Abstract:
BACKGROUND:The aim of this study was to assess the impact of Peyton's 4-step approach on musculoskeletal ultrasound skills in a peer-teaching environment as compared to traditional "see one, do one" training and to evaluate students' acceptance of the training strategy. MATERIAL AND METHODS:A total of 491 second year medical students (342 women, 149 men) completed a compulsory curricular course on musculoskeletal ultrasound. We randomly assigned students to receive traditional peer teaching or peer teaching using Peyton's four-step approach in small groups. All groups received theoretical and practical hands-on training of selected views of the knee and shoulder. We assessed differences in practical skills (objective structured practical examination, OSPE) and evaluation results with respect to teaching strategy. RESULTS:There were no relevant differences between the two teaching interventions regarding the OSPE results. Students scored significantly higher in the knee view (knee 6.5 ± 1.7 points, shoulder 6.0 ± 1.9 points; p < 0.001), needed less time to display the required image (knee 36 ± 21 s, shoulder 43 ± 20 s; p < 0.001) and more students obtained the cut-off mark of 60% to pass the exam (knee 73%, shoulder 61%; p < 0.001). Acceptance of the peer-teaching concept was high, and the overall rating of the instructors was good. The majority of students enjoyed the course and rated it highly. CONCLUSION:Traditional teaching and Peyton's 4-step approach seem to be equally effective for teaching basic musculoskeletal ultrasound skills to undergraduate medical students. Qualitative analysis revealed high acceptance of both peer teaching strategies. Differences in course content complexity and degree of difficulty need to be addressed in future courses. HINTERGRUND:Der Ultraschall der Bewegungsorgane findet breite Anwendung in der Diagnostik von Pathologien und in der Intervention. Die frühe Implementierung von Ultraschallkursen in das medizinische Curriculum könnte zu einer besseren medizinischen Versorgung führen. Die Sonografie wird häufig mit der „See one, do one“-Methode angeleitet, obgleich unklar bleibt, ob dies die beste Herangehensweise darstellt. Die vorliegende Arbeit untersucht, ob die 4-Schritt-Methode nach Peyton konventionellen Lehrstrategien in der Vermittlung des muskuloskelettalen Ultraschalls durch Peer-Dozierende überlegen ist und wie die Technik von den Studierenden beurteilt wird. MATERIAL UND METHODEN:Insgesamt absolvierten 491 Studierende (342 Frauen, 149 Männer) eine curriculare Lehrveranstaltung zum Thema Gelenksonografie. Ausgesuchte Schnitte an Knie und Schulter wurden randomisiert auf konventionelle Weise und nach der 4-Schritt-Methode nach Peyton von speziell geschulten Peer-Dozierenden unterrichtet. Die erlernten Fertigkeiten wurden in einer Objective structured practical Examination (OSPE) geprüft. Beurteilt wurde die benötigte Zeit zum Einstellen der Schnitte, die technische Durchführung und die Bildqualität. Die Studierenden wurden gebeten, den Kurs zu evaluieren. ERGEBNISSE:Bezüglich der praktischen Ausführung und der Qualität der Schnittbilder zeigten sich die beiden Lehrmethoden sowohl für die Schulter- als auch für die Kniegelenksonografie als ebenbürtig. Der Vergleich der Lehrinhalte (Knie vs. Schulter) hatte signifikante Differenzen bezüglich der Bildauswertung (Knie 6,5 ± 1,7 Punkte, Schulter 6,0 ± 1,9 Punkte; p < 0,001), der benötigten Zeit (Knie 36 ± 21 s, Schulter 43 ± 20 s; p < 0,001) und des Erreichens der Bestehensgrenze von 60% (Knie: 73% der Studierenden, Schulter: 61% der Studierenden; p < 0,001) gezeigt. Unabhängig von der Lehrmethode bewerteten die Studierenden die Peer-Dozierenden als kompetent und befanden die Inhalte als adäquat für den Unterricht durch Gleichgestellte. Über 70% der Studierenden hatten Spaß an den Kursstunden. Sowohl der Knie- als auch der Schultergelenkkurs wurden im Mittel mit über 8 von 10 Punkten bewertet. SCHLUSSFOLGERUNG:Für die Vermittlung von Grundkenntnissen der Gelenksonografie sind die konventionelle Methode und die 4-Schritt-Methode nach Peyton ebenbürtig. Die Durchführung des Unterrichts durch Peer-Dozierende wird positiv bewertet und findet hohe Akzeptanz bei den Studierenden. Unterschieden im Schwierigkeitsgrad und der Komplexität der Lehrinhalte ist in künftigen Kursen Rechnung zu tragen.
journal_name
Z Orthop Unfalljournal_title
Zeitschrift fur Orthopadie und Unfallchirurgieauthors
Gradl-Dietsch G,Hitpaß L,Gueorguiev B,Nebelung S,Schrading S,Knobe Mdoi
10.1055/a-0715-2435subject
Has Abstractpub_date
2019-06-01 00:00:00pages
270-278issue
3eissn
1864-6697issn
1864-6743journal_volume
157pub_type
杂志文章,随机对照试验abstract::Soft-tissue management is essential for the outcome in total knee arthroplasty. In combination with osseous resections and component positioning, correction of the underlying ligamentous dysbalance should yield a stable joint throughout the flexion arc. Different "philosophies" with regard to technique, timing and tac...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2007-965688
更新日期:2007-09-01 00:00:00
abstract::The main reason for total hip arthroplasty (THA) revision is the wear-related aseptic loosening. Younger and active patients after total joint replacement create high demands, in particular, on the bearings. The progress, especially for alumina ceramic-on-ceramic bearings and mixed ceramics have solved many problems o...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0035-1545802
更新日期:2015-04-01 00:00:00
abstract:INTRODUCTION:Trauma or infectious diseases can cause destruction of the epiphyseal region of the knee with premature partial bridging of the physis and deviation of length and axis. There is only little information about tumorous lesions as pathogenetic factor for these deviations. We have been searching for an approac...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1038999
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:Brace treatment prevents the progression of scoliosis and reduces surgical treatment rates. However, the efficacy of brace treatment varies depending on the patient's age, gender, curve magnitude and type, structure of the curve, and patient compliance at the beginning of treatment. METHODS:Between January ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/a-1269-0000
更新日期:2020-11-24 00:00:00
abstract:BACKGROUND:Osteochondral lesions (OCL) of the talus show a distinct distribution pattern. Vascular, metabolic, idiopathic, and biomechanical factors have been proposed as influencing factors. However, the association of hindfoot alignment and the location of talar OCL is not known. MATERIALS AND METHODS:In 22 patients...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0034-1368604
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Tibial tubercle avulsion fractures are rare, they represent less than 1% of all physeal fractures. Compared to monolateral tibial tubercle avulsion fractures, bilateral occurrence is even rarer. The purpose of this study is to report about the so far largest group of bilateral avulsion fractures and to compa...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/a-0979-2384
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Total hip and knee replacements are very frequently performed operative procedures in German hospitals. Despite the high number of cases, only few data on treatment procedures of the clinical routine and their impact on postoperative length of stay and clinical outcome are available. The aim of our survey wa...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,多中心研究
doi:10.1055/s-0034-1383023
更新日期:2014-10-01 00:00:00
abstract:AIM:Problems with the patellofemoral joint are still one of the most common difficulties after total knee arthroplasty. One of the main reasons for these problems seems to be the rotatory malposition of the femoral component. We examined the rotation of the femoral component and the symmetry of the flexion gap of knee ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0029-1240587
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate long-term clinical and radiological results as well as survival rates of the NexGen® CR posterior cruciate retaining prosthesis. PATIENTS AND METHODS:We evaluated a consecutive series of 761 total knee replacements performed on 716 patients from 1999 to 2001 at our ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 临床试验,杂志文章
doi:10.1055/s-0035-1546040
更新日期:2015-10-01 00:00:00
abstract::Background MRSA represents a considerable health threat to orthopaedic patients. Throughout the last decade, livestock-associated MRSA emerged increasingly in livestock all over Europe. LA-MRSA broke the species barrier, colonizing and causing infections in humans. Nevertheless, to date there are no studies concerning...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0043-103457
更新日期:2017-06-01 00:00:00
abstract:INTRODUCTION:Infantile idiopathic scoliosis (IIS) is a rare orthopaedic condition. Braces and casts are popular options in the treatment of IIS but there is a paucity of studies commenting on the outcome of non-operative treatment. The purpose of this study was to analyse failure and success after non-operative treatme...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0031-1280330
更新日期:2012-02-01 00:00:00
abstract:AIM:This study investigated the fusion properties of a new intervertebral spacer that is directly fixed to the adjacent vertebrae by screws. The new spacer was compared with an identical spacer without direct fixation but with an additional plate and with an autologous bone graft. METHODS:A single-level, cervical fusi...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2007-965798
更新日期:2007-11-01 00:00:00
abstract::Tuberculosis constitutes an important clinical entity with 90 million new infections worldwide during the last decade. 10 % of these infections affect osseous structures based on haematogenous spread. Therefore, tuberculous spondylodiscitis remains a major illness in orthopaedics which needs to be considered in cases ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1039246
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Hallux valgus is one of the most prevalent foot deformities, and surgical treatment of Hallux valgus is one of the most common procedures in foot and ankle surgery. Diagnostic and treatment standards show large variation despite medical guidelines and national foot and ankle societies. The aim of this nation...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0043-120352
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Currently, there is a need for scientific evidence on the efficacy of classical massage therapy for chronic, unspecific back pain, especially for the improvement in functional impairment and long-term pain reduction. According to the National Health Care Guidelines, classical massage for nonspecific low back...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,随机对照试验
doi:10.1055/a-0715-2332
更新日期:2019-06-01 00:00:00
abstract::The number of patients with meniscal injuries is increasing constantly, but the treatment algorithms are undergoing continuous change. The effects of meniscal surgery, as well as the indications for the procedure, are currently a matter of heated debate. Various German speaking associations addressing topics related t...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0042-116683
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:The concept of combined anteversion for total hip arthroplasty (THA) proposes a relationship between the cup and stem components that theoretically maximises the postoperative range of motion and minimises the risk for impingement of the joint. Using computer-assisted navigation tools, an anteversion angle o...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0029-1240969
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:The dislocated posterolateral fragment of the distal tibia is considered as a key fragment for the successful reduction of comminuted ankle fractures. The reduction of this fragment can either be achieved indirectly by joint reduction using the technique of closed anterior-posterior screw fixation, or direct...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0035-1545706
更新日期:2015-06-01 00:00:00
abstract:INTRODUCTION:The aim of this study was to evaluate the long term results of joint preserving surgery with hamstring release and dorsal capsulotomy for the treatment of therapy resistant knee flexion contracture in patients with severe haemophilia. METHODS:16 patients having undergone hamstring release and dorsal capsu...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 临床试验,杂志文章
doi:10.1055/s-2007-965228
更新日期:2007-05-01 00:00:00
abstract:AIM:Elastic stable intramedullary nailing (ESIN)is the therapy of choice in pediatric forearm shaft fractures. It requires increased intraoperative image intensifier times and radiation load. METHOD:We performed a retrospective analysis of 78 operative procedures from a five-year period. In 16 cases the image intensif...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 临床试验,杂志文章
doi:10.1055/s-2007-965171
更新日期:2007-03-01 00:00:00
abstract:INTRODUCTION:Lawn mower injuries in children usually involve the lower extremities and can lead to serious amputation injuries. Treatment should look not only at the acute reconstruction, but also on maintaining the ability to grow. We report the case of a two-year-old boy with amputation of the heel. CASE REPORT:The ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0031-1298260
更新日期:2012-04-01 00:00:00
abstract:AIM:Dynamic gait analysis of blocked distal tibiofibular joint (TFJ) has not performed yet. This prospective study investigated patients treated for ankle fractures with combined syndesmotic complex lesions after surgery including tibiofibular positioning screw using CT data detecting fibular maltorsion and dynamic gai...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 临床试验,杂志文章
doi:10.1055/s-0029-1185695
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:The Surgical Safety Checklist (SSC) was introduced by the World Health Organization (WHO) in 2008 in order to analyse and reduce perioperative surgical morbidity. Preoperative estimation of the expected surgery time (EST) by the surgeon is an integral part of the SSC. OBJECTIVE:The aim of the present study ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0042-101416
更新日期:2016-06-01 00:00:00
abstract::The ideal treatment for massive rotator cuff tears is influenced by the morphology and chronicity of the tear, tissue quality, the degree of concomitant osteoarthritis, and patient-specific factors. Traditionally, massive rotator cuff tears have wrongly been equated with irreparable tears. A variety of improvements in...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1558056
更新日期:2016-02-01 00:00:00
abstract:AIM:The aim of this study is the determination of physical activity in everyday life of handicapped persons due to cerebral palsy using standardised testing procedures. METHOD:The subjects were examined according to the Conconi test on a treadmill at increasing speeds for their fitness. We used a continuous heart rate...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0032-1328492
更新日期:2013-06-01 00:00:00
abstract::The present paper gives an overview of the different types of short stem total hip replacements. There is a pronounced inhomogeneity of the nomenclature in clinical practice as well as in regard to the scientific literature. Examples include neck preserving implants, meta-, epi- or metadiaphyseal fixed implants, micro...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,评审
doi:10.1055/a-0808-5115
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:The Morel-Lavallée lesion is one of the concomitant soft tissue lesions of pelvic fractures. Its role in spine fractures and its treatment in combination with osteosynthesis of pelvic or spine fractures have not yet been determined. The aim of this study was to analyse the best diagnostic and treatment optio...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,评审
doi:10.1055/a-0596-8018
更新日期:2018-10-01 00:00:00
abstract:AIM:The aim of this study was to compare the different diagnostic features (symptoms, physical examination, radiographic features and intraoperative findings) of osteoarthritis of the knee before total joint replacement and consequently relate them with each other. METHOD:Patients with primary osteoarthritis of the kn...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 临床试验,杂志文章
doi:10.1055/s-2007-965550
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:The Mayo Elbow Performance Score is a clinical assessment to rate the performance of the elbow from a medical and/or therapeutic perspective. It is simple and efficient to operate and therefore frequently used in research as well as in clinics. However, an adequate translation of the MEPS into the German lan...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/a-0974-3836
更新日期:2020-10-01 00:00:00
abstract::Cement-augmented pedicle screws can increase the stability of fixators for unstable vertebral fractures in the elderly. Fixators can be inserted quickly and with minimally invasive techniques, reducing surgical risks. From March 2012 until July 2014, we treated 40 patients with percutaneous augmented fixators for unst...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0043-111594
更新日期:2017-10-01 00:00:00