Purpose:This systematic review aimed to summarise the evidence on the effectiveness of heat therapy for the treatment of non-specific neck pain, one of the most frequently reported musculoskeletal conditions. Materials and Methods:This review followed established methodological guidelines for systematic reviews. A computerised literature search was conducted in Medline via PubMed in January 2025 using the key terms "neck pain" and "heat". Methodological quality was assessed using the Cochrane Risk of Bias tool for randomised controlled trials, and the quality of evidence was graded using the GRADE approach. Results:The database search identified 91 studies, of which only two met the inclusion criteria. A total of 67 participants were included. Both studies investigated dry heat therapy using heat wraps or heat cells. While reductions in neck pain and neck-related disability were reported, the evidence base was very limited due to the small number of included studies, small sample sizes, and low methodological quality of both studies. Conclusion:The current evidence regarding heat therapy for non-specific neck pain is highly limited and insufficient to support either a recommendation for or against its use. The available findings are based on only two small studies with considerable methodological limitations, substantially limiting confidence in the conclusions. Nevertheless, given the absence of expected serious adverse effects, heat application may still be considered as a self-management option for patients with non-specific neck pain.

Global temperatures are increasing. Adaptation of health behavior could mitigate adverse effects of heat, but health benefits are probably limited and depend on the context. Therefore, other strategies are also needed. Our study aimed to identify adverse effects of light heat (> 27–32 °C) and moderate heat (> 32–40 °C) and to analyze whether psychosocial factors were associated with these effects. We conducted a prospective cohort study based on an access-restricted online survey and publicly available weather data. A total of 1810 individuals were contacted by 64 GP practices in 16 German federal states. Individuals were eligible if they were ≥ 18 years old and had ≥ 1 of 15 specific chronic diseases. Heat exposure was defined as thermal stress and operationalized by maximum temperatures and relative humidity assessed by 88 meteorological stations. Psychosocial factors were measured by standardized questionnaires assessing health literacy, self-efficacy, social support, risk expectations, and somatosensory amplification. Adverse effects of heat were operationalized by limitations in usual activities due to 14 specific symptoms reported at up to 12 follow-up assessments per participant. Data were analyzed by multivariable, multilevel, and mixed-effects linear regression. A total of 4434 observations of 509 individuals were analyzed. Response rate was 28.1

INTRODUCTION:Climate change poses the greatest threat to the livelihoods and health of current and future generations. Its effects on general practice have already become evident, particularly in the areas of heat stress and new allergens. Continuing education courses aimed at general practitioners can both highlight opportunities for more climate-friendly work and adaptation to a changing disease spectrum and motivate transformative action regarding planetary health. The factors affecting the success of these continuing education courses are unclear. METHODS:26 general practitioners were surveyed in a qualitative study using semi-structured individual interviews. These were evaluated using a structured content analysis based on Mayring, and six subject areas with respective category systems were derived. RESULTS:The extent to which training content on planetary health motivates general practitioners to take transformative action depends on several factors. On the one hand, structural factors of training courses, such as a manageable time frame, appealing presentation of content, and opportunities for interaction, were identified as particularly relevant. On the other hand, content-related aspects proved to be particularly important for motivating participants. In addition to offering the greatest possible practical relevance, the discussion of individual factors such as self-efficacy, personal responsibility, and personal benefits was frequently mentioned. DISCUSSION:Our findings provide the foundation for designing continuing education programs for general practitioners on planetary health based on various influencing factors. Future research projects must clarify the extent to which participants with little intrinsic motivation for the topic can be motivated to implement measures related to planetary health. CONCLUSION:Training courses designed to motivate transformative action in the context of planetary health should be practical and interactive, and they should strengthen participants' self-efficacy.

Hintergrund Der Klimawandel stellt die größte Bedrohung für die Lebensgrundlage und Gesundheit heutiger und zukünftiger Generationen dar. Bereits jetzt zeigen sich Auswirkungen auf die hausärztliche Arbeit, insbesondere in den Bereichen Hitzebelastung und neuer Allergene. An Hausärzt*innen adressierte Fortbildungen können Möglichkeiten der klimafreundlicheren Arbeit und Anpassung an ein verändertes Krankheitsspektrum aufzeigen und zu transformativem Handeln in Bezug auf Planetary Health motivieren. Unklar ist, welche Faktoren Einfluss auf den Erfolg dieser Fortbildungen haben. Methode 26 Hausärzt*innen wurden in einer qualitativen Studie mithilfe semistrukturierter Einzelinterviews befragt, die mittels einer strukturierten, an Mayring angelehnten Inhaltsanalyse ausgewertet wurden. Es wurden sechs Themengebiete mit jeweiligem Kategoriensystem abgeleitet. Ergebnisse Inwieweit Fortbildungsinhalte zu Planetary Health Hausärzt*innen zu transformativem Handeln motivieren, ist abhängig von mehreren Faktoren. Als besonders relevant wurden einerseits strukturelle Faktoren der Fortbildungen wie ein überschaubarer zeitlicher Umfang, ansprechende Aufbereitung der Inhalte und Möglichkeiten zur Interaktion identifiziert. Andererseits zeigen sich inhaltliche Aspekte als besonders wichtig zur Motivationsbildung. Häufig genannt wurde neben größtmöglicher Praxisrelevanz die Thematisierung individueller Faktoren wie Selbstwirksamkeit, Eigenverantwortung und persönliche Benefits. Diskussion Unsere Ergebnisse liefern eine Grundlage für die Konzeption von hausärztlichen Fortbildungen zu Planetary Health anhand diverser Einflussfaktoren. Zukünftige Forschungsprojekte müssen klären, inwiefern insbesondere Teilnehmende, die wenig intrinsische Motivation gegenüber dem Thema besitzen, zur Umsetzung der Maßnahmen in Bezug auf Planetary Health motiviert werden können. Schlussfolgerung Fortbildungen, die zu transformativem Handeln im Kontext von Planetary Health motivieren sollen, sollten praxisrelevant und interaktiv gestaltet sein sowie die Selbstwirksamkeit der Teilnehmenden stärken.

BACKGROUND:It is known that Emergency Departments (EDs) handle lower patient loads during periods when general practitioners (GPs) are on service. However, the acute cases managed by GPs are not well described yet. OBJECTIVE:This study aims to assess acute medical cases presented at GP's offices. METHODS:Medical students documented urgent medical cases as defined by patients during a practice internship in GP practices in Northern Germany, from February to July 2024. Levels of urgency were defined as "not-acute" (could have been treated on another day), "acute" (had to be treated the same day) and "emergency" (had to be treated immediately). Additionally, patient's concerns and expectations were written down and analyzed using qualitative content analyses. RESULTS:A total of 523 cases were collected from 53 practices. The majority of cases (82%) were treated solely within the practice. Regarding levels of urgency, 275 (53%) were graded acute, 170 (33%) were not-acute and 70 (13%) cases were graded emergencies. Patients' motivations for urgently visiting their GP are rooted in fears, motivated by relatives, psychological issues and pain. Expectations range from reassurance to diagnostic examinations to the issuing of a sick leave. DISCUSSION:GPs play a critical role in managing acute medical cases. The holistic approach of GPs including strategies to cope with uncertainty might be useful to be expanded to more specialties of medicine in the acute care sector. CONCLUSION:Motivations and expectations of a visit to a GP practice were diverse but comprehensible. An additional way to address the fears and uncertainties that send patients to the doctor could be through telemedicine offerings and educational initiatives, potentially starting as early as school age.

Objective:Communication skills are a central component of the medical profession and are already taught during medical studies. However, the design of teaching content for doctor-patient communication across Germany is not based on empirical data collected from physicians' everyday professional practice, meaning optimal preparation for future work is not guaranteed. The aim of this study was to identify the need for relevant topic content and to use the limited teaching time in communication courses for these topics, providing educators with empirically based selection criteria. Methodology:Using an exploratory sequential mixed-methods design, the need for relevant topics was determined. All teaching practices of the University of Lübeck were invited in writing to participate in the study. Teaching physicians rated, using a topic catalogue, which topics they considered relevant for communication courses in medical studies, as well as how challenging and frequent these topics are in everyday professional life. Results:The questionnaire was completed by 46 of the 70 invited teaching physicians (65.7%). Fifteen topics, including breaking bad news and communicating one's own mistakes, were rated as relevant for communication courses. Conclusion:The results provide tailored recommendations for case studies in communication courses that are relevant for medical students' later professional practice. A concrete implementation involves the selection of relevant topics, enabling the practice of frequently encountered but less challenging topics at the beginning of studies and more difficult but rarer topics in advanced studies.

RATIONALE:Clinical Practice Guidelines (CPGs) represent evidence-based tools designed to assist healthcare practitioners and patients in decisions in clinical practice. Evidence supports the clinical benefits of adhering to CPGs. However, their successful implementation and adherence in clinical settings often encounter challenges. AIMS AND OBJECTIVES:This systematic review aimed to explore barriers and facilitators influencing adherence to CPGs in Germany. METHOD:The protocol of this study was registered in the Open Science Framework (OSF) registry (DOI: 10.17605/OSF. IO/GMFUB). In November 2022 we searched on PubMed and Embase for primary studies employing qualitative, quantitative and mixed-methods approaches that focus on barriers or facilitators to CPGs adherence in the Germany. Two reviewers independently screened articles, extracted data, and evaluated the quality of the studies. The collected data on barriers and facilitators of CPG adherence were systematically categorized and analyzed using the Theoretical Domains Framework (TDF). RESULTS:A total of 24 studies were included, mainly focusing on adherence to national CPGs. This review introduces a new domain, guideline characteristics, reflecting the need to address barriers and facilitators to CPG development, implementation, dissemination and format, which couldn't be encompassed within the existing 14 domains of TDF framework. Among healthcare professionals, the most frequently reported influencing factors were related to the environmental context and resources (encompassing aspects such as employer support for CPG utilization), the CPG development and dissemination process (including layout, wording, and interactive tools) and beliefs about consequences (such as contradictions with practical experience). Knowledge (knowledge about the content of CPGs, awareness about published CPGs), primarily as a barrier, and reinforcement facilitators (notably financial support), were also frequently reported. CONCLUSION:The findings revealed multilevel factors contributing to CPG adherence, with environmental context and resources emerging as the most frequently reported considerations. This systematic review offer holistic insights into the barriers and facilitators of CPG adherence in Germany. The results contribute to a better understanding of the topic and serve as a resource for developing targeted strategies to enhance CPG adherence and implementation within the German healthcare system.

BackgroundAs a result of climate change, exposure to high temperatures is becoming more common, even in countries with temperate climates. For patients with chronic diseases, heat poses significant health risks. Empowering patients is a crucial element in protecting the population from the adverse effects of heat. In this context, self-reports of protective behavior are often used to gain a mutual understanding of patients’ issues. However, the extent to which self-reported behavior is associated with health complaints remains unclear. ObjectiveThis study aims to describe the association between light to moderate heat and health complaints in everyday life, and to analyze whether self-reported protective behavior and related psychosocial factors are linked to these complaints. MethodsWe conducted a pilot cohort study using internet climate data merged with an online survey of patients with chronic diseases recruited through general practitioner practices. Patients were eligible if they were 18 years or older and had at least one chronic disease. The heat was modeled using temperature and humidity data. Health complaints were assessed through up to 7 follow-up evaluations on the hottest day of each week during the observation period. Data were analyzed using 3 nested models with mixed effects multivariable linear regression, adjusting for random effects at the climate measuring station and participant levels. Model 1 included heat exposure, sociodemographic data, and chronic diseases. Model 2 added protective behavior and health literacy, while model 3 incorporated self-efficacy and somatosensory amplification (ie, the tendency to catastrophize normal bodily sensations such as insect bites). ResultsOf the 291 eligible patients, 61 (21.0%) participated in the study, providing 294 observations. On average, participants were 61 (SD 14) years old, and 31 (51%) were men. The most prevalent conditions were cardiovascular diseases (n=23, 38%) and diabetes mellitus (n=20, 33%). The most commonly reported symptoms were tiredness/fatigue (232/294 observations, 78.9%) and shortness of breath (142/294 observations, 48.3%). Compared with temperatures of 27°C or lower, a heat index between over 27°C and 32°C (β=1.02, 95% CI 0.08-1.96, P=.03) and over 32°C (β=1.35, 95% CI 0.35-2.35, P=.008) were associated with a higher symptom burden. Lower health literacy (β=–0.25, 95% CI –0.49 to –0.01, P=.04) and better self-reported protective behavior (β=0.65, 95% CI 0.29-1.00, P<.001) were also linked to increased symptom burden but lost statistical significance in model 3. Instead, lower self-efficacy (β=–0.39, 95% CI –0.54 to –0.23, P<.001) and higher somatosensory amplification (β=0.18, 95% CI 0.07-0.28, P=.001) were associated with a higher symptom burden. ConclusionsCompared with colder weather, light and moderate heat were associated with more severe health complaints. Symptom burden was lower in participants with higher self-efficacy and less somatosensory amplification. Self-reported protective behavior was not linked to a lower symptom burden. Instead, we found that patients who tended to catastrophize normal bodily sensations reported both better protective behavior and a higher symptom burden simultaneously. Trial RegistrationClinicalTrials.gov NCT05961163; https://clinicaltrials.gov/ct2/show/NCT05961163

Background:Medical school graduates are faced with the difficult decision of choosing a specialty training program. Understanding the decision criteria as well as the intracurricular factors-which have been studied less frequently and thus lack clarity-may help to prevent an impending shortage of certain specialists and to ensure the recruitment of young doctors into supposedly less popular specialties. Evidence-based changes to the medical curriculum are needed to support the balanced development of health care systems with demand-driven staffing of all specialties, especially in the outpatient sector and in rural areas. The aim of this systematic review was to identify the intracurricular factors that influence medical students' choice of specialty that have been described in the international literature. Methods:A systematic review was conducted by searching Medline. After applying the inclusion and exclusion criteria to the 2537 primary results and 19 hits from an additional manual search, data were extracted from 334 studies. In addition, a quality assessment of all included studies was performed. Results:A total of 14 influencing factors were identified from the reviewed literature, of which "clinical-practical experience", "clinical role models", and "voluntary offerings" were mentioned most frequently. We sorted the factors into four main categories: "Teaching"; "Teaching environment, influence and interaction"; "Curriculum"; and "Voluntary work". The studies were highly heterogeneous regarding research methods and the quality of reporting. Conclusion:Involving students in the planning and structuring of clinical phases, active feedback, voluntary offerings, seminars/simulations, and involvement in the clinical team can increase a specialty preference. Conversely, discrimination, prejudice and poor quality of teaching and clinical exposure may act as a deterrent. It is necessary to sensitize medical staff regarding their role and influence in the decision-making process. Further prospective and qualitative research is needed to address this issue adequately.

Objectives:To analyse stress coping styles of medical students at different time points of medical education and to identify predictors of functional coping.Methods:A cross-sectional study was conducted among medical students (N = 497, 361 women and 136 men) before year one (n = 141), after year one (n = 135) and after year five (n = 220). Students answered the Brief Coping Orientation to Problems Experienced Inventory, the Work-Related Behaviour and Experience Patterns, the Perceived Medical School Stress Instrument and the Maslach Burnout Inventory. Multiple regression was used to examine factors associated with functional coping.Results:Single factor ANOVA indicated a significant difference for functional coping between the time points (F (2, 494) = 9.52, p < .01), with fifth-year students scoring significantly higher than students before or after year one. There was a significant difference in dysfunctional coping (F (2, 494) = 12.37, p < .01), with students before year one and after year five scoring higher than those after year one. Efficacy (β = 0.15, t (213) = 4.66, p < .01), emotional distancing (β = 0.04, t (213) = 3.50, p < .01) and satisfaction with life (β = 0.06, t (213) = 4.87, p < .01) were positive predictors of functional coping.Conclusions:Scores for both functional and dysfunctional coping vary during medical education. The reasons for low coping scores after year one require further explanation. These findings represent a starting point for investigations into how to promote functional coping during early medical education.

Introduction: Climate change is the greatest threat to human health and therefore has a direct impact on the work of physicians. At the same time, the health sector is also an originator of pollutants that burden the climate. The concept of Planetary Health describes, among other things, ways in which the health sec-tor can counter the effects of climate change. Nevertheless, the inclusion of contents on sustainable action in the education of health professionals has not been made mandatory to date. The aim of this study is to answer the question of how an intervention has to be designed so that medical students specifically develop an interest in dealing with the topic on their own.Methods: The intervention consisted of & BULL; learning about Planetary Health in a preparatory seminar for family medicine internship at a Ger-man university,& BULL; completing a specifically developed checklist (comprising eight items on mobility, energy and material) during the two-week internship in a family medicine teaching practice and & BULL; allowing access to a curated collection of materials on this topic (open educational resources like texts, podcast episodes and videos) on a learning platform.For evaluation purposes, a qualitative study with guided focus group interviews of attendees was conducted. The fully transcribed focus group transcripts were analysed using Mayring's structuring qua-litative content analysis. Additionally, we checked the semester evaluation for feedback on the interven-tion.Results: Four focus groups comprising n = 14 medical students (11 female, 3 male) were conducted. Dealing with Planetary Health as a topic during medical education was considered relevant. The partially restrained to negative reaction of the teaching practice staff involved to the checklist had a demotivating effect. A lack of time was given as a further reason for not dealing with the topic independently. Participants suggested integrating specific Planetary Health content in mandatory courses and considered environmental medicine to be especially suited. As a didactic method, case-based working in small groups seemed to be particularly appropriate. In the semester evaluation, we found both approving and critical commentaries.Discussion: Participants considered Planetary Health a relevant topic in the context of medical educa-tion. The intervention proved to be of limited use in motivating students to deal with the topic indepen-dently. A longitudinal integration of the topic in the medical curriculum seems to be appropriate.Conclusions: From the students' perspective, it is important to teach and acquire knowledge and skills regard-ing to Planetary Health in the future. Despite a high level of interest, additional offers are not being utilised due to a lack of time and should therefore be made part of the mandatory curriculum, where possible.

Zusammenfassung Hintergrund Leitlinien (LL) sind ein wichtiges Instrument der Qualitätsförderung – auch in der hausärztlichen Versorgung. Seit Jahren erstellen hochmotivierte Mitglieder der Deutschen Gesellschaft für Allgemeinmedizin und Familienmedizin (DEGAM) meist ehrenamtlich methodisch anspruchsvolle hausärztliche Leitlinien oder sind an der Entwicklung interdisziplinärer Leitlinien beteiligt. Der Innovationsausschuss des Gemeinsamen Bundesausschusses (G-BA) schreibt seit 2020 Förderprogramme zur (Weiter‑)Entwicklung von Leitlinien aus. Ziel der Arbeit Mit dieser Publikation sollen durch den Innovationsausschuss des G‑BA aktuell geförderte DEGAM-Leitlinienprojekte vorgestellt werden. Material und Methoden Die Vorstellung erfolgt durch eine Kurzbeschreibung der geförderten Leitlinien durch die zugehörigen Autoren(gruppen). Ergebnisse In der 2. Ausschreibungsrunde des G‑BA zur Förderung medizinischer Versorgungsleitlinien (2021) haben sich 5 Autorenteams der DEGAM um eine Finanzierung für die Förderung beworben und die Förderzusagen erhalten. Bei den geförderten DEGAM-Leitlinien handelt es sich um a) eine neue Leitlinienentwicklung, b) die Updates (Aktualisierung) von 2 bestehenden Leitlinien und c) das Update und gleichzeitige Upgrade einer DEGAM-Leitlinie von S1- auf S3-Niveau sowie die Aktualisierung einer S3-Leitlinie als „living guideline“. Diskussionen Leitlinienerstellung ist ressourcenintensiv und fordert ehrenamtliches Engagement. Die G‑BA-Förderung öffnet der DEGAM Möglichkeiten zu Leitlinien(weiter)entwicklungen, die sonst nicht oder nicht als Upgrades erfolgt wären. Um Leitlinienentwicklung voranzubringen, braucht es zusätzliche Förderungen, da die Ressourcen ehrenamtlich motivierter Leitlinienentwickler:innen endlich sind. Die G‑BA-Förderung unterstützt damit auch mittelfristig die Nachwuchsgewinnung von Leitlinienentwickler:innen. Inwiefern diese Nachwuchsförderung nachhaltig ist, wird sich in der Zukunft erweisen.

Climate change is the greatest threat to human health and therefore has a direct impact on the work of physicians. At the same time, the health sector is also an originator of pollutants that burden the climate. The concept of Planetary Health describes, among other things, ways in which the health sector can counter the effects of climate change. Nevertheless, the inclusion of contents on sustainable action in the education of health professionals has not been made mandatory to date. The aim of this study is to answer the question of how an intervention has to be designed so that medical students specifically develop an interest in dealing with the topic on their own.The intervention consisted ofFor evaluation purposes, a qualitative study with guided focus group interviews of attendees was conducted. The fully transcribed focus group transcripts were analysed using Mayring's structuring qualitative content analysis. Additionally, we checked the semester evaluation for feedback on the intervention.Four focus groups comprising n = 14 medical students (11 female, 3 male) were conducted. Dealing with Planetary Health as a topic during medical education was considered relevant. The partially restrained to negative reaction of the teaching practice staff involved to the checklist had a demotivating effect. A lack of time was given as a further reason for not dealing with the topic independently. Participants suggested integrating specific Planetary Health content in mandatory courses and considered environmental medicine to be especially suited. As a didactic method, case-based working in small groups seemed to be particularly appropriate. In the semester evaluation, we found both approving and critical commentaries.Participants considered Planetary Health a relevant topic in the context of medical education. The intervention proved to be of limited use in motivating students to deal with the topic independently. A longitudinal integration of the topic in the medical curriculum seems to be appropriate.From the students' perspective, it is important to teach and acquire knowledge and skills regarding to Planetary Health in the future. Despite a high level of interest, additional offers are not being utilised due to a lack of time and should therefore be made part of the mandatory curriculum, where possible.

Background In many countries, the number of applicants to medical schools exceeds the number of available places. This offers the need, as well as the opportunity to medical schools to select those applicants most suitable for later work as a doctor. However, there is no generally accepted definition of a ‘good doctor’. Clinical competencies may serve as surrogates. The aim of this study was to compare medical students in Germany selected based either on their pre-university grade point average alone or based on the result of a university-specific selection procedure regarding their clinical competencies with an emphasis on family medicine in the later years of training. Methods We used the ‘Allgemeinarztbarometer Ausbildung’ (Undergraduate Family Medicine Barometer), an instrument developed to assess clinical competencies with an emphasis on family medicine, to compare students in the pre-university grade point average admission-quota and the university-specific selection procedure admission-quota in the fifth year of training. Students were judged by their supervising general practitioners after a two-week practical course. Competencies were rated on a five-point Likert-scale (1 = ‘totally agree’ i.e. the student is very competent to 5 = ‘totally disagree’ i.e. the student is not competent at all). Results We included 94 students (66% female). Students in the university-specific selection procedure quota ( n = 80) showed better mean scores in every item of the Undergraduate Family Medicine Barometer. We found a statistically significant difference between the two groups for the item assessing communication skills ( M [university-specific selection procedure quota] = 1.81, SD = 0.84 vs. M [pu-GPA quota] = 2.38, SD = 0.96; t [91] = -2.23, p = .03; medium effect size). Logistic regression revealed no statistically significant age or gender contribution. Conclusions Despite the small sample-size, our results indicate, that students selected via an university-specific selection procedure show better communicative competencies in the later years of training.

Ziel des beschriebenen Projekts war es, Studierenden trotz kurzfristiger, pandemiebedingter Absage der Objective Structured Clinical Examination-(OSCE-)Prüfungen ein Assessment auf Prüfebene des shows how nach Miller anbieten zu können. Studierende sollten Videos erstellen, in denen sie selbst bei der Durchführung von verschiedenen körperlichen Untersuchungen bei hausärztlichen Beratungsanlässen zu sehen sind. Geschulte Bewerteninnen bewerteten die auf die Lernplattform hochgeladenen Videos und gaben auf Wunsch ein mündliches Feedback. Die Notenvergabe lag mit 65 „sehr gut“ und 38 „gut“ in einem sehr milden Bereich. Zwölf Prozent der Studierenden wünschten sich ein mündliches Feedback. Ihre Bewertung des Vorgehens fiel gemischt aus. Die Bewerter:innen erlebten ihre Aufgabe und den Ablauf als durchweg positiv. Technisch war das videobasierte Assessment einwandfrei umsetzbar. Die kurzfristige Umsetzung eines videobasierten Assessments im Kontext der medizinischen Ausbildung zeigte sich als machbar. Es könnte nicht nur als Notlösung in Pandemiezeiten, sondern auchzukünftig alszusätzliche Möglichkeit für formatives Feedback dienen.

Places to study at medical schools are scarce, which makes well-designed selection procedures employing criteria with predictive validity for good students and doctors necessary. In Germany, the pre-university grade point average (pu-GPA) is the main selection criterion for medical school application. However, this is criticised. According to a decision by the Federal Constitutional Court, selection must be supplemented with a criterion other than the pu-GPA. Empathy is a core competency in medical care. Therefore, it seems to be an appropriate criterion. This study evaluates the feasibility of an empathy questionnaire and empathy appraisal by a panel for applicant selection. We employed a sequential explanatory mixed-methods design. Results of self- and external assessments of empathy were compared in a quantitative analysis. Thereafter, the concept of empathy and the approach to empathy appraisal by the selection panel members were explored qualitatively in six focus groups with 19 selection panel members using a semi-structured guideline. Transcripts were content analysed using both deductive and inductive coding. We found no significant correlation of self- and external empathy assessment ( ρ (212) = − .031, p > .05). The results of the focus groups showed that, while panel members judged the external empathy assessment to be useful, they had neither a homogenous concept of empathy nor an implicit basis for this assessment. This diversity in panel members’ concepts of empathy and differences in the concepts underlying the Davis Interpersonal Reactivity Index seem to be the main reasons for the lack of correlation between self- and external empathy assessments. While empathy is a possible amendment to established selection criteria for medical education in Germany, its external assessment should not be employed without training panel members based on an established theoretical concept of empathy and an objective self-assessment measure.

Background:Due to the COVID-19 pandemic, the Objective Structured Clinical Examination (OSCE) examinations were cancelled in the short term. This project described how to offer medical students an alternative assessment at Miller's competence level of "shows how".Methods:Students produced videos in which they can be seen performing various physical examinations related to family medicine consultations. Trained assessors rated the videos uploaded to the learning platform and gave verbal feedback if requested.Results:The grading (65 "very good" and 38 "good") was very mild. Twelve per cent of the students requested verbal feedback. Their evaluation of the procedure was mixed. The evaluators consistently assessed their task and the process as positive. Technically, the video-based assessment could be implemented without any problems.Conclusions:The short-term implementation of a video-based assessment in the context of medical education proved to be feasible. It could serve not only as an emergency solution under a pandemic, but also as an additional opportunity for formative feedback in the future.