Qualitätsverbesserung von MC Fragen [Quality assurance of Multiple Choice Questions]

[english] Because of the missing relevance of graded examinations at the German medical faculties, there was no need to reflect the question quality in written examinations consistently. Through the new national legislation for medical education certification-relevant, faculty-internal examinations are prescribed. Until now, there is a lack of structures and processes which could lead to an improvement of the question quality. To reflect the different performance of the students, a different severity and a good selectivity of the test questions are necessary. For a interdisciplinary examination for fourth year undergraduate students at the University Hospital Duesseldorf, new Multiple choice (MC)- questions which are application-orientated, clearly formulated and to a large extent free from formal errors should be developed. The implementation took place in the conception and performance of Workshops for the construction of MC-questions and the appointment of an interdisciplinary review-committee. It could be shown that an author training facilitates and accelerates the review-process for the committee and that a review process reflects itself in a high practise-orientation of the items. Prospectively, high-quality questions which are created in a review-process and metrological analysed could be read into inter-university databases. Therewith the initial expenditure of time could be reduced. The interdisciplinary constitution of the review-committee offers the possibility of an intensified discussion over content and relevance of the questions. <br>[german] Wegen fehlender notenrelevanter Prüfungen an den Medizinischen Fakultäten in Deutschland bestand bisher keine Notwendigkeit, die Fragenqualität in schriftlichen Prüfungen konsequent zu reflektieren. Erst durch die neue Approbationsordnung sind zeugnisrelevante, fakultätsinterne Prüfungen vorgeschrieben. Es fehlen somit oftmals Strukturen und Prozesse, die zu einer Verbesserung der Fragenqualität führen. Damit die Klausuren das unterschiedliche Leistungsspektrum der Studierenden widerspiegeln, sind u.a. unterschiedliches Schwierigkeitsniveau und eine gute Trennschärfe der Prüfungsfragen notwendig. Für eine fachübergreifende Klausur des vierten Studienjahres an der Universität Düsseldorf sollten neue MC -Fragen entwickelt werden, die anwendungsorientiert prüfen, eindeutig formuliert und weitgehend frei von formalen Fehlern sind. Die Umsetzung erfolgte in der Konzeption und Durchführung von Workshops zur Erstellung von MC-Fragen für Fragenautoren und die Einrichtung eines interdisziplinären Reviewkomitees. Es konnte gezeigt werden, dass eine Autorenschulung den Reviewprozess für das Reviewkomitee erleichtert und beschleunigt. Der Nutzen des Reviewprozesses spiegelt sich in einer hohen Anwendungsorientierung der einzelnen Items wider. Hochwertige, in einem Reviewverfahren erstellte und messtechnisch analysierte Prüfungsfragen könnten künftig in interuniversitäre Datenbanken eingegeben werden und damit den anfänglich erforderlichen Zeitaufwand relativieren. Durch die interdisziplinäre Zusammensetzung des Reviewkomitees bietet sich außerdem die Möglichkeit einer verstärkten Diskussion über die Inhalte der Prüfungsfragen

Effective didactic training for medical teachers

The purpose of this study was to develop, test, evaluate and finally implement effective state-of-the-art Teacher Trainings in didactic skills and methods. The training concept should be designed and beneficial for medical teachers in under- and postgraduate Medical Education.Methods: A 5-day workshop with 12 theoretical and 9 „hands-on" modules has been designed and stepwise improved, according to trainees' feedback. All trainees were educated in small groups (6 to 10 participants per workshop). The workshops consisted of mini-lectures, repeated microteaching exercises and video-supported feedback concerning the following key-competencies: Communication of goals, methods to trigger interactivity, design of slides in ppt-presentations, effective feedback-techniques and use of media, time-management, skills teaching, assessment methods (e.g. OSCE and others), evaluation and general presentation skills. The evaluation was based on two components: A) Trainees' scores in two OSTEs (objecitve structured teaching exercises) at the beginning and end of workshop: the ratings of 15 to 20 external oberservers were checked for significant trends (X2 -Test Pearson) in 17 pregiven criteria for high teaching effectiveness. B) The trainees rated 20 teaching competencies in a retrospective „pre-post-analysis" (self-assessment questionaire) at the end of each workshop and after 6 to 12 months later. The results revealed highly significant improvements (p < 0.01) in 15 of 17 OSTE-criteria and in 19 of 20 items of the pre-post-analysis, predominantly estimated to be „persistent". Overall, trainees' feedback has been highly encouraging to continue and broaden the program. The discussion covers potential factors for the training success as well as pitfalls and controverse issues of time and costs.In conclusion, the designed 5-day training workshops to enhance didactic skills and teaching methods turned out to be highly effective and can be attended by all medical teachers with different teaching backgrounds and specialities (http://www.medidak-pilotprojekt.de/). The training has been CME-certified for 21 credits (category „C") by the Academy of the Physicians' State Association North-Rhine-Westfalia (LÄK Nordrhein)