What do patients think about the Hungarian health care system and medical students' learning outcomes? A cross-sectional study on the patients' perspective in Hungary.

BACKGROUND: The doctor-patient relationship has changed a lot in the 21st century and the varying expectations of the patients play an important role in future professional medical care. The knowledge of patients' needs is crucial in determining the learning outcomes in medical education. The objective of this study was to examine the expectations of the patients regarding professional and soft skills (e.g. communicational skills, empathy) of doctors and to get a deeper view. METHODS: Face-to face data collection through self-reported questionnaire in accredited health care institutions (GPs, hospitals, outpatient care) in Hungary was carried out in 2019. Descriptive statistics, independent sample t-tests, k-means cluster and gap matrices were performed to analyze the data. RESULTS: In total 1115 patients (male-female: 50-50%, age groups: between 18 and 30: 20%, between 31 and 60: 40% above 60: 40%) participated in the survey. They rated sixteen learning outcomes along with two dimensions: importance and satisfaction. Except for one learning outcome, patients rated the outcomes more important than they were satisfied with them (negative gap). Positive gap was registered only in the case of respecting individual specialty during patient care. CONCLUSIONS: The results suggest the importance of learning outcomes in relation to the rate of satisfaction from the patients' perspectives. In addition, the results support that patients' need are not met in medical care. Patients' ratings also make an emphasis on the fact that besides professional knowledge other learning outcomes are also important in health care which should have been emphasized as a basis in medical education.

Do we need special pedagogy in medical schools? - Attitudes of teachers and students in Hungary: a cross-sectional study.

BACKGROUND: The quality of medical education is a key factor. The fact that mostly physicians teach tomorrow's physicians without acquiring pedagogical skills before becoming a teacher is a cause of concern. In Hungary, where traditional teaching methods are common, and teachers have not had pedagogical courses in medical education there has not been any research dealing with the issue. On the one hand, we aimed with this cross-sectional study to examine the attitudes of teachers towards learning outcomes of medical students to get a view about the opinions about their importance and rate of delivery. On the other hand, we analyzed the pedagogical skills of teachers from the students' and teachers' perspective in Hungary. METHODS: Data collection through self-reported questionnaires in online form in all the four Hungarian higher education institutions offering medical education was carried out among teachers and students with active student legal status in 2017. We validated the questionnaires of the two respondents' groups. We used gap matrices to represent the correspondences of the delivery and perceived importance of the learning outcomes. We calculated averages of the pedagogical skills and compared them with t-tests. RESULTS: The response rates are 11.18% in case of the students (1505) and 24.53% in case of the teachers (439). The results indicate the lack of concordance between the rates of the learning outcomes in terms of their importance and delivery - no positive gap can be observed -, and the need for pedagogical skills among teachers and students. The opinions of students compared to teachers' are all statistically higher according to the averages. CONCLUSIONS: The study results underline the necessity of a transition and paradigm shift in medical education from delivering solely professional knowledge towards pedagogically prepared practice and patient oriented teaching methods as well as acquiring pedagogical knowledge as part of the training of medical teachers in Hungary.

Problemas profesionales de los licenciados en enfermería en el desarrollo de habilidades pedagógicas / Profesional problems of the bachelors in nursing regarding the development of pedagogical skills

Introducción: la gestión del cuidado enfermero es el objeto de la enfermería. Para ello se necesita que los docentes responsabilizados con la formación de los futuros profesionales y técnicos en enfermería estén preparados desde el punto de vista pedagógico y debe manifestarse en el desarrollo de habilidades. Objetivo: determinar los problemas profesionales que presentan los licenciados en enfermería en el desarrollo de habilidades pedagógicas. Métodos: estudio descriptivo de corte transversal, se exploró el desarrollo de habilidades pedagógicas mediante un muestreo aleatorio simple. Se seleccionaron 30 docentes y 10 profesores principales y asesores metodológicos de la carrera de enfermería de la Facultad de Ciencias Médicas "10 de octubre"; se empleó la sistematización y la revisión bibliográfica para el análisis de los planes de clases, investigaciones relacionadas con palabras clave: problemas profesionales, habilidades pedagógicas y formación docente. Se aplicó un cuestionario, prueba de desempeño y se observaron los indicadores de las habilidades pedagógicas, entrevista a directivos y sesiones de trabajo metodológico. Resultados: los problemas profesionales fueron la no aplicación de principios del proceso pedagógico profesional, insuficiencias en el uso de los métodos de trabajo educativo, insuficiente utilización de la caracterización estudiantil, carencia de investigaciones educativas, utilización de formas de educación en el trabajo e insuficiencia de relaciones interdisciplinarias del plan de estudios. Conclusiones: los problemas profesionales guardan relación con la insuficiente superación en el área pedagógica, la identificación de estos sirve para trazar la vía hacia la superación profesional pedagógica de los docentes de enfermería(AU)

Introduction: Nursing care management is the object of nursing. For this, it is necessary for the teachers responsible for the training of future professionals and technicians in nursing to be prepared from the pedagogical point of view, which must be manifested in the development of skills. Objective: To determine the professional problems presented by nursing graduates in the development of pedagogical skills. Methods: Descriptive, cross-sectional study, in which the development of pedagogical skills was explored through simple random sampling. Thirty teachers and ten main professors and methodological advisers of the Nursing major of the School of Medical Sciences in Diez de Octubre Municipality were selected; systematization and bibliographic review were used for the analysis of lesson plans, research was developed in relation with the key words: professional problems, pedagogical skills and teacher training. A questionnaire was applied, performance test and indicators of pedagogical skills were observed, together with interviews with managers and methodological work sessions. Results: Professional problems were the non-application of principles of the professional pedagogical process, inadequacies in the use of educational work methods, insufficient use of student characterization, lack of educational research, use of forms of education at work, and inadequacy of interdisciplinary relationships in the curriculum. Conclusions: The professional problems are associated with the insufficient overcoming in the pedagogical area, the identification of which serves to trace the way towards the pedagogical professional improvement of Nursing teachers(AU)

Peer Teaching to Foster Learning in Physiology.

INTRODUCTION: Peer teaching is an effective tool to promote learning and retention of knowledge. By preparing to teach, students are encouraged to construct their own learning program, so that they can explain effectively to fellow learners. Peer teaching is introduced in present study to foster learning and pedagogical skills amongst first year medical under-graduates in physiology with a Hypothesis that teaching is linked to learning on part of the teacher. MATERIALS AND METHODS: Non-randomized, Interventional study, with mixed methods design. Cases experienced peer teaching whereas controls underwent tutorials for four consecutive classes. Quantitative Evaluation was done through pre/post test score analysis for Class average normalized gain and tests of significance, difference in average score in surprise class test after one month and percentage of responses in closed ended items of feedback questionnaire. Qualitative Evaluation was done through categorization of open ended items and coding of reflective statements. RESULTS: The average pre and post test score was statistically significant within cases (p = 0.01) and controls (p = 0.023). The average post test scores was more for cases though not statistically significant. The class average normalized gain (g) for Tutorials was 49% and for peer teaching 53%. Surprise test had average scoring of 36 marks (out of 50) for controls and 41 marks for cases. Analysed section wise, the average score was better for Long answer question (LAQ) in cases. Section wise analysis suggested that through peer teaching, retention was better for descriptive answers as LAQ has better average score in cases. Feedback responses were predominantly positive for efficacy of peer teaching as a learning method. The reflective statements were sorted into reflection in action, reflection on action, claiming evidence, describing experience, and recognizing discrepancies. CONCLUSION: Teaching can stimulate further learning as it involves interplay of three processes: metacognitive awareness; deliberate practice, and self-explanation. Coupled with immediate feedback and reflective exercises, learning can be measurably enhanced along with improved teaching skills.