Too much time or not enough? An observational study of teacher wait time after questions in case-based seminars.

BACKGROUND: We define teacher wait time (TWT) as a pause between a teacher question and the following response given by a student. TWT is valuable because it gives students time to activate prior knowledge and reflect on possible answers to teacher questions. We seek to gain initial insights into the phenomenon of TWT in medical education and give commensurate recommendations to clinical teachers. METHODS: We observed n = 719 teacher questions followed by wait time. These were video-recorded in 29 case-based seminars in undergraduate medical education in the areas of surgery and internal medicine. The seminars were taught by 19 different clinical teachers. The videos were coded with satisfactory reliability. Time-to-event data analysis was used to explore TWT overall and independently of question types. RESULTS: In our sample of case-based seminars, about 10% of all teacher questions were followed by TWT. While the median duration of TWT was 4.41 s, we observed large variation between different teachers (median between 2.88 and 10.96 s). Based on our results, we recommend that clinical teachers wait for at least five, but not longer than 10-12 s after initial questions. For follow-up and reproduction questions, we recommend shorter wait times of 5-8 s. CONCLUSIONS: The present study provides insights into the frequency and duration of TWT and its dependence on prior questions in case-based seminars. Our results provide clinical teachers with guidance on how to use TWT as an easily accessible tool that gives students time to reflect on and respond to teacher questions.

Reflect to interact - fostering medical students' communication through reflection-focused e-learning.

BACKGROUND: Previous research indicates that reflection can foster medical communication competence. However, best practices for embedding reflection in online medical education are missing. This study examined how reflection processes can be promoted and embedded in an e-learning course on physician-patient communication to foster learning. METHODS: We investigated three differently designed e-learning conditions featuring different proportions of reflection triggers and compared their effects on students' reflections. We had 114 medical students in their first clinical year complete one of the variants: video modelling (VM, n = 39), video reflection (VR, n = 39), or a variant merging both approaches (VMR, n = 36). Each student wrote a total of nine reflections based on the same guiding questions at three time points embedded in the course. The students' levels of reflection were measured using an adapted version of the REFLECT rubric (scale 0-18). RESULTS: Students of all course variants achieved good levels of reflection beyond the descriptive level at all three time points, with no significant differences between the variants. The mean reflection scores at the end of the course were M = 14.22 for VM (SD = 2.23), M = 13.56 for VR (SD = 2.48), and M = 13.24 for VMR (SD = 2.21). Students who completed VM showed significantly improved levels of reflection over the course, whereas we found no statistically significant development for those in VR or VMR. The reflection scores correlated significantly positively with each other, as did the text lengths of the written reflections. Reflection scores also correlated significantly positively with text length. CONCLUSIONS: Our study offers a teaching strategy that can foster good levels of reflection, as demonstrated in the three e-learning variants. The developed reflection prompts can be easily embedded in various e-learning environments and enable reflections of good quality, even in settings with limited available teaching time.

[Virtual DEGUM-certified course in the head and neck region-a useful complement to conventional course formats?] / Virtuell abgehaltene DEGUM-zertifizierte Kurse im Kopf-Hals-Bereich ­ eine sinnvolle Ergänzung zum konventionellen Kursformat?

BACKGROUND: Training in clinical ultrasound has become highly relevant for working as an otorhinolaryngologist. While there is a high demand for standardized and certified training courses, until recently, there was no possibility to attend web-based and exclusively virtual head and neck ultrasound courses certified by the Deutsche Gesellschaft für Ultraschall in der Medizin (DEGUM; German Society for Ultrasound in Medicine). OBJECTIVE: The aim of this study was to provide a qualitative and semi-quantitative analysis of the first purely virtual DEGUM-certified head and neck ultrasound courses. MATERIALS AND METHODS: In 2021, three purely web-based DEGUM-certified head and neck ultrasound courses were carried out and then qualitatively analyzed using questionnaires including an examination. RESULTS: The purely virtual implementation of head and neck ultrasound courses proved to be a viable alternative to the conventional course format, with a high level of acceptance among the participants. The lack of practice among the participants remains a relevant criticism. CONCLUSION: A more dominant role of web-based and remote ultrasound training is likely and should be considered as an alternative depending on existing conditions. Nevertheless, acquisition of practical sonographic skills remains a major hurdle if courses are purely digital.

Training in medical communication competence through video-based e-learning: How effective are video modeling and video reflection?

OBJECTIVE: The present study investigated the efficacy of the didactic approaches of video modeling (VM, best-practice examples), video reflection (VR, problem-based approach), and the combination of both (VMR) in fostering medical communication competence in a video-based digital learning environment. METHODS: N = 126 third-year medical students who participated in the pre-post study were assigned to either the intervention groups (VM, VR, and VMR) or the wait-list control group. The efficacy of the three approaches was assessed by means of a situational judgment test (SJT) of medical communication competence. To investigate the differences between the wait-list control and the intervention groups (H1), between the single-mode and combined conditions (H2), and between VM and VR (H3), we applied planned contrast analyses. RESULTS: The planned contrasts showed that the VR condition significantly improved learning outcomes in comparison to the VM condition (H3). The decreased mean scores of the VM condition offset the increased mean scores of VR, and thus no significant differences could be found in H1 and H2. CONCLUSIONS: Our study provides promising evidence that VR fosters medical communication competence more effectively than VM. PRACTICAL IMPLICATIONS: Medical students' learning in video-based digital environments can be facilitated by the use of interactive VR.

Structure and quality of bedside teaching: A videographic analysis.

Bedside teaching (BST) is a core element of medical education. In light of a reported decrease in BST, evidence on how to use BST time most efficiently should be developed. Given that little research into the tangible quality characteristics of good BST has been reported, we investigated the influence of various teacher and structural characteristics on the perceived quality of BST. We filmed and coded 36 BSTs involving 24 lecturers and 259 students. Structural characteristics of interest were: number of students and patients, overall duration, and the proportion of clinical examination. Lecturer questionnaires provided insight into teaching experience and intrinsic motivation, and student evaluations assessed the quality of BSTs in three dimensions. Correlations are reported using the Pearson r and a linear mixed model (LMM). The intrinsic motivation of lecturers was significantly positively correlated with perceived quality, but their experience was only weakly so correlated. In the LMM, a significant association was observed for the quality dimension of clinical teaching with the number of patients and the proportion of time spent on clinical examination. Based on our findings, we recommend including multiple patients in BSTs, and providing substantial opportunities for clinical examination. Regarding lecturers, motivation matters more than experience.

Measuring informal workplace learning outcomes in residency training: a validation study.

BACKGROUND: Informal workplace learning (WPL) has no concrete learning objective and takes place without a responsible supervisor, which makes it difficult to assess its learning outcomes. Formal learning situations, as they are known from universities or schools, do not exist in this context and make a conventional assessment of learning goals and achievements impossible. Informal learning in the workplace is of central importance, and the assessment of informal learning outcomes in medical education is an under-researched area. The aim of our study was to adapt and validate an informal WPL questionnaire (originally developed for social workers) to assess learning outcomes due to informal WPL in residency training. METHODS: A total of 528 residents (n = 339 female; age: M = 29.79; SD = 3.37 years) completed an adapted questionnaire on informal WPL outcomes and the Freiburg Questionnaire to Assess Competencies in Medicine (i.e. medical knowledge, communication, and scholarship). Exploratory factor analysis was used to determine the underlying factor structure. The reliability of the factors was tested using McDonald's omega, and the correlation between the factors and the three subscales of the Freiburg questionnaire was tested using Spearman's rho correlation coefficient. To investigate construct validity, a structural equation model was calculated to examine the relationships between medical competencies and informal learning outcomes. RESULTS: The exploratory factor analysis yielded a four-factor solution that best fit the data. The scores of all four factors (GLO-CD: generic learning outcomes-competence development, GLO-R: generic learning outcomes-reflection, JSLO: job-specific learning outcomes, and OLLO: organisational learning outcomes) showed good internal consistency (Ω ≥ .69). The structural equation model showed that "medical expertise" had an impact on all four factors of informal learning at work. "Scholarship" seemed to predict GLO-CD and GLO-R. CONCLUSIONS: Our four-factor model reveals meaningful determinants of informal WPL in relation to residency training. The instrument is therefore the first promising attempt to assess informal WPL in the broader context of medical education during residency, thus supporting its construct validity.

Professional Identity and Motivation for Medical School in First-Year Medical Students: A Cross-sectional Study.

Background: Professional identity formation (PIF) is a life-long process, starting even before professional education. High levels of motivation for medical school are essential for effective learning and academic success. Both are key factors in future physicians' professional and personal development, and according to self-determination theory, professional identity (PI) and students' levels of motivation could be closely linked. Therefore, we sought to investigate whether PI and strength of motivation for medical school are associated in new medical students. Methods: In a cross-sectional survey, all new medical students in Munich, Germany, were asked to complete the Macleod Clark Professional Identity Scale (MCPIS-9) and the Strength of Motivation for Medical School-Revised questionnaire (SMMS-R) as well as to provide information about age, gender, and waiting time before starting medical school. Results: Eight hundred eleven out of 918 new medical students participated in the survey. A positive correlation between the MCPIS-9 and the SMMS-R (p < 0.001) was found. Female students showed higher scores in the SMMS-R (p < 0.05) and the SMMS-R-subscale Readiness to Start (p < 0.001). The amount of waiting semesters showed a positive correlation with the total SMMS-R score (p < 0.01) as well as with the subscales Readiness to Start and Persistence (both p < 0.001). Discussion: We found an association between PI and strength of motivation for medical school in a large cohort of new medical students. Female gender and more waiting semesters were associated with higher levels of self-perceived motivation and higher scores on the SMMS-R-subscale Readiness to Start. More research is needed to better understand this topic to further improve medical education.

Student mistakes and teacher reactions in bedside teaching.

We analyse interactions between teachers and students during video-recorded bedside teaching sessions in internal medicine, orthopaedics and neurology. Multiple raters used a high-inference categorical scheme on 36 sessions. Our research questions concern the types of student mistakes, clinical teachers' reactions to them and if they use different strategies to address different types of mistakes. We used a Poisson model and generalized mixed models to analyse these research questions. Most frequently, students made reproduction mistakes. Relatively high rates of rejection and a similar prevalence of low and high levels of elaboration and correction time for students were observed. Reproduction mistakes were associated with the highest level of rejection and the lowest level of elaboration. High levels of elaboration were observed when students were applying skills in new situations. Students were most often allowed time to correct when mistakes in the areas of analysis or application of skills and knowledge had occurred. There is a decrease in the rate of making mistakes for neurology and orthopaedics compared to internal medicine. Reproduction mistakes influence significantly the outcome feedback compared to application mistakes. Analytic and reproduction mistakes influence elaboration significantly compared to application mistakes. We found a significant effect whether the lecturer allows time for correction of reproduction mistakes compared to application mistakes. These results contribute to the understanding of interactive, patient-centred clinical teaching as well as student mistakes and how teachers are reacting to them. Our descriptive findings provide an empirical basis for clinical teachers to react to student mistakes in didactically fruitful ways.

Flipping the classroom in neurological bedside teaching: a prospective controlled study.

BACKGROUND: Bedside teaching is essential to foster core clinical competences in medical education, especially in Neurology. However, bedside skills are declining and new concepts to enhance the effectiveness of bedside teaching are needed, also in view of limited in-person teaching possibilities in the ongoing pandemic situation. If theoretical knowledge is taught prior to in-person sessions this might allow to better focus on practical application aspects during bedside teaching. We thus aimed to answer the question to what extent such an approach can enhance the effectiveness of neurological bedside teaching. METHODS: In this prospective controlled study, neurological bedside courses following a traditional and a flipped classroom (FC) approach were compared with regards to their effects on theoretical knowledge and practical skills of medical students. Evaluations were obtained from 161 students and their lecturers participating in a neurological bedside teaching course at a German university hospital between October 2020 and July 2021. Students were randomly assigned to course dates. However, the 74 students assigned to course dates from May to July 2021 completed a mandatory online preparation course prior to the bedside teaching. These students served as the interventional group (IG) and the remaining 87 students formed the control group (CG). Ratings of knowledge and skills provided by the students and their lecturers on numerical rating scales served as primary outcome measures. Moreover, the time needed to recapitulate theoretical contents during the in-person teaching session was assessed as a secondary outcome measure. Group comparisons were performed using t-statistics. RESULTS: Theoretical knowledge upon entering the course was rated significantly higher in the IG by the students (p < 0.001) and lecturers (p = 0.003). Lecturers also rated the practical skills of students in the IG significantly higher (p < 0.001). Furthermore, significantly less time was needed to recapitulate theoretical contents during the in-person session in the IG (p = 0.03). CONCLUSIONS: Using a FC approach enhances the effectiveness of in-person neurological bedside teaching. Thus, these concepts are particularly valuable in the ongoing pandemic situation. Moreover, they might allow to reuse e-learning contents developed during the pandemic and to develop future bedside teaching concepts.

Is there an increase over time in the complexity of teacher questions and student responses in case-based clinical seminars? A cross-sectional video study.

BACKGROUND: Case-based group discussions (CBGD) are a specific, interaction-focused format dedicated to fostering medical students' skills in applying basic biomedical knowledge to patient cases. Existing conceptions of CBGD suggest that a gradient towards increased opportunities for students to make elaborative verbal contributions is an important element of such seminars. To verify this assumption, we investigate empirically if clinical teachers progress from more basic, knowledge-oriented questions towards more advanced, elaboration-oriented questions in such seminars. METHODS: We videotaped 21 different clinical teachers and 398 medical students in 32 CBGD-seminars on surgery and internal medicine. We coded closed-reproductive and open-elaborative teacher questions as well as reproductive and elaborative student responses to these questions. Inter-rater reliability was satisfactory. To determine trends regarding the teacher questions / student responses, we compared eight time-segments of equal duration per seminar. RESULTS: Overall, clinical teachers asked more closed-reproductive than open-elaborative questions. Students gave more reproductive than elaborative responses. Regarding the frequencies of these forms of teacher questions / student responses, we found no significant differences over time. CONCLUSIONS: Clinical teachers did not deliberately modify the types of questions over time to push students towards more elaborative responses. We conclude that the critical question to which degree promising teaching approaches are actually put into clinical teaching practice should be raised more purposefully in medical education research.

How is modern bedside teaching structured? A video analysis of learning content, social and spatial structures.

BACKGROUND: Bedside teaching (BST) is an essential and traditional clinical teaching format. It has been subject to various impediments and has transformed over time. Besides a decrease in bedside time, there has also been a didactic diversification. In order to use time at the bedside effectively and understand the current design of BST, we here offer an evidence-based insight into how BST is practiced. This may serve as a basis for a refinement of its didactic design. METHODS: In the current study, we investigate the interrelationships between learning content and the social as well as spatial structures of BST. To this end, we have empirically analysed almost 80 hours of video material from a total of 36 BST sessions with good interrater reliability. RESULTS: BST lasted on average 125 min, most of which was spent in plenary and less than a third of the time at the patient's bedside. History taking was primarily practiced at the bedside while case presentations, clinical reasoning and theoretical knowledge were largely taught away from the patient. Clinical examination took place to a similar extent in the patient's room and in the theory room. CONCLUSIONS: Even though the filmed BSTs are not purely "bedside", the teaching format investigated here is a typical example of undergraduate medical education. In order to maximize the teaching time available, a suitable learning space should be provided in addition to the bedside. Moreover, the clinical examination should be revised in its general sequence prior to the BST, and conscious decisions should be made regarding the social structure so as to optimize the potential of small groups and plenary sessions.

Effectiveness of non-bedside teaching during the COVID-19 pandemic: a quasi-experimental study.

BACKGROUND: The COVID-19 pandemic poses a huge challenge for clinical teaching due to contact restrictions and social distancing. Medical teachers have to balance potential risks and benefits of bedside teaching, especially in course formats intended to foster practical clinical skills. In this context, we aimed to address the question, whether presence-based teaching formats without patient involvement are suitable to teach practical skills. METHODS: In this quasi-experimental study, presence-based teaching formats with and without patient contact were retrospectively compared regarding their effects on medical students' theoretical knowledge and practical skills, i.e. the performance and clinical interpretation of the neurological exam. To this end, evaluations from 102 students and their lecturers participating in a neurological bedside teaching course at a German university hospital between October 2020 and April 2021 were obtained. Students were initially randomly assigned to course dates. However, 53 students assigned to courses in November and December 2020, were not able to go bedside due to contact restrictions. These students formed the interventional group and the remaining 49 students the control group. The primary outcome measures were students' overall grading of the course (school grades, 1-6) as well as ratings of knowledge and skills provided by the students themselves and their lecturers on a numerical rating scale (0-10). Comparison between groups was performed using frequentist and Bayesian t-statistics. RESULTS: The teaching format without patient contact received a significantly poorer overall grade by the students (p = 0.018). However, improvements in the students' self-ratings of knowledge and skills did not differ between the two formats (all p > 0.05, BF10max = 0.42). Moreover, especially practical skills were even rated significantly better in the group without patient contact by the lecturers (p < 0.001). CONCLUSIONS: Teaching formats without patient contact are less well-received by the students. However, they are able to teach practical skills regarding the performance and clinical interpretation of examination techniques. Still, the evaluations obtained might not adequately capture the importance of bedside teaching in preparing future physicians for their practice. Perspectively, hybrid teaching approaches including flipped-classroom concepts hold considerable potential to enhance effectiveness of bedside teaching in the present pandemic situation and in the future.

A video-based situational judgement test of medical students' communication competence in patient encounters: Development and first evaluation.

OBJECTIVE: We developed and evaluated the Video-Based Assessment of Medical Communication Competence (VA-MeCo), a construct-driven situational judgement test measuring medical students' communication competence in patient encounters. METHODS: In the construction phase, we conducted two expert studies (npanel1 = 6, npanel2 = 13) to ensure curricular and content validity and sufficient expert agreement on the answer key. In the evaluation phase, we conducted a cognitive pre-test (n = 12) and a pilot study (n = 117) with medical students to evaluate test usability and acceptance, item statistics and test reliability depending on the applied scoring method (raw consensus vs. pairwise comparison scoring). RESULTS: The results of the expert interviews indicated good curricular and content validity. Expert agreement on the answer key was high (ICCs> .86). The pilot study showed favourable usability and acceptance by students. Irrespective of the scoring method, reliability for the complete test (Cronbach's α >.93) and its subscales (α >.83) was high. CONCLUSION: There is promising evidence that medical communication competence can be validly and reliably measured using a construct-driven and video-based situational judgement test. PRACTICE IMPLICATIONS: Video-based SJTs allow efficient online assessment of medical communication competence and are well accepted by students and educators.

Medical students' engagement in the context of the SARS-CoV-2 pandemic: The influence of psychological factors on readiness to volunteer.

Objective: To avert staff shortages during the first wave of the SARS-CoV-2 pandemic in spring 2020, the medical faculties of the Technical University of Munich (TUM) and the Ludwig Maximilian University of Munich (LMU) appealed to their students to volunteer for relief work. In this study, we examine the influence of psychological factors on the students' decisions to respond to this call or not. Methodology: We report on a cross-sectional study based on an online survey among medical students at the TUM and LMU. The survey consisted of a questionnaire containing items on motivation and other factors related to the decision for or against volunteering. Questions were also asked about anxieties regarding COVID-19 and the occurrence of depressive symptoms, as well as about resilience. Results: Responses from 244 participants were analysed. Students' decisions to volunteer revealed both altruistic and introjected motivations. For those students who did not volunteer, time overlaps and workload related to other activities played an important role. Between the two groups, no significant difference was detected in terms of their resilience and COVID-19-related anxieties. However, the non-volunteering students reported a significantly higher prevalence of depressive symptoms. Conclusion: Sense of duty and the desire to help were, according to the students, the most important reasons for volunteering. Depressive symptoms and lack of time made volunteering less likely. Resilience and COVID-19-related anxieties do not seem to have had any influence on the decision to volunteer or not.

Measuring hygiene competence: the picture-based situational judgement test HygiKo.

BACKGROUND: With the onset of the COVID-19 pandemic at the beginning of 2020, the crucial role of hygiene in healthcare settings has once again become very clear. For diagnostic and for didactic purposes, standardized and reliable tests suitable to assess the competencies involved in "working hygienically" are required. However, existing tests usually use self-report questionnaires, which are suboptimal for this purpose. In the present study, we introduce the newly developed, competence-oriented HygiKo test instrument focusing health-care professionals' hygiene competence and report empirical evidence regarding its psychometric properties. METHODS: HygiKo is a Situational Judgement Test (SJT) to assess hygiene competence. The HygiKo-test consists of twenty pictures (items), each item presents only one unambiguous hygiene lapse. For each item, test respondents are asked (1) whether they recognize a problem in the picture with respect to hygiene guidelines and, (2) if yes, to describe the problem in a short verbal response. Our sample comprised n = 149 health care professionals (79.1 % female; age: M = 26.7 years, SD = 7.3 years) working as clinicians or nurses. The written responses were rated by two independent raters with high agreement (α > 0.80), indicating high reliability of the measurement. We used Item Response Theory (IRT) for further data analysis. RESULTS: We report IRT analyses that show that the HygiKo-test is suitable to assess hygiene competence and that it allows to distinguish between persons demonstrating different levels of ability for seventeen of the twenty items), especially for the range of low to medium person abilities. Hence, the HygiKo-SJT is suitable to get a reliable and competence-oriented measure for hygiene-competence. CONCLUSIONS: In its present form, the HygiKo-test can be used to assess the hygiene competence of medical students, medical doctors, nurses and trainee nurses in cross-sectional measurements. In order to broaden the difficulty spectrum of the current test, additional test items with higher difficulty should be developed. The Situational Judgement Test designed to assess hygiene competence can be helpful in testing and teaching the ability of working hygienically. Further research for validity is needed.

Medical Trainees' Experiences With Dying and Death.

This study investigates medical trainees' experiences with dying and death, by means of semistructured interviews. Nine medical students and nine residents reported a total of 114 experiences. The great majority of these experiences took place during the final year of medical school. The authors identified the latent characteristics, which illustrate an in-depth understanding of the significance of the described experiences. Three main themes emerged: circumstances of death, personal relationship, and one's own role. The age of the dying person, the extent of suffering, time frame and setting, and the patients' behaviors were factors that influence the perceptions of the experiences. The interviewees reported powerful emotional consternation by the patients' deaths with whom they had developed a close relationship. Failure, helplessness, and guilt were negatively associated perceptions of one's own role. This study illustrates the tension between emotional concern and professional detachment. It highlights the continuing existence of a physician image, in which control represents the key issue.

Isn't here just there without a "t" - to what extent can digital Clinical Case Discussions compensate for the absence of face-to-face teaching?

Objective: COVID-19 challenges curriculum managers worldwide to create digital substitutes for classroom teaching. Case-based teaching formats under expert supervision can be used as a substitute for practical bedside teaching, where the focus is on teaching clinical reasoning skills. Methods: For medical students of LMU and TU Munich, the interactive, case-based, and supervised teaching format of Clinical Case Discussion (CCD) was digitised and implemented as dCCD in their respective curricula. Case discussions were realised as videoconferences, led by a student moderator, and took place under the supervision of a board-certified clinician. To prevent passive participation, additional cognitive activations were implemented. Acceptance, usability, and subjective learning outcomes were assessed in dCCDs by means of a special evaluation concept. Results: With regard to acceptance, students were of the opinion that they had learned effectively by participating in dCCDs (M=4.31; SD=1.37). The majority of students also stated that they would recommend the course to others (M=4.23; SD=1.62). The technical implementation of the teaching format was judged positively overall, but findings for usability were heterogeneous. Students rated their clinical reasoning skills at the end of the dCCDs (M=4.43; SD=0.66) as being significantly higher than at the beginning (M=4.33; SD=0.69), with low effect size, t(181)=-2.352, p=.020, d=0.15. Conclusion: Our evaluation data shows that the dCCD format is well-accepted by students as a substitute for face-to-face teaching. In the next step, we plan to examine the extent to which participation in dCCDs leads to an increase in objectively measured clinical reasoning skills, analogous to a face-to-face CCD with on-site attendance.

How can communicative competence instruction in medical studies be improved through digitalization?

The teaching of communicative competence plays an increasingly important role in medical education. In addition to traditional teaching formats, such as role-plays with simulated patients, technology-based approaches become more important in medical education. Teaching materials are increasingly augmented by videos of simulated doctor-patient conversations. This combination allows the content of teaching materials to be demonstrated with video or for videos to create a basis for reflection activities. In addition, conversation videos can illustrate different qualities of clinical communication and serve as illustrative material for describing particular issues in more detail. In addition to teaching clinical communicative competence, the assessment of this competence also plays an important role in medical educational research. So far, this has mainly been conducted through direct observation using checklists or rating scales. Relatively little is known about the assessment of communicative competence using standardized online-based tests. Situational Judgement Tests (SJTs) offer a promising approach in this respect. The BMBF-funded (BMBF = Bundesministerium für Bildung und Forschung - Federal Ministry of Education and Research) joint project voLeA (Entwicklung videobasierter Lehr- und Assessmentmodule zur Gesprächskompetenz im Medizinstudium = Development of video-based teaching and assessment modules for communicative competence in medical studies) addresses these two issues. Specifically, the project is engaged in developing e-learning modules to promote communicative competence and an assessment of this competence using an SJT. The present paper focuses on the benefits of technology-based learning and assessment units for clinical communicative competence in medical studies, using the voLeA project as an example.

International mobility of students in the medical disciplines from a comparative perspective.

Objective: We analyze the extent to which students of human, veterinary and dental medicine complete study-related stays abroad (frequency, type and duration of stays abroad and countries visited). Furthermore, we investigate the possible correlations between completed stays abroad and the duration of studies, the completion of a doctorate and entering professional life. Methods: The data come from a written cross-sectional survey of 742 graduates of their respective study programs at Bavarian universities. The evaluation was carried out using descriptive and inferential statistical methods. Results: Slightly more than half of the surveyed students completed study-associated stays abroad, with notable differences between the three study programs. The students most frequently completed internships abroad lasting an average of nine weeks. Switzerland was the most common country of destination for the stays abroad. Furthermore, there were no or only weak correlations between stays abroad, the duration of studies and progress towards a doctorate or the commencement of professional employment abroad. There were no correlations with the stress experienced as part of initial employment after graduation. Conclusion: The results clearly indicate that stays abroad are quite usual for students in the medical disciplines and are almost standard in the study of human medicine. The selection of the countries visited indicates that the primary goal of the students' stays abroad is to deepen their competence with a view to later employment in their home country.