Papers by Bernhard J Marschall
Research Square (Research Square), Jul 16, 2020
Background: Assessment of the presence and the characteristics of sexual harassment in academic m... more Background: Assessment of the presence and the characteristics of sexual harassment in academic medicine is a global issue. Only limited international data are available so far.
BMC Family Practice, Jul 14, 2020
Background: The responsibility for helping patients understand potential health benefits and risk... more Background: The responsibility for helping patients understand potential health benefits and risks, especially regarding screening tests, falls largely to general practitioners (GPs). The Berlin Numeracy Test (BNT) specifically measures risk literacy (i.e., the ability to understand different aspects of statistical numeracy associated with accurate interpretation of information about risks). This study explored the association between risk literacy levels and clinical experience in GPs vs. medical students. Additionally, the effect of GP risk literacy on evaluation of the predictive value of screening tests was examined. Methods: The participants were 84 GPs and 92 third-year medical students who completed the BNT (total score range 0-4 points). The GPs received an additional case scenario on mammography screening as a simple measure of performance in applying numeracy skills. Results: Despite having an average of 25.9 years of clinical experience, GPs scored no better than medical students on risk literacy (GPs: 2.33 points, 95% confidence interval [CI] 2.08-2.59; students: 2.34, 95% CI 2.07-2.61; P = .983). Of all GPs, 71.6% (n = 58) greatly overestimated the real predictive value. Conclusions: In this study, we found no difference in risk literacy between current students and current GPs. GPs lack risk literacy and consequently do not fully understand numeric estimates of probability in routine screening procedures.
Research Square (Research Square), Jan 8, 2021
Background: Assessment of the presence and the characteristics of sexual harassment in academic m... more Background: Assessment of the presence and the characteristics of sexual harassment in academic medicine is a global issue. Only limited international data are available so far.
Research Square (Research Square), Jan 21, 2021
Background: Assessment of the presence and characteristics of sexual harassment in academic medic... more Background: Assessment of the presence and characteristics of sexual harassment in academic medicine is a global issue. Only limited international data are available so far. Methods: Aim: To assess the extent of sexual harassment and identify the perpetrators in the student population of the medical school of Münster, Germany. A survey was undertaken, using the Medical Women's International Association sexual harassment questionnaire translated into German. The anonymous online questionnaire was sent as a link to all medical undergraduates at Münster Medical School via a mailing list between 1 October and 30 November 2018. Identifying or potentially identifying data were not collected. Data were analysed by descriptive statistical methods such as categorical variables. Baseline characteristics, e.g. answers by male or female medical students, were correlated with their individual sexual harassment experiences and perpetrator groups by means of univariate analysis. Results: A total of 2162 medical students were asked to participate, with 623 (28.8%) completing the survey. Sexual harassment is a significant issue among medical students at Münster Medical School with over half (58.9%) of all undergraduates being exposed to sexually harassing behaviour. In total, 31.8% of all participants reported having experienced unwanted physical sexual contact such as unwanted physical touching, with 87.6% of the victims being female. Overall, 41.3% personally experienced verbal sexual harassment of which 87.4% were female. Furthermore, 8.5% of undergraduates faced forced sexual contact such as oral, anal or vaginal penetration, intercourse and rape, with all victims being female. Perpetrators in these cases were mostly male medical superiors (7.0%) and male patients (18.3%). In general, most perpetrators were patients, followed by medical superiors and educators, and less frequently by colleagues. Conclusions: Sexual harassment in medical education and the medical workplace is a significant problem in a German medical school. Most students experiencing sexual harassment are females. Female students also experience the more serious forms of sexual harassment more often.
Research Square (Research Square), Sep 2, 2019
Background Responsibility for helping patients understand potential health benefits and risks fal... more Background Responsibility for helping patients understand potential health benefits and risks falls largely to general practitioners (GPs), especially for screening tests. The Berlin Numeracy Test (BNT) specifically measures risk literacy, meaning the range of statistical numeracy associated with accurate interpretation of information about risks. This study explored the association between the level of risk literacy and clinical experience, and risk literacy's impact on evaluating the predictive value of screening tests. Methods
DOAJ (DOAJ: Directory of Open Access Journals), 2005
Fragestellung: Der Studierfahigkeitstest der medizinischen Fakultat an der Universitat Munster, d... more Fragestellung: Der Studierfahigkeitstest der medizinischen Fakultat an der Universitat Munster, der im Rahmen des Auswahlverfahrens der Universitat Munster durchgefuhrt wird, umfasst neben einem naturwissenschaftlichen Verstandnistest und einem Motivationsschreiben[for full text, please go to the a.m. URL]
Fragestellung: Im Rahmen des Auswahlverfahrens der Hochschulen wird in Munster seit dem WS 2012/2... more Fragestellung: Im Rahmen des Auswahlverfahrens der Hochschulen wird in Munster seit dem WS 2012/2013 ein Studierfahigkeitstest fur Bewerber auf einen (Zahn)Medizinstudienplatz durchgefuhrt. Dieser setzt sich aus einem Bewerbungsschreiben, einem medizinisch-naturwissenschaftlichen[for full text, please go to the a.m. URL]
Springer eBooks, 2002
Einleitung: Die studentische Ausbildung geniest einen wachsenden Stellenwert und wird nicht zulet... more Einleitung: Die studentische Ausbildung geniest einen wachsenden Stellenwert und wird nicht zuletzt durch die geplante leistungsbezogene Mittelvergabe zu einem vitalen Interesse der mit der universitaren Lehre betrauten Einrichtungen. Eine standardisierte Evaluation der Lehrveranstaltungen stellt hierbei ein unverzichtbares Werkzeug sowohl fur die klinikinterne Bewertung und Weiterentwicklung des Lehrkonzepts als auch fur die gezielte externe Forderung dar. In der Vergangenheit wurden Evaluationsmasnahmen in der Regel mit papierbasierten Fragebogen durchgefuhrt. Nachteile ergaben sich hierbei durch den logistischen Aufwand, die anschliesend notwendige Neueingabe in eine Auswertungssoftware sowie den damit verbundenen Zeitverlust. Ziel dieser Arbeit war daher die Etablierung eines Internet-basierten Systems zur anonymisierten online-Evaluation, um eine kontinuierliche und zeitnahe Auswertung zu ermoglichen. Methoden: Auf Basis von Open-Source-Software (Linux, Apache, MySQL, Perl) wurde eine Web-Anwendung entwickelt. Die Formulierung der Evaluationsfragen erfolgte mit Hilfe der Extensible Markup Language (XML), wobei mit 6 verschiedenen Fragetypen ein auserst flexibles Instrument zum individuellen Entwurf der Fragebogen zur Verfugung stand. Die zu evaluierenden Veranstaltungen wurden mittels ihrer verschiedenen Termine, Themen und Teilnehmergruppierungen identifiziert und verwaltet, so das von der semesterubergreifenden Vorlesung bis hin zum Kleingruppenunterricht ein einfaches Handling gewahrleistet war. Der Zugang zum System erfolgte uber anonymisierte Nutzerkennungen, wobei die Semesterzugehorigkeit uber ein nicht personenbezogenes Kennwort verifiziert wurde. Um ein zeitnahes Feedback zu ermoglichen, wurde jeder Veranstaltungsreihe nur ein definierter Evaluationszeitraum zugewiesen. Mittels eines codierten Nachweises der individuellen quantitativen Evaluationsleistung konnte die Evaluation verpflichtend in die Kriterien zur Scheinvergabe integriert werden. Ergebnisse: Im Sommersemester 2001 wurden mittels der online-Erhebung 4 Veranstaltungsreihen mit insgesamt 53 Terminen evaluiert. Dabei wurden bis zu 15 verschiedene Aspekte von der Darstellung der Lehrinhalte bis zum Einsatz visueller Medien erfast. Drei der Veranstaltungsreihen waren als Frontalvorlesungen der unterschiedlichen Themengebiete der Allgemein- und Viszeralchirurgie, sowie der Unfall- und Handchirurgie ausgelegt. Bei einer fur die Scheinvergabe verpflichtenden Evaluation erreichten 80% der Teilnehmer die Kurskriterien. An der freiwilligen Evaluation der vierten Veranstaltungsreihe, einer Seminarreihe in Kleingruppenunterrichtsform, beteiligten sich 32% der Teilnehmer. Diskussion: Die ausgewerteten Daten zeigen, das das Programm erfolgreich in die Nutzung eingefuhrt werden konnte. Eine hohe Beteiligung durch die Studierenden, eine wesentliche Reduktion des Evaluationsaufwands und ein zeitnahes Feedback machen es zu einem interessanten Tool um sowohl innovative Lehrprojekte adaquat zu implementieren, als auch bestehenden Curricula hinsichtlich einer qualitatsbezogenen Mittelvergabe zu evaluieren. In diesem Sinne ist in naher Zukunft die fakultatsweite Nutzung zur Lehrevaluation vorgesehen. Daruber hinaus ermoglicht der konfigurierbare Aufbau des Programms weitergehende Nutzungen, die beispielhaft mit einer Nutzerbefragung im Rahmen eines Teleradiologiepro-jekts umgesetzt wurden.
PubMed, 2023
Background: Medical students need to be prepared for various situations in clinical decision-maki... more Background: Medical students need to be prepared for various situations in clinical decision-making that cannot be systematically trained with real patients without risking their health or integrity. To target system-related limitations of actor-based training, digital learning methods are increasingly used in medical education, with virtual reality (VR)- training seeming to have high potential. Virtually generated training scenarios allow repetitive training of highly relevant clinical skills within a protected, realistic learning environment. Thanks to Artificial Intelligence (AI), face-to-face interaction with virtual agents is feasible. Combining this technology with VR-simulations offers a new way of situated context-based, first-person training for medical students. Project goal and method: The authors' aim is to develop a modular digital training platform for medical education with virtual, interactable agents and to integrate this platform into the medical curriculum. The medical tr.AI.ning platform will provide veridical simulation of clinical scenarios with virtual patients, augmented with highly realistic medical pathologies within a customizable, realistic situational context. Medical tr.AI.ning is scaled to four complementary developmental steps with different scenarios that can be used separately and so each outcome can successively be integrated early within the project. Every step has its own focus (visual, movement, communication, combination) and extends an author toolbox through its modularity. The modules of each step will be specified and designed together with medical didactics experts. Perspective: To ensure constant improvement of user experience, realism, and medical validity, the authors will perform regular iterative evaluation rounds.Furthermore, integration of medical tr.AI.ning into the medical curriculum will enable long-term and large-scale detection of benefits and limitations of this approach, providing enhanced alternative teaching paradigms for VR technology.
2022 IEEE Conference on Virtual Reality and 3D User Interfaces Abstracts and Workshops (VRW), Mar 1, 2022
Patient protection and university hospital specialisations render a systematic training of physic... more Patient protection and university hospital specialisations render a systematic training of physician-related skills increasingly difficult. Substitutes such as manikins or actor-based role-playing simulations are expensive and cannot be used for all clinical situations. As a consequence, teaching practical clinical skills has become one of the key concerns of modern medical education. Here we present a VR-based training prototype which allows medical students to perform brain death examinations in a virtual intensive care environment. Brain death diagnosis is a prime example for the challenges of medical education since it can neither be trained in simulations nor involve real patients, so that our simulation - for the first time - enables practical training of this legally obligatory and medically crucial diagnostic procedure. In particular, we motivate the use-case and teaching goals and describe the implementation of our prototype which is evaluated by medical experts to ensure medico-didactic standards.
GMS Journal for Medical Education, 2021
Einleitung: Ausländische ÄrztInnen sind in Deutschland fester Bestandteil der Ärzteschaft. ÄrztIn... more Einleitung: Ausländische ÄrztInnen sind in Deutschland fester Bestandteil der Ärzteschaft. ÄrztInnen mit einer Ausbildung aus einem Drittstaat müssen laut der Approbationsordnung für Ärzte eine Kenntnisprüfung ablegen, für die die Landesprüfungsämter oder die Bezirksregierungen zuständig sind. Projektbeschreibung: Der Vorbereitungskurs besteht aus 10 Modulen. Freitags werden Fälle in Kleingruppen besprochen und fachspezifische Untersuchungstechniken geübt. Samstags werden mit SimulationspatientInnen bestimmte Krankheiten simuliert. Nach der Interaktion bekommen die TeilnehmerInnen ein 360°-Feedback von FachdozentInnen, PsychologInnen und KollegInnen aus der Gruppe. Durch die Corona-Pandemie wurde der schon seit 2 Jahren bestehende Kurs innerhalb von einer Woche auf ein Onlineformat umgestellt. Die Freitagseinheiten wurden mit Power-Point visualisiert und Lernvideos besprochen. Samstags wurden die Fälle mit SimulationspatientInnen telemedizinisch simuliert. Ergebnisse: Der Kurs konnte ohne Unterbrechung durchgeführt werden (75 Stunden als Präsenz-, 75 Stunden als Online-Unterricht). In der mündlichen Evaluation der TeilnehmerInnen wurde die telemedizinische Vermittlung von praktischen Fertigkeiten bemängelt. 7/22 (32%) der TeilnehmerInnen haben an der Kenntnisprüfung teilgenommen, 6/7 (86%) haben die Prüfung bestanden (in Präsenzunterricht 18/19 (95%)). Diskussion: Der Präsenzunterricht wurde eindeutig präferiert. Es wurden Einschränkungen durch das telemedizinische Setting festgestellt. Die Bestehungsquote hat sich durch die Umstellung nicht verändert. Schlussfolgerung: Die Umstellung von Präsenzeinheiten auf Online war möglich. Die Erfahrungen flossen in die Entwicklung der Online-Semester an unserer Fakultät ein, insbesondere der Unterricht mit den SimulationspatientInnen.
Auscultation torsos are widely used to teach position-dependent heart sounds and murmurs. To prov... more Auscultation torsos are widely used to teach position-dependent heart sounds and murmurs. To provide a more realistic teaching experience, both whole body auscultation mannequins and torsos have been used in clinical examination skills training at the Medical Faculty of the University of Muenster since the winter term of 2008-2009. This training has since been extended by simulated patients, which are normal, healthy subjects who have undergone attachment of the electronic components of the auscultation mannequins to their chests to mimic pathophysiological conditions ("hybrid models"). The acceptance of this new learning method was examined in the present pilot study. In total, 143 students in their second preclinical year who were participating in auscultation training were randomized into an intervention group (hybrid models) and a control group (auscultation mannequins). One hundred forty-two (99.3%) of these students completed a self-assessment Likert-scale questionnaire regarding different teaching approaches (where 1 ϭ "very poor" to 100 ϭ "very good"). The questionnaire focused on the "value of learning" of different teaching approaches. Direct comparison showed that students evaluated the hybrid models to be significantly more effective than the auscultation mannequins (median: 83 vs. 64, P Ͻ 0.001). The cardiac auscultation training was generally assessed positively (median: 88). Additionally, verbal feedback was obtained from simulated patients and tutors (trained students who had successfully passed the course a few semesters earlier). Personal feedback showed high satisfaction from student tutors and simulated patients. Hybrid simulators for teaching cardiac auscultation elucidated positive responses from students, tutors, and simulated patients. hybrid simulator; heart auscultation; auscultation MANY GENERATIONS of doctors have used stethoscopic auscultation of the heart and lungs as an essential part of assessing patients' health. This technique is currently an effective and inexpensive assessment method (10, 20, 23). However, there have been complaints about the enormous loss of auscultation skills among health professionals, especially doctors (11). Current research in this field has revealed that physicians' general skills in cardiac auscultation are astonishingly low (12). Additionally, cardiac auscultation skills do not substantially increase during specialist training (13). This is why medical schools play a very important role in teaching auscultation.
Gastroenterology, May 1, 2012
the first formal Gastroenterology meeting in Zambia sponsored by the British Society of Gastroent... more the first formal Gastroenterology meeting in Zambia sponsored by the British Society of Gastroenterology participants expressed interest in improving knowledge base of gastroenterology. This objective was met by a structured 4 day symposium focusing on case based presentations and introduction to endoscopy. The beneficial effect of a structured symposium in developing countries warrants further attention as a mechanism to improve disease awareness in areas where resources are limited.
Medical Teacher, Oct 17, 2018
Context: Deficits in basic skill performance and long-term skill retention among medical students... more Context: Deficits in basic skill performance and long-term skill retention among medical students and novice doctors are a persistent problem. This controlled study tested whether the addition of a mastery learning component to simulationbased teaching is associated with long-term retention and performance of peripheral venous catheter insertion. Methods: Fourth-year medical students were assigned to receive either the control (simulation without mastery learning, n ¼ 131) or the intervention (simulation þ mastery learning, n ¼ 133) instruction in peripheral venous catheter insertion. Performance was assessed at one year post-instruction. Eighty-four students from the control group and 71 from the intervention group participated in the assessment. Results: Students who received the mastery learning instruction achieved higher overall test scores than did controls (median mastery learning score: 20.0, IQR 2.0; median control score 19.0, IQR 3.0; Mann-Whitney U test, p < 0.001, effect size d ¼ 0.82). Pass rates also differed significantly between the groups, with 74.5% (n ¼ 53) of the intervention group passing compared with 33% (n ¼ 28) of the control group (p < 0.001). Conclusions: Mastery learning is an effective means of teaching practical skills to medical students, and is associated with higher scores at a 1-year follow up.
Die Wirbelsäule, Mar 8, 2017
Was ist der Bedarf? Der Bedarf an Kolleginnen und Kollegen, die in der Wirbelsäulenchirurgie eine... more Was ist der Bedarf? Der Bedarf an Kolleginnen und Kollegen, die in der Wirbelsäulenchirurgie eine Ausbildung beginnen und/oder abschließen ist groß. Klinikleitungen beklagen, dass offene Weiterbildungsplätze nicht flächendeckend mit geeigneten Kandidat(inn)en besetzt werden können. Kontrovers wird diskutiert, ob es sich um einen gefühltenalso subjektivenoder einen objektiven Mangel handelt. Dies ähnelt der aktuell geführten Diskussion um den Mangel an Nachwuchs in anderen chirurgischen Fachbereichen. Obwohl der Anteil weiblicher Jungmediziner zunehmend ansteigt, scheint die Wirbelsäulenchirurgie immer noch eine männliche Domäne zu sein. Dabei handelt es sich um keinen untypischen Befund im Bereich der chirurgischen Weiterbildung. In einem 2014 erschienen Artikel zu "Gender differences in the learning and teaching of surgery: a literature review" konnte anhand einer systematischen Metaanalyse evaluiert werden, dass ein europaweiter 10-20 %iger Frauenanteil in der Chirurgie zu finden ist im Vergleich zu 50-70 % Anteil weiblicher Medizinstudierenden. Nur 2-29 % der weiblichen Medizinstudierenden bekunden laut Metaanalyse Interesse an einem operativen Fach (bei den Männern 15-42 %) [1]. Vor diesem Hintergrund zeichnen sich zwei zentrale Fragen ab, die nachfolgend näher beleuchtet werden sollen: "Welche Unternehmungen können hilfreich sein, um wirksam Nach
Springer eBooks, 1998
Bei weiterhin steigender Zahl von Patienten auf der Nierentransplantationswarteliste wurden versc... more Bei weiterhin steigender Zahl von Patienten auf der Nierentransplantationswarteliste wurden verschiedene Programme zur Transplantation marginaler Spendernieren etabliert.
PubMed, 2016
Objective: Inserting peripheral venous catheters (PVCs) has been identified as a core competency ... more Objective: Inserting peripheral venous catheters (PVCs) has been identified as a core competency for medical students. Because the performance - even of hygienic standards - of both students and novice physicians is frequently inadequate, medical faculties must focus on competence-based learning objectives and deliberate practice, features that are combined in mastery learning. Our aim was to determine the competency of students in inserting PVCs before and after an educational intervention. Design: This study comprised a skills assessment with pre- and post-tests of a group of third-year students who received a simulation-based intervention. A newly established curriculum involved one hour of practice at inserting PVCs on simulators. Students were required to pass a test (total 21 points, pass mark 20 points) developed on the concept of mastery learning. An unannounced follow-up test was performed one week (8 days) after the intervention. Setting: The simulation center of the medical faculty in Muenster. Participants: Third-year students who received the intervention. Results: One hundred and nine complete data sets were obtained from 133 students (82.5%). Most students (97.2%) passed the test after the intervention (mean score increase from 15.56 to 20.50, P<0.001). There was a significant decrease in students' performance after one week (8 days): only 74.5% of participants passed this retest (mean score reduction from 20.50 to 20.06, P<0.001). Conclusion: Mastery learning is an effective form of teaching practical skills to medical students, allowing a thorough preparation for the challenges of daily clinical practice.
Research Square (Research Square), Aug 27, 2020
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Papers by Bernhard J Marschall