Fig. 4

Scores according to the German grade system, varying from 0 (failed) to 13–15 points (very good), by semester (S0 before TPC introduction; S2, S3, first and second semester after TPC introduction), and by examination (theoretical knowledge, clinical and manual skills). The scores of theoretical knowledge and clinical skills improved from S0 to S2 (Wilcoxon, P = 0.006 resp. P = 0.002) and did not differ significantly from S2 to S3 (Wilcoxon, P = 1.000). There was no difference in manual skills between semesters (Wilcoxon, P = 1.000)