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Abstract

Background: Problem-based learning is a method of acquiring knowledge and competences on the basis of work on the problem. Medical universities use the PBL method more widely in the course of teaching future physicians, in the CMUJ classes using the PBL method were introduced in the third year of studies, as a part of the Introduction to Clinical Sciences.

Methods: At the end of course, the students voluntarily filled in a questionnaire (17 questions con-cerning various aspects of the course). A total of 105 questionnaires were analyzed. Statistica 12.0 program was used for this analysis.

Results: 95.5% of respondents positively perceived the way of conducting classes in the form of PBL and considered them to be in line with their expectations (81%). 80% of respondents confirmed the usefulness of classes in acquiring knowledge and integrity with pre-clinical subjects. Divided opinions were expressed by the respondents as to the benefits and satisfaction from independent presentation and teaching of other students, 34.3% rather emphasized the benefits, while 28.6% expressed a negative opinion.

Conclusions: The study confirmed usefulness of classes conducted using the PBL method, both in terms of deepening the knowledge and repetition of already gained knowledge, as well as beneficial reception of classes by students. The course may be modified in the future by increasing the number of cases.
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Bibliography

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6. Skrzypek A., Szeliga M., Jagielski P., Perera I., Dębicka-Dąbrowska D., Wilczyńska-Golonka M.: The modified Peyton approach in the teaching of cardiac auscultation. Folia Med Crac. 2019; 59 (4): 21–32.
7. Oliveira L.B., Díaz L.J., Carbogim F. da C., Rodrigues A.R., Püschel V.A.: Effectiveness of teaching strategies on the development of critical thinking in undergraduate nursing students: a meta-analysis. Rev Esc Enferm USP. 2016 Apr; 50 (2): 355–364.
8. Kong L.N., Qin B., Zhou Y.Q., Mou S.Y., Gao H.M.: The effectiveness of problem-based learning on development of nursing students’ critical thinking: a systematic review and meta-analysis. Int J Nurs Stud. 2014 Mar; 51 (3): 458–469.
9. Yuan H., Williams B.A., Fan L.: A systematic review of selected evidence on developing nursing students’ critical thinking through problem-based learning. Nurse Educ Today. 2008 Aug; 28 (6): 657–663. doi: 10.1016/j.nedt.2007.12.006. Epub 2008 Feb 11. Review.
10. Zahid M.A., Varghese R., Mohammed A.M., Ayed A.K.: Comparison of the problem based learning- driven with the traditional didactic-lecture-based curricula. Int J Med Educ. 2016 Jun 12; 7: 181–187. doi: 10.5116/ijme.5749.80f5.
11. Ibrahim N.K., Banjar S., Al-Ghamdi A., Al-Darmasi M., Khoja A., Turkistani J., Arif R., Al-Sebyani A., Musawa A.A., Basfar W.: Medical students preference of problem-based learning or traditional lectures in King Abdulaziz University, Jeddah, Saudi Arabia. Ann Saudi Med. 2014 Mar–Apr; 34 (2): 128–133.
12. Surif J., Ibrahim H., Mokhtar M.: Implementation of Problem Based Learning in Higher Education Institutions and Its Impact on Students’ Learning 4th. Int Symp Probl Learn 2013. 2013; 66–71.
13. Arneson H., Ekberg K.: Evaluation of empowerment processes in a workplace health promotion intervention based on learning in Sweden. Health Promot Int. 2005 Dec; 20 (4): 351–359. Epub 2005 Sep 16.
14. Susskind J.E.: Powerpoint’s Power in the Classroom: Enhancing Students’ Self-Efficacy and Attitudes. Computers and Education. 2005 Sep; v45 n2: 203–215.
15. DeBord K.A., Aruguete M.S., Muhlig J.: Are Computer-Assisted Teaching Methods Effective? Teaching of Psychology. 2004; 31 (1): 65–68.
16. Nouri H., Shahid A.: The effect of Powerpoint presentations on student learning and attitudes. Glob Perspect Account Educ. 2005; 2: 53–73.
17. Atta I.S., Alghamdi A.H.: The efficacy of self-directed learning versus problem-based learning for teaching and learning ophthalmology: a comparative study. Adv Med Educ Pract. 2018 Sep 4; 9: 623–630.
18. Chang B.J.: Problem-based learning in medical school: A student’s perspective. Ann Med Surg (Lond). 2016 Nov; 22; 12: 88–89.
19. Skrzypek A., Cegielny T., Szeliga M., Jabłoński K., Nowakowski M.: Different perceptions of Problem Based Learning among Polish and Scandinavian students. Is PBL the same for everyone? Preliminary study. General and Professional Education. 2017; 3: 58–64. ISSN 2084-1469.
20. Ibrahim M.E., Al-Shahrani A.M., Abdalla M.E., Abubaker I.M., Mohamed M.E.: The Effectiveness of Problem-based Learning in Acquisition of Knowledge, Soft Skills During Basic and Preclinical Sciences: Medical Students’ Points of View. Acta Inform Med. 2018 Jun; 26 (2): 119–124.
21. Skrzypek A., Perera I., Szeliga M., Jagielski P., Dębicka-Dąbrowska D., Wilczyńska-Golonka M., Górecki T., Cebula G.: The modified Peyton’s approach and students’ learning style. Folia Med Crac. 2020; 60 (2): 67–80.
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Authors and Affiliations

Dorota Dębicka-Dąbrowska
1
Agnieszka Skrzypek
1
Marta Szeliga
1
Grzegorz Cebula
1

  1. Department of Medical Education, Faculty of Medicine, Jagiellonian University Medical College Kraków, Poland
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Abstract

The SARS-CoV-2 pandemic contributed to the implementation of changes in the methodology of conducting many courses at medical universities. Achieving learning outcomes was associated with self-discipline and an increased portion of students’ independent work. The aim of the study is to analyze the adaptation of teaching methods to the requirements of the COVID-19 pandemic at the Department of Medical Education of Jagiellonian University Medical College. The university authorities, instructors and students made every effort not to neglect their education. The Microsoft Teams platform allowed for the efficient organization of remote classes. Lectures, activities based on dialogue, brainstorming and role- -playing were conducted via the Internet. Presentations and short films were made available to students. The safety of individuals participating in classes was guaranteed by password access and an invitation sent prior to an online meeting. Remote learning allowed for the synthesis and deepening of students’ knowledge, improvement of communication skills and development of clinical thinking as future doctors. The disadvantages of online education was the inability to improve practical skills, especially on phantoms, under the direct supervision of a trained instructor.
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Bibliography

1. Ahmad Al Samaraee: The impact of the COVID-19 pandemic on medical education. British Journal of Hospital Medicine. 2020; 81 (7). Published Online: 20 Jul 2020 https://doi.org/10.12968/ hmed.2020.0191.
2. Skrzypek A., Stalmach-Przygoda A., Dębicka-Dąbrowska D., Kocurek A., Szopa M., Górski S., Szeliga M., Małecki M., Grodecka A., Cebula G., Nowakowski M.: Selected didactic methods used in education of medical students at the Department of Medical Education of Jagiellonian University Medical College. What’s new in medical didactics? General and Professional Education. 2018; 1: 26–32.
3. Silverman J., Kurtz S., Draper J.: Skills for Communicating with Patients, 3rd edition. London: CRC Press, 2016.
4. Małecki Ł., Stalmach-Przygoda A., Górski S., Kocurek A., Skrzypek A., Kowalska B., Nowakowski M.: Wprowadzenie całościowego kursu komunikacji medycznej dla studentów Wydziału Lekarskiego Uniwersytetu Jagiellońskiego Collegium Medicum.= The introduction of a comprehensive communication course for medical students of the Faculty of Medicine at the Jagiellonian University Medical College. Uniwersytet Jagielloński Collegium Medicum Zakład Dydaktyki Medycznej. Sztuka Leczenia. 2017; 1: 73–84.
5. Maran N.J., Glavin R.J.: Low- to high-fidelity simulation — a continuum of medical education? Medical Education. 2003; 37: 22–28.
6. Nikendei Ch., Huber J., Stiepak J., Huhn D., Lauter J., Krautter M.: Modification of Peyton’s four-step approach for small group teaching — a descriptive study. BMC Medical Education. 2014. https://doi. org/10.1186/1472-6920-14-68.
7. Skrzypek A., Szeliga M., Jagielski P., Perera I., Dębicka-Dąbrowska D., Wilczyńska-Golonka M., Górecki T., Cebula G.: The modified Peyton approach in the teaching of cardiac auscultation. Folia Med Crac. 2019; 59 (4): 21–32.
8. Skrzypek A., Kocurek A., Stalmach-Przygoda A., Małecki Ł., Górski S., Kowalska B., Szeliga M., Jabłoński K., Matłok M., Cebula G., Nowakowski M.: Rola profesjonalnych pacjentów symulowanych w nauczaniu komunikacji klinicznej. The role of professional simulated patients in teaching of clinical communication. General and Professional Education. 2017; 4: 29–35.
9. Czekajlo M., Dabrowski M., Dabrowska A.: Symulacja medyczna jako profesjonalne narzędzie wpływające na bezpieczeństwo pacjenta wykorzystywane w procesie nauczania. Merkur Lekarski. 2015; 38 (228): 360–363.
10. Green M., Tariq R., Green P.: Improving Patient Safety through Simulation Training in Anesthesiology: Where Are We? Anesthesiol Res Pract. 2016; 4237523. doi: 10.1155/2016/4237523. Epub 2016 Feb 1.
11. Dieckmann P., Patterson M., Lahlou S., Mesman J., Nystrom P., Krage R.: Variation and adaptation: learning from success in patient safety-oriented simulation training. Adv Simul (Lond). 2017; 2: 21. doi: 10.1186/s41077-017-0054-1.
12. Skrzypek A., Cegielny T., Szeliga M., Jabłoński K., Nowakowski M.: Different perceptions of Problem Based Learning among Polish and Scandinavian students. Is PBL the same for everyone? Preliminary study. General and Professional Education. 2017; 3: 58–64.
13. McMillan M., Little P.: Conceptualizing Problem-Based Learning: Ensuring Realization of Curriculum Intentions. J Probl Based Learn. 2020; 7 (1):1–2.
14. Lucey C.R., Johnston S.C.: The Transformational Effects of COVID-19 on Medical Education. JAMA. 2020; 324 (11): 1033–1034. doi: 10.1001/jama.2020.14136.
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Authors and Affiliations

Agnieszka Skrzypek
1
Ian Perera
1
Marta Szeliga
1
Grzegorz Cebula
1

  1. Department of Medical Education, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
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Abstract

Background: Medical education has changed in response to scientific advances and social needs.
Aim: The aim of the study was to examine curricula of medical schools around the world and to observe the trends that currently dominate in medical education.
Method: We have collected information on the current curricula of various medical schools using their official websites. When necessary, we supplemented the information using published articles describing the curriculum of a given medical school. Results: Our findings reveal that medical schools demonstrate the need for constant reforms and adaptation to changing conditions worldwide. Generally, there is a tendency to integrate basic and clinical fields, to sooner establish bedside teaching, to provide less theoretical and more practical approaches to teaching, to implement more communication skills, and provide students with research training.
Conclusions: Medical education has evolved and will continue to change with time. Medical schools introduce modifications to their curricula and share their experiences.
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Authors and Affiliations

Dorota Zawiślak
1
Robert Kupis
1
Ian Perera
1
Grzegorz Cebula
1

  1. Centre of Innovative Medical Education, Department of Medical Education, Jagiellonian University Medical College, Kraków, Poland
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Abstract

Introduction: The Dundee Ready Education Environment Measure (DREEM) is an instru-ment that assesses the educational environment.
Aim: The aim of this study was to psychometrically evaluate a Polish version of the DREEM instrument.
Material and Methods: 203 medical students who fully completed the DREEM questionnaire were included in the study. Validity was evaluated through the analysis of construct validity and reliability.
Results: After language validation the internal consistency was assessed. Cronbach’s alpha for the overall score was 0.93 and the five subscales were: perceptions of learning 0.86, perceptions of teachers 0.82, perceptions of atmosphere 0.75, academic self-perceptions 0.61, and social-self perceptions 0.61. The exploratory factor analyses, however, yielded dimensions that did not fully correspond to the original DREEM subscales.
Conclusions: Internal consistency of the Polish version of the DREEM scale as a whole was excellent, however for each of five originally developed subscales it was lower and vary a lot; construct validity of Polish version was not compatible with the original structure of the DREEM scale but was reasonable. A new five-factor solution obtained in this study could be a reliable tool for assessing the medical education environment in the Polish circumstances, but it will require confirmation in future study.
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Authors and Affiliations

Dorota Zawiślak
1
Kamila Żur-Wyrozumska
1
Mariusz Habera
1
Karolina Skrzypiec
1
Agnieszka Pac
2
Grzegorz Cebula
1

  1. Department of Medical Education, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
  2. Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Kraków, Poland
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Abstract

Background: At the Department of Medical Education, Centre for Innovative Medical Education at Jagiellonian University Medical College, a completely remote OSCE (e-OSCE) was con-ducted for the first time using the Microsoft Teams platform. 255 test takers were tasked with presenting their communication and clinical skills in order to assess clinical reasoning.
Aim: Analysis of the assessment of the OSCE adaptation to the requirements of the COVID-19 pandemic at the Department of Medical Educations in the form of the e-OSCE from the students’ perspective.
Methods: Discussion of the OSCE modification was carried out among 6th-year medical students and graduates undergoing validation of their foreign medical degrees. In order to assess students’ opinions of the e-OSCE, we used questionnaires. The Statistica 12.0 program was used to analyse the results.
Results: According to 91.57% of respondents, the e-OSCE was well-prepared. 60% of students strongly agree and 29.47% rather agree that the order of the stations was appropriate and clear. A majority of respondents rated the e-OSCE as fair. 66.32% of respondents strongly agree and rather agree that the proportions of communication and clinical skills were appropriate. The vast majority of the participants of the exam (81.05%) had enough time for individual stations. A statistically significant (p <0.0001) correla-tion was found between the type of classes and preparation for the e-OSCE. For 61.05% of respondents, the Laboratory Training of Clinical Skills course was the best preparation for students taking the e-OSCE. Taking into account the stressfulness of the OSCE, only 15.96% of students found the online form more stressful than the traditional (in-person) exam.
Conclusions: The e-OSCE in students’ opinions was well-organized. Informing test-takers prior to the e-OSCE about the role of invigilators assessing individual stations should be improved. The e-OSCE has been proven to be suitable for assessing a wide range of material and validating communication and clinical skills in appropriate proportions. The e-OSCE is fair according to examinees’ opinion. The study proves that even in a pandemic, it is possible to prepare an online exam without exposing examiners and examinees to the dangers posed by COVID-19.

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Authors and Affiliations

Agnieszka Skrzypek
1
Natalia Baster
1
Ian Perera
1
Anna Żądło
1
Agata Stalmach-Przygoda
1
Marta Szeliga
1
Grzegorz Cebula
1

  1. Department of Medical Education, Centre for Innovative Medical Education, Faculty of Medicine Jagiellonian University Medical College, Kraków, Poland
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Abstract

Introduction: Trauma is one of the leading causes of death in the European Union. The European Trauma Course (ETC) is a training course that focuses on administering aid to trauma patients in a Hospital’s Emergency Department by creating an effective and well-organized trauma team. The purpose of the study is to analyze how the ETC training is evaluated by its participants and whether it is tailored to local needs.

Materials and Methodology: The study includes eight courses conducted between 2010 and 2015, involving 109 medical professionals. Participants were given questionnaires where they could evaluate the various aspects of the course and comment on each of them, using a four-level scale. Finally, 78 surveys were qualified for the study.

Results: The exercises were very highly rated (average 3.79 points), mainly for their interesting scenarios and station preparation. Equally well-evaluated was the short and concise method of instruction. The lowest ranked aspect was the course fee (2.41 points). There were oft en negative comments about the use of English during the training (lectures and manuals).

Discussion: The opinions of Polish students were similar to those of ETC participants in other European countries. There are many interesting advantages of workshop scenarios, while the downside is the time constraint. Nevertheless, the ETC has been very successful. High ratings and positive feedback affirm the high demand for such courses in Poland.

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Authors and Affiliations

Kaja Gąska
Grzegorz Cebula
Grzegorz Danielczok
Michał Nowakowski
Piotr Kolęda
Janusz Andres
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Abstract

Background: The aim of the study was to determine the predominant learning style and type of intelligence based on the VARK questionnaire and Multiple Intelligences Questionnaire respectively in second year medical students. Determining the relationship between individual preferences of students, based on their learning style and predominant type of intelligence and the perception of the modified Peyton’s four-step approach used to teach cardiac auscultation.

Methods: The opinion of participants 236 of the modified four-step approach was attained through the use of anonymous questionnaires. Using the VARK questionnaire, the participants’ learning style was defined. The predominant type of intelligence was determined by the Multiple Intelligences Question-naire.

Results: The kinesthetic style was the predominant unimodal learning style in second year medical students (in Polish and international students). The most predominant type of intelligence in Polish students was visual-spatial and mathematical and logical, while in international students the predominant types were visual-spatial and mixed type of intelligence. Quantitative analysis indicated that the modified Peyton’s approach is a valuable learning and teaching method for most students, independent of their predominant learning style or intelligence type. The exception was a small group of students with lin-guistic intelligence predominance according to the Multiple Intelligence Questionnaire, for which the Peyton method was more difficult.

Conclusions: This study proves that the modified Peyton’s approach is useful and effective didactic tool and can be successfully applied to most students. This is a new learning strategy for teaching cardiac auscultation in laboratory conditions in classes for a significant majority. Due to the fact that a group of students with a predominance of linguistic intelligence more often perceived the Peyton method to be difficult, it is worth combining traditional methods with new ones in class so that all students, regardless of unimodal learning style or prevailing type of intelligence, are taught satisfactorily.

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Authors and Affiliations

Agnieszka Skrzypek
Ian Perera
Marta Szeliga
Paweł Jagielski
Dorota Dębicka-Dąbrowska
Magdalena Wilczyńska-Golonka
Tomasz Górecki
Grzegorz Cebula
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Abstract

B a c k g r o u n d: The aim of the study was to evaluate the usefulness of the modified Peyton’s four-step approach in the teaching of cardiac auscultation and to determine students’ perception of Peyton’s four-step approach.

Me t h o d s: The opinion of the participants on the usefulness of the modifi ed four-step approach was attained through the use of anonymous questionnaires, voluntarily completed by students, and on the basis of semi-structured interviews conducted with a subset of students. 187 second-year students of our 6-year long curriculum were enrolled. They attended an obligatory Laboratory Training of Clinical Skills course. The average group size was 16 students.

R e s u l t s: The survey findings identified that 88.1% of participants found it helpful in developing their understanding of cardiac auscultation. 89.8% of all participants claimed that the new modified four-step approach facilitated memorization. The modified Peyton’s four-step method allows for better organization of classes in the opinion of 87.6% students. The advantages of the method were noticed by the majority of students.

C on c l u s i o n s: The modified Peyton’s four-step approach in the teaching of cardiac auscultation under laboratory conditions was perceived by students to be a comprehensible method that facilitates understanding and memorization. Th is approach allows for improved organization of classes. From the student’s perspective this method allows one to master the technique of cardiac auscultation in the classroom, through the increased demand of the participants’ attention, activity and involvement.

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Authors and Affiliations

Agnieszka Skrzypek
Marta Szeliga
Paweł Jagielski
Ian Perera
Dorota Dębicka-Dąbrowska
Magdalena Wilczyńska-Golonka
Tomasz Górecki
Grzegorz Cebula
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Abstract

O b j e c t i v e s: Patient-centered care (PCC) is associated with better doctor-patient relationships, resulting in a decrease in symptoms, hospitalizations and health costs. However, studies analyzing factors infl uencing patient-centered attitudes show ambiguous results. The purpose was to assess the impact of the Clinical Communication Course (CCC) in Jagiellonian University, Cracow and other factors on Patient-Centered Attitudes (PCA) and Attitude toward Clinical Skills Learning (CSLA).

M e t h o d s: We retrospectively compared Polish-speakers (CCC+, n = 160), English-speakers (CCCen+, n = 55) aft er the CCC and upperclassmen Polish-speakers without it (CCC–, n = 122). Validated questionnaires to measure PCA (Leeds Attitude Toward Concordance II and Patient-Practitioner Orientation Scale (PPOS)) and for CSLA (Communication Skills Attitude Scale with negative subscale (CSAS-N)) were used. The higher the scores, the more PCA, and negative CSLA respectively. Students completed questionnaires and answered questions regarding age, sex, motivation to study (coded as humanitarian — MotHUM, financial — MotFIN, combination — MotMIX) and considered specialization — coded as with more human contact (family medicine, psychiatry, pediatrics — SpecHUM) and others (SpecNHUM). Statistics were prepared in R.

R e s u l t s: CCC+ scored higher in PPOS (2.91 vs. 2.74; p = 0.003) than CCC– and higher in CSAS-N than CCCen+ (31.22 vs. 28.32; p = 0.004). In CCC+ SpecHUM scored lower than SpecNHUM in PPOS (2.65 vs. 2.94, p = 0.012). MotFIN scored higher then MotMIX in PPOS (3.01 vs. 2.7, p = 0.036). Correlations were statistically significant.

C o n c l u s i o n: CCC improved PCA in CCC+. Th ey showed more negative CSLA than CCCen+. Among CCC+, surprisingly, SpecNHUM presented more PCA than SpecHUM as well as MotFIN compared to MotMIX.

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Authors and Affiliations

Michał Pers
Stanisław Górski
Agata Stalmach-Przygoda
Łukasz Balcerzak
Magdalena Szopa
Aleksandra Karabinowska
Jolanta Świerszcz
Ian Perera
Grzegorz Cebula
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Abstract

Objectives: The OSCE (Objective Structured Clinical Examination) is a common method of assessing clinical skills used at many universities. An important and simultaneously difficult aspect of good examination preparation is obtaining a properly trained and well-motivated group of assessors. To effectively recruit and maintain cooperation with assessors, it is worth knowing their opinion. The aim of this study was to investigate the opinions of teacher-examiners about the OSCE and to identify the factors that could shape this opinion and influence on motivation.

Methods: A cross-sectional study was conducted using a questionnaire on teachers who participated as OSCE examiners. This questionnaire consisted of 21 questions about their perceptions. Answers were rated in a five-point Likert-type scale. Chi-square or Fisher’s exact test was used to analyze the data.

Results: A total of 49 (out of 52) teachers participated in this study. Nearly 90% of examiners believed that it is fair, and more than 90% that it is transparent. Despite the fact that 67% of examiners believe that the examination is difficult to organize and 71% believe it is stressful for students; according to 72% of respondents the OSCE has a positive effect on learning. More than 91% of examiners believed that the OSCE is an appropriate test to assess students’ skills. Opinions about the examination were independent of specialty, seniority, gender or having taken the OSCE as students.

Conclusion: Teacher-examiners viewed the OSCE as a fair and transparent examination, adequate for the assessment of skills and, despite it being difficult to organize, worth doing as it is appropriate to assess practical skills and positively influences students’ motivation to learn tested skills.

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Authors and Affiliations

Agata Stalmach-Przygoda
Michał Nowakowski
Anna Kocurek
Ian Perera
Agnieszka Skrzypek
Jadwiga Mirecka
Jolanta Świerszcz
Bogumiła Kowalska
Stanisław Górski
Michał Pers
Grzegorz Cebula
Magdalena Szopa

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