Distance education offers flexible learning opportunities in terms of time, place and learning speed to teachers and students through internet technologies. However, the learning opportunities provided in distance education environments require students to act more autonomously and take more responsibility for regulating their learning processes to achieve their learning goals. For this reason, it is crucial to reveal the relationships between flexibility, self-regulated effort and satisfaction factors to provide efficient and effective learning environments in distance education. Accordingly, within the scope of this study, it is aimed to investigate university students’ perceptions of flexibility, self-regulated effort and satisfaction with the distance education process, and their views on distance education. Survey research was used as the research method in the study. The study sample consisted of 1760 university students studying at 28 different universities. Data were analysed using t-test, ANOVA, and regression methods. As a result of the study, male students were more satisfied with distance education than female students, and education faculty students had the highest level of satisfaction. In addition, self-regulated effort and flexibility variables were significant factors affecting students’ satisfaction towards distance education. Furthermore, the advantages and problems of distance education and suggestions for future distance learning environments were presented in the light of students views. Finally, the study’s implications and various recommendations for practitioners and researchers were discussed in detail. Distance education is a method that allows students and teachers to come together and receive education through internet technologies, regardless of time and place, and is widely used today. This is especially true for higher education institutions, where the number of online courses and students registering for them has jumped  regarding distance education?As distance education becomes more and more widespread, this raises various questions about how to design effective distance education environments for students. Thus, it is crucial to reveal the relationships between flexibility, self-regulated effort, and satisfaction to create efficient and effective learning environments in distance education. In this context, the distance education process carried out during the COVID-19 pandemic has been examined with the following research questions. In this sense, the research questions are as follows:The study was designed as survey research. Survey research is based on taking the opinions of a large group of people about a particular topic or issue . With the onset of the Covid-19 epidemic, first-term emergency remote teaching applications were carried out in universities in Turkey, and unplanned distance education was generally offered. In the next semester, when the data of this study were collected, a more planned distance education period was provided to the students since it was determined in advance that the courses would be given by distance education. In this context, instructors were given seminars on distance education, and the technical infrastructure of universities was strengthened, enabling instructors to prepare for distance lessons at least three months ago. The courses were carried out through asynchronous materials presented through a specific learning management system  and synchronous course sessions held weekly by the instructors. Ethics committee approval of the study was obtained from the university where the researchers were affiliated. The students were subjected to the survey at the end of the fall semester of the 2020–2021 academic year. One thousand eight hundred twenty-five undergraduate students responded to the questionnaire presented within the scope of the research, and the data of 1760 undergraduate students were accepted as valid and complete. One thousand seven hundred sixty undergraduate students  studying in 17 faculties of 28 universities, including 27 universities in different regions of Turkey and one university in the TRNC participated in the study. The students had an average of 20.97 years (SD = 3.23). In the study, the faculties were examined under four categories: Education, Social Sciences, Medical and Health Sciences, and Engineering and Natural Sciences. The students participating in the study were mostly from education faculties , and these students were pre-service teachers in different departments. The students in the discipline of Medical and Health Sciences  were receiving education at Medical, Dentistry, and Nursing faculties and Vocational School of Health Services.On the other hand, the students in the Social Sciences discipline n = 391, 22.2%) received education in Literacy, History, Religion, Law, Tourism, and Business departments. Additionally, the students in Engineering and Natural Sciences  were studying at engineering faculties and natural sciences departments such as biology, chemistry, and physics. A great majority of the participants were first-year students , followed by sophomore, senior, and junior students, respectively. Table , 22.2% rAn online survey prepared by the researchers was used as a data collection tool in the study. Before completing the survey, the participants were asked to read and approve a consent form to participate in the study voluntarily. The first part of the survey included questions about the demographic characteristics of the participants. Its second part had 18 items in the 5-point Likert type (1: I strongly disagree…5: I strongly agree) to determine the participants’ perceived flexibility, self-regulated effort, and satisfaction. It is rated by taking the arithmetic average of the items in each factor, and the average arithmetic ranges are as follows; 1.00–1.80; “Strongly disagree”, 1.81–2.60; “Disagree”, 2.61–3.40; “Neutral”, 3.41–4.20; “Agree”, and 4.21–5.00; “Strongly agree”. Bergamin et. al.  developeThe related factors accounted for 56.456% of the total variance. It was determined that the composite reliability coefficient for the overall scale was 0.91 and the Cronbach’s alpha internal consistency coefficient was 0.83. Lange and Costley’s  study usQuantitative data obtained from the study were analysed with descriptive and predictive methods in line with the research questions. First, the skewness and kurtosis values were utilised to determine whether they were normally distributed. Tabachnick and Fidell  state thThe qualitative data obtained at the beginning of the analysis process was organised by one of the researchers in line with the purpose of the research and divided into conceptually meaningful codes. Then, by creating a code list, the relationship of each data with the relevant code was checked. After this stage, all codings’ common and similar features were gathered under themes. Finally, the themes created were reconsidered with the work of three researchers, discussed extensively, and the themes on which a common view was agreed were determined.Table Table Table 2 = 0.004. Tamhane T2 post hoc test for multiple comparisons found that the mean value of FTM was significantly different between Social and Education (p < 0.05). There was a statistically significant difference in FTC, Welch’s F  = 5.814, p < 0.05, est. ω2 = 0.008. FTC was significantly different between Health and Education (p < 0.05). There was a statistically significant difference in FC, Welch’s F  = 12.808, p < 0.05, est. ω2 = 0.020. FC was significantly different between Education and the other three disciplines (p < 0.05). There was a statistically significant difference in SRE, Welch’s F  = 9.439, p < 0.05, est. ω2 = 0.014. SRE was significantly different between Social and Education, and Health and Education (p < 0.05). Lastly, there was a statistically significant difference in SAT, Welch’s F  = 4.570, p < 0.05, est. ω2 = 0.006. SAT was significantly different between Social and Education, and Social and Natural & Engineering. However, the estimated omega squared values showed that the total variances in the dependent variables were quite low. The post hoc comparisons are presented in Table A Welch's ANOVA revealed a statistically significant difference in FTM between at least two groups, Welch’s F 3, 1756) = 3.617, p < 0.05, est. ω = 3.617,Table Table Students’ views on the distance education process examined and created advantages, problems, and suggestions of online learning categories. Figure “I do not think that the courses I took during the distance education process were at all productive. Of course, while it would be wrong of me to say that I didn’t learn anything at all, it doesn’t offer the interaction that face-to-face education does.“ “I want to go back to formal education as soon and as safely as possible. I can’t otherwise improve my skills required by my profession. I feel that my friends would agree with me.” “The pandemic rendered distance education mandatory. Model-wise, it has some highly successful advantages in both motivation and learning. That said, they should offer some courses both face-to-face as well as online.” “It has as many pros as it does cons. If they were to implement a hybrid system combining the best of both distance and face-to-face education, it could lead to outstanding results.” “I’m majoring in the health department. Therefore, I don’t find distance education to be sufficient enough – especially since I wasn’t able to do any of the practices.” Based on Fig. “More synchronous and asynchronous resources should be provided. Our instructors should make the videos—as well as their asynchronous resources–.” “They should send us videos of the applied classes that we otherwise didn’t have the chance to take part in.” “Instructors who work with disabled students should be more careful and inclusive when teaching their courses. They should offer them a variety of materials that cater to their needs—that, to me, is very important.” “Trying to reach/contact instructors—whatever the matter may be—is challenging. Even if they see your messages on OBS, they don’t reply. I’ve had so many problems with this.” “Distance education isn’t sufficient enough when it comes to my learning. I can’t focus—especially when I’m at home, I can’t listen to anything with my family members around.” “I had a lot of problems with distance education. I live in a rural area—I wasn’t able to take part in most of my courses/classes due to (lack of) internet access.” “Only the copy groups successfully made it through distance education. Beyond that, students who couldn’t copy anything failed due to exams, which were (too) result-focused. All teachers were concerned about was preventing cheating. Their goal should have been to create exams that were fairer.” It was observed that the student’s views on the problems they experienced in the online learning process mostly focused on the inadequacy of the variety of materials offered in distance education. Also, they frequently mentioned the difficulties they encountered in accessing the courses, the lack of reliability in the exams, and the problems of focusing/adaptation in the courses. The problems such as the lack of communication between the students and the instructor and other students, the ineffectiveness of the applied courses, and the intensive homework of the instructors in the process were mostly reported. The problems the students expressed the least included the low digital competencies of the instructors and the failure to enter the exam grades on time. Some of the problems experienced by the students in line with their online learning experiences are as follows;“As someone who both works and studies at the same time, this opportunity greatly allowed me to use my time better.” “Distance education’s biggest pro was that it allowed me to watch my classes/courses when I wanted and for as long as I wanted. I was also able to choose at what time I did so according to when I was alert.” “I realised that I could continue my education without having to be bound to  spaces only. I feel that I’ll be able to make good use of that in my teaching career. It gave our teachers the chance to enrich their classes with diverse materials—which, in turn, allowed us to recognise our learning path out and create a suitable working plan around that.” “The videos our instructors made for (some of) our applied classes (which otherwise they would have had taught live/in-person) were great. They allowed me to understand processes in a more detailed fashion, and I could re-watch them.” The students’ views about the advantages offered by online learning were mostly observed on recording and re-watching the courses. Moreover, they frequently stated that online learning provided time/space flexibility and material diversity. The least expressed advantage by the students was the decrease in expenditures and expenses. Some of the students’ views on the advantages offered by online learning are as follows;The data for this study were collected at the end of the year when the COVID-19 pandemic emerged. When the data was collected, the courses in all universities were compulsory in distance education, asynchronous materials in the learning management system and synchronous live lessons. Within the scope of the present study, flexibility, self-regulated effort, and satisfaction in the online learning process of university students and their views on the distance education process were investigated.The study found that the students’ flexibility of time management and flexibility of content levels were quite high. The students could structure their learning processes whenever, wherever, and for as long as they wanted in the online learning process. In terms of content flexibility, the students became a part of the learning process with their views, could rank the subjects according to their importance, choose where they would study, and learn the subjects grasping their interest. These results can be interpreted as the fact that the students adopted and applied the advantages of online learning, such as flexibility, time and place independence, repeatability of lessons and resources (Chow & Shi, It was determined that the self-regulated efforts of the students in the online learning process were moderate. This result suggested that the students sometimes discontinued the work they planned to do without completing it due to losing focus; they gave up when the course was not understood and studied only on its easily understandable parts. In addition, they did not complete the subject when the instructional materials were complicated. However, based on this result, it can be interpreted that the online learning process that students experienced for the first time contributed to their self-regulation, albeit relatively. Students should have self-regulated learning skills to attend effectively learning activities in a flexible learning environment (Bergamin et al., This study found that students’ satisfaction with the distance education process was at a low level. However, in the literature, it has been stated that when various factors such as course resources, interaction, instructor satisfaction and evaluation are effectively structured in advance in distance education, students can mostly be satisfied with distance education (Baturay & Yükseltürk, It was determined that male students’ flexibility, self-regulated effort, and satisfaction levels were higher than their female counterparts. There was a significant difference in flexibility of teacher contact and satisfaction, but the effect values were low. The literature includes results reporting that satisfaction does not change according to gender, and even though there is a significant difference, the effect size is small (Er Turkuresin, There were moderate correlations between flexibility, self-regulated effort, and satisfaction. This result can be interpreted as the fact that these variables were crucial in structuring the effective online learning process. Satisfaction is one of the critical factors in determining the effectiveness of the online education process and is intertwined with many other factors (Hamdan et al., In this study, the university students’ flexibility, self-regulated effort, and satisfaction levels in the distance education process were examined in detail, and important results were revealed. The data were collected from a high number of students in the study, which increased the generalizability of the results. However, limitations of the study are that the study was conducted in the context of universities in Turkey and TRNC, using a convenience sampling method, by collecting data with self-reported data. Another limitation of this study is the possibility that the crisis environment created by the pandemic may affect the findings since the data were collected during the distance education process carried out during the COVID-19 pandemic period. Based on the study results, it can be said that universities should develop strategies based on disciplines to increase the satisfaction of students when they have to take the necessary courses due to the pandemic process and offer education entirely online. Additional support services can be provided to the instructors so that the student–teacher interaction is not interrupted during the distance education process. In-service training can be organised to improve the distance education competencies of instructors. For increasing students’ self-regulation skills, students can be supported in this process by organising specific activities in classes starting from primary school. A hybrid approach can be adopted, especially in applied courses. Universities should go into a restructuring process according to their conjunctures and establish sustainable digital transformation strategies to increase the effectiveness of online education. Path analysis studies can be carried out by examining other variables affecting distance education satisfaction in future studies. In addition, the students’ self-regulated learning skills can be modelled by examining the log data on their teaching systems.


Tuberculosis is still a challenging disease, infecting around a third of the world’s population. As comorbidity with mental disorder is common, it is relevant to associate them at a diagnostic, therapeutic and prognostic level.We present a clinical case describing a patient with psychosis, further diagnosed with tuberculosis during psychiatric treatment. Moreover, we present a summarized revision of the state of the art.Revision of the state of the art, drawing from PubMed and using the keywords “mental health”, “psychosis” and “tuberculosis”, in the last 10 years.Male, 61 years old, heavy smoker and alcohol drinker. Admitted for allegedly feeling “worms” in his body. After medical examination, a weight loss of 13 kg in five months and symptoms compatible with tenesmus stood out. Following diagnostic tests, the patient was diagnosed with Ekbom Syndrome and Ganglionar Tuberculosis; he was then medicated with the adequate antipsychotic and tuberculostatic agents, which resulted in overall clinical improvement.This case illustrates the relationship between tuberculosis and mental disorders, in a patient with a low literacy level and a precarious socioeconomic background, known risk factors for mental disorder in patients with tuberculosis and are often associated with poor therapeutic adherence. Although proper treatment of the mental disorder is key to reducing the risk of tuberculostatic dropout, the stigma of mental disorder and tuberculosis decreases the probability of these patients seeking proper treatment. Thus, we alert the medical community for the possibility of psychiatric comorbidity in patients with diagnosed tuberculosis – and vice-versa –, allowing for an early intervention,No significant relationships.


The Covid-19 pandemic put forth a new kind of affective exhaustion. Being forced to stay at home, diminish social interactions and reduce the scale of their everyday mobility, many people experienced boredom, sluggishness, and existential immobility. While state-imposed pandemic policies changed rapidly, everyday life remained strangely unmoving. A sense of being stuck unfurled―as if not only social life, but time itself had come to a halt. At the same time, there was a latent sense of tension and increased aggressiveness which became manifest not only in protests and riots, but also in the texture of everyday life. In this contribution, we argue that both of these states―the feeling of being stuck, and the feeling that this putative tranquility is nothing but the calm before a storm―can be conceptualized as affective stasis. Through a rearticulation of the ancient concept of stasis, we show that these two at first glance incongruous affective conditions are intricately entangled. In Ancient Greek, the term stasis meant “stand, standing, stance”. Being used in a wide variety of contexts―politics, navigation, sports, rhetoric, medicine, and others―stasis took on different meanings which can be semantically organized around two opposite poles: one is the total absence of motion, and the other is an event of radical and often violent social and political change. Drawing on affect theory, phenomenology, and ancient Greek semantics, we propose affective stasis as a novel conceptual framework for political phenomenology. The Covid-19 pandemic put forth a strange new kind of affective exhaustion. Lockdowns and strict contact restrictions were something most citizens in Central and Western Europe had never experienced before. Not surprisingly, the restrictions affected social classes in unequal ways: Whereas most blue-collar workers had no choice but to leave home if they did not want to lose their jobs, white collar work was largely relocated to the domestic sphere. Being forced to stay inside, diminish social interactions and drastically reduce the scope of their everyday mobility, those who worked from home tended to experience a blurry disarray of boredom, sluggishness and existential strain. While state-imposed pandemic policies changed frequently, everyday life remained strangely unmoving. A sense of being stuck unfurled―as if not only social life, but time itself had come to a halt. At the same time, however, there was also a latent sense of tension and growing tetchiness that seemed to creep through the social fabric as a whole. Domestic violence rose to a new level . Already from the first lines, it becomes clear that the “blah” Grant refers to is not an individual or even idiosyncratic experience, but rather an affective condition widely shared:At first, I didn’t recognize the symptoms that we all had in common. Friends mentioned that they were having trouble concentrating. Colleagues reported that even with vaccines on the horizon, they weren’t excited about 2021. A family member was staying up late to watch “National Treasure” again even though she knows the movie by heart. And instead of bouncing out of bed at 6 a.m., I was lying there until 7, playing Words with Friends.It wasn’t burnout — we still had energy. It wasn’t depression — we didn’t feel hopeless. We just felt somewhat joyless and aimless. It turns out there’s a name for that: languishing. Not surprisingly, this situation incited a search for new words that would allow to pin down this blurred experience. One linguistic label was proposed by organizational psychologist Adam Grant. In the spring of 2021, right in the middle of the “third wave” of the pandemic, he published an article in the to weaken, wither, or become faint; […] [t]o live in an oppressive or dispiriting place, situation, or condition. […] To fail to make progress; to be unsuccessful. […] To droop in spirits; to pine or brood […]. […] To waste away with longing for; to yearn (to do something). […] Of an activity or emotion: to grow slack, lose vigour or intensity. “Languishing” was not created during the pandemic, although its excellent fit could let one presume as much. It is an old word whose use in everyday language had of late gone out of fashion. According to the Oxford English Dictionary, languishing meansNew York Times article, Grant himself describes languishing as “a sense of stagnation and emptiness. It feels as if you’re muddling through your days, looking at your life through a foggy windshield.” According to Grant, this “dwindling of drive” often comes unnoticed; it is not a condition that suddenly befalls you, but one you slowly slide into. If grief was the dominant emotion of 2020, then languishing, Grant concludes, “might be the dominant emotion of 2021”  might explode. Sometimes, it felt as if there was nothing but a thin membrane between exhaustion and explosion, total ossification and incalculable upheaval. Grandmaster Flash’s 1982 message―“Don’t push me / Coz I’m close to the edge / I’m trying not to lose my head” . The notion of languishing captures the feeling of being stuck, but it misses its tetchy flipside. It neither explains the emotional edginess nor the latent affects that unaware labor was supposed to deflect. Another concept is needed which provides a more comprehensive understanding of the affective climate during the pandemic and how its two sides relate to one another. We believe that affective stasis is more apt to meet this demand.supposed to be constantly moving. Depending on the type of bodily fluid, medicine distinguishes between different forms of stasis, such as haemostasis, or lymphatic stasis. Such congestions can be dangerous and pathogenic. Prolonged constipation, for example, can result in a gradual self-poisoning of the body. Outside the relatively well-delineated domain of medicine, however, the word stasis is rarely used in our days.Unlike other ancient Greek words  the term stasis never really made it into the everyday lexicon of modern-day English. You will hardly hear it in ordinary conversations or read it in the newspapers. The only domain in which the word has been able to gain a firm foothold in contemporary English is the one of medicine. In medical terminology, stasis basically refers to a “stagnation or stoppage of the circulation of any of the fluids of the body”  which normally  are in motion. Not every form of stagnation or immobility, thus, is to be understood as stasis, but only the immobility of something that is στάσις […] a standing, the posture of standing. 2. a position, post, station: a point of the compass […] 3. the state or condition in which a person is, Lat. status. II. a party, company: esp. a party formed for political purposes, a faction, party. 2. sedition, faction.In ancient Greece, the situation was different. Depending on the context, stasis (στάσις)―the plural being staseis (στάσεις)―could take on a wide array of meanings, which, again depending on the context, branched out into an increasingly finely differentiated semantic field. To get a first impression of this field, let us have a look at one of the standard school lexicons of ancient Greek, the so-called “Little Liddell” , but also for a form of immobility which is genuinely affective. Particularly wide-ranging are the contexts in which the word was used to denote “the place in which one stands or should stand, position, posture, station”: In navigation stasis could mean the “position in relation to the compass”, in rhetoric the “position, opinion of a philosopher”, in ancient sports it could refer to “a boxer’s position”, and in the realm of law to the “position taken up by a litigant”. Outside these specific contexts, stasis could also generally mean the “state of affairs” or the “position, state, condition of a person […]; esp. of moral, social, political position”. Furthermore, stasis could also mean “party, company, band”, especially a “party formed for seditious purposes”, “faction, sedition, discord”, and “division, dissent” . Stasis, thus, is always about situatedness in a comprehensive sense, not only understood as a spatial position, but also as social, political, moral, and affective one. Conceptualizing stasis as situatedness involves thinking through the ways in which position and posture, standing, status and stance, are interdependent. It involves an “ecological” understanding of the relation between bodies and spaces. The ancient notion of stasis seems to indicate that the potentialities of a body―its agency and possibilities of being―are pre-structured by the position it occupies in a specific environment and its relation to other bodies. This implies de-potentiating the modern notion of agency as a capacity that all people can freely make use of in equal ways. The ancient understanding of stasis rather suggests that your agential and existential possibilities―what you can do and be―strongly depends on where and how you are standing. Your stasis suggests certain (re)actions and precludes certain others.Given how broad this semantic field is, it is difficult to make sense of it at first. What holds all these different meanings of stasis together? Is there something like a common denominator? The direction of an answer is pointed out by the consideration that stasis at the same time is both a To give some examples: In boxing, a southpaw is more likely to attack with her right arm; that means that in her basic stance or fighting position certain moves are more preordained than others. The same holds true for a social position, a philosophical opinion, or the position taken up by a litigant in a legal dispute: In certain spaces, you can often already tell from the bodily posture of a person if she is rich or poor. A Platonist philosopher will hardly produce materialistic arguments. And a defense lawyer who represents the standpoint that her client is innocent, will unlikely pursue the strategy of claiming diminished culpability. Where you stand and how you are standing influences which moves you will make and which not. This comprehensive idea of situatedness is well-captured in the English translation of stasis as “stand, standing, stance” Kennedy, , 98. In political one. The political sphere―that is, the material and imaginary space of the polis―was the realm in which the notion of stasis became particularly relevant  stance, (2) standpoint, (3) group of people with the same standpoint, (4) in the plural: two or more groups with opposing standpoints, (5) the split between groups, and (6) civil war. , taking a stand, hardening of the fronts, revolt and civil strife within a community composed of many individual bodies (politics). The movement from one pole to the other does not take place smoothly though, in a gentle glide, but discontinuously with an abrupt jolt. Between immobility and disruption, standstill and upheaval, there is a tipping point, a critical threshold. It marks the point at which things can no longer just go on as they are and the “state of affairs”  abruptly changes. Part of the fascination of the concept of affective stasis is due to the question of this threshold: At which point, prompted by which factors, does an immobilizing, sluggish condition tip over into its intensive, eruptive opposite? Before we attempt to answer this question, it is important that we get clearer on the two contrasting dimensions of affective stasis.Conceptually, affective stasis is clamped between two opposite poles: Both poles come along with specific affective qualities. The general “feel” of the immobility-pole can be described in terms of deprivation: as loss of intensity, vigor or emotional fluency. The immobility-pole is not only connected to feelings of boredom and stagnation but can also take the form of idle complacency or blatant frustration. When tending to this pole, affective stasis acts passivating and stiffening. In this regard, affective stasis resembles the condition conceptualized by Frantz Fanon as “affective ankylosis” , 122. LiThe affective qualities connected to the other side, the pole of disruption, are more difficult to grasp since the feelings connected to it for the most part remain latent and vague. Initially, much like an approaching storm, the coming disruption can only be presumed to occur, based on indirect hints such as subtle changes in the affective atmosphere. One feels that something is “in the air” without being able to precisely pin it down. It is not the disruptive event itself, but rather that which comes right before it: a sudden tension, a nervous twitch in the eye, an electric crackle, a fist closing. Even if this affective state is experienced as intensity-increasing, it still has something to do with a lack of affective plasticity: The polarisation which precedes the disruptive event―no matter whether this refers to civil wars in ancient poleis or to violent clashes between anti-vaxxers and police forces nowadays―results from an antagonistic social constellation or political impasse in which neither side is willing to move. The obduracy characteristic of enmity and hatred also points to a lack of affective plasticity. Although immobility and disruption feel differently, they are equally induced by a lack of affective plasticity. Phenomenologically, this state can be described in terms of a deadlocked tension, a charged condition perpetually at the verge of an outburst, but usually stopping just short of an actual eruption (of vigorously expressed anger or even manifest violence). The difference between the two poles can also be articulated in terms of temporality. Whereas the immobility-pole is related to slowdown and stagnation, the disruption-pole is related to a sense of precipitous (and often catastrophic) acceleration. Affective stasis, thus, encompasses both: the dull routine in which it feels like nothing is changing at all, and a tensed anticipation of a sudden disruption in which all things seem about to be overthrown.6It is precisely this polarity which makes the concept well-suited for capturing the general affective climate during the pandemic. While it is true that the virus compelled many to unlearn old habits, it is also true that the new routines and behaviors we developed instead very soon became stifling and sour. Even for the more privileged, domestic space under lockdown turned into a space of confinement. Being confined to the same rooms with the same individuals, following the same routines day after day, bereft of new experiences and contingent social encounters  The concept of affective stasis helps us to carve out the link between the feeling of being stuck and its tetchy affective backside. At the same time, it directs analytical attention towards the tipping point at which an enduring state of affective immobility resulting from an externally imposed impasse turns into an event of disruptive, tension-riddled change. While it is true that lockdowns and other state-imposed restrictions aimed at controlling social movement and interaction, it is also true that this form of control was rather means than purpose. In other words, political authorities hazarded the consequences that gave rise to affective stasis, but it would be misguided to assume that the restrictive measures were intentionally designed to produce an affective climate of sloth and inertia. But there are other instances where the production of affective stasis is a crucial part of governmental technology rather than an unwanted side effect. Studies on migrant affects and institutions like refugee camps, prisons and detention centers, for example, could benefit from integrating the concept of affective stasis into their analytical toolbox. In fact, we do believe that emotion research in general deals with a range of topics whose affective dynamics evolve around a polarity comparable to the one we described as characteristic for affective stasis.The Gift (1966). We deem it promising to follow this line further, not just for bringing out the peculiar affective texture of life during the pandemic, but also for enriching the overall understanding of the social dimension of affectivity. Theories of gift exchange highlight forms of “enhanced” sociality where social relatedness expands well beyond the experiential orientation of interacting agents to include a rich repertoire of gestures, bodily styles and orientations, greeting practices and certainly also material exchange in various registers. The social distancing measures implemented during the pandemic have considerably curbed much of this richer sociality; we think that the resulting condition of severely stunted affective vitality is indicative of the significance of this oft-neglected dimension.(2) Central to affective stasis is a lack of affective plasticity. During the pandemic crisis the dwindling of affective plasticity was remarkably doubled by a parallel dwindling of social vitality, convivial encounters and festive togetherness. The latter can be conceived of as rich modes of social relationality which belong to the same sphere as the practices of reciprocal exchange Marcel Mauss described in his famous essay (3) Our proposal emphasizes the importance of relating the affective to the political. We have sketched the contours of a framework that circles in on affective conditions that supervene not only on features internal to agents or to interacting individuals, but encompass parts of the wider socio-political context in which affective experiences are situated. Affective stasis is more than a modality of felt experience, and, as the ancient Greek semantics of the term reminds us, it is connected to aspects of political constellations: for instance, to a situation of standoff between different factions in society whose respective standpoints have suddenly or gradually hardened into an antagonistic rift. Affective stasis in the political realm concerns situations in which a dangerous tension builds up between competing camps to a point where an open conflict seems ready to erupt at any moment. Therefore, we propose affective stasis as a diagnostic angle geared to political constellations and to the mindsets and affective orientations of those individuals that find themselves positioned in these constellations. This means that deploying this concept can only be productive if it is combined with a detailed analysis of the particular socio-political situation at hand; it requires a lot of detail on the nature of a given conflict, on the contesting factions and the history of the particular community and its various conflicts, alliances and dynamics of social change over time. The combination of a theoretical angle with such a broader diagnostic perspective makes this framework appealing outside the specialist realm of the philosophy of mind and emotion. Accordingly, we consider our proposal to be a contribution to a contemporary political phenomenology.With the preceding analysis, we hope to have kindled broader interest in the notion of affective stasis and to have motivated efforts to further elucidate the notion and apply the associated conceptual perspective to other historical and contemporary constellations. As global crises proliferate, it is important to expand the conceptual repertoire of philosophy towards notions that originate from the human experience of political impasse. Complex affective conditions have to be front and center in such an endeavor.


Hundred years ago, Kurt Lewin published a series of articles in which he vehemently argued against the idea that associations between stimuli and responses motivate behavior. This article reviews his empirical work and theory and the cogency of Lewin’s conclusion according to modern standards. We conclude that Lewin’s criticism of the contiguity principle of associationism is still valid, and is now supported by a broad range of theories on learning, motivation, and action control. Implications for modern dual-system theory and modern theories on motivated action and (instructed) task sets are discussed. Psychologische Forschung , psychologist Kurt Lewin published two articles entitled “The problem of the measurement of will and the basic law of association. I and II,” in which he strongly argued against the view that mental associations energize behavior  will automatically activate the other element (the behavior). This contiguity principle of associationism states that the mere perception of a stimulus can be sufficient to energize the associated behavior via a spread of activation. However, as Lewin has argued, this view is not plausible and, as we will conclude in this review, his skeptical stance is now shared by many influential theories on learning, motivation, and action control.Can mental associations energize behavior? In the first issues of the journal r Lewin, , 1922b. r Lewin, . The comPsychologische Forschung together with Kurt Goldstein and Hans Walter Gruhle in the year 1921. This close relationship likely explains why Psychologische Forschung became his preferred publication outlet until his emigration to USA in the year 1933.Kurt Lewin was an assistant at the Institute of Psychology in Berlin at the time of the publication of his 1922 articles. In 1911, he started a doctorate study at the University of Berlin under the auspices of Carl Stumpf who was the director of the psychological laboratory and a dedicated ‘experimentalist’ Perlina, . Lewin, Zeitschrift für Psychologie a few years earlier  of which 12 were included in the report and a preliminary report (“vorläufige Mitteilung”) which appeared in the journal r Lewin, , 1922b. r Lewin, . Lewin’sr Lewin, . A majorr Lewin, . Furtherron lim fäb nuk) that were presented on a mechanized memory drum. In line with the memory research of his mentor Georg Elias Müller  activity on each syllable. For example, instructions of heterogeneous activities were to generate a rhyming syllable  or to rearrange the letters . Ach assumed that the participant must expend willpower to overcome the previously established reproductive tendency, which should cost time and/or result in systematic errors. This was indeed observed in many experiments . Furthermore, for comparisons, Ach included separate test blocks with a free reproduction task in which the participant could name any syllable, whereas Lewin alternately presented practiced and new (weakly practiced) syllables during the test phase, using a procedure introduced by one of Ach’s students , a different (a heterogeneous), or a neutral (indifferent) task with that syllable. In one study, for example, the participant practiced letter rearrangement and rhyming with separate lists of syllables, intermixed with so-called variable syllables that appeared in both lists with equal frequency. After extensive task practice, the syllables were presented again during the test phase but this time with instructions of the same task or a different task. Lewin hypothesized that, if a reproductive tendency was established by the repetition of a particular task-related activity during the practice phase, then rhyming of previously rhymed syllables should be faster, and rhyming of previously rearranged syllables should be slower in the test phase, compared to rhyming of variable syllables. Results, however, showed no performance differences depending on whether the syllable was practiced before with the same or different tasks. In a summary of this set of studies, he therefore concluded:Lewin’s research focus consequently shifted to a systematic investigation of the activities performed in each phase, and whether practice of a particular task would affect performance in the test phase differently depending on whether he or she had practiced the same  syllables that required from the participant the construction of a new (rhyming) syllable on each syllable presentation. Consequently, he eliminated these syllables from the design and presented only lists of syllables that the participant must either rhyme or rearrange during the practice phase. In the subsequent test phase, participants continued with these tasks in separate blocks, but this time the list also contained a syllable that was previously used for the other task. Results showed that participants responded to these intermixed syllables very slowly, and sometimes even incorrectly with the previously practiced response. This interference effect was observed with a low number of only eight practice trials for each task. Lewin, therefore, concluded that the generation of a reproductive tendency does not depend on the frequency of contiguous presentations but, rather, on the participant’s readiness for reproduction, which is an intentional process.In Part II, he examined conditions that must be met for the generation of a reproductive tendency Lewin, . SpecifiLewin’s research was in line with other criticism of Ach’s combined method that argued for a goal dependency of reproductive tendencies established with this procedure Selz, . FurtherAch  thereforLewin  illustraAccording to Ach’s account, an intense will act should be necessary to overcome the down-pressing habit established via countless repetitions. Lewin, by contrast, hypothesized that the person can execute the instructed action effortless on explicit request, because a new action readiness was formed on the experimenter’s instruction. Lewin’s thought experiment was not realized, but everyday intuition, and controlled laboratory studies using related setups, appear to fit more to Lewin’s prediction. For example, Wickens  trained According to Lewin, however, the person should experience difficulties with opening the new door when her goal is to enter the next room. With this superordinate action goal, the downward push of the door handle is misapplied as a routine activity of entering the next room, even when the person has good knowledge of how this door can be opened. Action errors, such as opening the door in the practiced way, hence are only predicted for situations in which the routine activity is an integral part of another, superordinate goal-directed activity. Importantly, this integration process is triggered by the preparation of a superordinate activity or task—and hence under voluntary control.Lewin discussed several ways how a readiness for action could develop without associative learning. First, a readiness to act could be formed by conscious, or even automated, acts of will. The conscious wilful act is typical for task settings in which participants must follow the instructions of the experimenter; however, it can also occur in the absence of explicit prompts when the person is free to decide on how to solve a problem or task. For example, Lewin speculated that Ach’s memorization instructions for the learning phase actually suggested a reproductive activity to the participant, although this was not explicitly mentioned in the task instruction. Furthermore, an action readiness could be formed by automated acts of will, for instance, when the activity is needed for a superordinate activity. In the door handle example described above, the downward push of the door handle is triggered automatically on the sight of the door handle, because door opening is an integral part of entering the next room. After preparation of the superordinate activity, the subroutine is automatically initiated without additional intervention by the conscious will.Second, an existing action readiness could be transformed to another action readiness or it could be replaced by a better fitting one. Lewin mentioned the rhyming task as an example where the subject started with rhyming and, after some practice, switched to the reproduction of previously rhymed syllables. The readiness to produce a rhyming syllable was transformed to a readiness to reproduce previously generated (rhyming) syllables, presumably because the latter activity was more convenient for the participant.Third, the action readiness could also be latent in the sense of a persisting disposition that was formed by inborn drives and/or educational practices. Lewin discussed as example the person’s readiness to identify an object as familiar, which exists independently of a conscious or automated decisional act. Lewin was aware of the vagueness of the concept, and in his article, he described several criteria for the identification of a latent action readiness Lewin, , p. 99.Action readiness includes a cognitive specification of the appropriate conditions on which the prepared action is released. Lewin referred to these conditions as “Aktivierungsreize” (“activating stimuli”). Examples from Lewin’s own studies are two-syllable words for which the instructed task was rhyming, but basically, every target of a planned response can become an activating stimulus. The concept of activating stimuli resembles Ach’s concept of a “referential idea” (“Bezugsvorstellung”) that specifies the necessary means for reaching a particular goal  as a type of action readiness that could be wilfully instantiated. Furthermore, the instruction of a new task alone is often not sufficient for a change in action readiness, because the existing one must be actively removed or terminated. Lewin did not clarify how this is implemented on the process level; however, the theorizing fits to modern research on task set inertia , that are directed at the satisfaction of a particular need , from so-called habits of execution (“Ausführungsgewohnheit”). Both types often go hand in hand , but only the habit of execution produces a practice effect in the sense that the behavior is executed faster and/or more readily with repetition.organization of activities which involves a search and combination of activities that are appropriate for bringing success. Practice effects are produced by increasing the efficiency of action planning processes, which consists in (i) the elimination of detours, such as removing redundant movements and planning steps; and (ii) improvements in the coordination and timing of movements. This was a remarkable modern analysis of skill acquisition that is now supported by many research findings organization of activities results in the formation of a cognitive action complex (“Tätigkeitskomplex” or “Komplextätigkeit”) that can be activated with a “single impulse of will”, which releases the behavior sequence in an automated fashion on a subconscious level. Again, one can see here a precursor of a modern action control perspective that posits the execution of a cognitively compiled “action plan” with minimal conscious intervention Hommel, .In addition, Lewin posited a distinction between knowledge updating and the acquisition of an action complex. Knowledge of an action must not be confused with the competency to perform an action, although he also emphasized the dynamic interaction between both during the early stages of action learning. New knowledge generates a subjective image (“subjektives Bild”) that can psychologically exist without generating a (reproductive) action tendency. Although Lewin did not fully elaborate the concept of a subjective image, it has much similarity to Tolman’s concept of a “cognitive map” and latent learning. Tolman  gave Lew4As we have described above, Kurt Lewin argued in his articles vehemently against the idea that associations between stimuli and responses can energize behavior. A few years later, he summarized this position in the following way:connections are never causes of events [emphasis in the original], wherever and in whatever form they may occur.”  has shown that the couplings created by habit are never, as such, the motor of a psychical event. […]. Rather, certain psychical energies, that is, tense psychical systems which derive, as a rule, from the pressure of will or of a need, are always the necessary condition of the occurrence—in whatever way—of the psychical event. […]. For This conclusion did, however, not had a lasting impact on subsequent psychological theorizing, presumably because Lewin’s articles were subsequently mainly discussed as a major blow against Ach’s combined method and the German experimental will psychology , which can interfere with another action complex, also overlaps with the modern conceptualization of a ‘task set’ and switching between different task sets. Logan and Gordon  defined intended actions do not qualitatively differ from other motivated actions, which is why he also referred to the former as “quasi-needs.” Multiple action tendencies could persist at any given time and could compete for realization in a situation, which adds a dynamic component to the model . Gestalt psychology, in contrast, emphasizes the organization of events and the interaction between these events (“the whole is other than the sum of its part”). For the Gestalt psychologist, proximity in space and time (contiguity) is just one organizing principle out of many (Köhler, and a dedicated experimentalist, we believe that Lewin would have liked that.Lewin’s early publications could, first and foremost, be read a methodological critique of Ach’s measurement idea of willpower with associative equivalence. It is, however, much more than this! In line with principles of Gestalt psychology Koffka, , they ca Köhler, . As Lewi Köhler, , both ha Köhler, . Hundred


As a part of a major reform of the medical curriculum in Germany, the national catalogue of learning objectives is being revised with the focus shifting from theory-based learning to teaching practical skills. Therefore, we conducted an online survey to answer the question, which practical skills are essential in anesthesia. Participants were asked to rate the relevance of several skills, that medical students should be able to perform at the time of graduation. A total of 2898 questionnaires could be evaluated. The highest ratings were made for “bringing a patient into lateral recumbent position” and “diagnosing a cardiac arrest”. All learning objectives regarding regional anesthesia were rated as irrelevant. Furthermore, learning objectives like “performing a bronchoscopy” or “performing a rapid sequence induction” had low ratings. In the subgroup analysis, physicians with advanced training and those who were working at university hospitals rated most skills with higher relevance compared to others. Our survey provides a good prioritization of practical skills for the development of new curricula and assessment frameworks. The results can also help to establish our discipline as a cross-sectional subject in competency-based medical education, thus further increasing the attractiveness for medical students. In the past decades, medical school curricula have progressed from mostly fact- and theory-based to a more practical, skill-based approach. As a result, competency-based medical education has become increasingly important ,2,3,4. IThe suggested changes included an adjustment of the National Competency Based Catalogues of Learning Objectives for Undergraduate Medical Education (NKLM in German), which defines future core competencies and activities medical students need to achieve in order to be eligible for medical licensing in Germany ,10. AlreThe majority of undergraduate anesthesiologic training in Germany takes place in form of lectures, seminars and practical training. However, the respective weighting of the teaching formats and the number of hours varies between the different universities . This alWithout question, a key aspect of anesthesia practice is the ability to perform practical procedures efficiently and safely . TherefoAs a first step, practical skills considered to be relevant for an anesthesiologist, were defined. For this purpose, the NKLM and the DGAI catalogue for learning objectives for medical students were screened . The NKLAn online questionnaire for data collection was created using the SoSci Survey software  and made available to participants via an internet link . The stuIn the actual questionnaire, an introductory and explanatory text was followed by the collection of sociodemographic data: Information on gender, age, position within the department or possible retirement and the level of care of the hospital were recorded. The “level of care” is clearly defined for each hospital and set by the respective authorities in Germany. Also the presence of the additional sub-specialty board certifications, such as emergency medicine, pain medicine, palliative care, or intensive care, as well as information on active participation in student training had been queried.This was followed by the evaluation of a total of 65 practical learning objectives. The order of the practical skills surveyed was based on the conduct of anesthesia and other fields of anesthesiologists’ work. Therefore, the categories were in the order “premedication visit”, “preparation of general anesthesia”, “general anesthesia”, “regional anesthesia and pain therapy”, “intensive care medicine” and finally “emergency medicine”.A six-point Likert scale  to “very relevant” (6)) was used to determine the relevance each learning objectives at the end of undergraduate training in medical school .A pretest was conducted to validate the questionnaire. For this purpose, 12 participants were interviewed in January 2020. The survey group was mixed in terms of gender and age. Nine anesthesiologists in several hospitals, as well as one non-specialist physician and two non-physician colleagues answered the questionnaire. The pretest was carried out using the same online tool as the actual test and was also evaluated using the same evaluation technique via SPSS . The only difference was that a special pretest version of the online questionnaire was used (provided by the SoSci Survey software), which included the possibility for participants to give feedback on each question via extra text fields. We received feedback on technical feasibility, usability, the understanding of individual questions, and the duration of the test. Individual wording was subsequently adjusted and questions supplemented. After this revision, we carried out the online-based survey.The link to the survey was sent to all members of the DGAI through its official e-mail distribution list. This list contains e-mail addresses of physicians in postgraduate training to become specialists in anesthesiology, specialists and retired physicians . The link was not personalized, or password protected. The survey was accessible for a total of three weeks from 11th May to 31st May 2020. The firm deadline was set to increase the response rate as much as possible . One remt-test  if more than two groups were compared). If the data were not normally distributed, comparisons between groups were performed using a Mann-Whitney-U test (for two groups) or a Kruskal-Wallis test (if more than two groups were compared). Effects were considered significant if p-values were less than 0.05. Statistical analyses were performed using SPSS version 26.0 . The figures were created using GraphPad Prism version 9.4.1 for Windows . The manuscript adheres to the applicable Standards for Quality Improvement Reporting Excellence in Education (SQUIRE-EDU) guidelines [All data collected during the survey were considered for the analysis. Accordingly, this included the rating of learning objectives of survey participants with questionnaires, which had been filled out completely. All data are presented as median and interquartile range (IQR) as well as mean ± standard deviation (SD) were appropriate. Learning objectives rated with a median of “not relevant at all”  on the 6-point Likert scale were considered irrelevant for the curriculum in the evaluation. In contrast, the learning objectives that were mostly rated as “very relevant”  were considered as essential for future curricula in the field of anesthesiology. To perform analyses of individual groups, normal distribution was determined using a Shapiro-Wilk test. If normal distribution was present, differences between two groups were tested for significance using Student’s idelines .During the three-week study period, a total of 2898 questionnaires were returned at least in part, 2046 were completely filled. This corresponds to a response rate of 19%. The number of responses on each day of the survey is shown in 58.94% of respondents were male, 37.51% female, and 0.28% diverse. 3.28% did not provide any information on gender. The age distribution of the participants can be seen in 70.3% (n = 2037) of the survey participants stated that they were holding an additional certification in emergency medicine, 44.1% (n = 1279) were board certified in intensive care medicine. Additional board certifications in pain medicine  or palliative care  were less common. 56.8% (n = 1647) of survey participants reported to be actively involved in training medical students. Other demographics, such as personal qualifications or workplace, are shown in Here, a “hospital with low level of care” is a small hospital with only a few specialties . A “hospital with advanced level of care” offers a broader range of specialties . A “hospital with maximum level of care” offers  all medical specialties independently of a university. A “hospital with special supply mission” is, for example, a specialized heart center.Six learning objectives were rated as particularly relevant with a median value of 6 on the Likert scale. These six objectives belong to the categories of emergency medicine  and preparation of general anesthesia . All learning objectives in the regional anesthesia category were rated as irrelevant with a median rating of 1. Furthermore, learning objectives “performing a quick check”, “performing a bronchoscopy”, “performing an minithoracotomy” and “performing a rapid sequence induction” were also considered as not relevant at all.p < 0.001). Furthermore, all regional anesthesia procedures were rated higher by retired physicians compared to all other positions. There was a large difference in the rating among the learning objectives with regard to the subgroup by the skill “transferring information regarding a patient among healthcare professionals utilizing a defined technique (for example SBAR)”: While physicians in training rated it with a median of 5 (mean 4.58/6), all other positions rated it with a median of only 4.Physicians in postgraduate training rated most of the individual practical skills with higher relevance compared to specialists, senior physicians, heads of departments and retired physicians. For example, the learning objective “setting up an iv-drip for infusion” was rated by physicians-in-training with a median of 6, while chief residents reported a median of only 5 here , “demonstrating ultrasound examination utilizing the eFAST principle” with a median of 3 vs. 2 (p < 0.001) and “evaluating a patient using the ABCDE system” with a median of 6 vs. 5 (p < 0.001).Colleagues at university hospitals were more likely to rate practical skills as more relevant than physicians working at other levels of care. The vast majority of statistically significant differences were observed between the results of colleagues in university hospitals and physicians providing anesthesia care in outpatient anesthesia practices. Some examples are “performing a 12-channel-ecg and interpretation” with a median of 6  vs. 4 (outpatient anesthesia) (p = 0.025), whereas specialist in intensive care medicine rated “communication adequately with patients and/or relatives in crisis situations” as less relevant than their peers without the additional board certification (p = 0.004).Anesthesiologists, who held an additional qualification in emergency medicine, intensive care medicine, palliative medicine or pain medicine rated the specific knowledge in these topics as less relevant than those colleagues, who did not have a corresponding additional qualification. For example, “taking patient history focused on pain symptoms” was rated less relevant among board certified pain physicians . EPAs, more specifically, are units of professional practice (tasks or bundles of tasks) that can be fully entrusted to an individual, once they have demonstrated the necessary competence to execute them unsupervised . EspeciaThe evaluation of individual practical skills with higher relevance by physicians in training compared to all other levels of training is striking. A recent study showed that perfectionism, defined as a combination of high standards and high self-criticism, is becoming increasingly common among current medical students . This maAnesthesiologists at university hospitals rated individual practical skills with higher relevance than physicians working at other hospitals. This is also true when comparing university hospital staff to those of outpatient anesthesia practices in the majority of skills. One reason for this could be that, on average, patient comorbidity is higher at university hospitals. This means that many practices are used more frequently and thus become more relevant. Physicians from university hospitals are more often actively involved in the training of medical students. This leads to regular engagement with the teaching of practical skills and thus possibly assigns them greater importance.Some aspects might act as limitations in our study. Due to the fact that the survey was conducted online, direct enquiries were not possible. However, it was possible to contact the study initiators via e-mail, which was done only five times in total. Therefore, it might possibly be valid to assume that the survey was easy to understand. Furthermore, the link to the survey was not personalized or password-protected. Possible distortions of the results cannot be ruled out completely. However, in our opinion it seems unrealistic that the survey was filled out more than once or answered by colleagues from other disciplines. The low overall response rate of 19% should be seen as another limitation. However, it corresponds to the experience of other online surveys. Paper-based surveys can maybe achieve significantly better response rates if they are completed on site. This at least reflects the authors’ personal experience with respect to student evaluation of teaching . With regard to medical colleagues, such a type of survey would be possible with the aim of achieving the highest possible response rates, e.g., within the context of conferences–but with the increased risk of a selection bias. This is no longer the case if the survey is sent out by post-the latter would not have been realistic for this survey either. The relatively large size of the questionnaire may have had a negative influence on the survey. Nevertheless, we have tried to keep it as simple and understandable as possible. In addition, we again tried to increase the response rate by sending a reminder by e-mail. According to the literature, a second and possibly a third reminder would have been helpful to increase the number of participants again ,48. UnfoFurthermore, there is a heterogeneous picture in the distribution of sociodemographic aspects, such as age, individual qualifications and workplaces. In terms of the age of participants in the survey, young physicians in training appear to be rather underrepresented, as perceived, and the group of survey participants over the age of 60 somewhat overrepresented. A possible explanation could be that more experienced colleagues and retired physicians might have more time resources or are more motivated to contribute to the further development of their own specialty. According to the authors, the distribution of the participants’ workplaces is fairly representative, with physicians in the outpatient sector and physicians at university hospitals appearing to be somewhat overrepresented. In the latter group, the higher participation is most likely due to the regular contact with students and thus the higher acceptance of the survey. The high rate of survey participants with an additional certification in emergency medicine seems surprising at first glance. However, it should be noted here that this is not a specialist in emergency medicine . It is an additional certification that entitles the physicians to work preclinically as emergency physicians. Anesthesiologists make up the majority of emergency physicians working in Germany, so this number should not distort the results of the survey.In summary our survey provides a good prioritization of practical skills from the fields of anesthesiology, intensive care, emergency medicine, pain medicine and palliative care by experts in the field. The results could therefore be used as the foundation for the development of new curricula and assessment frameworks in Germany and other countries, in which the teaching of practical skills is an important component. Additionally, these results might be able to assist during the establishment of our specialty as a cross-sectional subject in the field of competency-based medical education. In addition to basic anesthesiology and intensive care medicine, topics such as “perioperative care” and “patient safety” play a major role. This might then lead to a potentially greater attractiveness and appeal of our discipline to medical students, who hopefully will decide to become anesthesiologists themselves. In the future, it will be necessary to clarify which teaching formats are best suited to teach each of the learning objectives prioritized here and how the learning objectives can ultimately also be tested in the best standardized way.