[Implementation of a Laparoscopic Simulation Training in Undergraduate Medical Education - The Lübeck Toolbox-Curriculum]. / Implementierung eines laparoskopischen Simulationstrainings in der studentischen Lehre ­ das Lübecker Toolbox-Curriculum.

BACKGROUND: Simulation-based training has become increasingly relevant in minimally invasive surgery (MIS). It is unclear whether or not the established Lübeck Toolbox (LTB) Curriculum for the acquisition of basic MIS skills can be implemented to supplement standard undergraduate education in surgery and how it would be accepted. MATERIALS UND METHODS: Since 04/2015, students at the medical school of the University of Lübeck have had the option to complete the highly standardized and validated LTB Curriculum. It consists of six subsequent tasks with pre-defined learning goals. Video tutorials allow for a self-educating approach. The individual training progress is documented continuously as scheduled by the curriculum. The program was evaluated in a standardized manner using an established online platform for the evaluation of university courses at the University of Lübeck. RESULTS: Between 04/2015 and 07/2016, 63 students completed the LTB Curriculum. The general interest in a surgical specialty rose from an average of 1.61 (SD 0.78) before to 1.12 after the curriculum. The numbers of required repetitions for the training tasks 1 - 6 were median 24 (6 - 79), 23 (5 - 61), 7 (5 - 33), 15 (5 - 59), 16 (5 - 50), and 18 (7 - 48), respectively. None of the 63 students terminated the curriculum prematurely. On average, 4.35 (SD 1.58) hours per week were spent training with an overall duration of 4.1 (SD 1.2) weeks required to go through the LTB Curriculum. Evaluation results showed an overall rating of 1.0 (SD 0.17). The average learning progress, didactics and structure of the curriculum were rated as 1.0 (SD 0.24), 1.14 (SD 0.36), and 1.0 (SD 0.24), respectively. The relevance for the following study years and the future professional activity was reported to be 1.2 (SD 0.45) on average. CONCLUSION: As an addition to the regular undergraduate program, the Lübeck Toolbox Curriculum was well accepted by many students. Evaluation showed exceedingly positive results. Furthermore, the data suggest that the LTB Curriculum may increase the interest in a surgical specialty among medical students. This aspect seems to be relevant in times where surgeons should make every effort to recruit young doctors for surgical residency.

Perceived Medical School stress of undergraduate medical students predicts academic performance: an observational study.

BACKGROUND: Medical students are exposed to high amounts of stress. Stress and poor academic performance can become part of a vicious circle. In order to counteract this circularity, it seems important to better understand the relationship between stress and performance during medical education. The most widespread stress questionnaire designed for use in Medical School is the "Perceived Medical School Stress Instrument" (PMSS). It addresses a wide range of stressors, including workload, competition, social isolation and financial worries. Our aim was to examine the relation between the perceived Medical School stress of undergraduate medical students and academic performance. METHODS: We measured Medical School stress using the PMSS at two different time points (at the end of freshman year and at the end of sophomore year) and matched stress scores together with age and gender to the first medical examination (M1) grade of the students (n = 456). RESULTS: PMSS scores from 2 and 14 months before M1 proved to be significant predictors for medical students' M1 grade. Age and gender also predict academic performance, making older female students with high stress scores a potential risk group for entering the vicious circle of stress and poor academic performance. CONCLUSIONS: PMSS sum scores 2 and 14 months before the M1 exam seem to have an independent predictive validity for medical students' M1 grade. More research is needed to identify potential confounders.

Are the results of questionnaires measuring non-cognitive characteristics during the selection procedure for medical school application biased by social desirability?

Introduction: A stronger consideration of non-cognitive characteristics in Medical School application procedures is desirable. Psychometric tests could be used as an economic supplement to face-to-face interviews which are frequently conducted during university internal procedures for Medical School applications (AdH, Auswahlverfahren der Hochschulen). This study investigates whether the results of psychometric questionnaires measuring non-cognitive characteristics such as personality traits, empathy, and resilience towards stress are vulnerable to distortions of social desirability when used in the context of selection procedures at Medical Schools. Methods: This study took place during the AdH of Lübeck University in August 2015. The following questionnaires have been included: NEO-FFI, SPF, and AVEM. In a 2x1 between-subject experiment we compared the answers from an alleged application condition and a control condition. In the alleged application condition we told applicants that these questionnaires were part of the application procedure. In the control condition applicants were informed about the study prior to completing the questionnaires. Results: All included questionnaires showed differences which can be regarded as social-desirability effects. These differences did not affect the entire scales but, rather, single subscales. Conclusion: These results challenge the informative value of these questionnaires when used for Medical School application procedures. Future studies may investigate the extent to which the differences influence the actual selection of applicants and what implications can be drawn from them for the use of psychometric questionnaires as part of study-place allocation procedures at Medical Schools.