gms | German Medical Science

Introduction: Traditional and problem-based medical curricula in Germany follow a very different aproach to teaching,learning and assessing. Especially in the basic medical sciences as anatomy, physiology, biochemistry and psychology medical students face very oppositional courses. Traditional students are presented with a systematic elaboration of the basic sciences in lectures and in practical tutorials. They finish the studies of the basic medical sciences after two years with a high stake national exam (Physikum). Problem-based cirrucula students are presented with "real" medical cases or problems from the first day of their studies. In small groups they have to agree on what knowledge they need to solve the presented problems and then they are given time to study and develop the knowledge needed. They continue learning the basic sciences throughout the whole five years course and do not have to pass the Physikum.

At Charité both approaches are maintained for the last ten years as two medical curricula - a traditional and a problem-based exist in parallel. They might have little in common but since 2003 all students from both curricula have to sit a Progress Test at the beginning of each semester. Therefore the development of the student´s medical knowledge in all subjects and organ-systems taught during the both courses can be illustrated for all cohorts after 2003.

Aim and method: This studie´s aim was to illustrated this knowledge development on a longitudinal base focussing on the basic medical sciences. The Progress Test data of 10 cohorts (5 years) incl. more than 4000 Tests of traditional and 2000 Tests of problem-based students were cumulated. For each semester t-tests and effect sizes were calculated.

Results: Significant difference in knowlegde of basic medical sciences for the two courses could not be found during the first two years of medical studies, even though the traditional students attend up to five times more hours of theaching. Only after the Physikum the traditional students take a clear lead in basic sciences knowedge. At the end of five years of medical studies both curricula are almost on the same knowledge level.

Discussion: The development of medical student´s knowledge can be illustrated with a formative assessment tool like a Progress Test and raise questions like:

• Which level of knowledge do we wish our graduates to have?
• What does induce knowledge: teaching or assessing?
• How should knowlegde develop during medical training?[1]