Lucyna Iwanow

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 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.

Knowledge of students of selected universities about expanding professional competence of nurses and midwives with reference to prescribing medicines, writing out prescriptions, and referring for diagnostic tests

Abstract Introduction. Since January 1st, 2016, particular groups of nurses and midwives in Poland are allowed to write prescriptions and refer patients to diagnostic procedures without doctors’ involvement. Aim. The aim of the study was to assess what university students know about the changes that expanded the professional competencies of nurses and midwives. Material and methods. The study group comprised of 535 students of three different universities. The group was 82% female and the mean age was 23 years (min.=19; max.=58, SD=4.780). Nursing students were the largest group among the study participants (177 individuals which meant 33% of the total), followed by Medicine students (145 individuals, 27% of all), Midwifery (107 persons, 20% of the total), and Public Health (100 persons, 19% of all). As many as 324 respondents (60%) had never participated in any medical law-related courses. A voluntary and anonymous survey containing 39 questions divided into 3 parts: 13 questions about knowledge, 26 statements concerning attitudes using a Likert scale, 8 demographic questions) was used. Obtaining an approval from the University’s Ethical Review Board was not required. Pearson’s chi-square test was used to compare frequency of the correct answers by students of every major. The Kruskal-Wallis rank test with a post-hoc analysis for multiple comparison of mean rank sums, STATISTICA version 12.5 (StatSoft, Inc.), licensed to MUW, α=0.05, were used to calculate the differences in summative points for correct answers. Results. Nursing students were significantly more likely to choose the correct answers, unlike Medicine or Public Health students (p<0.001), as well as Midwifery students (p<0.002). The answers provided by the students of Medicine, Public Health, and Midwifery were relatively similar. Conclusions. The knowledge of students of various Polish universities concerning the expansion of professional competencies of nurses and midwives was insufficient and needs to be urgently updated. Learning curricula to be modified not only for students of Nursing and Midwifery but also for other members of therapy team, e.g. physicians and pharmacists as well as specialists in public health.