Aleksander Zarzeka

Comparative analysis of opinions of Warsaw Medical University students on electronic examinations and final tests by their participation in this form of knowledge assessment – preliminary report

Abstract Introduction. Apart from the increasing popularity of modern information technologies and the development of e-learning methods used for teaching medicine and health sciences, there was a spike of interest in using modern computer techniques for checking students’ knowledge. Aim. The aim of the study was to compare the opinions of students of Medical University of Warsaw about the examinations and final tests conducted using the e-exam ASK Systems platform, measured by their participation in this form of assessmen knowledge. Material and methods. 148 students; group 1 comprised students participating in an e-exam (59 persons) and group 2 included students not participating in an e-exam (89 persons). A voluntary, anonymous questionnaire study, electronic questionnaire, 58 statements measured using the Likert scale. Questionnaire reliability assessment: analysis of internal consistency with Cronbach’s Alfa coefficient (α>0.70). Statistical analysis: STATISTICA 12.0 licensed to WMU, Mann-Whitney U test. Results. Cronbach’s α coefficient for the scale amounted to 0.70. Members of group 1 were more likely to admit that students need to put in extra effort into participating in an e-exam (p<0.001) and that test results might be worse than in case of a regular exam (p<0.050). Group 1 significantly more often reported that the participation in an e-exam can cause additional examination stress (p<0.002) and makes cheating during exams more probable (p<0.003). Conclusions. 1. An analysis of the questionnaire demonstrated that this tool is reliable and can be used in further studies. 2. The participation in an e-exam slightly influenced the opinions of students on this form of knowledge assessment, which may mean that the students’ expectations concerning e-exams were consistent with the actual course of the exam. Therefore, students do not need any special procedure to prepare for e-exams. 3. This was a pilot study and it needs to be continued among the same group of students before and after the e-exam.

Validation study of the Polish version of the Evidence-Based Practice Profile Questionnaire

BackgroundDecisions about patient care in clinical practice should be made based on proven scientific evidence of efficacy and safety (i.e., evidence-based practice [EBP]). Currently, there are no available tools in Poland for assessing the knowledge and attitudes of specialists in health sciences towards EBP. Therefore, by validating the Polish version of the original English Evidence-Based Practice Profile Questionnaire (EBP2Q), we may provide an appropriate instrument for assessing EBP.MethodsThe validation group consisted of 1,362 people, including nurses and midwives taking the specialization exam, second-degree students in nursing/midwifery, and staff of selected municipal and clinical hospitals in Warsaw, Pruszkow, and Chelm. The study was conducted from March to June 2014. The following psychometric properties of the EBP2Q were assessed: reliability (Cronbach’s alpha coefficient, and test-retest), validity (exploratory factor analysis, Spearman’s r correlation coefficient, and assessment of inter-group differences), as well as unidimensionality of domains (principal component analysis).ResultsAll domains of the EBP2Q were characterized by high reliability (Cronbach’s alpha ranging from 0.800 to 0.972). The Polish version showed a strong similarity of factor structure with the original English EBP2Q, indicating that the condition for theoretical validity is fulfilled. Maintenance of the theoretical and discriminative validity and unidimensionality of five domains of the EBP2Q was confirmed.ConclusionsThe Polish version of the EBP2Q is comparable in terms of psychometry to the original English version. This questionnaire can be used to assess knowledge, attitudes, and skills concerning EBP among students and practicing professional nurses and midwives. The future validation of the EBP2Q in other groups of specialists in health sciences may increase the scope of applicability of this tool.

Validation of the positive health behaviours scale: a nationwide survey of nurses in Poland

Purpose. The aim was to adjust the positive health behaviours scale (PHBS) to make it suitable for use by nurses, and to validate the new version of the tool. Methods. A previously formulated PHBS was modified. The scale comprises 29 statements describing certain positive health behaviours in four subscales: nutrition, physical activity, relaxation and behaviours related to mental health, and preventive behaviours. The scale was enriched with items on avoiding risky behaviours and a question regarding respondents’ own assessment of their care for health. Analyses were conducted of reliability, construct validity, criterion validity and dimensionality of subscales. The questionnaire was completed by 1017 nurses. Results. Cronbachs α reached 0.844 for the entire scale and 0.623–0.761 for specific subscales. Empirical data did not confirm theoretical assumptions regarding the existence of a four-element structure of the PHBS. The scales diagnostic criteria were validated on the basis of positive results of correlation and trend analysis. Only one of the subscales proved homogeneous and could be considered unidimensional. Conclusions. The results confirmed the high internal consistency of the scale and its subscales. The factor structure of the PHBS was equivocal. The PHBS could be used in workplace-based health promotion programmes designed for nurses.

Promoting evidence-based practice – perceived knowledge, behaviours and attitudes of Polish nurses: a cross-sectional validation study

Purpose. Evidence-based practice (EBP) is recognized by the healthcare community as the gold standard for the provision of safe and compassionate healthcare. The aim was to describe nurses’ knowledge, behaviours and attitudes regarding EBP. Materials and methods. A cross-sectional approach was conducted during specialty state examinations in Poland in 2014 in a sample of 548 nurses. The self-completed reliable and valid evidence-based practice profile questionnaire (Australia) was used. Statistical analysis included Cronbach’s α coefficient, analysis of variance, the Guttman split-half method and calculations in Statistica version 12. Results. Although the participants’ beliefs about the benefits of EBP were high, their knowledge was relatively low. Statistically significant correlations were found between barriers and practice, knowledge and attitudes in relation to the level of nurses’ education (p < 0.001 to p < 0.05). Total Cronbach’s α coefficient was 0.970. Conclusions. Study findings highlight the importance of further supplementation of knowledge about EBP. The difficulties in using EBP in clinical practice are objective and require changes in the Polish system of nursing care. Additionally, life-long updating knowledge in the area of EBP by participation in various forms of postgraduate education can produce improvements in the knowledge, behaviours and attitudes of nurses in creating a positive EBP profile.

Knowledge of and attitudes towards extending professional powers among departmental nurses with respect to issuing prescriptions and independent referring for diagnostic tests – preliminary report

Abstract Introduction. An independent prescribing certain drugs, including issuing prescriptions, as well as an entitlement to refer patients for certain diagnostic tests, constitute the key competences of an advanced nurse/midwife practice. Aim. To analyze knowledge and attitudes of departmental nurses (DN) towards extending professional powers of nurses and midwives. Material and methods. The sample involved 23 DN (women: 100%) working in the Independent Public Children’s Teaching Hospital in Warsaw. The mean age was 49 years (mode and median: 50; min. 31, max. 61, SD=7.95). The mean of professional experience was 30 years (mode: 25, median: 30, min. 17, max. 40, SD=6.38). A voluntary and anonymous questionnaire with 10 questions referring to knowledge and 32 statements concerning attitudes evaluated in the Likert scale was conducted. Results. Almost all DN knew that prescribing drugs is a right and not an obligation. Nearly half of the DN knew when the new regulations shall enter into force. DN believed that the new regulations shall improve patient care and increase patient’s comfort and access to services. DN concern about preparation of nurses and midwives for new competences. Conclusions. 1. The study group’s level of knowledge about the new competences was insufficient and requires supplementing. 2. The attitudes of the study group towards the new competences were not unambiguous. It should, however, be noted that the study was conducted in a specialized children’s teaching hospital, where the application of the amended regulations is limited. 3. Although the nursing management staff supports the legislative changes, they object to the process of introducing them. This applies particularly to the necessity of an adequate preparation of nurses and midwives. 4. The study should be continued among a representative group of nurses with a similar level of education, professional experience, and place of work, with particular consideration of nurses working in the outpatient health care.

ASSESSMENT OF INTEREST IN TAKING UP SECOND-CYCLE PROGRAMME IN PUBLIC HEALTH AMONG FIRST-CYCLE STUDENTS OF WARSAW MEDICAL UNIVERSITY

Introduction: Pursuant to the Bologna Declaration, a vast majority of students graduating from the first-cycle programme (Bachelor’s degree) at Warsaw Medical University (WMU) may enrol in the second-cycle programme (Master’s degree) in the same major or change a major after obtaining a Bachelors degree and start a programme e.g. in Public Health. Beginning in the academic year 2017-2018, the second-cycle programme in Public Health runs at the Faculty of Health Sciences, WMU as a full-time course (day studies), offering three specialities: Health Promotion, Healthcare Management, and Clinical Trials and Health Technology Assessment. Since 2017 Public Health Division, Faculty of Health Sciences, Warsaw Medical University has been the only one to offer a programme in Public Health in Warsaw as a member of ASPHER The Association of Schools of Public Health in the European Region. An original curriculum implemented since the academic year 2017-2018 matches European standards. A number of selected courses are taught in English, e.g.: International Health Policy and European Health Policy. The curriculum includes also modules of courses devoted to developing skills expected by employers: Prevention of burnout and Developing relationships with customers. Aim: The study aimed at assessing the interest in taking up second-cycle programme in Public Health among firstcycle students of Warsaw Medical University. Material: The study enrolled a total of 115 third-year Bachelors degree students of Warsaw Medical University (women comprising 57.9% of the total). Mean age was 21.92 years (SD: 1.61, median: 22, min. 21, max. 32). First-cycle students of Public Health constituted the largest subgroup (24.6%), followed by students of Emergency Medicine and Obstetrics (10.5%). Methods: Participation in the survey was voluntary. Respondents completed an original and anonymous questionnaire available online at: https://goo.gl/forms/j1rGpofw56TphmUM2. The questionnaire comprised three questions and additional questions on sociodemographic data. In the survey, the respondents assessed their interest in commencing the second-cycle programme in Public Health and indicated a speciality that was most interesting for them at a full-time Masters programme. The questionnaire was sent to students to their current email addresses by respective Deans Office staff members on May 22, 2017.The authors of the present study did not receive the approval of the Ethical Review Board of Warsaw Medical University for the study due to the fact that, according to the communication of the Ethical Review Board of WMU: “The Ethical Review Board do not give any opinion on surveys, retrospective, and other non-invasive studies.” Results: Less than half of the students (42.1%, n=48) considered taking up second-cycle programme in Public Health at the Faculty of Health Sciences, Warsaw Medical University. Most students were interested in the new speciality introduced in the academic year 2017-2018: Clinical Trials and Health Technology Assessment (47.9%). The remaining two specialities: Healthcare Management (25%) and Health Promotion (14.6%) taught in the Public Health Division, Faculty of Health Sciences, WMU since 2012 were much less popular. Conclusion: Steps should be taken on a large scale to inform candidates and first-cycle students about the career development prospects after graduation from Public Health and to encourage students to continue education on a Masters programme.

ATTEMPT OF COMPARISON OF ATTITUDES TOWARDS DEVELOPMENT OF COMMUNICATION SKILLS AMONG POLISH AND SWISS STUDENTS OF MEDICAL UNIVERSITIES

Introduction: A high level of communication skills of medical personnel significantly improves the effectiveness of treatment managed by an interdisciplinary team, quality of health care, including patient and personnel safety, as well as patient and family satisfaction with health services. Aim: The study attempted to evaluate attitudes towards development of communication skills among Polish and Swiss students of medical universities Material: The study enrolled a total of 343 students (women: n=278, 81%): from Poland (n=229; 66.8%) and Switzerland (n=114, 33.2%, University of Basel). Polish students represented seven universities, the largest number of students being from Warsaw Medical University (n=143, 41.7%), Collegium Medicum in Bydgoszcz (n=53, 15.5%), and the University of Rzeszów (n=22, 6.4%). The respondents studied at a total of 11 faculties, with students of medicine comprising the largest proportion (n=137, 39.9%), followed by students of nursing (n=77, 22.4%) and obstetrics (n=35, 10.2%). Most respondents studied full-time (n=332, 96.8%) and were first-cycle students (n=222, 64.7%). Subgroups comprising the first-year students (n=117, 34.1%), second-year students (n=77, 22.4%), and third-year students (n=68, 19.8%) were most numerous. Mean age of the study group amounted to 22.63 years (median: 22; min. 19, max. 55, SD: 2.75). Methods: The study was conducted with the use of a standardised questionnaire Communication Skills Attitude Scale (CSAS). The survey was performed in March and April 2017 using two electronic questionnaires: Polish and English language versions. Questionnaire reliability was evaluated with Cronbachs α coefficient of 0.775. The approval of the Ethical Review Board of Warsaw Medical University was not necessary due to the nature of the study (non-invasive survey conducted among students). Results: A vast majority of the respondents (n=338, 98.5%) agreed that they need to have good communication skills in order to be able to do their work well. A vast majority of students (n=250, 72,9%) believed that acquiring communication skills is as important as learning medicine and it develops team working skills (n=306, 89,2%). When asked to self-assess their communication skills, students rated their competence related to communication with patients and other staff members as good or very good (n=235, 68.5% and n=222, 64.7%, respectively). Conclusion: The study group agreed that education in communication skills is very important and crucial for taking up employment in a health profession. Therefore, despite a high level of self-assessment, it needs to be considered whether to include communication-related issues in the teaching contents.

Evidence-Based Practice (EBP) w praktyce zawodowej pielęgniarek — analiza wiedzy, postaw i umiejętności w zależności od wykształcenia

Wstep. Podnoszenie kwalifikacji zawodowych oparte na najnowszych wynikach badan naukowych jest warunkiem koniecznym do sprawowania opieki pielegniarskiej na najwyzszym poziomie. Cel. Ocena wiedzy, postaw i umiejetności polskich pielegniarek w zakresie zastosowania Evidence-Based Practice w praktyce zawodowej w zalezności od wyksztalcenia. Material i metody. 820 pielegniarek i pielegniarzy (19 mezczyzn), 306 (37%) mialo wyksztalcenie średnie medyczne, 265 (32%) licencjackie, 249 (31%) magisterskie. Standaryzowany kwestionariusz Evidence-Based Practice (EBP) Profile Questionnaire z Uniwersytetu w Poludniowej Australii: 74 pytania zamkniete. Analiza rzetelności kwestionariusza, wspolczynnik α-Cronbacha: 0,905. Analiza statystyczna: nieparametryczny test Kruskala-Wallisa (p < 0,05), STATISTICA 12. Wyniki. Wyksztalcenie badanych mialo wplyw na rozumienie znaczenia terminu Evidence-Based Practice i jego role w pielegniarstwie (p < 0,001). Piecdziesiąt siedem procent magistrow zamierza rozwijac wlasne umiejetności w zakresie dostepu i oceny dowodow naukowych istotnych dla praktyki zawodowej (p < 0,001) oraz korzystac z odpowiedniej literatury naukowej w celu aktualizacji swojej wiedzy (p < 0,001). Osoby z wyksztalceniem licencjackim i magisterskim zdecydowanie cześciej korzystaly z elektronicznych baz piśmiennictwa naukowego i czytaly wyniki opublikowanych badan naukowych (p < 0,001). Wnioski. 1. W badanej grupie wyksztalcenie mialo wplyw na poziom wiedzy, postaw i umiejetności pielegniarek w zakresie zastosowania Evidence-Based Practice (EBP) w praktyce zawodowej. 2. Niewystarczająca znajomośc zagadnien związanych z wykorzystywaniem dowodow naukowych w codziennej praktyce klinicznej pielegniarek z wyksztalceniem średnim moze wynikac z systemu ksztalcenia zawodowego pielegniarek w Polsce, ktory obowiązywal przed wejściem Polski do Unii Europejskiej. 3. Bez wzgledu na poziom wyksztalcenia, istnieje w badanej grupie koniecznośc stalego, ustawicznego aktualizowania wiedzy z zakresu EBP.

Evidence-based Practice Profile Questionnaire — wierność rekonstrukcyjna kwestionariusza do badania wiedzy, postaw i umiejętności w zakresie EBM i EBP w grupie polskich pielęgniarek

Wstep. Ocena rzetelności jest waznym elementem badania jakości narzedzia badawczego i jednym z etapow w procesie adaptacji skali psychometrycznej do nowych warunkow kulturowych. Stworzony w Australii kwestionariusz Evidence-Based Practice Profile Questionnaire (EBP 2 Q) jest standaryzowanym narzedziem diagnostycznym przeznaczonym do badania wiedzy, postaw i umiejetności w zakresie praktyki medycznej opartej na dowodach naukowych. Cel. Celem pracy byla ocena rzetelności polskiej wersji jezykowej EBP 2 Q na podstawie badan w grupie specjalizujących sie pielegniarek i pielegniarzy. Material i metody. Grupa walidacyjna: 548 osob przystepujących do specjalizacyjnych egzaminow panstwowych organizowanych przez CKPPIP w 2014 roku (74% kobiet). Średnia wieku 42,0 ± 7,12 lat (min. 35 i maks. 56); staz pracy 19,0 ± 8,04 lat (min. 10, max. 37). Metodą badawczą byl EBP2Q skladający sie z 6 podskal, 74 stwierdzenia oparte na skali Likerta. Analiza statystyczna: wspolczynnik a-Cronbacha, rzetelnośc polowkowa Guttmana, moc dyskryminacyjna (wspolczynnik korelacji); obliczenia w pakiecie STATISTICA 12. Wyniki. Wartośc wspolczynnika a-Cronbacha dla calego kwestionariusza byla wysoka i wyniosla a = 0,905. Natomiast dla pomiaru rzetelności metodą polowkową Guttmana uzyskano wartośc 0,972. Wszystkie podskale EBP 2 Q charakteryzowaly sie wysokim stopniem wewnetrznej zgodności (a — 0,783–0,959) oraz dobrą rzetelnością rownoleglych polowek (0,804–0,982). Ponadto, w calej skali EBP 2 zidentyfikowano tylko dwie pozycje w domenie VI, ktore odznaczaly sie niskim stopniem mocy roznicującej. Wnioski. Wyniki oceny wierności rekonstrukcyjnej wskazują, ze proponowana polska wersja jezykowa EBP 2 Q jest rzetelnym narzedziem, ktore moze sluzyc do wiarygodnego pomiaru prowadzonego w polskiej populacji specjalizujących sie pielegniarek i pielegniarzy. Konieczne są jednak dalsze badania wlaściwości psychometrycznych tej wersji skali EBP 2 .

Próba szacowania edukacyjnej wartości dodanej jako miary efektywności kształcenia studentów pielęgniarstwa — badanie wstępne jednoośrodkowe

Wstep. Jedną z miar sluzących do oceny efektywności nauczania jest szacowanie edukacyjnej wartości dodanej (EWD), zdefiniowanej jako przyrost wiedzy studentow w wyniku prowadzenia procesu edukacyjnego. Cel pracy. Zbudowanie i wstepna walidacja modelu predykcyjnego o potencjalnym zastosowaniu w ocenie EWD. Material i metody. Przeanalizowano wyniki ksztalcenia z toku studiow na kierunku pielegniarstwo na Warszawskim Uniwersytecie Medycznym (WUM): zbior danych uczących sie (n = 1539) i testowych (n = 139); średnia wieku 19,6 ± 2,40 lat; 90% kobiet. Zastosowano model liniowej regresji wielorakiej z siedmioma predyktorami: oceny egzaminacyjne uzyskane przez studentow z zakresu nauk podstawowych i podstaw opieki pielegniarskiej; zmienna wynikowa: średnia ocen z egzaminow dotyczących opieki specjalistycznej; jakośc prognozy: wspolczynnik korelacji r-Pearsona; oszacowanie EWD na podstawie średniej roznicy miedzy wynikiem przewidywanym a rzeczywistym. Wyniki. Model regresji wielorakiej byl istotny statystycznie (F [7,1526] = 346,72; p < 0,0001), a poszczegolne predyktory wyjaśnialy w sumie ponad 60% wariancji średniej ocen. Jedynie oceny z przedmiotu fizjologia nie wykazywaly istotnego statystycznie wplywu na wartośc średniej ocen. Najwyzszy wplyw na osiągniecia studentow z zakresu opieki specjalistycznej mialy wyniki ksztalcenia z przedmiotow farmakologia (b stand. = 0,326) i podstawowa opieka (b stand. = 0,325). Otrzymany w toku analizy korelacyjnej wynik wskazuje na dobre parametry predykcyjne testowanego modelu regresji (korelacja r-Pearsona 0,772). EWD jako średnia z roznic miedzy wynikami oczekiwanymi a uzyskanymi z modelu predykcyjnego wyniosla –0,038. Wnioski . 1. Proponowany model regresji moze stanowic podstawe do szacowania EWD na kierunku pielegniarstwo na WUM. 2. Przedstawiona metodologia budowania i walidacji modelu predykcyjnego moze byc stosowana przez inne uczelnie ksztalcące studentow na kierunku pielegniarstwo na studiach pierwszego stopnia.