Sterz Jasmina, Britz Vanessa, Münzberg Matthias, Kadmon Martina, Schleicher Iris, Meder Adrian, Kamp Rainer, Janko Maren, Marzi Ingo, Rüsseler Miriam
Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Frankfurt.
Klinik für Unfallchirurgie und Orthopädie, BG-Unfallklinik, Ludwigshafen.
Z Orthop Unfall. 2018 Aug;156(4):393-398. doi: 10.1055/s-0044-100930. Epub 2018 Mar 9.
The national competence-based catalogue of learning-goals in surgery (NKLC) defines competence levels for each of its 230 goals, including "competence level in 1: factual knowledge" up to "competence level 3: independent action". Aside from the cumulative examinations influencing the learning behaviour of students, those teaching targets do not affect the second state examination. This study analyses the extent to which the questions of the German second medical licensing examination compiled by the IMPP (central German institute for medical and pharmaceutical examinations) are congruent with the trauma-surgical and orthopaedic learning goals in the NKLC, in which this thematic focus is emphasised.
Exam questions from autumn 2009 to autumn 2014 (n = 11) were retrospectively analysed. Orthopaedic and trauma-surgical teaching targets defined in NKLC were identified by five senior orthopaedic physicians and trauma surgery experts. All questions addressing one of these learning goals were identified and analysed (re: the number of learning goals, the number of questions addressing a trauma-surgical, or orthopaedic goal, as well as different competency levels).
We found 113 learning goals of NKLC (49.1% of the overall NKLC learning goals) identified as orthopaedic or trauma surgery subjects. During the study period, 543 questions included teaching targets referring to orthopaedic or trauma surgery subjects (15.6% of the total of 3480 questions). Per exam, a mean of 49.36 ± 14.1 questions (minimum 30; maximum 80) was identified that addressed a learning goal referring to these issues. For each exam, 13.45 ± 6.39 (minimum 6; maximum 24) questions referred to learning goals of competence level 3a and b, 21.45 ± 9.94 (minimum 9; maximum 39) questions referred to learning goals of competence level 2, and 14.45 ± 6.36 (minimum 6; maximum 25) questions referred to learning goals of competence level 1. Most questions addressed the topic: "disorders of the rheumatic spectrum" (n = 16 questions in autumn 2009).
Questions focusing on orthopaedic and trauma surgery appeared sufficiently often during the second state examination. There is a thematic imbalance, and important clinical learning goals tagged with high competence levels were not addressed in a satisfactory manner. This indicates that a clear adjustment between the state examination and NKLC is necessary.
德国国家外科学基于能力的学习目标目录（NKLC）为其230个目标中的每一个都定义了能力水平，从“能力水平1：事实性知识”到“能力水平3：独立行动”。除了影响学生学习行为的累积考试外，这些教学目标并不影响第二次国家考试。本研究分析了由德国中部医学和药学考试研究所（IMPP）编制的德国第二次医学执照考试的问题与NKLC中创伤外科和骨科学习目标的相符程度，其中该主题重点得到了强调。
对2009年秋季至2014年秋季的考试问题（n = 11）进行回顾性分析。由五位资深骨科医生和创伤外科专家确定NKLC中定义的骨科和创伤外科教学目标。识别并分析所有涉及这些学习目标之一的问题（涉及学习目标的数量、涉及创伤外科或骨科目标的问题数量以及不同的能力水平）。
我们发现NKLC的113个学习目标（占NKLC总学习目标的49.1%）被确定为骨科或创伤外科主题。在研究期间，543个问题包含涉及骨科或创伤外科主题的教学目标（占3480个问题总数的15.6%）。每次考试平均确定49.36 ± 14.1个（最少30个；最多80个）涉及这些问题的学习目标的问题。每次考试有13.45 ± 6.39个（最少6个；最多24个）问题涉及能力水平3a和b的学习目标，21.45 ± 9.94个（最少9个；最多39个）问题涉及能力水平2的学习目标，14.45 ± 6.36个（最少6个；最多25个）问题涉及能力水平1的学习目标。大多数问题涉及主题：“风湿性疾病谱”（2009年秋季有16个问题）。
在第二次国家考试中，关注骨科和创伤外科的问题出现得足够频繁。存在主题不平衡，并且具有高能力水平的重要临床学习目标没有得到令人满意的考查。这表明国家考试与NKLC之间需要进行明确调整。
