Evaluation of the concept of students learning practical gynecological and obstetric skills at a large German university hospital, using the example of the Homburg University Women's Clinic

Evaluation of the concept of students learning practical gynecological and obstetric skills at a large German university hospital, using the example of the Homburg University Women's Clinic | 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 Evaluation of the concept of students learning practical gynecological and obstetric skills at a large German university hospital, using the example of the Homburg University Women's Clinic Sebastian Findeklee, Mariz Kasoha, Gregor Leonhard Olmes, Klaus Diedrich, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9378015/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Introduction : The teaching and practical training of future doctors plays an important role in the university curriculum. Material and techniques : At the Women's Clinic of Saarland University Hospital in Homburg, we developed a five-day block placement concept that focused on learning practical gynecological and obstetric skills rather than simply imparting theoretical knowledge. The success of the block placement was assessed using a standardized questionnaire with the two items "How do you rate your learning outcomes from the placement?" and "The placement increased my interest in gynecology and obstetrics." The assessment was based on a scale of 1 to 6. Outcome : A total of 205 out of 220 students (93.2%) from the winter semester 2022/2023 participated in the evaluation and completed the questionnaire. 198 students (96.6%) rated their learning outcomes from the block internship as very good (1) or good (2), and 201 (98%) reported an increase in their interest in the subject area. Discussion : An overwhelming majority of students rated the practical teaching concept as very good or good, which speaks to the success of this practical teaching format. Nevertheless, the study also has some limitations. For example, only one cohort of medical students was surveyed. Furthermore, when establishing a new teaching concept, there is a risk that participants in an evaluation will not respond objectively, but rather according to the criterion of social desirability. We propose our practice-oriented block placement concept, which focuses on learning skills relevant to the future medical profession, as the standard curriculum for undergraduate teaching in gynecology and obstetrics, in order to inspire students for the field and thus ensure a sufficient number of motivated specialists in our field in the future. student teaching evaluation block internship gynecology and obstetrics Figures Figure 1 Introduction Student teaching is playing an increasingly important role at German university obstetrics and gynecology clinics. A key component of the training of future physicians in the field of obstetrics and gynecology is the clinical rotation. This rotation is mandatory in the curriculum and typically lasts 4–5 days, usually in the 4th or 5th year of study [ 1 ]. The main objective should be for future colleagues to gain a comprehensive overview of the field and to acquire practical skills alongside theoretical knowledge. Further objectives include, in the short term, preparation for the written and, if applicable, oral-practical second state examination in medicine (administered in multiple-choice format), and, in the long term, fostering motivation to work in obstetrics and gynecology in the future. At the Saarland University obstetrics and gynecology clinic in Homburg, the clinical rotation is implemented by a designated instructor, the clinic's teaching coordinator. The rotation has been continuously developed over the course of the semesters [ 2 ]. Both student feedback and internal discussions within the teaching department proved helpful. Although each university women's hospital in Germany offers its own individual clinical rotation, to our knowledge there is no recognized standard for the practical procedure. No publication explicitly describes the process and could serve as an example for other hospitals. Below, we describe the structure of the obstetrics and gynecology clinical rotation at the Homburg University Women's Hospital. We have had positive experiences with the procedure described here and achieved a high level of satisfaction among the participating students. Material and techniques Schedule of the block internship The clinical placement at the University Women's Hospital in Homburg lasts 5 days (Monday to Friday). It is divided into a clinical session in the morning from 8:00 a.m. to 12:30 p.m., followed—after a one-hour lunch break—by a seminar session from 1:30 p.m. to 4:00 p.m. Each week of the semester, a seminar group, typically consisting of 10 students, participates. The clinical placement begins on Monday at 7:45 a.m. with a 15-minute introductory session. During this session, the students are given an explanation of the schedule for the placement. Each student also receives a personalized name badge and a logbook for the placement. This logbook includes a schedule for the placement and a guide to fetometry in obstetric ultrasound. From 8:00 to 8:15 a.m., a tour of the clinic's five functional areas takes place. Typically, two students visit each area daily, depending on the size of the seminar group. These five areas are the general gynecology outpatient clinic with its specialized consultations for fertility, dysplasia, and urogynecology; the oncology outpatient clinic; the antenatal clinic; the delivery room; and the operating room. Following this, students provide an introduction to obstetric ultrasound for other students. During this 30-minute session, a student tutor explains the fundamentals of ultrasound and the procedure for fetometry. At the end of each morning, the tutor takes the student assigned to the antenatal clinic to practice fetometry at the bedside of a pregnant patient. The patients are asked beforehand and must consent to participate. In the afternoon, following some general remarks about the field and the structure of the training, the procedure for a gynecological examination using a speculum and breast trainer is explained, employing a pelvic phantom (for nulliparous and multiparous women) and a breast phantom (Koken 14 − 3 Mejiro 3-Chome, BCS 6476). Students then practice the examination in pairs under supervision. This is followed by a cardiotocography (CTG) course, in which the fundamentals of CTG analysis are taught based on the four basic criteria: basal rate, bandwidth, decelerations, and accelerations. Each student then receives a CTG and must analyze it according to these four criteria. Monday afternoon concludes with a laparoscopy video demonstrating the intraoperative site and anatomical structures. On Tuesday afternoon, the process of natural childbirth is discussed using a birth mannequin and fetal movements. Following this, the students demonstrate the previously demonstrated movements in pairs. Next, a role-playing exercise takes place in which the students must manage four obstetric emergencies in the delivery room (pathological CTG requiring emergency cesarean section, pathological CTG requiring vacuum extraction, shoulder dystocia, and uterine atony). The delivery room resident can then apply the CTG knowledge acquired the previous day. A subsequent discussion of the case and the emergency procedures follows. On Wednesday afternoon, a conization course is held. Here, each student practices conization on a sausage using the self-developed Homburg conization model with a monopolar loop [ 3 ]. Success is assessed by measuring the cone thickness (target 7–10 mm). If necessary, a re-resection is performed. The second part of the afternoon seminar consists of a 15-minute introduction to mammosonography. Then, each student, divided into two groups, performs mammosonography at the patient's bedside under supervision. The patient had to have previously agreed to participate voluntarily. Afterwards, there is an opportunity to practice a core needle biopsy of the breast using a self-made gelatin breast model with an olive-shaped tissue sample. The presence of a piece of the olive in the biopsy channel serves as confirmation of success. Since the summer semester of 2018, on Thursday mornings, students have had the opportunity to attend the endoscopy school run by a lecturer at Saarland University Hospital in Saarbrücken, instead of the five functional areas of the clinic. Here, the fundamentals of gynecological endoscopy are taught, and students have the opportunity to practice their skills on models they have designed themselves. In the second part, advanced students practice using laparoscopy instruments on a pelvic model and perform laparoscopic suturing. A laparoscopy simulator developed specifically by us was used for this purpose [4;5]. In the afternoon, the three most common gynecological cancers in Germany (endometrial, ovarian, and cervical cancer) will be discussed interactively using a clear whiteboard diagram. This will be followed—as a synthesis of gynecological and obstetrical disease patterns and preparation for the final exam—by a case seminar on gynecological and obstetric emergencies. Here, each student will receive a case presented in a PowerPoint presentation and will be asked to identify possible differential diagnoses and describe the diagnostic procedure in order to determine the most probable diagnosis. The final exam takes place on Friday afternoon. Each student presents a patient case with a specific condition (gestational diabetes, ectopic pregnancy, hypertensive disorder of pregnancy, miscarriage, uterine fibroids, breast cancer, ovarian cancer, cervical cancer, endometrial cancer, endometriosis). This condition is assigned to each participant at the beginning of the clinical rotation. Ideally, students should have seen the patient themselves during one of the mornings. If this is not possible, the ward physicians will provide assistance. The case presentation lasts approximately 5 minutes. This is followed by 2 to 3 questions about the condition, primarily for review and reinforcement within the group. The presentation is graded on a scale of 1 to 6 (German grading system). A supplementary script is available for the clinical rotation to further explore the material and prepare for the exam. Students can download this from the internet with password protection. Evaluation of the Success of the block internship The evaluation instrument was a standardized evaluation form from Saarland University Hospital, consisting of two questions: "How do you rate the learning outcomes of the placement?" and "The placement has increased my interest in the field of gynecology and obstetrics." Students could rate their responses on a scale of 1 to 6 (see table 1). Ethical approval was requested from the Ethics Committee of the Medical Faculty of Saarland University, but was not required because teaching and its evaluation are a mandatory component of the student curriculum. Outcome 220 students completed the block placement in obstetrics and gynecology at the Homburg University Women's Hospital in the winter semester of 2022/2023. The course was evaluated anonymously by 205 students, representing 93.2% of the total. 166 students (81%) rated their learning outcomes as very good, 32 (15.6%) as good, 4 (2%) as satisfactory, and 3 (1.4%) as adequate. No students received a failing or unsatisfactory rating. 175 students (85.4%) agreed that the placement increased their interest in obstetrics and gynecology, 26 students (12.7%) stated that this was mostly true, 3 students (1.4%) found it partially true, and only one student (0.5%) stated that it was not true. The evaluation results are summarized in table 1. Discussion The obstetrics and gynecology block internship can justifiably be described as the heart of undergraduate medical education in our field. It undoubtedly represents a crucial moment in the curriculum, as it offers the opportunity to present the field in all its breadth and to inspire future colleagues to pursue our specialization. It can also be seen as the final opportunity for self-promotion before choosing an elective rotation during the final year of clinical practice. Various models designed for undergraduate medical education exist in the literature. These range from role-playing to practical exercises using models [6;7]. These elements are also incorporated into our block placement. Integrating the greatest possible proportion of practical exercises into the placement was particularly important to us, as theoretical knowledge can also be acquired through self-study, for example, with the help of a provided accompanying script. At the same time, it was essential to also cover theory in order to meet the immediate goal of exam preparation. Therefore, following the introduction of the optional endoscopy course on Thursday mornings in the summer semester of 2018, we decided to offer a theory block in the afternoon. This clearly demonstrates that the clinical rotations at our clinic are subject to constant change. They are continuously developed in consultation with clinic colleagues and students. Only in this way can they fulfill their objectives: imparting specialist knowledge, teaching human qualities such as empathy and communication skills, conveying principles of responsible medical practice, and, last but not least, inspiring young people to pursue a career in obstetrics and gynecology. This component appears particularly pressing in light of demographic trends. Despite its importance—both for the quality of clinical training and for the recruitment of future gynecologists—there is no recognized standard for the implementation of the clinical rotation among German university obstetrics and gynecology departments. We therefore propose the clinical rotation procedure published here at our department as a standard for other university obstetrics and gynecology departments. We base this proposal on our own positive experiences implementing it under everyday clinical conditions and, above all, on the high level of student satisfaction, as evidenced by the excellent evaluation results obtained using a standardized questionnaire. These positive evaluation results are consistent with previous studies from our department, which show, on the one hand, that students can acquire practical skills very quickly and, on the other hand, that they evaluate practical teaching very well [8;9]. Fortunately, this has also led to our department attracting numerous students for the practical year, many of whom were persuaded to begin their residency training at our department. This will become even more important in the future, given the increasing shortage of skilled workers. However, our study also has some limitations. Firstly, it is a single-center study. Secondly, the block placement was only evaluated over one academic year. Therefore, the data set is still relatively small and does not allow for far-reaching conclusions. Furthermore, there is always the risk that students might respond according to social desirability criteria during their personal placement supervision. It must be noted, however, that the evaluation was conducted entirely anonymously by marking boxes on the questionnaire, without any possibility of identifying the evaluator. Despite all these limitations, the evaluation results are encouraging. In the future, it would be interesting to conduct cross-sectional studies in the field of teaching research to compare teaching between different university hospitals, with the aim of continuously improving the quality of student teaching. Conclusion We suggest our practice-oriented block internship concept, which focuses on learning skills relevant to the future medical profession, as a standard curriculum for student teaching in the field of gynecology and obstetrics, in order to inspire students for the subject and thus ensure the recruitment of a sufficient number of motivated specialists in our field in the future. Declarations Conflict of interest The authors declare no conflict of interest. Funding Declaration There was no funding of the study. Author contribution declaration S.F. did the concept and the evaluation of the block internship. M.K. did proof-reading and translation. G.L.O. constructed the items of the survey. K.D. had the idea and did the conception of the manuscript. M.T.G. was responsible for the figure and the simulator. R.S. made the table. E.F.S. made the proof of concept and the organization of the internship. B.H.H. wrote the manuscript together with S.F. References Yang P, Xiong T, Dong X, Yang S, Yue J. Interprofessional teaching rounds in medical education: improving clinical problem-solving ability and interprofessional collaboration skills. Med Educ Online 2025;30(1):2451269 Olmes GL, Zimmermann JSM, Stotz L, Takacs FZ, Hamza A, Radosa MP, Findeklee S, Solomayer EF, Radosa JC. Students' attitudes toward digital learning during the COVID-19 pandemic: a survey conducted following an online course in gynecology and obstetrics. Arch Gynecol Obstet 2021;304(4):957–963 Takacs FZ, Solomayer EF, Hamza A, Juhasz-Böss I, Sklavounos P, Radosa JC, Findeklee S. Conisation course for medical students-experience from a German University Hospital. J Turk Ger Gynecol Assoc 2020;21(2):79–83 Banerjee C, Noé KG. Laparoscopic pectopexy: a new technique of prolapse surgery for obese patients. Arch Gynecol Obstet 2011;284(3):631–635 Findeklee S, Hamoud BH, Diedrich K, Sima RM, Solomayer EF, Spüntrup C. Training of young medical professionals: implementation of modern training concepts, taking into account the changed framework conditions for training-a pilot project for operational subjects. Arch Gynecol Obstet 2024;309(6):2727–2733 Yu JH, Chang HJ, Kim SS, Park JE, Chung WY, Lee SK, Kim M, Lee JH, Jung YJ. Effects of high-fidelity simulation education on medical students' anxiety and confidence. PLoS One 2021;16(5):e0251078 Okuda Y, Bryson EO, DeMaria S Jr, Jacobson L, Quinones J, Shen B, Levine AI. The utility of simulation in medical education: what is the evidence? Mt Sinai J Med 2009;76(4):330–43 Hamza A, Warczok C, Meyberg-Solomayer G, Takacs Z, Juhasz-Boess I, Solomayer EF, Radosa MP, Radosa CG, Stotz L, Findeklee S, Radosa JC. Teaching undergraduate students gynecological and obstetrical examination skills: the patient's opinion. Arch Gynecol Obstet 2020;302(2):431–438 Findeklee S, Breitbach GP, Radosa JC, Morinello E, Spüntrup E, Solomayer EF, Spüntrup C. Significant improvement of laparoscopic knotting time in medical students through manual training with potential cost savings in laparoscopy - an observational study. J Turk Ger Gynecol Assoc 2020;21(3):150–155 Tables Table 1: results of the evaluation of the block internship in gynecology and obstetrics at the University Women's Hospital Homburg Item very good good satisfactory sufficient inadequate insufficient How do you assess the learning outcomes of the internship? 166 (81%) 32 (15.6%) 4 (2%) 3 (1.4%) 0 0 The internship strengthened my interest in the field of gynecology and obstetrics. 175 (85.4%) 26 (12.7%) 3 (1.4%) 0 0 1 (0.5%) *legend 1- very good or applicable 2- good or mostly applicable 3- satisfactory or partially applicable 4- sufficient or rather not applicable 5- deficient or mostly not applicable 6- insufficient or not applicable Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 08 May, 2026 Reviews received at journal 19 Apr, 2026 Reviewers agreed at journal 19 Apr, 2026 Reviews received at journal 18 Apr, 2026 Reviewers agreed at journal 16 Apr, 2026 Reviewers invited by journal 14 Apr, 2026 Editor assigned by journal 14 Apr, 2026 Submission checks completed at journal 13 Apr, 2026 First submitted to journal 10 Apr, 2026 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. 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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-9378015","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":625677407,"identity":"8f052c30-268a-45df-8aeb-d6057e2b1d92","order_by":0,"name":"Sebastian 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A key component of the training of future physicians in the field of obstetrics and gynecology is the clinical rotation. This rotation is mandatory in the curriculum and typically lasts 4\u0026ndash;5 days, usually in the 4th or 5th year of study [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The main objective should be for future colleagues to gain a comprehensive overview of the field and to acquire practical skills alongside theoretical knowledge. Further objectives include, in the short term, preparation for the written and, if applicable, oral-practical second state examination in medicine (administered in multiple-choice format), and, in the long term, fostering motivation to work in obstetrics and gynecology in the future.\u003c/p\u003e \u003cp\u003eAt the Saarland University obstetrics and gynecology clinic in Homburg, the clinical rotation is implemented by a designated instructor, the clinic's teaching coordinator. The rotation has been continuously developed over the course of the semesters [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Both student feedback and internal discussions within the teaching department proved helpful. Although each university women's hospital in Germany offers its own individual clinical rotation, to our knowledge there is no recognized standard for the practical procedure. No publication explicitly describes the process and could serve as an example for other hospitals.\u003c/p\u003e \u003cp\u003eBelow, we describe the structure of the obstetrics and gynecology clinical rotation at the Homburg University Women's Hospital. We have had positive experiences with the procedure described here and achieved a high level of satisfaction among the participating students.\u003c/p\u003e"},{"header":"Material and techniques","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eSchedule of the block internship\u003c/h2\u003e \u003cp\u003eThe clinical placement at the University Women's Hospital in Homburg lasts 5 days (Monday to Friday). It is divided into a clinical session in the morning from 8:00 a.m. to 12:30 p.m., followed\u0026mdash;after a one-hour lunch break\u0026mdash;by a seminar session from 1:30 p.m. to 4:00 p.m. Each week of the semester, a seminar group, typically consisting of 10 students, participates.\u003c/p\u003e \u003cp\u003eThe clinical placement begins on Monday at 7:45 a.m. with a 15-minute introductory session. During this session, the students are given an explanation of the schedule for the placement. Each student also receives a personalized name badge and a logbook for the placement. This logbook includes a schedule for the placement and a guide to fetometry in obstetric ultrasound. From 8:00 to 8:15 a.m., a tour of the clinic's five functional areas takes place. Typically, two students visit each area daily, depending on the size of the seminar group. These five areas are the general gynecology outpatient clinic with its specialized consultations for fertility, dysplasia, and urogynecology; the oncology outpatient clinic; the antenatal clinic; the delivery room; and the operating room. Following this, students provide an introduction to obstetric ultrasound for other students. During this 30-minute session, a student tutor explains the fundamentals of ultrasound and the procedure for fetometry. At the end of each morning, the tutor takes the student assigned to the antenatal clinic to practice fetometry at the bedside of a pregnant patient. The patients are asked beforehand and must consent to participate. In the afternoon, following some general remarks about the field and the structure of the training, the procedure for a gynecological examination using a speculum and breast trainer is explained, employing a pelvic phantom (for nulliparous and multiparous women) and a breast phantom (Koken 14\u0026thinsp;\u0026minus;\u0026thinsp;3 Mejiro 3-Chome, BCS 6476). Students then practice the examination in pairs under supervision. This is followed by a cardiotocography (CTG) course, in which the fundamentals of CTG analysis are taught based on the four basic criteria: basal rate, bandwidth, decelerations, and accelerations. Each student then receives a CTG and must analyze it according to these four criteria. Monday afternoon concludes with a laparoscopy video demonstrating the intraoperative site and anatomical structures.\u003c/p\u003e \u003cp\u003eOn Tuesday afternoon, the process of natural childbirth is discussed using a birth mannequin and fetal movements. Following this, the students demonstrate the previously demonstrated movements in pairs. Next, a role-playing exercise takes place in which the students must manage four obstetric emergencies in the delivery room (pathological CTG requiring emergency cesarean section, pathological CTG requiring vacuum extraction, shoulder dystocia, and uterine atony). The delivery room resident can then apply the CTG knowledge acquired the previous day. A subsequent discussion of the case and the emergency procedures follows.\u003c/p\u003e \u003cp\u003eOn Wednesday afternoon, a conization course is held. Here, each student practices conization on a sausage using the self-developed Homburg conization model with a monopolar loop [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Success is assessed by measuring the cone thickness (target 7\u0026ndash;10 mm). If necessary, a re-resection is performed. The second part of the afternoon seminar consists of a 15-minute introduction to mammosonography. Then, each student, divided into two groups, performs mammosonography at the patient's bedside under supervision. The patient had to have previously agreed to participate voluntarily. Afterwards, there is an opportunity to practice a core needle biopsy of the breast using a self-made gelatin breast model with an olive-shaped tissue sample. The presence of a piece of the olive in the biopsy channel serves as confirmation of success.\u003c/p\u003e \u003cp\u003eSince the summer semester of 2018, on Thursday mornings, students have had the opportunity to attend the endoscopy school run by a lecturer at Saarland University Hospital in Saarbr\u0026uuml;cken, instead of the five functional areas of the clinic. Here, the fundamentals of gynecological endoscopy are taught, and students have the opportunity to practice their skills on models they have designed themselves. In the second part, advanced students practice using laparoscopy instruments on a pelvic model and perform laparoscopic suturing. A laparoscopy simulator developed specifically by us was used for this purpose [4;5]. In the afternoon, the three most common gynecological cancers in Germany (endometrial, ovarian, and cervical cancer) will be discussed interactively using a clear whiteboard diagram. This will be followed\u0026mdash;as a synthesis of gynecological and obstetrical disease patterns and preparation for the final exam\u0026mdash;by a case seminar on gynecological and obstetric emergencies. Here, each student will receive a case presented in a PowerPoint presentation and will be asked to identify possible differential diagnoses and describe the diagnostic procedure in order to determine the most probable diagnosis.\u003c/p\u003e \u003cp\u003eThe final exam takes place on Friday afternoon. Each student presents a patient case with a specific condition (gestational diabetes, ectopic pregnancy, hypertensive disorder of pregnancy, miscarriage, uterine fibroids, breast cancer, ovarian cancer, cervical cancer, endometrial cancer, endometriosis). This condition is assigned to each participant at the beginning of the clinical rotation. Ideally, students should have seen the patient themselves during one of the mornings. If this is not possible, the ward physicians will provide assistance. The case presentation lasts approximately 5 minutes. This is followed by 2 to 3 questions about the condition, primarily for review and reinforcement within the group. The presentation is graded on a scale of 1 to 6 (German grading system).\u003c/p\u003e \u003cp\u003eA supplementary script is available for the clinical rotation to further explore the material and prepare for the exam. Students can download this from the internet with password protection.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eEvaluation of the Success of the block internship\u003c/h3\u003e\n\u003cp\u003eThe evaluation instrument was a standardized evaluation form from Saarland University Hospital, consisting of two questions: \"How do you rate the learning outcomes of the placement?\" and \"The placement has increased my interest in the field of gynecology and obstetrics.\" Students could rate their responses on a scale of 1 to 6 (see table 1). Ethical approval was requested from the Ethics Committee of the Medical Faculty of Saarland University, but was not required because teaching and its evaluation are a mandatory component of the student curriculum.\u003c/p\u003e\n\u003ch3\u003eOutcome\u003c/h3\u003e\n\u003cp\u003e220 students completed the block placement in obstetrics and gynecology at the Homburg University Women's Hospital in the winter semester of 2022/2023. The course was evaluated anonymously by 205 students, representing 93.2% of the total.\u003c/p\u003e \u003cp\u003e166 students (81%) rated their learning outcomes as very good, 32 (15.6%) as good, 4 (2%) as satisfactory, and 3 (1.4%) as adequate. No students received a failing or unsatisfactory rating. 175 students (85.4%) agreed that the placement increased their interest in obstetrics and gynecology, 26 students (12.7%) stated that this was mostly true, 3 students (1.4%) found it partially true, and only one student (0.5%) stated that it was not true. The evaluation results are summarized in table 1.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe obstetrics and gynecology block internship can justifiably be described as the heart of undergraduate medical education in our field. It undoubtedly represents a crucial moment in the curriculum, as it offers the opportunity to present the field in all its breadth and to inspire future colleagues to pursue our specialization. It can also be seen as the final opportunity for self-promotion before choosing an elective rotation during the final year of clinical practice.\u003c/p\u003e \u003cp\u003eVarious models designed for undergraduate medical education exist in the literature. These range from role-playing to practical exercises using models [6;7]. These elements are also incorporated into our block placement. Integrating the greatest possible proportion of practical exercises into the placement was particularly important to us, as theoretical knowledge can also be acquired through self-study, for example, with the help of a provided accompanying script. At the same time, it was essential to also cover theory in order to meet the immediate goal of exam preparation. Therefore, following the introduction of the optional endoscopy course on Thursday mornings in the summer semester of 2018, we decided to offer a theory block in the afternoon. This clearly demonstrates that the clinical rotations at our clinic are subject to constant change. They are continuously developed in consultation with clinic colleagues and students. Only in this way can they fulfill their objectives: imparting specialist knowledge, teaching human qualities such as empathy and communication skills, conveying principles of responsible medical practice, and, last but not least, inspiring young people to pursue a career in obstetrics and gynecology. This component appears particularly pressing in light of demographic trends.\u003c/p\u003e \u003cp\u003eDespite its importance\u0026mdash;both for the quality of clinical training and for the recruitment of future gynecologists\u0026mdash;there is no recognized standard for the implementation of the clinical rotation among German university obstetrics and gynecology departments. We therefore propose the clinical rotation procedure published here at our department as a standard for other university obstetrics and gynecology departments. We base this proposal on our own positive experiences implementing it under everyday clinical conditions and, above all, on the high level of student satisfaction, as evidenced by the excellent evaluation results obtained using a standardized questionnaire. These positive evaluation results are consistent with previous studies from our department, which show, on the one hand, that students can acquire practical skills very quickly and, on the other hand, that they evaluate practical teaching very well [8;9]. Fortunately, this has also led to our department attracting numerous students for the practical year, many of whom were persuaded to begin their residency training at our department. This will become even more important in the future, given the increasing shortage of skilled workers.\u003c/p\u003e \u003cp\u003eHowever, our study also has some limitations. Firstly, it is a single-center study. Secondly, the block placement was only evaluated over one academic year. Therefore, the data set is still relatively small and does not allow for far-reaching conclusions. Furthermore, there is always the risk that students might respond according to social desirability criteria during their personal placement supervision. It must be noted, however, that the evaluation was conducted entirely anonymously by marking boxes on the questionnaire, without any possibility of identifying the evaluator. Despite all these limitations, the evaluation results are encouraging.\u003c/p\u003e \u003cp\u003eIn the future, it would be interesting to conduct cross-sectional studies in the field of teaching research to compare teaching between different university hospitals, with the aim of continuously improving the quality of student teaching.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eWe suggest our practice-oriented block internship concept, which focuses on learning skills relevant to the future medical profession, as a standard curriculum for student teaching in the field of gynecology and obstetrics, in order to inspire students for the subject and thus ensure the recruitment of a sufficient number of motivated specialists in our field in the future.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConflict of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Declaration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere was no funding of the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contribution declaration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eS.F. did the concept and the evaluation of the block internship.\u003c/p\u003e\n\u003cp\u003eM.K. did proof-reading and translation.\u003c/p\u003e\n\u003cp\u003eG.L.O. constructed the items of the survey.\u003c/p\u003e\n\u003cp\u003eK.D. had the idea and did the conception of the manuscript.\u003c/p\u003e\n\u003cp\u003eM.T.G. was responsible for the figure and the simulator.\u003c/p\u003e\n\u003cp\u003eR.S. made the table.\u003c/p\u003e\n\u003cp\u003eE.F.S. made the proof of concept and the organization of the internship.\u003c/p\u003e\n\u003cp\u003eB.H.H. wrote the manuscript together with S.F.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eYang P, Xiong T, Dong X, Yang S, Yue J. Interprofessional teaching rounds in medical education: improving clinical problem-solving ability and interprofessional collaboration skills. Med Educ Online 2025;30(1):2451269\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOlmes GL, Zimmermann JSM, Stotz L, Takacs FZ, Hamza A, Radosa MP, Findeklee S, Solomayer EF, Radosa JC. Students' attitudes toward digital learning during the COVID-19 pandemic: a survey conducted following an online course in gynecology and obstetrics. Arch Gynecol Obstet 2021;304(4):957\u0026ndash;963\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTakacs FZ, Solomayer EF, Hamza A, Juhasz-B\u0026ouml;ss I, Sklavounos P, Radosa JC, Findeklee S. Conisation course for medical students-experience from a German University Hospital. J Turk Ger Gynecol Assoc 2020;21(2):79\u0026ndash;83\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBanerjee C, No\u0026eacute; KG. Laparoscopic pectopexy: a new technique of prolapse surgery for obese patients. Arch Gynecol Obstet 2011;284(3):631\u0026ndash;635\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFindeklee S, Hamoud BH, Diedrich K, Sima RM, Solomayer EF, Sp\u0026uuml;ntrup C. Training of young medical professionals: implementation of modern training concepts, taking into account the changed framework conditions for training-a pilot project for operational subjects. Arch Gynecol Obstet 2024;309(6):2727\u0026ndash;2733\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYu JH, Chang HJ, Kim SS, Park JE, Chung WY, Lee SK, Kim M, Lee JH, Jung YJ. Effects of high-fidelity simulation education on medical students' anxiety and confidence. PLoS One 2021;16(5):e0251078\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOkuda Y, Bryson EO, DeMaria S Jr, Jacobson L, Quinones J, Shen B, Levine AI. The utility of simulation in medical education: what is the evidence? Mt Sinai J Med 2009;76(4):330\u0026ndash;43\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHamza A, Warczok C, Meyberg-Solomayer G, Takacs Z, Juhasz-Boess I, Solomayer EF, Radosa MP, Radosa CG, Stotz L, Findeklee S, Radosa JC. Teaching undergraduate students gynecological and obstetrical examination skills: the patient's opinion. Arch Gynecol Obstet 2020;302(2):431\u0026ndash;438\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFindeklee S, Breitbach GP, Radosa JC, Morinello E, Sp\u0026uuml;ntrup E, Solomayer EF, Sp\u0026uuml;ntrup C. Significant improvement of laparoscopic knotting time in medical students through manual training with potential cost savings in laparoscopy - an observational study. J Turk Ger Gynecol Assoc 2020;21(3):150\u0026ndash;155\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1: \u003c/strong\u003eresults of the evaluation of the block internship in gynecology and obstetrics at the University Women\u0026apos;s Hospital Homburg\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"628\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eItem\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003every good\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003egood\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u003cstrong\u003esatisfactory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cstrong\u003esufficient\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u003cstrong\u003einadequate\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003einsufficient\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eHow do you assess the learning outcomes of the internship?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e166 (81%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e32 (15.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e4 (2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e3 (1.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eThe internship strengthened my interest in the field of gynecology and obstetrics.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e175 (85.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e26 (12.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e3 (1.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1 (0.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*legend\u003c/p\u003e\n\u003cp\u003e1-\u0026nbsp;very good or applicable\u003c/p\u003e\n\u003cp\u003e2-\u0026nbsp;good or mostly applicable\u003c/p\u003e\n\u003cp\u003e3-\u0026nbsp;satisfactory or partially applicable\u003c/p\u003e\n\u003cp\u003e4-\u0026nbsp;sufficient or rather not applicable\u003c/p\u003e\n\u003cp\u003e5-\u0026nbsp;deficient or mostly not applicable\u003c/p\u003e\n\u003cp\u003e6- insufficient or not applicable\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"archives-of-gynecology-and-obstetrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"arch","sideBox":"Learn more about [Archives of Gynecology and Obstetrics](https://www.springer.com/journal/404)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/arch/default.aspx","title":"Archives of Gynecology and Obstetrics","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"student teaching, evaluation, block internship, gynecology and obstetrics","lastPublishedDoi":"10.21203/rs.3.rs-9378015/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9378015/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eIntroduction\u003c/strong\u003e\u003c/em\u003e: The teaching and practical training of future doctors plays an important role in the university curriculum.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eMaterial and techniques\u003c/strong\u003e\u003c/em\u003e: At the Women's Clinic of Saarland University Hospital in Homburg, we developed a five-day block placement concept that focused on learning practical gynecological and obstetric skills rather than simply imparting theoretical knowledge. The success of the block placement was assessed using a standardized questionnaire with the two items \"How do you rate your learning outcomes from the placement?\" and \"The placement increased my interest in gynecology and obstetrics.\" The assessment was based on a scale of 1 to 6.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eOutcome\u003c/strong\u003e\u003c/em\u003e: A total of 205 out of 220 students (93.2%) from the winter semester 2022/2023 participated in the evaluation and completed the questionnaire. 198 students (96.6%) rated their learning outcomes from the block internship as very good (1) or good (2), and 201 (98%) reported an increase in their interest in the subject area.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDiscussion\u003c/strong\u003e: An overwhelming majority of students rated the practical teaching concept as very good or good, which speaks to the success of this practical teaching format. Nevertheless, the study also has some limitations. For example, only one cohort of medical students was surveyed. Furthermore, when establishing a new teaching concept, there is a risk that participants in an evaluation will not respond objectively, but rather according to the criterion of social desirability. We propose our practice-oriented block placement concept, which focuses on learning skills relevant to the future medical profession, as the standard curriculum for undergraduate teaching in gynecology and obstetrics, in order to inspire students for the field and thus ensure a sufficient number of motivated specialists in our field in the future.\u003c/p\u003e","manuscriptTitle":"Evaluation of the concept of students learning practical gynecological and obstetric skills at a large German university hospital, using the example of the Homburg University Women's Clinic","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-23 09:16:34","doi":"10.21203/rs.3.rs-9378015/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-05-08T12:32:58+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-19T10:32:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"181660401762929717536301870152417865932","date":"2026-04-19T10:30:08+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-18T07:29:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"79973964431901512616119034527228120019","date":"2026-04-16T15:43:29+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-14T22:04:55+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-14T15:35:55+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-13T14:22:28+00:00","index":"","fulltext":""},{"type":"submitted","content":"Archives of Gynecology and Obstetrics","date":"2026-04-10T10:04:23+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"archives-of-gynecology-and-obstetrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"arch","sideBox":"Learn more about [Archives of Gynecology and Obstetrics](https://www.springer.com/journal/404)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/arch/default.aspx","title":"Archives of Gynecology and Obstetrics","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"294f1bd4-bd66-48d6-aadd-6a929cf4fb21","owner":[],"postedDate":"April 23rd, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Revision requested","date":"2026-05-08T12:32:58+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-16T20:08:16+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-23 09:16:34","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9378015","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9378015","identity":"rs-9378015","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}