Prevalence and characteristics of test anxiety in first year anatomy students.

BACKGROUND: Test anxiety is a common phenomenon at universities with the potential to impair academic performance and student well-being. This study was conducted to investigate prevalence, characteristics, and development of the test anxiety categories "emotionality", "worry", "interference", and "lack of confidence" among first year medical students. METHODS: Overall, 625 freshman medical students were enrolled. They were recruited from the participants of a first semester anatomy course. The participants were assessed four times with a validated psychological test anxiety questionnaire (Prüfungsangstfragebogen, PAF). The first assessment was conducted at the commencement of the first semester. All further assessments were performed two days prior to each of three mandatory oral anatomy tests in the course of one half year. Prevalence rates as well as mean global and subscale scores of the test anxiety dimensions "emotionality", "worry", "interference" and "lack of confidence" were determined and compared between assessments. RESULTS: Approximately 50% of the study participants showed pronounced test anxiety in at least one dimension over the observation period. Only about 10% were considered test anxiety-positive according to the global PAF scale. Worry showed the highest (up to 48%) and interference the lowest (≈5%) prevalence rates. Emotionality had a stable prevalence of approximately 17%, whereas lack of confidence showed a rising trend over the observation period from 15.2% up to 24.0%. CONCLUSION: Test anxiety is substantially more prevalent among medical students as commonly reported and deserves more detailed, dimension-specific exploration in future. Especially worry and lack of confidence give reason for concern, demanding further investigation.

Feasibility of Clinical Hypnosis for Test Anxiety in First-Year Medical Students.

The purpose of this pilot study was to characterize test anxiety among first-year medical students at the University of Erlangen-Nürnberg and to test clinical hypnosis as a possible intervention. The "Prüfungsangstfragebogen," a shortened and revised German version of the Test Anxiety Inventory, was used to estimate test anxiety. It was administered 3 times: at the commencement of winter term 2017/18 and 2 days prior to each of 2 mandatory oral anatomy exams. The test-anxiety categories emotionality, worry, interference, and lack of confidence were evaluated. The effect of clinical hypnosis on test anxiety was estimated. The global test anxiety and lack of confidence scores were reduced significantly over time in the group that underwent clinical hypnosis but not in the control group. Direct comparisons of hypnosis vs. control group yielded no statistically significant differences in the test anxiety scores.

Leveraging medical imaging for medical education - A cinematic rendering-featured lecture.

BACKGROUND: The integration of medical imaging into anatomical education offers advantages in understanding and learning. However, spatial orientation with conventional (2D) imaging data is challenging, and the students' ability to imagine structures in three dimensions is individual. In addition, the quality of current volume rendering methods is limited. OBJECTIVE: We tested Cinematic Rendering (CR), a novel visualization technique that provides photorealistic volume rendering, in the setting of an interactive anatomy lecture with first-year undergraduate medical and dental students. Our goal was to estimate the acceptance and positive effects CR adds to the subjects. METHODS: A total of 120 students were surveyed with specifically designed self-assessment questionnaires on the use of CR as a tool in anatomical education. RESULTS: Of 120 participating students (87 medical and 33 dental) a large majority of 95.9% (Q3) experienced CR as helpful to understand anatomy better. Overall a large majority of the students experienced CR as helpful for learning and understanding, 85% saw an improvement in anatomical education through the integration of CR (Q3-6) and could also imagine using CR as a self-study tool on an electronic device. CONCLUSION: Our undergraduate medical and dental students experienced CR as a beneficial tool for anatomical education in the chosen setting (lecture) and see further opportunities for the sensible use of this technique. Future research on the topic should include other application possibilities as well.

Obligation, capacity, skills and stamina - Development of a site-adapted competence profile for medical students in Germany.

In order to get admission to study medicine at a German university, the most important criterion is the proof of an excellent final college prep school examination (Abitur) in order to get an adequate study place without time loss. For the purpose of a suitable selection for admission of candidates, however, the best qualified and suitable applicants should be found to be distributed to the limited available university places for medicine. The final examination mark alone can represent such a suitability - if at all - only to a very limited extent. In order to figure out which skills and competences characterize a potential medical student and after studies a well-practicing and resilient later physician, we sought for initial steps to apply competence profiling as a predictor matching suitable prerequisites to a subsequent successful outcome. In order to meet these demands, we founded a project called ComMedMent at the Friedrich Alexander University of Erlangen-Nürnberg (FAU), where we defined competences for successfully becoming a medical expert while studying the medical curriculum. Here we present a comprehensive catalogue of 16 standards and meaningful key competencies for potentially successful medical students at the FAU. In collaboration with the Center for Competence Balancing - CeKom SÜD - (Pforzheim; Germany) and a local competence team comprising institute management, lecturers and students of different educational backgrounds, a target profile for the "ideally equipped students and later successful practitioners" was established. The identification of a site-specific and/or general requirement profile for medical students could open up new perspectives for the selection process and show the opportunities for helping students along the path to becoming medical experts.

Integration of the musculature in the course "functional anatomy of the locomotor system"-Preparing medical students for the dissection course.

PURPOSE: To enhance the efficacy of the preclinical first-year course for medical and dental students 'functional anatomy of the locomotor system' (demo course) which serves as a preparation for the dissection course at the Friedrich-Alexander University of Erlangen-Nürnberg, Germany. METHODS: The muscular system was integrated into the curriculum of the demo course. Moreover, the number of tutors was increased from around 5 to 15 for approximately 120 students. A detailed course agenda, which had been lacking hitherto, was developed for each course day. Extensive preparation and briefing of course tutors was introduced. Self-prepared questionnaires were applied to compare student attitudes towards the demo course before and after the restructuring process. Surveys were conducted at the end of the unchanged demo course, at the end of the dissection course in the following term (same students) and at the end of the restructured demo course. RESULTS: The mark given for overall course quality improved from 3 ("satisfactory") to 2 ("good"). The students felt significantly better prepared for the dissection course after the restructuring process, although they perceived the work load as more challenging in relation to the limited time available. They assessed the new course as better structured and stated that the muscular system had been important for the functional comprehension of the locomotor system. CONCLUSIONS: According to student opinion, the attempt to improve the demo course quality by providing a detailed course agenda and enhanced tutelage had been successful. As expected, the musculature is critical to functional understanding of the locomotor system.

Teaching to Relax: Development of a Program to Potentiate Stress-Results of a Feasibility Study with Medical Undergraduate Students.

Medical students are a population at risk for the development of stress-related risk states (e.g. burnout) and manifest mental disorders (e.g. depression). Still the learning of coping mechanisms against stress is not an integral part of the medical curriculum. In a pilot study we developed an elective course for learning relaxation techniques (Relacs) which was geared to the clinical practice of autogenic training (AT) with psychiatric patients. The course focussed on an innovative and mostly communicative transfer of knowledge about AT, progressive muscle relaxation and medical hypnosis and stressed the principle of repeated and supervised exercises in small student groups alongside self-administered exercise. 42 students took part in this course and showed a very high acceptance for the topic and positive evaluation. Moreover, we found a distinct improvement of the participants' mental parameters (burnout, anxiety) and a good knowledge about the course's contents within the final exams at the end of the semester. The structure and realisation of the course is easily adaptable and very effective regarding the improvement of the students' mental health. Due to our results and the commonly known prevalence of stress-related disorders in medical students we postulate the integration of courses on relaxation strategies in the medical curriculum.

[Development and correlation of work-related behavior and experience patterns, burnout and quality of life in medical students from their freshmanship to the first state examination]. / Entwicklung und Zusammenhang von Arbeitsverhalten, Burnout-Beschwerden und Lebensqualität bei Studierenden der Humanmedizin vom Studienstart bis zum ersten Staatsexamen.

Symptoms of burnout are common among medical students. Although they usually start with a good health status, their condition deteriorates over the course of their studies. In our study ESTRELLAS we examined 530 medical students in the preclinical semesters with validated psychological questionnaires. The longer the students were studying, the more showed risky working habits. Cognitive and emotional burnout symptoms increased coincidentally in their intensity, whereas the mental quality of life continuously deteriorated. Medical students' cognitive and emotional burnout symptoms are constantly increasing from the beginning of their studies. Contemporaneously, the mental quality of life is deteriorating. This might be based on a drastic change towards risky working habits. We suggest to actively work against this process to keep our motivated students and prospective physicians productive and in good mental health.

Strategies against burnout and anxiety in medical education--implementation and evaluation of a new course on relaxation techniques (Relacs) for medical students.

Burnout and stress-related mental disorders (depression, anxiety) occur in medical students and physicians with a significantly higher prevalence than in the general population. At the same time, the learning of coping mechanisms against stress is still not an integral part of medical education. In this pilot study we developed an elective course for learning relaxation techniques and examined the condition of the students before and after the course. 42 students participated in the semester courses in 2012 and 2013 as well as in a survey at the start and end of each course. The students were instructed in autogenic training (AT) and progressive muscle relaxation according to Jacobsen (PMR) with the goal of independent and regular exercising. At the beginning and the end of the semester/course the students were interviewed using standardized, validated questionnaires on burnout (BOSS-II) and anxiety (STAI-G), depression (BDI), quality of life (SF-12) and sense of coherence (SOC-L9). We compared the results of our students participating in Relacs with results from eight semester medical students (n = 88), assessed with the same questionnaires at similar points of time within their semester. Participating students showed a significant decline in cognitive and emotional burnout stress and in trait anxiety. Furthermore, they showed a reduction in state anxiety and a conspicuous decrease in mean depression. The sense of coherence increased at the same time. A comparative cohort of medical students of 8th semester students, showed lower values for the specified measurement parameters at the beginning, but showed no progressive changes. Our course introducing AT and PMR led to a significant reduction of burnout and anxiety within the participating group of medical students. Even the course attendance for just one semester resulted in significant improvements in the evaluated parameters in contrast to those students who did not attend the course.

[From freshmanship to the first "Staatsexamen"--increase of depression and decline in sense of coherence and mental quality of life in advanced medical students]. / Vom Studienstart bis zum ersten Staatsexamen--Zunahme von Depressivität bei gleichzeitigem Verlust des Kohärenzgefühls und der psychischen Lebensqualität in höheren Semestern Humanmedizin.

Psychiatric disorders (Burnout, depression, anxiety disorders) are common among medical students with a distinctly higher prevalence compared to the general public. Although medi-cal students show a normal health status at the beginning of their university study period, a deterioration of these aspects in higher semesters is evident and continues when they become residents. In our study ESTRELLAS we examined 530 medical students in the preclinical semesters (1st-4th) before their first "Staatsexamen" with validated psychological questionnaires for depression, anxiety, quality of life and sense of coherence. Students in their 1st semester show normal values like the general public. During the 4 semesters a slow and continuous rise of depressive symptoms and anxiety was detected. Quality of life and sense of coherence constantly deteriorated. An increase of physical symptoms was not detected. In the 4th semester the number of depressive students had already doubled. The development of worsening psychological problems and resulting psychiatric disorders seems to be a continuous process, starting with the beginning of the medical studies and growing continuously during the preclinical semesters. Effect-ive strategies for coping with distress should be integrated in the medical curriculum at universities from the very first semester on. Relaxation techniques could thus be an opportunity.