Scene from Uro-Island.

<p>The players' character together with Vesix in a laboratory. Different things like cells, cristalls and tools have been collected into the inventory. Later the character can use them together with the correct devices in the laboratory, e.g. the microscope or the autoclave, to proceed in the unfolding story of the game.</p

Students' attitudes towards the learning experience, answers on the questionnaire on a 4-point Likert scale (1: no agreement to 4: full agreement).

<div><p>Students in the GbEl group had significantly more fun, would like to learn more with GbEl and felt more confident in the content domain. The following questions were asked:</p> <p><b>additional material</b>: Would you like to have more learning material like this in your training?</p> <p><b>fun</b>: Did you enjoy working with the learning material?</p> <p><b>confidence</b>: Do you feel confident in the domain of laboratory urinalysis now?</p></div

ITT analysis: distribution of the data in the script group and the GbEL group.

<p>ITT analysis: distribution of the data in the script group and the GbEL group.</p

Scene from Uro-Island.

<p>The character controlled by the player ("the doctor") exploring the island. He engages in dialogues with the non-player character ("Vesix).</p

CONSORT Diagram. A total of 145 students were randomized of which 144 students were analyzed.

<p>CONSORT Diagram. A total of 145 students were randomized of which 144 students were analyzed.</p

Dealing with foreign cultural paradigms: A systematic review on intercultural challenges of international medical graduates

<div><p>Objectives</p><p>An increasing number of International Medical Graduates (IMG), who are defined to be physicians working in a country other than their country of origin and training, immigrate to Western countries. In order to ensure safe and high-quality patient care, they have to take medical and language tests. This systematic review aims to (1) collect all empiric research on intercultural communication of IMGs in medical settings, (2) identify and categorize all text passages mentioning intercultural issues in the included studies, and (3) describe the most commonly reported intercultural areas of communication of IMGs.</p><p>Methods</p><p>This review was based on the PRISMA-Guidelines for systematic reviews. We conducted a broad and systematic electronic literature search for empiric research in the following databases: MEDLINE, BIOSIS Citation Index, BIOSIS Previews, KCI-Korean Journal Database and SciELO Citation Index. The search results were synthesized and analyzed with the aid of coding systems. These coding systems were based on textual analysis and derived from the themes and topics of the results and discussion sections from the included studies. A quality assessment was performed, comparing the studies with their corresponding checklist (COREQ or STROBE). Textual results of the studies were extracted and categorized.</p><p>Results</p><p>Among 10,630 search results, 47 studies were identified for analysis. 31 studies were qualitative, 12 quantitative and 4 studies used mixed methods. The quality assessment revealed a low level of quality of the studies in general. The following intercultural problems were identified: IMGs were not familiar with shared decision-making and lower hierarchies in the health care system in general. They had difficulties with patient-centered care, the subtleties of the foreign language and with the organizational structures of the new health care system. In addition, they described the medical education in their home countries as science-oriented, without focusing on psychosocial aspects.</p><p>Conclusion</p><p>There is a need for a better training of IMGs on culture-related and not culture-related topics in the new workplace country. The topics that emerged in this review constitute a basis for developing these courses. Further empiric research is needed to describe the findings of this review more precisely and should be in accordance with the existing reporting guidelines.</p></div

Culture-related results of the qualitative and mixed methods studies.

<p>The red color indicates problems for the IMGs with this issue. The blue color indicates differences between the home and the new culture of the IMGs.</p

Inter-rater comparison of the 500 most recent records of the first search.

<p>NF = Nabeel Farhan. KM = Kerstin Michalski.</p

Main-categories of the quantitative coding system.

<p>Main-categories of the quantitative coding system.</p

Frequency of mentions by topic in the qualitative (<i>n</i> = 31) and mixed methods studies (<i>n</i> = 4; <i>n</i>_sum = 35) and their assessment types.

<p>Percentage in parenthesis relative to the row sum.</p