A summary of the U.S. Marine Recruit Assessment Program (RAP) procedures and survey from 2003 to 2021

The Recruit Assessment Program (RAP) is a cross-sectional, baseline survey of U.S. Marine recruits administered at Marine Corps Recruit Depot, San Diego. This report presents RAP study procedures and survey content that was administered to 229,015 participants between 2003 and 2021. Self-reported data were collected on recruit demographics, physical and mental health, adverse life experiences, lifestyle and risky behaviors, and substance use. In 2013, the survey was updated to remove questions with other linkable and reliable sources and those with low completion rates and low relevance to Marine health research; the removal of these items allowed for the addition of instrument measures for major depression, post-traumatic stress disorder, anger, and resilience with no significant change to overall survey length. Average completion rates are approximately 95%. Multiple studies have shown the utility of RAP data collected thus far as a robust data repository of pre-service health and behavioral measures.

Exercise is inversely associated with functional dyspepsia among a sample of Chinese male armed police recruits.

BACKGROUND: There is no study evaluating the association between exercise and functional dyspepsia (FD) based on the Rome IV criteria. We aimed to investigate the prevalence of FD and evaluate the association between exercise and FD based on Rome IV criteria among a sample of Chinese armed police recruits. METHODS: An on-site questionnaire survey on FD among a sample of Chinese armed police recruits was conducted based on the Rome IV criteria in 2021. Potential confounders included age, body mass index (BMI), race, marriage, education, smoking, and drinking variables were adjusted. RESULTS: A total of 2594 recruits were enrolled, including 46 FD participants and 2548 non-FD participants. In the model adjusted for all demographic variables among participants excluding irritable bowel syndrome (IBS) and functional constipation (FC), compared with no exercise participants, 1 h < each exercise time ≤ 2 h (OR = 0.15, 95% CI: 0.03-0.77, P = 0.0230) was inversely associated with FD and compared with no exercise participants, mild exercise (OR = 0.09, 95% CI: 0.01-0.71, P = 0.0220) was significantly inversely associated with FD. CONCLUSIONS: The incidence rate of FD in this sample Chinese armed police recruits was 1.77%, and 1 h < each exercise time ≤ 2 h and mild intensity exercise were independently inversely associated with FD. However, the causal relationship needs to be verified by further randomized controlled trials.

Prevalence of COVID-19 fear and its association with quality of life among fire service recruits after ceasing the dynamic zero-COVID policy in China.

Background: In December 2022, China terminated its dynamic zero-COVID policy. To date, however, no research has been conducted upon mental health issues and their relationship with quality of life (hereafter QoL) among fire service recruits since the dynamic zero-COVID policy ended. This study explored fear of COVID-19 (FOC) prevalence and correlates as well as its network structure and interconnections with QoL among fire service recruits. Methods: A cross-sectional survey design was used to assess fire service recruits in Beijing and Sichuan, Guangxi and Guizhou provinces of China between February 13 and 16, 2023. Fear of COVID-19 was measured using the Fear of COVID-19 Scale, depression was assessed with the Patient Health Questionnaire, anxiety was examined using the Generalized Anxiety Disorder scale, and QOL was evaluated with the World Health Organization Quality of Life-brief version. Univariate and multivariate analyses were used to explore correlates of COVID-19 fear. Network analysis assessed the structure of fear of COVID-19 and its associations with QoL. Results: A total of 1,560 participants were included in this study. The overall prevalence of fear of COVID-19 was 38.85% (n = 606; 95% CI = 36.42-41.32%). Being afraid of COVID-19 was significantly related to depression (OR = 1.084; p < O.OO1) and physical fatigue (OR = 1.063; p = 0.026). Fire service recruits with more fear of COVID-19 had lower QOL (F = 18.061 p < 0.001) than those with less fear of COVID-19 did. The most central symptoms included FOC6 ("Sleep difficulties caused by worry about COVID-19"), FOC7 ("Palpitations when thinking about COVID-19") and FOC2 ("Uncomfortable to think about COVID-19"). The top three symptoms negatively associated with QoL were FOC4 ("Afraid of losing life because of COVID-19"), FOC6 ("Sleep difficulties caused by worry about COVID-19") and FOC2 ("Uncomfortable to think about COVID-19"). Conclusion: Over one-third of fire service recruits reported fear of COVID-19 after China's dynamic zero-COVID policy had terminated. Poorer QoL was related to fear of COVID-19. Targeting core symptoms of the fear network structure could help improve the physical and mental health of fire service recruits during public health crises.

Occupational protection behavior and its influencing factors of newly recruited nurses.

AIM: Aim The objective of this study was to understand the occupational protective behaviors of newly recruited nurses and explore the influencing factors. METHODS: A convenience sampling method was used to select newly recruited nurses in our hospital from July 2018 to November 2019. The survey was conducted using the general information questionnaire, work attitude scale (Wa), and occupational protective behavior scale. RESULTS: The total score of occupational protective behaviors of 150 newly enrolled nurses was 18.94 ± 3.59. There was a significant negative correlation between work attitude score and occupational protective behaviors (r = -0.324, p < 0.001). Multiple linear regression analysis showed that gender, previous participation in nursing skill-based competitions, experience of needlestick injuries before recruit, work attitude score, average daily sleep time (p < 0.05) were independent factors influencing occupational protective behaviors. CONCLUSIONS: The overall occupational protective awareness of newly enrolled nurses is relatively weak and needs to be further improved. The group's ability to improve occupational protective behaviors may be positively impacted through increased adaptability, improved sleep, active participation in nursing skill-based competitions, strengthening guidance and education on occupational protection.

Regional Differences in Intestinal Parasitic Infections among Army Recruits in a Southern Mozambique Training Center: A Cross-Sectional Study.

Due to the high prevalence and diversity of clinical manifestations, intestinal parasitic infections (IPIs) represent a public health problem. The objective of the work was to determine the prevalence of IPIs among army recruits at a practice and training center in southern Mozambique. Sociodemographic information was obtained through semi-structured interviews. Single urine and stool samples were collected from 362 recruits. Parasite diagnosis was made by filtration, formaldehyde-ether and Kato-Katz techniques. Positive individuals underwent abdominal ultrasound. Then, descriptive statistics and cross-tabulations were performed, and p-values < 0.05 were considered significant. The prevalence of infection with at least one parasite was 25.1% (95% CI: 20.5-29.6; n = 91). The most common parasites were Entamoeba coli (10.7%; 95% CI: 7.4-13.7; n = 37) and Trichuris trichiura (6.1%; 95% CI: 4.6-9.9; n = 25). Parasitic infection was associated with the origin of the participant (p-value < 0.001), and the province of Sofala had the highest prevalence among the provinces studied (70.6%; 95% CI: 47.0-87.8; 12/17). Since oral fecal transmission occurs for several parasites, routine screening and deworming prior to enrollment at the army training center is recommended to reduce transmission of intestinal parasites among recruits.

Coral affected by stony coral tissue loss disease can produce viable offspring.

Stony coral tissue loss disease (SCTLD) has caused high mortality of at least 25 coral species across the Caribbean, with Pseudodiploria strigosa being the second most affected species in the Mexican Caribbean. The resulting decreased abundance and colony density reduces the fertilization potential of SCTLD-susceptible species. Therefore, larval-based restoration could be of great benefit, though precautionary concerns about disease transmission may foster reluctance to implement this approach with SCTLD-susceptible species. We evaluated the performance of offspring obtained by crossing gametes of a healthy P. strigosa colony (100% apparently healthy tissue) with that of a colony affected by SCTLD (>50% tissue loss) and compared these with prior crosses between healthy parents. Fertilization and settlement were as high as prior crosses among healthy parents, and post-settlement survivorship over a year in outdoor tanks was 7.8%. After thirteen months, the diseased-parent recruits were outplanted to a degraded reef. Their survivorship was ∼44% and their growth rate was 0.365 mm ± 1.29 SD per month. This study shows that even diseased parent colonies can be effective in assisted sexual reproduction for the restoration of species affected by SCTLD.

Epidemiological survey of warts in Chinese military recruits: A cross-sectional and follow-up study.

Background: Warts are very common in military personnel, either at war or during peace times. However, little is known about the prevalence and natural course of warts in military recruits in China. Objective: To investigate the prevalence and natural course of warts in Chinese military recruits. Methods: In this cross-sectional study, the head, face, neck, hands, and feet of 3093 Chinese military recruits aged 16-25 years in Shanghai were examined for the presence of warts upon enlistment medical examinations. Questionnaires were distributed to collect the general information of the participants before the survey. All the patients were followed up by telephone interview for 11-20 months. Results: The prevalence rate of warts in Chinese military recruits was 2.49%. The diagnosis of most cases was common and plantar warts, which were usually less than 1 cm in diameter and with mild discomfort. Multivariate logistic regression analysis showed that smoking and sharing personal items with others were risk factors. Coming from southern China was a protective factor. Over 2/3 of patients recovered within 1 year and the type, number, and size of warts and treatment choice did not predict resolution.Study limitations and Conclusions This study demonstrated that warts had a relative lower morbidity and a higher spontaneous resolution rate in Chinese military recruits. The telephone interviews following the initial survey and the limitations of a cross-sectional study were the main drawbacks.

Enhanced Adenovirus Vaccine Safety Surveillance in Military Setting, United States.

The US Coast Guard Academy began adenovirus vaccination of incoming cadets in 2022. Of 294 vaccine recipients, 15%-20% had mild respiratory or systemic symptoms within 10 days postvaccination but no serious adverse events after 90 days. Our findings support the continued use of adenovirus vaccines in congregate military settings.

Acclimation potential of Acropora to mesophotic environment.

Mesophotic coral ecosystems may serve as a refuge for reef-building corals to survive the ongoing climate change. Distribution of coral species changes during larval dispersal. However, the acclimation potential in the early life stages of corals at different depths is unknown. This study investigated the acclimation potential of four shallow Acropora species at different depths via the transplantation of larvae and early polyps settled on tiles to 5, 10, 20, and 40 m depths. We then examined physiological parameters, such as size, survival, growth rate, and morphological characteristics. The survival and size of juveniles of A. tenuis and A. valida at 40 m depth were significantly higher than those at other depths. In contrast, A. digitifera and A. hyacinthus showed higher survival rates at shallow depths. The morphology (i.e., size of the corallites) also varied among the depths. Collectively, the shallow coral larvae and juveniles displayed substantial plasticity at depth.

Temporal changes in physical fitness in Norwegian male and female military conscripts between 2006 and 2020.

Reduced physical fitness has been documented in Western children and adults over the past five decades. The same trend has been observed among soldiers, but the number of studies is scarce. Thus, the aim of the present study was to investigate temporal changes in physical fitness in Norwegian conscripts. All conscripts who performed entry fitness tests between 2006 and 2020 were included in the study (n = 105 100; 17% females). Endurance was measured with the 3000 m run, while push-ups, sit-ups, and pull-ups (2006-2016) and medicine ball throw, standing long jump, and pull-ups (2017-2020) were used to measure muscle strength. Mean (95% confidence intervals) 3000 m run time was reduced by 52 (47, 57) seconds in men, 90 (76, 105) seconds in women, and 16 (11, 20) seconds in both sexes combined. Muscle strength increased statistically significantly in four out of five tests in men, three out of six tests in women, and two out of five tests for both sexes combined. Effect sizes for statistically significant changes ranged from 0.06 to 0.82. In conclusion, Norwegian conscripts improved their cardiorespiratory endurance between 2006 and 2020, with improvements observed for most muscle strength tests. When analyzing both sexes combined, the improvements diminished. The latter is attributed to a sevenfold increase in relative number of female conscripts over the 15-year period. The present findings should not be generalized to all young Norwegian men and women since conscripts are selected based on fitness, and only ~15% of the population end up serving.

Exploring links between Chinese military recruits' psychological stress and coping style from the person-environment fit perspective: The chain mediating effect of self-efficacy and social support.

The choice of coping style of recruits under psychological stress in the process of military task execution has been an important topic in the promotion of military operations and cohesion of military forces. Taking a positive coping style under psychological stress can help recruits overcome the negative effects of stress and improve military morale and group combat effectiveness. Although soldiers' psychological stress in the process of military mission execution having an impact on coping style has been studied by a large body of literature, very little literature has focused on the mechanism of self-efficacy and social support between recruits' psychological stress and coping style from the person-environment fit perspective. Therefore, this study was conducted to analyze the impact of recruits' psychological stress on coping style through a chain mediation model and to discuss the role of self-efficacy and social support in this relationship. Two waves of survey data were utilized to test the research hypotheses on a sample of 1028 Chinese recruits performing military tasks. The results indicated that recruits' psychological stress negatively impacted positive coping styles and positively correlated with negative ones. In addition, self-efficacy and social support mediated the relationship between psychological stress and positive coping style, and self-efficacy mediated the relationship between psychological stress and negative coping style. More importantly, self-efficacy and social support play the chain mediating effect between psychological stress and positive coping style.

Evaluation of Military Recruits With Complaints of Palpitations After Physical Training: A Study From Turkey.

Objective Recruits undergo medical examination before mandatory service. After enlistment, if recruits have health problems, they are sent to a medical board to establish fitness for their duties. We aimed to analyze the complaints of palpitations after physical training in recruits without a known history of cardiovascular disease (CVD) and determine whether the diagnoses were suitable for duty. Methods This cross-sectional descriptive study was conducted among 25,666 participants who were admitted to an outpatient cardiology clinic due to complaints of palpitations between August 2016 and June 2022. Information regarding socio-demographic characteristics was collected. Laboratory test results and electrocardiography (ECG) were analyzed. The diagnoses were evaluated. Results In total, 582 patients who were dismissed from the military were included in the study. The mean age of patients was 19.23±2.02 years. Among the patients, drug use (26; 6.2%) and history of addictive substance use (178; 30.6%) were low. The number of days of service under 10 was high (450; 77.3%). The prevalence of sleep disturbance (122; 21%) and hydration habits (154; 26.5%) were low. According to ECG findings, premature atrial contractions were high (250; 42.9%). There was a significant correlation between the ECG findings and seasons (p<0.001).Rheumatic valve disease (83; 14.26%) and supraventricular tachycardia (77; 13.23%) were the most common diagnoses. Conclusion 2.2 percent of all participants admitted to the hospital due to palpitations were dismissed from the military service, and 0.7 percent of them were diagnosed with cardiac conduction system disease.

Supply of Antioxidants vs. Recruit Firefighters' Cellular Immune Status: A Randomized Double-Blinded Placebo-Controlled Parallel-Group Trial.

Background: Physical exercise can affect the immune system. We studied the effect of antioxidants on hematological and immune biomarkers after heavy training. Methods: 24 well-trained and well-fed male firefighters were randomly divided into supplemented and placebo groups, and tested for immunology-related variables using venous blood samples in the fasting state, pre- (M1) and post- (M2) five weeks of daily micronutrient supplementation (15 mg of beta-carotene, 200 mg of vitamin C, 136 mg of vitamin E, 200 µg of selenium, 15 mg of zinc, 100 mg of magnesium). Total leukocytes and a differential count for five populations were determined using standard procedures (MAXM­Beckman Coulter Diagnostics; Brea, CA, USA). Lymphocyte subsets were determined through immunophenotyping. Results: Although all values were within the normal range for healthy adults and athletes in the supplemented group (SG), mean CD3+CD8+, CD8+ and CD16+CD56+ decreased (p < 0.05; small to moderate effects), while mean CD4+, CD19+ and CD4+/CD8+ increased (p < 0.05; small effects) after five-weeks. Regarding the placebo group (PG), higher total leukocyte count (p < 0.05; trivial effect) and natural killer cells percentage (CD16+CD56+; p < 0.05; moderate effect) were observed when comparing M1 and M2. Conclusions: Antioxidants supplementation did not alter well-fed male firefighters recruit firefighters' immune cell response during the five-week physical training program.

A study of adult rubella outbreak and its implications on increasing number of women in uniform.

Background: Rubella, although a fairly innocuous disease, is a known cause of severe birth defects in newborn. With number of women in uniform on the rise and they being assigned instructional and medical care duties, adult rubella outbreak in a training centre as in this study poses grave threat to them; besides, having disruption potential for their training. Methods: This study was conducted at an Airmen Training Centre of the Indian Air Force having more than 2500 recruits, in five squadrons. All cases of fever with rash and/or lymphadenopathy were included in the study. The demographic, epidemiological and clinical data of all the cases were analyzed and medical records reviewed. Results: A total of 31 male recruits reported over 5 days. Among those, 21 cases were from a single squadron to which the index belonged. Twelve women officers were doing instructional duties at the time of outbreak though none became infected. Fever with a rash (90.32%) was the commonest presentation, and lymphadenopathy (64.51%) was the most common sign. Attack rate (AR) with-in the squadron most affected was 4.18%, with an overall AR of 1.23%. The case fatality rate of the disease was nil. Conclusion: Till the fully immunized cohort of young recruits start getting enrolled, it will be prudent to introduce rubella vaccine to limit the loss of vital training man-hours and prevent the possibility of congenital rubella syndrome in the women instructors and medical caregivers, working in the line of their duty.

Antropometría nutricional en la España de mediados del siglo XX. Medidas comparadas de estudiantes y reclutas / Nutritional anthropometry in mid-20th century Spain. Comparativemeasurements of students and recruits

Introducción: La talla y el perímetro torácico son indica-dores del estado de salud y bienestar de una población.Dichas medidas antropométricas dependen de agentes socio-económicos, nutricionales y ambientales. Objetivos: Analizar la estatura y el perímetro del tórax delos reclutas de diferentes provincias españolas en la décadade los 50 del pasado siglo. Asimismo, comparar dichas medi-das corporales con las de los estudiantes del mismo períodode tiempo. Material y Métodos: Se parte de dos muestras, una de2421 sujetos de los reclutamientos de 1950 a 1953 de dife-rentes provincias españolas y la otra, de 957 estudiantes va-rones de 23 a 33 años. Se confrontaron talla y perímetro to-rácico de los reclutas de las diferentes regiones. Secompararon dichas medidas entre soldados y estudiantes uni-versitarios. Resultados: Las estaturas más elevadas de reclutas seencontraban en las zonas catalana y vasco-navarra y la me-nor correspondía a la castellano-leonesa. Los soldados galle-gos y vasco-navarros poseían un perímetro torácico estadísti-camente mayor que el de los andaluces y castellano-leoneses.Los estudiantes tienen un promedio de talla superior a la delos reclutas, tanto a nivel general como en la mayoría de lasregiones geográficas comparadas. Igualmente, el perímetrotorácico medio del alumnado universitario es mayor que el delos soldados, a nivel del conjunto de España y de todas las re-giones analizadas. Conclusiones: Los reclutas más altos eran los del norestey los de mayor tórax, los de la zona septentrional de España.Las medidas de estudiantes fueron mayores que las de los dereclutas.(AU)

Introduction: Stature and thoracic perimeter are indica-tors of health and wellbeing status of a population. These an-thropometric measures are affected by socioeconomic, nutri-tional and environmental factors. Objectives: To analyze the stature and thoracic perime-ter of the recruits of different Spanish provinces in the decadeof the ‘50s of the last century. Also to compare these bodymeasurements with those of the students of the same period. Methods: This study was based on two samples, one com-posed of 2421 recruits conscripted between 1950 and 1953from different Spanish provinces. The second one featured956 male students aged 23-33. We collected the stature andthoracic perimeter of the recruits from different regions. Wecompared said measures between recruits and students. Results: The tallest recruits were found in the Catalan andBasque-Navarre areas and the shortest in the Castilian-Leonese area. Galician and Basque-Navarrese soldiers had astatistically greater thoracic perimeter than Andalusian andCastilian-Leonese soldiers. The students have a higher aver-age stature than the recruits, both overall and in most of thegeographical regions compared. Likewise, the average tho-racic perimeter of university students is greater than that ofsoldiers, at the level of Spain as a whole and of all the regionsanalyzed. Conclusion: The tallest recruits belonged to the northeastwhilst those with the largest thoracic perimeters were fromnorthern Spain. The measurements from students werehigher than those from the recruits.(AU)

Cardiorespiratory fitness in police recruits: Assessing the validity of the 20-meter shuttle run test for recruitment purposes.

BACKGROUND: Although the 20-meter shuttle run test (20MSR) is frequently used by police organisations for recruitment purposes, to our knowledge no study has yet assessed the accuracy of this test to estimate maximal oxygen consumption (VO2max) in police recruits. OBJECTIVE: The primary objective of this study was to assess the validity of the 20MSR as a predictor of VO2max in police cadets. METHODS: 49 police cadets completed both an indirect calorimetry VO2max assessment and a 20MSR. Based on their results, estimated VO2max was calculated using an established equation. Furthermore, two models estimating the VO2max was also developed using the final stage completed and sex as independent variables in the first model (model A) as well as the final half-stage completed and sex in the second model (model B). RESULTS: A strong and significant bivariate correlation was found between measured VO2max and the final stage completed at the 20MSR (r = 0.874, p < 0.001). Nevertheless, limits of agreement analysis showed relatively large agreement errors between measured VO2max and estimated VO2max based on the established equation (0.46±6.29 ml·min-1·kg-1), model A (0.00±5.58 ml min-1 kg-1), and model B (0.00±5.48 ml min-1·kg-1). CONCLUSIONS: Although the 20MSR can be a useful tool to estimate cardiorespiratory fitness for research and conditioning purposes, the large agreement errors found in this study suggest that results at the 20MSR should be interpreted with caution when making "pass or fail" decisions.

Sleep of recruits throughout basic military training and its relationships with stress, recovery, and fatigue.

OBJECTIVE: Studies in basic military training (BMT) examining sleep are largely cross-sectional, and do not investigate relationships between sleep, stress, recovery and fatigue. The aims of this study were to (1a) quantify changes in recruits' sleep quantity and quality over 12 weeks of BMT; (1b) quantify changes in recruits' perceptions of stress, fatigue and recovery over BMT; and (2) explore relationships between sleep, and perceptions of stress, fatigue and recovery. METHODS: 45 recruits (37 male; 8 female, age: 25.2 ± 7.2 years, height: 176.2 ± 10.0 cm, mass: 76.8 ± 15.0 kg) wore ActiGraph GT9X's for 12 weeks of BMT, collecting sleep duration, efficiency and awakenings. Subjective sleep quality, fatigue were measured daily, with stress and recovery measured weekly. Multi-level models assessed relationships between sleep, and stress, recovery, and fatigue. RESULTS: Objective daily means for sleep duration were 6.3 h (± 1.2 h) and 85.6% (± 5.5%) for sleep efficiency. Main effects were detected for all mean weekly values (p < 0.05). Sleep quality showed the strongest relationships with stress, recovery and fatigue. The best model to explain relationships between, stress, recovery and fatigue, included sleep quality, sleep duration, sleep efficiency and awakenings. CONCLUSIONS: The reported mean sleep duration of 6.3 h per night may negatively impact training outcomes across BMT. Combining both subjective and objective measures of sleep best explained relationships between sleep metrics stress, fatigue and recovery. Perceived sleep quality was most strongly related to change in stress, recovery, or post-sleep fatigue.

Core muscle functional strength training for reducing the risk of low back pain in military recruits: An open-label randomized controlled trial.

BACKGROUND: Core muscle functional strength training (CMFST) has been reported to reduce injuries to the lower extremity. However, no study has confirmed whether CMFST can reduce the risk of low back pain (LBP). OBJECTIVE: This study identified the effects of CMFST on the incidence of LBP in military recruits. DESIGN, SETTING, PARTICIPANTS AND INTERVENTION: We performed a prospective, open-label, randomized, controlled study in a population of young healthy male naval recruits from a Chinese basic combat training program. Participants were randomly assigned to either the core group or the control group. In additional to normal basic combat training, recruits in the core group underwent a CMFST program for 12 weeks, while recruits in the control group received no extra training. MAIN OUTCOME MEASURES: At the beginning of the study and at the 12th week, the number of participants with LBP was counted, and lumbar muscle endurance was measured. In addition, when participants complained of LBP, they were assessed using the visual analog scale (VAS) and Roland Morris Disability Questionnaire (RMDQ). RESULTS: A total of 588 participants were included in the final analysis (295 in the core group and 293 in the control group). The incidence of LBP in the control group was about twice that of the core group over the 12-week study (20.8% vs 10.8%, odds ratio: 2.161-2.159, P < 0.001). The core group had better lumbar muscle endurance at 12 weeks than the control group ([200.80 ± 92.98] s vs [147.00 ± 84.51] s, P < 0.01). There was no significant difference in VAS score between groups, but the core group had a significantly lower RMDQ score at week 12 than the control group (3.33 ± 0.58 vs 5.47 ± 4.41, P < 0.05). CONCLUSION: This study demonstrated that the CMFST effectively reduced the incidence of LBP, improved lumbar muscle endurance, and relieved the dysfunction of LBP during basic military training.

[The surgeon's balancing act-Teaching in the clinical routine]. / Der Chirurg im Spagat ­ Lehre im klinischen Alltag.

BACKGROUND: Thus medical students must be inspired to undertake this specialty. Students complain that the teaching is subordinate to patient care and limited by a lack of time and medical personnel. Although there are many studies assessing student perceptions, few exist that focus on the issues that teachers face. OBJECTIVE: To analyse student teaching in the daily routine and its potential' problems from the surgeon's perspectives. MATERIAL AND METHODS: In this prospective study guidelines for semistructured interviews with formulated, open questions were created, which were specified with further questions. All interviews were conducted using these guidelines and recorded. The number of interviews were a function of the concept of content saturation. RESULTS: All 22 participants perceived that the teaching in clinical practice is of paramount importance. Nevertheless, respondents described that learning goals in the clinical routine are not always achieved. The main reason is a lack of time; however, as clinical experience increases other factors will similarly become more important: Consultants and heads of departments complain about deficiencies in students' previous knowledge, including insufficient motivation. Most respondents described that they do not feel appreciated for teaching. Overall, student teaching was perceived as an additional burden but all respondents found the task to be extremely worthwhile. CONCLUSION: In addition to the lack of personnel, a lack of appreciation is the most significant obstacle towards effective teaching. It is therefore important to increase the value of teaching by rewarding good achievements and the creation of effective transparency.