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Berlin – Association of Scientific Medical Societies eV (Omph) believes that it is necessary to strengthen the teaching of scientific competence in medical studies as well as continue the training of doctors. They believe that there should be uniform requirements at the national level in this regard in the future.
No matter where doctors work in the health or research system, it is essential that they are able to read and interpret the latest studies. They must be able to apply medical guidelines, record registration data and understand, classify and evaluate statistics in the context of patient care, this was the tenor of today’s AWMF Berlin forum.
“Basic methodological and scientific knowledge is a prerequisite for the application of evidence-based medicine,” said Rolf Detlef Traed, President of the AWMF. “We need scientific competence for future medical doctors. This must be justified in studies and additional training and continued throughout life,” says Tredy. “You also need competent research doctors who ask the right scientific questions. However, the study of human medicine does not currently provide a foundation for Good for either.
Application of guidelines
“Patient care is an applied science,” emphasized Andreas Stalmach from the University Hospital Jena. Medical knowledge is currently multiplying in a very short time. Therefore, doctors must be able to read and understand guidelines that are constantly updated. He called for the necessity of teaching the application of the guidelines during the study. Above all, students should be made interested in science and guidelines. This requires role models who regularly apply current guidelines in daily clinical practice.
This situation must also be reflected in the upcoming reform of medical studies: “We, at the AWMF, welcome the fact of intensifying scientific training through the new licensing regulations by allowing a certain amount of time for research work,” emphasized Trade. It is hoped that the current draft of the new medical licensing regulations will be implemented soon.
The students themselves are also seeking changes in the curriculum in the direction of science and are looking forward to the new licensing regulations coming into force. German-wide surveys of medical students have clearly shown that the majority would like to see more teaching of scientific skills during their studies, as Christian Paxmann, Federal Coordinator for Medical Education at the Federal Representation of Medical Students in Germany, confirmed today (bvmd).
In fact, according to surveys, the majority of medical students currently consider scientific training in medical schools to be inadequate. Paxman explained that it does not provide optimal preparation for a future doctoral degree. The medical student at the University of Leipzig explained that two-thirds of students wanted to write a scientific paper during their studies – as will now be established in the new draft licensing regulations. As a future doctor, you must have done scientific work yourself. “We also need practical competence when it comes to scientific competence, not just cognitive competence,” Paxman said.
Specifically, students wanted interactive and innovative courses, a connection to core curriculum content, and mandatory completion of an academic paper – across all colleges nationwide. However, academic work should not grossly increase the workload and should perhaps be moved to a lecture-free period during which an internship should also be completed. “The course also needs to be studyable,” Paxman says.
Julia Eckel, spokesperson for “Science in Medical Studies” at the Department of Study and Teaching Development at the Medical Faculty of Mannheim, University of Heidelberg, spoke about what promoting scientific competence in medical studies could look like. In their college, the “MaReCuM” model course clearly enhances the scientific skills of medical students. “We have implemented a mandatory guide to achievement in academic work,” she explained.
Providing tools of the trade
“We provide students with tools for scientific work,” Eckel explained. They attended events on literature research, evidence-based medicine, good scientific practice, critical evaluation of scientific evidence and scientific writing. These tools are essential to correctly read and classify scientific findings in the context of the patient. In a research paper, students ultimately have to produce their own scientific achievements, Eckel continues. Laboratory training, experimental planning, biomathematics, epidemiology, and evidence-based medicine in the clinic complement the curriculum. In MaReCuM, “development and analysis of scientific evidence, ability to research independently, and readiness for lifelong learning” are also defined as core competencies.
But the AWMF also demands that scientific competence be enhanced later – through further training. Clinicians must be able to conduct patient-oriented research according to DFG standards. “Medical work is also clinical research,” Tredy says. Unfortunately, this is not adequately reflected in continuing education regulations.
Erika Baum, Chair of the AWMF’s Standing Committee for the Development of Quality in Research and Teaching, criticized the ethical, scientific and legal foundations of medical work only as knowledge, but not as work competence. this is not enough. Scientific competence is the competence to work for cooperation between disciplines and professions. “Doctors must be able to process data from daily care in a scientific way so that it can be used for research — not just in university hospitals, but across the board,” Baum says. Registration of studies and networks of research practices in the outpatient sector will help generate innovations and improve the quality of treatment and patient care.
Specifically, the AWMF calls for the recognition of research periods for further medical training. To date, clinical scientist programs (CSP) have not even been recognized uniformly by all state medical societies. Baum criticized: “Some medical societies are generous if the general framework shows a reasonable structure for further training, others categorically exclude periods of scientific activity without direct patient contact.” Most of the doctors at CSP carried out clinical and research activities at the same time.
This was confirmed by Il Kang Na, Director of the Clinical Scientists Program Berlin Institute of Health At Charité (BIH) and Charité – Universitätsmedizin Berlin. The doctor and scientist have called for computer science programs to be made permanent. “Physician researchers build the bridge between research and clinical practice,” she said. “They identify gaps in care and are key drivers of research.” Na stressed the “excellent” cooperation with the Berlin Medical Association in this regard. It gives recognition for further training for up to three years. “We need these agreements on the recognition of research periods by medical associations,” she stressed.
“In the short term, we require that six months in clinical research or health services research count toward the training period,” Baum added. In addition, times should be set that take into account the specific competencies of the relevant additional training regulations under the CSP, for example research into allergic diseases, which enhances and enhances allergy medicine competencies, according to the general practitioner.
Henrik Herrmann, President Schleswig-Holstein Medical Association Co-Chair of the Permanent Conference on Continuing Medical Education Federal Medical AssociationHe emphasized that clinical research can certainly be done in further education. “The specific grades for the training period must then be verified in individual cases by the responsible state medical association.” This is certainly different, but “I have no understanding of the general disapproval.” In his case in Schleswig-Holstein, up to 48 months are already waiting and further training has been recognized.
“In Germany, more training is generally carried out as part of medical professional activity,” emphasized Hermann. It is important that the trainee has direct contact with people authorized to provide further training. The various doctor roles will also be deepened in further training. “Transferring scientific competence is of course part of this,” Herrmann says. Scientific aspects in further education are reflected, for example, in the application of guidelines and studies or in the preparation of scientifically based reports. The overall goal is always to ensure high-quality patient care. © ER/aerzteblatt.de
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