Hempel Gunther, Weissenbacher Andreas, Becker-Rux Diana, Mescha Swantje, Stehr Sebastian N, Werdehausen Robert
Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Leipzig AöR, Liebigstr. 20, 04103, Leipzig, Deutschland.
Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Jena, Jena, Deutschland.
Schmerz. 2022 Dec;36(6):389-397. doi: 10.1007/s00482-022-00665-7. Epub 2022 Aug 26.
The field of pain medicine was established as an obligatory subject area of medical schools in Germany in 2016. No prior study has evaluated the effects of this curricular change on students' competences in the field of pain medicine.
The aim of this study was to find out to what extent the introduction of the additional subject "pain medicine" positively influenced the students' acquisition of competences measured via a self-assessment.
A longitudinal and interdisciplinary curriculum for pain medicine was developed according to the current recommendations for curriculum development for medical education. In parallel, a questionnaire was created for the students' self-assessment of their own level of knowledge and the importance of pain medicine teaching content on a 5-stage Likert scale. The surveys were conducted before the implementation of the curriculum (2014), directly after the first cohort finished (2016) and 5 years after the implementation (2019) and compared by Kruskal-Wallis test.
The implementation of the curriculum has led to significant improvement in relevant aspects. For example, students now feel better prepared overall for the treatment of pain patients (2.67 in 2014 vs. 3.18 in 2019). Individual sub-aspects such as taking a pain history (3.63 vs. 4.10) or drawing up an analgesia scheme (3.56 vs. 4.14) are now also subjectively better mastered.
Even though the results are encouraging, there is further potential for improvement in some sub-areas. For example, the students' rating regarding the question about their preparation for treating patients in pain is not yet satisfactory. Therefore, the curriculum should be developed further with a focus on competence orientation. Digital teaching formats can be integrated as well as interprofessional units and simulated patients. Additionally, the examination formats should be further developed towards standardized practical examinations.
2016年疼痛医学领域在德国被确立为医学院校的一门必修学科领域。此前尚无研究评估这一课程变化对学生在疼痛医学领域能力的影响。
本研究的目的是了解增设“疼痛医学”这门学科在多大程度上通过自我评估对学生能力的获得产生了积极影响。
根据当前医学教育课程开发的建议，制定了一门疼痛医学的纵向跨学科课程。同时，设计了一份问卷，让学生按照5级李克特量表对自己的知识水平以及疼痛医学教学内容的重要性进行自我评估。调查在课程实施前（2014年）、第一批学生完成课程后立即（2016年）以及课程实施5年后（2019年）进行，并通过Kruskal-Wallis检验进行比较。
课程的实施在相关方面带来了显著改善。例如，学生现在总体上感觉对疼痛患者的治疗准备得更好了（2014年为2.67，2019年为3.18）。现在，诸如采集疼痛病史（3.63对4.10）或制定镇痛方案（3.56对4.14）等各个子方面在主观上也掌握得更好了。
尽管结果令人鼓舞，但在一些子领域仍有进一步改进的潜力。例如，学生对关于他们治疗疼痛患者准备情况问题的评分仍不尽人意。因此，应进一步开发课程，以能力导向为重点。可以整合数字教学形式以及跨专业单元和模拟患者。此外，考试形式应进一步朝着标准化实践考试发展。
