Seminar "Neurologie" 2017
On thursday 4th of May 2017 our journey to Tirana began. We met at 6:20 am at the train station in Witten and took our plane at 10:20 in airport Köln/Bonn. After two flights via Vienna we arrived at 2 pm in Tirana tired but excited. There a taxi driver was waiting for us and drove us to the house of 'Hope for Albania' that was managed by Dinie and Koos. They served us tea and updated us about their projects in Tirana. Later we walked through the city. As we set a fixed time with the albanian tutors for dinner we only did a quick sightseeing tour. At 7pm we met with the albanian medical students at a fish restaurant in a newly renovated neighbourhood. We got to know each other, had a lot of fun and discussed the seminar and the following day. We ended the evening by going to the opening of the mediterranean Biennale for young artists, an art festival in Tirana.
During landing, we got a fist impression of the beautiful landscape of Albania including the mountains around Tirana. We got inspired to get up early on Friday to have breakfast with our hosts and to catch the cable car up the Mount Dajti. After a nice trip up the mountain and enjoying a hike through the woods we decided to have lunch with a stunning view over Tirana. Before we were heading to the seminar at the university we had a team-meeting discussing the timetable and topics we will be teaching. Nearly sixty students were waiting patiently for us when we arrived at the university. After a quick introduction Dr. Charlotte Weyland started the theoretical part in form of a presentation about general neurological cases and the cranial nerves. After each topic one german and one albanian tutor with 12 to 13 students came together to practice the examinations and to improve the practical skills. Dr. Weyland was supervising the students’ extermination and helped out with questions. Because of the very theory based medical teaching in Tirana the students were having lots of fun practicing different kinds of examination. The seminar lasted till 8pm. The students were dismissed with the instruction to be there at 9 am on the following morning. It’s been a pleasure guiding the use of medical tools and watching the students fast learning progress. The students were very pleased and were looking forward to the next two days. Tired from all the impressions we went back to our place to organise the next day. When we finished our meeting, we went out together for enjoying an traditional Albanian dinner.
After the usual friendly breakfast with Koos and Dinie we started the seminar at 09:00. After the cranial nerves on the day before followed now the theoretical part of the motor system. The following practice with reflex hammers probably was the highlight of the day. The shyness in the beginning, which we sometimes noticed at the seminars before was almost not existent. With much effort the students were trying out how to hold the hammer in a proper way, at which area a reflex can be provoked the best and which nerve or segments correspond to the reflexes. Next on was the part about sensibility. The students took active part with questions and remarks.
The lunch break brought something special this time: Not only some food and refreshment, but more important a meeting with the dean of the universities medical faculty. Prof. Kasneci initiated the meeting thanking us for the seminars we held over the years and proposing a more official collaboration. While still keeping the project on the level of students the university would like to get in contact with the University of Witten/Herdecke. In this way the organisation could go an easier way, concerning time and place/rooms for the seminar and could open the way to a closer cooperation with the hospital. Albanian Doctors could be included better and there might be the possibility to do physical examination in groups at real patients. Surely Future Doctors Network cannot speak for the university, but we´re looking forward to present the idea to the faculty and hope for good results.
The Seminar continued with Charlotte explaining some disorders of peripheral nerves and differentiating these with problems of the central nervous system. The practical part afterwards was dominated by examining the sensory system with examples of mononeuropathy of the median or radial nerve.
“Acting like a drunkard” was the task for the seminars´part about the cerebellum and coordination and led to some laughs in the examination. A small quiz with examples of neurologic disorders marked the end of the days work. Especially appreciated were clinical cases of stroke patients and regarding images of CT-scans that had to be solved by the students.
After the long day the five of us needed some time at our temporary albanian home to relax and organise the cases for the OSCE at Sunday. For the night we had time to go out for dinner and meet with the albanian tutors. We enjoyed the stillness of an artificial lake in a park made by the former dictator Hoxha. A view on the lightened town with the stars and the moon reflecting in the dark waters brought the opportunity for interesting conversations about albanian culture and education system. The last thing that was to experience on the long Saturday was a party of the “mediteranean Biennale”. One of the very few occasion in which it was allowed to access the “pyramid”, a former television building by the government, very prominent for Tirana. Sleeping after this day was a joy we all accepted gladly.
On Sunday morning, we started the OSCE at the university. This time we did the exam together with the Albanian Tutors. We made 4 cases for 8 stations (4 german, 4 albanian) and between 9 and 11 every 30 minutes another group of 8 students came to show what they learned.
After having such a good, productive atmosphere on Friday and Saturday we were impressed how good the albanian students did the examinations. Although we made difficult cases (e.g. „Patient feels weakness of his right hand“ or „Patient has double vision. Try to find a diagnosis.“) most of them were able to do an entire, structured examination.
After the OSCE went as planned we proudly handed out 43 certificates and made the obligatory group picture in front of the building. One hour was left until the taxi pickup to the airport. Whilst the students from LMA tidied up the room, we packed our suitcases, ate lunch and prepared for the flight. The way back home was without any problems and we already started evaluating the feedback and writing the seminar report in the plane.
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Seminar "Notfallmedizin" 2017
Our group, 3 members of FDN and a doctor, took a flight at 6:50 am from Düsseldorf Airport to Vienna. As we arrived in Vienna we used the transfer time to have a look at the presentations, coordinate the timetable with the doctor and make some fine adjustments together. Also, we worked out some focus themes, which we saw as very important for future doctors to master.
At round about 3 pm we arrived at Tirana airport. We took a taxi to a certain point where we would meet our Albanian counterpart. They brought us to the hotel where we had a short meeting. In this meeting, which can be seen as an informal talk, was revealed that we had some serious communication problems. During this meeting we collected the following information. That we would have to skip Sunday’s program because of an early flight back to Germany, while the Albanians expected a seminar on this day. As an alternative we planned to start the seminar on Thursday but the Albanians did not get that right. We found out that the seminar would begin on Friday at 1 pm. The number of participants would be 60 whereas we expected that there would be maximum 50. Other information we received that day was that the students recently attended a 10-day seminar about emergency medicine, while we thought the topic would be new to them.
There was no chance to start the seminar on Thursday because there was no room blocked for our seminar in the university on Thursday and no way to reach all the participants. Since we had no seminar, we used the day to deepen the relations between FDN and our Albanian counterpart. They showed us a part of their capital, culture and food. We let the evening come to an end together with the tradition, to sit by the local lake and drink a beer. By this time we were 23 hours on our feet. We set the time for breakfast and a discussion about how to adjust the seminar at 9 am and fell exhausted in bed.
As consequence of the problems described in the report, we need to make a precise checklist affecting the material needed to give a competent seminar but also affecting the most import parameters of the seminar and communication.
All in all, our goal should be to standardize the emergency-medicine-seminar.
In the morning our team met up for breakfast where while fuelling up with energy for the day, we went through the day program once again and discussed who will be in charge for which station. Due to the big number of participants we decided that our experienced Albanian co-tutors would be in charge for certain stations as well. After this we went to the University where the students were ready to get started. The first part of the seminar consisted of an introduction to emergency medicine and case studies. The doctor held a presentation in which he animated to students to participate and answer questions. He emphasized the importance of communication and team work in emergency medicine. At first the participants were shy but after a short time they answered his questions more naturally. The subjects handled in the presentation where the ABCDE-scheme and how to perform an intravenous access and draw blood form it. After the theoretical part the student put their hands on the practice. In groups of seven, they moved from station to station. The ABCDE-scheme worked well and at the end of the exercise the students followed the algorithm patiently. For most students securing an intravenous access and drawing blood was probably the most anticipated and exciting part of the day. Many participants were insecure and scared of making mistakes and failing. The doctor helped every student who felt unsure about whether he or she was doing it right so that in the end everybody was successful. Afterwards we did a short recap of the day and the participants gave us a very positive feedback. Everybody was looking forward to the next day. Then the students went back home and we had a short break in our hotel before our Albanian friends came to pick us up for dinner. Going out to dinner and tasting traditional food with our Albanian counterpart is a tradition that takes place on every seminar of FDN. The atmosphere was nice and we had very good and productive conversations. After a having a good time together we made our way back to the hotel and called it a night.
We got up early in the morning to have breakfast and do some last work for preparing the seminar. We walked to the University to start the seminar at 9 a.m. The topics for today were reanimation and intubation. We started with the lectures for both topics to have the whole afternoon for practicing.
As already mentioned we forgot to bring our laryngoscope to Albania, which is necessary for training the intubation. The Albanian students were able to borrow one from the dean of the medical faculty. We were really happy to have one but when we tried it the light was not working. During the lectures of the doctor we were hard working on fixing the laryngoscope to enable the participants of the seminar to train the intubation. We discovered that the problem was inside the handle. We went to a little shop and bought some batteries, tape and power cable. We constructed a new energy source by this and connected it to the spatula. We were really happy to see that this improvised laryngoscope worked out.
After the lectures we had lunch break. We used the free time to prepare the rooms for the practice stations. There was a station for bag-mask ventilation, for intubation, reanimation, reanimation of children and stable side position. The participants of our seminar were really in to practice intubation because otherwise they haven´t the chance to practice it. We practiced until 6 pm and continued with handing out the certificates and a group photo in front of the University.
After the seminar we cleaned the room as good as possible and took all our equipment back to the hotel. Our Albanian partner students gave us a guided walk through the university hospital of Tirana. After that we said goodbye to the Albanian students and went back to the hotel. We had a little diner and went to bed.
After a very short night we woke up on sunday at 1.15 am to start our trip back to Düsseldorf, Germany.
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Seminar "Innere Medizin" 2017
Nachdem wir über eine Stunde am Flughafen Check-in gewartet hatten, ging es mit einer der letzten Airberlin-Maschinen über Wien nach Tirana. Dort kamen wir am 26.10.2017 bei strahlendem Sonnenschein und 22 Grad an. Wir fuhren mit dem Taxi zu unserem beliebten Hostel von Koos und Dinie und wurden wie immer herzlich empfangen. Nach einer ersten Erkundungstour für unsere erstmals Mitgereisten, trafen wir uns mit drei der albanischen Tutoren in unserer Unterkunft. Hier besprachen wir organisatorische sowie inhaltliche Themen für das kommende Wochenende. Im Anschluss gingen wir in der Stadt noch etwas essen und fielen dann sehr müde ins Bett.
Dieser Tag ging für uns mit einem entspannten Frühstück los. Es folgten Vorbereitungen für das Seminar. Unsere Ärztin Malin Wörster überarbeitete noch die Präsentationen und wir überlegten uns spannende Fälle für den OSCE am Sonntag und entwarfen Checklisten. Um 14 Uhr startete dann der erste Seminartag mit den Themen Schilddrüse, lymphatisches und arterielles System. Leider wurden zu dem Seminar mehr Leute zugelassen als ursprünglich geplant und zusätzlich tauchten noch unangemeldete Studenten auf, sodass wir am ersten Tag 75 Teilnehmer hatten. Dies war durch einen Mangel an Tutoren und zu wenig Platz eine Herausforderung. Abends trafen wir uns noch mit den albanischen Tutoren von LMA und gingen etwas essen.
Nach dem wie immer leckeren Frühstück bei Koos und Dinie begann der Seminartag um 9 Uhr. Am Vormittag behandelten wir die Untersuchung der Lunge und des Herzens. Hierbei zeigte die Ärztin erstmals auch Echokardiographien und spielte Audiodateien von Herz- und Lungengeräuschen ab. Nach einer einstündigen Mittagspause im Studentencafe Medicus führten wir nach dem theoretischen Teil Abdomenuntersuchungen durch. Anschließend hatten die Studierenden die Möglichkeit am Venenpunktionskurs teilzunehmen. Wir führten ihn nach dem Motto „Wer stechen möchte, muss sich auch stechen lassen!“ aus, was sehr erfolgreich war. Am Abend gingen wir mit den albanischen Tutoren in ein italienisch-albanisches Restaurant, in dem es unglaublich gutes Essen gab!
Nach einer Stunde mehr Schlaf durch die Zeitumstellung machten wir uns auf dem Weg zur Universität für den OSCE. Wir hatten uns für 4 Stationen entschieden (Abdomen mit Schwerpunkt Leber, Herz, Lunge und Schilddrüse) und hatten durch die 2 Räume, die uns zur Verfügung standen, die Möglichkeit doppelt so viele Studierende gleichzeitig zu prüfen, da es uns vier deutsche Studentinnen und 4 albanische Tutoren gab, die die Stationen besetzen konnten. Anders hätten wir die große Menge an Studierenden auch zeitlich nicht untergebracht. Nach dem OSCE gab es noch ein kleines Feedback und Abschlussworte unserer Ärztin Malin Wörster und anschließend fand die Verteilung der Zertifikate statt. Nach dem Gruppenfoto warteten wir leider vergeblich auf das bestellte Taxi und mussten dann spontan doch selbst Taxis suchen. Wir kamen pünktlich am Flughafen Tirana an, starteten mit etwas Verspätung aufgrund eines Sturms in Wien in Richtung Deutschland und landeten ein paar Stunden später im kalten Düsseldorf.
Wir hatten ein tolles, aber auch anstrengendes Wochenende und hoffen, dass es den albanischen Teilnehmern genauso viel Spaß gemacht hat wie uns.
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