Change in postgraduate medical education - how much didactic shaping is possible at all? A document analysis of the guideline regulations on specialty training 1992-2018 with a focus on surgery.

Background: The structures of postgraduate medical education are regulated by the (guideline) regulations on specialty training ((M-)WBO). This formal structure is the result of medical discourse between medical associations, specialist societies and other associations. Various developments can be seen in the WBO.

Personality traits predict the need for cognitive closure in advanced undergraduate medical students.

Background: Uncertainty in medical decision-making is a significant challenge influenced by various patient- and physician-related factors. They include physicians' clinical reasoning skills and their tolerance for uncertainty. Medical students are trained in clinical reasoning and have to learn to manage uncertainty.

Medical students' leadership competence in health care: development of a self-assessment scale.

Background: Medical leadership plays an increasing role already in early career stages. Undergraduate medical students in the transition to postgraduate education feel not well prepared for their leadership roles. While leadership curricula have been developed, instruments for students' self-assessment of leadership competences as part of their professional development are still missing.

Unnecessary diagnostic imaging requested by medical students during a first day of residency simulation: an explorative study.

Background: Physicians' choice of appropriate tests in the diagnostic process is crucial for patient safety. The increased use of medical imaging has raised concerns about its potential overuse. How appropriately medical students order diagnostic tests is unknown.

"Do you smoke?" - content and linguistic analysis of students' substance histories in simulated patient interviews.

Background: The use of tobacco, alcohol and other drugs has considerable health consequences. Substance histories are often only incompletely taken in everyday clinical practice. When learning to take a medical history in medical school, one of the learning objectives is to inquire about consumption behavior.

Relationships between self-efficacy beliefs and personal factors in final-year medical students.

Background: Medical students entering postgraduate training often feel ill-prepared for clinical practice. This has implications for physician well-being and the quality of patient care. Self-efficacy represents an important contributing factor in the transition process.

Matching of advanced undergraduate medical students' competence profiles with the required competence profiles of their specialty of choice for postgraduate training.

Background: Matching between undergraduate students and their chosen specialty has implications for their personal job satisfaction and performance as well as societies' needs regarding health care quality. Knowledge regarding student-specialty fit can help improve students' decisions and detect potential deficiencies in specific competences. In this study, we compare self-assessed competence profiles of medical students close to graduation with the competence profiles of their specialty of choice for postgraduate training.

Development of an instrument for medical students' self-assessment of facets of competence for patient-centred care.

Objective: To develop a facets of competence self-assessment instrument (FOCSI) with operationalised items for ten competence facets required for patient-centred care at the beginning of residency.

Methods: We conducted focus groups and cognitive interviews with final-year medical students to develop items that match students' clinical experience. We tested 50 items in two samples and analysed model fit and internal consistency of all possible combinations to identify the optimal ten-item-solution.

"Fit for the finals" - project report on a telemedical training with simulated patients, peers, and assessors for the licensing exam.

Background: Undergraduate medical students take the licensing exam (M3) as a two-day oral-practical examination. The main requirements are to demonstrate history taking skills and coherent case presentations. The aim of this project was to establish a training in which students can test their communication skills during history taking and their clinical reasoning skills in focused case presentations.

A simulation-based OSCE with case presentation and remote rating - development of a prototype.

Simulation-based examination formats improve the possibility to assess medical students' competences during their performance. Additionally, videotaping of simulations allows for remote rating, providing advantages for raters, students, and exam organizers. We describe a simulation-based OSCE prototype with remote rating of students' competences, developed to replace a conventional OSCE at Hamburg Medical Faculty.

Implicit expression of uncertainty in medical students during different sequences of clinical reasoning in simulated patient handovers.

Background: Dealing with medical uncertainty is an essential competence of physicians. During handovers, communication of uncertainty is important for patient safety, but is often not explicitly expressed and can hamper medical decisions. This study examines medical students' implicit expression of uncertainty in different sequences of clinical reasoning during simulated patient handovers.

Advanced undergraduate medical students' perceptions of basic medical competences and specific competences for different medical specialties - a qualitative study.

Background: Medical graduates should have acquired basic competences that enable them to practice medicine independently as physicians and to enter postgraduate training in any specialty they wish. Little is known about advanced undergraduate medical students' perceptions of basic medical competences needed to start postgraduate training and about specialty-specific competences. This qualitative study aims to identify medical students' perceptions of basic medical competences and specific competence requirements for different specialties.

Assessment of final-year medical students' entrustable professional activities after education on an interprofessional training ward: A case-control study.

Introduction: Interprofessional training wards (ITWs) are implemented to provide medical students with a holistic and authentic health care experience to improve their clinical competencies. Controlled outcome studies assessing students' competencies after ITW-training are uncommon. In this case-control study, we assessed final-year medical students who received ITW-training regarding entrustable professional activities (EPAs) and communicative as well as social competencies.

Intuitive concepts in internal medicine and their occurrence in undergraduate medical students in different semesters.

Dealing with errors in medical practice is of great importance for patient safety. In the natural sciences, intuitive concepts, so-called misconceptions, are increasingly coming into focus of teaching because they lead to a faulty understanding of contexts and thus to faulty scientific reasoning. In medicine, intuitive concepts still play a subordinate role.

How does multisource feedback influence residency training? A qualitative case study.

Introduction: Multisource feedback (MSF), also called 360-degree assessment, is one form of assessment used in postgraduate training. However, there is an ongoing discussion on its value, because the factors that influence the impact of MSF and the main impact of MSF are not fully understood. In this study, we investigated both the influencing factors and the impact of MSF on residency training.

Frequency of medical students' language expressing implicit uncertainty in simulated handovers.

Objectives: The aim of this study was to investigate the number and type of implicit expressions of uncertainty by medical students during simulated patient handovers.

Methods: Eighty-seven volunteer medical students, a convenience sample collected on a first-come, first-served basis, participated in simulated handovers. They each worked with three simulated patients who presented with different chief complaints and personal conditions.

Final-year medical students' self-assessment of facets of competence for beginning residents.

Background: Final-year undergraduate medical students often do not feel well prepared for their start of residency training. Self-assessment of competences is important so that medical trainees can take responsibility for their learning. In this study, we investigated how final-year medical students self-assessed their competences as they neared their transition to postgraduate training.

Validation of the ComCare index for rater-based assessment of medical communication and interpersonal skills.

Objectives: To develop and validate a short instrument to assess undergraduate medical students' communication and interpersonal skills in videographed history taking situations with simulated patients.

Methods: Sixty-seven undergraduate medical students participating in an assessment including videographed physician-patient encounters for history taking with five simulated patients were included in this study. The last video of each participant's consultation hour was rated by two independent assessors with the eight-item ComCare index for assessment of communication and interpersonal skills newly designed for the external rater perspective (ComCareR).

General population's knowledge about the anatomical locations of organs and medical terms today and 50 years ago: a replication study.

Physicians are frequently not aware that patients may not be familiar with the meaning of medical terms or have limited knowledge about the location of organs. These aspects of functional health competence require particular attention when designing communication curricula for undergraduate medical students. The aim of our study was to evaluate the knowledge of laypersons about the anatomical locations of organs and the definitions of commonly used medical terms as relevant aspects of health literacy.

Evaluating the Global Rating scale's psychometric properties to assess communication skills of undergraduate medical students in video-recorded simulated patient encounters.

Objectives: To evaluate the psychometric properties of the Global Rating scale (GR) as an observer-based tool to assess communication skills of undergraduate medical students in video-recorded patient encounters.

Methods: Seventy advanced undergraduate medical students participated in a simulation-based assessment including patient consultations. Simulated patients rated these encounters with the Consultation and Relational Empathy (CARE) scale.