gms | German Medical Science

Background: Germany is presently experiencing a movement towards competence-based medical training. A significant component of this training is self-reflection and student autonomy. To achieve their objective students must have a concept of what skills they think are relevant to their training, i.e. what constitutes a competent doctor. This research project aims to investigate what and which ideals do students model themselves after and how do they go about achieving this ideal.

Methods: Medical students from the 3^rd, 6^th, 7^th and 9^th semesters of the University Duisburg-Essen were asked to complete a questionnaire. Results obtained were coded using an SPSS© Software system and then analysed. Semi-structured interviews were conducted with students in the preclinical (2-3 Semester), during and after clinical clerkships (8 semester) and final year medical students.

Results: 474 Questionnaire responses were returned. Trends indicate the clinical performance of medical colleagues plays a more significant role in the concept of the competent doctor in older students. Older students are less likely to set short-term goals to navigate their learning needs. Younger students rely more on learning resources such as electronic media and books to assess their knowledge and competence. The majority of students were satisfied with their current knowledge and practical expertise.

In the interview section, preclinical students placed great emphasis on getting passing grades as a means to progressing to the clinical stage. Their concept of the ideal doctor was mainly idealistic and based on social interactions with senior doctors. Middle grade students placed less emphasis on grades and use mainly negative clinical experiences to reflect on their learning needs. Final year students felt ready for the challenge of medical practice but were mainly disillusioned, as the concepts of the ideal doctor did not correlate with the realities of practicing medicine.

Discussion/Conclusion: The performance of medical colleagues plays a significant role in how students conceptualise their ideal doctor. Most students play an active role in their training by setting both long and short-term goals. Students actively reflect on their clinical competencies and medical knowledge although they dont do this consciously. Knowledge plays a significant role in the initial stages of training but the focus switches to competence as students progress. Students are generally satisfied with their present performance. As students progress through their training, they exhibit a general trend towards acceptance that their concept of a clinically competent and knowledgeable doctor does not correlate with the realities of actual medical practice. Students mostly regard exams as a poor indicator of their concept of a clinically competent doctor.