Experience-based learning during the final year - quantitative content analyses of students' self-reports.

PURPOSE: The final year offers students the opportunity to explore their future role as a physician in different environments. Learning success depends in large part on how students experience these assignments. The aim of this study is to analyze students' self-reported experiences to derive factors that promote experience-based learning in the transition phase during the final year of medical school in order to optimally prepare students for professional practice. METHOD: Data were collected from 2013 to 2019 via written survey after each assignment in the final year. Students were asked to report their pleasant and unpleasant experiences in free-text fields. The text material was analyzed using quantitative content analysis. RESULTS: The authors included 1762 questionnaires for analysis. They formed 12 main categories from the text material, equally covering pleasant and unpleasant experiences. Supervisors and teamwork played a central role in both questions, responsibility and working areas frequently led to positive experiences, and working conditions to negative ones. CONCLUSION: This study confirms the great importance of supervision. Above all, successful collaboration serves as a door opener into a feeling of security which students need to take on responsibility. The authors adapted Dornan's model of experience-based learning to the transition phase to help medical schools establish tailored conditions for students' successful entry into professional practice.

Opening up a tailored tutor qualification program for medical students to other healthcare students - a mixed-method study.

BACKGROUND: Peer-led tutorials are widely used in medical education to promote practical skills acquisition and support faculty staff. Typically, student tutors are custom trained for this specific task. We investigated whether opening up an existing medical tutor qualification program to other degree programs is successful in terms of acceptance among students, acquisition of tutor-specific and interprofessional competencies, and which factors contribute to success or failure. METHODS: We developed a two-day tutor qualification program and conducted it annually from 2016 to 2020 with medical and other healthcare students. At the end of each course, we administered a written survey in which the participants rated the following items: their attitudes towards interprofessional learning (using the UWE-IP-D Interprofessional Learning Scale), the interprofessional learning setting, the teaching approach, and their competency acquisition (each on a five-point Likert scale; 1 = strongly agree, 5 = strongly disagree). Furthermore, we assessed participants' qualitative feedback in free-text fields and performed inductive content analyses. RESULTS: The study participation rate was high (response rate 97%; medical students: n = 75; healthcare students: n = 22). Participants stated high levels of competency acquisition (total M = 1.59, individual items' M's ranging from 1.20 to 2.05) and even higher satisfaction with the teaching approach (total M = 1.28, individual items' M's ranging from 1.43 to 1.05). Overall satisfaction with the training was M = 1.22; SD = 0.58. No significant differences in ratings were found between the student groups. The qualitative results showed that students appreciated the interprofessional setting and experienced it as enriching. The most positive feedback was found in didactics/teaching methods on role-plays and group work; most suggestions for improvement were found in the area of structure and organisation on breaks and time management. CONCLUSIONS: Opening up an existing medical tutor qualification program to other student groups can be seen as fruitful to teach not only tutor-related aspects but also interprofessional competencies. The results demonstrate the importance of detailed planning that considers group composition and contextual conditions and provides interactive teaching methods to promote interprofessional experiences. This study offers important information about prerequisites and methodological implementation that could be important for the interprofessional redesign of existing training programs.

Attitudes towards interprofessional collaboration in young healthcare professionals.

Successful interprofessional (IP) collaboration has great potential to improve healthcare delivery. The aim of this study was to evaluate and compare the attitudes towards IP collaboration in young health professionals who had not been exposed to IP learning activities. About one year after graduation from their vocational training, 387 graduates from various healthcare professions [Nurses (nursing and pediatric nursing), Therapists (physical therapy, speech and language therapy), Diagnostic professionals (biomedical science and radiography)], were invited to participate in an online survey. In total, data from 129 graduates were considered for data analyses. The University of Western England Interprofessional Questionnaire was administered to self-assess graduates individual attitude towards IP collaboration and learning using four scales. All health professional groups showed an overall positive attitude in communication and teamwork as well as in IP relationships and expressed a neutral attitude in IP learning and IP interactions. There were no significant differences in the overall scores between the health professional groups. In total, the three health professional groups showed similar attitudes towards IP collaboration and learning, despite their different scope of work. Results may help to design IP learning activities and this may contribute to better communication with and to know more about each other.

[Pathology of the corneal endothelium in bullous keratopathy following iris clip lens implants]. / Pathologie des Hornhaut-Endothels bei der bullösen Keratopathie nach Iris-Cliplinsen-Implantation.

12 patients developed pseudophakic bullous keratopathy 2 to 7 years following i.c. cataract-extraction with implantation of 4-loop iris clip lenses necessitating perforating keratoplasty. To study the pathogenesis of pseudophakic bullous keratopathy the corneal endothelium of the excised button was investigated light-microscopically after vital staining of the endothelium. Additionally the surface of the explanted intraocular lenses were examined by the method of Wolter. The result is a central cell density of the excised corneal buttons between 179 and 867 cells/mm2. Large cell-free areas were always found indicating that a disturbance of the endothelial barrier function is the major reason for corneal decompensation. A relation between inflammatory cell deposits on the IOL-surfaces and the endothelial decompensation was not apparent. As the main reason for endothelial decompensation a chronical mechanically induced endothelial cell loss is supposed leading to disturbances of the endothelial barrier function. To prevent a repeated corneal decompensation it is recommended to remove iris-clip-lenses during the procedure of perforating keratoplasty.

[Cytology of the corneal endothelium in endothelial dystrophy]. / Zytologie des Hornhautendothels bei Endotheldystrophien.

The corneal endothelium of 17 corneal buttons with endothelial dystrophy was investigated by means of vital staining and light microscopy. Each type of dystrophy was characterized by typical morphological changes in the endothelium: in Fuch's endothelial dystrophy (n = 13), subendothelial guttata formation is characteristic; in congenital hereditary endothelial dystrophy (n = 2), a high amount of multinucleated endothelial cells was found; in posterior polymorphous dystrophy (n = 2), a multilayered endothelium was the striking feature. There is a coherent endothelial cell layer in endothelial dystrophy that may indicate a disturbance in the endothelial pump function rather than a barrier defect caused by gaps between the endothelial cells.