The digital use of simulated patients in times of the corona pandemic - considerations and proposals.

The corona pandemic has posed major challenges for teaching with simulated persons (SPs), which usually requires the physical presence of the participants. Within a short period of time, a large number of individual solutions were developed. The committee "Simulated Persons" of the Society for Medical Education has developed considerations and proposals in five areas to meet the qualitative challenges of the method. First and foremost, the safety of the SPs is at stake, both in terms of infection prevention and role-related stress to which the SPs are now exposed at home alone instead of the usual setting, where they are in a teaching building with the connection to the staff on site. Furthermore, it should be noted that the changed framework conditions also require a reflection on behalf of the learning objectives, since not all teaching scenarios with SPs can be transferred from a real setting to a digital environment. Furthermore, even under corona conditions, the constructive alignment must not be disregarded, i.e. the question of testability must be considered from the very beginning. Aspects of the technical infrastructure for all participants and compliance with data protection requirements must also be considered. Last but not least, the forced changes are also an opportunity to take a proactive approach to the topic of telemedicine in teaching.

Feedback in medical education - a workshop report with practical examples and recommendations.

Background: As a teaching method, feedback is an integral part of medical education. However, there is a lack of a uniform theoretical basis or generally recognized guidelines for its specific design. Against this background, the aim of this article is to discuss conceptual considerations and empirical findings regarding feedback using various practical examples. Procedure and conceptual considerations: Building on the results of a workshop of the Committee for Communicative and Social Competences of the Society for Medical Education (GMA), this article first explains central conceptual considerations and empirical results on the topic of feedback. A particular focus is on various variables that influence the effect of feedback. This includes the feedback source, the frequency of feedback, starting points of feedback, the connection between feedback and reflection as well as the motivation and meta-cognitive skills of the feedback recipient. Practical examples: The implementation of feedback in practice is illustrated using eight examples from the field of medical and dental education. They stem from various settings and the focus is on formative oral feedback. It will become evident that the focus is more on the givers of feedback than the recipients of feedback. Instructions for recipients of feedback on how to reflect on it is still the exception. Discussion: Many of the relevant aspects for the effect of feedback described in the literature are already taken into account in the practical examples discussed. In conclusion, seven recommendations are made for implementing feedback in practice.

Simulated patients in medical education - a survey on the current status in Germany, Austria and Switzerland.

Objective: In German-speaking countries (Germany, Austria, Switzerland), simulated patients (SPs) have been a fixture for years and are used in teaching and examinations. As part of ongoing methodological standardization efforts and to support current and future faculty and curriculum developments, this exploratory study systematically investigates how and under what framework and conditions SPs are currently used in German-speaking countries. Methodology: The online questionnaire developed in cooperation with the Committee for Simulated Patients of the Society for Medical Education comprises 58 questions covering the organization and administration, size and design of the SP pool, general conditions and minimum standards for the assignments of the SPs. All medical faculties from Germany, Austria and German-speaking Switzerland were invited to participate in the survey and a descriptive data analysis was performed. Results: 38 responses from 45 faculties were included in the evaluation of the survey (response rate: 84.4%). Most SP programs are affiliated with the Office of the Dean of Studies and skills labs or training centers and funded by faculty resources. Both the working hours in the SP programs and the qualifications of the employees vary extensively. The same applies to the number and average age of the employed SPs. On average each faculty uses 1,290 SP hours per year (min=45, max=6,500). The majority of SPs are used in a teaching environment, together with lecturers. At all sites, SPs provide feedback to students. This is always based on a uniform standard. All SPs receive training, which predominantly focuses on playing their role and giving feedback. Discussion: There are a variety of SP programs in German-speaking countries. While there are a few clear similarities (for example, feedback from SPs), many organizational and methodological aspects are handled differently. Although this allows innovation and flexibility, it also weakens the didactic SP method in its standardization and thus in the comparability of quality. A certain degree of standardization and high methodical quality is of great importance, especially in scientific and faculty internal discussions and with a view to the use of SPs in high-stakes examinations which must be improved in the future.

"Hopefully, I will never forget that again" - sensitizing medical students for drug safety by working on cases and simulating doctor-patient communication.

Objective: This project is part of the "PJ-STArT-Block", a one-week course preparing 10th semester medical students for their final practical year. The focus is on sensitizing students to aspects of medication safety by becoming aware of their skills and their deficits in terms of application and communication of pharmacological knowledge. The modules were evaluated regarding feasibility, acceptance and possible effects. Furthermore, the areas in which students see their pharmacological deficits or learning successes were gathered. Methods: In simulated physician-patient conversations, the students are to identify drug-related problems such as medication errors, adverse drug events or interactions. Together with their fellow students and under medical or pharmaceutical moderation, they then have to find solutions for the identified problems and communicate these solutions to the patients. Based on paper cases, students practice, reflect, and discuss the research of reliable information about drugs and medication therapy. The written evaluation included the evaluation by school grades and the possibility of comments in free text. A content analysis of interviews with students at the beginning of the project aimed to identify areas of pharmacology in which they see their own deficits. Results: Evaluation results including the free text comments indicate students' acceptance of our pharmacology modules. According to this, the students realize the importance of aspects relevant for medication safety. The areas mentioned in 35 interviews in which students localize deficits, correspond to the topics that were intended when conceiving the modules and which are important for medication safety (e.g. interactions, adverse drug effects, dosages). Conclusion: Implementation of context-based, application-oriented teaching formats as recently claimed for pharmacological education to improve the quality of prescriptions, is possible, as the Cologne example shows. The student evaluation turns out positively and indicates a critical self-reflection. The students identified various pharmacological deficits in themselves, which have since been confirmed and quantified in another study.