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Article ; Online: A communication-focused curriculum for dental students – an experiential training approach

Simone Alvarez / Jobst-Hendrik Schultz

BMC Medical Education, Vol 18, Iss 1, Pp 1-

2018 Volume 6

Abstract: Abstract Background Successful interaction and communication with patients is as vital for dentists as it is for physicians. Therefore, the aim of this study was the development and evaluation of an interactive, experiential training curriculum with an ... ...

Abstract	Abstract Background Successful interaction and communication with patients is as vital for dentists as it is for physicians. Therefore, the aim of this study was the development and evaluation of an interactive, experiential training curriculum with an emphasis on communication for dual degree seekers of medicine and dentistry. Methods A pre-clinical course with an emphasis in physician/dentist-patient communication and interaction was adapted by a team of subject experts based largely on the propositions of Experiential Learning Theory. After attending the course, dental students (N = 81) rated the course on a Likert- style scale and answered two open questions. Results Students found the interactive course curriculum to be very helpful and vital. Many students reported that their initial interest in the course was mainly because it is a dual degree requirement, but later on rated the course as highly important in terms of later physician/dentist-patient interaction. One aspect of the curriculum course participants regarded as very important, yet neglected during dental studies, was (self-) perception. Conclusion In the view of dental students, the rigorous structure of the pre-clinical dental curriculum does not allow for time spent on topics such as (self-) perception and awareness, but training one’s ability to self-reflect and think critically about one’s own actions, conduct or position can aid with advanced medical and dental studies and practices later on. Experiential courses with an emphasis on patient-physician/dentist communication should be offered early on during pre-clinical medical and dental studies as a regular part of the curriculum.
Keywords	Experiential learning ; Self-awareness ; Dental studies ; Curriculum development ; Communication ; Special aspects of education ; LC8-6691 ; Medicine ; R
Subject code	370
Language	English
Publishing date	2018-03-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Medical educators’ perception of communication training with simulated patients

Simone Alvarez / Jobst-Hendrik Schultz

BMC Research Notes, Vol 10, Iss 1, Pp 1-

an explorative study approach

2017 Volume 5

Abstract: Abstract Objective Medical students’ perceptions of the use of simulated patients (SP) in communication training in medicine have been studied intensively, but insights about faculty perception of this type of simulation training remain rare. This study ... ...

Abstract	Abstract Objective Medical students’ perceptions of the use of simulated patients (SP) in communication training in medicine have been studied intensively, but insights about faculty perception of this type of simulation training remain rare. This study aimed to assess medical educators’ perception of the relevancy of SP communication training, as well as its closeness to reality. Medical educators were surveyed by standardized questionnaire and open-ended questions. The questionnaire allowed educators to rate several aspects of the training such as its closeness to reality and relevancy to real-life physician–patient interaction. Results Educators’ perception of relevance and realism of SP training increases with teaching experience. This appears to be influenced by factors such as internal or external status of the educator, personal experience with communication training during medical studies, as well as medical field taught. Communication training with SP is valued highly by medical educators mainly because of its versatility and broad spectrum of applicability. The wide range of application of SP in medical education seems most evident to senior educators because of their increased amount of experience with physician–patient interaction, whereas junior educators appear often hindered by the aspect of simulation caused by the thought that the patients are “merely” actors.
Keywords	Simulated patient ; Simulation training ; Communication ; Educator perception ; Medical education ; Medicine ; R ; Biology (General) ; QH301-705.5 ; Science (General) ; Q1-390
Language	English
Publishing date	2017-11-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Communication Skills (CS) training of physicians in China and its role in actual challenges of patient-physician relationship

Junfeng Du / Gwendolyn Mayer / Elisabetta Posenato / Svenja Hummel / Ali Zafar / Till Bärnighausen / Jobst-Hendrik Schultz

BMC Medical Education, Vol 22, Iss 1, Pp 1-

a cross-sectional survey

2022 Volume 11

Abstract: Abstract Background The Chinese healthcare system is affected by frequent disputes between physicians and patients. Although recent reforms have contributed towards improving the patient-physician relationship, distrust in physicians is still high. ... ...

Abstract	Abstract Background The Chinese healthcare system is affected by frequent disputes between physicians and patients. Although recent reforms have contributed towards improving the patient-physician relationship, distrust in physicians is still high. Communication skills (CS) training of physicians holds the key to improving patient confidence and diffusing stressful situations. This survey reports on the status of CS training in medical education in China, and the experiences and attitudes of physicians towards CS training. Methods A cross-sectional survey was conducted at medical institutions across China. A questionnaire developed for this study included the status of CS training, current aspects of patient-physician relationships, perceived own CS and patient-centeredness with Likert-scaled items from 1 (most negative) to 6 (most positive). Physicians’ attitude towards CS training was measured with the Communication Skills Attitude Scale (CSAS) and its subscales PAS (Positive Attitude Scale) and NAS (Negative Attitude Scale). Data were analyzed descriptively and for group differences between the hospital level and operating vs. non-operating physicians. Binary logistic regression analysis was done to find associations explaining the occurrence of verbal and physical attacks and the role of CS attitudes. Results Out of 1080 questionnaires, 772 physicians met inclusion criteria. A total of 466/772 participants (60.4%) had received at least one CS training during their career. The participants rated the current situation related to patient-physician relationship in China as highly stressful (mean = 4.52, SD = 1.26, 95% CI: 4.43–4.60), experiencing verbal attacks in the past three years once a year in 372/772 cases (48.2%) and physical attacks 111/772 times (14.4%). The mean PAS was 62.96 (SD = 7.63, 95% CI: 62.41–63.47). Being female was associated with increased risk of verbal attacks (OR = 1.51, 95% CI: 1.01–2.25) while working in a tertiary hospital and showing high levels of PAS decreased this risk (OR = ...
Keywords	Medical education ; Communication skills ; Doctor-patient-relationship ; China ; Patient-centered communication ; Special aspects of education ; LC8-6691 ; Medicine ; R
Subject code	796
Language	English
Publishing date	2022-11-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Implementing and optimizing a communication curriculum in medical teaching

Christian Andreas Brünahl / Barbara Hinding / Leonie Eilers / Jennifer Höck / Anke Hollinderbäumer / Holger Buggenhagen / Kirsten Reschke / Jobst-Hendrik Schultz / Jana Jünger

PLoS ONE, Vol 17, Iss 2, p e

Stakeholders' perspectives.

2022 Volume 0263380

Abstract: Objective The relevance of communication in medical education is continuously increasing. At the Medical Faculty of Hamburg, the communication curriculum was further developed and optimized during this project. This article aims to describe the ... ...

Abstract	Objective The relevance of communication in medical education is continuously increasing. At the Medical Faculty of Hamburg, the communication curriculum was further developed and optimized during this project. This article aims to describe the stakeholders' perceived challenges and supporting factors in the implementation and optimization processes. Methods The initial communication curriculum and its development after a one-year optimization process were assessed with a curricular mapping. A SWOT analysis and group discussions were carried out to provide information on the need for optimization and on challenges the different stakeholders faced. Results The curricular mapping showed that the communication curriculum is comprehensive, coherent, integrated and longitudinal. In both the implementation and the project-related optimization processes, support from the dean, cooperation among all stakeholders and structural prerequisites were deemed the most critical factors for successfully integrating communication content into the curriculum. Conclusion The initiative and support of all stakeholders, including the dean, teachers and students, were crucial for the project's success. Practice implications Although the implementation of a communication curriculum is recommended for all medical faculties, their actual implementation processes may differ. In a "top-down" and "bottom-up" approach, all stakeholders should be continuously involved in the process to ensure successful integration.
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Stress and stressors of medical student near-peer tutors during courses

Jan Hundertmark / Simone Alvarez / Svetla Loukanova / Jobst-Hendrik Schultz

BMC Medical Education, Vol 19, Iss 1, Pp 1-

a psychophysiological mixed methods study

2019 Volume 16

Abstract: Abstract Background Structured peer-led tutorial courses are widespread and indispensable teaching methods that relieve teaching staff and contribute to the development of students’ competencies. Nevertheless, despite high general stress levels in ... ...

Abstract	Abstract Background Structured peer-led tutorial courses are widespread and indispensable teaching methods that relieve teaching staff and contribute to the development of students’ competencies. Nevertheless, despite high general stress levels in medical students and associated increases in psychopathology, specific knowledge of peer tutors’ additional burdens is very limited. Methods Sixty student near-peer tutors from two structured peer-teaching programmes volunteered to participate. On multiple occasions in three different course sessions, we assessed tutors’ subjective stress, affective state, heart rate variability, and salivary cortisol. Additionally, tutors named everyday and course-specific stressors, which were evaluated by means of content analyses. Results The study participation rate was high (63% of all active tutors). The participating tutors are socially well adapted and resilient individuals. They report a variety of stressors such as time pressure, participant characteristics, teacher role demands, and study requirements, but nevertheless display only moderate psychological and physiological stress that decreases over sessions. Tutors’ negative affect in sessions is low; their positive affect is consistently high for senior as well as novice tutors. Tutors rate their courses’ quality as high and quickly recover after sessions. Conclusions Tutors successfully cope with teaching-associated and everyday life demands. The results corroborate the viability and success of current peer-teaching programmes from the tutors’ perspective. This study is the first to comprehensively quantify tutors’ stress and describe frequent stressors, thus contributing to the development of better peer teaching programmes and tutor qualification training.
Keywords	Peer assisted learning ; Peer teaching ; Tutors ; Stress ; Medical students ; Cortisol ; Special aspects of education ; LC8-6691 ; Medicine ; R
Subject code	370
Language	English
Publishing date	2019-04-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: User experience and acceptance of patients and healthy adults testing a personalized self-management app for depression

Gwendolyn Mayer / Svenja Hummel / Neele Oetjen / Nadine Gronewold / Stefan Bubolz / Kim Blankenhagel / Mathias Slawik / Rüdiger Zarnekow / Thomas Hilbel / Jobst-Hendrik Schultz

Digital Health, Vol

A non-randomized mixed-methods feasibility study

2022 Volume 8

Abstract: 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 ...

Abstract	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 ...
Keywords	Computer applications to medicine. Medical informatics ; R858-859.7
Subject code	150
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	SAGE Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Teaching patient-centred communication skills during clinical procedural skill training - a preliminary pre-post study comparing international and local medical students

Ede Nagy / Gloria Matondo Miguel Luta / Daniel Huhn / Anna Cranz / Jobst-Hendrik Schultz / Anne Herrmann-Werner / Till Johannes Bugaj / Hans-Christoph Friederich / Christoph Nikendei

BMC Medical Education, Vol 21, Iss 1, Pp 1-

2021 Volume 11

Abstract: Abstract Background International medical students are frequently confronted with intercultural, psychosocial, and language barriers and often receive lower marks in written, oral, and clinical-practical examinations than fellow local students. Training ... ...

Abstract	Abstract Background International medical students are frequently confronted with intercultural, psychosocial, and language barriers and often receive lower marks in written, oral, and clinical-practical examinations than fellow local students. Training communication competence in procedural skills, such as blood sampling, is further challenge in this particular group of medical students. This pre-post comparative intervention study aimed to investigate the effects of training communication skills during the performance of procedural skills (taking blood samples from a silicone model) in international and local students as part of their clinical practical medical training. Methods Study participants performed blood sampling on an arm prosthesis model (part-task trainer) before and after the communication skills training, focusing on accompanying communication with a simulation patient sitting next to the arm model. The pre- and post-evaluation video was assessed by two independent evaluators using a binary checklist, the Integrated Procedural Performance Instrument (IPPI) and global assessments of clinical professionalism in terms of procedural and communication performance. Linear models with mixed effects were used. Group differences regarding global competence levels were analysed with χ2-tests. Results International medical students did not perform as well as their local counterparts in the pre- and post-examinations. Both groups improved their performance significantly, whereby the international students improved more than their local counterparts in terms of their communication performance, assessed via binary checklist. Clinical professionalism evaluated via global assessments of procedural and communication performance highlights the intervention’s impact insofar as no international student was assessed as clinically not competent after the training. Conclusions Our results suggest that already a low-dose intervention can lead to improved communication skills in medical students performing procedural tasks and significantly increase their confidence in patient interaction.
Keywords	International medical students ; Skills-lab training ; Communication skills ; IPPI ; Binary checklist ; Special aspects of education ; LC8-6691 ; Medicine ; R
Subject code	796
Language	English
Publishing date	2021-09-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Adaptive versus maladaptive cardiac remodelling in response to sustained β-adrenergic stimulation in a new 'ISO on/off model'.

Stefanie Maria Werhahn / Julia S Kreusser / Marco Hagenmüller / Jan Beckendorf / Nathalie Diemert / Sophia Hoffmann / Jobst-Hendrik Schultz / Johannes Backs / Matthias Dewenter

PLoS ONE, Vol 16, Iss 6, p e

2021 Volume 0248933

Abstract: On the one hand, sustained β-adrenergic stress is a hallmark of heart failure (HF) and exerts maladaptive cardiac remodelling. On the other hand, acute β-adrenergic stimulation maintains cardiac function under physiological stress. However, it is still ... ...

Abstract	On the one hand, sustained β-adrenergic stress is a hallmark of heart failure (HF) and exerts maladaptive cardiac remodelling. On the other hand, acute β-adrenergic stimulation maintains cardiac function under physiological stress. However, it is still incompletely understood to what extent the adaptive component of β-adrenergic signaling contributes to the maintenance of cardiac function during chronic β-adrenergic stress. We developed an experimental catecholamine-based protocol to distinguish adaptive from maladaptive effects. Mice were for 28 days infused with 30 mg/kg body weight/day isoproterenol (ISO) by subcutaneously implanted osmotic minipumps ('ISO on'). In a second and third group, ISO infusion was stopped after 26 days and the mice were observed for additional two or seven days without further ISO infusion ('ISO off short', 'ISO off long'). In this setup, 'ISO on' led to cardiac hypertrophy and slightly improved cardiac contractility. In stark contrast, 'ISO off' mice displayed progressive worsening of left ventricular ejection fraction that dropped down below 40%. While fetal and pathological gene expression (increase in Nppa, decrease in Myh6/Myh7 ratios, increase in Xirp2) was not induced in 'ISO on', it was activated in 'ISO off' mice. After ISO withdrawal, phosphorylation of phospholamban (PLN) at the protein kinase A (PKA) phosphorylation site Ser-16 dropped down to 20% as compared to only 50% at the Ca2+/Calmodulin-dependent kinase II (CaMKII) phosphorylation site Thr-17 in 'ISO off' mice. PKA-dependent cardioprotective production of the N-terminal proteolytic product of histone deacetylase 4 (HDAC4-NT) was reduced in 'ISO off' as compared to 'ISO on'. Taken together, these data indicate that chronic ISO infusion induces besides maladaptive remodelling also adaptive PKA signalling to maintain cardiac function. The use of the 'ISO on/off' model will further enable the separation of the underlying adaptive from maladaptive components of β-adrenergic signalling and may help to better define and ...
Keywords	Medicine ; R ; Science ; Q
Subject code	572
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Analysis of risk communication teaching in psychosocial and other medical departments

Franziska Baessler / Ali Zafar / Anja Ciprianidis / Fabienne Louise Wagner / Sonja Bettina Klein / Sophie Schweizer / Marina Bartolovic / Daniela Roesch-Ely / Beate Ditzen / Christoph Nikendei / Jobst-Hendrik Schultz

Medical Education Online, Vol 25, Iss

2020 Volume 1

Abstract: Aims: Teaching students about risk communication is an important aspect at medical schools given the growing importance of informed consent in healthcare. This observational study analyzes the quality of teaching content on risk communication and ... ...

Abstract	Aims: Teaching students about risk communication is an important aspect at medical schools given the growing importance of informed consent in healthcare. This observational study analyzes the quality of teaching content on risk communication and biostatistics at a medical school. Methods: Based on the concept of curriculum mapping, purpose-designed questionnaires were used via participant observers to record the frequency, characteristics and context of risk communication employed by lecturers during teaching sessions for one semester. The data was analyzed quantitatively and descriptively. Results: Teaching about risk communication was observed in 24.4% (n = 95 of 390) sessions. Prevalence varied significantly among different departments with dermatology having the highest rate (67.9%) but lesser in-depth teaching than medical psychology where risk communication concepts were discussed on a higher scale in 61.4% sessions. Relevant statistical values were not mentioned at all in 69% of these 95 sessions and clinical contexts were used rarely (55.8%). Supplementary teaching material was provided in 50.5% sessions while students asked questions in 18.9% sessions. Conclusions: Students are infrequently taught about communicating risks. When they are, the teaching does not include the mention of core biostatistics values nor does the teaching involve methods for demonstrating risk communication.
Keywords	risk communication ; medical education ; medical curriculum ; informed consent ; communication skills ; biostatistics ; Special aspects of education ; LC8-6691 ; Medicine (General) ; R5-920
Subject code	370
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Taylor & Francis Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Effects of realistic e-learning cases on students' learning motivation during COVID-19.

Ann-Kathrin Rahm / Maximilian Töllner / Max Ole Hubert / Katrin Klein / Cyrill Wehling / Tim Sauer / Hannah Mai Hennemann / Selina Hein / Zoltan Kender / Janine Günther / Petra Wagenlechner / Till Johannes Bugaj / Sophia Boldt / Christoph Nikendei / Jobst-Hendrik Schultz

PLoS ONE, Vol 16, Iss 4, p e

2021 Volume 0249425

Abstract: Background Keeping up motivation to learn when socially isolated during a pandemic can be challenging. In medical schools, the COVID-19 pandemic required a complete switch to e-learning without any direct patient contact despite early reports showing ... ...

Abstract	Background Keeping up motivation to learn when socially isolated during a pandemic can be challenging. In medical schools, the COVID-19 pandemic required a complete switch to e-learning without any direct patient contact despite early reports showing that medical students preferred face-to-face teaching in clinical setting. We designed close to real-life patient e-learning modules to transmit competency-based learning contents to medical students and evaluated their responses about their experience. Methods Weekly e-learning cases covering a 10-week leading symptom-based curriculum were designed by a team of medical students and physicians. The internal medicine curriculum (HeiCuMed) at the Heidelberg University Medical School is a mandatory part of clinical medical education in the 6th or 7th semester. Case-design was based on routine patient encounters and covered different clinical settings: preclinical emergency medicine, in-patient and out-patient care and follow-up. Individual cases were evaluated online immediately after finishing the respective case. The whole module was assessed at the end of the semester. Free-text answers were analyzed with MaxQDa following Mayring`s principles of qualitative content analyses. Results N = 198 students (57.6% female, 42.4% male) participated and 1252 individual case evaluations (between 49.5% and 82.5% per case) and 51 end-of-term evaluations (25.8% of students) were collected. Students highly appreciated the offer to apply their clinical knowledge in presented patient cases. Aspects of clinical context, interactivity, game-like interface and embedded learning opportunities of the cases motivated students to engage with the asynchronously presented learning materials and work through the cases. Conclusions Solving and interpreting e-learning cases close to real-life settings promoted students' motivation during the COVID-19 pandemic and may partially have compensated for missing bedside teaching opportunities.
Keywords	Medicine ; R ; Science ; Q
Subject code	370
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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