PJplus - a project improving practical training during the final year of medical education

Practical training on the patient is crucial in medical students' last year education - the so-called practical year (PJ) in Germany. Due to difficulties in combining student training with the everyday tasks on ward, it is often criticised as not sufficient for a good preparation for later practical work. The Medical Faculty of the University of Jena therefore designed a project called "PJplus". The project includes mentoring and workplace-based assessment by means of Mini-Clinical Evaluation Exercise (Mini-CEX) in combination with training workshops for supervisors. Three years after the first clinical departments started voluntary participation, the project was evaluated by comparing the experience and the self-assessed learning progress of students from departments participating in this project (PJplus group) with those non-participating (control group).

An online questionnaire was sent to all medical students registered at the University of Jena for PJ between March 2016 and April 2017. The students were invited to participate at the end of each section of their PJ within that period. The answers of the PJplus group were compared to the answers of the control group using descriptive and multivariable analysis.

201 students participated in the survey and filled out 257 questionnaires. PJplus was recommended by 80% of the students participating in the project. The PJplus group (n=92) was significantly more satisfied with their PJ and felt significantly better prepared for work than the control group (n=165). The project's elements mentoring and feedback could lead to a better improvement in practical medical skills. However, only 17% of the students managed to conduct the required amount of three Mini-CEX during their PJ rotation and 52% of the students seemed to have lost contact to their mentor or did not have one at all. These difficulties arose due to unfamiliarity with the project, shortage of time and staff on ward or due to lack of motivation among supervisors.

Adding mentoring and feedback to the PJ helps to better prepare students for their practical work after finishing studies. With the project presented, it is feasible to integrate these elements in a structured way. Nevertheless, a good control of the elements' implementation and consistent training of the supervising physicians is needed to ensure long-term success.