ABSTRACT
Background: Aging simulation games are established tools in undergraduate medical education aiming to provide medical students with insights into elderly patient's everyday life and raise awareness for age-related difficulties. At Leipzig University, a 90-min ageing simulation game is part of a compulsory geriatric medicine course in the fifth study year (of six). In the course of online teaching during the COVID-19 pandemic, we replaced the classroom-based simulation with an elementary online version based on four PDF documents containing audio and video links, directives for 'do it yourself' experiences and prompts for reflection. Research question: Is a simple, self-directed online ageing game able to provide students with relevant experiences and insights to enhance their understanding of elderly patients? Methods: Anonymous post-hoc survey among 277 fifthyear medical students eligible for the course in 2020. Descriptive statistical analysis and qualitative analysis of students' free-text responses regarding their main insights from the course. Result(s): Response rate was 92.4% (n=256, ;age =26 years, 60% women). 88% of the students enjoyed working on the course, and 83% perceived it as practice-orientated. 75% reported having gained new personal insights and 60% new professional knowledge. Although 92% reported an enhanced understanding of elderly patients, 85% disagreed that online simulations may generally replace realworld ageing games. PDF documents containing audio and video links directly imitating conditions (visual or hearing impairment) were rated best. Students' main insights from the course (qualitative data) most frequently referred to aspects of professional interaction with geriatric patients, knowledge about conditions/diseases, role reversal, and enhanced empathy. Conclusion(s): Very simple online ageing game equivalents can provide students with relevant insights and raise awareness for elderly patients' needs. They might be alternatively implemented into the education of health professionals where resource-intensive real-world simulations are unfeasible.
ABSTRACT
Background: The SARS-CoV-2 pandemic is a global crisis with massive effects on all areas of society, such as the labor market, social security systems, and healthcare. It represents a complex stress situation that hardly leaves anyone unscathed. As a result, a significant increase in mental stress and ill- ness has been observed since the beginning of the pandemic. The coronavirus pandemic almost paralyzed rehabilitation in the spring of 2020. When comparing the 1st quarter of 2019 with that of 2021 (cumulative), a decrease of –32.8% is recorded for 2021 in the applications for services for medical rehabilitation (total 2020 to 2019: –14.2%). For the rehabilitation centers, the central and vital question is under which conditions rehabilitation measures can be carried out safely and successfully even in times of a pandemic. This also includes the confi-dence of potential rehabilitation patients, referring physicians, and employees in the structural and procedural measures taken by the centers. Materials and methods: The study aims to shed light on the effects and coping attempts of the pandemic in medical rehabilitation from different perspectives and to provide indications for routine care in “COVID normal operation”. The focus is on a comparative analysis of the results of the routine survey in the period October 2019 to June 2020, interviews with the management level of the center as well as a cat-amnestic follow-up survey of rehabilitation patients who completed a psychosomatic rehabilitation measure in the center in the period January to September 2020. Results: The interviews at the management level and the analysis of the safety concept show that a crisis team was installed at a very early stage in the center and a safety concept was established, which met with a high level of acceptance among all participants and contributed to a feeling of safety. The comparison of the routine survey shows that, with the exception of individual cases, the rehabilitation measures were carried out and completed according to plan. In most areas, the ratings have even improved in the 1st half of 2020 compared to the 4th quarter of 2019. The results of the catamnestic survey confirm the results of the routine survey. The rehabilitation patients who were treat-ed at the Rehazentrum Bad Bocklet during the COVID pandemic showed pronounced psychosomatic and participation-related limitations in the period before or at admis-sion. Regarding concerns and fears about the COVID situation, almost half of all respondents stated strong or very strong fears about the effects of the COVID pandemic on personal or close persons. In the foreground are fears that a close person could become infected or die. The hospital’s safety measures in terms of hygiene and adapted struc-tures and processes were rated positively by around three quarters of respondents. This is also confirmed by the results of the outcome parameters examined. The personal therapy goals were achieved for about three quarters of the respondents. Positive chang-es were seen in terms of health, health com-plaints, anxiety and depression symptoms, global health and the development of the ability to work, among other things. The RTW rates are 71% (time point method) and 81% (cumulative time course). The benefit of the rehabilitation measure is rated as high by 73% of the respondents is the treatment satisfaction. Substantial influences of rehab motivation, admission periods, and percep-tion and evaluation of COVID measures at the center on key outcome parameters are shown. These results emphasize the role of appropriate safety and hygiene measures adapted to the current hazard situation in the context of rehabilitation measures. The results indicate that the hospital succeeded in implementing suitable measures right at the beginning of the pandemic, and in com-municating and living these measures ac-cordingly. In addition, they allow the conclu-sion that under suitable safety and hygiene conditions, rehabilitation measures can also be carried out safely in times of pandem c and still show stable effects in essential tar-get criteria of medical rehabilitation after one year.
ABSTRACT
Background: During the COVID-19 pandemic, the University of Leipzig completely switched to online teaching. Thus, we developed a practice-oriented digital equivalent of a mandatory 2- week general practice (GP) clerkship. The digital clerkship mainly contained clinical cases, visual diagnoses, informational and examination videos, as well as regular possibilities for exchange (e.g. video chat) with associated GP teachers in their practices, faculty members and fellow students. Research question: How did the participants accept, use and evaluate the new format and its single components regarding working enjoyment, learning gain, practical relevance and insights into general practice? How do evaluations differ from those of two previous semesters? Methods: Cross-sectional survey among 4th year (of six) medical students at Leipzig medical faculty completing their digital mandatory GP clerkship between April and June 2020. Additional cohort comparison with evaluations of two previous semesters. Results: Out of 192 students who completed the digital clerkship, 99 participated in the study (51.6%). For the cohort comparison, evaluations from 277 students of the two previous semesters (conventional clerkship) were available. Most participants reported to have enjoyed the online-based clerkship (88%), to have learned a lot (90%), to have gained insights into general practice (77%) and perceived high practical relevance (91%). Two-thirds stated that the new format should complement future clerkships. Clinical cases, visual diagnoses, examination videos and communication with GP teachers were rated best regarding working enjoyment, learning gain, practical relevance and insights into a GP's work. Cohort comparison revealed partially better evaluations regarding knowledge transfer for the digital clerkship while imparting of skills and attitudes was evaluated worse. Conclusion: Our digital teaching formats were well accepted by the students. In particular, learning from selected clinical cases, visual diagnoses, video tutorials, and explicit slots for exchange with GP teachers and faculty members have a high potential to complement future conventional clerkships usefully.