[Multimodal selection of medical students: The predictive power of individual process components in the two-stage selection process at Witten/Herdecke University (UW/H)]. / Multimodale Auswahl von Medizinstudierenden: Vorhersagekraft einzelner Verfahrensbestandteile im zweistufigen Auswahlverfahren an der Universität Witten/Herdecke (UW/H).

OBJECTIVE: According to the legislator's ideas, the selection of medical students in Germany should no longer be based on the Abitur grade alone. This approach has already been implemented in the two-stage selection process at Witten/Herdecke University (UW/H) using several criteria. On the one hand, the present study aims to determine the prognostic value of the procedural components for the overall performance on the selection day. On the other hand, the different strategies of the applicants in processing the written task (phase 1) will be examined with regard to their application success. METHODOLOGY: Data on applications for the summer semester 2020 (N = 819 phase 1; N = 233 phase 2) were available retrospectively. A stepwise regression analysis was conducted to determine the predictive power of each procedural component. Using a summary content analysis, the four essays from the applicants' motivation letters were structured and categories were identified, and an extreme group comparison (Group 1: Not invited; Group 2: University acceptance; N = 60 essays) was conducted. RESULTS: As the stepwise regression analysis shows, the individual biographical interview emerged as the strongest predictor in terms of overall performance, followed by lecture, group interview, and multiple mini interviews. Content analysis extracted content and scaling categories for the individual essays, as well as an additional meta-category (Impression Management, IM). Successful applicants demonstrated, among other things, better judgment skills, more sophisticated reasoning skills, and an internalized role model as a physician. In addition, they used defensive IM strategies, e.g., subjectification and self-deprecation, more frequently. CONCLUSION: Biographical interview is considered the strongest predictor of overall performance. The dimensions of impression management, reasoning quality and judgment proved to be reliable predictors of successful performance in the selection process. In addition, role image as a physician and professional commitment had a favorable effect on the selection decision.

[How important is an academic career in medicine today? A survey among medical students in Germany: Results of study arm XIII of the KARiMED study]. / Wie wichtig ist heute noch eine akademische Karriere in der Medizin? Eine Befragung von Medizinstudierenden in Deutschland: Ergebnisse des Studienarms XIII der KARiMED-Studie.

OBJECTIVE: Academic careers still play a significant role in medicine. Although the doctorate remains interesting for many students, there are no data available from medical students, for example, with regard to the interest in habilitation. In parallel, a good work-life/family balance is a key career element for young medical professionals. The aim was to obtain an up-to-date opinion on the academic career of medical students. METHODOLOGY: Using an online survey, medical students of all semesters in Germany were questioned on the topics of academic career, mentoring, and work-life balance from October 2017 to December 2018. For this purpose, the medical students were invited by e-mail to participate and answer an anonymized online questionnaire. RESULTS: A total of 1,775 participants from all 38 German medical faculties (68.3% female; age 23.3 ±â€¯4.0 years) were included. Almost half of the participants could envision working in a branch office after graduation. While a professional career appeared important to a clear majority (70.8%), leisure time was rated as even more important (84.3%), and work-life balance clearly prioritized personal life (41.2%) over career (9.6%). Acquiring a title was rated as important to one's career by 53.6%. However, while the acquisition of a doctorate was still an option for 88.0% of the respondents, the situation is significantly different for academic titles following a successful habilitation. Although the significance of a habilitation is rated as high to very high (66.1%), the titles of assistant professor ("yes": 13.0%), associate professor (6.0%) or university professor (7.0%) are much less likely to be considered by medical students and are therefore rated as "maybe" and "no". Nevertheless, almost 60% wished for better information and advice in their future field of work. CONCLUSION: Careers in medicine are undergoing a transformation where better compatibility of leisure/family and work is no longer the sole focus. On the contrary, work-life blending is sought, as a connection between work and life. Changes are therefore necessary for professional and especially academic careers in order to make working in science and research attractive again.

Bad things can happen: are medical students aware of patient centered care and safety?

OBJECTIVES: Quality and safety in healthcare are of the utmost importance, but little is known about whether undergraduate students are aware of patient safety concepts. The objectives of our study were to assess the perception of medical students of challenges in patient safety, and collect their perceptions of error management and prevention. METHODS: This study used an exploratory mixed method strategy. The first study phase collected data from semi-structured interviews of 28 students. Based on this, an online survey was constructed and sent to about 80,000 medical students in Germany. 1053 replies were received and analyzed for responses based on gender, curriculum type (problem based [PBC] vs. science based curriculum [SBC]) and years of training. RESULTS: Most students understand the importance of patient safety, error avoidance, and the challenges of patient safety interventions. Four themes were identified: (a) the culture of patient safety (what is a good doctor? Doctors' responsibility), (b) the working environment (the inevitability of mistakes, high work load, hierarchy, competition, teamwork), (c) the challenges of risk reduction (error avoidance, management, skills), and (d) materialistic issue (income vs. humanistic values). Female students were more risk aware than male students. Sixteen percent of students expect negative effects (e.g. punishment) when medical errors were disclosed in a team. Regardless, >70% regard teamwork as an effective error avoidance measure. Error disclosure willingness was high (89.7%). CONCLUSIONS: Although not formally part of the curriculum, students had a positive perspective concerning patient safety. The opportunities and challenges for incorporating patient safety content into the training curriculum were identified and presented.

Designing Categories for a Mixed-Method Research on Competence Development and Professional Identity through Collegial Advice in Nursing Education in Germany.

BACKGROUND: The aim of nursing education in Germany is the development of different competences, including professional identity. To promote this, the use of collegial consultation in the form of collegial advice is recommended. How collegial advice affects the development of competences and professional identity, and which didactic and organizational framework conditions are favorable for this have not yet been conclusively clarified. OBJECTIVES: The aim of the study is to determine how collegial consultation affects the development of competence and professional identity of student nurses. Enabling and hindering factors for the success of collegial advice will be identified. Design/ Participants: A mixed-methods study with 25 student nurses who completed training in collegial advice and then regularly engaged in collegial advice for one year. METHODS: A content analysis from four focus group interviews using a category system developed for this purpose. RESULTS: This article reports the development of the category system necessary for the content analysis with examples. The resulting categories are presented. CONCLUSIONS: The category system has high objectivity, reliability, and validity. It contains links to competence and identity research in the care sector. A suitable instrument has been developed for further evaluation of the focus group interviews.

Clothes Make the Man-What Impact Does the Dress of Interprofessional Teams Have on Patients?

Physicians' attire seems to play an important role in the success of patient treatment. The classic doctor's white coat initiates a strong signal to the patient and can have a determining effect on a successful doctor-patient relationship. In a quantitative online questionnaire study comprising 52 questions, participants were shown four photos of an interprofessional German family medicine team in varying attire. One important study feature relating to the ongoing coronavirus pandemic was that the team was portrayed wearing FFP2 masks in one photo. We measured core values regarding the team's perception in terms of sympathy, competence, trust, choosing the practice as a personal health care provider, and wanting to participate in the team. The questionnaire was posted online between March and May 2021. It was accessed 1435 times and 906 sheets were qualified for statistical analysis. For the first time in this field of research, a practice team's attire was investigated. We found a significant influence of different clothing on the perception of sympathy, competence, trust, elective practice, and team participation. Wearing an FFP2 mask promotes feelings of security and competence. The study shows that in times of fast social changes due to rapid digitalization and an ongoing pandemic, we should present ourselves in different ways as a medical team depending on the patient groups we are targeting and the feelings we want to evoke.

Millennials Medical Students Generation at the Crosswalks: Motivations and Attitudes Towards Study and Future Career - A Mixed-Method Study.

Background and Objectives: The aim of this study was to investigate in the millennium medical student generation the influence of the curriculum (problem-based curriculum [PBC] vs science-based curriculum [SBC]), gender and semester level on medical students' motives to study medicine, their attitudes toward their career and in this regard their view about their study condition in university. Methods: Semi-structured qualitative interviews with 28 medical students were performed and analyzed using Mayring's content analysis. Based on these results, a quantitative questionnaire for a nationwide survey was developed using a mixed-method-approach and send to most medical faculties in Germany. Data from n=1053 students entered statistical analysis. Results: Humanistic ideals prevailed in the choice to enter medical school and to become a physician. PBC students were found to be significantly (p<0.001) more idealistic and patient oriented, and they regard their curriculum more competitive than SBC-students (p<0.001). A balanced work and family life is essential for all students but particularly important for the PBC - group, male and undergraduate students. The majority of students wanted to work with patients and omitted patient-distant line of work. Undergraduate SBC-students saw their studies as old-fashioned citing lack of patient contact (p<0.001 compared to PBC), which eased in the graduate study part. Conclusion: This study found major differences in student's perceptions depending on curriculum type. PBC-students were more idealistic, and humanistic ideals prevailed in comparison to SBC. For both, close patient contact is essential in their training. Particularly for female students, lifestyle factors and a balanced work-life-integration outweigh career ambitiousness. This study offers an important insight to policy makers and educators to understand the motivation and perceptions of the millennial student generation regarding their studies and future career plans, which should be considered in educational policies.

Mental Stress in Medical Students during the Pandemic and Their Relation to Digital and Hybrid Semester-Cross-Sectional Data from Three Recruitment Waves in Germany.

BACKGROUND: Because of the COVID-19 pandemic, students had to interrupt their regular studies, and universities changed their teaching formats. The aim of this study was to analyze medical students' stress perception, wellbeing, life and work satisfaction, and cool down reactions, and to compare the survey data of online and hybrid semesters with pre-pandemic education formats in-person. METHODS: Cross-sectional surveys at three time points enrolling 1061 medical students (58% women; 24.4 ± 3.4 years); 30.8% from pre-pandemic formats in-person, 22.8% from pandemic online semesters, and 46.1% from pandemic hybrid semesters. RESULTS: Both students' stress perception and psychological wellbeing decreased during the pandemic semesters. Their satisfaction with the university support was at its lowest during the hybrid semesters. Regression analyses indicated that students' stress perception can be explained only to some extent by their general dissatisfaction with their medical studies or teaching formats. CONCLUSIONS: The lockdowns affected students in more ways than simply their teaching formats. Students require individual support to adjust to difficult situations, and particularly medical students in their preclinical phase compared to students in their clinical phases. These are challenges for the medical education system, which must find ways to be prepared for future times of crisis and insecurity.

Germany-wide evaluation of residency in neurological intensive care medicine.

BACKGROUND: Neurointensive medicine is an important subspecialization of neurology. Its growing importance can be attributed to factors such as demographic change and the establishment of new therapeutic options. Part of the neurological residency in Germany is a six-month rotation on an intensive care unit (ICU), which has not yet been evaluated nationwide. The aim of this study was to evaluate kind and feasibility of neurointensive care training in Germany and to discover particularly successful training concepts. METHODS: In a preliminary study, ten residents and ten instructors were interviewed. Using content analysis, two questionnaires were created, which contained questions about specific teaching methods as well as individual satisfaction. The questionnaires were sent to 187 neurological clinics in Germany, and residents and instructors were asked to participate in the study. The data analysis was performed using SPSS and content analysis for the free-text data. RESULTS: Seventy of the 187 clinics contacted did not offer ICU-rotation. At 59,8% (n = 70) of the remaining hospitals, a total of 154 participants (84 residents, 70 educators) could be recruited. General satisfaction with the neurointensive medical training is high in both groups (residents: 3.34 ± 0.54; instructors: 3.79 ± 0.41, evaluated on the basis of a Likert scale from 1 = "not satisfied" to 5 = "fully satisfied"). Specific teaching methods (e.g. simulation trainings, feedback sessions) are perceived as very useful by residents, but rarely take place. Instructors are interested in educational opportunities such as didactic courses. CONCLUSION: This study provides an overview of the ICU-rotation as part of the five-year neurological residency. Neurointensive care rotations usually take place at maximum care hospitals and last at least seven months. Despite frequent time and personnel restrictions, motivation of trainers and residents is high. Nevertheless, teaching methods as simulation training and educational opportunities for instructors must be expanded.

Medical Students' Perceptions towards Digitization and Artificial Intelligence: A Mixed-Methods Study.

Digital technologies in health care, including artificial intelligence (AI) and robotics, constantly increase. The aim of this study was to explore attitudes of 2020 medical students' generation towards various aspects of eHealth technologies with the focus on AI using an exploratory sequential mixed-method analysis. Data from semi-structured interviews with 28 students from five medical faculties were used to construct an online survey send to about 80,000 medical students in Germany. Most students expressed positive attitudes towards digital applications in medicine. Students with a problem-based curriculum (PBC) in contrast to those with a science-based curriculum (SBC) and male undergraduate students think that AI solutions result in better diagnosis than those from physicians (p < 0.001). Male undergraduate students had the most positive view of AI (p < 0.002). Around 38% of the students felt ill-prepared and could not answer AI-related questions because digitization in medicine and AI are not a formal part of the medical curriculum. AI rating regarding the usefulness in diagnostics differed significantly between groups. Higher emphasis in medical curriculum of digital solutions in patient care is postulated.

[How does a patient-centered, future-oriented medical curriculum look like? The patients' view]. / Wie sieht ein patientenzentriertes, zukunftsgerichtetes Curriculum im Humanmedizinstudium aus? Die Sicht der Patient*innen.

AIM OF THE STUDY: Medical training in Germany is in a state of flux. Medical education must be adapted to fit the changing health care needs of future societies. This study aims to gain the patients' perspective on the education of medical students to improve future curricula. METHODOLOGY: Using a semi-structured interview guide, 17 interviews were conducted with patients undergoing inpatient (N=9) or outpatient (N=8) medical treatment. The interviews were subjected to computer-assisted analysis guided by Grounded Theory. RESULTS: 480 codings were condensed into seven main categories: Science Fiction Medicine, Society and the Patient, Professional Environment and Health Care System, Medical Curriculum and Continuing Education, Value System and Motivation, Psychosocial Competence and Medical Professional Competence. The largest main categories are Psychosocial Competence (114 codings) and Professional Environment and Health Care System (105 codings). CONCLUSION: There is a need for psychosocial education in addition to medical knowledge. A future-focused curriculum should entail practice-oriented education to ensure the training of motivated physicians who possess strengthened digital skills and act on ethical principles and values. Assessment of the patients' perspective should play a crucial role in medical education research.

The prognostic validity of the formative for the summative MEQ (Modified Essay Questions).

Objective: The purpose of formative examinations is that students and lecturers receive an early feedback regarding the success of learning behavior and teaching methods. These also serve as practice for later summative exams. The aim of this paper is to investigate to what extent the result of the formative MEQ* at the end of the first semester at Witten/Herdecke University (UW/H) in the study program human medicine can be used as a predictor for the summative MEQ-1 at the end of the second semester which is part of the equivalence examination replacing the state examination. Methodology: The predictive value of the score achieved in the MEQ* on the MEQ-1 score, as well as the potential influence of the variables gender, age, high school graduation grade (German Abiturnote), professional background, and self-efficacy expectancy, was determined for students of human medicine. Results: Data from two cohorts of UW/H with a total of 88 students were included. Scores on the formative MEQ* correlate with those on the summative MEQ-1 in both cohorts. In regression analyses, only the score on the MEQ* proves to be a significant predictor of performance on the MEQ-1 (40.5% variance explanation). Particularly significant predictors are the scores in the subjects anatomy and clinical reasoning. Vocational training or pre-study only appear to contribute to higher scores in the MEQ* after the first semester, but have no further significance in predicting scores in the MEQ-1. Conclusion: The MEQ* was confirmed to be a good predictor of the MEQ-1. Thus, it serves as a formative exam to inform students about their current state of knowledge with regard to the summative exam MEQ-1, so that they can adequately adapt their learning strategies in the course of the second semester.

[Child and Career, but When? Mixed Methods Research on Starting a Family During Student Years vs. after Graduation from Medical School]. / Kind und Karriere, aber wann? ­ Mixed Methods Research zum Thema Medizinstudium als alternativer Zeitpunkt für die Familiengründung.

BACKGROUND: More and more women are studying medicine these days. They often face a conflict between having children and pursuing a career. Thus, a challenging question arises for a new generation of young doctors: How can children and career be reconciled? Also, the right time to start a family plays an important role. At the University Witten/Herdecke, students with and without children were asked to what extent their time when they were students of medicine proved to be a convenient time to start a family. METHODS: A questionnaire survey was carried out in which a total of 423 medical students took part. A further 12 medical students with children were also interviewed about their situation using a guided interview. Results were evaluated using a qualitative content analysis. RESULTS: Medical students with children saw that there were advantages in terms of family and career to starting a family during their studies, but noted the disadvantages in terms of studies and the financial situation. The majority of medical students without children were undecided about the ideal time to start a family, but only 18% considered the student years to be the ideal time for this. Among medical students with children, on the other hand, 50% considered the student years as the ideal time to start a family and only five percent perceived the time after their studies as ideal. CONCLUSION: In order to facilitate combining children and career across the entire career path as a medical doctor, political and university policy concepts should be developed that take into consideration financial relief and flexible study organization.

Selection procedure human medicine and psychology at the University of Witten/Herdecke: adaptation to the virtual zoom room.

Introduction: For the selection of students for the winter semester 2020/21, the established selection procedure of the University of Witten/Herdecke (UW/H) was adapted to the virtual space in view of the current contact ban and recommended keeping of distance. The three stations in the second step of the procedure, the biographical one-on-one interview, presentation and discussion on a subject-specific topic as well as multiple mini interviews (MMI) on the social skills of the applicants were audiovisual and in real time in zoom meetings. Project description: The medical, psychological and student reviewers were prepared for the virtual selection procedure in training sessions. Three weeks before the selection days, the applicants received information on the technical requirements for the interviews and on data protection for the persons affected by the collection of personal data. The evaluation of the virtual selection procedure was carried out by the reviewers using an online questionnaire with 8 socio-demographic, 5 organizational, 8 content and 3 open questions. Results: The 108 reviewers conducted selection interviews in tandems (medical/psychological and student reviewers) with 178 applicants for human medicine and 105 applicants for psychology. The online evaluation by 58 reviewers (response rate 53.7%) showed a positive agreement with the virtual selection procedure, with a more favorable assessment of organization and content by the medical and psychological reviewers compared to the student reviewers. Discussion: The adequate adaptation of the selection procedure of the UW/H to the virtual zoom room as well as its acceptance are confirmed by the successful execution of the selection days for the students for the winter semester 2020/21 and the evaluation of the reviewers. Conclusion: The results and analysis of this exceptional situation will be used to also conduct the upcoming selection procedure for the summer semester 2021 in the virtual space. A valid assessment for the future use of a virtual selection procedure as a possible supplement to the personal selection interviews at the University of Witten/Herdecke remains to be made.

Spontaneously retrievable knowledge of German general practitioners depending on time since graduation, measured with the progress test medicine.

Background: General practitioners and general internists occupy a key position in German and Austrian healthcare systems. They provide primary care and act as gatekeepers between medical disciplines and sectors of care. Their explicit medical knowledge levels, however, can be quite disparate. Objective: This study analyses whether general practitioners' performances on a standardised knowledge test changes with four relevant socio-demographic variables. Design: The survey was based on the Progress Test Medicine (PTM), a standardised 200 item knowledge test on graduate level. After formal blueprinting and item analysis, 60 items of PTM were selected ("PTM-GP") for our study. Participants: PTM-GP was presented ad hoc to general practitioners and internists from Germany and Austria at a number of professional meetings in 2011. 161 volunteers completed the survey. Main measures: For evaluation, correlation analysis (Spearman), Kruskal Wallis-tests for non-parametric data and an analysis of covariance (ANCOVA) were calculated. Results: Overall, four indicators turned out to be slightly significant for the performance on the PTM-GP, namely: time passed since graduation, the grade received in the licensing examination, the type of institution for postgraduate training, and the medical specialisation. Conclusions: Recent graduates performed better in the PTM-GP; a doctor's licensing examination grade as well as training at a university hospital correlated positively with PTM-GP performance. A general doctor's knowledge level is moderately influenced by exam grades, time since graduation, the institutional affiliation of postgraduate training and medical specialisation. Individual changes in knowledge over time have to be deliberately considered in lifelong learning. In consequence, the on-going teaching of medical knowledge should be integrated mandatory and verifiable into general doctors' everyday practices, e.g. through repetitive knowledge tests with individual feedback and recommendations for further continuing medical education (CME).

Comparison of the evaluation of formative assessment at two medical faculties with different conditions of undergraduate training, assessment and feedback.

Introduction: Both formative and summative assessments have their place in medical curricula: formative assessment to accompany the learning process and summative assessment to ensure that minimum standards are achieved. Depending on the conditions of undergraduate training, assessment and feedback, students place more or less importance on formative assessment, and thus the fulfilment of its function may be questionable. This study describes how the low-stakes formative Berlin Progress Test (BPT) is embedded at two medical faculties with partially different framework conditions and what effects these have on the students' testing efforts and the evaluation of the test, especially the perception of its benefits and (intangible) costs, such as non-participation in contemporaneous activities and emotional impairments. Methods: In this study, the proportion of non-serious BPT participants at two medical faculties (total sample: NF1=1,410, NF2=1,176) in winter term 2015/16 was determined both by the number of unanswered questions on the test itself and in a survey using a standardized instrument (NF1=415, NF2=234). Furthermore, open questions were asked in this survey about perceived benefits and perceived costs, which were analyzed with qualitative and quantitative methods. Results: The BPT is generally better accepted at Faculty 2. This can be seen in the higher proportion of serious test takers, the lower perceived costs and the higher reported benefit, as well as the higher proportion of constructive comments. Faculty 2 students better understood the principle of formative testing and used the results of the BPT as feedback on their own knowledge progress, motivation to learn and reduction of exam fear. Discussion: When medical faculties integrate formative assessments into the curriculum, they have to provide a framework in which these assessments are perceived as an important part of the curriculum. Otherwise, it is questionable whether they can fulfil their function of accompanying the learning process.

Institutional strategies related to test-taking behavior in low stakes assessment.

Low stakes assessment without grading the performance of students in educational systems has received increasing attention in recent years. It is used in formative assessments to guide the learning process as well as in large-scales assessments to monitor educational programs. Yet, such assessments suffer from high variation in students' test-taking effort. We aimed to identify institutional strategies related to serious test-taking behavior in low stakes assessment to provide medical schools with practical recommendations on how test-taking effort might be increased. First, we identified strategies that were already used by medical schools to increase the serious test-taking behavior on the low stakes Berlin Progress Test (BPT). Strategies which could be assigned to self-determination theory of Ryan and Deci were chosen for analysis. We conducted the study at nine medical schools in Germany and Austria with a total of 108,140 observations in an established low stakes assessment. A generalized linear-mixed effects model was used to assess the association between institutional strategies and the odds that students will take the BPT seriously. Overall, two institutional strategies were found to be positively related to more serious test-taking behavior: discussing low test performance with the mentor and consequences for not participating. Giving choice was negatively related to more serious test-taking behavior. At medical schools that presented the BPT as evaluation, this effect was larger in comparison to medical schools that presented the BPT as assessment.

Media Use Among Students From Different Health Curricula: Survey Study.

BACKGROUND: Mobile devices such as smartphones, tablets, and laptop computers enable users to search for information and communicate with others at any place and any time. Such devices are increasingly being used at universities for teaching and learning. The use of mobile devices by students depends, among others, on the individual media literacy level and the curricular framework. OBJECTIVE: The objective of this study was to explore whether there were differences in media use in students from various curricula at the Faculty of Health, Witten/Herdecke University. METHODS: During the 2015-16 winter term, a survey was conducted at the Faculty of Health, Witten/Herdecke University, in which a total of 705 students (out of 1091 students; response rate: 705/1091, 64.61%) from 4 schools participated voluntarily: medicine (346/598), dentistry (171/204), psychology (142/243), and nursing science (46/46). The questionnaire developed for the study included 132 questions on 4 topics: (1) electronic and mobile devices (19 questions), (2) communication and organization of learning (45 questions), (3) apps/programs/websites/media (34 questions), and (4) media literacy (34 questions). The questionnaire was distributed and anonymously completed during in-class courses. RESULTS: Students from all 4 schools had at least two electronic devices, with smartphones (97.4%, 687/705) and laptops (94.8%, 669/705) being the most common ones. Students agreed that electronic devices enabled them to effectively structure the learning process (mean 3.16, SD 0.62) and shared the opinion that university teaching should include imparting media literacy (mean 2.84, SD 0.84). Electronic device ownership was the highest among medical students (mean 2.68, SD 0.86) and medical students were the only ones to use a tutorial (36.1%, 125/346). Dental students most widely used text messages (mean 3.41, SD 0.49) and social media (mean 2.57, SD 1.10) to organize learning. Psychology students considered mobile devices to be most ineffective (mean 2.81, SD 0.83). Nursing science students used emails (mean 3.47, SD 0.73) and desktop computers (39%, 18/46) most widely. CONCLUSIONS: The results show that almost all students use electronic learning (e-learning) tools. At the same time, different profiles for different degree programs become apparent, which are to be attributed to not only the varying curricula and courses but also to the life circumstances of different age groups. Universities should, therefore, pay attention to the diverse user patterns and media literacy levels of students when planning courses to enable successful use of e-learning methods.

Qualitative Studies on Implicit Criteria during the Individualized Selection Procedure for Medical Studies at Witten/Herdecke University (UW/H).

Objective: The individualized two-stage selection procedure for medical studies at Witten/Herdecke University (UW/H) has been in use for more than 30 years and comprises explicit and implicit selection criteria. This analysis aims at identifying the implicit criteria and answering the question whether an internal consistency of these implicit criteria may be verified for the different phases of the selection procedure (when evaluating the statements of purpose, during the selection weekend and during the concluding discussions of assessors). Methodology: Three qualitative studies on all phases of the selection procedure at UW/H have been conducted for determining the implicit assessment criteria of assessors: statements of purpose in extreme group comparison (12 admissions versus 18 rejections); semi-structured expert interviews (N=25) on the selection weekend; focus group analysis of the concluding discussions on two selection weekends (N=16). Results: The content analysis of the statements of purpose yielded 14 main categories with significant deviations between extreme groups in the categories school career, reasons for application and reflections as well as regarding the higher education entrance qualification grade. Based on the expert interviews, three main categories could be identified: intellectual ability, motivation and social competence, and the ability to reflect as a cross-content category. The focus group analysis yielded four main categories: performance, personality, personal growth potential and ability to reflect. Most frequently, the ability to reflect was mentioned as an assessment criterion. Conclusion: The main assessment categories are: motivation for the medical profession and starting studies at UW/H; performance and scholastic aptitude; personality, personal growth potential and social competence, as well as the ability to reflect as the most important basic competence and general category. Assessors consider the ability to reflect as a predictor of lifelong professional development as a physician.

Enhancing medical students' reflectivity in mentoring groups for professional development - a qualitative analysis.

BACKGROUND: Professional competence is important in delivering high quality patient care, and it can be enhanced by reflection and reflective discourse e.g. in mentoring groups. However, students are often reluctant though to engage in this discourse. A group mentoring program involving all preclinical students as well as faculty members and co-mentoring clinical students was initiated at Witten-Herdecke University. This study explores both the attitudes of those students towards such a program and factors that might hinder or enhance how students engage in reflective discourse. METHODS: A qualitative design was applied using semi-structured focus group interviews with preclinical students and semi-structured individual interviews with mentors and co-mentors. The interview data were analyzed using thematic content analysis. RESULTS: Students' attitudes towards reflective discourse on professional challenges were diverse. Some students valued the new program and named positive outcomes regarding several features of professional development. Enriching experiences were described. Others expressed aversive attitudes. Three reasons for these were given: unclear goals and benefits, interpersonal problems within the groups hindering development and intrapersonal issues such as insecurity and traditional views of medical education. Participants mentioned several program setup factors that could enhance how students engage in such groups: explaining the program thoroughly, setting expectations and integrating the reflective discourse in a meaningful way into the curriculum, obliging participation without coercion, developing a sense of security, trust and interest in each other within the groups, randomizing group composition and facilitating group moderators as positive peer and faculty role models and as learning group members. CONCLUSIONS: A well-designed and empathetic setup of group mentoring programs can help raise openness towards engaging in meaningful reflective discourse. Reflection on and communication of professional challenges can, in turn, improve professional development, which is essential for high quality patient care.

Development and validation of a computer-based situational judgement test to assess medical students' communication skills in the field of shared decision making.

OBJECTIVE: To develop a computer-based test (CBT) measuring medical students' communication skills in the field of shared decision making (SDM) and to evaluate its construct validity. METHODS: The CBT was developed in the context of an experimental study comparing three different trainings for SDM (including e-learning and/or role-play) and a control group. Assessment included a CBT (Part A: seven context-poor questions, Part B: 15 context-rich questions) and interviews with two simulated patients (SP-assessment). Cronbach's α was used to test the internal consistency. Correlations between CBT and SP-assessment were used to further evaluate construct validity of the CBT. RESULTS: Seventy-two students took part in the study. Mean value for the CBT score was 72% of the total score. Cronbach's α was 0.582. After eliminating three items, Cronbach's α increased to 0.625. Correlations between the CBT and SP-assessment were low to moderate. The control group scored significantly lower than the training settings (p<0.001). CONCLUSION: The CBT was reliable enough to test for group differences. For summative assessment purposes, considerably more questions would be needed. PRACTICE IMPLICATIONS: We encourage teachers who particularly work with large student numbers to consider CBT as a feasible assessment method for cognitive aspects of communication skills.