Grażyna Dykowska

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.

Evaluation of critical points of hospital pharmacotherapy in relation to patient safety in Poland

Pharmacological treatment conducted in the hospital can be considered a process affecting patient safety. A number of publications shows that errors in the process of pharmacotherapy (medication errors) are one of the main causes of adverse events. According to the International Council of Nurses (ICN), errors associated with pharmacological treatment can be divided into 2 main groups: 1. system failures – errors related to the organization of the system, and 2. human errors – errors related to the human factor. However, it should be noted that an adverse event is the result of both dimensions – system errors and human errors combined can result in an adverse event or a near miss. Taking care of these 2 aspects of patient safety, i.e., improving organization of the system and facilitating the work of medical staff, can have a positive effect on pharmacotherapy conducted at hospital – on both social and economic level. The aim of this study was to identify the critical points of the pharmacotherapy process and to provide the potential solutions of a preventive nature developed on the basis of authors’ experience.

Assessment of Human Resources for Health in Poland with Particular Emphasis on International Migration of Nurses and Doctors in Light of Demographic Changes: Analysis of Existing Data

Background. Human resources are a crucial part of delivering health care services to population. There is a great need for assessing the actual size of human resources in each country in the world. The situation concerning human resources of nurses and doctors in Poland is alarming. Poland has one of the lowest ratios of nurses and doctors per 1,000 population among 28 countries in the EU. Piel. Zdr. Publ. 2016, 6, 1, 7–14 DOI: 10.17219/pzp/60384 PRACE ORYGINALNE

Analysis of information on rheumatology from a selected Internet forum in the context of the need for telemedicine solutions

Objectives The aim of this study was to determine how often patients and undiagnosed people who complain of musculoskeletal system and rheumatic diseases look for knowledge contained on an Internet forum. Content analysis was used to identify the level of Internet users’ activity in the rheumatology section, compared to other areas of medicine. Material and methods Material included information posted on the Internet forum established at http://medyczka.pl/. The method employed was a quantitative and qualitative analysis of the content. The method was based on qualitative assessment of the first post in each thread presented on the rheumatologic subforum, by assigning keywords, subjectively determined by the researcher, to such a post. For each keyword a specific definition was established, determining a situation in which a given keyword was used. Results The quantitative analysis qualified rheumatology in the last place in terms of Internet users’ activity compared to other branches of medicine. The qualitative assessment of the rheumatologic forum indicated that the three most common keywords were joint pain (32), joints swelling (13), and schoolage (13). The three most common intentional keywords (arranged in order of their decreasing number) were diagnosis based on symptoms (29), interpretation of the laboratory test results (9), and how to deal with symptoms (8). Conclusions The analysis leads to the conclusion that the rheumatologic subforum, along with other subforums listed above, presents a critically low level of discussion. There is a large disproportion between the number of active and passive forum users, suggesting that numerous individuals search the forum for presented information. Based on the qualitative analysis of the information stocks of the rheumatologic subforum, it was established that most of the questions posted concerned young individuals, who complained of joint pain and swelling, and asked for a possible diagnosis based on the presented symptomatology, interpretation of the laboratory test results and alleviation of disease symptoms.

Incidence of acute allergic reactions to contrast medium following CT examination on the basis of analysis of medical record data – preliminary report

Abstract Introduction. A contrast-enhanced CT examination can have negative health implications. It can spark both allergic and other adverse reactions. Aim. The study aimed at analyzing the incidence of acute allergic reactions to Ultravist 370, used as a contrast medium in a CT examination. Material and methods. The analysis of medical records that comprised 12295 patients who had undergone a CT examination. Women accounted for 50.7% of the study participants. Mean age of the patients was 62 years (min. 15; max. 92, SD=10.123). In the study, 6219 patients were examined without using a contrast medium and 6076 individuals underwent a contrast-enhanced CT examination. In the further analysis, Group 1 comprised of 15 patients from the contrastenhanced CT examination group who confirmed being allergic to a contrast medium after the CT examination and Group 2 comprised 49 persons who had reported being allergic to iodine before the CT examination. Results. 15 patients (8 women and 7 men) developed an allergy to Ultravist 370 (contrast medium). An acute allergic reaction was most likely to happen in two groups of patients: between 31-40 and 51-60 years. Some 12 out of 15 patients had no contraindications for taking an iodine-based contrast medium. The most frequent allergic reactions to Ultravist 370 were rash and urticaria (15 patients). Five patients out of those who experienced adverse reactions reported two symptoms of allergy each while other patients reported one symptom only. Patients with mild symptoms of acute reaction to a contrast medium (15 patients) received pharmacotherapy recommended by a radiologist. Some 13 individuals received Solu-Medrol intravenously and 2 patients received Solu-Medrol intravenously and Fenicort intramuscularly. Conclusions. 1. Using Ultravist 370 in patients is safe, since there is very low risk of adverse side effects caused by the application of this contrast medium. 2. In the present study, age, gender, and risk factors contributed to the development of acute allergic reactions. However, due to the small size of the study group, it is obvious that issues like the incidence of symptoms of discomfort or intolerance of the drug need further research. 3. Owing to the fact that essential biochemical tests had not been performed on a large group of patients, doctors referring patients to a CT examination should take care of their own safety by properly preparing themselves for this procedure. 4. It seems essential to develop and implement regular trainings for CT laboratory staff with reference to the following issues: the incidence and nature of acute adverse reactions to non-ionic contrast medium (Ultravist 370), as well as the procedures for dealing with side effects

Assessment of knowledge of midwives about the scope of professional responsibility under the amended provisions of law

Abstract Introduction. To work safely, knowledge of law is crucial for midwives who should be familiar with the midwife’s rights and duties as well as their professional responsibility. Aim. Assessment of knowledge of midwives about their professional responsibility. Material and methods. A total of 103 MA Midwifery students of the Medical University of Warsaw, including 55 working and 48 not working as midwives. A diagnostic poll, original anonymous questionnaire, 25 close-ended questions, 8 openended questions. Statistical analysis: STATISTICA 10.0, Mann-Whitney U test, p<0.05. Results. Seventy-one percent of the study participants had knowledge of the binding provisions of law and 83% considered this kind of knowledge as necessary in their professional activity. Twenty-four percent of the total did not know any legal regulations. Thirty percent was not familiar with the Nurses and Midwives Act. Only 52% of the study participants were knowledgeable about the legal protection of midwives and indicated the protection established for public officers. Forty-six percent of the total said that the Act on Professional Self-Government of Nurses and Midwives of July 1st, 2011 regulates the issue of self-governance. As many as 30 study participants knew that membership in the self-governing body of midwives is obligatory. Conclusions. Knowledge of nurses about professional responsibility under amended provisions of law is insufficient and does not improve with experience as a midwife. Due to the fact that new acts on professional responsibility of midwives were implemented in Poland beginning in January 1st, 2012, it is advisable to extend qualifications and knowledge of midwives in order to improve their knowledge of professional issues. Midwives should constantly update their knowledge of legal regulations on their profession