Experts perceive and evaluate domain-specific visual information with high accuracy. In doing so, they exhibit eye movements referred to as "expert gaze" to rapidly focus on task-relevant areas. Using eye tracking, it is possible to record these implicit gaze patterns and present them to histology novice learners during training. This article presents a comprehensive evaluation of such expert gaze cueing on pattern recognition of medical students in histology. For this purpose, 53 students were randomized into two groups over eight histology sessions. The control group was presented with an instructional histology video featuring voice commentary. The gaze cueing group was presented the same video, but with an additional overlay of a live recording of the expert's eye movements. Afterward, students' pattern recognition was assessed through 20 image-based tasks (5 retention, 15 transfer) and their cognitive load with the Paas scale. Results showed that gaze cueing significantly outperformed the control group (p = 0.007; d = 0.40). This effect was evident for both, retention (p = 0.003) and transfer tasks (p = 0.046), and generalized across different histological contexts. The cognitive load was similar in both groups. In conclusion, gaze cueing helps histology novice learners to develop their pattern recognition skills, offering a promising method for histology education. Histology educators could benefit from this instructional strategy to provide new forms of attentional guidance to learners in visually complex learning environments.

To learn and comprehend the large amount of information in gross anatomy, undergraduate students must self-regulate their learning to be properly prepared for the exams within the available time. Even though there are many studies on learning strategies and their influence on test results and motivation, the aim of this study is to investigate characteristics of learning strategies in detail and in relation to the anatomy course of first semester students and how their use is related to anatomy test performance. For assessing the learning strategies, we used the short version of the questionnaire “Learning Strategies of University Students” (LIST-K) (Klingsieck, 2018). Further, we investigated potential influences of motivation and resources used during the self-regulated learning process. The participants in this study (N = 108) filled in the above-mentioned questionnaire LIST-K and a written multiple-choice anatomy test. A k-means cluster analysis revealed three groups of students differing in their self-reported use of learning strategies. Students used either (1) predominantly metacognitive and resource-related strategies, (2) predominantly cognitive strategies, or (3) no specific learning strategies at all. We found no significant overall relationships between the use of learning strategies and test performance. A stepwise linear regression identified the use of cognitive learning strategies (β =.269) as a significant predictor for test performance (R² =.149, p =.003), possibly as these specific learning strategies help with a systematic and effective approach while studying anatomy and retrieving large amount of memorized information. Further, motivation was identified as a negative predictor (β = -.277), which might be a result of the short time periods students have to study for exams. Overall findings underline the importance of self-regulated learning as a positive predictor on academic performance. By understanding these factors, a more student-centered approach could be adopted by educators to improve medical education and equip students with valuable approaches for their continuous education, even beyond university.

Background: In 2021, university teaching at the Faculty of Medicine Tuebingen was transferred to a digital setting. Due to the discontinuation of face-to-face teaching, students lacked the temporal and spatial framework of the curriculum and the possibility to socialise with fellow students was extremely limited. Increased demands were placed on the students' self-organisation, and the possibility of collaborative learning was drastically limited. The present study investigated the extent to which these study conditions affected the academic performance of medical students in the oral exam after the 60-hour introductory anatomy lecture. Specifically, collaborative, and organisational learning strategies were considered.Methods: Learning strategies of 146 students were assessed by means of a questionnaire. The anatomy exam was used to assess the academic performance. In addition, students were asked to rate their own oral exam performance.Results: Students used strategies of collaborative learning (M = 3.30, SD = 0.88) and self-organisation (M = 3.28, SD = 0.72) about equally as often. A significant correlation was found between the use of collaborative learning strategies and the ability for realistic self-assessment (rho =-0.22, P =.02). Collaborative behaviour could be divided into Initiative Collaborative Learning and Subordinate Collaborative Learning. Only the former had an influence on the ability for realistic self-assessment. Neither organisational learning strategies nor collaborative learning strategies had an influence on academic performance.Discussion and conclusion: Initiative collaborative learners showed a higher degree of realistic self-assessment. This could be explained through a more distinct social referencing, as fellow students' knowledge levels can be related early on to their own academic performance. There was no correlation between the learning strategies used and the exam result.

Abstract Introduction The ability to self-assess is a crucial skill in identifying one’s own strengths and weaknesses and in coordinating self-directed learning. The Dunning-Kruger effect occurs when limited knowledge causes individuals to overestimate their competence and underestimate others’, leading to poor self-assessment and unrecognized incompetence. To serve as a foundation for developing strategies to improve self-assessment, the self-assessment abilities of first-semester students were assessed. Methods In the final weeks of the summer 2021, winter 2021/22, and summer 2022 semesters, the academic performance (oral anatomy exam) of first semester students was assessed (0–15 points). Before the exam results were announced, students were asked to self-assess their performance. Results Exam scores (M = 10.64, SD = 2.95) and self-assessed scores (M = 10.38, SD = 2.54) were comparable. The absolute difference between them, as a measure of self-assessment ability ranged from − 9 to + 9 points (M = -0.26, SD = 2.59). Among participants (N = 426), 18.5% assessed themselves accurately, 35.5% overestimated, and 46.0% underestimated their performance. The correlation between actual score and self-assessment was ρ = -0.590 (p < 0.001), reflecting the Dunning-Kruger effect. When separated by gender, correlation for females was ρ = -0.591 (p < 0.001), and for males ρ = -0.580 (p < 0.001). Conclusions Realistic self-assessment is a challenge for first-semester students. The data indicate that females tend to overestimate their performance while males underestimate theirs. A pronounced Dunning-Kruger effect is evident in both genders, with significant negative correlations between self-assessment and actual performance. There are several reasons for the occurrence of the Dunning-Kruger effect. Considering that the COVID-19 pandemic influenced learning environments, collaborative learning was significantly restricted. The lack of opportunities for comparison could potentially lead to unrealistic self-assessment.

Objectives: Teaching of ECG interpretation frequently relies on visual schemas. However, subsequent student ECG interpretation skills are often poor. Expertise research shows that expert looking patterns frequently deviate from the steps taught in schema learning. The present study made a cardiology expert's gaze interpreting ECGs visible - through eye-tracking videos with cued retrospective reporting (CRR) - and investigated the potential as an additional expert-driven route to improve medical students' ECG interpretation skills. Methods: N =91 Medical students participated in the RCT of an ECG elearning session aimed at medical students' ECG interpretation skills gain, either receiving the newly developed eye-tracking video with CRR audio commentary materials (n=47) n =47) or studying via four clinical cases only (n=44). n =44). Three outcome scores relating to different aspects of ECG interpretation skills were derived from pre-post MCQ ECG tests. The effect of the EYE-ECG training and additional characteristics (e.g., prior experience, interest) on student ECG interpretation skills were evaluated using t-tests and multivariate linear regression. Results: A small, non-significant advantage of the EYE-ECG training signifying a tendency for greater knowledge gain was observed, compared to training as usual. In multivariate regression models, the predictive value of clinical case 1 was an unexpected finding warranting further exploration. Conclusion: Additional gains after an only 9-minute intervention using videos of expert's real-time gaze pattern in combination with hearing their thought processes during ECG interpretation is a promising finding. Furthermore, a number of specific performance characteristics enabling students to best benefit from ECG training were identified and possible modifications to the learning intervention suggested.

Graphical representations of data are common in many disciplines. Previous research has found that physics students appear to have better graph comprehension skills than students from social science disciplines, regardless of the task context. However, the graph comprehension skills of physics students have not yet been compared with (veterinary) medicine students, both of which are disciplines that require multiple science, technology, engineering, and mathematics (STEM) courses. This study extends previous research on this subject by exploring whether physics majors possess superior graph comprehension skills due to their study discipline. Here, participants solved 24 graph comprehension tasks across various subjects, including mathematics, physics, and medicine; these tests were conducted at the beginning and end of their first semester. Graph comprehension gain was calculated based on the percentage of correct and incorrect answers in the pretest and the post-test. In addition to these comparisons, we replicated previous research that successfully distinguished correct and incorrect solvers based on their visual behavior by using a novel machine-learning method tailored to small datasets. Through this replication of statistical analyses, we aim to ensure the reliability of adaptive learning systems in the future, regardless of data size, using the same machine-learning method. Physics and medical students were found to exhibit relatively similar graph comprehension gain; this is in contrast to previous research comparing physics and non-STEM students. Our results also revealed that both physics and medical students use similar visual strategies to solve these tasks. However, correct and incorrect solvers could be distinguished via machine-learning methods regardless of their discipline. Our research suggests that visual behavior is a good predictor of graph comprehension skills.

Background:In Ethiopia, the University Entrance Exam (UEE) score is the only criteria for selecting prospective medical students entering the university system, disregarding their career choice motivation.Methods:A cross-sectional study design was conducted to identify medical students career choice motivation and predictors of college academic achievement at Gondar university, Ethiopia. The study was conducted on 222 medical students enrolled at Gondar University in 2016. A self-administered questionnaire was used to collect data on study participants demographic characteristics, career choice motivation, and informed career choice. Data on the UEE score and student's college academic achievement were collected from the university registrar. Descriptive statistics and regression analysis were used to analyze the data.Results:Desire to help others as a medical doctor and prevent and cure diseases were mentioned as the first important career choice reasons by 147 (68.2%) and 135 (64.0%) study participants, respectively. The results of regression analysis showed that the UEE score was significantly associated with pre-clinical cumulative GPA (R2=.327, p<.05) and 5th year cumulative GPA (R2=.244, p<.05) respectively. The stepwise multiple regression revealed that UEE score, having prior knowledge about medical profession, positive experience in the medical school, and intrinsic career choice motivation significantly predicted 5th year cumulative GPA (p<.05). The high beta weight of 0.254 and 0.202 confirmed the strongest prediction to come from prior knowledge about the medical profession and positive experience in medical school, respectively.Conclusion and Recommendation:The UEE score is a significant predictor for medical students' academic achievement, but it should not be the sole admission criterion. We suggest that comprehensive admissions criteria covering both cognitive and non-cognitive factors, as well as informed career choice, be developed to select the best applicants in the future.

Advancements in artificial intelligence are rapidly increasing. The new‐generation large language models, such as ChatGPT and GPT‐4, bear the potential to transform educational approaches, such as peer‐feedback. To investigate peer‐feedback at the intersection of natural language processing (NLP) and educational research, this paper suggests a cross‐disciplinary framework that aims to facilitate the development of NLP‐based adaptive measures for supporting peer‐feedback processes in digital learning environments. To conceptualize this process, we introduce a peer‐feedback process model, which describes learners' activities and textual products. Further, we introduce a terminological and procedural scheme that facilitates systematically deriving measures to foster the peer‐feedback process and how NLP may enhance the adaptivity of such learning support. Building on prior research on education and NLP, we apply this scheme to all learner activities of the peer‐feedback process model to exemplify a range of NLP‐based adaptive support measures. We also discuss the current challenges and suggest directions for future cross‐disciplinary research on the effectiveness and other dimensions of NLP‐based adaptive support for peer‐feedback. Building on our suggested framework, future research and collaborations at the intersection of education and NLP can innovate peer‐feedback in digital learning environments. Practitioner notes What is already known about this topic There is considerable research in educational science on peer‐feedback processes. Natural language processing facilitates the analysis of students' textual data. There is a lack of systematic orientation regarding which NLP techniques can be applied to which data to effectively support the peer‐feedback process. What this paper adds A comprehensive overview model that describes the relevant activities and products in the peer‐feedback process. A terminological and procedural scheme for designing NLP‐based adaptive support measures. An application of this scheme to the peer‐feedback process results in exemplifying the use cases of how NLP may be employed to support each learner activity during peer‐feedback. Implications for practice and/or policy To boost the effectiveness of their peer‐feedback scenarios, instructors and instructional designers should identify relevant leverage points, corresponding support measures, adaptation targets and automation goals based on theory and empirical findings. Management and IT departments of higher education institutions should strive to provide digital tools based on modern NLP models and integrate them into the respective learning management systems; those tools should help in translating the automation goals requested by their instructors into prediction targets, take relevant data as input and allow for evaluating the predictions.

Background:Due to SARS-CoV-2, the Bavarian Ministry of Health decided in April 2020 to postpone the second national board examination in human medicine and to bring forward the start of the practical year (in German: Praktisches Jahr, further abbreviated with PJ) from May to April 2020. The different tertial times made it necessary for affected students to reorganise the PJ and rendered the preparation for the national board examination that had already taken place obsolete. As a result, students had to prepare for it again after the PJ and take it together with the third national board examination.Research question:How do students affected by the early PJ differ in their perception of the practical year and in their psychological well-being from the comparison groups with a regular PJ schedule?Methodology:The study is based on quantitative data from the Dean of Studies Office of the Medical Faculty of Ludwig-Maximilians-Universität München (LMU) and an online survey. The sample consists of LMU students who started the early PJ in April 2020 (n=86) and two comparison groups: The cohort of LMU students who started their PJ regularly in May 2019 (n=50), and students from other German universities who started their PJ regularly in May 2020 (n=98) and took the second national board examination in human medicine in spring 2020.Results:For students affected by the early PJ, there were measurable negative effects on the choice of training institutions, the quality of the PJ content, preparation for the national board examinations, and career planning. Compared to regular students from other federal states, affected students reported higher psychological stress, with comparable resilience.Conclusion:It can be assumed that the insights gained apply to the entirety of medical students in the affected federal states of Bavaria and Baden-Württemberg. As a conclusion, we make the recommendation to include the position of the students in decisions of great consequence.

Whenever learners produce text, natural language processing (NLP) has great potential to improve learning.Theories from learning sciences should guide the implementation of NLP into concrete learning scenarios.However, theoretical concepts are much more abstract than the targets and inputs NLP can work with.Therefore, a process is needed which translates theory into NLP tasks.As such a process is missing, we propose a terminological and procedural scheme which researchers and practitioners can employ to develop NLP-based adaptive support measures for learning processes.It defines a sequence of leverage points, support measures, adaptation targets, automation goals, data, prediction targets, input, intrinsic metrics, NLP model, and extrinsic metrics.To illustrate it, we apply it to peer-feedback as a use case. Problem statementRecent developments in artificial intelligence (AI) promise to foster various learning processes (Dawson et al., 2019).Yet, to do so, theories of learning are indispensable (Wise & Shaffer, 2015).For example, peer-feedback is assumed to boost learning because, among other reasons, it provides feedback which can be easier to understand than teacher feedback and constitutes an additional learning opportunity (Li et al., 2020).However, for this purpose, learners should provide high-quality feedback (Patchan et al., 2016), but not all learners have the necessary prior knowledge and skills.Consequently, AI might support the learners when composing their feedback.As feedback often is written text, natural language processing (NLP) is the most relevant field of AI for this task.Yet, applying NLP to peer-feedback is complex: NLP and learning sciences have their own terminologies and approaches to conceptualize phenomena.Hence, mapping the theoretical learning process to NLP becomes a complex endeavor of synchronizing terminology, goals, and procedures.A guiding framework that helps researchers and practitioners through this development process is missing.For this reason, in this conceptual paper, we propose a terminological and procedural scheme to guide the development of NLP support measures and exemplify it for peer-feedback.

Background: Entrustable Professional Activities (EPAs) are units of professional practice that are defined as tasks or responsibilities that are entrusted to an unsupervised execution by a trainee. In 2021, a framework of 29 EPAs was developed for surgical residency training programs in Ethiopia, with the goal of residents being able to perform independently by the time they grad-uate. However, studies show that surgical residents lack confidence and are unable to execute EPAs autonomously upon graduation, and concerns have been raised about graduate compe-tencies in EPA execution. The goal of this research is to assess how surgical team members judge/ perceive residents' performance in executing these EPAs autonomously at the time of graduation and how residents rate their own capability and autonomy in executing EPAs in order to sys-tematically introduce and implement EPAs in Ethiopian medical education Methods: A survey was conducted in the Departments of Surgery at four residency training in-stitutions in Ethiopia. All eligible surgical team members and final-year general surgery residents were invited to participate. Surgical team members were asked to rate the observed performance of a group of graduating surgical residents in each of the 29 EPAs, and residents were asked to rate their own capability in executing EPAs. The analysis focused on variations in performance ratings between surgical team members and residents, as well as across surgical team members. Results: A total of 125 surgical team members and 49 residents participated in this study. Resi-dents rate their competence in performing these EPAs higher than surgical team members, mean 4.2 (SD = 0.63) vs. 3.7 (SD = 0.9). A statistically significant difference in perceptions of capa-bility, autonomy, and expectations in executing EPAs was observed between the two groups of study (p = 0.03, CI: 0.51-0.95), as well as within surgical team members (p < 0.001). Conclusions: Differences in perceptions of capability, autonomy, and expectations between resi-dents and surgical team members, as well as within faculty members, were seen in executing EPAs. There were concerns about graduate surgical residents' competence to execute EPAs autonomously at the time of graduation. Surgical team members perceived that a set of gradu-ating surgical residents are not yet safe to perform these EPAs independently (without supervi-sion) and still requires distant supervision.

The interpretation of graphs plays a pivotal role in education because it is relevant for understanding and representing data and comprehending concepts in various domains. Accordingly, many studies examine students’ gaze behavior by comparing different levels of expertise when interpreting graphs. This literature review presents an overview of 32 articles comparing the gaze behavior of experts and non-experts during problem-solving and learning with graphs up to January 2022. Most studies analyzed students’ dwell time, fixation duration, and fixation count on macro- and meso-, as well as on micro-level areas of interest. Experts seemed to pay more attention to relevant parts of the graph and less to irrelevant parts of a graph, in line with the information-reduction hypothesis. Experts also made more integrative eye movements within a graph in terms of dynamic metrics. However, the determination of expertise is inconsistent. Therefore, we recommend four factors that will help to better determine expertise. This review gives an overview of evaluation strategies for different types of graphs and across various domains, which could facilitate instructing students in evaluating graphs.

The way medical students learn anatomy is constantly evolving. Nowadays, technologies such as tablets support established learning methods like drawing. In this study, the effect of drawing on a tablet on medical students' anatomy learning was investigated compared to drawing or summarizing on paper. The quality of drawings or summaries was assessed as a measure of the quality of strategy implementation. Learning outcome was measured with an anatomy test, both immediately afterward and after 4-6 weeks to assess its sustainability. There were no significant group differences in learning outcome at both measurement points. For all groups, there was a significant medium strength correlation between the quality of the drawings or summaries and the learning outcome (p < 0.05). Further analysis revealed that the quality of strategy implementation moderated outcomes in the delayed test: When poorly implemented, drawing on a tablet (M = 48.81) was associated with lower learning outcome than drawing on paper (M = 58.95); The latter (M = 58.89) was related to higher learning outcome than writing summaries (M = 45.59). In case of high-quality strategy implementation, drawing on a tablet (M = 60.98) outperformed drawing on paper (M = 52.67), which in turn was outperformed by writing summaries (M = 62.62). To conclude, drawing on a tablet serves as a viable alternative to paper-based methods for learning anatomy if students can make adequate use of this strategy. Future research needs to identify how to support student drawing, for instance, by offering scaffolds with adaptive feedback to enhance learning.

AIM:The training of scientific skills and competencies is an essential part of academic medical studies. As part of the MaReCuM model study program at Heidelberg University's Mannheim Medical School, a fifth-year rotation on scientific skills in the field of pain medicine was implemented. This paper describes this competence-oriented rotation as well as the investigation of the educational effect. METHOD:A total of 114 fifth-year medical students participated in the survey (response rate: 83%). The control group completed the fifth year prior to the implementation of the rotation. The experimental group was required to participate in the rotation and the real healthcare research study "Case management program: low back pain". A survey of both groups was conducted on the first day of the rotation and at the end of the module. RESULTS:The innovative and competency-based learning unit was successfully implemented as part of the MaReCuM model study program and carried out with partners in general practice as well as the Mannheim Institute of Public Health. The participating students accepted the rotation well. There was no measurable effect on the subjective learning success of the rotation in the evaluation. DISCUSSION:To the authors' knowledge, this educational approach has never been tested before in a German study program. The presented rotation offers an additional option for the training of scientific competencies as part of medical studies. The missing of a measurable effect could be due to the extensive experience of the medical students as well as the limitations on participation in a real healthcare study. An additional learning opportunity could be created by connecting the preexisting lectures to a longitudinal module on scholarly competencies. The implementation of the program also offers a unique opportunity for educational research on the acquisition of scientific competencies in medical students.

Abstract Background: Entrustable Professional Activities (EPAs) are units of professional practice that are defined as tasks or responsibilities that are entrusted to an unsupervised execution by a trainee. In 2021, a framework of 29 EPAs was developed for surgical residency training programs in Ethiopia. The goal is that graduating surgical residents being able to perform independently by the time they graduate. However, residents' ability to carry out EPAs is being questioned. The objective of this study is to assess how faculty members judge residents' performance in executing these EPAs, as well as how residents rate their own ability. The study builds on previous work that developed EPAs for surgical residency training, making it relevant to systematically introduce and implement EPAs.Methods: A survey was conducted in the Departments of Surgery at four residency training institutions in Ethiopia from June 21 to August 21, 2021. All eligible faculty members and final-year general surgery residents were invited to participate in the study. Surgical team members were asked to judge performance of residents, and residents were asked to rate their own capability in executing EPAs. The analysis focused on variations in performance ratings between surgical team members and residents, as well as across faculty members.Results: A total of 125 surgical team members and 49 graduating general surgery residents participated in this study. Residents rate their competence in performing these EPAs higher than surgical team members (mean 4.2 (SD = 0.63) vs. 3.7 (SD = 0.9). A statistically significant difference was observed between the two groups of study on the overall mean rating of resident performance (combined dependent variables) (P =0.03, CI: 0.51-0.95), as well as within surgical faculty members (P < 0.001).Conclusions: In executing EPAs, there was disagreement between the residents' and surgical team members' judgment, as well as among faculty members. Faculty expected residents to still require supervision in these EPAs. This suggest that the programs may produce graduating residents who are ill prepared for independent practice. The perception/judgment gap that exists between residents and surgical teams and among faculty members could pose a problem in education.

Mixed research findings on peer feedback indicate that its efficiency seems to be influenced by its characteristics, its mindful cognitive processing, and the presence of justifications. Further, these aspects seem to positively or negatively affect cognitive load in the recipient. In a 2 × 3 design, we systematically varied types of peer feedback (elaborated specific feedback with/without justifications) on an essay and sender’s competence (high/average/low). We measured cognitive load during the peer-feedback reading and performance tasks and correlated eye tracking data with performance measures to infer mindful cognitive processing. We found an interaction effect of justifications and sender’s competence on text-revision performance. The impact of justifications on text-revision performance was moderated by cognitive load. Mindful cognitive processing seemed to increase when more transitions between text elements occurred, however, more intense mindful cognitive processing did not necessarily lead to better performance but rather served a compensatory purpose to sustain performance.

BACKGROUND: Entrustable Professional Activities (EPAs) have been proposed as a means to translate competencies into clinical practice. Although EPAs for residency training have become available, 1 set of core EPAs cannot automatically be transferred from one context to another due to cultural variability. Further, there is a lack of African-and Asian-based EPA development and implementation studies. We developed an end-of-training EPAs framework to inform surgical residency training programs in the local context of Ethiopian medical education. METHODS: A three-round Delphi method was used to establish consensus about important surgical EPAs among experts. A total of 136 experts representing all surgical residency training institutions in Ethiopia were invited to participate. Round 1 & 2 consisted of senior expert panelists (n = 8) to identify potential EPAs and determine the content validity. Round 3 consisted of a survey (n = 128) to further validate the identified EPAs by attending surgeons who work with them. Each EPA had to achieve at least 80% or higher agreement among experts to be considered having acceptable content validity. RESULTS: In round 1, a total of 272 EPAs were proposed, reduced, and grouped to 39 consented EPAs. In round 2, the same experts rated each EPA's relevance, resulting in 32 EPAs with a satisfactory item-level content validity index (I-CVI > 0.83). Overall, in the survey in round 3, 29 EPAs met the standard criterion for acceptability (S-CVI/Ave = 0.90) and achieved a high degree of final consensus (ICC = 0.998, 95% CI [0.996, 0.999]; (F = 439.2, p < 0.0001). CONCLUSIONS: The framework of 29 validated and accepted EPAs can guide future surgical residency training programs in the Ethiopian medical education context. The framework allows programs to move from a time-dependent to an outcome-based model and transforms traditional assessment into entrustment decisions. Thus, the use of the framework can improve the quality of training and patient care in Ehtiopia. ((C) 2021 The Authors. Published by Elsevier Inc. on behalf of Association of Program Directors in Surgery.)

Zusammenfassung Zielsetzung Die Vermittlung von Wissenschaftskompetenzen ist ein unverzichtbares Charakteristikum eines akademischen Medizinstudiums. Im Rahmen des Modellstudiengangs Mannheimer Reformiertes Curriculum für Medizin (MaReCuM) wurde die Lehrveranstaltung Wissenschaftliches Arbeiten im Fach Schmerzmedizin in das 5. Studienjahr implementiert. Die Ziele der Arbeit umfassen die Beschreibung dieser kompetenzorientierten Lehrveranstaltung sowie eine Evaluation der Lerneffekte der Lehrveranstaltung. Methodik 114 Studierende haben sich an einer Fragebogenerhebung beteiligt. Die historische Kontrollgruppe absolvierte das 5. Studienjahr vor Einführung der Lehrveranstaltung. Die Interventionsgruppe nahm verpflichtend an der Lehrveranstaltung sowie an der realen Versorgungsforschungsstudie Case-Management-Programm Kreuzschmerzteil. In beiden Gruppen erfolgte eine Fragebogenerhebung zu schmerzmedizinischem Vorwissen und Interesse sowie zur Akzeptanz der Lehrveranstaltung und dem subjektiv wahrgenommenen Lernerfolg. Ergebnisse Die innovative und kompetenzorientierte Lehrveranstaltung konnte erfolgreich in das Curriculum des Modellstudiengangs implementiert und mit den Partnern in der Allgemeinmedizin und dem Mannheim Institute of Public Health wie geplant durchgeführt werden. Die Lehrveranstaltung wurde von den teilnehmenden Studierenden akzeptiert. In der begleitenden Evaluation hatte die Teilnahme an der Lehrintervention an und für sich keinen messbaren Einfluss auf den subjektiven Lernerfolg. Diskussion Unseres Wissens nach wurde dieser didaktische Ansatz in der curricularen Lehre bislang noch nicht verfolgt. Die vorgestellte Lehrveranstaltung eröffnet eine weitere Option zur Vermittlung von Wissenschaftskompetenzen im Rahmen des Medizinstudiums. Ein Effekt der Lehrveranstaltung auf den subjektiven Lernerfolg war in der untersuchten Form und am Ende des Moduls nicht messbar. Gründe dafür könnten in den vielfältigen und umfangreichen Vorerfahrungen der Studierenden des Modellstudiengangs MaReCuM sowie in Limitationen bei der Teilnahme an der realen Versorgungsforschungsstudie liegen. Durch die Verknüpfung der Lehrintervention mit anderen Lehrveranstaltungen zu einem longitudinalen Wissenschaftsmodul kann eine zusätzliche Lerngelegenheit im Bereich der Arztrolle des Gelehrten geschaffen werden. Die Implementierung der Lehrveranstaltung bietet darüber hinaus die Gelegenheit für vergleichende Untersuchungen zum Erwerb von Wissenschaftskompetenzen der Studierenden im Fach Humanmedizin.

Objective: Statistical literacy (SL) of physicians, i.e. the ability to use and interpret statistical numbers in the context of science, is an essential prerequisite for risk estimation and communication. Together with scientific reasoning and argumentation (SRA) skills, SL provides the basis for evidence-based practice. Several studies suggest that in medical students both skills are underdeveloped. The aim of the present study was to investigate these skills in practicing physicians and how these skills were acquired. Methods: Data collection in N=71 physicians was conducted online and as paper pencil. SL was assessed with multiple-choice items. SRA skills evidence evaluation and drawing conclusions were measured with a decision scenario. Results: Study results indicated that physicians have medium levels of SL (M=17.58, SD=6.92, max 30 pts.) and SRA (evidence evaluation: M=7.75, SD=1.85, max 10 pts.; drawing conclusions: M=37.20, SD=5.35, max 60 pts.). Skills development via autodidactic learning activities (M=4.78, SD=1.13, range 1-6) was reported significantly more often than development during formal medical education (M=2.31, SD=1.46), t(71)=-9.915, p<.001, or in extracurricular activities (M=3.34, SD=1.87), t(71)=4.673, p<.001. The active involvement in research seemed decisive: The number of publications and time spent in research significantly correlated with SL, r(71)=.355, p=.002; respectively r(71)=.280, p=.018. SRA skills were predicted by the type of MD-thesis, β=-.380, p=.016, and working in research, β=3.355, p=.008. Conclusion: Active involvement in research activities seems to be a very important factor for the development of both SL and SRA skills. The implementation of systematic fostering of these skills during formal medical education seems warranted.

BACKGROUND:Childhood stroke is rare and can predispose to post-stroke epilepsy. The purpose of this study was to evaluate long-term quality of life (QoL) in patients with childhood stroke, focusing on epileptic aspects.METHOD:This involves a retrospective study of 98 patients with childhood stroke (pre- and neonatal strokes excluded), who had been inpatients between 1986 and 2003 for early rehabilitation. Data were obtained via interviews using a standardized questionnaire: QoL evaluation with KINDL, functional outcome with Barthel Index, and motor handicaps-assessment with modified Rankin Score.RESULTS:Forty-nine of 98 patients (31 males, mean follow-up 16 years, range 8-25 years) were included. Six patients passed away (three of sudden unexpected death in epilepsy). At least one epileptic seizure occurred in 27/49 patients (occurrence: 2 days-13 years.; mean 3.3 years.). Epilepsy manifested in 19/49 patients. No correlation was found between the development of epilepsy and the location or etiology of the stroke. The presence of functional independence was significantly higher in seizure-free patients and in patients without epilepsy. For the external assessment (filled in for the patient by the parent/caregiver), there was no significant difference in QoL in patients with and without epilepsy; however, in the in-person KINDL questionnaire a significantly lower QoL was noted in epilepsy patients compared with patients without epilepsy.CONCLUSION:One important finding in our study is that in the long-term course 39% of patients developed epilepsy after a childhood stroke. It occurred as late as 13 years after the acute episode and affected the QoL especially in cognitively less handicapped patients.