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Article ; Online: Die Rolle des Internets als medizinische Informationsquelle für orthopädische Patienten.

Hertling, Stefan / Matziolis, Georg / Graul, Isabel

Orthopadie (Heidelberg, Germany)

2022 Volume 51, Issue 7, Page(s) 521–530

Abstract: Introduction: The advance of the digital revolution in medicine and health is called "e-health". The Internet serves as a digital health information platform and is indispensable as a source of medical information. The aim of this work was to examine ... ...

Title translation	The role of the Internet as a source of medical information for orthopedic patients.
Abstract	Introduction: The advance of the digital revolution in medicine and health is called "e-health". The Internet serves as a digital health information platform and is indispensable as a source of medical information. The aim of this work was to examine the behavior of orthopedic patients with respect to finding information on their illnesses. The role and the importance of the Internet as an informative health application for these patients are highlighted. Materials and methods: The basis of this prospective cross-sectional study was a patient survey in Germany of orthopedic patients from July 2019 to July 2020. Descriptive statistics were calculated, and regression analyses were carried out to show coherent results. Results: We analyzed the responses of 1262 orthopedic patients. Most of them used the Internet as a digital health information platform. Patients rated their Internet skills as good to very good, regardless of age or educational level. Most respondents said that they currently use the Internet at least once a week to find out about their orthopedic illnesses. Patients reported a positive change in attitude towards the Internet as a digital source of medical information, and its use has increased in the past 12 months. Conclusion: The Internet as an informative digital health application in orthopedics is used intensively and is widely accepted by patients. While mistrust of orthopedic health information from the Internet has decreased, patient confidence in meaningful digital health information platforms has increased. The Internet is seen as a useful health information platform alongside medical advice.
MeSH term(s)	Cross-Sectional Studies ; Germany ; Humans ; Internet ; Orthopedics ; Prospective Studies
Language	German
Publishing date	2022-03-29
Publishing country	Germany
Document type	Journal Article
ISSN	2731-7153
ISSN (online)	2731-7153
DOI	10.1007/s00132-022-04238-5
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Article: Students' and lecturers' perspectives on the implementation of online learning in medical education due to COVID-19 in Germany: a cross-sectional pilot study.

Hertling, Stefan F / Back, David A / Kaiser, Mario / Loos, Franziska M / Schleußner, Ekkehard / Graul, Isabel

Frontiers in medicine

2023 Volume 10, Page(s) 1145651

Abstract: Background: During the coronavirus disease 2019 (COVID-19) crisis, many things changed in universities around the world. In-person learning was not possible. Instead, courses were offered in digital form. The sudden change posed enormous challenges to ... ...

Abstract	Background: During the coronavirus disease 2019 (COVID-19) crisis, many things changed in universities around the world. In-person learning was not possible. Instead, courses were offered in digital form. The sudden change posed enormous challenges to universities, students, and teachers. The aim of this study was to investigate the disadvantages as well as the advantages and opportunities of digital learning. Objective: This study investigated the evaluation of an elective module by medical students and teachers in the traditional in-person and virtual teaching forms during the COVID-19 pandemic. Methods: Using the elective module "Sports Medicine," which includes both lectures and practical units, the opinions of the medical students about conventional teaching compared to digital instruction were evaluated. In the winter semester of 2019/2020, all classes were taught face-to-face but had to be switched to virtual teaching in the summer semester of 2020 on an Results: The students perceived digital teaching to be superior in most subareas compared to in-person teaching in terms of framework, instructor evaluation, skill acquisition, topic selection, and overall rating. Medical students seemed to feel better with digital teaching in most areas of evaluation. The lecturers found the new form of teaching rather unsettling and criticized the lack of verbal and especially nonverbal communication as well as the short preparation time for the new challenge. The instructors were uncomfortable with some aspects of the virtual teaching format. Conclusion: In the wake of the COVID-19 pandemic, medical schools should rapidly digitize their teaching offerings and support faculty members in their computer-based competence with continuing education opportunities and time resources.
Language	English
Publishing date	2023-04-24
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2023.1145651
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Article: Gender gap-Gender-specific development in the field of obstetrics and gynecology in Germany in the last 20 years.

Hertling, Stefan / Kaiser, Mario / Schleußner, Ekkehard / Loos, Franziska Maria / Eckhardt, Niklas / Graul, Isabel

Frontiers in medicine

2023 Volume 10, Page(s) 1207388

Abstract: Background: Gender Gap refers to differences between men and women in terms of access to medical education, career development, and leadership positions in medical practice and research. Although women now make up most medical school graduates in many ... ...

Abstract	Background: Gender Gap refers to differences between men and women in terms of access to medical education, career development, and leadership positions in medical practice and research. Although women now make up most medical school graduates in many countries, they are often underrepresented in higher positions. Objective: The aim of this study is therefore to analyze the gender-specific development in the field of Obstetrics and Gynecology in Germany over the past 20 years and to survey the current Materials and methods: An narrative review was carried out on the development of female graduates of human medicine, the proportion of women in contract medical care and clinical care, as well as the gender-specific evaluation of obtaining a gynecological/obstetric additional qualification. habilitation figures in the field of Obstetrics and Gynecology were evaluated about gender distribution. All data were received from federal institutes. Results: A total of 46.7% ( Discussion: The problem with the gender gap in medicine, does not seem to be access to teaching or starting a residency. But in the functions with increasing responsibility and management functions, e.g., as senior physicians, women are already rarely seen. In Obstetrics and Gynecology, too, there is a shortage of women in leading positions, despite the relatively high numbers, for example as senior physicians. Factors like maternity and establishing a family are points mentioned therefore, but also stereotypes seem to be considerable facts. Conclusion: However, it is important to recognize the need for more women in higher positions in medicine and actively work to encourage more women to choose a career in medicine.
Language	English
Publishing date	2023-12-07
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2023.1207388
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Article ; Online: Acceptance, Use, and Barriers of Telemedicine in Transgender Health Care in Times of SARS-CoV-2: Nationwide Cross-sectional Survey.

Hertling, Stefan / Hertling, Doreen / Martin, David / Graul, Isabel

JMIR public health and surveillance

2021 Volume 7, Issue 12, Page(s) e30278

Abstract: Background: The global incidence in the treatment of transgender people is increasing. During the COVID-19 pandemic, many consultations had to be cancelled, postponed, or converted to a virtual format. Telemedicine in the management of transgender ... ...

Abstract	Background: The global incidence in the treatment of transgender people is increasing. During the COVID-19 pandemic, many consultations had to be cancelled, postponed, or converted to a virtual format. Telemedicine in the management of transgender health care could support physicians. Objective: The aim of this study was to analyze the acceptance, use, and barriers of telemedicine in transgender health care in times of SARS-CoV-2 in Germany. Methods: This prospective cross-sectional study was based on a survey of gynecological endocrinologists and transgender patients undergoing gender-affirming hormone treatment in Germany during the COVID-19 pandemic. Descriptive statistics were calculated, and regression analyses were performed to show correlations. Results: We analyzed responses of 269 transgender patients and 202 gynecological endocrinologists treating transgender patients. Most believed that telemedicine was useful. Physicians and patients rated their knowledge of telemedicine as unsatisfactory. The majority of respondents said they did not currently use telemedicine, although they would like to do so. Patients and physicians reported that their attitudes toward telemedicine had changed positively and that their use of telemedicine had increased due to COVID-19. The majority in both groups agreed on the implementation of virtual visits in the context of stable disease conditions. In the treatment phases, 74.3% (150/202) of the physicians said they would use telemedicine during follow-ups. Half of the physicians said they would choose tele-counseling as a specific approach to improving care (128/202, 63.4%). Obstacles to the introduction of telemedicine among physicians included the purchase of technical equipment (132/202, 65.3%), administration (124/202, 61.4%), and poor reimbursement (106/202, 52.5%). Conclusions: Telemedicine in transgender health care found limited use but high acceptance among doctors and patients alike. The absence of a structured framework is an obstacle for effective implementation. Training courses should be introduced to improve the limited knowledge of physicians in the use of telemedicine. More research in tele-endogynecology is needed. Future studies should include large-scale randomized controlled trials, economic analyses, and the exploration of user preferences.
MeSH term(s)	COVID-19 ; Cross-Sectional Studies ; Humans ; Pandemics ; Prospective Studies ; SARS-CoV-2 ; Telemedicine ; Transgender Persons
Language	English
Publishing date	2021-12-03
Publishing country	Canada
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2369-2960
ISSN (online)	2369-2960
DOI	10.2196/30278
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Article ; Online: Telemedicine as a Therapeutic Option in Sports Medicine: Results of a Nationwide Cross-Sectional Study among Physicians and Patients in Germany.

Hertling, Stefan / Loos, Franziska Maria / Graul, Isabel

International journal of environmental research and public health

2021 Volume 18, Issue 13

Abstract: Background: Worldwide, the number of treatments in the field of sports medicine is increasing. However, the COVID-19 pandemic has changed everyday life. Many consultations had to be cancelled, postponed, or converted to a virtual format. Telemedicine in ...

Abstract	Background: Worldwide, the number of treatments in the field of sports medicine is increasing. However, the COVID-19 pandemic has changed everyday life. Many consultations had to be cancelled, postponed, or converted to a virtual format. Telemedicine in sports medicine could support physicians. This study analyzes the use and perception of telemedicine applications among physicians and patients in the field of sports medicine in Germany. Methods: This prospective cross-sectional study was based on a survey of sports medicine physicians and patients in Germany during the COVID-19 pandemic. Descriptive statistics were calculated. Results: We analyzed the responses of 729 patients and 702 sports medicine physicians. Most believed that telemedicine is useful. Both physicians and patients rated their knowledge of telemedicine as unsatisfactory. The majority of respondents said they do not currently use telemedicine but would like to do so. Patients and physicians reported that their attitude had changed positively towards telemedicine and that their usage had increased due to COVID-19. The majority in both groups agreed on implementing virtual visits in stable disease conditions. Telemedicine was considered helpful for follow-up monitoring and prevention by both groups. Conclusion: Telemedicine in sports medicine has seen limited use but is highly accepted among physicians and patients alike. The absence of a structured framework is an obstacle to effective implementation. Training courses should be introduced to improve the limited knowledge regarding the use of telemedicine. More research in telemedicine in sports medicine is needed. This includes large-scale randomized controlled trials, economic analyses and explorations of user preferences.
MeSH term(s)	COVID-19 ; Cross-Sectional Studies ; Germany/epidemiology ; Humans ; Pandemics ; Physicians ; Prospective Studies ; SARS-CoV-2 ; Sports Medicine ; Telemedicine
Language	English
Publishing date	2021-07-02
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1660-4601
ISSN (online)	1660-4601
DOI	10.3390/ijerph18137110
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Article: Significance of Lumbar MRI in Diagnosis of Sacral Insufficiency Fracture.

Graul, Isabel / Vogt, Sophia / Strube, Patrick / Hölzl, Alexander

Global spine journal

2020 Volume 11, Issue 8, Page(s) 1197–1201

Abstract: Study design: Retrospective observational study.: Objective: The aim of the present study was to evaluate the role of lumbar magnetic resonance imaging (MRI) in the diagnostic algorithm of sacral insufficiency fractures (SIF). The primary objective ... ...

Abstract	Study design: Retrospective observational study. Objective: The aim of the present study was to evaluate the role of lumbar magnetic resonance imaging (MRI) in the diagnostic algorithm of sacral insufficiency fractures (SIF). The primary objective was to compare the sensitivity in fracture detection and correct fracture classification according to MRI and computed tomography (CT). The secondary objective was to identify differences of additional pathologies found in MRI of the lumbar spine and the pelvis and their rates. Methods: A total of 943 patients (from 2010 to 2017) with fracture of the pelvic ring were screened. All patients without high-energy trauma and radiologic diagnostics consisting of X-ray, CT, and MRI of the pelvis or the lumbar spine including the sacrum were included. Differences in fracture detection and description in the various radiologic procedures were evaluated. Detection rates of additional pathologies in MRI of the pelvis and lumbar spine were recorded. Results: A total of 77 subjects were included. The sensitivities for SIF were 14% in X-ray and 88% in CT, and all fractures were detected in MRI. MRI showed a more complex fracture pattern compared with CT in 65% of the cases. Additional pathologies were seen in MRI of the lumbar spine (51%) and that of the pelvis (18%). Conclusions: We suggest performing MRI of the lumbar spine including the sacrum with coronal STIR (short tau inversion recovery) sequence for elderly patients with suddenly increasing low back pain at an early stage. This procedure might improve fracture detection, classification, and recognition of concomitant pathologies.
Language	English
Publishing date	2020-08-04
Publishing country	England
Document type	Journal Article
ZDB-ID	2648287-3
ISSN	2192-5690 ; 2192-5682
ISSN (online)	2192-5690
ISSN	2192-5682
DOI	10.1177/2192568220941821
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Article ; Online: Digitization in gynecology and obstetrics in times of COVID-19: Results of a national survey.

Hertling, Stefan / Hertling, Doreen / Loos, Franziska / Martin, David / Graul, Isabel

Internet interventions

2021 Volume 26, Page(s) 100478

Abstract: Introduction: In the COVID-19 pandemic, many consultations had to be cancelled, postponed, or converted to a virtual format. The use of telemedicine in the management of Women's Health Care could support doctors (tele-gynecology). This study analyses ... ...

Abstract	Introduction: In the COVID-19 pandemic, many consultations had to be cancelled, postponed, or converted to a virtual format. The use of telemedicine in the management of Women's Health Care could support doctors (tele-gynecology). This study analyses the use and perception of telemedicine applications among gynecologists in Germany. Materials and methods: This prospective cross-sectional study was based on a survey of gynecologists in Germany during the COVID-19 pandemic. Descriptive statistics were calculated, and regression analyses were performed to show correlations. Results: The gynecologists expect telemedicine to be used in gynecology and obstetrics. 76.4% (365/478) of the respondents rated their knowledge of telemedicine as insufficient. The majority of respondents (437/478, 91.6%) said they did not currently use telemedicine, although 67.3% (321/478) would like to do so. Obstacles to the introduction of telemedicine include the purchase of technical equipment (325/478, 68.1%), administration (305/478, 64.0%) and poor reimbursement (233/478, 48.9%). Gynecologists surveyed would prefer telemedicine to communicate directly with other doctors (388/478, 81.2%) rather than to communicate with patients (228/478, 47.8%). In the treatment phases, 73.2% (349/478) of the respondents would use telemedicine during follow-up. Half of the respondents would choose tele counseling as a specific approach to improving care (246/478, 51.5%). Conclusion: Telemedicine in gynecology finds little use but high acceptance. The absence of a structured framework is an obstacle to effective implementation. Training courses should be introduced to improve the limited knowledge in the use of telemedicine. More research in tele-gynecology is needed. These include large-scale randomized controlled trials, economic analyses and the exploration of user preferences.
Language	English
Publishing date	2021-11-11
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2764252-5
ISSN	2214-7829 ; 2214-7829
ISSN (online)	2214-7829
ISSN	2214-7829
DOI	10.1016/j.invent.2021.100478
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Article ; Online: Einfluss der beruflichen Tätigkeit auf Erkrankungen des Bewegungsapparates der oberen Extremität.

Hertling, Stefan / Loos, Franziska / Matziolis, Georg / Kirschner, Isabella / Graul, Isabel

Orthopadie (Heidelberg, Germany)

2021 Volume 51, Issue 8, Page(s) 669–676

Abstract: Introduction: Diseases of the musculoskeletal system of the upper extremity are the reason for increasing sickness-related absenteeism among the working population.: Objective: The aim of this study is to investigate the influence of occupational ... ...

Title translation	The influence of occupational activity on diseases of the musculoskeletal system of the upper extremity.
Abstract	Introduction: Diseases of the musculoskeletal system of the upper extremity are the reason for increasing sickness-related absenteeism among the working population. Objective: The aim of this study is to investigate the influence of occupational dependence on the development of musculoskeletal disorders of the upper extremities and to present health-related risks in addition to occupation-specific factors. Materials and methods: We included 1070 patients who underwent surgical rotator cuff (RC) reconstruction for an RC lesion between 2016 and 2019. The relevant data were retrospectively documented from the hospital information system. The patients' occupations were classified according to the Classification of Occupations 2010 (KldB 2010) and compared with routinely recorded and anonymized freely available data (Federal Statistical Office, Federal Employment Agency). Results: Of the 1070 patients, 844 were of working age. The age structure of the individual areas showed no significant differences. Based on the comparisons of patient data with the population, significantly higher RC injury rates were found in agriculture, forestry, animal husbandry and horticulture (p = 0,003); construction, architecture, surveying and building services engineering (p < 0,001); transport, logistics, protection, and security (p < 0.001) and business organization, accounting, law, and administration (p < 0,001). There was a significantly reduced risk in science, geography and computer science (p = 0.015); commercial services, goods trade, distribution, hotel and tourism (p < 0,001); health, social affairs, teaching and education (p < 0,001). Conclusion: The prevalence of RC lesions shows a statistical correlation with the occupation performed depending on the occupational branches. In addition to occupational dependency, gender-specific work factors play a role. Shoulder pain in gainful employment should be considered in a more differentiated way. This should enable preventive measures to be taken in a targeted manner.
MeSH term(s)	Humans ; Musculoskeletal Diseases/epidemiology ; Musculoskeletal System ; Occupational Diseases/epidemiology ; Retrospective Studies ; Upper Extremity
Language	German
Publishing date	2021-12-22
Publishing country	Germany
Document type	Journal Article
ISSN	2731-7153
ISSN (online)	2731-7153
DOI	10.1007/s00132-021-04199-1
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Article ; Online: Digital teaching tools in sports medicine: A randomized control trial comparing the effectiveness of virtual seminar and virtual fishbowl teaching method in medical students.

Hertling, Stefan / Hertling, Doreen / Matziolis, Georg / Schleußner, Ekkehard / Loos, Franziska / Graul, Isabel

PloS one

2022 Volume 17, Issue 6, Page(s) e0267144

Abstract: Background: Since the COVID-19 pandemic, the demand for online courses has increased enormously. Therefore, finding new methods to improve medical education is imperative.: Objective: The aim of this study was to compare the self-reports of the ... ...

Abstract	Background: Since the COVID-19 pandemic, the demand for online courses has increased enormously. Therefore, finding new methods to improve medical education is imperative. Objective: The aim of this study was to compare the self-reports of the individual student-centered virtual teaching techniques (seminar versus fishbowl) in a group of medical students. Methods: During the second semester of 2020, students in the clinical phase of the study (n = 144) participated in the optional subject of Sports Medicine. The students were divided into 2 groups. One group (n = 72) received the knowledge transfer in the form of a virtual seminar, the other group (n = 72) in the form of a virtual fishbowl. Results: Virtual seminar and virtual fishbowl students gave insights into these teaching techniques. Most of the students from the virtual fishbowl group believed that the virtual fishbowl format allowed them to be more actively involved in learning. The mean quiz scores were statistically higher for students in the virtual fishbowl group than students in the virtual seminar group (p < 0. 001). Conclusion: This study concluded that virtual seminars and virtual fishbowl formats could be served as structured learning and teaching formats. At the same time, the virtual fishbowl format can promote an active exchange of knowledge from students' perspectives.
MeSH term(s)	COVID-19/epidemiology ; Humans ; Learning ; Pandemics ; Sports Medicine ; Students, Medical ; Teaching
Language	English
Publishing date	2022-06-16
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0267144
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Article ; Online: How far has the digitization of medical teaching progressed in times of COVID-19? A multinational survey among medical students and lecturers in German-speaking central Europe.

Hertling, Stefan Ferdinand / Back, David Alexander / Eckhart, Niklas / Kaiser, Mario / Graul, Isabel

BMC medical education

2022 Volume 22, Issue 1, Page(s) 387

Abstract: Background: To ensure successful medical education despite the COVID-19 pandemic, the demand for online instruction has substantially increased. Fast and efficient teaching in a digital format poses a great challenge for medical students and lecturers ... ...

Abstract	Background: To ensure successful medical education despite the COVID-19 pandemic, the demand for online instruction has substantially increased. Fast and efficient teaching in a digital format poses a great challenge for medical students and lecturers as well as the universities. Objective: The aim of this study is to capture the readiness of medical students and faculty members to participate in rapidly- evolving online education. Methods: This cross-sectional study is based on two questionnaires distributed among medical students and associate deans for education in Germany, Austria and Switzerland. Questions included decision- making questions, categorical questions, and open-ended questions, all addressing the frequency and format of the digital education offered, the perceived quality of digital education, and medical student satisfaction with digital education. Questions about missing content and areas for improvement from the perspectives of medical students were included. The associate deans were asked for their opinions about the impact of the pandemic on teaching, the organizational setup and implementation of digital education by universities, and plans for future initiatives. Results: Three thousand and thirty medical students (m = 752 and f = 2245) from 53 universities participated in the study. The study showed that 92% of students were affected by the pandemic, and 19% of the students viewed the changes as entirely negative. 97% of the medical students were able to participate in digital courses, but only 4% were able to learn exclusively online. For 77% of the medical students, digital offerings accounted for over 80% of the education offered. In terms of content, medical students complained about a lack of practical teaching, such as contact with patients, lecturers, fellow medical students, and a poor perceived quality of teaching due to dubbing, frequent changeover of seminars, problem-oriented learning groups and in-person teaching, a lack of interaction possibilities and a lack of technical equipment, such as lecturers' knowledge and server capacities, at the universities. Overall, almost half of the medical students (42%) rated the implementation of digital teaching at their universities as good or very good. Forty-one of the 53 associate deans responded to the questionnaire, and 35 felt medical education was influenced by the pandemic. The associate deans (80%; 33/41) felt that the digitalization of medical education was negatively influenced by the pandemic. Only 44% (18/41) felt that their universities were well or very well positioned for digital teaching. All the associate deans believe that digital teaching in medicine will continue after the pandemic. Conclusions: In the German-speaking world, the rapid conversion of medical teaching to a digital format has been well implemented in many cases. The perceived quality of the implementation of digital education still lacks practical relevance and the use of new digital media, such as learning games, VR, and online question time. The digital format of medical education will likely continue beyond the COVID-19 pandemic.
MeSH term(s)	COVID-19/epidemiology ; Cross-Sectional Studies ; Education, Distance ; Education, Medical ; Germany ; Humans ; Internet ; Pandemics ; Students, Medical ; Surveys and Questionnaires
Language	English
Publishing date	2022-05-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2044473-4
ISSN	1472-6920 ; 1472-6920
ISSN (online)	1472-6920
ISSN	1472-6920
DOI	10.1186/s12909-022-03470-z
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