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  • Springer  (161)
  • German Medical Science; Düsseldorf, Köln  (7)
  • 1
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    German Medical Science; Düsseldorf, Köln
    In:  Jahrestagung der Gesellschaft für Medizinische Ausbildung - GMA; 20061110-20061112; Köln; DOC06gma019 /20061023/
    Publication Date: 2006-10-23
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
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    German Medical Science; Düsseldorf, Köln
    In:  GMS Zeitschrift für Medizinische Ausbildung; VOL: 24; DOC50 /20070216/
    Publication Date: 2007-02-17
    Keywords: ddc: 610
    Language: German
    Type: article
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  • 3
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    German Medical Science; Düsseldorf, Köln
    In:  GMS Zeitschrift für Medizinische Ausbildung; VOL: 22; DOC18 /20050420/
    Publication Date: 2005-04-21
    Description: A comprehensive evaluation-based system for quality assurance was developed at the Medical Faculty of Freiburg during the course of several years. The system comprises the following levels: Level-I: Annual summative evaluation of the entire curriculum (academic years 1 through 5 and separately the Practical Year). The primary goal is a deficit analysis of the teaching quality of the several disciplines, thereby mainly referring to structural parameters.Level-II: Formative evaluation of the several courses/lectures with emphasis on didactic parameters. It allows a more detailed analysis of the quality of teaching. Especially those disciplines are examined that are identified by the level-I-evaluation as being in need of improvement. The intention of any form of evaluation is its use as an instrument for optimising the teaching quality. Therefore transferring the evaluation results in measures improving quality is resolutely pursued on all levels of evaluation.
    Description: Im Laufe mehrerer Jahre ist in Freiburg ein umfassendes evaluationsbasiertes System zur Sicherung bzw. Optimierung der Lehrqualität entstanden. Dieses System umfasst folgende Ebenen: Ebene-I: Summative Jahresendevaluation aller Hauptvorlesungen und Kurse der scheinpflichtigen Fächer der ersten fünf Studienjahre sowie gesondert des Praktischen Jahres (PJ). Ziel ist die Defizitanalyse der Lehrqualität auf der Ebene der einzelnen Fächer, vorwiegend bezogen auf strukturelle Faktoren. Ebene-II: Formative Evaluation einzelner Lehrveranstaltungen schwerpunktmäßig unter didaktischen Gesichtspunkten. Besonders die durch die Ebene-I identifizierten Schwachstellen des Lehrangebotes werden hier detaillierter analysiert. Der Anspruch jeglicher Form der Evaluation ist ihre Nutzung als Instrument zur Optimierung der Qualität. Insofern wird auf allen Ebenen konsequent an der Umsetzung der Ergebnisse in qualitätsverbessernde Maßnahmen gearbeitet.
    Keywords: medical education ; quality of teaching ; teaching evaluation ; quality improving measures ; Medizinische Ausbildung ; Qualität der Lehre ; Lehrevaluation ; qualitätsverbessernde Maßnahmen ; ddc: 610
    Language: German
    Type: article
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  • 4
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    German Medical Science; Düsseldorf, Köln
    In:  German Medical Science; VOL: 2; DOC01 /20040226/
    Publication Date: 2004-02-27
    Description: Background: The present status of outpatient treatment of depression in Germany was evaluated with respect to the adherence of general practitioners (GPs) and specialists of psychiatry to clinical practice guidelines. Methods: In total, 488 depressed patients' psychopathology, diagnostic assessment, therapeutic measures and referral frequency were documented at inclusion into study by 43 general practitioners and 23 specialists of psychiatry in three regions of Germany. The investigation of change in depressive symptoms after six to eight weeks by means of self-assessment could be evaluated for 165 patients.Results: The results of diagnostic assessment demonstrated that diagnoses of depression were not always based on the diagnostic criteria for depression (ICD-10): 33% of GPs' and 17% of specialists' patients were included as depressed patients into the study despite not fulfilling the ICD-10 criteria in the standardized documentation. Therapeutic undertreatment was more often found in the group of GPs. Referrals were found not to be oriented towards guidelines. After six to eight weeks, one half of patients reported a reduction in depressed symptoms, the other half of patients reported a stagnation or even a progression. Conclusions: The study has shown that physicians in outpatient settings still fail to orient themselves towards guideline recommendations. This reflects the need for physicians to receive guideline training, with the aim of improving the quality of care for depression. A quality management intervention program consisting of guideline training and an interdisciplinary quality circle to improve depression treatment and networking was supported by the authors and is currently being evaluated.
    Description: Hintergrund: Der aktuelle Status der ambulanten Depressionsversorgung in Deutschland wurde erhoben. Methode: Insgesamt wurden bei 488 depressiven Patienten Psychopathologie, diagnostische und therapeutische Maßnahmen sowie das Überweisungsverhalten zum Zeitpunkt des Studieneinschlusses von 43 Haus- und 23 Fachärzten für Psychiatrie in drei Studienregionen Deutschlands dokumentiert. Die Veränderung der depressiven Symptomatik nach sechs bis acht Wochen im Rahmen einer Selbstbeurteilung konnte bei 165 Patienten erfasst werden. Ergebnisse: Die Ergebnisse der diagnostischen Maßnahmen zeigten, dass die individuelle Diagnosestellung nicht immer auf den diagnostischen Kriterien einer Depression (ICD-10) basierte: 33% der Hausarzt- und 17% der Facharzt-Patienten wurden als depressive Patienten in die Studie eingeschlossen, obwohl sie die ICD-10 Kriterien laut der standardisierten Dokumentation nicht erfüllten. Eine ungenügende therapeutische Versorgung wurde häufiger bei den Hausärzten gefunden. Das Überweisungsverhalten orientierte sich nicht immer an verfügbaren, aktuellen Leitlinien. Nach sechs bis acht Wochen berichtete die Hälfte der Patienten eine Symptomverbesserung, während die andere Hälfte keine Veränderung oder sogar eine Verschlechterung angab. Diskussion: Die Studie hat gezeigt, dass die Leitlinienorientierung im ambulanten Versorgungssegment optimierbar erscheint. Dies verdeutlicht einen hohen Bedarf an ärztlichen Leitlinienschulungen, um die Qualität in der ambulanten Depressionsbehandlung zu verbessern. Derzeit wird von den Autoren eine durchgeführte Qualitätsmanagement-Intervention aus Leitlinienschulung und interdisziplinären Qualitätszirkeln zur Verbesserung der Depressionsversorgung und Vernetzung evaluiert.
    Keywords: ADOLESCENT ; ADULT ; AGED ; DEPRESSIVE DISORDER/* ; DEPRESSIVE DISORDER/*diagnosis ; DEPRESSIVE DISORDER/*epidemiology ; DEPRESSIVE DISORDER/therapy ; FEMALE ; GERMANY/epidemiology ; HUMAN ; MALE ; MIDDLE AGED ; PHYSICIANS, FAMILY ; PRIMARY HEALTH CARE/* ; PRIMARY HEALTH CARE/*statistics & numerical data ; REFERRAL AND CONSULTATION/statistics & numerical data ; DIAGNOSIS, DIFFERENTIAL ; ANTIDEPRESSIVE AGENTS/therapeutic use ; HEALTH KNOWLEDGE, ATTITUDES, PRACTICE/* ; PRACTICE GUIDELINES ; ADOLESZENT ; ERWACHSENER ; ALTE MENSCHEN ; DEPRESSIVE STÖRUNG/* ; DEPRESSIVE STÖRUNG/*Diagnose ; DEPRESSIVE STÖRUNG/*Epidemiologie ; DEPRESSIVE STÖRUNG/Therapie ; WEIBLICH ; DEUTSCHLAND/Epidemiologie ; MENSCH ; MÄNNLICH ; MENSCHEN IM MITTLEREN ALTER ; HAUSÄRZTE ; MEDIZINISCHE GRUNDVERSORGUNG/* ; MEDIZINISCHE GRUNDVERSORGUNG/*Statistik & Zahlen ; ÜBERWEISUNG UND KONSULTATION/Statistik & Zahlen ; DIFFERENTIALDIAGNOSE ; ANTIDEPRESSIVA/therapeutische Anwendung ; WISSEN, EINSTELLUNG, VERHALTEN (GESUNDHEIT)/* ; KLINISCHE RICHTLINIEN ; ddc: 610
    Language: English
    Type: article
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  • 5
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    German Medical Science; Düsseldorf, Köln
    In:  GMS Zeitschrift für Medizinische Ausbildung; VOL: 22; DOC17 /20050420/
    Publication Date: 2005-04-21
    Description: In addition to the annual summative evaluation of the entire curriculum at the Medical Faculty of Freiburg a formative course evaluation has been developed. The primary goal was a valid and detailed analysis of the quality of structure, process and outcome concerning the several courses as a basis for quality improvement.Method: The multidimensional questionnaire was constructed in consideration of academic and pragmatic aspects. The student evaluation takes place at the end of the individual course. The instructor receives the results on the next working day.Results: The internal consistency of the questionnaire as well as of its four main components supply evidence for the reliability of the procedure. Validity of content is ensured by the method of construction. The analysis of the four main components of the questionnaire shows construct validity. The assumed bias variables "interest in the subject" and "previous knowledge" did not influence the overall score. The clear improvements of the results indicate the relevance of the evaluation system.Conclusions: The formative teaching evaluation of the Medical Faculty of Freiburg allows a valid assessment of teaching quality. At the same time it provides precise perspectives for quality improving measures. Therefore it is highly accepted and effectively used by the instructors.
    Description: Ergänzend zur alljährlich durchgeführten summativen Jahresendevaluation wurde an der Medizinischen Fakultät Freiburg eine formative Lehrveranstaltungsevaluation entwickelt. Ziel war eine valide detaillierte Analyse der Struktur-, Prozess-, und Ergebnisqualität der einzelnen Lehrveranstaltung als Grundlage für Verbesserungen. Methodik: Das multidimensionale Erhebungsinstrument wurde aufwändig unter Berücksichtigung wissenschaftlicher und pragmatischer Ansprüche konstruiert. Die Befragung der Studierenden erfolgt am Ende der einzelnen Lehrveranstaltung. Die Ergebnisse liegen dem Dozenten bereits am nächsten Werktag vor. Ergebnisse: Die interne Konsistenz des Fragebogens sowie seiner vier Hauptkomponenten sprechen für die Reliabilität des Verfahrens. Inhaltliche Validität ist durch das Konstruktionsverfahren gewährleistet. Eine Analyse der Hauptkomponenten des Fragebogens belegt die Konstruktvalidität. Die vermuteten studentischen Zerrfaktoren "Themainteresse" und "Vorkenntnisse" können als solche ausgeschlossen werden. Die Wirkung der Evaluation zeigt sich in deutlichen Verbesserungen der Ergebnisse bei nachfolgenden Evaluationen.Schlussfolgerungen: Die Freiburger formative Lehrveranstaltungsevaluation ermöglicht eine valide Beurteilung der Lehrqualität und liefert gleichzeitig konkrete Ansatzpunkte für qualitätsverbessernde Maßnahmen. Offensichtlich findet sie dadurch große Akzeptanz und wird nachweislich wirkungsvoll im Sinne einer Lehrqualitätssteigerung von den Dozenten als Instrument genutzt.
    Keywords: teaching evaluation ; quality management in medical education ; questionnaire construction ; dimensions of teaching quality ; Lehrveranstaltungsevaluation ; Qualitätsmanagement in der medizinischen Ausbildung ; Fragebogenkonstruktion ; Dimensionen der Lehrqualität ; ddc: 610
    Language: German
    Type: article
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  • 6
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    German Medical Science; Düsseldorf, Köln
    In:  104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft (DOG); 20060921-20060924; Berlin; DOC06dogP079 /20060918/
    Publication Date: 2006-09-19
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 7
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    German Medical Science; Düsseldorf, Köln
    In:  Kooperative Versorgung - Vernetzte Forschung - Ubiquitäre Information; 49. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 19. Jahrestagung der Schweizerischen Gesellschaft für Medizinische Informatik (SGMI) und Jahrestagung 2004 des Arbeitskreises Medizinische Informatik (ÖAKMI) der Österreichischen Computer Gesellschaft (OCG) und der Österreichischen Gesellschaft für Biomedizinische Technik (ÖGBMT); 20040926-20040930; Innsbruck; DOC04gmds040 /20040914/
    Publication Date: 2004-09-14
    Keywords: ddc: 610
    Language: German
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  • 8
    ISSN: 1432-0916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Mathematics , Physics
    Notes: Abstract We consider a nonlinear, elliptic, free-boundary problem involving an initially unknown setA that represents, for example, the cross-section of a steady vortex ring or of a confined plasma in equilibrium. The solutions are characterized by a variational principle which allows us to describe their behaviour under a limiting process such that the diameter ofA tends to zero, while the solutions degenerate to the solution of a related linear problem. This limiting solution is the sum of the Green function of the linear operator and of a smooth function satisfying the boundary conditions. Mathematically speaking, this limiting process, that we call “nonlinear desingularization”, is a novel kind of bifurcation phenomenon since the nonlinear effect here involves smoothing the singularity of the associated linear problem.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-1106
    Keywords: Human movement ; Spastic hemiparesis ; Bimanual coordination
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A Fitts' task was used to examine whether the large movement asymmetry in subjects with spastic hemiparesis can be reduced or eliminated when both limbs are required to perform functionally equivalent tasks. Furthermore, it was determined whether any such benefit was expressed as mutual accommodation, or whether one hand “slaves” the other. Finally, the effect of increased task constraints on the magnitude of the asymmetry was considered. A group of ten students served as controls. Subjects had to grasp small balls and subsequently place them into holes. As expected, large total response time differences were present between the hands of the hemiparetic subjects in the unimanual conditions. However, 92% of the difference between hands was eliminated in the bimanual conditions. It is argued that the observed temporal invariance, or time locking, between hands in the bimanual conditions might be facilitated through the activity of bilateral controls exerted from each hemisphere and neural crosstalk at different levels of the central nervous system. Still, an asymmetric tendency remained in the bimanual conditions: a tendency existed for the impaired hand to reach the “target” later in time compared with the dominant hand. This tendency was enlarged as the asymmetry in task demands for the two limbs increased.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-1238
    Keywords: Low T3 syndrome ; Selenium ; Deiodination ; Glutathione peroxidase ; Balance study ; Critically ill ; Trauma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective Thyroxine (T4) is deiodinated to triiodothyronine (T3) by the hepatic type I iodothyronine deiodinase, a selenoprotein that is sensitive to selenium (Se) deficiency. After severe injury, T4 deiodination is decreased, leading to the low T3 syndrome. Injury increases free radical production, which inactivates the iodothyronine deiodinase. The aims were to study the Se status after major trauma and to investigate its relation to the low T3 syndrome. Design Preliminary prospective descriptive study. Setting Intensive care unit at a university teaching hospital. Patients and methods 11 patients aged 41±4 years (mean±SEM), with severe multiple injuries (Injury Severity Score 29±2 points). A balance study was performed from day 1 to day 7. Serum and urine samples were collected from the time of admission until day 7, then on days 10, 15, 20, 25 and 30. Nonparametric tests and Pearson's correlation coefficients were used for analysis. Results Cumulated Se losses were 0.88±0.1 μmol/24h. Serum Se was decreased from admission to day 7. T3, free T3, and the T3/T4 ratio were low until day 5, being lowest on day 2; T4 and thyroid stimulating hormone were normal. Serum Se was correlated with T3 (r=0.55,p=0.0001), and with free T3 (r=0.35). Conclusion Se status is altered after trauma, with decreased Se serum levels upon admission to the ICU but with no major Se losses. Se is probably redistributed to the tissues. The correlation between Se and T3, along with the parallel decrease in T4 deiodination, indicates that reduced deiodination might be related to the transient decrease in serum Se.
    Type of Medium: Electronic Resource
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