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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

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

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

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

Purpose: Oral health and diseases are significant components of general health. However, oral health-care remains at the lowest of older patients’ priorities. The inability to obtain dental care can result in progression of dental disease, leading to a diminished quality of life and overall health. Teledentistry (TD) provides an opportunity to improve the quality of oral health services. The aim of our narrative review was to analyze the usefulness of teledentistry as a part of telemedicine to improve oral health in the elderly.
Materials/Methods: The PubMed database search was done for: teledentistry, oral health, oral- health related diseases, elderly, older adults.
Results: The applicability of TD has been demonstrated from children to older adults. Older adults have many obstacles in getting oral health care, including low income, lack health insurance, frailty, anxiety, depression, mobility problems or other handicaps. Available data suggests that the usefulness of TD in the provision of oral care in elderly people living in residential aged care facilities. Moreover, TD procedures were found to be as accurate as traditional face-to-face dental examinations, they was cost-effective and well accepted among patients and caregivers.
Conclusions: TD might be a very useful tool for professional education, improving access and patient satisfaction of dental care. However, such TD modes would be difficult to widely implementation in community-dwelling older people who cannot access dental care. The ongoing “Patient centric solution for smart and sustainable healthcare (ACESO)” project will add to the intelligent oral health solutions.
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Authors and Affiliations

Barbara Gryglewska
1 2
Ian Perera
2
Ewa Klimek
1 2
Małgorzata Fedyk-Łukasik
1 2
Karolina Piotrowicz
1 2
Irina Mocanu
3
Ligia Muntianu
4
Jerzy Gąsowski
1 2

  1. Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland
  2. University Hospital, Kraków, Poland
  3. Centrul IT Pentru Stiinta si Tehnologie, and Computer Science Department, University Politehnica of Bucharest, Romania
  4. UMF Carol Davila Bucharest Faculty of Dental Medicine, Department of Removable Prosthodontics, Bucharest, Romania
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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

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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