted a total hip replacement 18 months postoperatively. There was no non-union of the femoral neck The clinical outcome after 4.2 years was very good. The mean Harris Hip Score was 95 points (of a max. of 100 pts.). Conclusions: The osteosynthesis of femoral neck fractures in younger patients showed good results and a low risk of AVN and non-union. Therefore the internal fixation of the femoral neck fracture should be preferred for the younger patients instead of a primary total hip replacement.
    Zeitschrift fur Orthopadie und Unfallchirurgie 02/2014; 152(1):20-5. · 0.65 Impact Factor
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    ABSTRACT: Die Ergebnisse nach operativ behandelten dislozierten, distalen Radiusfrakturen sind begrenzt. Dabei korrelieren die radiographischen Ergebnisse nicht gut mit den funktionellen Ergebnissen. Diese Tatsache legt die Vermutung nahe, dass radiographisch nicht darstellbare, zusätzliche karpale Primärläsionen dafür verantwortlich sind. Die vorliegende Studie soll klären, inwieweit karpale begleitende Läsionen mit dislozierten distalen Radiusfrakturen assoziiert sind.Es wurde eine konsekutive Serie von 104 Patienten mit dislozierten distalen Radiusfrakturen eingeschlossen. Das verletzte Handgelenk wurde radiographisch, computertomographisch und MR-tomographisch in Hinblick auf zusätzliche Verletzungen untersucht.Radiographisch zeigten sich nach AO 51/104 Frakturen als Typ A, 10/104 als Typ B und 39 als Typ C. CT-morphologisch waren nur 5 der 51 Typ-A-Frakturen reine metaphysäre Frakturen. MR-tomographisch wiesen alle als Typ A klassifizierten Frakturen ligamentäre Verletzungen auf. Die MRT-Untersuchung ergab 77/104 akute Läsionen des TFCC und 19/104 skapholunäre Bandrupturen.Die Ergebnisse der Studie stützen die Hypothese, dass jede dislozierte distale Radiusfraktur eine zusätzliche Läsion radiographisch nicht erkennbarer karpaler Strukturen mit sich bringt.
    Der Unfallchirurg 01/2014; 117(1). · 0.64 Impact Factor
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    ABSTRACT: Introduction: The changes in medical licensing regulations introduced in Germany in 2012 require the development of specific catalogues, termed logbooks, that define the practical skills medical students should acquire in different specialties. In conjunction with another change in medical education, which allows medical students to freely select any German university hospital or academic teaching hospital for their one-year internship, these catalogues are a prerequisite for ensuring comparable training standards throughout Germany. The German licensing regulations provide no details regarding the contents or form of the logbooks but only mention a "training programme" in very general terms. A logbook is commonly understood to define clear learning objectives to be accomplished during a specified interval (4 months). The conference of German medical faculties proposed a basic logbook for compulsory training modules (surgery and internal medicine) that is intended to serve as a model (formally and contentwise) for those who develop similar catalogues for elective training modules. Here we present our logbook for an elective training module in orthopaedic surgery and traumatology. Material and Method: The logbook presented here is based on the catalogue of learning outcomes in orthopaedic surgery and traumatology developed by an expert board of the medical teaching study group of the German Society of Orthopaedic Surgery and Traumatology (DGOU) in 2011. The objectives defined for the one-year internship are of necessity divided into orthopaedic surgery and traumatology skills that must be acquired by all medical students and those that are optional (compulsory and elective modules). Using a set of predefined criteria, the authors developed the catalogue of learning outcomes (logbook) presented here. The catalogue outlines the competencies to be acquired in an elective orthopaedic surgery and traumatology module, leaving it to each medical faculty to work out the details. Where applicable, comprehensive skills across a number of (compulsory and elective modules) learning objectives are arranged in such a way that they can be taught at different levels of complexity. Results: The logbook covers 15 skill domains from different specific components of orthopaedic surgery and traumatology. Where these skills overlap with those also required in compulsory modules (e.g., surgery), the required level of complexity may be lower for students in the elective module. The text is supplemented by figures with synopses of the major issues and summaries for easy reference. Conclusion: With the recent changes in German licensing regulations for physicians, it has become necessary to set up a logbook of uniform learning outcomes to assist medical students and their teachers alike. The authors have developed such a logbook of elective training modules in orthopaedic surgery and traumatology to be taught during the one-year undergraduate internship of German medical students.
    Zeitschrift fur Orthopadie und Unfallchirurgie 12/2013; 151(6):610-631. · 0.65 Impact Factor
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    ABSTRACT: Intraoperative radiotherapy (IORT) using the INTRABEAM(®) system promises a flexible use regarding radiation protection compared to other approaches such as electron treatment or HDR brachytherapy with (192)Ir or (60)Co. In this study we compared dose rate measurements of breast- and Kypho-IORT with C-arm fluoroscopy which is needed to estimate radiation protection areas. C-arm fluoroscopy, breast- and Kypho-IORTs were performed using phantoms (silicon breast or bucket of water). Dose rates were measured at the phantom's surface, at 30cm, 100cm and 200cm distance. Those measurements were confirmed during 10 Kypho-IORT and 10 breast-IORT patient treatments. The measured dose rates were in the same magnitude for all three paradigms and ranges from 20μSv/h during a simulated breast-IORT at two meter distance up to 64 mSv/h directly at the surface of a simulated Kypho-IORT. Those measurements result in a circle of controlled area (yearly doses >6 mSv) for each paradigm of about 4 m±2 m. All three paradigms show comparable dose rates which implies that the radiation protection is straight forward and confirms the flexible use of the INTRABEAM(®) system.
    Zeitschrift für Medizinische Physik 11/2013; · 1.21 Impact Factor
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    ABSTRACT: Die objektive Feststellung von Sicherheit im Krankenhaus bedarf einer eigenen Definition und ist nicht mit Parametern der Betriebssicherheit, wie in anderen Bereichen, messbar. Die Erfassung und Quantifizierung sog. vermeidbarer unerwünschter Ereignisse (VUE) macht Sicherheit messbar(er). VUE treten im Rahmen von Krankenhausbehandlungen zu 9,2 % auf, die Sterblichkeit bei diesen Ereignissen liegt bei 0,1 %. Die subjektive Bewertung und das mediale Interesse an solchen unerwünschten Ereignissen korreliert jedoch selten mit objektiv messbaren Sicherheitsparametern. VUE wie Komplikationen, Fehler, Versagen und Verstöße sollten sorgsam definiert und klar unterschieden werden. Kumulativ liegt die Komplikationshäufigkeit perioperativ (weltweit) sicher über 10 %. Die Sicherheit im Zusammenhang mit Operationen wird eingriffsbezogen am meisten durch Wundinfektionen (Sicherheit 98 %) und nosokomiale Infektionen (Sicherheit 97 %) gefährdet. Die Sicherheit vor Problemen in Anästhesie, Bluttransfusion und sog. Indexereignisse (z. B. Patienten-/Seitenverwechslung) ist deutlich höher. Objektiv kann ein Krankenhaus nach den meisten Parametern als sicher für die Patienten angesehen werden. Checklisten verbessern nachweislich die Sicherheit. Meldesysteme (für kritische Ereignisse), Schulungen und Trainings- und Verhaltensänderungen könnten die Sicherheit möglicherweise verbessern, die Effekte sind allerdings schwer messbar.
    Der Unfallchirurg 10/2013; 10:884-891. · 0.64 Impact Factor
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    ABSTRACT: Patient safety in hospitals is difficult to define and is not measurable by operational safety parameters as in other fields. So-called adverse events (AE) are a collective of complications, failures, mistakes, errors and violations. Estimations of at least 9.2 % AEs in surgery with 0.1 % fatalities are given worldwide but there are no correlations between objective quantification of AEs and subjective or public perception of safety during the perioperative period. Patient safety during this period is mostly endangered by wound infections (safety 98 %) and nosocomial infections (safety 97 %). In spite of these facts, safety parameters for problems in anesthesia, blood transfusion, in retaining surgical instruments and so-called index events, such as patient and side identification errors are much higher. Patient safety is maintained in hospitals by objective means (surgical). Checklists have been proven to improve safety and critical incidence reporting, training and changing of attitudes could have further advantages but they are difficult to measure.
    Der Unfallchirurg 10/2013; 116(10):884-891. · 0.64 Impact Factor
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    ABSTRACT: The Kypho-IORT procedure is a recently developed surgical technique to combine intraoperative radiotherapy with cement augmentation of the vertebra for spinal metastases. The technical feasibility and the operation principle of this new method have been described. In the following article the refinement of the standard operation procedure and the technical development of the method are described. Not only the procedural improvements but also the learning curves of the inaugurators are pointed out. Moreover, the article presents the measures which were necessary to educate trainees during surgical master classes in this new method and to transfer the method. The learning success was quantified by recording the accuracy reached by the trainees in the key procedure during hands-on cadaver exercises. Improvements of the standard operation procedure could be successfully transferred in a second master class. The method of Kypho-IORT and the demonstrated way of postgraduate education is feasible to instruct trainees. The Kypho-IORT procedure can be learnt and performed safely by running through the surgical master class.
    Der Orthopäde 09/2013; 42(9):772-9. · 0.51 Impact Factor
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    ABSTRACT: Operative and radiotherapeutic procedures are available for the treatment of symptomatic vertebral metastases. The method for treatment of vertebral metastases presented in this article involves a combination of intraoperative radiotherapy (IORT) and kyphoplasty. Kyphoplasty-IORT allows treatment of symptomatic vertebral metastases between vertebrae T3 and L5. With the patient under intubation narcosis an extrapedicular or bipedicular access to the vertebra is selected as for conventional kyphoplasty. This is followed by insertion of special sheaths of the radiation applicator and radiation therapy is intraoperatively administered via a radiation generator (Intrabeam®, Carl Zeiss Surgical, Oberkochen, Germany). The radiation dose is 8 Gy at a depth of 5-10 mm depending on the study protocol (50 kV X-radiation). Following radiation a conventional kyphoplasty procedure (Medtronic, USA) is carried out and the vertebra stabilized with cement. The procedure presented demonstrates a new approach to treatment of vertebral metastases and represents a valuable alternative to previously established methods.
    Der Orthopäde 07/2013; · 0.51 Impact Factor
  • R Gologan, S Aziriu, U Obertacke, U Schreiner
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    ABSTRACT: BACKGROUND: Injuries due to domestic violence are a frequent occurrence in emergency departments. Although domestic violence has been well analyzed from the sociological point of view, medical data concerning patterns of injuries are rare. METHODS: Victims of domestic violence who presented at the emergency department of a maximum care hospital were included in the study. Sociodemographic data and patterns of injuries were documented. RESULTS: Of the patients who presented at the emergency room 1.4 % suffered injuries due to domestic violence and 70 % were women who had been predominantly attacked by the (ex) partner. The male victims were predominantly attacked by friends. In 88 % the head and neck were involved. Male patients were attacked with objects (as a kind of weapon) more frequently than women. A migration background was documented in 45 % of the female and 30 % of the male patients. CONCLUSION: Patterns can be easily recognized: the victims were predominantly female and were attacked by the (ex) partner. Injuries were localized to the upper part of the body. No excessive violence with life-threatening or fatal injuries was observed.
    Der Unfallchirurg 06/2013; · 0.64 Impact Factor
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    ABSTRACT: Hintergrund Häusliche Gewalt ist eine Unterform vorkommender Gewaltformen. Die soziologischen Aspekte häuslicher Gewalt sind gut erforscht und publiziert. Im Hinblick auf körperliche Verletzungsfolgen von häuslicher Gewalt lassen sich nur wenige Daten finden. Patienten und Methode Aus dem Patientengut einer unfallchirugischen Notaufnahme eines Hauses der Maximalversorgung wurden Opfer häuslicher Gewalt identifiziert. Es wurden persönliche und soziodemographische Daten sowie Daten zum Verletzungsmuster erfasst. Ergebnisse Opfer häuslicher Gewalt waren 1,4 % der in der Notaufnahme vorstelligen Patienten; 70 % waren Frauen, die überwiegend (68 %) durch den (Ex-)Lebenspartner Gewalt erfuhren; 30 % waren Männer, welche überwiegend (46 %) von Bekannten Gewalt erfuhren. Ein Migrationshintergrund lag bei 45 % der Frauen und 38 % der Männer vor. Am häufigsten wurden der Kopf und Hals (88 %) verletzt. Zu 94 % lag eine stumpfe Gewalteinwirkung vor. Männer wurden tendentiell häufiger mit Gegenständen angegriffen. Schlussfolgerung Es sind Muster erkennbar: Betroffene sind überwiegend Frauen und häufiger Menschen mit Migrationshintergrund. Die (überwiegend stumpfe) Gewalt wird innerhalb einer Partnerschaftsbeziehung, seltener in direkter Verwandtschaftslinie verübt. Die Richtung der Gewalt zielt auf den Kopf. Exzessive Gewalt mit lebensgefährlichen Verletzungen wurde nicht beobachtet.
    Der Unfallchirurg 06/2013; · 0.64 Impact Factor
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    ABSTRACT: Competency-based medical education is a prerequisite to prepare students for the medical profession. A mandatory professional qualification framework is a milestone towards this aim. The National Competency-based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM) of the German Medical Faculty Association (MFT) and the German Medical Association will constitute a basis for a core curriculum of undergraduate medical training. The Surgical Working Group on Medical Education (CAL) of the German Association of Surgeons (DGCH) aims at formulating a competency-based catalogue of learning objectives for surgical undergraduate training to bridge the gap between the NKLM and the learning objectives of individual medical faculties. This is intended to enhance the prominence and visibility of the surgical discipline in the context of medical education. On the basis of different faculty catalogues of learning objectives, the catalogue of learning objectives of the German Association of Orthopedics and Orthopedic Surgery and the Swiss Catalogue of Learning Objectives representatives of all German Surgical Associations cooperated towards a structured selection process of learning objectives and the definition of levels and areas of competencies. After completion the catalogue of learning objectives will be available online on the webpage of the DGCH.
    Der Chirurg 03/2013; · 0.52 Impact Factor
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    ABSTRACT: BACKGROUND: The functional outcome of surgically treated dislocated fractures of the distal radius is limited and does not correlate with radiographic results. Additional carpal lesions are assumed to be the cause. This study has evaluated which carpal lesions are associated with dislocated fractures of the distal radius. MATERIAL AND METHODS: A total of 104 consecutive patients with dislocated fractures of the distal radius were included in the study. The injured wrist was examined by radiography, computed tomography (CT) and magnetic resonance imaging (MRI) to determine additional carpal lesions. RESULTS: Radiographically 51 of the 104 fractures presented as type A according to the AO classification, 10 as type B and 39 as type C. The CT scan detected that only 5 of the 51 type A fractures were exclusively metaphyseal fractures. All type A fractures were associated with ligamental lesions in MRI. CONCLUSIONS: The results of the study confirm the hypothesis that every dislocated fracture of the distal radius is a combined carpal trauma associated with additional osseous and/or ligamental lesions.
    Der Unfallchirurg 10/2012; · 0.64 Impact Factor
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    ABSTRACT: Aims and background. Kyphoplasty is an effective procedure providing structural stability and pain alleviation in vertebral metastases. To prevent early regrowth, patients typically receive postoperative fractionated radiotherapy, which is associated with long treatment duration. Therefore, we established a new approach to deliver intraoperative radiotherapy during kyphoplasty to shorten the treatment time and reach structural stability and sterilization of the metastases (Kypho-IORT). Methods and study design. For Kypho-IORT, a 50 kV X-ray source with a specially designed applicator was used. A radiation dose of 8 Gy in 5 mm distance was delivered. After radiation the device was removed and the kyphoplasty was completed according to the standard procedure. Since August 2009, 18 patients with instable or painful spinal metastases received Kypho-IORT. The median age was 63 years (range, 43-73). Results. Kypho-IORT was successfully performed in 18 of 21 vertebral lesions (86%). No severe complications occurred during or early after IORT. The median pain score using a visual analogue scale decreased from 5/10 before the procedure to 2.5/10 at day 1 (P <0.001) and to 0/10 six weeks after the procedure (P = 0.001). Imaging studies were available for 15 of 18 patients. Stable disease within the irradiated vertebral body was seen in 14 patients (93%) and local progressive disease in one patient (7%). No re-irradiation due to local progressive disease or pain recurrence was necessary within the median follow-up of 4.5 months. Conclusions. Kypho-IORT is well tolerated without severe side effects and provides fast improvement of pain. Although stable disease was seen in 93% of the patients, a longer follow-up is necessary to assess the effectiveness. A dose escalation study to establish the maximally tolerated dose has been initiated.
    Tumori. 07/2012; 98(4):434-40.
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    ABSTRACT: In einer Übersichtsarbeit von Abraham & Marshall (1999) wurde dargelegt, dass sämtliche, an über 15.000 Patienten durchgeführten Studien mit dem Ziel der Beeinflussung der dysregulierten, inflammatorischen Reaktion bei Sepsis und Multiorganversagen enttäuschende Ergebnisse aufwiesen. Ursache hierfür liegt vorrangig in dem theoretischen Konzept einer isolierten,überschießenden Bildung endogener proinflammatorischer Mediatoren ( z.B. TNF, Interleukine, PAF), welche durch Autodestruktion zur Entwicklung eines septischen Multiorganversagens führen.Untersuchungen der letzten Jahre zeigen jedoch, dass eine inflammatorische Reaktion nicht mit einer isolierten Ausschüttung proinflammatorischer Mediatoren einhergeht, sondern gleichzeitig eine erhebliche antiinflammatorische Reaktion nachweisbar ist, die proinflammatorische Reaktion eine essentielle Komponente einer adäquaten Wirtsreaktion darstellt und aufgrund der hohen Redundanz des Zytokinnetzwerkes der therapeutische Ansatz einer Neutralisation eines einzelnen Mediators nicht mehr gerechtfertigt ist. Zukünftige mediatormodulatorische Therapieansätze setzten neben einer Charakterisierung möglicher individueller inflammatorischer Reaktionsformen und der Identifizierung klinisch relevanter immunologischer Parameter ein engmaschiges immunologisches Monitoring voraus, wodurch eine individuell adaptierte Mediatormodulation ermöglicht wird.
    Der Unfallchirurg 05/2012; 103(10):903-907. · 0.64 Impact Factor
  • Udo Obertacke, Dieter Nast-Kolb
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    ABSTRACT: Die unfallchirurgische Versorgung älterer Menschen ist personell wie sachlich aufwendiger und mit höheren Kosten belastet, als die Versorgungg eines jüngeren Kollektivs. Die medizinischen Versorgungsstrategien müssen den Aspekt der mittel- bis langfristig gesteuerten ambulanten Rehabilitation mit einbeziehen, um einer durch den Unfall ausgelösten zu frühzeitigen dauerhaften Pflegebedürftigkeit vorzubeugen.
    Der Unfallchirurg 04/2012; 103(3):227-239. · 0.64 Impact Factor
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    ABSTRACT: To evaluate whether this new method is clinically applicable after theoretical and cadaver testing. The incidence of spinal metastases requiring therapy is increasing, due to enhanced life expectancy. Due to results from studies with epidural compression a combined surgical and radiation therapy is often chosen. Minimal invasive cement augmentation is an increasingly used technique, due to fast pain relief and immediate stabilisation. On the other hand, stereotactic radiosurgery is considered to provide a more durable response and better local disease control than conventional radiotherapy with the application of higher doses. Therefore the combination of cement stabilisation and simultaneous intra-operative radiation with immediate stabilisation and high-dose radiation could be an interesting therapeutic option. The results of a clinical feasibility study are presented. 17 patients could be treated with the new method. In two patients (10%) intra-operative radiation could not be applied. No surgical interventions for complications were required. Summarizing Kypho-IORT is technically feasible with an intra-operative risk profile comparable to sole kyphoplasty and a shorter treatment time and hospitalisation for the patients compared to conventional multifraction radiation. Radiation could not be applied in 10% of cases due to technical difficulties. The results of this feasibility study permit further evaluation of this new technique by a dose escalation study which is currently in preparation.
    International Orthopaedics 01/2012; 36(6):1255-60. · 2.32 Impact Factor
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    ABSTRACT: Medical education in Germany has undergone significant changes. The current article attempts to give an overview of final year medical education in Germany and implications for further developments. Challenges in final year medical education mainly arise from the lack of clearly defined learning objectives, the provision of structure, independent patient management and professional guidance and supervision. The abolition of the one-and-a-half-year period of pre-registration medical training in 2004 and the changes in the structure of state examinations in line with the amendment of medical licensing regulations in 2002, meant pressure on the efficiency of final year medical education on the one hand, and additional burden on final year students on the other. In this article, a broad variety of innovative models that have been implemented at different medical faculties, and which address final year students' needs, will be reported. Further challenges, such as the integration of general medicine rotations, the abolishment of the second state examination in its present form, and the integration of final year students' individual career plans will be discussed.
    Zeitschrift für Evidenz Fortbildung und Qualität im Gesundheitswesen 01/2012; 106(2):75-84.
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    ABSTRACT: Introduction Recent studies have raised the question of whether last year medical students and first year residents show an adequate attitude toward their patient’s pain as reflected by prescribed pain medication. Underuse of analgetics could be demonstrated in several studies even after a correct diagnosis of pain was made and has led to the term “oligoanalgesia.” Our study was aimed at evaluating the potential of improving student attitudes toward pain by changing the curriculum during the last year of medical education. Methods The study was designed as a prospective, randomized controlled, blinded cohort study. A recent change by law (2002) in the official curriculum (“Approbationsordnung”) made it possible to compare two groups of last year medical students who were trained in different curricula during a 1-year transitional period. One group received special training on various aspects of pain and analgesic therapy (new curriculum), while the other group followed the conventional curriculum (old curriculum) without further special training. Both students and examiners were blinded toward the study target. Measurement parameters were a clinical experiment with standardized patients (OSCE) and a key features test. Results The study shows a considerable improvement of attitude toward pain in those students undergoing the new curriculum. This group demonstrated better OSCE results and significant improvement in key features tasks, and also outperformed the old curriculum group in the choice of analgesia. Discussion Our results confirm the importance of humanistic attitudes in future doctors in addition to the traditional implementation of knowledge and skills. Changes in the medical curriculum can positively influence these attitudes.
    European Journal of Trauma and Emergency Surgery 12/2011; · 0.26 Impact Factor
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    ABSTRACT: Practical training on clinical cases and work with patients is one of the most important steps within the educational programme of undergraduates. Until now a general programme with specific learning targets for undergraduate training in orthopedic and trauma surgery is lacking. In this article we present an educational skills programme developed by a national committee composed of specialists in the field of orthopaedic and trauma surgery. This programme is based on existing guidelines of German medical universities. The facultative and obligatory guidelines developed by the national committee are presented. The presented learning programme contains chapters regarding the increasing requirements within the field of orthopaedic and trauma surgery and provides reproducible contents with the possibility for learning control.
    Zeitschrift fur Orthopadie und Unfallchirurgie 10/2011; 149(5):568-74. · 0.65 Impact Factor
  • M. Ruesseler, U. Obertacke
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    ABSTRACT: Teaching in the clinical setting is challenging; however, it is the location where students apply their learned facts and learn skills and attitudes most effectively. In order to improve clinical teaching, it is important to know and implement the principles of adult learning. The clinical teacher should know or assess the learners’ prior knowledge and skills, as well as their stage of learning, before starting a new teaching session. The learners should be actively involved in the clinical processes. Questions to probe students’ deeper understanding and capability to analyze, synthesize, and apply medical knowledge should be an important part of clinical teaching. Regular structured feedback is an important part of any learning experience. KeywordMedical education–Clinical teaching–Adult learning
    European Journal of Trauma and Emergency Surgery 05/2011; 37(3):313-316. · 0.26 Impact Factor

Publication Stats

2k Citations
303.18 Total Impact Points


  • 2008–2014
    • Orthopädisch-Chirurgische Zentrum
      Cham Regen, Bavaria, Germany
  • 1992–2013
    • Universität Heidelberg
      • • Department of General, Visceral and Transplantation Surgery
      • • Department of Internal Medicine II, General Internal Medicine and Psychosomatics
      • • Department of Radiation Oncology
      • • Psychosomatic and General Clinical Medicine
      • • Institute of Clinical Radiology
      • • Department of Orthopedics and Traumatology
      • • Institute of Immunology and Serology
      Heidelberg, Baden-Wuerttemberg, Germany
  • 2003–2012
    • Universität Mannheim
      Mannheim, Baden-Württemberg, Germany
  • 1987–2012
    • University Hospital Essen
      • Klinik für Unfallchirurgie
      Essen, North Rhine-Westphalia, Germany
  • 2011
    • Universitätsklinikum Freiburg
      Freiburg an der Elbe, Lower Saxony, Germany
  • 2008–2011
    • Goethe-Universität Frankfurt am Main
      • Klinik für Unfall-, Hand-, und Wiederherstellungschirurgie
      Frankfurt am Main, Hesse, Germany
  • 2006
    • Johannes Gutenberg-Universität Mainz
      • Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie
      Mainz, Rhineland-Palatinate, Germany
  • 2005
    • Klinikum Landshut
      Landshut, Bavaria, Germany
  • 2002
    • University of Amsterdam
      • Faculty of Medicine AMC
      Amsterdam, North Holland, Netherlands
  • 1987–2002
    • University of Duisburg-Essen
      Essen, North Rhine-Westphalia, Germany
  • 1996
    • Ludwig Boltzmann Institute for Experimental and Clinical Traumatology
      Wien, Vienna, Austria