Use of digital teaching resources and predictors of medical student performance during the pandemic: A prospective study.

BACKGROUND: The coronavirus pandemic has led to increased use of digital teaching formats in medical education. A number of studies have assessed student satisfaction with these resources. However, there is a lack of studies investigating changes in student performance following the switch from contact to virtual teaching. Specifically, there are no studies linking student use of digital resources to learning outcome and examining predictors of failure. METHODS: Student performance before (winter term 2019/20: contact teaching) and during (summer term 2020: no contact teaching) the pandemic was compared prospectively in a cohort of 162 medical students enrolled in the clinical phase of a five-year undergraduate curriculum. Use of and performance in various digital resources (case-based teaching in a modified flipped classroom approach; formative key feature examinations of clinical reasoning; daily multiple choice quizzes) was recorded in summer 2020. Student scores in summative examinations were compared to examination scores in the previous term. Associations between student characteristics, resource use and summative examination results were used to identify predictors of performance. RESULTS: Not all students made complete use of the digital learning resources provided. Timely completion of tasks was associated with superior performance compared to delayed completion. Female students scored significantly fewer points in formative key feature examinations and digital quizzes. Overall, higher rankings within the student cohort (according to summative exams) in winter term 2019/20 as well as male gender predicted summative exam performance in summer 2020. Scores achieved in the first formative key feature examination predicted summative end-of-module exam scores. CONCLUSIONS: The association between timely completion of tasks as well as early performance in a module and summative exams might help to identify students at risk and offering help early on. The unexpected gender difference requires further study to determine whether the shift to a digital-only curriculum disadvantages female students.

Prospective postmortem evaluation of 735 consecutive SARS-CoV-2-associated death cases.

Coronavirus disease 19 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic with significant mortality. Accurate information on the specific circumstances of death and whether patients died from or with SARS-CoV-2 is scarce. To distinguish COVID-19 from non-COVID-19 deaths, we performed a systematic review of 735 SARS-CoV-2-associated deaths in Hamburg, Germany, from March to December 2020, using conventional autopsy, ultrasound-guided minimally invasive autopsy, postmortem computed tomography and medical records. Statistical analyses including multiple logistic regression were used to compare both cohorts. 84.1% (n = 618) were classified as COVID-19 deaths, 6.4% (n = 47) as non-COVID-19 deaths, 9.5% (n = 70) remained unclear. Median age of COVID-19 deaths was 83.0 years, 54.4% were male. In the autopsy group (n = 283), the majority died of pneumonia and/or diffuse alveolar damage (73.6%; n = 187). Thromboses were found in 39.2% (n = 62/158 cases), pulmonary embolism in 22.1% (n = 56/253 cases). In 2020, annual mortality in Hamburg was about 5.5% higher than in the previous 20 years, of which 3.4% (n = 618) represented COVID-19 deaths. Our study highlights the need for mortality surveillance and postmortem examinations. The vast majority of individuals who died directly from SARS-CoV-2 infection were of advanced age and had multiple comorbidities.

Males as victims of intimate partner violence - results from a clinical-forensic medical examination centre.

Only few studies have reported on males as victims of intimate partner violence (IPV) so far. The aim of the present study is to analyse frequency and case characteristics of physical violence against male IPV victims examined in a clinical-forensic medical examination centre for victims of violence in Germany over an 11-year period, contributing to a better understanding of IPV in men. Male victims represented 6.2% of IPV cases (n = 167) with a median age of 40 years. Cases were reported to the police in 78.4% before medicolegal examination. In 60.5% of the cases, the perpetrator was the current partner, and 82% occurred in a domestic environment with a predominance of female offenders. In more than half of the cases (57.5%), the victims consulted the examination centre without prior healthcare utilisation. About one-third of the victims reported previous IPV (31.7%). The findings point to the relevance of men as victims of IPV, case group-specific risk factors, injury-dependent behaviour related to healthcare utilisation, the need to establish or strengthen specialised support services for affected men and underscore the importance of clinical-forensic services in documenting and assessing violence-related injuries.