Child sexual abuse in the context of the Roman Catholic Church: a review of literature from 1981-2013.

Child sexual abuse in the Catholic Church has been increasingly recognized as a problem not limited to individual institutions. Recent inquiry commission reports provide substantial information on offense dynamics, but their conclusions have not been synthesized with empirical research to date. The aim of this systematic literature review was to bring together key findings and identify gaps in the evidence base. The three main focus points were (a) types of publications and methodology used, (b) frequency information on child sexual abuse in the Catholic Church, (c) individual factors in offending, and (d) institutional factors in offending. It was found that reports, legal assessments, and research on child sexual abuse within the Catholic Church provide extensive descriptive and qualitative information for five different countries. This includes individual psychological factors (static risk predictors, multiple trajectories) and institutional factors (opportunity, social dynamics) as well as prevalence rates illustrating a high "dark figure" of child sexual abuse.

Child sexual abuse in religiously affiliated and secular institutions: a retrospective descriptive analysis of data provided by victims in a government-sponsored reappraisal program in Germany.

BACKGROUND: The disclosure of widespread sexual abuse committed by professional educators and clergymen in institutions in Germany ignited a national political debate, in which special attention was paid to church-run institutions. We wanted to find out whether the nature of the abuse and its effect on victims differed depending on whether the abuse had been experienced in religiously affiliated versus secular institutions. METHODS: In 2010, the German government established a hotline that victims could contact anonymously to describe their experiences of sexual abuse. The information provided by callers was documented and categorized. Our analysis looked at a subset of the data collected, in order to compare the nature of the abuse experienced at three types of institutions: Roman Catholic, Protestant, and non-religiously affiliated. Non-parametric tests were used to compare frequency distributions, and qualitative data were analyzed descriptively. RESULTS: Of the 1050 victims in our sample, 404 had been in Roman Catholic, 130 in Protestant, and 516 in non-religious institutions. The overall mean age at the time of reporting was 52.2 years. Males (59.8%) outnumbered females. Victims who had been in religiously affiliated institutions were significantly older than those who had been in secular institutions. Almost half the victims had been abused physically as well as sexually, and most victims reported that the abuse had occurred repeatedly and that the assaults had been committed by males. Patterns of abuse (time, type, and extent), and the gender of the offenders did not differ between the three groups. Intercourse was more frequently reported by older victims and by females. Similar percentages of victims in all groups reported current psychiatric diagnoses (depression, anxiety disorders, PTSD). Significantly more victims from Protestant institutions reported having current psychosocial problems. CONCLUSION: The results suggest that child sexual abuse in institutions is attributable to the nature of institutional structures and to societal assumptions about the rights of children more than to the attitudes towards sexuality of a specific religion. The exploratory data arising from this study may serve as a starting point for building hypotheses, and may point the way toward improvements in prevention and intervention strategies.

[Integrating the e-learning programme EGONE into the block of training in obstetrics and gynaecology]. / Integration des E-Learning-Programmes EGONE in das Blockpraktikum der Gynäkologie/Geburtshilfe.

OBJECTIVE: EGONE is an E-Learning Forum for Gynaecology, Obstetrics, Neonatology and Reproductive Endocrinology based on the Swiss Catalogue of Learning Objectives. For two semesters, students attending the gynaecology block at the Medical Faculty of the University of Ulm have been provided with licences to use EGONE. Students can work on a specially equipped computer and practise whenever they want. The aim of this study was to generate hypotheses as to which factors favour the use of EGONE and which didactic implications for the learning success the application of EGONE has. METHODS: During August 2009, 28 medical students in their 8th and 9th semester were interviewed after having completed their block of training in gynaecology. The instruments used included a questionnaire and a partially standardised interview. RESULTS: We found that the e-learning offering EGONE was basically met with a positive response from the medical students at the University of Ulm. Regarding the integration of EGONE, three problem areas were identified: shortage of equipment, lack of dependable access and functional, but not curricular integration. Students' suggestions for better integration of EGONE were related to two subject areas: establishing an assisted learning centre (e.g., PC pool with library) and developing curricular independence and relevance (e.g., specific application to patient cases, conducting seminars with EGONE). CONCLUSION: The integration of the e-learning programme EGONE presupposes a logical, didactic concept for the whole clinical block of training in gynaecology as well as dependable, sufficient infrastructure and technical equipment and providing didactic support to users.

Family-friendliness in Medical Studies in Baden-Württemberg. Results of a state-wide study.

This paper describes the results of the study on "Family-friendliness of the Medical Studies in Baden-Württemberg" carried out in 2009-2011 by the working group "Family, Time policy and E-Learning" of the University Hospital of Ulm, supported by the Ministry of Science, Research and the Arts of Baden-Württemberg. This state-wide survey of the studying conditions and personal circumstances of medical students with children at the five medical schools in Baden-Württemberg aims to describe existing and necessary factors of family-friendliness. A total of 238 students with children participated in the quantitative online survey conducted during the summer semester 2010 which was based on topics from previous qualitative interviews with student parents.The data shows that even though founding a family while at university is usually planned, student parents are faced with significant compatibility issues, demonstrating the need for additional measures to individualise course organisation and to make the curriculum more flexible. At the same time, the need to significantly increase information and advisory services alongside the establishment of additional support services for student parents is discernable. The study contributes to the debate on the family-friendliness of universities and university hospitals and adds practice-oriented approaches to solutions.

Practical approaches to family-friendly medical studies.

Based on the pilot study carried out by the Office of the Dean of the Medical University of Ulm on the family-friendliness of the organisation of medical education in Ulm, this paper describes concrete measures that were designed at the university or have been partly implemented already. More flexibility and customization are essential characteristics and prerequisites of a family-friendly medical school as part of university education structures. Flexibility and customization can be achieved by designing lesson plans and study regulations so that both childcare is assured and that in emergencies, help can be quickly offered with a minimum of bureaucracy. More flexibility includes, amongst other things, adequate means for the individual to compensate for missed compulsory attendances and examination dates. The necessary shift in thinking and the willingness to cooperate on behalf of the management and teaching staff can be supported through the audit for family-friendliness "berufundfamilie" (job and family) or "familiengerechte hochschule" (family-friendly university), as well as strategic management tools of family-friendly corporate policies. Supporting mechanisms such as effectively networked advice services, course progression monitoring based on data, providing a parents' passport with a cross-semester training contract, creating more interaction between student-parents or other students through a parent community or by study pairings and finally, reliable information on and compliance with the maternity leave rules for pregnant and breastfeeding medical students can help safeguard successful studying with children.

Family and career-conscious hospitals - problem areas and necessary steps.

This paper aims to describe the wide range of compatibility issues between work in the medical profession and the family. Several topics are intertwined and overlap in some areas. Family friendliness in curative medicine, healthcare, medical studies and the training, specialisation and CPD of doctors is a key theme in the current debate on the future of health and family policies. The rising proportion of women and changes in the medical community characterise the future of medicine. Topics such as working hours and organisation of work, as well as family support and maternity leave, must be discussed further and in particular regarding employees in the health services. This overview will describe where Germany has issues, what is already being done well in the hospitals but could still be improved.

How high are the personnel costs for OSCE? A financial report on management aspects.

OBJECTIVE: The OSCE (objective structured clinical examination) was put to the test in order to assess the clinical practical skills of students in medical studies in the medical faculties. For the implementation of an OSCE, a large number of personnel is necessary. In particular for subjects with limited resources, therefore, efficient cost planning is required. In the winter semester 09/10, the Department of Neurology at the Medical Faculty of the University of Ulm introduced the OSCE as a pilot project. A financial report retrospectively shows the personnel expenses. The report is intended as an example for an insight into the resources needed for the OSCE with simulated patients. METHOD: Included in the calculation of the financial costs of the OSCE were: employment, status of staff involved in the OSCE, subject-matter and temporal dimension of the task. After the exam, acceptance of the examination format was reviewed by a focus group interview with the teachers and students. RESULT: The total expenses for the personnel involved in the OSCE amounted to 12,468 €. The costing of the clinic's share was calculated at 9,576 €. Tuition fees from the students have been used to the amount of 2.892 €. For conversion of total expenditure to the number of examines the sum of 86 € per student was calculated. Both students and teachers confirmed the validity of the OSCE and recognised the added value in the learning effects. CONCLUSION: The high acceptance of the OSCE in neurology by both students and teachers favours maintaining the test format. Against the background of the high financial and logistical costs, however, in individual cases it should be assessed how in the long-term efficient examination procedure will be possible.

Starting a family during medical studies? Results of a pilot study on family friendliness in the study of medicine at the University of Ulm.

OBJECTIVE: The Ulm pilot study aimed to explore factors for a successful combination of medical education and starting a family. The empirical data derived from this study constitutes the foundation for an evidence-based reform of the medical curriculum in Ulm. METHODS: In 2009, qualitative interviews with 37 of the 79 medical students with children at University of Ulm were conducted and analyzed using content analysis. The detected problem areas were used to develop a quantitative questionnaire for studying parents and academic teaching members in medical education in Ulm. RESULTS: The parents were older, more often married and more likely to already have obtained a first training. One third of the students thought there was no ideal time to start a family during the years of medical education or specialist training. However, the majority of the students (61%) were convinced that parenthood is more compatible with medical studies than with specialist training. The interview data suggests that the end of medical school (4(th) to 6(th) year of studies), preferably during semester break, is especially suitable for child birth since it allows students to continue their studies without 'losing time'. CONCLUSION: The biography and career of studying parents in medicine have specific characteristics. Universities and teaching hospitals are required to no longer leave the compatibility of family and study responsibilities to the students themselves. Rather, flexible structures need to be implemented that enable students to start a family while continuing their education. This means providing more childcare and greater support regarding academic counselling and career development.