Objective: The present study gives a brief introduction into 1. the definition of physician empat... more Objective: The present study gives a brief introduction into 1. the definition of physician empathy (PE) and 2. its influence on patients' health outcomes. Furthermore 3. we present assessment instruments to measure PE from the perspective of the patient and medical student. The latter topic will be explored in detail as we conducted a pilot study on the German versions of two self-assessment instruments of empathy, which are mostly used in medical education research, namely the "Jefferson Scale of Physician Empathy, Student Version" (JSPE-S) and the "Interpersonal Reactivity Index" (IRI). Methods: We first present an overview of the current empirical and theoretical literature on the definition and outcome-relevance of PE. Additionally, we conducted basic psychometric analyses of the German versions of the JSPE-S and the IRI. Data for this analyses is based on a cross-sectional pilot-survey in N=44 medical students and N=63 students of other disciplines from the University of Cologne. Results: PE includes the understanding of the patient as well as verbal and non-verbal communication, which should result in a helpful therapeutic action of the physician. Patients' health outcomes in different healthcare settings can be improved considerably from a high quality empathic encounter with their clinician. Basic psychometric results of the German JSPE-S and IRI measures show first promising results. Conclusion: PE as an essential and outcome-relevant element in the patient-physician relationship requires more consideration in the education of medical students and, thus, in medical education research. The German versions of the JSPE-S and IRI measures seem to be promising means to evaluate these education aims and to conduct medical education research on empathy.
Background: Good communication is a major factor in delivering high quality in care. Research ind... more Background: Good communication is a major factor in delivering high quality in care. Research indicates that current communication skills training alone might not sufficiently enable students to find context-specific creative solutions to individual complex personal and interpersonal challenges in the clinical context. This study explores medical students' experiences with real communication dilemmas in a facilitated group setting. The aims were to gain a better understanding of whether and, if so, how reflective practice can enhance students' ability to find creative individual solutions in difficult communication situations and to identify factors within the reflective setting that foster their creative competency. Methods: Thematic content analysis was used to perform a secondary analysis of semi-structured interview data from a qualitative evaluation of a group reflective practice training for final-year medical students. The categories that arose from the iterative deductive-inductive approach were analyzed in light of current scientific understandings of creativity. Results: Reflection on real difficult clinical communication situations appears to increase medical students' ability to handle such situations creatively. Although group reflection on clinical dilemmas involving personal aspects can stir up emotions, participating students stated they had learned a cognitive process tool that enhanced their communicative competence in clinical practice. They also described changes in personal attitudes: they felt more able to persevere and to tolerate ambiguity, described themselves more open and self-efficient in such complex clinical communication situations and thus more motivated. Furthermore, they reported on factors that were essential in this process, such as reflection on current and real challenges, a group format with a trainer. Conclusions: Reflective practice providing a cognitive process tool and using real clinical challenges and trainer support in communication education may provide learners with the skills and attitudes to develop creativity in practice. Implementing reflection training in clinical communication education may increase students' overall communicative competency.
The aim of this study was to investigate the relevance and the barriers of physician empathy in m... more The aim of this study was to investigate the relevance and the barriers of physician empathy in medical rehabilitation by conducting a narrative literature review and a qualitative survey in physicians. First, we described the current state of research of physician empathy in medical rehabilitation based on a narrative (non-systematic) review of the literature. Additionally, the questions of relevance and barriers of physician empathy were examined in a qualitative short survey with physicians from Rehabilitation Medicine, Internal Medicine, Pediatric and Family Medicine. The qualitative data were analyzed according to the summarizing content analysis of Mayring. Only n=13 studies of physician empathy were conducted in Rehabilitation Medicine; of those, just a few were from Germany and a small number investigated the influence of empathy on patient health outcomes. The qualitative survey's results regarding the definition, patient outcomes and barriers of physician empathy are similar to other theoretical and empirical studies on those issues. Moreover, they show many new, practical aspects, particularly in the field of barriers of physician empathy. Although physician empathy has been shown to be an outcome-relevant factor in acute health care, less attention has been paid to it in Rehabilitation research. Physicians from Rehabilitation Medicine, Internal Medicine, Pediatric and Family Medicine perceive empathic behavior also as an outcome-relevant ability, which is particularly hindered by time pressure and stress but also by personal and patient-specific factors.
Intra- and interpersonal competences (IICs) are essential for medical expertise. However, the eff... more Intra- and interpersonal competences (IICs) are essential for medical expertise. However, the effects of current medical curricula seem to not be sustainable enough, even though poorly trained IICs have negative effects on medical practice. A defensive attitude towards openly addressing personal–professional challenges seems to hinder a sustainable implementation of IICs training. Therefore, this study asks about the changeability of IICs and target factors of their implementation in medical education. The aim was to detect factors for the sustainable implementation of IICs in medical education from medical and non-medical perspectives. For this purpose, a total of 21 experts were interviewed. The interview material was analysed according to grounded theory principles to generate core categories to answer the research questions. As a first result, analysis revealed that IICs are changeable and developable, not in all, but in many students. It also showed four central prerequisites f...
ZUSAMMENFASSUNG Hintergrund Verschiedene Studien berichten über das Stresserleben von Krankenhaus... more ZUSAMMENFASSUNG Hintergrund Verschiedene Studien berichten über das Stresserleben von Krankenhausmitarbeitern während der COVID-19-Pandemie, aber auch vor der Pandemie fühlten sich viele ärztliche Klinikmitarbeiter durch ein hohes Arbeitspensum oder unklare Vorgaben emotional erschöpft. Methoden Kognitive Bewertungen und das Stresserleben von ärztlichem Krankenhauspersonal aus 6 Kliniken im zeitlichen Verlauf der COVID-19-Pandemie wurden ausgewertet. Neben der deutschsprachigen Version des „Stress Appraisal Measure“ (SAM) wurden die COVID-19-Patientenbelegungen und die relative Bettenbelegung erfragt; Korrelationen im Quer- und Längsschnitt wurden berechnet. Ergebnisse Teilnehmer t1: 170, t2: 55, t3: 47 Ärzte. Obwohl keine Erfahrung mit einer solchen Pandemie vorhanden war, waren die SAM-Mittelwerte nicht auffallend unterschiedlich im Zeitverlauf. Höhere lokale Neuinfektionen gingen nicht einher mit einer erhöhten Bewertung, die Situation als bedrohlich oder stressend zu erleben. Ho...
Fragestellung/Zielsetzung: Die professionelle Persönlichkeitsentwicklung ist neben dem Erwerb von... more Fragestellung/Zielsetzung: Die professionelle Persönlichkeitsentwicklung ist neben dem Erwerb von medizinischen Kompetenzen ein wichtiger Teil der ärztlichen Ausbildung. Um passende curriculare Unterstützungsangebote zu implementieren, ist es notwendig zu verstehen, wie Medizinstudierende [zum vollständigen Text gelangen Sie über die oben angegebene URL]
Fragestellung/Zielsetzung: Aktive Teilhabe in der Praxis der Patientenversorgung ist für Medizins... more Fragestellung/Zielsetzung: Aktive Teilhabe in der Praxis der Patientenversorgung ist für Medizinstudierende essentiell, um ärztliche Kompetenzen und ein Sinn für die professioneller Identität zu erwerben. Die klinische Lernumgebung wird jedoch zunehmend durch Spezialisierung, [zum vollständigen Text gelangen Sie über die oben angegebene URL]
Fragestellung/Einleitung: Im Gemeinschaftskrankenhaus Herdecke gibt es seit 2007 eine internistis... more Fragestellung/Einleitung: Im Gemeinschaftskrankenhaus Herdecke gibt es seit 2007 eine internistische, integrativ-medizinische Ausbildungsstation(ASIM). Studierende übernehmen unter enger ärztlicher Supervision die Patientenversorgung von 2–4 Patienten. Diese Studie untersucht, [for full text, please go to the a.m. URL]
Fragestellung/Einleitung: Psychische Belastungen im Studien- und Ausbildungsalltag sind bekannt [... more Fragestellung/Einleitung: Psychische Belastungen im Studien- und Ausbildungsalltag sind bekannt [ref:1], [ref:2] und bei nationalen und internationalen Tagungen und Kongressen ein wiederkehrendes Thema. Die Ursachen für die Belastungen sind unterschiedlich und für [zum vollständigen Text gelangen Sie über die oben angegebene URL]
Fragestellung: Die Vermittlung reflektiver Fähigkeiten wird zunehmend in der Ärzte-Ausbildung emp... more Fragestellung: Die Vermittlung reflektiver Fähigkeiten wird zunehmend in der Ärzte-Ausbildung empfohlen. Unsere Studie verfolgt zwei Ziele: a. die Beschreibung eines klinischen Begleitseminares "Reflektives Lernen" (RL) und b. die Darstellung der qualitativen Ergebnisse v[for full text, please go to the a.m. URL]
Fragestellung: Nachdem die erste PJ-Ausbildungsstation Innere Medizin sowohl von Studierenden als... more Fragestellung: Nachdem die erste PJ-Ausbildungsstation Innere Medizin sowohl von Studierenden als auch von Patienten und Mitarbeitern positiv evaluiert wurde [ref:2], [ref:3] hat das Integrierte Begleitstudium Anthroposophische Medizin (IBAM) das Modell der klinischen Ausbildungsstation[for full text, please go to the a.m. URL]
Background: In October 2018, the University of Witten/Herdecke (UW/H) launched the new reformed m... more Background: In October 2018, the University of Witten/Herdecke (UW/H) launched the new reformed medical education programme called Medicine 2018+. A major innovation compared to the existing model programme was the introduction of thematic focuses. A longitudinal communication skills curriculum was integrated into the new thematic focus "professional and personal development – inner work" (IAP). With the start of the new programme, the IAP curriculum has been built step-by-step over time, i.e. the first four semesters have already been implemented, the following semesters are being planned. Project description: IAP aims to provide students with patient-centred medicine. Five areas of competence were defined: Doctor-patient communication, team competence, staying healthy, my paths to becoming a doctor, medicine and society. The focus of this article is on the communication curriculum. The first year of study focusses on the training of basic communication skills. In the 2nd...
Background Professional intrapersonal and interpersonal competences (IICs) form an important part... more Background Professional intrapersonal and interpersonal competences (IICs) form an important part of medical expertise but are given little attention during clinical training. In other professional fields such as psychotherapy, education and aviation, training in IICs is an integral part of education and practice. In medicine, IICs tend to actually decline during studies. To date it is unclear why IICs are given less attention in medicine, despite evidence for their importance in the treatment process. In view of this, the study examined the role of IICs in the treatment process, the current situation of IIC training in medicine and, most importantly, the reasons for the comparatively low focus on IICs in the clinical training of medical students. Methods Semi-structured interviews were carried out with 21 experts from a variety of medical specialties and non-medical professions that provide a training with a stronger focus on IIC development. The interviews were evaluated using gro...
Introduction & question: Active student participation (ASP) in Clinical Education Wards (CEW) int... more Introduction & question: Active student participation (ASP) in Clinical Education Wards (CEW) integrates students actively in interprofessional health care teams. By this manner of workplace based learning (WBL) students acquire practical skills and different qualities of professionalism. Previous[for full text, please go to the a.m. URL]
Introduction: The University of Witten/Herdecke (UW/H) was founded in 1982 as the first privately... more Introduction: The University of Witten/Herdecke (UW/H) was founded in 1982 as the first privately run German university. In addition to economics, dentistry, a center for life sciences and the institute for general studies, the main focus from the inception of the University was the development of a model course in medical studies. Methodology: A description of the history of the development of medical studies in relation to the reasons for its founding, its founding ideals and their implementation; phases of development, transformations and influencing factors are presented in detail. External assessments are also used for this purpose. Result: The “Herdecke Model” was first implemented with the initial group of medical students in 1983. In the past 36 years the curriculum for medical education in Witten/Herdecke has evolved to meet internal and external requirements. The goals of the founders for a reform of medical studies and the founding ideals of the UW/H have continued to lea...
This study examines whether students in the clinical phase show reduced well-being and lower empa... more This study examines whether students in the clinical phase show reduced well-being and lower empathy scores compared to preclinical students. Furthermore, it explores students' most stressful experiences. Methods: A cross-sectional mixed-methods study was conducted among medical students of the revised patient-and student-centred curriculum at Witten/Herdecke University (Germany). An online survey included questions regarding empathy (JSPE-S), well-being (WHO-5), distressing factors in the learning and clinical environments, mistreatment and thoughts of dropping out. Results: 176 (34 %) of 517 medical students completed the questionnaire, 73 being preclinical and 103 clinical students. Despite lower well-being, clinical student did not demonstrate lower empathy levels. Main stressors during the clinical phase were negative physician role models and financially focussed care rather than challenging patient encounters. Compared to preclinical students, clinical students showed more mistreatment experiences and higher ratings towards thoughts of dropping out. Conclusion: Our results illustrate contemporary challenges to establishing a learner-centred clinical environment that nurtures well-being and empathy of medical students. The sustainment of empathy despite more stressful experiences and lower well-being may be due to protective factors. Practice Implications: The paper suggests activities to support clinical students to find ways to adapt the clinical learning environment to students' needs.
Background: Professional intrapersonal and interpersonal competences (IICs) form an important par... more Background: Professional intrapersonal and interpersonal competences (IICs) form an important part of medical expertise but are given little attention during clinical training. In other professional fields such as psychotherapy, education and aviation, training in IICs is an integral part of education and practice. In medicine, IICs tend to actually decline during studies. To date it is unclear why IICs are given less attention in medicine, despite evidence for their importance in the treatment process. In view of this, the study examined the role of IICs in the treatment process, the current situation of IIC training in medicine and, most importantly, the reasons for the comparatively low focus on IICs in the clinical training of medical students. Methods: Semi-structured interviews were carried out with 21 experts from a variety of medical specialties and non-medical professions that provide a training with a stronger focus on IIC development. The interviews were evaluated using grounded theory. Results: The experts confirmed the idea that IICs are an equally important component in the treatment process, along with medical knowledge and technical skills. They also described large differences between the IICs possessed by physicians but noted a general developmental need. The key shortcoming was perceived to be a deep-seated defensiveness towards learning from mistakes and deficits e.g. through reflection and feedback. The interaction of different factors that seem to be reasons for this defensiveness and perpetuate it were identified: lack of support in dealing with insecurities in the face of responsibility; the notion of medicine as a science with the categories of right and wrong answers; and a range of pressures arising from the setting, such as hierarchical, economic and competition pressures.
Objective: The present study gives a brief introduction into 1. the definition of physician empat... more Objective: The present study gives a brief introduction into 1. the definition of physician empathy (PE) and 2. its influence on patients' health outcomes. Furthermore 3. we present assessment instruments to measure PE from the perspective of the patient and medical student. The latter topic will be explored in detail as we conducted a pilot study on the German versions of two self-assessment instruments of empathy, which are mostly used in medical education research, namely the "Jefferson Scale of Physician Empathy, Student Version" (JSPE-S) and the "Interpersonal Reactivity Index" (IRI). Methods: We first present an overview of the current empirical and theoretical literature on the definition and outcome-relevance of PE. Additionally, we conducted basic psychometric analyses of the German versions of the JSPE-S and the IRI. Data for this analyses is based on a cross-sectional pilot-survey in N=44 medical students and N=63 students of other disciplines from the University of Cologne. Results: PE includes the understanding of the patient as well as verbal and non-verbal communication, which should result in a helpful therapeutic action of the physician. Patients' health outcomes in different healthcare settings can be improved considerably from a high quality empathic encounter with their clinician. Basic psychometric results of the German JSPE-S and IRI measures show first promising results. Conclusion: PE as an essential and outcome-relevant element in the patient-physician relationship requires more consideration in the education of medical students and, thus, in medical education research. The German versions of the JSPE-S and IRI measures seem to be promising means to evaluate these education aims and to conduct medical education research on empathy.
Background: Good communication is a major factor in delivering high quality in care. Research ind... more Background: Good communication is a major factor in delivering high quality in care. Research indicates that current communication skills training alone might not sufficiently enable students to find context-specific creative solutions to individual complex personal and interpersonal challenges in the clinical context. This study explores medical students' experiences with real communication dilemmas in a facilitated group setting. The aims were to gain a better understanding of whether and, if so, how reflective practice can enhance students' ability to find creative individual solutions in difficult communication situations and to identify factors within the reflective setting that foster their creative competency. Methods: Thematic content analysis was used to perform a secondary analysis of semi-structured interview data from a qualitative evaluation of a group reflective practice training for final-year medical students. The categories that arose from the iterative deductive-inductive approach were analyzed in light of current scientific understandings of creativity. Results: Reflection on real difficult clinical communication situations appears to increase medical students' ability to handle such situations creatively. Although group reflection on clinical dilemmas involving personal aspects can stir up emotions, participating students stated they had learned a cognitive process tool that enhanced their communicative competence in clinical practice. They also described changes in personal attitudes: they felt more able to persevere and to tolerate ambiguity, described themselves more open and self-efficient in such complex clinical communication situations and thus more motivated. Furthermore, they reported on factors that were essential in this process, such as reflection on current and real challenges, a group format with a trainer. Conclusions: Reflective practice providing a cognitive process tool and using real clinical challenges and trainer support in communication education may provide learners with the skills and attitudes to develop creativity in practice. Implementing reflection training in clinical communication education may increase students' overall communicative competency.
The aim of this study was to investigate the relevance and the barriers of physician empathy in m... more The aim of this study was to investigate the relevance and the barriers of physician empathy in medical rehabilitation by conducting a narrative literature review and a qualitative survey in physicians. First, we described the current state of research of physician empathy in medical rehabilitation based on a narrative (non-systematic) review of the literature. Additionally, the questions of relevance and barriers of physician empathy were examined in a qualitative short survey with physicians from Rehabilitation Medicine, Internal Medicine, Pediatric and Family Medicine. The qualitative data were analyzed according to the summarizing content analysis of Mayring. Only n=13 studies of physician empathy were conducted in Rehabilitation Medicine; of those, just a few were from Germany and a small number investigated the influence of empathy on patient health outcomes. The qualitative survey's results regarding the definition, patient outcomes and barriers of physician empathy are similar to other theoretical and empirical studies on those issues. Moreover, they show many new, practical aspects, particularly in the field of barriers of physician empathy. Although physician empathy has been shown to be an outcome-relevant factor in acute health care, less attention has been paid to it in Rehabilitation research. Physicians from Rehabilitation Medicine, Internal Medicine, Pediatric and Family Medicine perceive empathic behavior also as an outcome-relevant ability, which is particularly hindered by time pressure and stress but also by personal and patient-specific factors.
Intra- and interpersonal competences (IICs) are essential for medical expertise. However, the eff... more Intra- and interpersonal competences (IICs) are essential for medical expertise. However, the effects of current medical curricula seem to not be sustainable enough, even though poorly trained IICs have negative effects on medical practice. A defensive attitude towards openly addressing personal–professional challenges seems to hinder a sustainable implementation of IICs training. Therefore, this study asks about the changeability of IICs and target factors of their implementation in medical education. The aim was to detect factors for the sustainable implementation of IICs in medical education from medical and non-medical perspectives. For this purpose, a total of 21 experts were interviewed. The interview material was analysed according to grounded theory principles to generate core categories to answer the research questions. As a first result, analysis revealed that IICs are changeable and developable, not in all, but in many students. It also showed four central prerequisites f...
ZUSAMMENFASSUNG Hintergrund Verschiedene Studien berichten über das Stresserleben von Krankenhaus... more ZUSAMMENFASSUNG Hintergrund Verschiedene Studien berichten über das Stresserleben von Krankenhausmitarbeitern während der COVID-19-Pandemie, aber auch vor der Pandemie fühlten sich viele ärztliche Klinikmitarbeiter durch ein hohes Arbeitspensum oder unklare Vorgaben emotional erschöpft. Methoden Kognitive Bewertungen und das Stresserleben von ärztlichem Krankenhauspersonal aus 6 Kliniken im zeitlichen Verlauf der COVID-19-Pandemie wurden ausgewertet. Neben der deutschsprachigen Version des „Stress Appraisal Measure“ (SAM) wurden die COVID-19-Patientenbelegungen und die relative Bettenbelegung erfragt; Korrelationen im Quer- und Längsschnitt wurden berechnet. Ergebnisse Teilnehmer t1: 170, t2: 55, t3: 47 Ärzte. Obwohl keine Erfahrung mit einer solchen Pandemie vorhanden war, waren die SAM-Mittelwerte nicht auffallend unterschiedlich im Zeitverlauf. Höhere lokale Neuinfektionen gingen nicht einher mit einer erhöhten Bewertung, die Situation als bedrohlich oder stressend zu erleben. Ho...
Fragestellung/Zielsetzung: Die professionelle Persönlichkeitsentwicklung ist neben dem Erwerb von... more Fragestellung/Zielsetzung: Die professionelle Persönlichkeitsentwicklung ist neben dem Erwerb von medizinischen Kompetenzen ein wichtiger Teil der ärztlichen Ausbildung. Um passende curriculare Unterstützungsangebote zu implementieren, ist es notwendig zu verstehen, wie Medizinstudierende [zum vollständigen Text gelangen Sie über die oben angegebene URL]
Fragestellung/Zielsetzung: Aktive Teilhabe in der Praxis der Patientenversorgung ist für Medizins... more Fragestellung/Zielsetzung: Aktive Teilhabe in der Praxis der Patientenversorgung ist für Medizinstudierende essentiell, um ärztliche Kompetenzen und ein Sinn für die professioneller Identität zu erwerben. Die klinische Lernumgebung wird jedoch zunehmend durch Spezialisierung, [zum vollständigen Text gelangen Sie über die oben angegebene URL]
Fragestellung/Einleitung: Im Gemeinschaftskrankenhaus Herdecke gibt es seit 2007 eine internistis... more Fragestellung/Einleitung: Im Gemeinschaftskrankenhaus Herdecke gibt es seit 2007 eine internistische, integrativ-medizinische Ausbildungsstation(ASIM). Studierende übernehmen unter enger ärztlicher Supervision die Patientenversorgung von 2–4 Patienten. Diese Studie untersucht, [for full text, please go to the a.m. URL]
Fragestellung/Einleitung: Psychische Belastungen im Studien- und Ausbildungsalltag sind bekannt [... more Fragestellung/Einleitung: Psychische Belastungen im Studien- und Ausbildungsalltag sind bekannt [ref:1], [ref:2] und bei nationalen und internationalen Tagungen und Kongressen ein wiederkehrendes Thema. Die Ursachen für die Belastungen sind unterschiedlich und für [zum vollständigen Text gelangen Sie über die oben angegebene URL]
Fragestellung: Die Vermittlung reflektiver Fähigkeiten wird zunehmend in der Ärzte-Ausbildung emp... more Fragestellung: Die Vermittlung reflektiver Fähigkeiten wird zunehmend in der Ärzte-Ausbildung empfohlen. Unsere Studie verfolgt zwei Ziele: a. die Beschreibung eines klinischen Begleitseminares "Reflektives Lernen" (RL) und b. die Darstellung der qualitativen Ergebnisse v[for full text, please go to the a.m. URL]
Fragestellung: Nachdem die erste PJ-Ausbildungsstation Innere Medizin sowohl von Studierenden als... more Fragestellung: Nachdem die erste PJ-Ausbildungsstation Innere Medizin sowohl von Studierenden als auch von Patienten und Mitarbeitern positiv evaluiert wurde [ref:2], [ref:3] hat das Integrierte Begleitstudium Anthroposophische Medizin (IBAM) das Modell der klinischen Ausbildungsstation[for full text, please go to the a.m. URL]
Background: In October 2018, the University of Witten/Herdecke (UW/H) launched the new reformed m... more Background: In October 2018, the University of Witten/Herdecke (UW/H) launched the new reformed medical education programme called Medicine 2018+. A major innovation compared to the existing model programme was the introduction of thematic focuses. A longitudinal communication skills curriculum was integrated into the new thematic focus "professional and personal development – inner work" (IAP). With the start of the new programme, the IAP curriculum has been built step-by-step over time, i.e. the first four semesters have already been implemented, the following semesters are being planned. Project description: IAP aims to provide students with patient-centred medicine. Five areas of competence were defined: Doctor-patient communication, team competence, staying healthy, my paths to becoming a doctor, medicine and society. The focus of this article is on the communication curriculum. The first year of study focusses on the training of basic communication skills. In the 2nd...
Background Professional intrapersonal and interpersonal competences (IICs) form an important part... more Background Professional intrapersonal and interpersonal competences (IICs) form an important part of medical expertise but are given little attention during clinical training. In other professional fields such as psychotherapy, education and aviation, training in IICs is an integral part of education and practice. In medicine, IICs tend to actually decline during studies. To date it is unclear why IICs are given less attention in medicine, despite evidence for their importance in the treatment process. In view of this, the study examined the role of IICs in the treatment process, the current situation of IIC training in medicine and, most importantly, the reasons for the comparatively low focus on IICs in the clinical training of medical students. Methods Semi-structured interviews were carried out with 21 experts from a variety of medical specialties and non-medical professions that provide a training with a stronger focus on IIC development. The interviews were evaluated using gro...
Introduction & question: Active student participation (ASP) in Clinical Education Wards (CEW) int... more Introduction & question: Active student participation (ASP) in Clinical Education Wards (CEW) integrates students actively in interprofessional health care teams. By this manner of workplace based learning (WBL) students acquire practical skills and different qualities of professionalism. Previous[for full text, please go to the a.m. URL]
Introduction: The University of Witten/Herdecke (UW/H) was founded in 1982 as the first privately... more Introduction: The University of Witten/Herdecke (UW/H) was founded in 1982 as the first privately run German university. In addition to economics, dentistry, a center for life sciences and the institute for general studies, the main focus from the inception of the University was the development of a model course in medical studies. Methodology: A description of the history of the development of medical studies in relation to the reasons for its founding, its founding ideals and their implementation; phases of development, transformations and influencing factors are presented in detail. External assessments are also used for this purpose. Result: The “Herdecke Model” was first implemented with the initial group of medical students in 1983. In the past 36 years the curriculum for medical education in Witten/Herdecke has evolved to meet internal and external requirements. The goals of the founders for a reform of medical studies and the founding ideals of the UW/H have continued to lea...
This study examines whether students in the clinical phase show reduced well-being and lower empa... more This study examines whether students in the clinical phase show reduced well-being and lower empathy scores compared to preclinical students. Furthermore, it explores students' most stressful experiences. Methods: A cross-sectional mixed-methods study was conducted among medical students of the revised patient-and student-centred curriculum at Witten/Herdecke University (Germany). An online survey included questions regarding empathy (JSPE-S), well-being (WHO-5), distressing factors in the learning and clinical environments, mistreatment and thoughts of dropping out. Results: 176 (34 %) of 517 medical students completed the questionnaire, 73 being preclinical and 103 clinical students. Despite lower well-being, clinical student did not demonstrate lower empathy levels. Main stressors during the clinical phase were negative physician role models and financially focussed care rather than challenging patient encounters. Compared to preclinical students, clinical students showed more mistreatment experiences and higher ratings towards thoughts of dropping out. Conclusion: Our results illustrate contemporary challenges to establishing a learner-centred clinical environment that nurtures well-being and empathy of medical students. The sustainment of empathy despite more stressful experiences and lower well-being may be due to protective factors. Practice Implications: The paper suggests activities to support clinical students to find ways to adapt the clinical learning environment to students' needs.
Background: Professional intrapersonal and interpersonal competences (IICs) form an important par... more Background: Professional intrapersonal and interpersonal competences (IICs) form an important part of medical expertise but are given little attention during clinical training. In other professional fields such as psychotherapy, education and aviation, training in IICs is an integral part of education and practice. In medicine, IICs tend to actually decline during studies. To date it is unclear why IICs are given less attention in medicine, despite evidence for their importance in the treatment process. In view of this, the study examined the role of IICs in the treatment process, the current situation of IIC training in medicine and, most importantly, the reasons for the comparatively low focus on IICs in the clinical training of medical students. Methods: Semi-structured interviews were carried out with 21 experts from a variety of medical specialties and non-medical professions that provide a training with a stronger focus on IIC development. The interviews were evaluated using grounded theory. Results: The experts confirmed the idea that IICs are an equally important component in the treatment process, along with medical knowledge and technical skills. They also described large differences between the IICs possessed by physicians but noted a general developmental need. The key shortcoming was perceived to be a deep-seated defensiveness towards learning from mistakes and deficits e.g. through reflection and feedback. The interaction of different factors that seem to be reasons for this defensiveness and perpetuate it were identified: lack of support in dealing with insecurities in the face of responsibility; the notion of medicine as a science with the categories of right and wrong answers; and a range of pressures arising from the setting, such as hierarchical, economic and competition pressures.
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Papers by Gabriele Lutz