Selbsteinschätzung der vorhandenen klinischen Fertigkeiten von Medizinstudierenden im 3.-6. Studienjahr - eine Pilotstudie aus vier europäischen Ländern

Background: Clinical training concepts of medical students differ in the various European countries. The goal of this paper is to study the differences at the beginning of medical practice in specific clinical skills on an international level.Methods: The data were collected by a publically accessible online questionnaire online from February to June 2010. The participants in the study were recruited through the official letter sent by deaneries and student organisations. Two thousand nine hundred and seven medical students participated in the online survey. From study years 1 to 6, 2406 valid data records (67.3 percent female; 32.7 percent male) from four different European countries were sent. The skills in the questionnaire included patient consultation and anamnesis, physical examination, auscultation, gypsum and bandage dressing, suture techniques, venepuncture, and laying of indwelling catheters. Results: One thousand six hundred and twenty-nine data records of medical students in their training years 3 to 6 were assessed. The average age of the students was 24.7 years. On a scale from 1 to 10, the average satisfaction of the students with their medical faculty was 6.47 (±2.07); the assessment of the preparation for the clinical activities was 4.72 (±2.13). By comparison, British students indicated most satisfaction with their training (6.70±1.85). With respect to the clinical skills, the students interviewed felt safest in patient consultation and anamnesis (7.63±2.13) followed by blood sampling (7.46±2.29). The topics of surgical suturing techniques (4.40±2.81) and the gypsum and bandaging techniques (2.63±2.23) were taught worst subjectively.Discussion: The training of medical students in basic clinical skills is an essential part of the studies. This study was able to demonstrate that the subjective trust of medical students in their personal skills positively correlated with the satisfaction with their own university. The results pointed out that future curricula of universities could profit from an increased focus on clinical skills.Hintergrund: Klinische Ausbildungskonzepte von Medizinstudenten unterscheiden sich in den verschiedenen europäischen Ländern. Ziel dieser Studie war es Unterschiede am Beginn der ärztlichen Tätigkeit in spezifischen klinischen Fähigkeiten im internationalen Vergleich zu untersuchen.Methodik: Die Daten wurden im Rahmen eines öffentlich zugänglichen Onlinefragebogens im Zeitraum von Februar bis Juni 2010 erhoben. Die Rekrutierung der Studienteilnehmer erfolgte über das offizielle Anschreiben von Dekanaten und Studentenvereinigungen. 2907 Medizinstudenten nahmen an der Onlinebefragung teil. Aus den Studienjahren 1-6 stammten 2406 gültige Datensätze (67,3% weiblich; 32,7% männlich) aus vier verschiedenen europäischen Ländern. Bei den erfragten Fähigkeiten handelte es sich um Patientengespräche und Anamneseerhebung, körperliche Untersuchung, Auskultation, Gips- und Verbandsversorgung, Wundnahttechniken, Venenpunktion und das Legen von Venenverweilzugängen.Ergebnisse: 1629 Datensätze von Medizinstudenten in den Ausbildungsjahren 3-6 wurden ausgewertet. Das durchschnittliche Alter der Studenten betrug 24,7 Jahre.Die durchschnittliche Zufriedenheit der Studenten mit ihrer medizinischen Fakultät lag auf einer Skala von 1 bis 10 bei 6,47 (±2.07), die Bewertung der Vorbereitung auf die klinische Tätigkeit betrug 4.72 (±2.13). Im Vergleich zeigten britische Studenten die größte Zufriedenheit mit ihrer Ausbildung (6.70±1.85). Von den klinischen Fähigkeiten fühlten sich die befragten Studenten am sichersten bei der Patientengesprächsführung und Anamneseerhebung (7.63±2.13), gefolgt von Blutabnahmen (7.46±2.29). Inhalte der chirurgischen Nahttechniken (4.40±2.81) und Gips- und Verbandstechniken (2.63±2.23) wurden subjektiv in allen Ländern am schlechtesten vermittelt.Diskussion: Die Ausbildung von Medizinstudenten in klinischen Basisfähigkeiten ist ein essenzieller Bestandteil des Studiums. Diese Studie konnte zeigen, dass das subjektive Vertrauen der Medizinstudenten in die persönlichen Fähigkeiten positiv mit der Zufriedenheit in die eigene Universität korreliert. Die Ergebnisse weisen darauf hin, dass zukünftige Lehrpläne der Universitäten von einem vermehrten Fokus auf klinische Fähigkeiten profitieren könnten

Antimicrobial resistant and extended-spectrum ß-lactamase (ESBL) producing Escherichia coli isolated from fecal samples of African dromedary camels

This study was conducted to determine the distribution of antimicrobial resistance among Escherichia coli isolated from feces of healthy dromedary camels in Kenya. A total of 162 fecal samples were cultivated for E. coli. Samples were also subcultivated to detect E. coli with extended-spectrum ß-lactamases (ESBLs). Antimicrobial susceptibility testing (AST) was performed by disk diffusion using a panel of 16 antimicrobials. In addition, isolates were screened for the presence of the plasmid-mediated colistin resistance genes mcr-1 to mcr-5. Samples from 20 (12.4%) of the camels contained antimicrobial resistant (AMR) E. coli, and 85% of the AMR isolates were multidrug resistant (MDR). The highest frequency of resistance was observed to tetracycline (11.7%), followed by ampicillin and streptomycin (both 10.5%), and sulfamethoxazole/trimethoprim (9.9%). Two (1.2%) of the isolates showed intermediate resistance to cefazolin and streptomycin, respectively. All the isolates were susceptible to amoxycillin/clavulanic acid, ciprofloxacin, fosfomycin, aztreonam and kanamycin, and 86.4% of the isolates were susceptible to all 16 antimicrobials used in this study. The prevalence of fecal carriage of ESBL producing E. coli was 0.6%. PCR and amplicon sequencing showed that the ESBL producer belonged to E. coli phylogenetic group A, sequence type (ST) 48, and harbored blaCTX-M-15. None of the isolates contained mcr genes. The results indicate that dromedary camels in Kenya may be reservoirs of AMR E. coli, including ESBL producers, that could potentially be transmitted to humans by direct contact or via the food chain

A Novel Model-Less Method for the Emulation of PMSM in Power-Hardware-in-the-Loop Platforms

Power-Hardware-in-the-Loop (PHIL) is gaining increasing attention as a technology enabling rapid testing and development of switching converters in power electronics and variable speed drive applications. When Permanent Magnet Synchronous Machines (PMSMs) emulation is required for the PHIL platform, the electrical and mechanical model of the machine must be solved in real-time by a Digital Real-Time Simulator (DRTS). The real-time resolution of the electrical model represents one of the challenging aspects of PHIL implementation. This paper shows that the PMSM electrical model can be removed and accurate emulation of the PMSM can still be achieved. Such a solution allows to contemporary reduce the development time of the PHIL platforms and its cost. In this work, a theoretical analysis is carried out to compare the novel model-less solution to the state-of-the-art implementation of PHIL. The theoretical work is supported and validated through experimental results, confirming the fairness of the proposed approach