Data from: The future of practical skills in undergraduate medical education – an explorative Delphi-Study

Background: 64% of young medical professionals in Germany do not feel adequately prepared for the practical requirements of the medical profession. The goal of “outcome-orientated training” is to structure medical curricula based on the skills needed when entering the workforce after completing undergraduate medical education, and thus to bridge the gap between the skills graduates have attained and those necessary for a career in the medical profession. Outcome frameworks (OFs) are used for this purpose. In preparation for developing the National Competence-Based Catalogue of Learning Objectives for Medicine (NKLM) – the German OF – the “Consensus Statement of Practical Skills in Undergraduate Medical Education” (which structures the teaching and acquisition of practical skills in Germany and which strongly influenced the “Clinical-Practical Skills” chapter of the NKLM) was published in 2011.

It is not uncommon for at least a decade to elapse between the definition and implementation of an OF and the students’ graduation, which can further increase the gap between necessary and acquired skills. Thus, the purpose of this paper is to posit theses for future development in healthcare and to apply these theses to a current OF.

Methodology: Partially structured interviews with experts were used to generate theses pertaining to general, future development in healthcare. These theses were assessed by physician experts based on the likelihood of implementation by the year 2025. The 288 learning goals of the consensus statement were assessed for their relevance for medical education in the interim.

Results: 11 theses were generated for the development of medicine, and these theses were assessed and discussed by 738 experts. These theses include the increase in diseases associated with old age, the increasing significance of interprofessional cooperation, and the growing prevalence of telemedicine applications. Of the 288 learning goals of the consensus statement, 231 of the goals were assessed as relevant, and 57 were deemed irrelevant for the short-term future.

Discussion: The theses on the future of healthcare, which were generated in this study and which were validated by numerous experts, provide indications of future developments of overall requirements for medical school graduates. For example, when applied to the content of the “Clinical-Practical Skills” NKLM chapter, they largely validate the future relevance of developing practical skills while also providing indications for their further development as applied to the consensus statement.

背景：德国有64%的年轻医疗从业者认为自己未能充分胜任医疗行业的实际工作要求。“结果导向型培训（outcome-orientated training）”的目标是，以本科医学教育毕业后入职所需的技能为依据构建医学课程体系，以此弥合毕业生已掌握技能与医疗行业职业所需技能之间的差距。结果导向框架（Outcome Frameworks, OFs）正是用于实现这一目标的工具。为制定德国国家医学能力导向学习目标目录（National Competence-Based Catalogue of Learning Objectives for Medicine, NKLM）——即德国本土的结果导向框架，2011年发布了《本科医学教育实践技能共识声明》，该声明为德国实践技能的教学与习得构建了体系，并对NKLM的“临床实践技能（Clinical-Practical Skills）”章节产生了深远影响。

通常，结果导向框架的制定与落地，与学生毕业之间的时间间隔至少可达十年，这会进一步拉大毕业生所需技能与已掌握技能之间的差距。因此，本研究的目的在于提出若干关乎医疗行业未来发展的论题，并将这些论题应用于现行的结果导向框架。

方法：本研究采用半结构化专家访谈法，生成与医疗行业整体未来发展相关的论题。由医学专家针对这些论题在2025年前的落地可行性进行评估。同时对该共识声明中的288项学习目标进行中期医学教育相关性评估。

结果：本研究共生成11项医学发展论题，由738名专家对这些论题进行评估与讨论。这些论题涵盖老年相关性疾病发病率上升、跨专业协作的重要性日益凸显，以及远程医疗应用的普及率不断提升等内容。在该共识声明的288项学习目标中，231项被评估为具有短期教育相关性，其余57项则被认定为短期无需关注。

讨论：本研究生成并经多位专家验证的医疗行业未来发展论题，可为医学院毕业生所需的整体能力要求的未来发展方向提供指引。例如，将这些论题应用于NKLM的“临床实践技能”章节内容时，不仅在很大程度上验证了实践技能培养的未来相关性，同时也为该共识声明框架下的实践技能进一步发展提供了方向指引。