Scientific competence during medical education - insights from a cross- sectional study

Scientific competence during medical education - insights from a cross- sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Scientific competence during medical education - insights from a cross- sectional study Maximilian Vogt, Nadja Jahn, Mark Enrik Geissler, Jean-Paul Bereuter, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3786498/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract Background Medical knowledge regarding the pathophysiology, diagnosis and treatment of diseases is constantly evolving. To effectively incorporate these findings into professional practice, it is crucial that scientific competencies are a central component of medical education. This study seeks to analyse the current state of scientific education and students' desires for integration into the curriculum. Methods From October to December 2022, a survey was distributed at the Medical Faculty Dresden to all medical students from the 1st to 5th academic year (AY). The survey investigates current expectations of applying scientific competencies later in professional life, and the students were asked to self-assess various scientific skills and in relation to the National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education. The self-assessments were objectified through a competence test with ten multiple-choice questions. The desire for curricular teaching was inquired. Results 860 students completed the survey. This corresponds to a response rate of 64%. In the 5th AY, approximately 80% of the participants stated that they expected to work with scientific literature on a daily to monthly basis in future professional life and to communicate corresponding scientific findings to patients. Only 30–40% of the 5th AY rate their scientific competencies as sufficient to do this appropriately. This corresponds with the self-assessed competencies that only slightly increased over the 5 AYs from 14.1 ± 11.7 to 21.3 ± 13.8 points (max. 52) and is also reflected in the competence test (1st AY 3.6 ± 1.75 vs. 5th AY 5.5 ± 1.68, max. 10 points). Half of the students in the 4th and 5th AYs were dissatisfied with the current teaching of scientific skills. The majority preferred the implementation of a science curriculum (56%), preferably as seminars dealing with topics such as literature research, analysis, and science communication. Conclusions The results show discrepancies between expectations of using scientific knowledge in everyday professional life, self-rated and objectively recorded competencies, and the current state of curricular teaching of scientific competencies. There is a strong need for adequate practical training, particularly in critical analyses of scientific literature, which enables the communication of scientific knowledge to patients. undergraduate medical education scientific education science curriculum needs assessment research competence scientific skills curriculum development Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 1. Introduction Scientific education and life-long learning are crucial since future generations of physicians will have to address multiple emerging medical challenges ( 1 , 2 ). This finding contrasts with the results of previous investigations revealing that scientific education is not sufficiently addressed in German medical curricula ( 3 – 5 ), especially in regular courses ( 6 ). Often, scientific education takes place late in the curriculum and mainly in connection with a doctoral thesis ( 4 ). It is important to note that a thesis project is not a mandatory component of the medical curriculum but is acquired by a large fraction of medical students ( 7 ). The scope and depth of scientific thesis projects are often limited ( 8 , 9 ), and it is unclear whether the current system is capable of adequately preparing young physicians to make significant contributions to medical research, advance healthcare and ensure patient safety. Therefore, various stakeholders, such as the German Research Foundation and the German Science and Humanities Council campaign for integrating systematic scientific training into the nationwide curriculum ( 10 ). It has been shown that medical students themselves have a positive attitude toward science ( 11 , 12 ) and wish to acquire more scientific competencies ( 3 ). Nationwide efforts and political support are necessary for subsequent changes, and a curricular reform was initiated in 2017 ( 13 ) and may offer an opportunity to address the deficiencies in scientific education within the medical curriculum, which can differ between different medical schools. In line with this, the German Competency Based Catalogue of Learning Objectives (NKLM, 14) has been proposed as an obligatory national framework for 80% of the medical curriculum. In section VIII. 1. of this framework, scientific competencies are addressed by specific learning objectives ( 15 ). Learning objectives and competency levels according to Miller ( 16 ) have been included. Several German medical schools have already started to implement scientific curricula and related research projects ( 6 , 17 – 19 ), which could result in a greater number of conducted research projects as well as accepted grant applications ( 17 ). However, such initiatives are intrinsically motivated by individual faculties and are not mandatory ( 20 ); as far as we know, such initiatives omit the students’ perspective on curriculum development. This, however, may be an important aspect regarding needs-orientation and acceptance and has been recommended ( 21 , 22 ). At the Medical Faculty Dresden (MFD) a structured medical thesis programme has been implemented since 2011 ( 23 ). In addition, a clinician scientist program was established in 2017 ( 24 ). While both initiatives attempt to improve scientific education, their accessibility is competitive and limited to a small number of applicants. Therefore, collaborative efforts involving educators and students are necessary to establish a scientific curriculum that is intrinsically embedded in regular medical education programs. Since there are currently no sufficient data on how students perceive the necessity and accessibility of scientific education, we collect relevant data from the MFD from a student's perspective over all academic years (AY). These data are crucial for the design and implementation of a potential standardised scientific curriculum that meets students’ expectations and needs. The primary objectives of the conducted study are as follows: To assess how medical students perceive the need for scientific competencies in their future professional life and how they self-evaluate their current abilities. To determine whether the students' self-assessment of scientific competencies aligns with the currently proposed learning objectives and competence levels in the National Competence-Based for Undergraduate Medical Education (NKLM 2.0). To envision what a scientific curriculum may look like based on the students' opinions. 2. Methods 2.1. Survey design This cross-sectional study was performed with an online survey using LimeSurvey 3 (Hamburg, Germany). The survey was designed by the authors as an iterative collaborative process. All survey items were reviewed by experts in the field from the MFD. All the questions were further evaluated by medical students to assess the amount of time required and to identify and remove ambiguity. The answers collected during this review process were not included in the final data analysis. The questionnaire ( Suppl. 1 ) consisted of eight different topics related to scientific training. We requested participant information (9 items) and asked whether the participants were interested in performing a medical thesis (4 items). We asked the students about the relevance of eight scientific competencies and how often they anticipate using them during their future professional life (ranging from daily to never). Furthermore, we further asked them to self-assess their scientific skills (13 items, oriented toward the research process) according to different competence levels and in line with the NKLM: 1 (can name facts), 2 (can explain), 3a (can perform under supervision), and 3b (can perform independently). Students should also rate, if and at which level (from voluntary to mandatory) these scientific competencies should be included in the medical curriculum (17 items). Students were then asked to indicate their level of agreement on a four-point Likert scale to statements regarding satisfaction and the desire for a compulsory science curriculum. To objectify the self-assessment, a competence test was included in the questionnaire, which included ten multiple choice (MC) questions covering different science topics (science theory and method, biometry, literature, good scientific practice, clinical studies). The questionnaire ended with questions regarding the digital scientific program at MFD (2 items). The participants needed approximately 15 minutes on average to answer all questions. 2.2. Distribution and data acquisition The survey was distributed to medical students of the MFD from October to December 2022 in compulsory courses (1. AY: biology; 2. AY: physiology; 3. AY: laboratory medicine; 4. AY: general medicine; 5. AY: occupational medicine), and appropriate times were allocated for participants to complete the survey. 2.3. Participants and data protection The study including the experimental protocol and the terms of realisation has been approved by the Ethical committee at the Technical University of Dresden (SR-EK-152032023) as well as by the data protection officer. Only medical students of the MFD were allowed to participate in the study. Informed consent was used. The participation was voluntary. The data have been collected completely anonymous and was stored on servers of the Technische Universität Dresden. We initially obtained data from 1075 students, but only completed questionnaires were included in the subsequent analysis (n = 856). 2.4. Data treatment and analysis Python 3.8.5 was used for data analysis (Python Software Foundation, Delaware, USA) within the Visual Studio Code 1.84.0 environment (Microsoft Corporation, Washington, USA). The raw data and the source code of the performed analyses are provided in Suppl. 2 and 3 . Responses regarding previous education were categorised into healthcare-related studies (e.g., biology, psychology), healthcare-related education (e.g., physiotherapy, medical technical assistance), and non-healthcare-related education/study (e.g., economics). Parameters such as age and high school grade were analysed descriptively using means and standard deviations. Likert-scale questions were analysed using percentages. For the consideration of relevance in later professional work (8 items), a calculation was performed according to the following scheme: never or rarely = 0 points; monthly = 1 point; daily or weekly = 2 points. This results in a relevance sum score ranging from 0 to 16 points. For the 13 items of self-assessment, we transferred competency levels to points: can do nothing = 0 points, can name facts = 1 point, can explain = 2 points, can perform under supervision = 3 points, can perform independently = 4 points. This process results in a subjective assessment sum score ranging from 0 to 52 points. In addition, the five-point Likert scale was used to scale the statements about the science curriculum, and the responses were numbered from 1–5 in ascending order of agreement with the statements. We analysed the data set for relevant effects on the scientific training, and the full results are presented in Supplement 4. We used the student's t-test to assess differences between two groups. For more than two groups, we used ANOVA with post hoc Tukey’s HSD. The level of significance was set to alpha = 0.05. In our analysis, box plots depict the 1st and 3rd quartiles, with whiskers extending to 1.5 times the interquartile range and the median distinctly marked inside the box. 3. Results 3.1. Sample characteristics Out of 1333 enrolled medical students a total number of 1075 (80.6%) participated in the survey. A total of 856 complete responses were included in further analyses (Table 1 ). In four of the five AYs, we achieved response rates > 50%. Overall, nearly half of the students (48.4%) had already completed health-related training before starting medical school, although this difference strongly differed between academic years. Table 1 Survey sample distribution and demographic data per academic year 1st academic year 2nd academic year 3rd academic year 4th academic year 5th academic year Enrolled Students 229 223 293 294 294 Participating Students, n 215 87 219 160 175 Response Rate (%) 93,9 39 74,7 54,4 59,5 Sex (n, %) Male 65 (30.2%) 17 (19.5%) 73 (33.3%) 48 (30%) 58 (33.1%) Female 149 (68.3%) 70 (80.5%) 145 (66.2%) 111 (69.4%) 116 (66.3%) Diverse 1 (0.5%) 0 1 (0.5%) 1 (0.6%) 1 (0.6%) Age, in years (Mean, SD) 21.8 ± 2.7 23.2 ± 3.7 23.1 ± 2.7 24.3 ± 3.2 25.2 ± 2.9 High School GPA (Mean, SD) 1.56 ± 0.52 1.56 ± 0.48 1.54 ± 0.42 1.50 ± 0.48 1.51 ± 0.40 Promotion (n, %) strives for it 140 (65.1%) 67 (77.0%) 173 (79.0%) 57 (35.6%) 31 (17.7%) not planned 3 (1.4%) 2 (2.3%) 5 (2.3%) 9 (5.6%) 10 (5.7%) started 1 (0.5%) 1 (1.1%) 6 (2.7%) 70 (43.8%) 113 (64.6%) dont know 69 (32.1%) 17 (19.5%) 35 (16.0) 20 (12.5%) 18 (10.3) cancelled 0 0 0 2 (1.3%) 1 (0.6%) others 2 (0.9%) 0 0 1 (0.6%) 2 (1.1%) Educational Background (n,%) none 81 (37.7%) 25 (28.7%) 122 (55.7%) 96 (60.6%) 116 (66.3%) Healthcare-related Education 118 (54.9%) 59 (67.8%) 81 (37.0%) 45 (28.1%) 42 (24.0%) Healthcare-related Study 11 (5.1%) 3 (3.5%) 10 (4.6%) 15 (9.4%) 13 (7.4%) Non-healthcare Education and Study 5 (2.3%) 0 6 (2.7%) 4 (2.5%) 4 (2.3%) 3.2. Scientific skills - assessment of relevance To assess the subjective importance of different scientific skills in future daily work, responses from 5th AY students (n = 175) are presented (Fig. 1 ). Some scientific skills were considered to be more relevant than others: working on research projects was expected to be a less frequently needed skill. It was chosen by approximately 13% of respondents on a monthly or more frequent basis, compared to over 70% who expected to use it less often. In contrast, comprehending the evidence of a guideline was perceived as relevant by approximately two-thirds (61.9%) and as an activity that would later be performed monthly or more frequently. Nearly half of the students (47.7%) expected to work with scientific literature either daily or weekly in their medical practice; 34.1% expected to do so at least monthly. Explaining scientific evidence about diagnosis and treatment to patients was considered relevant at least monthly by 89% of the students. 3.3 Scientific education - satisfaction across academic years The satisfaction with teaching scientific skills differed among AYs. In the first AY, two-thirds of the students (65.6%) chose "no statement possible". This option was chosen by 20% or less in AY 4 and AY 5. While every fourth student (27.5%) in the second year of study responded 'rather disagree' or 'disagree' to the statement 'I am satisfied with the teaching of scientific skills at my faculty', more than half (52.6%) of the 5th AY students did so (Fig. 2 ). The percentage of students who were completely satisfied remained constant at approximately 3% from the second year onwards. In addition, most students (> 50%) in each AY agreed fully or partly with the statement “I would like to have scientific work included in the compulsory curriculum” (Fig. 3 ). 3.4. Medical thesis - influencing factors for intensive scientific training At the time of the survey, 54.4% (n = 183) of the participating 4th and 5th AY students (n = 335) had already started working on a doctoral thesis, and 26.6% (n = 88) were planning to do so (Table 1 ). To analyse the motivation to obtain a doctoral degree, we asked several questions using a 10-point interval scale (1 = no influence to 10 = strong influence). The question "How much do you think the completion of a medical doctorate will influence the following areas?”, was answered as follows: influence on patient care (mean = 3.27, SD = 2.36), on professional career (mean = 7.07, SD = 2.11), on salary (mean = 5.58, SD = 2.48), and on social reputation (mean = 7.63, SD = 2.22). The doctorate status only slightly influenced the response behaviour (Fig. 4 a-d). 3.5. Scientific skills – self-assessment compared to different competence levels We compared the self-assessments of 5th year students (n = 175) to different competence levels and to a proposed catalogue of learning objectives for the national medical curriculum. Working with scientific literature was rated by more than 80% of all students as a relevant, at least monthly, skill used in later professional life (Fig. 1 ). Despite the high relevance, 59.4% of the 5th AY students rated themselves clearly below the level of being able to perform under supervision or independently and therefore below the targeted NKLM level (Fig. 5 ). This competence is also highly relevant to doctoral students. Among all 5th-year students, > 50% rated themselves as not being able to work under supervision or independently regarding good scientific practice and working on a research project (Fig. 5 ). Overall, a substantial number of students (between ~ 10–30%, depending on the competence addressed) state “0” in the 5th AY, which means they assess themselves as “can do nothing”. 3.6. Identification of factors that influence differences in scientific attitude We found relevant differences for the factor "later career aspirations" in the context of the cumulative relevance score. We discovered that among all participants (n = 856), those who saw themselves either in research (n = 18) or in a university hospital (n = 148) tended to rate scientific training as more relevant than those with a preference for practice (n = 390) or hospital (n = 271). An ANOVA revealed a significant difference in relevance scores across the four groups (F(3, 823) = 43.11, p < 0.001). The subsequent Tukey’s HSD post hoc test showed significant differences between hospital and research (difference between the means = 3.35, p < 0.001), hospital and university hospital (difference between the means = 2.23, p < 0.001), practice and research (difference between the means = 3.76, p < 0.001), and practice and university hospital (difference between the means = 2.63, p < 0.001). However, a clear majority (77.2%) of the participants saw themselves either in practice or in a nonuniversity hospital and rated scientific training as less relevant for later professional life (Fig. 6 ). To measure the subjective level of current scientific knowledge, a 13-item self-assessment score was collected (Fig. 7 ). The self-assessment showed a high variance in all AYs (minimum SD = 11.1), indicating the heterogeneity of the students' scientific knowledge while also having a high Cronbach's alpha (Cronbach's alpha = 0.947, 95% CI = 0.942–0.952). However, an increase of 7.0 points (max. 52 points) was observed from the 1st to the 5th AY (coef.=0.87/academic semester, CI = 0.59–1.16). By modelling the factors that led to a higher degree of self-assessment in a general linear model (details about the fitted model are provided in the supplementary material), we were able to identify two strongly associated factors: pursuing a doctoral degree was associated with a higher self-assessment (median non doctorate 11.5 [interquartile range 5.0-19.3] vs. median doctorate 25.0 [interquartile range 13.5–37.0], p = 0.000; Fig. 8 a), and on the contrary, having previous medical education was associated with a lower self-assessment (median no previous education 18.5 [interquartile range 9.0–32.0] vs. median healthcare-related education 13.0 [interquartile range 8.0–22.0], p = 0.006; Fig. 8 b). The objective knowledge test included ten questions (Cronbach's alpha = 0.374, 95% CI = 0.310–0.435). Between the 1st and the 5th AY, an improvement of 2.0 points from a maximum of 10 points was achieved. Over the AYs, there was a marked increase in the number of correct answers to questions on bias, scale types and, to a lesser extent, level of evidence, particularly after students had attended the Biometry class, where these topics were covered ( Suppl. 5 ). 3.7. Perspective of curricular development - students' wishes Finally, the students were asked to indicate their preferred form of teaching for a range of topics in science education (Fig. 9 ). Students were allowed to make multiple choices (lecture, mandatory seminar or internship, and elective). We could see indications of more scientific content in a student-based curriculum: for most of the given content, including "scientific method", "literature research", "statistical data analysis", and "scientific writing", the mandatory seminar was the preferred teaching format (~ 50%). The majority preferred a lecture format on ethics in science (57.9%), while practical training was aspired to learn practical research skills (57.6%). 4. Discussion We present the results of a systematic assessment of the students’ perspectives on scientific education in medical training at the MFD, obtained in 2022. This has been done in preparation for the upcoming intended implementation of mandatory scientific training in the medical curriculum. This allows us to draw conclusions on how curricular change processes could be organised according to the needs of the target group. 4.1 Expectations versus reality The results of our survey showed substantial discrepancies with regard to the expected necessity of scientific competence in later professional life and the self-assessment of skills in the scientific field. In this analysis we focused on 5th AY because they are about to graduate and enter the medical profession as well as they should have acquired scientific competence by then. The majority of 5th AY students estimated that they would need scientific skills, such as working with and critically reflecting scientific literature, very frequently. Most students expected that their medical studies would enable them to interpret scientific results but evaluate their training as insufficient (Figs. 2 and 5 ), which has also been shown elsewhere ( 29 ). In a nationwide survey, approximately 93% agreed or rather agreed that the critical analysis of scientific publication is a key competency for physicians ( 3 ). However, most of our students rated themselves as low performers and clearly below the required level of being able to work independently. We also analysed how the 5th AY students regarded their self-assessment of good scientific practice and working capabilities in a research project. Again, we found that only one in four students considered themselves sufficiently educated. This is evidence of an insufficient competence level in graduates with respect to independent work in a doctoral thesis. Our results are in line with previous studies showing insufficient self-assessed scientific competencies in medical students, especially in terms of scientific methods and writing, practical training and statistics ( 3 , 4 ). Students younger than the 5th AY answered quite similarly (data not shown), thus supporting the results presented. Since there was no substantial change in the curriculum at our faculty over recent years, one can expect that the students who graduate in the next few years will also not be sufficiently trained in scientific skills. Thus, from the student's perspective, there is an urgent need to establish mandatory scientific training in the curriculum. There are different ways to implement this approach, but research-based learning ( 30 , 31 ) is one possibility for integrating scientific thinking in existing curricula. In line with this, Eckel et al. (2019) showed that slight modifications of a practical training course in physiology could improve scientific thinking in medical students without disturbing knowledge acquisition ( 32 ). 4.2 Impact of doctoral thesis and previous education We observed that students who were performing a doctoral thesis rated their skills overall better than did those who were not involved in a medical thesis ( Fig. 8 a ) . This indicates that actively working on a scientific project could positively affect the subjectively perceived increase in knowledge regarding scientific topics, as shown previously ( 7 ). In detail, among students involved in a thesis project, self-assessment with respect to methodology and practical methods increased, but scientific writing seemed difficult, even while performing a medical thesis ( 4 ). Overall, approximately 63% of all students complete a doctoral thesis in Germany ( 33 ), and approximately 210 students graduate per year at our faculty (personal communication, Prodekanat Forschung). Especially with regard to the factors influencing the motivation to perform a medical thesis, we found that social and career aspects played a more important role compared to e.g. improved patient care (Fig. 4 ). The importance of extrinsic “social” factors for completing a doctorate is consistent with the findings of other studies ( 29 , 34 ). Potential reasons for a low motivation to gain deeper insight into research in the context of a doctoral thesis may be inadequate access to scientific training programmes and supervision ( 3 , 35 – 37 ). In this regard, Kuhnigk et al. ( 38 ) and Pfeiffer et al. ( 39 ) showed that graduate programmes and professional training have an impact on the success and quality of medical theses. However, only ~ 15% of doctorate students are enrolled in graduate programs, although approximately 25% would like to attend such courses ( 29 ). Similarly, the MFD offers a structured graduate programme to medical students ( 23 ), but participation is based on competition for admission and reserved for a small number of students (~ 15 per year). Therefore, mandatory scientific theoretical and practical training for all students could improve the overall quality of medical theses. Furthermore, the implementation of a science-oriented longitudinal curriculum enforcing basic science concepts from the first semester onwards may enhance postgraduate professional care and patient safety. The students who had a previous medical education background before starting medical studies rated themselves less favorable according to the subjective assessment (Fig. 8 b). This could indicate that medically trained people already have an impression of the complexity of certain scientific topics. Older age and previous educational experience are associated with increased accuracy in self-assessment ( 40 ). Our data showed that this primarily affects self-assessment, as we could not observe the same effects on objective competency test scores (data not shown). 4.3 Self-assessment versus competency test The overall subjective assessment showed a high variance in the different AYs. We observed a slight increase in self-assessed abilities across AYs (Fig. 7 ); however, even in the higher AYs, the third quartile was only 32 points out of a maximum of 52 points (61.45%). This indicates a high level of uncertainty even among the more experienced students. It should be acknowledged that self-assessments are discussed critically in the literature and should not be used as the only criterion for assessing learning outcomes. Especially at the beginning of studies, such self-assessment may not be valid ( 41 ). For this reason, we focused on the answers of higher AYs to certain questions. We also observed that the majority of the 1st AY students who were at the beginning of their studies answered the question about satisfaction with the current science curriculum with "no statement possible". This shows that some of the students had a realistic assessment of the statements they were able to evaluate objectively, and this is useful in the context of internal control. Approximately 20% of the students in the 2nd and 3rd AYs also chose this option, yet < 5% of those in the 4th and 5th AYs chose this option. Nevertheless, the data from the early AYs seem useful for longitudinal follow-up, making it worth including all the study years in such analyses. To substantiate the self-assessment, we conducted a ten-question competence test covering various scientific topics (see Supl. for details). Here, we observed an increase in the average score (2.4 points; Fig. 7 ) from approximately 4 points (1st AY) to approximately 6 points (5th AY). In parts, we observed large differences in the correct answers to individual questions. There was a large amount of knowledge deficit with respect to the inductive research approach (< 20% correct answers), the scientific method (as the research process) and good scientific practice (~ 35–40% correct answers). These deficits remained constant over AYs (data not shown). Obviously, these topics were not addressed sufficiently during the course of the curriculum. This finding fits well with the self-assessment of the 5th AY, where only approximately 25–30% of the participants rated themselves as sufficiently trained to perform research either independently or at least in a supervised environment. In contrast, more than 50% could answer the question about the components of an abstract correctly from the first AY onwards, increasing to almost 80% in the fifth AY, indicating that this content had been successfully implemented. Questions addressing aspects of clinical research, i.e., randomisation, bias and scale types, displayed a clear trend over the AYs. With the 3rd AY onwards, there was a substantial increase in knowledge, which is in line with already implemented courses addressing biometry and statistics. However, the limited number of questions and the low Cronbach's alpha indicate that the test results can provide information only about topics that might be addressed more comprehensively in the curriculum. Notably, there were no differences between the sexes according to either the self-assessment or the objective competence test. This finding aligns with the marginal sex effects observed in the Bavarian Graduate Study in Medicine ( 42 ). 4.4 Students' wishes and best practices Looking more closely at the statement "I am satisfied with the teaching of scientific knowledge at my faculty", it becomes clear that satisfaction decreased with the experience of studying ( Fig. 2 ) . Finally, approximately 50% of the 5th AY quoted that they were satisfied or rather satisfied. This is even more alarming, as approximately 65% of our 5th AY cohort had already started a doctoral thesis, and a further approximately 18% would like to do so (data not shown). In a previous study Ratte et al. ( 3 ) showed that 79% of the students surveyed stated that they were not or rather not well prepared for working on a dissertation during their studies and that they wished for more training covering different scientific topics. This raises the question of how to design a future curriculum that improves student satisfaction, self-assessment, and in particular objective competence. Besides “Ethics in science” and “Good scientific practice”, the compulsory seminar was chosen as the favoured teaching format by our students for all the other topics (Fig. 9 ). This is interesting since at the MFD, the curriculum is already tightly timed, and seminars serve to discuss particularly important topics relevant to the majority of students. This finding confirms the importance attributed to scientific literacy by the students, as the target group knows its own curriculum best. In particular, the 5th AY is a valid group for such statements from a retrospective point of view, and we recommend the regular involvement of this experienced group during curriculum development. Lectures and occasional internships were also chosen (multiple answers possible), but they were chosen considerably less often. The option to "not anchor" a specific topic in the curriculum received less than 10% of the votes for any of the subject areas. Overall, our students wished for interactive student-centred formats, making discussions possible and leading to a well-grounded scientific education, which was also shown in other studies ( 3 ). 4.5 Outlook and next steps Due to the existing curriculum and limited possibilities for including new curricular content, we propose several steps to establish a longitudinal scientific curriculum on the basis of a needs assessment: 1. structured analysis of the curriculum and mapping to learning objective frameworks such as graduate profiles or the NKLM, 2. integration of the students' expectations into the curriculum, and 3. implementation accompanied by content training of faculty members regarding the basics of scientific working. This should be accompanied by assessing structural and/or financial needs to ensure that curriculum goals and resources are congruent with each other. Furthermore, we strongly suggest implementing digital courses, which could accompany development. The students' wish for interactive formats could be met without overloading the curriculum since familiarisation with the content could be performed individually (which will require saved time) followed by student-centred discussions tutored by experienced faculty members. In general, students need to be highly intrinsically motivated to learn the basics of science education, and so far, there has been little research into what student engagement might look like in concrete terms, e.g., time. 4.6 Limitations Our study faced several limitations. First, a new selection process has recently been implemented for the first and second AYs at the MFD. With the new selection process the fraction of students with a previous medical or non-medical educational background increased in comparison to the 3rd to 5th AYs, which were selected differently. Furthermore, after the 2nd AY, approximately 80 students per year coming from other universities inside Germany and from abroad continue their studies at MFD. Thus, the longitudinal homogeneity of our study group may be questioned. This longitudinal heterogeneity might have influenced the ratings (especially overall satisfaction). This limitation could not be avoided in the current assessment. Importantly, the current study can serve as a starting point for annual or at least repetitive investigations in which the annual cohort serves as its own control. As such, the potential effects of a longitudinal heterogeneity would cancel out. While our approach of surveying during mandatory courses ensured a commendable response rate, there was a noticeable decrease in participation during the third semester (second AY) due to illness of the course coordinator. Nevertheless, the response rate was close to 40%, which appears reasonable for a representative poll. Additionally, the relationship between self-assessment and objective competencies is tenuous at best, with some studies suggesting little to no correlation ( 41 ). Furthermore, the competency test applied in our study was time-constrained, limiting its robustness and, consequently, its inferential power. Finally, we did not ask the students how much time they would dedicate to their own scientific skills development. Due to the aim of independent scientific work and thinking, there is a significant need for practical skill acquisition, which is mostly achieved through hands-on experience. Although the limitations described above must be taken into account when interpreting the results, our database is a rich resource and a valid means of addressing a range of needs in the implementation of a science curriculum. 5. Conclusion Our study underscores the importance of rigorous scientific education in medical education. There is a clear request by students for the acquisition of necessary scientific competencies based on a mandatory science curriculum. In preparation for this, we highly recommend a needs assessment by means of a survey to establish a longitudinal research curriculum and to ensure that the implementation of the curriculum is successful and well accepted by students and teaching staff. Furthermore, this should be done on a nation-wide basis. Abbreviations AY academic year Fig. Figure MFD medical faculty Dresden NKLM German Competency Based Catalogue of Learning Objectives Suppl. Supplement Declarations Ethics approval and consent to participate The study including the experimental protocol and the terms of realisation has been approved by the Ethical committee at the Technical University of Dresden (SR-EK-152032023) as well as by the data protection officer. The survey was offered to medical students of the MFD in compulsory courses. Informed consent was used. The participation was voluntary. Consent for publication Not applicable. Availability of data and materials All data generated or analysed during this study are included in the supplement. Competing interest The authors declare that they have no competing interests. Funding The project was funded by FOSTER (012-2023 and A4-2022), an initiative by the Federal Ministry of Education and Research (BMBF) and the state of Saxony under the Excellence Strategy of the Federal Government and the State Government. The project was further funded by a MeDDrive Teaching Fond (65577) of the MFD. Author’s contribution Conceptualization, M.V., N.J., M.E.G, J.P.B., L.G.; methodology, M.E.G, J.P.B., L.G.; investigation, M.V., N.J., M.E.G, J.P.B., R.B.G; software, M.V.; formal analysis, M.V., S.G.; data curation, MV; writing original draft preparation, N.J., M.E.G., J.P.B., L.G; writing review and editing, L.G., S.G., I.G., A.D.; visualisation, M.V.; supervision, L.G.; project administration, L.G.; funding acquisition, N.J., J.P.B., L.G. All authors have read and agreed to the published version of the manuscript. Acknowledgments Thanks to Dr. Melanie Martin, Prof. Dr. Menschikowski, Dr. Jeannine Schübel, Dr. Maria Girbig for supporting the distribution. References Niessen CM, Krieg T. Clinician Scientists and PhDs: The Need to Connect Basic Research to Translational Medicine—A Personal Experience. J Invest Dermatol. 2014 Feb;134(2):295–8. Maxwell SA, Fuchs-Young R, Wells GB, Kapler GM, Conover GM, Green S, et al. Guiding Preclinical Medical Students in Finding, Synthesizing, and Communicating Translational Basic Research Literature: Roles for Basic Science Research Mentors. Acad Med. 2022 May;97(5):684–8. Ratte A, Drees S, Schmidt-Ott T. The importance of scientific competencies in German medical curricula - the student perspective. BMC Med Educ. 2018;18(1):146. Epstein N, Huber J, Gartmeier M, Berberat PO, Reimer M, Fischer MR. Investigation on the acquisition of scientific competences during medical studies and the medical doctoral thesis. GMS J Med Educ. 2018;35(2):Doc20. Kujumdshiev S, Rockenbauch K, Fischer M, Günther L, Peters H, Repp H, et al. Wissenschaftliche Kompetenzen in deutschen Medizinstudiengängen: eine Fragebogen-basierte Bestandsaufnahme des GMA-Ausschusses Wissenschaftliche Kompetenzen. In German Medical Science GMS Publishing House; 2021. p. DocP142. Bauer J, Schendzielorz J, Oess S, Mantke R. Ausmaß und Integration von Wissenschaftsmodulen in das Medizinstudium an den staatlichen Fakultäten und den privaten staatlich anerkannten Fakultäten in Deutschland: eine Querschnittsstudie. Z Für Evidenz Fortbild Qual Im Gesundheitswesen. 2022 Nov;174:90–6. Giesler M, Boeker M, Fabry G, Biller S. Importance and benefits of the doctoral thesis for medical graduates. GMS J Med Educ 331Doc8 [Internet]. 2016 Feb 15 [cited 2023 Oct 5]; Available from: http://www.egms.de/en/journals/zma/2016-33/zma001007.shtml Crisp AJ. Title of Dr should be sufficient for all doctors. BMJ. 2001 Mar 10;322(7286):617. Groneberg DA. Use of Dr is perhaps even more confusing in Germany than UK. BMJ. 2001 Jun 23;322(7301):1547. Wissenschaftsrat [Internet]. [cited 2023 Oct 29]. Publikationen - Anforderungen an die Qualitätssicherung der Promotion | Positionspapier (Drs. 1704-11), November 2011. Available from: https://www.wissenschaftsrat.de/download/archiv/1704-11.html Hren D, Lukić IK, Marusić A, Vodopivec I, Vujaklija A, Hrabak M, et al. Teaching research methodology in medical schools: students’ attitudes towards and knowledge about science. Med Educ. 2004;38(1):81–6. Pruskil S, Burgwinkel P, Georg W, Keil T, Kiessling C. Medical students’ attitudes towards science and involvement in research activities: A comparative study with students from a reformed and a traditional curriculum. Med Teach. 2009 Jan;31(6):e254–9. Bundesministerium für Bildung und Forschung - BMBF [Internet]. 2017 [cited 2023 Oct 29]. ‘Masterplan Medizinstudium 2020’ - BMBF. Available from: https://www.bmbf.de/bmbf/shareddocs/kurzmeldungen/de/masterplan-medizinstudium-2020.html LOOOP NKLM [Internet]. [cited 2023 Nov 3]. Available from: https://nklm.de/zend/menu NKLM 2.0 - Medizinische-wissenschaftliche Fertigkeiten [Internet]. [cited 2023 Nov 3]. Available from: https://nklm.de/zend/objective/list/orderBy/@objectivePosition/studiengang/PF2/zeitsemester/2021/fachsemester/VIII.1.%20Medizinisch-wissenschaftliche%20Fertigkeiten Miller GE. The assessment of clinical skills/competence/performance: Acad Med. 1990 Sep;65(9):S63-7. Moritz S, Halawi A, Proksch C, Werner JM, Paulsson M, Rothschild M, et al. Studies on acceptance, evaluation and impact of the Cologne program Research and Medical Studies. GMS J Med Educ. 2020;37(1):Doc5. Drees S, Schmitzberger F, Grohmann G, Peters H. The scientific term paper at the Charité: a project report on concept, implementation, and students’ evaluation and learning. GMS J Med Educ. 2019;36(5):Doc53. Eckel J, Schüttpelz-Brauns K, Miethke T, Rolletschek A, Fritz HM. The inventory as a core element in the further development of the science curriculum in the Mannheim Reformed Curriculum of Medicine. GMS J Med Educ. 2017;34(2):Doc22. Schendzielorz J, Jaehn P, Dors S, Holmberg C. Evaluierung der Wissenschaftskompetzenz im Brandenburger Modellstudiengang Medizin. 2020; Burk-Rafel J, Santen SA, Purkiss J. Study behaviors and USMLE Step 1 performance: Implications of a student self-directed parallel curriculum. Acad Med. 2017;92(11S):S67–74. Thomas PA, Kern DE, Hughes MT, Chen BY, editors. Curriculum development for medical education: a six-step approach. Third edition. Baltimore: Johns Hopkins University Press; 2016. 300 p. TU Dresden [Internet]. [cited 2023 Nov 3]. Homepage Carus Promotionskolleg Dresden. Available from: https://tu-dresden.de/med/mf/cpk/startseite TU Dresden [Internet]. [cited 2023 Nov 3]. Homepage Dresden School of Clinical Science. Available from: https://tu-dresden.de/med/mf/dscs/startseite Härtl A, Berberat P, Fischer MR, Forst H, Grützner S, Händl T, et al. Development of the competency-based medical curriculum for the new Augsburg University Medical School. GMS J Med Educ. 2017;34(2):Doc21. Baum C, Blomberg R, Breuer C, Bruckner-Tuderman L, Frosch M, Grüters-Kieslich A, et al. Die Bedeutung von Wissenschaftlichkeit für das Medizinstudium und die Promotion. (2019 Nr. 19). Available from: https://www.leopoldina.org/uploads/tx_leopublication/2019_Diskussionspapier_Wissenschaftlichkeit.pdf Hintze P. Empfehlungen der Senatskommission für Klinische Forschung. [cited 2023 Nov 2]; Available from: https://www.dfg.de/download/pdf/dfg_im_profil/geschaeftsstelle/publikationen/medizinausbildung_senat_klinische_forschung.pdf Wissenschaftsrat [Internet]. [cited 2023 Oct 29]. Publikationen - Empfehlungen zur Weiterentwicklung des Medizinstudiums in Deutschland auf Grundlage einer Bestandsaufnahme der humanmedizinischen Modellstudiengänge (Drs. 4017-14), Juli 2014. Available from: https://www.wissenschaftsrat.de/download/archiv/4017-14.html Loos S, Sander M, Martin A. Systematische Situationsanalyse zum wissenschaftlichen Nachwuchs in der klinischen Forschung. IGES Institut GMBH. Mieg HA, Lehmann J, editors. Forschendes Lernen: wie die Lehre in Universität und Fachhochschule erneuert werden kann. Frankfurt: Campus Verlag; 2017. 448 p. Huber L, Reinmann G. Vom forschungsnahen zum forschenden Lernen an Hochschulen: Wege der Bildung durch Wissenschaft. Wiesbaden [Heidelberg]: Springer VS; 2019. 426 p. Eckel J, Zavaritskaya O, Schüttpelz-Brauns K, Schubert R. An explorative vs. traditional practical course: how to inspire scientific thinking in medical students. Adv Physiol Educ. 2019 Sep 1;43(3):350–4. Im Blickpunkt: Promotionen als Indikator für die Leistung von Hochschulen. Auswertung von Daten des Statistischen Bundesamtes und des CHE Rankings 2019/20 – CHE [Internet]. [cited 2023 Oct 29]. Available from: https://www.che.de/download/im_blickpunkt_promotionen_2019-pdf/ Reimer, Maike, Dr. Gesamtbericht_MediBAS 2018_Humanmedizin_v02. [Internet]. [cited 2023 Oct 29]. Available from: https://www.bap.ihf.bayern.de/fileadmin/user_upload/BAP_Dateien/BAS/MediBAS/Feldbericht_Medizinerbefragung_Jahrgang_2017_2018.pdf Remes Ville, Helenius Ilkka, Sinisaari I. Research and medical students. Med Teach. 2000 Jan 1;22(2):164–7. Burgoyne LN, O’Flynn S, Boylan GB. Undergraduate medical research: the student perspective. Med Educ Online. 2010;15. Cormier D, Siemens G. The open course: Through the open door–open courses as research, learning, and engagement. Educ Rev [Internet]. 2010 [cited 2023 Oct 29];45(4). Available from: https://islandscholar.ca/islandora/object/ir:20478/datastream/PDF/view Kuhnigk O, Böthern AM, Reimer J, Schäfer I, Biegler A, Jueptner M, et al. Benefits and pitfalls of scientific research during undergraduate medical education. GMS Z Für Med Ausbild 275Doc72 ISSN 1860-3572 [Internet]. 2010 [cited 2023 Oct 28]; Available from: http://www.egms.de/en/journals/zma/2010-27/zma000709.shtml Pfeiffer M, Fischer MR, Bauer D. Publication activities of German junior researchers in academic medicine: which factors impact impact factors? BMC Med Educ. 2016;16:190. Brown G, Harris L. Student self-assessment. In SAGE Publications, Inc; 2013. p. 367–93. Gabbard T, Romanelli F. The Accuracy of Health Professions Students’ Self-Assessments Compared to Objective Measures of Competence. Am J Pharm Educ. 2021 Apr;85(4):8405. Epstein N, Reimer M, Gartmeier M, Fischer M, Berberat P, Huber J. The Munich Research Competence Scale: Research competence among doctoral candidates and graduates in medicine. Results from the second wave of the Bavarian Graduate Study in Medicine. Beitr Zur Hochschulforschung. 2021 Nov 19;43:210–26. Additional Declarations No competing interests reported. Supplementary Files Supplement1Survey.pdf Supplement2Dataset.csv Supplement3PythonScript.ipynb Supplement4pairsplot.png Supplement5ObjectiveAssessment.png Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 30 Jan, 2024 Reviews received at journal 22 Jan, 2024 Reviewers agreed at journal 08 Jan, 2024 Reviewers invited by journal 08 Jan, 2024 Editor assigned by journal 04 Jan, 2024 Editor invited by journal 04 Jan, 2024 Submission checks completed at journal 04 Jan, 2024 First submitted to journal 21 Dec, 2023 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3786498","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":265357133,"identity":"8f57db67-8230-42ee-89b8-bd91a205e57e","order_by":0,"name":"Maximilian Vogt","email":"","orcid":"","institution":"Technische Universität Dresden","correspondingAuthor":false,"prefix":"","firstName":"Maximilian","middleName":"","lastName":"Vogt","suffix":""},{"id":265357134,"identity":"936199e9-aae6-4d61-96cd-1b191333a1f0","order_by":1,"name":"Nadja Jahn","email":"","orcid":"","institution":"Technische Universität Dresden","correspondingAuthor":false,"prefix":"","firstName":"Nadja","middleName":"","lastName":"Jahn","suffix":""},{"id":265357135,"identity":"a97b67cd-b9ae-4719-ac76-4e7d1ec897aa","order_by":2,"name":"Mark Enrik Geissler","email":"","orcid":"","institution":"Technische Universität Dresden","correspondingAuthor":false,"prefix":"","firstName":"Mark","middleName":"Enrik","lastName":"Geissler","suffix":""},{"id":265357136,"identity":"8ef8e586-fa29-498c-9157-107b7d0f65bd","order_by":3,"name":"Jean-Paul Bereuter","email":"","orcid":"","institution":"Technische Universität Dresden","correspondingAuthor":false,"prefix":"","firstName":"Jean-Paul","middleName":"","lastName":"Bereuter","suffix":""},{"id":265357137,"identity":"2b3f79b3-0d14-4595-9b8c-f59b93b4618e","order_by":4,"name":"Rona Berit Geissler","email":"","orcid":"","institution":"Technische Universität Dresden","correspondingAuthor":false,"prefix":"","firstName":"Rona","middleName":"Berit","lastName":"Geissler","suffix":""},{"id":265357138,"identity":"a8daa1e7-fd4b-4803-a035-80b866167567","order_by":5,"name":"Ingmar Glauche","email":"","orcid":"","institution":"Technische Universität Dresden","correspondingAuthor":false,"prefix":"","firstName":"Ingmar","middleName":"","lastName":"Glauche","suffix":""},{"id":265357139,"identity":"db144d7f-ee68-4a04-88c3-02a47f03c72a","order_by":6,"name":"Sebastian Gerdes","email":"","orcid":"","institution":"Technische Universität Dresden","correspondingAuthor":false,"prefix":"","firstName":"Sebastian","middleName":"","lastName":"Gerdes","suffix":""},{"id":265357140,"identity":"5d6b037d-657a-4429-bd55-96bb4b56d55b","order_by":7,"name":"Andreas Deußen","email":"","orcid":"","institution":"Technische Universität Dresden","correspondingAuthor":false,"prefix":"","firstName":"Andreas","middleName":"","lastName":"Deußen","suffix":""},{"id":265357141,"identity":"a92ef263-a408-49da-99d4-6d5ebe0296bf","order_by":8,"name":"Lydia Günther","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+UlEQVRIie3RMWvCQBjG8acIdrlixxTrd4gInST9Kh4vOHXI6NChU10CWRMMfoZI10LfcKBLaVfBxSlTFjcHKX1jLXTxdOxwf+64444fHBzgcv3DfBkMBPW+KbMPDwMf6jQh2TZqMjyPyMK/xJxBPJrxFqzjdjxfb14/dTqmHNXIRoZhEQlJM3PZTcqVnqgyvMjebeTBZ4WFzpfUbCte6amcNK6e7aTYwei3muz440C+7MQoIbknBMx6sidPFiIvN7c+9ZIl3d1ETL00KsMimx8n92N62VSjoBMnuvS2HHSSBc3W1eNxgusBfr7mb2wBQMt+7XK5XC7gGxXbWMkcJNDmAAAAAElFTkSuQmCC","orcid":"","institution":"University Hospital Carl Gustav Carus, Technische Universität Dresden","correspondingAuthor":true,"prefix":"","firstName":"Lydia","middleName":"","lastName":"Günther","suffix":""}],"badges":[],"createdAt":"2023-12-21 10:59:32","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3786498/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3786498/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":49242370,"identity":"b5d193cf-ffe8-4ea9-9773-c1d22e5d4254","added_by":"auto","created_at":"2024-01-05 18:29:48","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":66880,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eAssessment of the need for scientific skills\u003c/strong\u003e \u003cstrong\u003eamong 5th AY students\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStudents (n = 175) were asked about specific skills regarding their expected frequency in later professional life. The responses are presented as a stacked bar chart in percentages. The 50% mark is denoted by a dashed line.\u003c/p\u003e","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-3786498/v1/b0c8a698f3560373148f9782.png"},{"id":49243371,"identity":"7589fdf1-6cd9-47ca-a90b-38cc311256b4","added_by":"auto","created_at":"2024-01-05 18:37:48","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":45954,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eAssessment of satisfaction with the current scientific curriculum across AYs. \u003c/strong\u003eThe responses of all the students are shown (n = 856). The responses are presented as a stacked bar chart in percentages. The 50% mark is denoted by a dashed line.\u003c/p\u003e","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-3786498/v1/89e47923d5aa12cb097f7f3e.png"},{"id":49242371,"identity":"07617900-4779-4bae-9536-76bfca00fb85","added_by":"auto","created_at":"2024-01-05 18:29:48","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":61539,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eEvaluation of the introduction of a compulsory curriculum for scientific education.\u003c/strong\u003e The answers of all students are shown (n = 856). The answers are shown as a stacked bar chart in percentages. The 50% mark is denoted by a dashed line.\u003c/p\u003e","description":"","filename":"Figure3.png","url":"https://assets-eu.researchsquare.com/files/rs-3786498/v1/2fce2cb09512914e2ce399b4.png"},{"id":49242373,"identity":"f73a2850-7fe6-4854-a7b6-23b6f3fe3398","added_by":"auto","created_at":"2024-01-05 18:29:48","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":28149,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eHistogram of students' assessments of the influence of several aspects dependent on a doctoral degree.\u003c/strong\u003e For the factors of patient care, career, salary and social reputation, the 856 students' responses to the question of influence were plotted on a 1-10 scale (1 = low influence to 10 = high influence) with a class width of 2 and dependent on doctorate status.\u003c/p\u003e","description":"","filename":"Figure4.png","url":"https://assets-eu.researchsquare.com/files/rs-3786498/v1/7aeffc4fe1d3dd220a46f64b.png"},{"id":49243373,"identity":"5082b2b4-6673-4df8-b35a-4803c8398601","added_by":"auto","created_at":"2024-01-05 18:37:48","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":68923,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSelf-assessed competencies for different scientific skills in the 5th AY. \u003c/strong\u003eThe self-assessment is plotted horizontally. The percentage of students who achieved the competence target required is shown by a black outline versus not in red.\u003c/p\u003e","description":"","filename":"Figure5.png","url":"https://assets-eu.researchsquare.com/files/rs-3786498/v1/f8908ea09bec87ddd698f417.png"},{"id":49242374,"identity":"fb6d1f0f-5ef0-4c53-8bc9-2ba3958e8fda","added_by":"auto","created_at":"2024-01-05 18:29:48","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":29021,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eBox plots for the relevance score of scientific competences (0-16) on later career aspirations. \u003c/strong\u003eAssessments of the relevance of scientific competences for later careers: practice (5.0 ± 2.5, n = 390), clinic (5.4 ± 2.5, n = 271), university hospital (7.6 ± 3.4, n = 148), and research (8.7 ± 2.7, n = 17). Significant differences among these groups were found, with specific differences identified between certain categories.\u003c/p\u003e","description":"","filename":"Figure6.png","url":"https://assets-eu.researchsquare.com/files/rs-3786498/v1/8b16331a78633a66e6710a87.png"},{"id":49242378,"identity":"21240b4b-12e6-469b-8d26-ec82071742f3","added_by":"auto","created_at":"2024-01-05 18:29:48","extension":"png","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":42912,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eBox plots for objective and self-assessment score distributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe box plots show both the objective assessment (0-10) in dark blue on the left y-axis and the subjective assessment (0-52) in light blue on the right y-axis. The distribution of scores is plotted over the academic years.\u003c/p\u003e","description":"","filename":"Figure7.png","url":"https://assets-eu.researchsquare.com/files/rs-3786498/v1/bedba684f980c7de9c637e6d.png"},{"id":49243375,"identity":"26e57156-c1f4-4705-924c-b0f59252c52c","added_by":"auto","created_at":"2024-01-05 18:37:48","extension":"png","order_by":8,"title":"Figure 8","display":"","copyAsset":false,"role":"figure","size":25453,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eFactors that influence the self-assessment score\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA) Box plots for self-assessed competences (0-52 points) by doctoral status in the 4th and 5th AY (Non-doctoral students vs. current doctoral students) B) Box plots for self-assessment of competences by educational background in the 4th and 5th AY of study. Students with no previous education and healthcare-related education were compared.\u003c/p\u003e","description":"","filename":"Figure8.png","url":"https://assets-eu.researchsquare.com/files/rs-3786498/v1/becddff4573bece27ef10eda.png"},{"id":49242380,"identity":"58122dd9-2f03-4a4b-9e44-7558ff45ec79","added_by":"auto","created_at":"2024-01-05 18:29:48","extension":"png","order_by":9,"title":"Figure 9","display":"","copyAsset":false,"role":"figure","size":181288,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eStudents’ wishes for a scientific curriculum \u003cbr\u003e\n \u003c/strong\u003eThe polar diagram shows the rankings of 12 items for a planned science curriculum as rated by students (multiple choices possible) for implementation in the curriculum (bottom right legend). The items were grouped into 3 content blocks (bottom left legend).\u003c/p\u003e","description":"","filename":"9.png","url":"https://assets-eu.researchsquare.com/files/rs-3786498/v1/13e632fa9a29309e97978594.png"},{"id":49243783,"identity":"5f9dd209-3f5d-42e9-b38c-7fd902928dfe","added_by":"auto","created_at":"2024-01-05 18:53:49","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1060063,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3786498/v1/21076d91-d040-46e9-8e4a-660e719b9f2a.pdf"},{"id":49242375,"identity":"2cbf4edf-1d4b-4ee0-aad1-384196b4dff2","added_by":"auto","created_at":"2024-01-05 18:29:48","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":170590,"visible":true,"origin":"","legend":"","description":"","filename":"Supplement1Survey.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3786498/v1/5483c43e0389e2cd6c3882e3.pdf"},{"id":49243671,"identity":"797b164b-c2a2-4a99-b697-443f37580d47","added_by":"auto","created_at":"2024-01-05 18:45:48","extension":"csv","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":81363,"visible":true,"origin":"","legend":"","description":"","filename":"Supplement2Dataset.csv","url":"https://assets-eu.researchsquare.com/files/rs-3786498/v1/848fed04e6ee3a5ea4b75623.csv"},{"id":49242382,"identity":"f930a856-afe0-4a0e-b602-724496a087fe","added_by":"auto","created_at":"2024-01-05 18:29:49","extension":"ipynb","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":229162,"visible":true,"origin":"","legend":"","description":"","filename":"Supplement3PythonScript.ipynb","url":"https://assets-eu.researchsquare.com/files/rs-3786498/v1/9c8ea663b7fd35d0a8d5117a.ipynb"},{"id":49242385,"identity":"80051a1f-e554-47aa-91a1-88a6ba34a460","added_by":"auto","created_at":"2024-01-05 18:29:49","extension":"png","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":3179919,"visible":true,"origin":"","legend":"","description":"","filename":"Supplement4pairsplot.png","url":"https://assets-eu.researchsquare.com/files/rs-3786498/v1/1600423ea034cddd589c5a6d.png"},{"id":49242381,"identity":"b8d813c4-39dc-4c77-827f-5b7f689bf5fc","added_by":"auto","created_at":"2024-01-05 18:29:48","extension":"png","order_by":5,"title":"","display":"","copyAsset":false,"role":"supplement","size":121286,"visible":true,"origin":"","legend":"","description":"","filename":"Supplement5ObjectiveAssessment.png","url":"https://assets-eu.researchsquare.com/files/rs-3786498/v1/c4bff5b23631e5e7463df642.png"}],"financialInterests":"No competing interests reported.","formattedTitle":"Scientific competence during medical education - insights from a cross- sectional study","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eScientific education and life-long learning are crucial since future generations of physicians will have to address multiple emerging medical challenges (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). This finding contrasts with the results of previous investigations revealing that scientific education is not sufficiently addressed in German medical curricula (\u003cspan additionalcitationids=\"CR4\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e), especially in regular courses (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Often, scientific education takes place late in the curriculum and mainly in connection with a doctoral thesis (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). It is important to note that a thesis project is not a mandatory component of the medical curriculum but is acquired by a large fraction of medical students (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). The scope and depth of scientific thesis projects are often limited (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e), and it is unclear whether the current system is capable of adequately preparing young physicians to make significant contributions to medical research, advance healthcare and ensure patient safety. Therefore, various stakeholders, such as the German Research Foundation and the German Science and Humanities Council campaign for integrating systematic scientific training into the nationwide curriculum (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). It has been shown that medical students themselves have a positive attitude toward science (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e) and wish to acquire more scientific competencies (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Nationwide efforts and political support are necessary for subsequent changes, and a curricular reform was initiated in 2017 (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) and may offer an opportunity to address the deficiencies in scientific education within the medical curriculum, which can differ between different medical schools. In line with this, the German Competency Based Catalogue of Learning Objectives (NKLM, 14) has been proposed as an obligatory national framework for 80% of the medical curriculum. In section VIII. 1. of this framework, scientific competencies are addressed by specific learning objectives (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Learning objectives and competency levels according to Miller (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e) have been included. Several German medical schools have already started to implement scientific curricula and related research projects (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan additionalcitationids=\"CR18\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e), which could result in a greater number of conducted research projects as well as accepted grant applications (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). However, such initiatives are intrinsically motivated by individual faculties and are not mandatory (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e); as far as we know, such initiatives omit the students\u0026rsquo; perspective on curriculum development. This, however, may be an important aspect regarding needs-orientation and acceptance and has been recommended (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAt the Medical Faculty Dresden (MFD) a structured medical thesis programme has been implemented since 2011 (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). In addition, a clinician scientist program was established in 2017 (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). While both initiatives attempt to improve scientific education, their accessibility is competitive and limited to a small number of applicants. Therefore, collaborative efforts involving educators and students are necessary to establish a scientific curriculum that is intrinsically embedded in regular medical education programs. Since there are currently no sufficient data on how students perceive the necessity and accessibility of scientific education, we collect relevant data from the MFD from a student's perspective over all academic years (AY). These data are crucial for the design and implementation of a potential standardised scientific curriculum that meets students\u0026rsquo; expectations and needs. The primary objectives of the conducted study are as follows:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eTo assess how medical students perceive the need for scientific competencies in their future professional life and how they self-evaluate their current abilities.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eTo determine whether the students' self-assessment of scientific competencies aligns with the currently proposed learning objectives and competence levels in the National Competence-Based for Undergraduate Medical Education (NKLM 2.0).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eTo envision what a scientific curriculum may look like based on the students' opinions.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e "},{"header":"2. Methods","content":"\u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003e2.1. Survey design\u003c/h2\u003e \u003cp\u003eThis cross-sectional study was performed with an online survey using LimeSurvey 3 (Hamburg, Germany). The survey was designed by the authors as an iterative collaborative process. All survey items were reviewed by experts in the field from the MFD. All the questions were further evaluated by medical students to assess the amount of time required and to identify and remove ambiguity. The answers collected during this review process were not included in the final data analysis.\u003c/p\u003e \u003cp\u003eThe questionnaire (\u003cb\u003eSuppl. 1\u003c/b\u003e) consisted of eight different topics related to scientific training. We requested participant information (9 items) and asked whether the participants were interested in performing a medical thesis (4 items). We asked the students about the relevance of eight scientific competencies and how often they anticipate using them during their future professional life (ranging from daily to never). Furthermore, we further asked them to self-assess their scientific skills (13 items, oriented toward the research process) according to different competence levels and in line with the NKLM: 1 (can name facts), 2 (can explain), 3a (can perform under supervision), and 3b (can perform independently). Students should also rate, if and at which level (from voluntary to mandatory) these scientific competencies should be included in the medical curriculum (17 items). Students were then asked to indicate their level of agreement on a four-point Likert scale to statements regarding satisfaction and the desire for a compulsory science curriculum. To objectify the self-assessment, a competence test was included in the questionnaire, which included ten multiple choice (MC) questions covering different science topics (science theory and method, biometry, literature, good scientific practice, clinical studies). The questionnaire ended with questions regarding the digital scientific program at MFD (2 items). The participants needed approximately 15 minutes on average to answer all questions.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.2. Distribution and data acquisition\u003c/h2\u003e \u003cp\u003eThe survey was distributed to medical students of the MFD from October to December 2022 in compulsory courses (1. AY: biology; 2. AY: physiology; 3. AY: laboratory medicine; 4. AY: general medicine; 5. AY: occupational medicine), and appropriate times were allocated for participants to complete the survey.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.3. Participants and data protection\u003c/h2\u003e \u003cp\u003e The study including the experimental protocol and the terms of realisation has been approved by the Ethical committee at the Technical University of Dresden (SR-EK-152032023) as well as by the data protection officer. Only medical students of the MFD were allowed to participate in the study. Informed consent was used. The participation was voluntary. The data have been collected completely anonymous and was stored on servers of the Technische Universit\u0026auml;t Dresden. We initially obtained data from 1075 students, but only completed questionnaires were included in the subsequent analysis (n\u0026thinsp;=\u0026thinsp;856).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.4. Data treatment and analysis\u003c/h2\u003e \u003cp\u003ePython 3.8.5 was used for data analysis (Python Software Foundation, Delaware, USA) within the Visual Studio Code 1.84.0 environment (Microsoft Corporation, Washington, USA). The raw data and the source code of the performed analyses are provided in \u003cb\u003eSuppl. 2 and 3\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eResponses regarding previous education were categorised into healthcare-related studies (e.g., biology, psychology), healthcare-related education (e.g., physiotherapy, medical technical assistance), and non-healthcare-related education/study (e.g., economics). Parameters such as age and high school grade were analysed descriptively using means and standard deviations. Likert-scale questions were analysed using percentages. For the consideration of relevance in later professional work (8 items), a calculation was performed according to the following scheme: never or rarely\u0026thinsp;=\u0026thinsp;0 points; monthly\u0026thinsp;=\u0026thinsp;1 point; daily or weekly\u0026thinsp;=\u0026thinsp;2 points. This results in a relevance sum score ranging from 0 to 16 points. For the 13 items of self-assessment, we transferred competency levels to points: can do nothing\u0026thinsp;=\u0026thinsp;0 points, can name facts\u0026thinsp;=\u0026thinsp;1 point, can explain\u0026thinsp;=\u0026thinsp;2 points, can perform under supervision\u0026thinsp;=\u0026thinsp;3 points, can perform independently\u0026thinsp;=\u0026thinsp;4 points. This process results in a subjective assessment sum score ranging from 0 to 52 points. In addition, the five-point Likert scale was used to scale the statements about the science curriculum, and the responses were numbered from 1\u0026ndash;5 in ascending order of agreement with the statements. We analysed the data set for relevant effects on the scientific training, and the full results are presented in Supplement 4. We used the student's t-test to assess differences between two groups. For more than two groups, we used ANOVA with post hoc Tukey\u0026rsquo;s HSD. The level of significance was set to alpha\u0026thinsp;=\u0026thinsp;0.05.\u003c/p\u003e \u003cp\u003eIn our analysis, box plots depict the 1st and 3rd quartiles, with whiskers extending to 1.5 times the interquartile range and the median distinctly marked inside the box.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e3.1. Sample characteristics\u003c/h2\u003e \u003cp\u003eOut of 1333 enrolled medical students a total number of 1075 (80.6%) participated in the survey. A total of 856 complete responses were included in further analyses (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). In four of the five AYs, we achieved response rates\u0026thinsp;\u0026gt;\u0026thinsp;50%. Overall, nearly half of the students (48.4%) had already completed health-related training before starting medical school, although this difference strongly differed between academic years.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSurvey sample distribution and demographic data per academic year\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1st academic year\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2nd academic year\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3rd academic year\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4th academic year\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5th academic year\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEnrolled Students\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e229\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e223\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e293\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e294\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e294\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParticipating Students, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e215\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e219\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e160\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e175\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResponse Rate (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e93,9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e74,7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e54,4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e59,5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex (n, %)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e65 (30.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17 (19.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e73 (33.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e48 (30%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e58 (33.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e149 (68.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70 (80.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e145 (66.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e111 (69.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e116 (66.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiverse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (0.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (0.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (0.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (0.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge, in years (Mean, SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21.8\u0026thinsp;\u0026plusmn;\u0026thinsp;2.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.2\u0026thinsp;\u0026plusmn;\u0026thinsp;3.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.1\u0026thinsp;\u0026plusmn;\u0026thinsp;2.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e24.3\u0026thinsp;\u0026plusmn;\u0026thinsp;3.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e25.2\u0026thinsp;\u0026plusmn;\u0026thinsp;2.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh School GPA (Mean, SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.56\u0026thinsp;\u0026plusmn;\u0026thinsp;0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.56\u0026thinsp;\u0026plusmn;\u0026thinsp;0.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.54\u0026thinsp;\u0026plusmn;\u0026thinsp;0.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.50\u0026thinsp;\u0026plusmn;\u0026thinsp;0.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.51\u0026thinsp;\u0026plusmn;\u0026thinsp;0.40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePromotion (n, %)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003estrives for it\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e140 (65.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67 (77.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e173 (79.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e57 (35.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e31 (17.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enot planned\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (1.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (2.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (2.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9 (5.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10 (5.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003estarted\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (0.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (1.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (2.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e70 (43.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e113 (64.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003edont know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e69 (32.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17 (19.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35 (16.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e20 (12.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18 (10.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ecancelled\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2 (1.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (0.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eothers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (0.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (0.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 (1.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducational Background (n,%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003enone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e81 (37.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (28.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e122 (55.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e96 (60.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e116 (66.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealthcare-related Education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e118 (54.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59 (67.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e81 (37.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e45 (28.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e42 (24.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealthcare-related Study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (5.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (3.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10 (4.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15 (9.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e13 (7.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-healthcare Education and Study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (2.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (2.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4 (2.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4 (2.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e3.2. Scientific skills - assessment of relevance\u003c/h2\u003e \u003cp\u003eTo assess the subjective importance of different scientific skills in future daily work, responses from 5th AY students (n\u0026thinsp;=\u0026thinsp;175) are presented (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Some scientific skills were considered to be more relevant than others: working on research projects was expected to be a less frequently needed skill. It was chosen by approximately 13% of respondents on a monthly or more frequent basis, compared to over 70% who expected to use it less often. In contrast, comprehending the evidence of a guideline was perceived as relevant by approximately two-thirds (61.9%) and as an activity that would later be performed monthly or more frequently. Nearly half of the students (47.7%) expected to work with scientific literature either daily or weekly in their medical practice; 34.1% expected to do so at least monthly. Explaining scientific evidence about diagnosis and treatment to patients was considered relevant at least monthly by 89% of the students.\u003c/p\u003e\u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Scientific education - satisfaction across academic years\u003c/h2\u003e \u003cp\u003eThe satisfaction with teaching scientific skills differed among AYs. In the first AY, two-thirds of the students (65.6%) chose \"no statement possible\". This option was chosen by 20% or less in AY 4 and AY 5. While every fourth student (27.5%) in the second year of study responded 'rather disagree' or 'disagree' to the statement 'I am satisfied with the teaching of scientific skills at my faculty', more than half (52.6%) of the 5th AY students did so (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The percentage of students who were completely satisfied remained constant at approximately 3% from the second year onwards. In addition, most students (\u0026gt;\u0026thinsp;50%) in each AY agreed fully or partly with the statement \u0026ldquo;I would like to have scientific work included in the compulsory curriculum\u0026rdquo; (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e3.4. Medical thesis - influencing factors for intensive scientific training\u003c/h2\u003e \u003cp\u003eAt the time of the survey, 54.4% (n\u0026thinsp;=\u0026thinsp;183) of the participating 4th and 5th AY students (n\u0026thinsp;=\u0026thinsp;335) had already started working on a doctoral thesis, and 26.6% (n\u0026thinsp;=\u0026thinsp;88) were planning to do so (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). To analyse the motivation to obtain a doctoral degree, we asked several questions using a 10-point interval scale (1\u0026thinsp;=\u0026thinsp;no influence to 10\u0026thinsp;=\u0026thinsp;strong influence). The question \"How much do you think the completion of a medical doctorate will influence the following areas?\u0026rdquo;, was answered as follows: influence on patient care (mean\u0026thinsp;=\u0026thinsp;3.27, SD\u0026thinsp;=\u0026thinsp;2.36), on professional career (mean\u0026thinsp;=\u0026thinsp;7.07, SD\u0026thinsp;=\u0026thinsp;2.11), on salary (mean\u0026thinsp;=\u0026thinsp;5.58, SD\u0026thinsp;=\u0026thinsp;2.48), and on social reputation (mean\u0026thinsp;=\u0026thinsp;7.63, SD\u0026thinsp;=\u0026thinsp;2.22). The doctorate status only slightly influenced the response behaviour (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003ea-d).\u003c/p\u003e\u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.5. Scientific skills \u0026ndash; self-assessment compared to different competence levels\u003c/h2\u003e \u003cp\u003eWe compared the self-assessments of 5th year students (n\u0026thinsp;=\u0026thinsp;175) to different competence levels and to a proposed catalogue of learning objectives for the national medical curriculum. Working with scientific literature was rated by more than 80% of all students as a relevant, at least monthly, skill used in later professional life (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Despite the high relevance, 59.4% of the 5th AY students rated themselves clearly below the level of being able to perform under supervision or independently and therefore below the targeted NKLM level (Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). This competence is also highly relevant to doctoral students. Among all 5th-year students, \u0026gt; 50% rated themselves as not being able to work under supervision or independently regarding good scientific practice and working on a research project (Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). Overall, a substantial number of students (between ~\u0026thinsp;10\u0026ndash;30%, depending on the competence addressed) state \u0026ldquo;0\u0026rdquo; in the 5th AY, which means they assess themselves as \u0026ldquo;can do nothing\u0026rdquo;.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e3.6. Identification of factors that influence differences in scientific attitude\u003c/h2\u003e \u003cp\u003eWe found relevant differences for the factor \"later career aspirations\" in the context of the cumulative relevance score. We discovered that among all participants (n\u0026thinsp;=\u0026thinsp;856), those who saw themselves either in research (n\u0026thinsp;=\u0026thinsp;18) or in a university hospital (n\u0026thinsp;=\u0026thinsp;148) tended to rate scientific training as more relevant than those with a preference for practice (n\u0026thinsp;=\u0026thinsp;390) or hospital (n\u0026thinsp;=\u0026thinsp;271). An ANOVA revealed a significant difference in relevance scores across the four groups (F(3, 823)\u0026thinsp;=\u0026thinsp;43.11, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The subsequent Tukey\u0026rsquo;s HSD post hoc test showed significant differences between hospital and research (difference between the means\u0026thinsp;=\u0026thinsp;3.35, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), hospital and university hospital (difference between the means\u0026thinsp;=\u0026thinsp;2.23, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), practice and research (difference between the means\u0026thinsp;=\u0026thinsp;3.76, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and practice and university hospital (difference between the means\u0026thinsp;=\u0026thinsp;2.63, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). However, a clear majority (77.2%) of the participants saw themselves either in practice or in a nonuniversity hospital and rated scientific training as less relevant for later professional life (Fig.\u0026nbsp;\u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eTo measure the subjective level of current scientific knowledge, a 13-item self-assessment score was collected (Fig.\u0026nbsp;\u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e7\u003c/span\u003e). The self-assessment showed a high variance in all AYs (minimum SD\u0026thinsp;=\u0026thinsp;11.1), indicating the heterogeneity of the students' scientific knowledge while also having a high Cronbach's alpha (Cronbach's alpha\u0026thinsp;=\u0026thinsp;0.947, 95% CI\u0026thinsp;=\u0026thinsp;0.942\u0026ndash;0.952). However, an increase of 7.0 points (max. 52 points) was observed from the 1st to the 5th AY (coef.=0.87/academic semester, CI\u0026thinsp;=\u0026thinsp;0.59\u0026ndash;1.16). By modelling the factors that led to a higher degree of self-assessment in a general linear model (details about the fitted model are provided in the supplementary material), we were able to identify two strongly associated factors: pursuing a doctoral degree was associated with a higher self-assessment (median non doctorate 11.5 [interquartile range 5.0-19.3] vs. median doctorate 25.0 [interquartile range 13.5\u0026ndash;37.0], p\u0026thinsp;=\u0026thinsp;0.000; Fig.\u0026nbsp;\u003cspan refid=\"Fig8\" class=\"InternalRef\"\u003e8\u003c/span\u003ea), and on the contrary, having previous medical education was associated with a lower self-assessment (median no previous education 18.5 [interquartile range 9.0\u0026ndash;32.0] vs. median healthcare-related education 13.0 [interquartile range 8.0\u0026ndash;22.0], p\u0026thinsp;=\u0026thinsp;0.006; Fig.\u0026nbsp;\u003cspan refid=\"Fig8\" class=\"InternalRef\"\u003e8\u003c/span\u003eb). The objective knowledge test included ten questions (Cronbach's alpha\u0026thinsp;=\u0026thinsp;0.374, 95% CI\u0026thinsp;=\u0026thinsp;0.310\u0026ndash;0.435). Between the 1st and the 5th AY, an improvement of 2.0 points from a maximum of 10 points was achieved. Over the AYs, there was a marked increase in the number of correct answers to questions on bias, scale types and, to a lesser extent, level of evidence, particularly after students had attended the Biometry class, where these topics were covered (\u003cb\u003eSuppl. 5\u003c/b\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e3.7. Perspective of curricular development - students' wishes\u003c/h2\u003e \u003cp\u003eFinally, the students were asked to indicate their preferred form of teaching for a range of topics in science education (Fig.\u0026nbsp;\u003cspan refid=\"Fig9\" class=\"InternalRef\"\u003e9\u003c/span\u003e). Students were allowed to make multiple choices (lecture, mandatory seminar or internship, and elective). We could see indications of more scientific content in a student-based curriculum: for most of the given content, including \"scientific method\", \"literature research\", \"statistical data analysis\", and \"scientific writing\", the mandatory seminar was the preferred teaching format (~\u0026thinsp;50%). The majority preferred a lecture format on ethics in science (57.9%), while practical training was aspired to learn practical research skills (57.6%).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e\u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003e We present the results of a systematic assessment of the students\u0026rsquo; perspectives on scientific education in medical training at the MFD, obtained in 2022. This has been done in preparation for the upcoming intended implementation of mandatory scientific training in the medical curriculum. This allows us to draw conclusions on how curricular change processes could be organised according to the needs of the target group.\u003c/p\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e4.1 Expectations versus reality\u003c/h2\u003e \u003cp\u003eThe results of our survey showed substantial discrepancies with regard to the expected necessity of scientific competence in later professional life and the self-assessment of skills in the scientific field. In this analysis we focused on 5th AY because they are about to graduate and enter the medical profession as well as they should have acquired scientific competence by then. The majority of 5th AY students estimated that they would need scientific skills, such as working with and critically reflecting scientific literature, very frequently. Most students expected that their medical studies would enable them to interpret scientific results but evaluate their training as insufficient (Figs.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and \u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e), which has also been shown elsewhere (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). In a nationwide survey, approximately 93% agreed or rather agreed that the critical analysis of scientific publication is a key competency for physicians (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). However, most of our students rated themselves as low performers and clearly below the required level of being able to work independently. We also analysed how the 5th AY students regarded their self-assessment of good scientific practice and working capabilities in a research project. Again, we found that only one in four students considered themselves sufficiently educated. This is evidence of an insufficient competence level in graduates with respect to independent work in a doctoral thesis. Our results are in line with previous studies showing insufficient self-assessed scientific competencies in medical students, especially in terms of scientific methods and writing, practical training and statistics (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eStudents younger than the 5th AY answered quite similarly (data not shown), thus supporting the results presented. Since there was no substantial change in the curriculum at our faculty over recent years, one can expect that the students who graduate in the next few years will also not be sufficiently trained in scientific skills. Thus, from the student's perspective, there is an urgent need to establish mandatory scientific training in the curriculum. There are different ways to implement this approach, but research-based learning (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e) is one possibility for integrating scientific thinking in existing curricula. In line with this, Eckel et al. (2019) showed that slight modifications of a practical training course in physiology could improve scientific thinking in medical students without disturbing knowledge acquisition (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e4.2 Impact of doctoral thesis and previous education\u003c/h2\u003e \u003cp\u003eWe observed that students who were performing a doctoral thesis rated their skills overall better than did those who were not involved in a medical thesis \u003cb\u003e(\u003c/b\u003eFig.\u0026nbsp;\u003cspan refid=\"Fig8\" class=\"InternalRef\"\u003e8\u003c/span\u003ea\u003cb\u003e)\u003c/b\u003e. This indicates that actively working on a scientific project could positively affect the subjectively perceived increase in knowledge regarding scientific topics, as shown previously (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). In detail, among students involved in a thesis project, self-assessment with respect to methodology and practical methods increased, but scientific writing seemed difficult, even while performing a medical thesis (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Overall, approximately 63% of all students complete a doctoral thesis in Germany (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e), and approximately 210 students graduate per year at our faculty (personal communication, Prodekanat Forschung). Especially with regard to the factors influencing the motivation to perform a medical thesis, we found that social and career aspects played a more important role compared to e.g. improved patient care (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). The importance of extrinsic \u0026ldquo;social\u0026rdquo; factors for completing a doctorate is consistent with the findings of other studies (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). Potential reasons for a low motivation to gain deeper insight into research in the context of a doctoral thesis may be inadequate access to scientific training programmes and supervision (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan additionalcitationids=\"CR36\" citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). In this regard, Kuhnigk et al. (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e) and Pfeiffer et al. (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e) showed that graduate programmes and professional training have an impact on the success and quality of medical theses. However, only\u0026thinsp;~\u0026thinsp;15% of doctorate students are enrolled in graduate programs, although approximately 25% would like to attend such courses (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). Similarly, the MFD offers a structured graduate programme to medical students (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e), but participation is based on competition for admission and reserved for a small number of students (~\u0026thinsp;15 per year). Therefore, mandatory scientific theoretical and practical training for all students could improve the overall quality of medical theses. Furthermore, the implementation of a science-oriented longitudinal curriculum enforcing basic science concepts from the first semester onwards may enhance postgraduate professional care and patient safety.\u003c/p\u003e \u003cp\u003eThe students who had a previous medical education background before starting medical studies rated themselves less favorable according to the subjective assessment (Fig.\u0026nbsp;\u003cspan refid=\"Fig8\" class=\"InternalRef\"\u003e8\u003c/span\u003eb). This could indicate that medically trained people already have an impression of the complexity of certain scientific topics. Older age and previous educational experience are associated with increased accuracy in self-assessment (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e). Our data showed that this primarily affects self-assessment, as we could not observe the same effects on objective competency test scores (data not shown).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003e4.3 Self-assessment versus competency test\u003c/h2\u003e \u003cp\u003eThe overall subjective assessment showed a high variance in the different AYs. We observed a slight increase in self-assessed abilities across AYs (Fig.\u0026nbsp;\u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e7\u003c/span\u003e); however, even in the higher AYs, the third quartile was only 32 points out of a maximum of 52 points (61.45%). This indicates a high level of uncertainty even among the more experienced students. It should be acknowledged that self-assessments are discussed critically in the literature and should not be used as the only criterion for assessing learning outcomes. Especially at the beginning of studies, such self-assessment may not be valid (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e). For this reason, we focused on the answers of higher AYs to certain questions. We also observed that the majority of the 1st AY students who were at the beginning of their studies answered the question about satisfaction with the current science curriculum with \"no statement possible\". This shows that some of the students had a realistic assessment of the statements they were able to evaluate objectively, and this is useful in the context of internal control. Approximately 20% of the students in the 2nd and 3rd AYs also chose this option, yet \u0026lt;\u0026thinsp;5% of those in the 4th and 5th AYs chose this option. Nevertheless, the data from the early AYs seem useful for longitudinal follow-up, making it worth including all the study years in such analyses.\u003c/p\u003e \u003cp\u003eTo substantiate the self-assessment, we conducted a ten-question competence test covering various scientific topics (see Supl. for details). Here, we observed an increase in the average score (2.4 points; Fig.\u0026nbsp;\u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e7\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e from approximately 4 points (1st AY) to approximately 6 points (5th AY). In parts, we observed large differences in the correct answers to individual questions. There was a large amount of knowledge deficit with respect to the inductive research approach (\u0026lt;\u0026thinsp;20% correct answers), the scientific method (as the research process) and good scientific practice (~\u0026thinsp;35\u0026ndash;40% correct answers). These deficits remained constant over AYs (data not shown). Obviously, these topics were not addressed sufficiently during the course of the curriculum. This finding fits well with the self-assessment of the 5th AY, where only approximately 25\u0026ndash;30% of the participants rated themselves as sufficiently trained to perform research either independently or at least in a supervised environment. In contrast, more than 50% could answer the question about the components of an abstract correctly from the first AY onwards, increasing to almost 80% in the fifth AY, indicating that this content had been successfully implemented. Questions addressing aspects of clinical research, i.e., randomisation, bias and scale types, displayed a clear trend over the AYs. With the 3rd AY onwards, there was a substantial increase in knowledge, which is in line with already implemented courses addressing biometry and statistics.\u003c/p\u003e \u003cp\u003eHowever, the limited number of questions and the low Cronbach's alpha indicate that the test results can provide information only about topics that might be addressed more comprehensively in the curriculum. Notably, there were no differences between the sexes according to either the self-assessment or the objective competence test. This finding aligns with the marginal sex effects observed in the Bavarian Graduate Study in Medicine (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003e4.4 Students' wishes and best practices\u003c/h2\u003e \u003cp\u003eLooking more closely at the statement \"I am satisfied with the teaching of scientific knowledge at my faculty\", it becomes clear that satisfaction decreased with the experience of studying \u003cb\u003e(\u003c/b\u003eFig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e. Finally, approximately 50% of the 5th AY quoted that they were satisfied or rather satisfied. This is even more alarming, as approximately 65% of our 5th AY cohort had already started a doctoral thesis, and a further approximately 18% would like to do so (data not shown). In a previous study Ratte et al. (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) showed that 79% of the students surveyed stated that they were not or rather not well prepared for working on a dissertation during their studies and that they wished for more training covering different scientific topics. This raises the question of how to design a future curriculum that improves student satisfaction, self-assessment, and in particular objective competence. Besides \u0026ldquo;Ethics in science\u0026rdquo; and \u0026ldquo;Good scientific practice\u0026rdquo;, the compulsory seminar was chosen as the favoured teaching format by our students for all the other topics (Fig.\u0026nbsp;\u003cspan refid=\"Fig9\" class=\"InternalRef\"\u003e9\u003c/span\u003e). This is interesting since at the MFD, the curriculum is already tightly timed, and seminars serve to discuss particularly important topics relevant to the majority of students. This finding confirms the importance attributed to scientific literacy by the students, as the target group knows its own curriculum best. In particular, the 5th AY is a valid group for such statements from a retrospective point of view, and we recommend the regular involvement of this experienced group during curriculum development. Lectures and occasional internships were also chosen (multiple answers possible), but they were chosen considerably less often. The option to \"not anchor\" a specific topic in the curriculum received less than 10% of the votes for any of the subject areas. Overall, our students wished for interactive student-centred formats, making discussions possible and leading to a well-grounded scientific education, which was also shown in other studies (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003e4.5 Outlook and next steps\u003c/h2\u003e \u003cp\u003eDue to the existing curriculum and limited possibilities for including new curricular content, we propose several steps to establish a longitudinal scientific curriculum on the basis of a needs assessment: 1. structured analysis of the curriculum and mapping to learning objective frameworks such as graduate profiles or the NKLM, 2. integration of the students' expectations into the curriculum, and 3. implementation accompanied by content training of faculty members regarding the basics of scientific working. This should be accompanied by assessing structural and/or financial needs to ensure that curriculum goals and resources are congruent with each other. Furthermore, we strongly suggest implementing digital courses, which could accompany development. The students' wish for interactive formats could be met without overloading the curriculum since familiarisation with the content could be performed individually (which will require saved time) followed by student-centred discussions tutored by experienced faculty members. In general, students need to be highly intrinsically motivated to learn the basics of science education, and so far, there has been little research into what student engagement might look like in concrete terms, e.g., time.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003e4.6 Limitations\u003c/h2\u003e \u003cp\u003eOur study faced several limitations. First, a new selection process has recently been implemented for the first and second AYs at the MFD. With the new selection process the fraction of students with a previous medical or non-medical educational background increased in comparison to the 3rd to 5th AYs, which were selected differently. Furthermore, after the 2nd AY, approximately 80 students per year coming from other universities inside Germany and from abroad continue their studies at MFD. Thus, the longitudinal homogeneity of our study group may be questioned. This longitudinal heterogeneity might have influenced the ratings (especially overall satisfaction). This limitation could not be avoided in the current assessment. Importantly, the current study can serve as a starting point for annual or at least repetitive investigations in which the annual cohort serves as its own control. As such, the potential effects of a longitudinal heterogeneity would cancel out. While our approach of surveying during mandatory courses ensured a commendable response rate, there was a noticeable decrease in participation during the third semester (second AY) due to illness of the course coordinator. Nevertheless, the response rate was close to 40%, which appears reasonable for a representative poll. Additionally, the relationship between self-assessment and objective competencies is tenuous at best, with some studies suggesting little to no correlation (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e). Furthermore, the competency test applied in our study was time-constrained, limiting its robustness and, consequently, its inferential power. Finally, we did not ask the students how much time they would dedicate to their own scientific skills development. Due to the aim of independent scientific work and thinking, there is a significant need for practical skill acquisition, which is mostly achieved through hands-on experience. Although the limitations described above must be taken into account when interpreting the results, our database is a rich resource and a valid means of addressing a range of needs in the implementation of a science curriculum.\u003c/p\u003e \u003c/div\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eOur study underscores the importance of rigorous scientific education in medical education. There is a clear request by students for the acquisition of necessary scientific competencies based on a mandatory science curriculum. In preparation for this, we highly recommend a needs assessment by means of a survey to establish a longitudinal research curriculum and to ensure that the implementation of the curriculum is successful and well accepted by students and teaching staff. Furthermore, this should be done on a nation-wide basis.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAY\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eacademic year\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eFig.\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eFigure\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMFD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003emedical faculty Dresden\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNKLM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGerman Competency Based Catalogue of Learning Objectives\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSuppl.\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSupplement\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study including the experimental protocol and the terms of realisation has been approved by the Ethical committee at the Technical University of Dresden (SR-EK-152032023) as well as by the data protection officer. The survey was offered to medical students of the MFD in compulsory courses. Informed consent was used. The participation was voluntary. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data generated or analysed during this study are included in the supplement.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe project was funded by FOSTER (012-2023 and A4-2022), an initiative by the Federal Ministry of Education and Research (BMBF) and the state of Saxony under the Excellence Strategy of the Federal Government and the State Government. The project was further funded by a MeDDrive Teaching Fond (65577) of the MFD.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor\u0026rsquo;s contribution\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualization, M.V., N.J., M.E.G, J.P.B., L.G.; methodology, M.E.G, J.P.B., L.G.; investigation, M.V., N.J., M.E.G, J.P.B., R.B.G; software, M.V.; formal analysis, M.V., S.G.; data curation, MV; writing original draft preparation, N.J., M.E.G., J.P.B., L.G; writing review and editing, L.G., S.G., I.G., A.D.; visualisation, M.V.; supervision, L.G.; project administration, L.G.; funding acquisition, N.J., J.P.B., L.G. All authors have read and agreed to the published version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThanks to Dr. Melanie Martin, Prof. Dr. Menschikowski, Dr. Jeannine Sch\u0026uuml;bel, Dr. Maria Girbig for supporting the distribution.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eNiessen CM, Krieg T. Clinician Scientists and PhDs: The Need to Connect Basic Research to Translational Medicine\u0026mdash;A Personal Experience. J Invest Dermatol. 2014 Feb;134(2):295\u0026ndash;8.\u003c/li\u003e\n\u003cli\u003eMaxwell SA, Fuchs-Young R, Wells GB, Kapler GM, Conover GM, Green S, et al. Guiding Preclinical Medical Students in Finding, Synthesizing, and Communicating Translational Basic Research Literature: Roles for Basic Science Research Mentors. Acad Med. 2022 May;97(5):684\u0026ndash;8.\u003c/li\u003e\n\u003cli\u003eRatte A, Drees S, Schmidt-Ott T. The importance of scientific competencies in German medical curricula - the student perspective. BMC Med Educ. 2018;18(1):146.\u003c/li\u003e\n\u003cli\u003eEpstein N, Huber J, Gartmeier M, Berberat PO, Reimer M, Fischer MR. Investigation on the acquisition of scientific competences during medical studies and the medical doctoral thesis. GMS J Med Educ. 2018;35(2):Doc20.\u003c/li\u003e\n\u003cli\u003eKujumdshiev S, Rockenbauch K, Fischer M, G\u0026uuml;nther L, Peters H, Repp H, et al. Wissenschaftliche Kompetenzen in deutschen Medizinstudieng\u0026auml;ngen: eine Fragebogen-basierte Bestandsaufnahme des GMA-Ausschusses Wissenschaftliche Kompetenzen. In German Medical Science GMS Publishing House; 2021. p. DocP142.\u003c/li\u003e\n\u003cli\u003eBauer J, Schendzielorz J, Oess S, Mantke R. Ausma\u0026szlig; und Integration von Wissenschaftsmodulen in das Medizinstudium an den staatlichen Fakult\u0026auml;ten und den privaten staatlich anerkannten Fakult\u0026auml;ten in Deutschland: eine Querschnittsstudie. Z F\u0026uuml;r Evidenz Fortbild Qual Im Gesundheitswesen. 2022 Nov;174:90\u0026ndash;6.\u003c/li\u003e\n\u003cli\u003eGiesler M, Boeker M, Fabry G, Biller S. Importance and benefits of the doctoral thesis for medical graduates. GMS J Med Educ 331Doc8 [Internet]. 2016 Feb 15 [cited 2023 Oct 5]; Available from: http://www.egms.de/en/journals/zma/2016-33/zma001007.shtml\u003c/li\u003e\n\u003cli\u003eCrisp AJ. Title of Dr should be sufficient for all doctors. BMJ. 2001 Mar 10;322(7286):617.\u003c/li\u003e\n\u003cli\u003eGroneberg DA. Use of Dr is perhaps even more confusing in Germany than UK. BMJ. 2001 Jun 23;322(7301):1547.\u003c/li\u003e\n\u003cli\u003eWissenschaftsrat [Internet]. [cited 2023 Oct 29]. Publikationen - Anforderungen an die Qualit\u0026auml;tssicherung der Promotion | Positionspapier (Drs. 1704-11), November 2011. Available from: https://www.wissenschaftsrat.de/download/archiv/1704-11.html\u003c/li\u003e\n\u003cli\u003eHren D, Lukić IK, Marusić A, Vodopivec I, Vujaklija A, Hrabak M, et al. Teaching research methodology in medical schools: students\u0026rsquo; attitudes towards and knowledge about science. Med Educ. 2004;38(1):81\u0026ndash;6.\u003c/li\u003e\n\u003cli\u003ePruskil S, Burgwinkel P, Georg W, Keil T, Kiessling C. Medical students\u0026rsquo; attitudes towards science and involvement in research activities: A comparative study with students from a reformed and a traditional curriculum. Med Teach. 2009 Jan;31(6):e254\u0026ndash;9.\u003c/li\u003e\n\u003cli\u003eBundesministerium f\u0026uuml;r Bildung und Forschung - BMBF [Internet]. 2017 [cited 2023 Oct 29]. \u0026lsquo;Masterplan Medizinstudium 2020\u0026rsquo; - BMBF. Available from: https://www.bmbf.de/bmbf/shareddocs/kurzmeldungen/de/masterplan-medizinstudium-2020.html\u003c/li\u003e\n\u003cli\u003eLOOOP NKLM [Internet]. [cited 2023 Nov 3]. Available from: https://nklm.de/zend/menu\u003c/li\u003e\n\u003cli\u003eNKLM 2.0 - Medizinische-wissenschaftliche Fertigkeiten [Internet]. [cited 2023 Nov 3]. Available from: https://nklm.de/zend/objective/list/orderBy/@objectivePosition/studiengang/PF2/zeitsemester/2021/fachsemester/VIII.1.%20Medizinisch-wissenschaftliche%20Fertigkeiten\u003c/li\u003e\n\u003cli\u003eMiller GE. The assessment of clinical skills/competence/performance: Acad Med. 1990 Sep;65(9):S63-7.\u003c/li\u003e\n\u003cli\u003eMoritz S, Halawi A, Proksch C, Werner JM, Paulsson M, Rothschild M, et al. Studies on acceptance, evaluation and impact of the Cologne program Research and Medical Studies. GMS J Med Educ. 2020;37(1):Doc5.\u003c/li\u003e\n\u003cli\u003eDrees S, Schmitzberger F, Grohmann G, Peters H. The scientific term paper at the Charit\u0026eacute;: a project report on concept, implementation, and students\u0026rsquo; evaluation and learning. GMS J Med Educ. 2019;36(5):Doc53.\u003c/li\u003e\n\u003cli\u003eEckel J, Sch\u0026uuml;ttpelz-Brauns K, Miethke T, Rolletschek A, Fritz HM. The inventory as a core element in the further development of the science curriculum in the Mannheim Reformed Curriculum of Medicine. GMS J Med Educ. 2017;34(2):Doc22.\u003c/li\u003e\n\u003cli\u003eSchendzielorz J, Jaehn P, Dors S, Holmberg C. Evaluierung der Wissenschaftskompetzenz im Brandenburger Modellstudiengang Medizin. 2020;\u003c/li\u003e\n\u003cli\u003eBurk-Rafel J, Santen SA, Purkiss J. Study behaviors and USMLE Step 1 performance: Implications of a student self-directed parallel curriculum. Acad Med. 2017;92(11S):S67\u0026ndash;74.\u003c/li\u003e\n\u003cli\u003eThomas PA, Kern DE, Hughes MT, Chen BY, editors. Curriculum development for medical education: a six-step approach. Third edition. Baltimore: Johns Hopkins University Press; 2016. 300 p.\u003c/li\u003e\n\u003cli\u003eTU Dresden [Internet]. [cited 2023 Nov 3]. Homepage Carus Promotionskolleg Dresden. Available from: https://tu-dresden.de/med/mf/cpk/startseite\u003c/li\u003e\n\u003cli\u003eTU Dresden [Internet]. [cited 2023 Nov 3]. Homepage Dresden School of Clinical Science. Available from: https://tu-dresden.de/med/mf/dscs/startseite\u003c/li\u003e\n\u003cli\u003eH\u0026auml;rtl A, Berberat P, Fischer MR, Forst H, Gr\u0026uuml;tzner S, H\u0026auml;ndl T, et al. Development of the competency-based medical curriculum for the new Augsburg University Medical School. GMS J Med Educ. 2017;34(2):Doc21.\u003c/li\u003e\n\u003cli\u003eBaum C, Blomberg R, Breuer C, Bruckner-Tuderman L, Frosch M, Gr\u0026uuml;ters-Kieslich A, et al. Die Bedeutung von Wissenschaftlichkeit f\u0026uuml;r das Medizinstudium und die Promotion. (2019 Nr. 19). Available from: https://www.leopoldina.org/uploads/tx_leopublication/2019_Diskussionspapier_Wissenschaftlichkeit.pdf\u003c/li\u003e\n\u003cli\u003eHintze P. Empfehlungen der Senatskommission f\u0026uuml;r Klinische Forschung. [cited 2023 Nov 2]; Available from: https://www.dfg.de/download/pdf/dfg_im_profil/geschaeftsstelle/publikationen/medizinausbildung_senat_klinische_forschung.pdf\u003c/li\u003e\n\u003cli\u003eWissenschaftsrat [Internet]. [cited 2023 Oct 29]. Publikationen - Empfehlungen zur Weiterentwicklung des Medizinstudiums in Deutschland auf Grundlage einer Bestandsaufnahme der humanmedizinischen Modellstudieng\u0026auml;nge (Drs. 4017-14), Juli 2014. Available from: https://www.wissenschaftsrat.de/download/archiv/4017-14.html\u003c/li\u003e\n\u003cli\u003eLoos S, Sander M, Martin A. Systematische Situationsanalyse zum wissenschaftlichen Nachwuchs in der klinischen Forschung. IGES Institut GMBH.\u003c/li\u003e\n\u003cli\u003eMieg HA, Lehmann J, editors. Forschendes Lernen: wie die Lehre in Universit\u0026auml;t und Fachhochschule erneuert werden kann. Frankfurt: Campus Verlag; 2017. 448 p.\u003c/li\u003e\n\u003cli\u003eHuber L, Reinmann G. Vom forschungsnahen zum forschenden Lernen an Hochschulen: Wege der Bildung durch Wissenschaft. Wiesbaden [Heidelberg]: Springer VS; 2019. 426 p.\u003c/li\u003e\n\u003cli\u003eEckel J, Zavaritskaya O, Sch\u0026uuml;ttpelz-Brauns K, Schubert R. An explorative vs. traditional practical course: how to inspire scientific thinking in medical students. Adv Physiol Educ. 2019 Sep 1;43(3):350\u0026ndash;4.\u003c/li\u003e\n\u003cli\u003eIm Blickpunkt: Promotionen als Indikator f\u0026uuml;r die Leistung von Hochschulen. Auswertung von Daten des Statistischen Bundesamtes und des CHE Rankings 2019/20 \u0026ndash; CHE [Internet]. [cited 2023 Oct 29]. Available from: https://www.che.de/download/im_blickpunkt_promotionen_2019-pdf/\u003c/li\u003e\n\u003cli\u003eReimer, Maike, Dr. Gesamtbericht_MediBAS 2018_Humanmedizin_v02. [Internet]. [cited 2023 Oct 29]. Available from: https://www.bap.ihf.bayern.de/fileadmin/user_upload/BAP_Dateien/BAS/MediBAS/Feldbericht_Medizinerbefragung_Jahrgang_2017_2018.pdf\u003c/li\u003e\n\u003cli\u003eRemes Ville, Helenius Ilkka, Sinisaari I. Research and medical students. Med Teach. 2000 Jan 1;22(2):164\u0026ndash;7.\u003c/li\u003e\n\u003cli\u003eBurgoyne LN, O\u0026rsquo;Flynn S, Boylan GB. Undergraduate medical research: the student perspective. Med Educ Online. 2010;15.\u003c/li\u003e\n\u003cli\u003eCormier D, Siemens G. The open course: Through the open door\u0026ndash;open courses as research, learning, and engagement. Educ Rev [Internet]. 2010 [cited 2023 Oct 29];45(4). Available from: https://islandscholar.ca/islandora/object/ir:20478/datastream/PDF/view\u003c/li\u003e\n\u003cli\u003eKuhnigk O, B\u0026ouml;thern AM, Reimer J, Sch\u0026auml;fer I, Biegler A, Jueptner M, et al. Benefits and pitfalls of scientific research during undergraduate medical education. GMS Z F\u0026uuml;r Med Ausbild 275Doc72 ISSN 1860-3572 [Internet]. 2010 [cited 2023 Oct 28]; Available from: http://www.egms.de/en/journals/zma/2010-27/zma000709.shtml\u003c/li\u003e\n\u003cli\u003ePfeiffer M, Fischer MR, Bauer D. Publication activities of German junior researchers in academic medicine: which factors impact impact factors? BMC Med Educ. 2016;16:190.\u003c/li\u003e\n\u003cli\u003eBrown G, Harris L. Student self-assessment. In SAGE Publications, Inc; 2013. p. 367\u0026ndash;93.\u003c/li\u003e\n\u003cli\u003eGabbard T, Romanelli F. The Accuracy of Health Professions Students\u0026rsquo; Self-Assessments Compared to Objective Measures of Competence. Am J Pharm Educ. 2021 Apr;85(4):8405.\u003c/li\u003e\n\u003cli\u003eEpstein N, Reimer M, Gartmeier M, Fischer M, Berberat P, Huber J. The Munich Research Competence Scale: Research competence among doctoral candidates and graduates in medicine. Results from the second wave of the Bavarian Graduate Study in Medicine. Beitr Zur Hochschulforschung. 2021 Nov 19;43:210\u0026ndash;26.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"undergraduate medical education, scientific education, science curriculum, needs assessment, research competence, scientific skills, curriculum development","lastPublishedDoi":"10.21203/rs.3.rs-3786498/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3786498/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eMedical knowledge regarding the pathophysiology, diagnosis and treatment of diseases is constantly evolving. To effectively incorporate these findings into professional practice, it is crucial that scientific competencies are a central component of medical education. This study seeks to analyse the current state of scientific education and students' desires for integration into the curriculum.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eFrom October to December 2022, a survey was distributed at the Medical Faculty Dresden to all medical students from the 1st to 5th academic year (AY). The survey investigates current expectations of applying scientific competencies later in professional life, and the students were asked to self-assess various scientific skills and in relation to the National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education. The self-assessments were objectified through a competence test with ten multiple-choice questions. The desire for curricular teaching was inquired.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003e860 students completed the survey. This corresponds to a response rate of 64%. In the 5th AY, approximately 80% of the participants stated that they expected to work with scientific literature on a daily to monthly basis in future professional life and to communicate corresponding scientific findings to patients. Only 30\u0026ndash;40% of the 5th AY rate their scientific competencies as sufficient to do this appropriately. This corresponds with the self-assessed competencies that only slightly increased over the 5 AYs from 14.1\u0026thinsp;\u0026plusmn;\u0026thinsp;11.7 to 21.3\u0026thinsp;\u0026plusmn;\u0026thinsp;13.8 points (max. 52) and is also reflected in the competence test (1st AY 3.6\u0026thinsp;\u0026plusmn;\u0026thinsp;1.75 vs. 5th AY 5.5\u0026thinsp;\u0026plusmn;\u0026thinsp;1.68, max. 10 points). Half of the students in the 4th and 5th AYs were dissatisfied with the current teaching of scientific skills. The majority preferred the implementation of a science curriculum (56%), preferably as seminars dealing with topics such as literature research, analysis, and science communication.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe results show discrepancies between expectations of using scientific knowledge in everyday professional life, self-rated and objectively recorded competencies, and the current state of curricular teaching of scientific competencies. There is a strong need for adequate practical training, particularly in critical analyses of scientific literature, which enables the communication of scientific knowledge to patients.\u003c/p\u003e","manuscriptTitle":"Scientific competence during medical education - insights from a cross- sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-01-05 18:29:43","doi":"10.21203/rs.3.rs-3786498/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-01-30T10:34:54+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-01-22T20:21:56+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"2b2e43c5-4d3e-44b1-ac90-cc3b5478a778","date":"2024-01-08T10:02:18+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-01-08T09:14:17+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-01-04T09:05:07+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-01-04T08:59:41+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-01-04T08:57:47+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2023-12-21T10:52:47+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"72ce1ecb-dfeb-43e6-9d78-2bce37e2fdb7","owner":[],"postedDate":"January 5th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2024-04-25T06:05:14+00:00","versionOfRecord":[],"versionCreatedAt":"2024-01-05 18:29:43","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3786498","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3786498","identity":"rs-3786498","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}