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. 2013 Aug 15;30(3):Doc33.
doi: 10.3205/zma000876. eCollection 2013.

Increase in medical knowledge during the final year of undergraduate medical education in Germany

Tobias Raupach  1 , Daniela Vogel, Sarah Schiekirka, Carolina Keijsers, Olle Ten Cate, Sigrid Harendza
Affiliations

Increase in medical knowledge during the final year of undergraduate medical education in Germany

Tobias Raupach et al. GMS Z Med Ausbild. .

Abstract
in English, German

Aims: In Germany, the final year of undergraduate medical education ('practice year') consists of three 16-week clinical attachments, two of which are internal medicine and surgery. Students can choose a specific specialty for their third 16-week attachment. Practice year students do not receive specific teaching to prepare them for the National Licensing Examination. It is unknown whether knowledge levels increase during this year. This study aimed at assessing knowledge at the beginning and the end of the final year of medical school.

Methods: Three hundred pre-selected United States Medical Licensing Examination type items from ten medical disciplines were reviewed by ten recent medical graduates from the Netherlands and Germany. The resulting test included 150 items and was taken by 77 and 79 final year medical students from Göttingen and Hamburg at the beginning and the end of their practice year, respectively.

Results: Cronbach's α of the pre- and post-test was 0.75 and 0.68, respectively. Mean percent scores in the pre- and post-test were 63.9±6.9 and 69.4±5.7, respectively (p<0.001; effect size calculated as Cohen's d: 0.87). In individual students, post-test scores were particularly high for items related to their specific chosen specialty.

Conclusion: The knowledge test used in this study provides a suitable external tool to assess progress of undergraduate medical students in their knowledge during the practice year. The pre-test may be used to guide individual learning behaviour during this final year of undergraduate education.

Zielsetzung: In Deutschland besteht das letzte Jahr des Studiums der Humanmedizin ("Praktisches Jahr", PJ) aus drei Tertialen von je 16 Wochen, von denen eines in der Inneren Medizin und eines in der Chirurgie abzuleisten ist. Die Fachrichtung des dritten Tertials von 16 Wochen kann von den Studierenden frei gewählt werden. Während des Praktischen Jahres findet keine gezielte Vorbereitung auf den schriftlichen Teil des Staatsexamens statt. Es ist unklar, inwieweit die Studierenden während des Praktischen Jahres auch neue Wissensinhalte erlernen. Ziel dieser Studie war es, zu Beginn und am Ende des Praktischen Jahres Wissensinhalte zu überprüfen. Methodik: Zehn Absolventen des Medizinstudiums in Deutschland und den Niederlanden trafen eine Auswahl aus 300 vorselektierten Fragen der US-amerikanischen Abschlussprüfung (USMLE), die zehn verschiedenen Fachrichtungen zugeordnet waren. Die ausgewählten 150 Fragen wurden im Rahmen zweier Tests PJ-Studierenden aus Göttingen und Hamburg vorgelegt: einmal zu Beginn (n=77 Studierende) und einmal am Ende des Praktischen Jahres (n=79). Ergebnisse: Die interne Konsistenz der beiden Tests (Cronbach’s α) betrug 0,75 (Prätest) bzw. 0,68 (Posttest). Der Anteil richtig beantworteter Fragen betrug im Prätest 63,9±6,9 und im Posttest 69,4±5,7 (p<0,001; Effektstärke als Cohen’s d: 0,87). Individuelle Studierende schnitten bei denjenigen Fragen besonders gut ab, die sich auf Inhalte ihres Wahlfachs bezogen.Schlussfolgerung: Der in dieser Studie verwendete Wissenstest eignet sich als externes Instrument zur Messung des Wissenszuwachses von Studierenden im Praktischen Jahr. Zudem kann der Prätest genutzt werden, um Studierende bei der Planung ihres Lernverhaltens während des Praktischen Jahres zu unterstützen.

Keywords: knowledge; practice; undergraduate medical education.

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Figures

Table 1
Table 1. Characteristics of study participants. P values were derived from independent t-tests (age) and χ2-tests (all other variables), respectively.
Table 2
Table 2. Student performance in the pre- and post-test by specialty. Results are given as percentages (mean±standard deviation) of the total available score in each specialty. P values were derived from independent t-tests.
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