Adapting the OSCE to the times of the COVID-19 pandemic. A look at the e-OSCE from the students' perspective.

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. A i m: 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. M e t h o d s: 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. R e s u l t s: 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) correlation 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. C o n c l u s i o n s: 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.

Psychometric validation and cross-cultural adaptation of the Integrated Palliative care Outcome Scale in Polish (IPOS-Pol).

OBJECTIVE: The study aimed to assess the reliability and validity of the IPOS-Pol for patient self-reporting. METHOD: Patients (>18 years of age) with advanced cancer admitted to three palliative care centers (inpatient units and home-based) were recruited to a multicenter, cross-sectional, observational, prospective study. Participants provided responses to the IPOS-Pol Patient version and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Core 15 - Palliative Care (EORTC QLQ-C15-PAL) Polish version at baseline (T1) and four to seven days later (T2). We assessed test-retest reliability, internal consistency, and construct validity of the tool. RESULTS: One hundred and eighty patients were included. Test-retest reliability demonstrated no statistically significant differences in the average outcomes of the IPOS-Pol between T1 and T2 (27.2 ± 9.2 vs. 26.5 ± 8.7; p > 0.05). The intra-class correlation coefficient between T1 and T2 was r = 0.83 (p < 0.0001), the intra-class correlation coefficient for test-retest reliability of the IPOS-Pol items ranged from 0.63 to 0.84 (p < 0.0001), and the Cronbach's α coefficient for internal consistency was 0.773. The correlation coefficient between the IPOS-Pol and EORTC QLQ-C15-PAL total score was 0.79 (p < 0.001). SIGNIFICANCE OF RESULTS: The patient version of the Polish adaptation of IPOS is a valid and reliable outcome measure for assessing symptoms and concerns of individuals receiving palliative care, as well as the quality of care provided.

Introduction to Clinical Sciences - self-resolving clinical problems in small groups - perception of course participants - pilot study.

B a c k g r o u n d: 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. M e t h o d s: At the end of course, the students voluntarily filled in a questionnaire (17 questions concerning various aspects of the course). A total of 105 questionnaires were analyzed. Statistica 12.0 program was used for this analysis. R e s u l t s: 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. C o n c l u s i o n s: 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.

The modified Peyton's approach and students' learning style.

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 Questionnaire. 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 linguistic 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.

Modification of teaching during the COVID-19 pandemic at the Department of Medical Education of Jagiellonian University Medical College.

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.

The modified Peyton approach in the teaching of cardiac auscultation.

BACKGROUND: 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. METHODS: The opinion of the participants on the usefulness of the modified 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. RESULTS: 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. CONCLUSIONS: 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. This 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.

Implementation of the modified four-step approach method for teaching echocardiography using the FATE protocol-A pilot study.

INTRODUCTION: Peyton's four-step approach is well-known and commonly used in medical education. It is a practical and useful method which is simple to apply. The study presents the implementation of the modified four-step approach method to teach how to perform the emergency echocardiographic assessment according to FATE (Focus-Assessed Transthoracic Echo) protocol. The aim of the study was to determine the feasibility and utility of this method FATE protocol teaching. DESIGN: We collected students' feedback relating to perception of this way of teaching. Based on a semistructured interview conducted with the students, as well as an evaluation of the electronic survey, it has been demonstrated that the four-step method is useful for teaching emergency echocardiographic assessment. SETTING: One Polish medical school. PARTICIPANTS: The classes were run in small groups as part of an elective ultrasound course for the fourth- and fifth-year students of the Faculty of Medicine of the Medical College. Twenty-two students were trained. RESULTS: Based on the opinions of the participants of the elective course and the teacher conducting the classes, which involved the use of the modified Peyton's four-step method in teaching echocardiography in emergency cases according to the FATE protocol, it has been determined that the four-step method is effective in imaging training. All participants claim that this method is clear and understandable. Advantages of the methodological approach: a slow-motion demonstration by the instructor, accompanied by the commentary on the activities undertaken and practical exercises performed by the participants, learning through repetition, requirement of constant concentration. CONCLUSIONS: Peyton's approach allows to use of the class time in maximal extend by consolidating new information and facilitating memorization through adequate instructor guidance and observation of the training of the peer students and repetition of the skills acquired.

Optimization of Methods Verifying Volunteers' Ability to Provide Hospice Care.

The subject of the presented work was an attempt at optimization of the methods used for verification of the candidates for medical voluntary workers in a hospice and decreasing the danger of a negative influence of an incompetent volunteer on a person in a terminal stage of a disease and his or her relatives. The study was carried out in St. Lazarus Hospice in Krakow, Poland, and included 154 adult participants in four consecutive editions of "A course for volunteers - a guardian of the sick" organized by the hospice. In order to improve the recruitment of these workers, the hitherto methods of selection (an interview with the coordinator of volunteering and no less than 50% of attendance in classes of a preparatory course for volunteers") were expanded by additional instruments-the tests whose usefulness was examined in practice. Knowledge of candidates was tested with the use of a written examination which consisted of four open questions and an MCQ test comprising 31 questions. Practical abilities were checked by the Objective Structured Clinical Examination (OSCE). A reference point for the results of these tests was a hidden standardized long-term observation carried out during the subsequent work of the volunteers in the stationary ward in the hospice using the Amsterdam Attitude and Communication Scale (AACS). Among the tests used, the greatest value (confirmed by a quantitative and qualitative analysis) in predicting how a given person would cope with practical tasks and in contact with the sick and their relatives had a practical test of the OSCE type.

Chronic heart failure in the elderly: still a current medical problem.

Congestive heart failure (CHF) is the final stage in several heart diseases. The diagnosis of CHF in older patients is a challenge. Preserved left ventricular systolic function is a characteristic type of CHF in seniors. The purpose of the study was to characterize elderly patients with CHF and to highlight specific features of the conditions in seniors. e most common etiology of HF in this group of patients is hypertension and coronary heart disease. In seniors atypical presentations of chronic heart failure is much more common than in younger patients. Malnutrition, limitations of exercise and sedentary lifestyles or comorbid diseases have an influence on asymptomatic, early stage of HF. There are better outcomes of treatment in obese individuals. It is called the obesity paradox. Open communication with a patient and his/her family may improve their response to therapy. When heart failure becomes an incurable disease and aggressive treatment is ineffective, palliative care should be considered in end-of-life heart failure patients. The goal of treatment in the remaining moments of life last moments of life should be maximizing the patient's comfort.

The Objective Structured Clinical Examination (OSCE) from the perspective of 3rd year's medical students - a pilot study.

BACKGROUND: In 2015 Department of Medical Education in Medical College of Jagiellonian University in Cracow performed a new format of integrated multidisciplinary skills assessment of third year students of medicine a er completing initial courses in internal medicine, surgery, pediatrics and gynecology. AIM: OSCE assessed from the perspective of 3rd year medical students. METHODS: Students of 3rd year's study of Faculty of medicine were evaluated by OSCE, which assessed their internal medicine, surgery, gynecology, pediatric skills. OSCE consisted of 12 stations. In order to assess student's opinions on OSCE, we used method of diagnostic survey; Statistica 12.0. RESULTS: OSCE passed 255 (98.83%) of the students in thefirst term. We analyzed 221 questionnaires, in which students expressed their opinion. 93.7% of the students considered OSCE as a well organized exam. 87.8% of students claimed that OSCE is fair and 95.5% that the exam is clear. 86.4% students are pleased with the introduction information about OSCE that was given before the examination. 78.6% students believe, that OSCE allows to properly identify skills that require improvement. Students, who didn't pass all stations with positive result, more o en (Chi^2 Pearsona, p = 0.01990) indicated improper balance between quantity of stations that check communication skills and these checking other clinical skills. CONCLUSIONS: is study confirms that OSCE in the students' opinions was well organized and fair. It proves that OSCE correctly selects students who need to improve their knowledge and skills. Students' preparing to the exams, their knowledge and skills, influences on the students' perception of OSCE.

[Analysis of lifestyle and risk factors of atherosclerosis in students of selected universities in Krakow].

Introduction: Reduction of risk factors of atherosclerosis, lifestyle modification significantly cause the reduction in the incidence, morbidity and mortality of cardiovascular diseases (CVDs). Objective: To evaluate cardiovascular risk factors and analyze the lifestyle of students finishing the first year of studies at selected universities in Krakow. Material and Methods: The study was performed in 2015roku. 566 students finishing the first year of study, including 319 (56.4%) men and 247 (43.6%) women were examined. The students were in age from 18 to 27 years, an average of 20.11± 1.15 years. They represented 6 different universities in Cracow. In order to assess eating habits, lifestyle and analysis of risk factors of cardiovascular disease was used method of diagnostic survey using the survey technique. BMI was calculated from anthropometric measurements. The program Statistica 12.0 were used in statistical analysis. Results: The analysis showed that most fruits and vegetables consume UR students and AWF, least of AGH. Only 34.8% of students regularly consume fish of the sea, there were no significant differences between universities. Sports frequently cultivate the students of AWF (93% of the students of this university). Academy of Fine Arts students drink the most coffee. Students of AGH frequently consume alcohol. 60% of all students never tried drugs, but only 25.7% of student of Fine Arts never tried drugs. Overweight occurs in 12.6% of students, and obesity in 1.1%. Conclusions: The most risk factors of atherosclerosis occur in students of AGH and ASP. The results of the study clearly indicate on the necessity of implementation of prevention and improvement of health behaviors in students of AGH and ASP universities.