"Basic Medical Skills" - Evaluation of a primary care oriented course concept within the new medical curriculum in Germany

Background and objective: To increase the practical orientation of medical student education in Germany, we have introduced a new mandatory course into the 3rd study year. This course combines doctor-patient communication training sessions with practical skills such as taking blood, changing dressings, etc. The primary care point of view to these topics was emphasized. The study describes the course and an evaluation of its effects on basic medical skills. Methods: Learning progress was measured using an anonymous self-evaluation questionnaire. Students graded their own competence in each individual course element using a 1-6 point scale (1='excellent' to 6='insufficient'). To objectify the learning process with regards to both practical skills and communicative competence we performed an "Objective Structured Clinical Examination" (OSCE).Results: Complete data are available from 154 of the 193 students participating in the course (average age 23.7 ±2.7 years). With regards to their competence in taking a case history, participants rated themselves with an average score of 3.99 before the course and an improved average score of 2.42 afterwards (P<0.0001). Students gave themselves credit for definite improvement in practical skills as well. Neither gender, age nor earlier medical training had any effect of the self-evaluation. Results of self-reported questionnaires corresponded well with the test results of the OSCE (N=193). Female students had significantly better results in the global rating in the communicative sections of the OSCE test than their male counterparts. Overall, the general evaluation of the course (grade 1.93) and its value for later medical competence (1.97) were very high in comparison to the average values for medical seminars at this university.Conclusion: We found high effects on clinical competence both in self-reported evaluations of the course and in the OSCE. A longitudinal study is under way in order to investigate to what extent this seminar will lead to long-term improvement of competence. The "gender bias" found in communication skills needs to be confirmed in pre/post investigations and long-term effects in order to find out, if male students need specific help in improving their communication skills.Zielsetzung: Die Arbeit beschreibt Ablauf und Evaluation eines neuen Pflichtkurses "Ärztliche Basisfähigkeiten" im 1. klinischen Semester. Dieser Kurs verbindet Übungen zur Arzt-Patienten-Kommunikation mit praktischen Übungen in Fertigkeiten wie Blutentnahme, Anlegen von Verbänden, etc. und greift dabei die Vorgabe zu einer stärkeren Praxisorientierung des Studiums entsprechend der neuen Approbationsordnung auf.Methodik: Selbsteinschätzung des Lernfortschritts der Studierenden gemäß einer Kompetenzskala sowie eine auf dem Schulnotensystem (1-6) beruhende Beurteilung der einzelnen Kurselemente. Fremdeingeschätzte Objektivierung des Lernerfolgs mittels einer "Objective Structured Clinical Examination" (OSCE).Ergebnisse: 154 der 193 Kursteilnehmer (Durchschnittsalter 23,7 (±2,7) Jahre) haben an der Befragung teilgenommen. Bezüglich ihrer Kompetenz in Anamneseerhebung gaben die Studierenden eine Verbesserung von der Durchschnittsnote 3,99 vor dem Kurs auf 2,42 an (p