Ergebnisse nach postero-inferiorem Kapselshift bei hinterer Schulterinstabilität:Eine prospektive Studie

Ziel der prospektiven Studie war die Überprüfung des operativen Therapiekonzeptes durch medial basierten postero-inferioren Kapselshift nach Versagen eines konservativen Ansatzes bei hinterer Schulterinstabilität bei 17 Patienten. Grundlage bildete die körperliche Untersuchung aus denen folgende Scores ermittelt wurden: der ASES-, Constant- und Rowe-Score. Zudem wurden postoperative Zufriedenheit, aktueller subjektiver Schmerzstatus, aktuelles subjektives Instabilitätsgefühl, sowie Einschränkungen in Beruf oder Sport erhoben. Follow-up 46,8 Monate: 76,5 % der Patienten mit zufrieden stellendem, davon bei 53 % mit excellentem Ergebnis im Rowe-Score. Im Constant-Score zeigten 82,4 % der Patienten gute Ergebnisse. Im ASES-Score zeigten 70,6 % der Patienten Werte über 80 Punkte. Alle Patienten verbesserten sich im Schnitt von prä- zu postoperativ in den drei Scores um 48,95 %. Dies zeigt, der postero-inferiore Kapselshift ist eine adäquate operative Therapie der posterioren Instabilität

Teaching ultrasound in a curricular course according to certified EFSUMB standards during undergraduate medical education: a prospective study

Background: As a non-invasive and readily available diagnostic tool, ultrasound is one of the most important imaging techniques in medicine. Ultrasound is usually trained during residency preferable according to German Society of Ultrasound in Medicine (DEGUM) standards. Our curriculum calls for undergraduate training in ultrasound of medical students in their 4th year of undergraduate education. An explorative pilot study evaluated the acceptance of this teaching method, and compared it to other practical activities in medical education at Muenster University. Methods: 240 medical students in their 4th year of undergraduate medical education participated in the training and completed a pre- and post-questionnaire for self-assessment of technical knowledge, self-assurance of the procedure, and motivation in performing ultrasound using a Likert scale. Moreover, students were asked about their interest in pursuing a career in internal medicine. To compare this training to other educational activities a standardized online evaluation tool was used. A direct observation of procedural skills assessment (DOPS) for the first time applied on ultrasound aimed to independently assess the success of our teaching method. Results: There was a significant increase in technical knowledge and self-assurance (p < 0.001) of the students’ self-assessments. The clinical relevance and self-motivation of the teaching were evaluated positively. The students’ DOPS results demonstrated proficiency in the understanding of anatomic structures shown in ultrasonographic images, including terminology, machine settings, and transducer frequencies. Conclusions: Training ultrasound according to certified DEGUM standards was successful and should be offered in undergraduate medical education. The evaluation of the course affirmed the necessity, quality and clinical relevance of the course with a top ranking score of hands-on training courses within the educational activities of the Medical Faculty of Muenster.<br