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BMC Med Educ. 2019 Jan 7;19(1):9. doi: 10.1186/s12909-018-1438-1.

Assessing core competences of medical students with a test for flight school applicants.

Author information

III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
III. Medizinische Klinik, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, D-20246, Hamburg, Germany.
German Aerospace Center (DLR), Hamburg, Germany.
III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Medical Faculty, Deanery, University of Augsburg, Augsburg, Germany.
TUM Medical Education Center, School of Medicine, Technical University of Munich, Munich, Germany.



Important competences of physicians regarding patient safety include communication, leadership, stress resistance, adherence to procedures, awareness, and teamwork. Similarly, while selected, prospective flight school applicants are tested for the same set of skills. The aim of our study was to assess these core competences in advanced undergraduate medical students from different medical schools.


In 2017, 67 medical students (year 5 and 6) from the universities of Hamburg, Oldenburg, and TU Munich, Germany, participated in the verified Group Assessment Performance (GAP)-Test at the German Aerospace Center (DLR) in Hamburg. All participants were rated by DLR assessment observers with a set of empirically derived behavioural checklists. This lists consisted of 6-point rating scales (1: very low occurrence to 6: very high occurrence) and included the competences leadership, teamwork, stress resistance, communication, awareness, and adherence to procedures. Medical students' scores were compared with the results of 117 admitted flight school applicants.


Medical students showed significantly higher scores than admitted flight school applicants for adherence to procedures (p < .001, d = .63) and communication (p < .01, d = .62). They reached significantly lower ratings for teamwork (p < .001, d = .77), stress resistance (p < 0.001, d = .70), and awareness (p < .001, d = 1.31). Students in semester 10 showed significantly (p < .02, d = .58) higher scores in domain awareness compared to the final year students. On average, flight school entrance level was not reached by either group for this domain.


Advanced medical students' low results for awareness are alarming as awareness is essential and integrative for clinical reasoning and patient safety. Further studies should elucidate and discuss whether awareness needs to be included in medical student selection or integrated into the curriculum in training units.


Assessment; Competences; Flight school applicants; Professionalism; Undergraduate medical education

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