The Brandenburg reformed medical curriculum: study locally, work locally.

The Brandenburg Medical School "Theodor Fontane" (MHB) was founded in 2014 by municipal and non-profit institutions in Bernau, Brandenburg an der Havel and Neuruppin to train more physicians for the non-metropolitan region of Brandenburg. Since the 2015 summer term, 48 medical students have been enrolled each year, accepted through the university's own selection process in which the score on the German school-leaving exam (Abitur) and time spent on the waiting list play subordinate roles. Tuition fees can be partially financed through scholarship agreements with regional hospitals if the applicants commit themselves to medical specialist training (Facharztweiterbildung) at a particular hospital. The main places of study are Neuruppin and Brandenburg an der Havel; there is a decentralized study phase from the eighth to tenth semester of study. The Brandenburg Reformed Medical Curriculum (BMM) complies with the model clause contained in the German regulations governing the licensing of medical doctors (ÄAppO). The curriculum is based on problem-based learning (PBL) and focused on competencies and consists of integrated interdisciplinary modules that combine, from the very beginning, basic sciences with clinical and theoretical medical subjects. The focus on general practice is visible in the regularly held "Practical Days" (Praxistag) during which second-year students and above have the opportunity to observe at participating medical practices and familiarize themselves with primary care in Brandenburg. A special focus of BMM is on the acquisition and development of communication and interpersonal skills. These are imparted through a longitudinal curriculum referred to as "Teamwork, Reflection, Interaction, Communication" (TRIK). High value is placed on critical thinking and scientific scholarship and this is reflected in an eight-week academic placement in which the students independently write a research paper. Several different teaching formats ensure that, along with learning specific subjects, sustained personal development can also take place. BMM's decentralized study phase starting in the eighth semester represents a special part of the curriculum in which students complete their clinical training in small groups at selected cooperating hospitals in Brandenburg. This phase encompasses not only hospital placements and other local patient-centered courses, but also centralized instruction via video conferencing to assure that basic sciences and clinical theory continue to be covered. Knowledge- and performance-based semester assessments, in particular OSCEs, reinforce the practical aspects of the training. These replace the M1 state medical examination in the first study phase. The first medical students are now in their ninth semester as of April 2019, making it still too early for final evaluations. The curriculum, successfully implemented to date, already satisfies core requirements of the Master Plan 2020 for undergraduate medical education (Masterplan Medizinstudium 2020) with the curriculum's organization and structure, curricular content, assessment formats and student admission process. With its decentralized structure, BMM specifically addresses the social and health policy challenges facing rural regions of Brandenburg. This is the first curriculum that has taken on the improvement of healthcare in rural regions as its central aim.

Student engagement in medical education: A mixed-method study on medical students as module co-directors in curriculum development.

Introduction: Beyond participation in evaluation of teaching, there is sparse research available on more active roles of medical students in curriculum development. We report on a model of student engagement where medical students function as module co-directors, and how this is experienced by faculty and student module directors. Methods: Student engage in co-development of their curriculum with a high level of autonomy in organizing their activities. We conducted a mixed-methods, convergent design study based on surveys with faculty and student module co-directors and a student co-director focus group. Quantitative data were analyzed descriptively. Qualitative analysis was performed inductively. Results: Quantitatively, the majority of both faculty and student module directors report that the curriculum benefits from the students' work (95 and 94%). Both groups see each other as equal partners (80 and 87%). Qualitatively, this is related to students' competencies such as "bringing in broad and unique knowledge of the curriculum", "giving the students' perspective a voice," and "contributing ideas for improvement". Key strategies and challenges of the student co-module directors are illuminated. Conclusions: Student module co-directors represent a well-accepted practice model for curriculum development. This report may stimulate other faculties to engage their students more actively in medical education.

Moving a mountain: Practical insights into mastering a major curriculum reform at a large European medical university.

AIM: Undergraduate medical education is currently in a fundamental transition towards competency-based programs around the globe. A major curriculum reform implies a dual challenge: the change of the curriculum and the delivering organization. Both are closely interwoven. In this article, we provide practical insights into our approach of managing such a fundamental reform of the large undergraduate medical program at the Charité - Universitätsmedizin Berlin. METHODS: Members of the project management team summarized the key features of the process with reference to the literature. RESULTS: Starting point was a traditional, discipline-based curriculum that was reformed into a fully integrated, competency-based program. This change process went through three phases: initiation, curriculum development and implementation, and sustainability. We describe from a change management perspective, their main characteristics, and the approaches that were employed to manage them successfully. CONCLUSIONS: Our report is intended to provide practical insights and guidance for those institutions which are yet considering or have already started to undergo a major reform of their undergraduate programs towards competency medical education.