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Abstract

There is a discrepancy between the research exploring e-learning at medical universities in Central/Eastern and Western European countries. The aim of the MeSPeLA study was to explore the understanding, experience and expectations of Polish medical students in terms of e-learning. Questionnaire containing open-ended and closed questions supplemented by focus group discussion was validated and performed among 204 medical students in Poland before COVID-19 pandemia. Several domains: understanding of e-learning definitions; students’ experience, preferences, expectations and perceptions of e-learning usefulness, advantages and disadvantages were addressed. The qualitative data were analyzed using an inductive approach. 46.0% of students chose a communication-oriented definition as the most appropriate. 7.4% claimed not to have any experience with e-learning. 76.8% of respondents indicated they had contact with e-learning. The main reported e-learning advantages were time saving and easier time management. The most common drawback was limited social interactions. The acceptance of the usage of e-learning was high. Medical undergraduates in Poland regardless of the year of studies, gender or choice of future specialization showed positive attitudes towards e-learning. Students with advanced IT skills showed a better understanding of the e-learning definition and perceived e-learning to be a more useful approach. The expectations and perceptions about e-learning in Polish medical schools seems similar to some extent to that in Western European and the United States so we can be more confident about applying some lessons from these research to Poland or other post-communist countries. Such application has been accelerated due to COVID-19 pandemia.
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Authors and Affiliations

Mirosława Püsküllüoğlu
1
Michał Nowakowski
2
Sebastian Ochenduszko
3
David Hope
4
Helen Cameron
5

  1. Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Kraków, Poland
  2. 2nd Department of General Surgery, Jagiellonian University Medical College, Kraków, Poland
  3. Department of Medical Oncology, Hospital Universitario Dr Peset, Valencia, Spain
  4. Centre for Medical Education, The Chancellor’s Building, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, Scotland
  5. Aston Medical School, Aston University, Birmingham, UK
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Abstract

B a c k g r o u n d: During COVID-19 pandemic, it is necessary to collect and analyze data concerning management of hospitals and wards to work out solutions for potential future crisis. The objective of the study was to investigate how surgical wards in Poland are managing during rapid development of the COVID-19 pandemic.
M e t h o d s: An anonymous, online survey was designed and distributed to surgeons and surgery residents working in surgical departments during pandemic. Responders were divided into two groups: Group 1 (responders working in a “COVID-19-dedicated” hospital) and Group 2 (responders working in other hospitals).
R e s u l t s: Overall, 323 responders were included in the study group, 30.03% of which were female. Medical staff deficits were reported by 21.15% responders from Group 1 and 29.52% responders from Group 2 (p = 0.003). The mean number of elective surgeries performed weekly prior to the pandemic in Group 1 was 40.37 ± 46.31 and during the pandemic was 13.98 ± 37.49 (p <0.001). In Group 2, the mean number of elective surgeries performed weekly before the start of the pandemic was 26.85 ± 23.52 and after the start of the pandemic, it was 7.65 ± 13.49 (p <0.001). There were significantly higher reported levels of preparedness in Group 1 in terms of: theoretical training of the staff, equipping the staff and adapting the operating theater to safely perform procedures on patients with COVID-19. Overall, 62.23% of responders presume being infected with SARS-CoV-2.
C o n c l u s i o n s: SARS-CoV-2 pandemic had a significantly negative impact on surgical wards. Despite the preparations, the number of responders who presume being infected with SARS-CoV-2 during present crisis is high.


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Authors and Affiliations

Tomasz Stefura
1
Justyna Rymarowicz
1
Michał Wysocki
1
Jacek Szeliga
2
Grzegorz Wallner
3
Michał Pędziwiatr
1
Michał Nowakowski
1
Piotr Major
1

  1. 2nd Department of General Surgery, Jagiellonian University Medical College, Kraków, Poland
  2. Department of General, Gastroenterological, and Oncological Surgery, Collegium Medicum Nicolaus Copernicus University, Toruń, Poland
  3. 2nd Department of General, Gastrointestinal and Oncological Surgery of the Alimentary Tract, Medical University of Lublin, Lublin, Poland
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Abstract

B a c k g r o u n d: Assessment of the neurocontrol of the external anal sphincter has long been restricted to investigating patients by invasive tools. Less invasive techniques have been regarded less uitable for diagnosis.

O b j e c t iv e: The aim was to develop a surface electromyography-based algorithm to facilitate fecal incontinence diagnosis, and to assess its sensitivity and specificity.

D e s i g n: Data analysis from a single center prospective study.

P a t i e n t s: All patients from colorectal surgery office were considered. They underwent a structured interview, a general physical and proctologic examination. Patients with diagnosed fecal incontinence (Fecal Incontinence Severity Index >10) were included into the study group. The control group consisted of healthy volunteers that scored 5 or less and had negative history and physical exam. Both groups underwent the same tests (rectoscopy, anorectal manometry, transanal ultrasonography, multichannel surface electromyography and assessment of anal reflexes).

M e t h o d s: EMG results were analyzed to find parameters that would facilitate fecal incontinence diagnosis.

O u t c o m e m e a s u r e s: Sensitivity and specificity of surface electromyography, to diagnose fecal incontinence, were assessed.

R e s u l t s: A total of 49 patients were included in the study group (mean age ± SD 58.9 ± 13.8). The control group (n = 49) gender matched the study group (mean age ± SD 45.4 ± 15.1). The constructed classification tree, based on surface electromyography results, correctly classified 97% of cases. The sensitivity and specificity of this classification tree, to diagnose FI, was 96% and 98% respectively.

L i m i t a t i o n s: The age of women in the control group differs significantly from mean age of other groups.

C o n c l u s i o n s: Surface electromyography is an good tool to facilitate diagnosing of fecal incontinence.

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Authors and Affiliations

Michał Nowakowski
Krzysztof A. Tomaszewski
Łukasz Machura
Paulina Trybek
Roman M. Herman
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Abstract

B a c k g r o u n d: The digital rectal examination (DRE) is a part of the standard physical examination and a useful diagnostic tool for detecting various lower gastrointestinal tract abnormalities. However nowadays it has been observed that medical students might not be properly prepared for performing and interpreting of DRE. The purpose of the study was to evaluate the knowledge and experience of Polish medical students about DRE.

Ma t e r i a l a n d M e t h o d s: A prospective study was carried out using a questionnaire accessible via internet platform. The survey consisted of 12 questions and considered experience as well as practical and theoretical knowledge about DRE. 976 responses from nine Polish medical universities were included in the study.

R e s u l t s: 38.68% of students have never performed DRE with “lack of opportunity during courses” (71.09%) as the most common reason. Among responders who performed this examination only 12.72% had done it more than two times. Usefulness of DRE was mostly assessed as high and very high (55.63%). Students in the self-assessment part indicated low and very low (18.72% and 39.61%) technical abilities and also low (25.34%) interpretation skills.

C on c l u s i o n: The knowledge of Polish medical students about DRE is insuffi cient. Medical universities should pay particular attention to this fi eld of examination to improve theoretical as well as practical skills of future doctors.

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Authors and Affiliations

Kaja Trzeciak
Katarzyna Chłopaś
Artur Kacprzyk
Tomasz Stefura
Michał Nowakowski
Michał Pędziwiatr
Piotr Major
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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

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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