In Germany, medical students in their final year will work in hospitals or medical offices to gain clinical experience. The final year is designed to prepare medical students for their work as junior doctors. It is divided into three parts and includes internal medicine and general surgery as mandatory parts. Many students develop enthusiasm or lack of enthusiasm while working in specific disciplines and often apply for jobs based on their experience in their final year. Despite the importance of this educational phase, the 36 medical faculties have implemented several different curricula and there is significant heterogeneity. There is no consistent nation-wide structure of the final year in Germany. General Surgery with its many subdiscplines is a central subject of the final year. We conducted a national survey to assess the educational structure of the final year in Germany. The survey demonstrated the significant heterogeneity of medical education provided by different medical schools. Acquisition of surgical knowledge is not guaranteed with the current structure and the anticipated knowledge gap of future doctors is worrying. We therefore recommend nation-wide consistent education for medical students in their final year, in order to ensure a solid and broad knowledge of general surgery.
ZusammenfassungDie fachärztliche Weiterbildung in Deutschland wird durch die Bundesärztekammer definiert und mittels Facharztprüfung kontrolliert. Die Umsetzung obliegt jedoch jeder Klinik selbst. Besonders in der Chirurgie geht es nicht nur um die Aneignung von theoretischem Wissen, sondern auch um die Erlangung praktischer Fähigkeiten. Diese werden seit jeher im Operationsaal geschult. Doch es mehren sich ethische Bedenken. Zusätzlich steigen die Anforderungen durch neue OP-Techniken und den wirtschaftlichen Druck, der auf Kliniken lastet. Die Einführung eines strukturierten Weiterbildungsprogramms kann zur Verbesserung der Ausbildungssituation beitragen. In unserer Klinik erfolgte die Entwicklung und Etablierung eines Weiterbildungscurriculums. Es werden theoretische und praktische Bausteine obligat in den Klinikalltag integriert, um die limitierte zur Verfügung stehende Zeit effektiv zur Weiterbildung zu nutzen. Die Verlagerung der Lernkurve vor den Operationssaal wird hoffentlich zur Reduktion von Komplikationen und OP-Zeit führen, was sowohl die Patientenzufriedenheit als auch die Klinikeffizienz erhöht. Die konsequente Umsetzung einer strukturierten Weiterbildung stellt eine große finanzielle und zeitintensive Herausforderung für alle Kliniken dar. Zukünftige Bemühungen müssen u. a. einen Fokus auf die Umsetzbarkeit innerhalb der Regelarbeitszeit setzen.
Purpose Structured reporting (SR) is increasingly used. So far, there is minimal experience with SR in whole-body computed tomography (WBCT). The aim of this study was to investigate the value of routine use of SR in WBCT in trauma with a focus on reporting time, reporting errors, and referrer satisfaction. Materials and Methods Reporting time and reporting errors of CT reports were prospectively quantified for residents and board-certified radiologists 3 months before and for 6 months after implementation of a structured report in the clinical routine. Referrer satisfaction was prospectively quantified by means of a survey before and after the implementation period of SR using a 5-point Likert scale. Before and after results were compared to determine the effect of structured reporting on WBCT in trauma at our institution. Results The mean reporting time was lower when using SR (65 ± 52 min. vs. 87 ± 124 min., p = .25). After 4 months, the median reporting time was significantly lower with SR (p = .02). Consequently, the rate of reports that were finished within one hour rose from 55.1 % to 68.3 %. Likewise, reporting errors decreased (12.6 % vs. 8.4 %, p = .48). Residents and board-certified radiologists reported fewer errors when using SR with 16.4 % vs. 12.6 % and 8.8 % vs. 2.7 %, respectively. General referrer satisfaction improved (1.7 ± 0.8 vs. 1.5 ± 1.1, p = .58). Referrers graded improvements for standardization of reports (2.2 ± 1.1 vs. 1.3 ± 1.1, p = .03), consistency of report structure (2.1 ± 1.1 vs. 1.4 ± 1.1, p = .09), and retrievability of relevant pathologies (2.1 ± 1.2 vs. 1.6 ± 1.1, p = .32). Conclusion SR has the potential to facilitate process improvement for WBCT in trauma in the daily routine with a reduction of reporting time and reporting mistakes while increasing referrer satisfaction. Key Points: Citation Format
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