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Background Peer-led tutorials are widely used in medical education to promote practical skills acquisition and support faculty staff. Typically, student tutors are custom trained for this specific task. We investigated whether opening up an existing medical tutor qualification program to other degree programs is successful in terms of acceptance among students, acquisition of tutor-specific and interprofessional competencies, and which factors contribute to success or failure. Methods We developed a two-day tutor qualification program and conducted it annually from 2016 to 2020 with medical and other healthcare students. At the end of each course, we administered a written survey in which the participants rated the following items: their attitudes towards interprofessional learning (using the UWE-IP-D Interprofessional Learning Scale), the interprofessional learning setting, the teaching approach, and their competency acquisition (each on a five-point Likert scale; 1 = strongly agree, 5 = strongly disagree). Furthermore, we assessed participants’ qualitative feedback in free-text fields and performed inductive content analyses. Results The study participation rate was high (response rate 97%; medical students: n  = 75; healthcare students: n  = 22). Participants stated high levels of competency acquisition (total M  = 1.59, individual items’ M’s ranging from 1.20 to 2.05) and even higher satisfaction with the teaching approach (total M  = 1.28, individual items’ M’s ranging from 1.43 to 1.05). Overall satisfaction with the training was M  = 1.22; SD  = 0.58. No significant differences in ratings were found between the student groups. The qualitative results showed that students appreciated the interprofessional setting and experienced it as enriching. The most positive feedback was found in didactics/teaching methods on role-plays and group work; most suggestions for improvement were found in the area of structure and organisation on breaks and time management. Conclusions Opening up an existing medical tutor qualification program to other student groups can be seen as fruitful to teach not only tutor-related aspects but also interprofessional competencies. The results demonstrate the importance of detailed planning that considers group composition and contextual conditions and provides interactive teaching methods to promote interprofessional experiences. This study offers important information about prerequisites and methodological implementation that could be important for the interprofessional redesign of existing training programs.

Objective: The A-allele of the fat mass and obesity-associated ( FTO ) gene variant rs9939609 has been associated with increased body weight, whereas no effect on weight loss during weight reduction programs has been observed. We questioned whether the AA-genotype interferes with weight stabilization after weight loss. Design: We conducted a monocentric, longitudinal study involving obese individuals. The FTO gene variant rs9939609 was genotyped in participants attending a weight reduction program that was divided into two phases: a weight reduction period with formula diet (12 weeks) and a weight maintenance phase (40 weeks). Body weight, body mass index (BMI), blood pressure and concentrations of blood glucose, total cholesterol, low-density lipoprotein, high-density lipoprotein and triglycerides were determined in week 0 ( T 0 ), after 12 weeks ( T 1 ) and at the end in week 52 (T 2 ). Subjects: A total of 193 obese subjects aged between 18 and 72 years (129 female, 64 male; initial body weight: 122.4±22.3 kg, initial BMI: 41.8±6.7 kg m −2 ) were included. Results: Genotyping revealed 32.1% TT-, 39.4% AT- and 28.5% AA-genotype carriers. At T 0 , carriers of the AA-genotype had significantly higher body weight ( P =0.04) and BMI ( P =0.005) than carriers of the TT-genotype. Of the 193 participants, 68 discontinued and 125 completed the program. Dropout rate was not influenced by genotype ( P =0.33). Completers with AA-genotype showed significantly lower additional weight loss during the weight maintenance phase than TT-genotype carriers ( P =0.02). Furthermore, among participants facing weight regain during weight maintenance ( n =52), more subjects were carrying the AA-genotype ( P =0.006). No influence of genotype on weight reduction under formula diet was observed ( P =0.32). Conclusion: In this program, the AA-genotype of rs9939609 was associated with a higher initial body weight and did influence success of weight stabilization. Thus, emphasizing the maintenance phase during a weight reduction program might result in better success for AA-genotype carriers.

The effectiveness of skills laboratory training is widely recognized. Yet, the transfer of procedural skills acquired in skills laboratories into clinical practice has rarely been investigated. We conducted a prospective, randomised, double-blind, controlled trial to evaluate, if students having trained intravenous (IV) cannulation in a skills laboratory are rated as more professional regarding technical and communication skills compared to students who underwent bedside teaching when assessed objectively by independent video assessors and subjectively by patients. 84 volunteer first-year medical students were randomly assigned to one of two groups. Three drop-outs occurred. The intervention group (IG; n = 41) trained IV cannulation in a skills laboratory receiving instruction after Peyton's 'Four-Step Approach'. The control group (CG; n = 40) received a bedside teaching session with volunteer students acting as patients. Afterwards, performance of IV cannulation of both groups in a clinical setting with students acting as patients was video-recorded. Two independent, blinded video assessors scored students' performance using binary checklists (BC) and the Integrated Procedural Protocol Instrument (IPPI). Patients assessed students' performance with the Communication Assessment Tool (CAT) and a modified IPPI. IG required significantly shorter time needed for the performance on a patient (IG: 595.4 SD(188.1)s; CG: 692.7 SD(247.8)s; 95%CI 23.5 s to 45.1 s; p = 0.049) and completed significantly more single steps of the procedure correctly (IG: 64% SD(14) for BC items; CG: 53% SD(18); 95%CI 10.25% to 11.75%; p = 0.004). IG also scored significantly better on IPPI ratings (median: IG: 3.1; CG: 3.6; p = 0.015;). Rated by patients, students' performance and patient-physician communication did not significantly differ between groups. Transfer of IV cannulation-related skills acquired in a skills laboratory is superior to bedside teaching when rated by independent video raters by means of IPPI and BC. It enables students to perform IV cannulation more professionally on volunteer students acting as patients.

Background The few studies directly comparing the methodological approach of peer role play (RP) and standardized patients (SP) for the delivery of communication skills all suggest that both methods are effective. In this study we calculated the costs of both methods (given comparable outcomes) and are the first to generate a differential cost-effectiveness analysis of both methods. Methods Medical students in their prefinal year were randomly assigned to one of two groups receiving communication training in Pediatrics either with RP ( N  = 34) or 19 individually trained SP ( N  = 35). In an OSCE with standardized patients using the Calgary-Cambridge Referenced Observation Guide both groups achieved comparable high scores (results published). In this study, corresponding costs were assessed as man-hours resulting from hours of work of SP and tutors. A cost-effectiveness analysis was performed. Results Cost-effectiveness analysis revealed a major advantage for RP as compared to SP (112 vs. 172 man hours; cost effectiveness ratio .74 vs. .45) at comparable performance levels after training with both methods. Conclusions While both peer role play and training with standardized patients have their value in medical curricula, RP has a major advantage in terms of cost-effectiveness. This could be taken into account in future decisions.

Objective Previous studies have shown positive treatment outcomes of e-mental health applications targeting depression. However, few applications provide personalized features. The aim of the present study is to ask for the user experience and acceptance of patients with depression and healthy adults, who tested the self-management app Self-administered Psycho Therapy SystemS over a period of 5 days. The results serve as a source for evidence-based recommendations for developers and clinicians. Methods A total of 110 participants (41 patients and 69 healthy controls) tested the app Self-administered Psycho Therapy SystemS over a period of 5 days and completed evaluation sheets developed for the purpose of this study. Quantitative measures were asked with 5-point Likert-scaled items (range: −2 to + 2) for the perceived quality of the programme and its components, its practicality (both referred to as user experience) and its acceptance. Student’s t-tests and Pearson correlations were calculated for group comparisons and associations, respectively. Open text fields were analysed by applying a qualitative structuring content analysis. Results The perceived quality of the total programme was rated with M = 0.96 (SD = 0.82), the practicality was M = 0.84 (SD = 0.08) and the acceptance was M = 0.25 (SD = 1.04). Patients rated perceived quality of the total programme and acceptance higher than healthy adults, while there was no difference in practicality. Acceptance was associated with increased depression scores (r = 0.33, p = .01), higher scores of perceived quality of the total programme (r = 0.48, p< .001) and of practicality (r = 0.45, p < .001). Feedback of both groups regarding usability, therapeutic content and personalization revealed a strong wish for guidance and insights into mood progress, opportunities for choice of interventions and features of customization for individualized treatment. Conclusions Patients with depression accepted the app Self-administered Psycho Therapy SystemS more than healthy adults and gave higher ratings in quality. User experience of all users shows a need for features of guidance, choice and personalization that clinicians and developers of future apps should pay attention to.

Recurrent nightmares, frequently associated with traumatic experiences, may impair quality of life and daily functioning. However, there have been few studies of posttraumatic nightmares occurring among children and youth, in particular for trauma-exposed populations in conflict zones. Using two quantitative data sets, this study investigates the prevalence and characteristics of recurrent nightmares among conflict-exposed young people in the Gaza Strip (N = 300) and examines the characteristics of posttraumatic nightmares and their association with academic functioning among treatment-seeking students in Gaza (N = 1093). Among 300 students (10-12 years old) who lived in the ongoing conflict area in Gaza, nightmares were often mentioned, with 56% reporting recurrent nightmares with an average weekly frequency of 4.20 nights in the past week (SD = 1.94) and a mean duration of 2.48 years (SD = 2.01). Similarly, the large sample of 1093 students (6-17 years of age) who sought help for nightmares and sleep disturbance reported recurrent traumatic nightmares on average 4.57 nights per week, with an average duration of 2.82 years. Their self-reported academic functioning was negatively affected by whether they experienced nightmares but was not associated with nightmare frequency or intensity. Given the high prevalence of nightmares and the relation between nightmares and academic functioning, students in conflict-affected areas appear to be a particularly vulnerable group. This study proposes screening and treating conflict-affected students for recurrent posttraumatic nightmares.

To determine the feasibility, efficacy, and outcomes of teaching internal jugular (IJ) central venous line placement (CVLP) to internal medicine residents in a hands-on training experience with adult patients. Data were obtained from 47 residents during their 3-year residency program through questionnaires and a proprietary system that tracks resident procedures. Twenty-five postgraduate year (PGY) 2 residents at the Mayo Clinic in Rochester, Minn, were assigned to IJ-CVLP training in the cardiac catheterization laboratory from January 2001 to June 2001. Their experience, analyzed immediately after training and at completion of residency, was compared with that of 22 PGY-2 residents in the same class who were not assigned to IJ-CVLP training. The median Likert scores of the residents' self-reported perception of independence in IJ-CVLP increased from 3.0 (mean ± SD score, 2.8±1.4) before the intervention to 5.0 (4.4±0.9) after the intervention ( P<.001, signed rank test). At graduation, trained residents had performed more IJ-CVLPs than the control residents (mean ± SD, 17.8±8.4 vs 9.8±6.3, respectively; P<.001). Residents who received IJ-CVLP training, compared with those who did not, showed a significant increase in the mean percentage of IJ-CVLPs performed independently between PGY-1 (2.2%) and PGY-3 (31.2%) ( P=.008). Training internal medicine residents to perform IJ-CVLP is feasible in the cardiac catheterization laboratory with supervision from an attending cardiologist. Trained residents performed significantly more IJ-CVLPs independently during their third year compared with their first year of training. We believe this initiative may be implemented successfully in graduate medical education curriculums.

Background To assess the student perspective on acceptability, realism, and perceived effect of communication training with peer role play (RP) and standardised patients (SP). Methods 69 prefinal year students from a large German medical faculty were randomly assigned to one of two groups receiving communication training with RP (N = 34) or SP (N = 35) in the course of their paediatric rotation. In both groups, training addressed major medical and communication problems encountered in the exploration and counselling of parents of sick children. Acceptability and realism of the training as well as perceived effects and applicability for future parent-physician encounters were assessed using six-point Likert scales. Results Both forms of training were highly accepted (RP 5.32 ± .41, SP 5.51 ± .44, n.s.; 6 = very good, 1 = very poor) and perceived to be highly realistic (RP 5.60 ± .38, SP 5.53 ± .36, n.s.; 6 = highly realistic, 1 = unrealistic). Regarding perceived effects, participation was seen to be significantly more worthwhile in the SP group (RP 5.17 ± .37, SP 5.50 ± .43; p < .003; 6 = totally agree, 1 = don't agree at all). Both training methods were perceived as useful for training communication skills (RP 5.01 ± .68, SP 5.34 ± .47; 6 = totally agree; 1 = don't agree at all) and were considered to be moderately applicable for future parent-physician encounters (RP 4.29 ± 1.08, SP 5.00 ± .89; 6 = well prepared, 1 = unprepared), with usefulness and applicability both being rated higher in the SP group (p < .032 and p < .009). Conclusions RP and SP represent comparably valuable tools for the training of specific communication skills from the student perspective. Both provide highly realistic training scenarios and warrant inclusion in medical curricula. Given the expense of SP, deciding which method to employ should be carefully weighed up. From the perspective of the students in our study, SP were seen as a more useful and more applicable tool than RP. We discuss the potential of RP to foster a greater empathic appreciation of the patient perspective.

Standardized patients are widely used in training of medical students, both in teaching and assessment. They also frequently lead complete training sessions delivering physical examination skills without the aid of faculty teaching staff-acting as \"patient instructors\" (PIs). An important part of this training is their ability to provide detailed structured feedback to students which has a strong impact on their learning success. Yet, to date no study has assessed the quality of physical examination related feedback by PIs. Therefore, we conducted a randomized controlled study comparing feedback of PIs and faculty staff following a physical examination assessed by students and video assessors. 14 PIs and 14 different faculty staff physicians both delivered feedback to 40 medical students that had performed a physical examination on the respective PI while the physicians observed the performance. The physical examination was rated by two independent video assessors to provide an objective performance standard (gold standard). Feedback of PI and physicians was content analyzed by two different independent video assessors based on a provided checklist and compared to the performance standard. Feedback of PIs and physicians was also rated by medical students and video assessors using a questionnaire consisting of 12 items. There was no statistical significant difference concerning overall matching of physician or PI feedback with gold standard ratings by video assessment (p = .219). There was also no statistical difference when focusing only on items that were classified as major key steps (p = .802), mistakes or parts that were left out during physical examination (p = .219) or mistakes in communication items (p = .517). The feedback of physicians was significantly better rated than PI feedback both by students (p = .043) as well as by video assessors (p = .034). In summary, our study demonstrates that trained PIs are able to provide feedback of equal quantitative value to that of faculty staff physicians with regard to a physical examination performed on them. However, both the students and the video raters judged the quality of the feedback given by the physicians to be significantly better than that of the PIs.

Hintergrund: Obwohl sich die Psychosomatische Medizin in den letzten Jahrzehnten erheblich weiterentwickelt hat [1], bleibt der Bereich der psychosomatischen Pflege nur ein untergeordneter Teil der psychiatrischen Fachweiterbildung für Pflegeberufe [vgl. 2]. Die Aufgaben der Pflege in der Psychosomatik unterscheiden sich jedoch an einigen Stellen von den pflegerischen Aufgaben im psychiatrischen Bereich, sodass bereits beschrieben wurde, dass die Pflegeausbildung und die Fachweiterbildung Psychiatriepflege für Pflegende in der Psychosomatik an vielen Stellen nicht mehr ausreichte [3]. Einzelne psychosomatische Kliniken etablierten deshalb bereits Weiterbildungsangebote für psychosomatische Pflegekräfte, ein bundesweit einheitliches Curriculum ist bisher jedoch noch nicht vorhanden. Der Verband psychosomatisch Pflegender in Deutschland e.V (PsoPD e.V.) und die DGPM haben eine Arbeitsgruppe gegründet, die sich der Entwicklung eines Curriculums annimmt. Als ein wesentlicher Schritt der Curriculumsentwicklung [4] wird aktuell eine Bedarfsermittlung (needs assessment) durchgeführt. Ziel: Im Rahmen der Studie soll der Bedarf nach einer fachspezifischen Weiterbildung für psychosomatische Pflegekräfte sowie fachbezogene Wünsche und Anregungen zur Umsetzung eines Curriculums seitens der Zielgruppe der psychosomatischen Pflegekräfte mithilfe von Fokusgruppen erfolgen. Methoden: Es werden Fokusgruppen mit psychosomatischen Pflegekräften an verschiedenen psychosomatischen Kliniken in Deutschland entweder online oder in Präsenz durchgeführt, aufgezeichnet, transkribiert und anschließend mithilfe einer thematischen Analyse nach Braun und Clark [5] qualitativ ausgewertet. Ergebnisse: Wir erwarten, dass die Teilnehmer:innen der Fokusgruppen einen hohen Bedarf an einer fachspezifischen Weiterbildung für die psychosomatische Pflege angeben. Weiterhin erhoffen wir uns fachspezifische Angaben über mögliche Themenbereiche, Rahmenbedingungen und Anregungen zu didaktischen Umsetzungen, z.B. spezifische Lehrformate und Ideen zu praktischen Anleitungen für den Fachbereich Psychosomatik. Ausblick: Auf Basis der Studienergebnisse soll die Notwendigkeit einer fachspezifischen Weiterbildung für die Psychosomatische Pflege dargestellt und der Lernzielkatalog für ein späteres Curriculum weiterentwickelt werden.