IntroductionThe present study aims to evaluate the role of sense of coherence and self-efficacy in relation to mental health and well-being, with and without social restrictions due to the COVID-19 pandemic. Additionally, this study seeks to investigate the differences in sense of coherence, self-efficacy, mental health and well-being depending on the manner in which the pandemic is being handled.MethodsA total of 27,162 students at Heidelberg University were surveyed via email at two measurement points, once with and once without social restrictions. The survey assessed sense of coherence, self-efficacy, mental health and well-being. To this end, the questionnaires Sense of Coherence Scale, Patient Health Questionnaire, WHO-Well-being-Index and the General Self-Efficacy Scale were employed. A total of 2,398 individuals participated in the initial measurement, while 701 individuals participated in the subsequent measurement.ResultsThe lifting of social restrictions has been associated with a notable improvement in well-being and mental health, particularly in the context of depressive syndromes. Further analysis demonstrated a positive correlation between the sense of coherence and self-efficacy at both measurement points, as well as between these two constructs and mental health and well-being. Furthermore, the sense of coherence and self-efficacy were found to account for a notable proportion of the observed variability in mental health and well-being values. Self-efficacy exhibited a significantly higher mean value at the initial measurement time point compared to the subsequent time point. In contrast, no significant difference was observed in the sense of coherence between the two measurement points.DiscussionThe findings presented here illustrate the significance of social interaction, sense of coherence and self-efficacy for mental health and well-being.

INTRODUCTION:Radiographic diagnostic competences are a primary focus of dental education. This study assessed two feedback methods to enhance learning outcomes and explored the feasibility of artificial intelligence (AI) to support education. MATERIALS AND METHODS:Fourth-year dental students had access to 16 virtual radiological example cases for 8 weeks. They were randomly assigned to either elaborated feedback (eF) or knowledge of results feedback (KOR) based on expert consensus. Students´ diagnostic competences were tested on bitewing/periapical radiographs for detection of caries, apical periodontitis, accuracy for all radiological findings and image quality. We additionally assessed the accuracy of an AI system (dentalXrai Pro 3.0), where applicable. Data were analysed descriptively and using ROC analysis (accuracy, sensitivity, specificity, AUC). Groups were compared with Welch's t-test. RESULTS:Among 55 students, the eF group by large performed significantly better than the KOR group in detecting enamel caries (accuracy 0.840 ± 0.041, p = .196; sensitivity 0.638 ± 0.204, p = .037; specificity 0.859 ± 0.050, p = .410; ROC AUC 0.748 ± 0.094, p = .020), apical periodontitis (accuracy 0.813 ± 0.095, p = .011; sensitivity 0.476 ± 0.230, p = .003; specificity 0.914 ± 0.108, p = .292; ROC AUC 0.695 ± 0.123, p = .001) and in assessing the image quality of periapical images (p = .031). No significant differences were observed for the other outcomes. The AI showed almost perfect diagnostic performance (enamel caries: accuracy 0.964, sensitivity 0.857, specificity 0.074; dentin caries: accuracy 0.988, sensitivity 0.941, specificity 1.0; overall: accuracy 0.976, sensitivity 0.958, specificity 0.983). CONCLUSION:Elaborated feedback can improve student's radiographic diagnostic competences, particularly in detecting enamel caries and apical periodontitis. Using an AI may constitute an alternative to expert labelling of radiographs.

Doctors’ interactional competencies play a crucial role in patient satisfaction, well-being, and compliance. Accordingly, it is in medical schools’ interest to select candidates with strong interactional abilities. While Multiple Mini Interviews (MMIs) provide a useful context to assess such abilities, the evaluation of candidate performance during MMIs is not always based on a solid theoretical framework. The newly developed selection procedure “Interactional Competencies – Medical Doctors (IC-MD)” uses an MMI circuit with five simulation patient scenarios and is rated based on the theoretically and empirically grounded construct of emotional availability. A first validation study with N = 70 first-semester medical students took place in 2021. In terms of convergent validity, IC-MD ratings showed strong correlations with simulation patients’ satisfaction with the encounter (r =.57) but no association with emotional intelligence measures. IC-MD ratings were not related to high school performance or a cognitive student aptitude test, indicating divergent validity. Inter-rater reliability (ICC = 0.63) and generalizability (Eρ2 = 0.64) were satisfactory. The IC-MD proved to be fair regarding participants’ age and gender. Participants with prior work experience in healthcare outperformed those without such experience. Participant acceptance of the procedure were good. The IC-MD is a promising selection procedure capable of assessing interactional competencies relevant to the medical setting. Measures of interactional competencies can complement the use of cognitive selection criteria in medical student admission. The predictive validity of the IC-MD needs to be addressed in future studies.

Objective:This position paper of the Committee on Methodology in Educational Research sets out the criteria for the acceptance, revision, or rejection of manuscripts of the article types project report and how to in the GMS Journal for Medical Education, as well as outlining the development of these criteria. Methods:In a workshop with writers, reviewers, and editors, we formulated and discussed common core elements for articles. We did this by consulting the journal's editorial board on the basis of guidelines for authors and reviewers from other journals and by using examples of articles considered less or more successful. From this, we derived specific aspects to be addressed and rejection criteria for the respective article types. Results:We have identified the target group, relevance, justification, and implication as the common core elements for both article types. We have also derived specific aspects to be addressed and rejection criteria from these core elements for each article type. Conclusion:A manuscript lacking core elements will be rejected. If aspects are not described sufficiently or are not clearly comprehensible, the manuscript must be revised.

The aim of this study was to reduce discrepancies between students and instructors in a preclinical dental course by employing structured peer feedback based on a detailed evaluation sheet. In a crossover study of dental students (n = 32), which compared peer feedback using an evaluation sheet (test) with the traditional method (control), participants completed tasks involving cavity and partial crown preparation. The practical tasks were scored numerically on a scale ranging from one (excellent) to six (failure). The amount of feedback provided by the instructor was also recorded. Statistical analysis was conducted using Wilcoxon signed-rank tests (p < 0.05). Regarding cavity preparation, no statistically significant difference was observed (median (25th–75th percentile)) between the grades received by the test (2.00 (1.50–3.00)) and control groups (2.25 (2.00–3.00)). However, the grades pertaining to partial crown preparation exhibited a statistically significant difference between the test (2.25 (2.00–2.50)) and control (2.50 (2.00–3.00)) groups. LimeSurvey and five-finger feedback were used to assess satisfaction with the new method, revealing that most students found the evaluation sheet and peer feedback to be effective. Within the limitations of this study, structured peer feedback using the evaluation sheet positively impacted grades pertaining to partial crown preparation, requiring less instructor feedback.

IntroductionInterprofessional training wards (IPTW) aim to improve undergraduates' interprofessional collaborative practice of care. Little is known about the effects of the different team tasks on IPTW as measured by external assessment. In Heidelberg, Germany, four nursing and four medical undergraduates (= one cohort) care for up to six patients undergoing general surgery during a four-week placement. They learn both professionally and interprofessionally, working largely on their own responsibility under the supervision of the medical and nursing learning facilitators. Interprofessional ward rounds are a central component of developing individual competencies and team performance. The aim of this study was to evaluate individual competencies and team performance shown in ward rounds.MethodsObservations took place in four cohorts of four nursing and four medical undergraduates each. Undergraduates in one cohort were divided into two teams, which rotated in morning and afternoon shifts. Team 1 was on morning shift during the first (t0) and third (t1) weeks of the IPTW placement, and Team 2 was on morning shift during the second (t0) and fourth (t1) weeks. Within each team, a tandem of one nursing and one medical undergraduate cared for a patient room with three patients. Ward round observations took place with each team and tandem at t0 and t1 using the IP-VITA instrument for individual competencies (16 items) and team performance (11 items). Four hypotheses were formulated for statistical testing with linear mixed models and correlations.ResultsA total of 16 nursing and medical undergraduates each were included. There were significant changes in mean values between t0 and t1 in individual competencies (Hypothesis 1). They were statistically significant for all three sum scores: “Roles and Responsibilities”, Patient-Centeredness”, and “Leadership”. In terms of team performance (Hypothesis 2), there was a statistically significant change in mean values in the sum score “Roles and Responsibilities” and positive trends in the sum scores “Patient-Centeredness” and “Decision-Making/Collaborative Clinical Reasoning”. Analysis of differences in the development of individual competencies in the groups of nursing and medical undergraduates (Hypothesis 3) showed more significant differences in the mean values of the two groups in t0 than in t1. There were significant correlations between individual competencies and team performance at both t0 and t1 (Hypothesis 4).DiscussionThe study has limitations due to the small sample and some sources of bias related to the external assessment by means of observation. Nevertheless, this study offers insights into interprofessional tasks on the IPTW from an external assessment. Results from quantitative and qualitative analysis of learners self-assessment are confirmed in terms of roles and responsibilities and patient-centeredness. It has been observed that medical undergraduates acquired and applied skills in collaborative clinic reasoning and decision-making, whereas nursing undergraduates acquired leadership skills. Within the study sample, only a small group of tandems remained constant over time. In team performance, the group of constant tandems tended to perform better than the group of random tandems. The aim of IPTW should be to prepare healthcare team members for the challenge of changing teams. Therefore, implications for IPTW implementation could be to develop learning support approaches that allow medical and nursing undergraduates to bring interprofessional competencies to team performance, independent of the tandem partner or team.

Zusammenfassung Hintergrund Mehr als 60 Jahre nach dem Erlass der ersten Approbationsordnung für Zahnärzte (ZÄPrO) trat im Jahr 2020 eine neue Approbationsordnung für Zahnärzte und Zahnärztinnen (ZApprO) in Kraft. Ziele dieser Untersuchung waren die Evaluation und ein Vergleich der auf den unterschiedlichen gesetzlichen Grundlagen basierenden Lehrveranstaltungen „Kurs der Technischen Propädeutik“ (TPK) und „Zahnmedizinische Propädeutik mit Schwerpunkt Dentale Technologie“ (ZPDT). Methoden Nach Abschluss der Veranstaltungen wurden folgende Parameter untersucht: (1.) theoretisches und praktisches Wissen, (2.) reguläre fachbereichsinterne Evaluation durch die Lernenden, (3.) spezielle Evaluation der Lernbedingungen aus Sicht der Lernenden und (4.) aus Sicht der Lehrenden. Die theoretischen und praktischen Prüfungen und die Fragebögen wurden hinsichtlich ihrer teststatistischen Kenngrößen (Schwierigkeit, Trennschärfe, interne Konsistenz) analysiert. Gruppenvergleiche zwischen TPK und ZPDT erfolgten durch t‑Tests für unabhängige Gruppen. Ergebnisse Lediglich bei der Evaluation zur Erfassung der speziellen Lernbedingungen aus Sicht der Lernenden konnten signifikante Unterschiede festgestellt werden, wobei die theoretische und praktische Wissensvermittlung im TPK niedriger als im ZPDT bewertet wurde. Diskussion Die vergleichbaren Ergebnisse der Wissensüberprüfungen und der regulären Evaluation, trianguliert mit der umfangreichen Evaluation durch Lernende und Lehrende, ermöglichten eine umfassende Beurteilung beider Veranstaltungen. Die ermittelten signifikanten Unterschiede eröffnen Möglichkeiten zur Optimierung des neu implementierten ZPDT-Kurses.

Introduction:In a quasi-naturalistic study design, we evaluate the change in psychopathological syndromes and general well-being after the alleviation of social restrictions. The aim of this study was to investigate the specific relationship between social isolation and depressive syndromes.Methods:At two timepoints, the first during maximal social restrictions, the second after social restrictions had widely ended for 9 months, depressive and other syndromes were measured in an online survey addressing the total cohort of students registered at Heidelberg University, Germany via e-mail (n = 27,162). The complete Patient Health Questionnaire (PHQ) was used with nine items for depressive syndromes. In addition, well-being was measured by the Well-Being Index WHO-5. In the quantitative and qualitative part of the study psychopathological syndromes and well-being were related to social isolation and feelings of loneliness.Results:After 1.5 years of pandemic-related social restrictions, "major" depressive syndromes were reported by 40.16% of the respondents to the PHQ in a sample of 2,318 university students. 72.52% showed a severely reduced Well-Being-Index. Nine months after the end of social restrictions, "major" depressive syndromes were reported by 28.50% of the participants. Well-being improved after the alleviation of social restrictions, as well: 53.96% showed a Well-Being Index of below 50 vs. 72.52% in the first study. The quantitative and qualitative analysis of the free texts of the respondents suggest that a significant amount of depressive syndromes and reduced well-being are related to social isolation and loneliness. While in the times of the pandemic restrictions the participants mostly reported "loneliness and social isolation" (24.2%) as their main problem, only 7.7% described these as their main problem after social restrictions had been loosened for 9 months. The qualitative analysis hints that at t2 participants were more likely to mention possible ways to actively deal with loneliness than at t1, which might be interpreted along the lines of the decrease in depressive syndromes.Discussion:Keeping the self-selection bias in mind our study results suggest that one third of "major" depressive syndromes and one quarter of severely reduced well-being accompany social restrictions or are even caused by them, with loneliness being an important factor. These results should be taken into account by health policies when coping with future pandemics.

Abstract Background:Oral health-related quality of life (OHRQoL) is recognized as a significant aspect of health outcomes. The Oral Health Impact Profile (OHIP-14) and the Psychosocial Impact Dental Aesthetics Questionnaire (PIDAQ) are valid instruments that capture different facets of OHRQoL. The OHIP-14 focuseson the effects of oral disorders, whereas the PIDAQ emphasizes the impacts of dental aesthetics on quality of life. The intention of this study was to adapt the OHIP-14 and PIDAQ in a Greek cultural context and to investigate their psychometric properties in all age groups of adults. Methods:The original English OHIP-14 and PIDAQ questionnaires were translated into Greek, cross-culturally adapted according to the forward-backward technique, pretested, and applied to a validation sample of 280 participants aged 18-79 in dental practice. In total, 59 participants in thevalidation set underwent the procedure after 12 weeks. Internal consistency and reproducibility established reliability. Content, construct, and convergent validity were supported. The questionnaires were also contrasted with sociodemographic variables (age, gender, education, residence). Discussion:Cronbach´s alpha was 0.94 for the OHIP-14-Gr and 0.95 for the PIDAQ-Gr. Correcteditem-total correlation coefficients ranged from 0.45 to 0.81 for the OHIP-14-Gr and from 0.53 to 0.82 for the PIDAQ-Gr. Average interitemcorrelation coefficients were 0.52 (OHIP-14-Gr) and 0.48 (PIDAQ-Gr). Interclass correlation coefficient(ICC) was 0.73 for theOHIP-14-Gr and 0.86 for the PIDAQ-Gr. Factor analysis with target rotation confirmed the four-dimensional factor structure of the PIDAQ-Gr. Item factor loadings varied between 0.38 and 1.09. Pearson`s correlation coefficients between the subscales and the total scores of the OHIP-14-Gr and PIDAQ-Gr ranged from 0.29 to 0.67,resulting in highly significant correlations for the total scores and subscales of the Greek questionnaires (p < 0.001). The results attribute good to excellent psychometric properties to the Greek versionsof the PIDAQ and OHIP-14. They indicate reliable and valid tools for the standardized assessment of the psychosocial impact of oral disorders and dental aesthetics among adults. The present study extends the use of these questionnaires to includethe important target group of young adults.

Young people and women seem to suffer more from social restrictions due to the COVID-19 pandemic than do others. Findings from pre-pandemic surveys identified students as a specific risk group for developing anxiety and depressive symptoms. Recent studies have indicated that students especially denoted a decrease in mental health during the pandemic. In a sample of n = 1938 university students (67.6% female), we investigated protective factors that are associated with mental health (defined as the absence of any mental disorder) and more specifically, the absence of major depression during the pandemic despite social restrictions. Investigated protective factors were social support, sense of coherence and situational coping strategies. The results of the multiple logistic regression analyses revealed that male gender, high sense of coherence and specific coping strategies could be identified to be associated with mental health in general and the absence of major depression. Protective coping strategies that were related to mental health in general were lower substance use, lower behavioral disengagement, higher positive reframing and lower self-blame. Protective coping strategies that were associated with the absence of major depression specifically were higher use of instrumental support, lower substance use, lower behavioral disengagement, higher positive reframing, higher emotional support, lower self-blame and lower humor. Social support was related to the absence of major depression, but not to mental health in general. Higher age in university students was associated with better mental health, but not with the absence of major depression specifically. These findings indicate that sense of coherence and situational coping strategies can buffer the adverse effect of social restrictions on mental health and thus, can serve as important resilience factors. Moreover, they highlight the political relevance of promoting specific coping strategies to foster mental health in students encompassing adverse events and social restrictions.

Introduction: Examinations are a central element of the medical curriculum: they contribute significantly to the quality assurance of medical training and subsequent medical care. In order to meet the high expectations placed on examinations in terms of content, legal and organizational aspects, continuous quality assurance measures are necessary. The aim of this paper was to record and analyze the quality assurance measures implemented at the medical faculty of Heidelberg. Methods: We investigated quality indicators that are relevant to medical examinations - adequate choice of examination formats, blueprint/validity, reliability and distribution of grades, feedback to students, consequences of examinations - within the faculty examinations in the decentrally organized Heidelberg Curriculum Medicinale (HeiCuMed). In addition, the organizational structures in examination management were examined. For this purpose, interviews were conducted with teaching staff, students and the technical examination administration. Results: The surveys show that the quality indicators in HeiCuMed have already been met in many areas. Optimization work remains to be done concerning the criteria "adequate choice of examination formats'', "feedback to students'' as well as the documentation of the examination process and the definition of substitution regulations. Discussion: Training courses, statistical analysis and accompanying research are essential for establishing additional innovative, practice-oriented examination formats. In order to improve feedback to students, formative assessments should be more intensively integrated into the curriculum. As a measure for structured quality-oriented examination management, it is also helpful to document the examination procedure and the staff assigned to it using templates. Conclusion: Especially with decentralized examination management, the internal coordination of individual departments is of great importance in order to guarantee the quality of examinations. Regular surveys of the parties involved can be of support by collecting best-practice examples and deliver the respective information in handouts encouraging interdisciplinary exchange.

Background: During the COVID-19 pandemic, a decrease in well-being and an increase in mental health problems were registered in medical and psychotherapeutic practices, counseling centers, and clinics. According to previous studies, younger people and women seemed to be particularly affected. The aim of this study was to describe mental health problems of students and to draw consequences for the further handling of pandemics and other crises. Method: Students at the University of Heidelberg, a typical German “full university,” were surveyed online using internationally comparable screening instruments like the Well-Being Index (WHO-5) and the Patient Health Questionnaire (PHQ). In addition, the students had the opportunity to describe in a narrative form their well-being and to make suggestions how to improve their situation. Results: Out of a population of 27,162 students who were contacted by email, 2,137 students completed the questionnaire. The salient finding is that according to the WHO-5 Well-Being Index, 72.2% of the respondents feel seriously impaired in their well-being. This corresponds to the finding that 75.8% of the respondents in the PHQ-D show indications of at least one syndrome diagnosis. Depression was found in 41.8% of the respondents in the PHQ-D. Indications of moderate to severe and severe depressive syndromes were present in 31.8%. Signs of somatoform syndromes are found in 25.4% and of anxiety syndromes in 20.0%. 1,089 students gave narrative reports on how they were feeling and made suggestions for improvement. About 75% reported severely reduced well-being. Their main complaints were loneliness and depression and lack of recognition for their specific academic and life situation during the pandemic. By far, the largest proportion of students supposed that their mental health issues were caused and/or intensified by the pandemic-related social contact restrictions. The vast majority of them made reasonable suggestions for controlled relaxation of contact restrictions. Conclusions: Students suffer severely from the pandemic-related social restriction. In respect to future pandemic outbreaks or other crises leading to social isolation, the dramatic consequences of social lockdowns should be taken into account. Under pandemic conditions, we especially should support persons lacking social networks.

IntroductionExaminations are a central element of the medical curriculum: they contribute significantly to the quality assurance of medical training and subsequent medical care. In order to meet the high expectations placed on examinations in terms of content, legal and organizational aspects, continuous quality assurance measures are necessary. The aim of this paper was to record and analyze the quality assurance measures implemented at the medical faculty of Heidelberg.MethodsWe investigated quality indicators that are relevant to medical examinations – adequate choice of examination formats, blueprint/validity, reliability and distribution of grades, feedback to students, consequences of examinations – within the faculty examinations in the decentrally organized Heidelberg Curriculum Medicinale (HeiCuMed). In addition, the organizational structures in examination management were examined. For this purpose, interviews were conducted with teaching staff, students and the technical examination administration.ResultsThe surveys show that the quality indicators in HeiCuMed have already been met in many areas. Optimization work remains to be done concerning the criteria “adequate choice of examination formats”, “feedback to students” as well as the documentation of the examination process and the definition of substitution regulations.DiscussionTraining courses, statistical analysis and accompanying research are essential for establishing additional innovative, practice-oriented examination formats. In order to improve feedback to students, formative assessments should be more intensively integrated into the curriculum. As a measure for structured quality-oriented examination management, it is also helpful to document the examination procedure and the staff assigned to it using templates.ConclusionEspecially with decentralized examination management, the internal coordination of individual departments is of great importance in order to guarantee the quality of examinations. Regular surveys of the parties involved can be of support by collecting best-practice examples and deliver the respective information in handouts encouraging interdisciplinary exchange.

Background The purpose of this pilot study was to create a valid and reliable set of assessment questions for examining Evidence-based Dentistry (EbD) knowledge. For this reason, we adapted and validated for dental students the Berlin Questionnaire (BQ), which assesses Evidence-based Medicine (EbM) abilities. Methods The Berlin Questionnaire was validated with medical residents. We adapted it for use in a dentistry setting. An expert panel reviewed the adapted BQ for content validity. A cross-sectional cohort representing four training levels (EbD-novice dental students, EbD-trained dental students, dentists, and EbM−/EbD-expert faculty) completed the questionnaire. A total of 140 participants comprised the validation set. Internal reliability, item difficulty and item discrimination were assessed. Construct validity was assessed by comparing the mean total scores of students to faculty and comparing proportions of students and faculty who passed each item. Results Among the 133 participants (52 EbD-novice dental students, 53 EbD-trained dental students, 12 dentists, and 16 EbM-/ EbD-expert faculty), a statistically significant ( p < 0.001) difference was evident in the total score corresponding to the training level. The total score reliability and psychometric properties of items modified for discipline-specific content were acceptable. Cronbach’s alpha was 0.648. Conclusion The adapted Berlin Questionnaire is a reliable and valid instrument to assess competence in Evidence-based Dentistry in dental students. Future research will focus on refining the instrument further.

Background: Due to the corona pandemic, we conducted the Heidelberg module of the Master of Medical Education (MME) study program, which focuses on teaching and assessment of communicative and interpofessional skills, digitally for the first time. Method: We outsourced the teaching to a pre-module phase in the weeks upfront. During the module week, the lecturers picked up again and deepened the topics and the participants created, revised and simulated a virtual OSCE course. Results/Conclusion: Evaluation and reflection of the module showed that the digital implementation including an OSCE examination can be an appropriate alternative to a classroom-based training. However, important elements of the MME program that provide networking possibilities and personal exchange can only be replicated in the digital environment to a limited extent. In the future, sensibly applied digital components can be used to enrich the study program.

Eine kompetenzorientierte und praxisnahe Ausbildung von Medizinstudierenden setzt — entsprechend dem Constructive-Alignment-Modell — praxisnahe Prüfungen voraus. Die Medizinstudierenden der Universität Freiburg schließen einen mehrstufigen Kurs zur Vermittlung von Basistechniken zur körperlichen Untersuchung mit der „Famulaturreifeprüfung“, einer sog. Performanzprüfung, ab. Dabei müssen sie in einem von sechs möglichen, zufällig zugelosten Prüfungsmodul ihre Fertigkeit zur körperlichen Untersuchung unter Beweis stellen. Es soll betrachtet werden, ob diese Vorgehensweise im Hinblick auf die Reliabilität der Prüfung vertretbar ist. Die Prüfungsergebnisse der 73 Studierenden, die im Sommersemester 2018 diese Famulaturreifeprüfung ablegten, wurden nach einer deskriptiven Auswertung einer Mixed-Model-Vari-anzanalyse sowie einer Berechnung der Reliabilität unterzogen. Es fanden sich keine Unterschiede in der Schwierigkeit der sechs Module, auch ließ sich kein Einfluss des Faktors Prüfer/in auf die Ergebnisse nachweisen. Die errechnete Reliabilität für die Prüfung in einem Modul lag bei 0,509, einem in der Literatur als „angemessen“ beschriebenen Wert. Prüfungen müssen einerseits definierten Testgütekriterien genügen, andererseits müssen sie vom personellen, organisatorischen und finanziellen Aufwand her durchführbar sein. Beide Kriterien werden von der „Freiburger Famulaturreifeprüfung“ erfüllt.

Background Peer-assisted learning is well established in medical education; however, peer tutors rarely act as assessors for the OSCE. In the compulsory, near-peer teaching programme covering basic medical skills at the University of Heidelberg, peer tutors serve as assessors on a formative OSCE. This study aimed to investigate the feasibility and acceptance of peer assessors and to survey the perceived advantages and disadvantages of their use. Methods In 2016 and 2017 all OSCE peer assessors (third to sixth-year medical students) and all of the peer-assessed students in 2017 (second-year-medical students) were invited to participate in a survey. Both groups were asked to complete a tablet-based questionnaire immediately after the OSCE. Peer assessors were asked to rate eight statements and the peer-assessed students to rate seven statements on a five-point Likert scale. Both were asked to comment on the advantages and disadvantages of peer-assessors. Results Overall, 74 of 76 peer assessors and 307 of 308 peer-assessed students participated in the study. 94% (67/74) of peer assessors and 90% (276/307) of the peer-assessed group thought that it is important to have peer tutors as assessors. Of the peer assessors, 92% (68/74) felt confident in giving structured feedback during the OSCE and 66% (49/74) felt they had improved their teaching skills. Of the peer-assessed students, 99% (306/307) were satisfied with their peers as OSCE assessors and 96% (292/307) considered the peer feedback during the OSCE as helpful. The participants mentioned structural benefits, such as lower costs, and suggested the quality of the OSCE was higher due to the use of peer assessors. The use of peer assessors was found to be beneficial for the learners in the form of high-quality feedback and an overall reduction in stress. Furthermore, the use of peer assessors was found to be beneficial for the peer assessors (improved teaching and clinical skills). Conclusion From a learner’s perspective, the use of peer assessors for a formative OSCE that is part of a near-peer teaching program aimed at junior medical students is favourable for all. A broad implementation of peer assessment in the formative OSCE should be encouraged to investigate effects on quality and stress-reduction.

Background: Objective Structured Clinical Examinations (OSCEs) have become an established examination format at German medical faculties. Medical experts routinely use a summative assessment to evaluate practical and communicative skills, while the use of the OSCE format by student examiners, as a formative examination, remains rather limited. Objective: The formative OSCE program of the Department of General Practice and Implementation Research at the Heidelberg Medical Faculty, which is conducted and evaluated by peer tutors, is examined with regard to its quality criteria and compared with summative OSCEs from other departments. Methods: Difficulties and discriminatory power of individual testing stations were determined for the summative, as well as the formative OSCE, and compared with each other. To assess the reliability of the measurements, an analysis of the data was carried out using the Generalizability theory. In addition, a comparison is made between the assessments of student examiners and second assessments by medical experts. Results: The stations of the formative OSCE show similar difficulties as those of the summative comparison OSCEs (Pform=0.882; Psum=0.845 - 0.902). With respect to measurement reliability, there are no differences between the OSCE in General Medicine and the other subjects. The assessments of student examiners and medical experts correlate highly (r=0.888). Conclusion: The formative OSCE in General Medicine is comparable to the summative comparison formats in terms of its quality criteria. The use of student examiners can be a reliable alternative to medical experts in formative OSCEs.

Background: Since 2013 a competency-oriented student progress test (SKPT) has been administered at a number of German medical schools. The questions are generated on the basis of a two-dimensional blueprint, on which one axis contains the five competency domains - communicative competence (CO), practical clinical competence (CP), theoretical clinical competence (CT), scientific competence (SC), and professional decision-making competence (PR) - that form part of the competency model of the National Competency-based Catalogue of Learning Objectives for Undergraduate Medicine (NKLM). The feedback for students is structured in part according to these domains. The aim of our study is to examine if 1. the results differentiated by competency domain show adequate measurement accuracy and 2. if the results for the different domains also contain different information. Methods: The SKPTs for the years 2013 to 2017, taken by a total of 3,027 students, were examined. The measurement accuracy was determined using the coefficient glb (greatest bound to reliability) and the standard error of measurement; discriminant analysis of the principal components was carried out to demonstrate differentiation between the competency domains. Results: The reliability of the competency domains was above 0.8 for all SKPTs; exceptions to this were seen in two of the tests for CO and PR that had a reliability of 0.7-0.8. The results for all of the individual competency domains differed in their informational content compared to the overall of the other domains; the same applies for all pairwise comparisons, with the exceptions of CP and CT. Discussion: The SKPT feedback for students that is differentiated by competency domains basically fulfills the requirements for measurement reliability and distinctness. An improvement of the measurement quality for CO and PR and a better differentiation between CP and CT is desirable.

OBJECTIVES:Reliable pediatric pharmacotherapy in all age groups requires the availability of age-appropriate drug administration. Orodispersible films (ODF) are a promising pediatric oral dosage form. ODFs would meet relevant targets: one dosage form matching the full range of pediatric patients, a minimum of non-toxic excipients, a stable drug formulation easily to be produced. However, there is a lack of reliable data on ODFs' acceptability, swallowability and palatability, especially in young children. The primary objective was to demonstrate non-inferiority in acceptability of a drug-free ODF in comparison to glucose syrup in children aged below one year. Secondary objectives were swallowability and palatability of the two formulations. STUDY DESIGN:The study was performed in an open, randomized, two-way cross-over design with three age groups: 2-28 days, 29 days-5 months, 6-12 months. 150 children (N = 50 per age group) were randomized to the order of receiving the ODF (2 × 3 cm) and age-adapted amounts of glucose syrup (0.5-3 mL). Deglutition and swallowing were assessed according to predefined evaluation criteria. The application of the formulations was documented by video to evaluate the palatability. RESULTS:The primary objective was confirmed: Non-inferiority of the acceptability of an ODF compared to syrup was demonstrated, even superiority of the ODF was shown (p < 0.0001). The secondary endpoints demonstrated positive results including the superior swallowability of the ODF in comparison to syrup (p < 0.0001). The palatability assessments were in favor of the ODF. CONCLUSION:ODFs are a promising and safe alternative to liquid formulations, even for children of very young ages.