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5.
GMS J Med Educ ; 38(5): Doc88, 2021.
Article in English | MEDLINE | ID: covidwho-1337616

ABSTRACT

Introduction: In Germany, foreign physicians are a fixed component of the medical profession. According to the German Medical Licensure Act, physicians having completed their qualification in another country are required to pass a knowledge examination which falls within the competence of examination offices or the regional governments. Project outline: The preparatory course consists of 10 modules. On Fridays, individual cases are discussed in small groups and specific examination techniques are trained. On Saturdays, illnesses are simulated by simulated patients. After each encounter, faculty experts, psychologists and peer group members provide the participants with 360° feedback. Due to the COVID-19 pandemic, the course which had been established 2 years beforehand has now been switched to an online class within one week. Friday units were visualized in power-point presentations and tutorial videos were discussed. On Saturdays, the cases were simulated by simulated patients and transmitted via a telemedicine platform. Results: The course could be conducted without interruptions (75 hours of in-class tuition and 75 hours of online tuition). In the oral evaluation the participants criticized telemedicine as a medium for imparting of practical skills. 7/22 (32%) of the participants underwent the knowledge examination and 6/7 (86%) of them passed it (versus 18/19 of the participants of in-class tuition (95%)). Discussion: There was a clear preference for in-class tuition. It was noted that the telemedical setting entailed some restrictions. However, the switch to online classes did not affect the pass rate. Conclusion: The switch from in-class to online units was feasible. The gained insights were taken into account when conceiving the online semester at our faculty and especially the tuition with the support of simulated patients.


Subject(s)
COVID-19 , Curriculum , Education, Medical , Foreign Medical Graduates , Internet , Licensure, Medical , Pandemics , Clinical Competence , Educational Measurement , Germany , Guidelines as Topic , Humans , Physical Distancing , Schools, Medical , Seasons
6.
GMS J Med Educ ; 38(5): Doc88, 2021.
Article in English | MEDLINE | ID: covidwho-1295610

ABSTRACT

Introduction: In Germany, foreign physicians are a fixed component of the medical profession. According to the German Medical Licensure Act, physicians having completed their qualification in another country are required to pass a knowledge examination which falls within the competence of examination offices or the regional governments. Project outline: The preparatory course consists of 10 modules. On Fridays, individual cases are discussed in small groups and specific examination techniques are trained. On Saturdays, illnesses are simulated by simulated patients. After each encounter, faculty experts, psychologists and peer group members provide the participants with 360° feedback. Due to the COVID-19 pandemic, the course which had been established 2 years beforehand has now been switched to an online class within one week. Friday units were visualized in power-point presentations and tutorial videos were discussed. On Saturdays, the cases were simulated by simulated patients and transmitted via a telemedicine platform. Results: The course could be conducted without interruptions (75 hours of in-class tuition and 75 hours of online tuition). In the oral evaluation the participants criticized telemedicine as a medium for imparting of practical skills. 7/22 (32%) of the participants underwent the knowledge examination and 6/7 (86%) of them passed it (versus 18/19 of the participants of in-class tuition (95%)). Discussion: There was a clear preference for in-class tuition. It was noted that the telemedical setting entailed some restrictions. However, the switch to online classes did not affect the pass rate. Conclusion: The switch from in-class to online units was feasible. The gained insights were taken into account when conceiving the online semester at our faculty and especially the tuition with the support of simulated patients.


Subject(s)
COVID-19 , Curriculum , Education, Medical , Foreign Medical Graduates , Internet , Licensure, Medical , Pandemics , Clinical Competence , Educational Measurement , Germany , Guidelines as Topic , Humans , Physical Distancing , Schools, Medical , Seasons
8.
Acad Med ; 96(9): 1236-1238, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1281877

ABSTRACT

The COVID-19 pandemic interrupted administration of the United States Medical Licensing Examination (USMLE) Step 2 Clinical Skills (CS) exam in March 2020 due to public health concerns. As the scope and magnitude of the pandemic became clearer, the initial plans by the USMLE program's sponsoring organizations (NBME and Federation of State Medical Boards) to resume Step 2 CS in the short-term shifted to long-range plans to relaunch an exam that could harness technology and reduce infection risk. Insights about ongoing changes in undergraduate and graduate medical education and practice environments, coupled with challenges in delivering a transformed examination during a pandemic, led to the January 2021 decision to permanently discontinue Step 2 CS. Despite this, the USMLE program considers assessment of clinical skills to be critically important. The authors believe this decision will facilitate important advances in assessing clinical skills. Factors contributing to the decision included concerns about achieving desired goals within desired time frames; a review of enhancements to clinical skills training and assessment that have occurred since the launch of Step 2 CS in 2004; an opportunity to address safety and health concerns, including those related to examinee stress and wellness during a pandemic; a review of advances in the education, training, practice, and delivery of medicine; and a commitment to pursuing innovative assessments of clinical skills. USMLE program staff continue to seek input from varied stakeholders to shape and prioritize technological and methodological enhancements to guide development of clinical skills assessment. The USMLE program's continued exploration of constructs and methods by which communication skills, clinical reasoning, and physical examination may be better assessed within the remaining components of the exam provides opportunities for examinees, educators, regulators, the public, and other stakeholders to provide input.


Subject(s)
Clinical Competence/standards , Educational Measurement/methods , Licensure, Medical/standards , COVID-19/prevention & control , Educational Measurement/standards , Humans , Licensure, Medical/trends , United States
11.
Acad Med ; 96(9): 1239-1241, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1254863

ABSTRACT

The discontinuation of the United States Medical Licensing Examination Step 2 Clinical Skills (CS) in 2020 in response to the COVID-19 pandemic marked the end of a decades-long debate about the utility and value of the exam. For all its controversy, the implementation of Step 2 CS in 2004 brought about profound changes to the landscape of medical education, altering the curriculum and assessment practices of medical schools to ensure students were prepared to take and pass this licensing exam. Its elimination, while celebrated by some, is not without potential negative consequences. As the responsibility for assessing students' clinical skills shifts back to medical schools, educators must take care not to lose the ground they have gained in advancing clinical skills education. Instead, they need to innovate, collaborate, and share resources; hold themselves accountable; and ultimately rise to the challenge of ensuring that physicians have the necessary clinical skills to safely and effectively practice medicine.


Subject(s)
Clinical Competence/standards , Educational Measurement/methods , Licensure, Medical/standards , COVID-19/prevention & control , Education, Medical, Undergraduate/standards , Education, Medical, Undergraduate/trends , Educational Measurement/standards , Humans , Licensure, Medical/trends , United States
12.
CMAJ ; 192(45): E1417-E1418, 2020 Nov 09.
Article in English | MEDLINE | ID: covidwho-1243862
17.
CMAJ ; 192(43): E1313-E1314, 2020 Oct 26.
Article in English | MEDLINE | ID: covidwho-1044584
19.
AJR Am J Roentgenol ; 215(6): 1411-1416, 2020 12.
Article in English | MEDLINE | ID: covidwho-976134

ABSTRACT

OBJECTIVE. In recent decades, teleradiology has expanded considerably, and many radiology practices now engage in intraorganizational or extraorganizational teleradiology. In this era of patient primacy, optimizing patient care and care delivery is paramount. This article provides an update on recent changes, current challenges, and future opportunities centered around the ability of teleradiology to improve temporal and geographic imaging access. We review licensing and regulations and discuss teleradiology in providing services to rural areas and assisting with disaster response, including the response to the coronavirus disease (COVID-19) pandemic. CONCLUSION. Teleradiology can help increase imaging efficiency and mitigate both geographic and temporal discrepancies in imaging care. Technologic limitations and regulatory hurdles hinder the optimal practice of teleradiology, and future attention to these issues may help ensure broader patient access to high-quality imaging across the United States.


Subject(s)
COVID-19/epidemiology , Teleradiology/trends , Confidentiality , Humans , Licensure, Medical , Physical Distancing , SARS-CoV-2 , United States/epidemiology
20.
Fertil Steril ; 114(6): 1135-1139, 2020 12.
Article in English | MEDLINE | ID: covidwho-962188

ABSTRACT

The COVID-19 pandemic accelerated the adoption of telemedicine internationally. The reproductive clinics that thrived in this tumultuous time had access to fully electronic medical records with user-friendly telehealth platforms and remote support staff for physicians. However, complete transition from in-person visits to telehealth uncovered many opportunities for innovation. At-home semen testing is not yet widely recognized, and patients still require an in-person visit for ultrasounds, procedures, and physical examinations. Although emergency policies and waivers have made it easier for providers to legally practice across state borders and receive payments from insurance companies, they vary from state to state and have not been cemented into law. Finally, clinical training for medical students, residents, and fellows has been affected by decreased clinical and surgical volume. However, trainees have also proven to be the most adaptable, quickly shifting to remote learning practices through social media, online surgical atlases, and wide distribution of "virtual visiting professor" lectures. As countries have eased physical distancing guidelines, patients ultimately benefit from having the option of a telehealth appointment. Although there is still much work to be done to improve telehealth, the COVID-19 pandemic has at least proven that it is a safe method of patient care and teaching.


Subject(s)
COVID-19 , Reproductive Medicine/trends , SARS-CoV-2 , Telemedicine/trends , Delivery of Health Care/methods , Delivery of Health Care/trends , Education, Medical , Female , Humans , Infertility/diagnosis , Infertility/therapy , Licensure, Medical , Male , Pregnancy , Reproductive Techniques, Assisted , Semen Analysis , Students, Medical
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