[Quality assurance in the teaching of medical students illustrated by the example of spa therapy for rheumatic diseases].

Background: The currently employed methods for quality assurance in student education are frequently considered as being inadequate. In the present study the request to plan a budget for the treatment of patients with ankylosing spondylitis is presented as an additional method to assess the influence of a teaching course on the student's attitude towards certain interventions. How would medical students distribute financial resources for the treatment of patients with ankylosing spondylitis? Does a course 'Excursion to a Spa' lead to changes in budgeting by the student?

Material and methods: Before and after a 4-day excursion to Bad Gastein (health resort primarily for patients with rheumatic diseases) to become better acquainted with the local treatment modalities medical students in semester 8.4 +/- 3.8 (5th year in medical school) were asked how they would distribute a fixed sum of EUR 5,000.- (= 100%) for a prospective period of 5 years over 9 given forms of treatment in a patient with ankylosing spondylitis in order to provide optimal improvement of the disease and quality of life.

Results: Before the excursion the students distributed the budget as follows: drug therapy 15%, spa therapy 17%, physical therapy 14%, exercise therapy 19%, massage therapy 11%, unconventional therapies 5%, psychological therapy 7%, changes in the household environment 8%, private pleasure 4%. After the excursion to the spa the medical students assigned more financial means on spa therapy (p = 0.024, Wilcoxon test) and unconventional therapies (p = 0.015).

Conclusion: Creating a budget for a defined disease appears to be a useful instrument for assessing the influence of a teaching course on medical students' attitude towards certain interventions and for detecting imbalances in the presentation of therapy procedures or discrepancies between the presentation and the aims of teaching.