Lehre im Fokus – Wie beurteilen Studierende ihre praktisch-klinische Ausbildung in der Chirurgie?

Rüsseler, Miriam; Schill, Anna; Kalozoumi-Paisi, P.; Ganzert, Christian; Arheilger, L.; Sterz, Jasmina; Kollewe, Thomas; Hoefer, Sebastian; Adili, Farzin

doi:10.1055/s-0042-116326

Cited by 11 publications

(8 citation statements)

References 22 publications

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“…Students’ supervision in the wards during clinical placements is mostly carried out by residents. They have to be more aware of their function as role models [29]. In this function, they should demonstrate the “how and why” of their daily work and decisions.…”

Section: Discussionmentioning

confidence: 99%

Young surgeons’ challenges at the start of their clinical residency: a semi-qualitative study

Stefanescu

Sterz

Hoefer

et al. 2018

Innovative Surgical Sciences

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IntroductionAccording to German regulations on licensing to practice medicine, the aim of undergraduate medical training is to produce a scientifically and practically trained physician who is able to work independently. More precisely, medical training has to impart the required knowledge and skills in diagnostics, therapy, health promotion, prevention, and rehabilitation. From the young residents’ point of view, this aim is not achieved, and they do not feel prepared to be a doctor. However, the literature on this subject relies mostly on data based on surveys, and there is a lack of deep analysis of the specific details of the topic. The aim of this study was to analyze in depth how junior doctors in their first and second years felt about their preparation for clinical practice as a doctor from their undergraduate training, as well as which teaching formats and factors influence their preparedness.MethodsThis semi-qualitative study is based on recorded interviews conducted using a structured interview manual. This serves to limit the subject matter of the interview and to target the topics. The study participants were 35 residents of general and visceral surgery, trauma surgery, and urology in their first and second years of medical specialty training. The number of participants was defined by the concept of saturation of the content. Basic data regarding age and the location and length of study were collected using a questionnaire. The audio recordings were transcribed word by word and analyzed with structured qualitative content analysis techniques.ResultsOnly 43% (n=15) of the 35 participating residents stated they were sufficiently prepared to be a doctor from undergraduate medical training, and 22.9% stated that they were not prepared for their work as a resident (8/35). However, 34.3% of the residents stated that undergraduate medical training did prepare them for some of the parts they were expected to master in daily clinical practice, but not other parts. Most of the participants described their first weeks as doctors as particularly stressful and exhausting. As major hurdles during their daily clinical work, participants described knowledge gaps regarding organizational and administrative pathways (71%), deficits in linking knowledge to clinical reasoning (71%), decision making (54%), and therapy planning (51%). Most participants stated that the practical placements during the semester, the clinical clerkships, and the last year internship were most effective as preparation for clinical residency. To be better prepared for clinical practice, participants suggested providing a clearer structure and that the course subjects bear better relations to each other. Nearly all participants proposed increasing patient encounters directly from the beginning of medical training as a longitudinal approach.DiscussionEven though we were able to demonstrate an increase in residents’ preparedness, 57% of the study participants still felt unprepared for their job to some extent. One might argue that starting a new profession will always result in a feeling of being unprepared to some extent. However, this unpreparedness can increase the risk for patients’ well being due to medical errors, which actually represents the third leading cause of death in the US after malignant tumors and cardiovascular diseases. Structured on-the-job adjustment, structured qualification training, and guided professional training are becoming increasingly important for future doctors as selection criteria for career choice and choice of employer. Thus, the surgical disciplines that are struggling with new young residents have to improve their concepts.

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Section: Discussionmentioning

confidence: 99%

Young surgeons’ challenges at the start of their clinical residency: a semi-qualitative study

Stefanescu

Sterz

Hoefer

et al. 2018

Innovative Surgical Sciences

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“…Despite this, students complain that too little feedback is provided in medical education [7]. Possible reasons for this are the fear of destroying a good relationship with the learner through negative feedback or the lack of time with which to integrate feedback into everyday clinical practice [8].…”

Section: Feedbackmentioning

confidence: 99%

Implementation of written structured feedback into a surgical OSCE

et al. 2021

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Background Feedback is an essential element of learning. Despite this, students complain about receiving too little feedback in medical examinations, e.g., in an objective structured clinical examination (OSCE). This study aims to implement a written structured feedback tool for use in OSCEs and to analyse the attitudes of students and examiners towards this kind of feedback. Methods The participants were OSCE examiners and third-year medical students. This prospective study was conducted using a multistage design. In the first step, an unstructured interrogation of the examiners formed the basis for developing a feedback tool, which was evaluated and then adopted in the next steps. Results In total, 351 students and 51 examiners participated in this study. A baseline was created for each category of OSCE station and was supplemented with station-specific items. Each of these items was rated on a three-point scale. In addition to the preformulated answer options, each domain had space for individual comments. A total of 87.5% of the students and 91.6% of the examiners agreed or rather agreed that written feedback should continue to be used in upcoming OSCEs. Conclusion The implementation of structured, written feedback in a curricular, summative examination is possible, and examiners and students would like the feedback to be constant.

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“…Insgesamt bewerten die Studierenden die Lehre am Krankenbett als dringend notwendig zum Erlernen praktischer Fertigkeiten [17][18][19]26]. Jedoch bemängeln sie, dass ihr eigener Unterricht der Patientenversorgung nachgeordnetund damit durch die Faktoren Zeit und ärztliches Personal deutlich und zunehmend limitiert ist [19,22,26]. Dies konnte in verschiedenen Arbeiten bestätigt werden, die einen Rückgang der Lehre am Krankenbett beschreiben [1,17,18].…”

Section: Hintergrundunclassified

Der Chirurg im Spagat – Lehre im klinischen Alltag

Sterz

Britz

Carstensen

et al. 2021

Chirurg

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Zusammenfassung Hintergrund Aufgrund des Nachwuchsmangels muss die Chirurgie vermehrt für die Weiterbildung zum Chirurgen begeistern. Studierende bemängeln, dass ihr Unterricht nachrangig zur Patientenversorgung und durch die Faktoren Zeit und ärztliches Personal limitiert ist. Obwohl es viele Arbeiten mit Fokus auf die Studierenden gibt, fehlen Arbeiten mit dem Fokus auf die Sicht der Lehrenden. Ziel der Arbeit Die Lehre im Fach Chirurgie im Stationsalltag und Ursachen von Problemen hierbei sollen aus Sicht der Lehrenden analysiert werden. Material und Methoden Im Rahmen der prospektiven Studie wurde ein Leitfaden für semistrukturierte Interviews mit ausformulierten, offenen Fragen erstellt, die mit weiteren Spezifizierungsfragen versehen wurden. Alle Interviews wurden anhand des Leitfadens geführt und aufgezeichnet. Die Anzahl der Interviews ergab sich aus dem Prinzip der inhaltlichen Sättigung. Ergebnisse Alle der 22 befragten Ärzte messen der Lehre im klinischen Alltag einen hohen Stellenwert bei. Dennoch beschreiben sie, dass die Lernziele im klinischen Alltag nicht immer erreicht werden. Als Hauptgrund hierfür wird die mangelnde Zeit genannt. Mit zunehmender klinischer Erfahrung kommen jedoch weitere Faktoren hinzu: Ober- und Chefärzte beklagen die zu geringen Vorkenntnisse und die zu geringe Motivation einiger Studierender. Die meisten Befragten beschreiben, keine Anerkennung für ihre Lehre zu erhalten. Insgesamt wird die studentische Lehre als zusätzliche Belastung wahrgenommen, die aber alle Befragten für lohnenswert halten. Diskussion Neben Personalmangel ist die fehlende Anerkennung das wichtigste Hemmnis für eine effektive Lehre. Es ist daher wichtig, die Wertigkeit der Lehre durch die Belohnung guter Lehrleistungen und Schaffung einer dahingehenden Transparenz zu erhöhen.

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Lehre im Fokus – Wie beurteilen Studierende ihre praktisch-klinische Ausbildung in der Chirurgie?

Cited by 11 publications

References 22 publications

Young surgeons’ challenges at the start of their clinical residency: a semi-qualitative study

Young surgeons’ challenges at the start of their clinical residency: a semi-qualitative study

Implementation of written structured feedback into a surgical OSCE

Der Chirurg im Spagat – Lehre im klinischen Alltag

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