Piotr Leszczyński

Analysis of Web-based learning methods in emergency medicine: randomized controlled trial

Introduction In medical education, Web-based learning is increasingly used as a complement to practical classes. The objective of the study was to perform a comparative analysis of three different forms of e-learning course on emergency medicine in terms of an indicator of knowledge growth and students’ satisfaction. Material and methods For the purpose of the study, we developed and implemented a tool in the form of an online course: A – non-animated presentation, B – video, C – interactive video. The participants were undergraduate students of emergency medicine and nursing (n = 106). A pre-test and a post-test were carried out, and the resulting data were analyzed using parametric tests (t-test, ANOVA, post-hoc). Final questionnaires assessing six parameters of satisfaction were also evaluated. Results A significant increase in knowledge in the experimental group which used an interactive video was observed (p = 0.04). Moreover, the number of replays of learning material was the highest in group C (2.09 ±2.48). The level of post-course satisfaction turned out to be comparable in all three groups (p = 0.62). Conclusions The study allowed the interactive course to be identified as the most effective method of distance learning among selected ones. Due to the limitations of the study, we conclude that there is a need for further studies on the effectiveness of e-learning in emergency medicine.

Multimedia and interactivity in distance learning of resuscitation guidelines: a randomised controlled trial

ABSTRACT The aim of the study was to conduct a comparative analysis of three forms of knowledge transfer online, taking into account the long-term knowledge growth rate and the satisfaction of students surveyed in respect to distance learning. The cohort of participants for this survey were students of the first degree, studying in the Emergency Medical Services. The authors created three e-learning courses in basic and advanced resuscitation procedures. The level of course participants’ satisfaction was analysed, as well as the knowledge growth rate measured three times: 7, 30 and 90 days, respectively, after finishing the course. The level of satisfaction in all the groups surveyed was comparable. The growth rate for knowledge was the highest in group C in the second and third survey, respectively (30 and 90 days after the end of the course), and a significant difference in favour of course C was demonstrated one month after finishing classes.

Tofacitinib in the treatment of patients with rheumatoid arthritis: position statement of experts of the Polish Society for Rheumatology

Tofacitinib is a newly approved small-molecule targeted synthetic disease-modifying antirheumatic drug. The drug was designed as a selective and specific inhibitor of pro-inflammatory receptor signalling. Tofacitinib inhibits the process of intracellular signalling from the receptor to the cellular nucleus and inhibits the inflammation process via a new pathway (inhibition of the Janus kinases), which is unavailable to biological medicines. Tofacitinib has been approved for use in the treatment of patients with moderate to severe active RA. The drug may be used in combination with methotrexate or another conventional synthetic disease-modifying antirheumatic drug or in monotherapy. The efficacy of tofacitinib has been confirmed in several clinical trials. The drug inhibits radiographic progression of the disease. The innovative mechanism of action of tofacitinib is a noteworthy feature because it offers hope of effective treatment for patients who fail to respond to other drugs. The presented article discusses the mechanism of action and the clinical application of tofacitinib. Tofacitinib represents a new group of disease-modifying antirheumatic drugs that can be placed on an equal footing with biological drugs already available.

Evaluation of virtual environment as a form of interactive resuscitation exam

ABSTRACT There is scientific evidence confirming the effectiveness of e-learning within resuscitation, however, there is not enough research on modern examination techniques within the scope. The aim of the pilot research is to compare the exam results in the field of Advanced Life Support in a traditional (paper) and interactive (computer) form as well as to evaluate satisfaction of the participants. A survey was conducted which meant to evaluate satisfaction of exam participants. Statistical analysis of the collected data was conducted at a significance level of α = 0.05 using STATISTICS v. 12. Final results of the traditional exam (67.5% ± 15.8%) differed significantly (p < 0.001) from the results of the interactive exam (53.3% ± 13.7%). However, comparing the number of students who did not pass the exam (passing point at 51%), no significant differences (p = 0.13) were observed between the two types exams. The feedback accuracy as well as the presence of well-prepared interactive questions could influence the evaluation of satisfaction of taking part in the electronic test. Significant differences between the results of a traditional test and the one supported by Computer Based Learning system showed the possibility of achieving a more detailed competence verification in the field of resuscitation thanks to interactive solutions. GRAPHICAL ABSTRACT

Distance Learning Methods in Continuing Education of Paramedics

Abstract The process of continuing education of paramedics is based on gaining educational credits during five-year educational periods. One of the forms of self-improvement are Internet-based educational programs. The lack of regulations concerning the organizational and technical aspects of e-learning made the authors attempt to analyze the phenomenon. The aim of the article is to present an initial analysis of the role of online educational programs in comparison with other forms of professional training of paramedics. One in three respondents has recently used one of the methods of distance learning. Despite the low awareness of the effectiveness of e-learning, almost 70% of the interviewees expressed a positive opinion about it and over 50% were willing to use such forms in the future. The respondents preferred online trainings in the asynchronous version, containing audio-visual materials and providing the possibility to obtain a certificate issued to the participant after completing the course. The demand for topics in the area of professional training included mainly the fields of Drug Therapy, electrotherapy, electrocardiogram (ECG) evaluation, medical segregation, and help in delivery in pre-hospital conditions. Modern forms of distance learning do not make it possible to acquire practical skills, yet their role in professional training of paramedics is still significant. According to the authors, online educational programs constitute an effective complement to traditional training through the performance of tasks in a mixed form, known as blended-learning.

Thrombocytopenia resistent to standard therapy in lupus patients – analysis of 3 cases and clinical statement

Hematologic disorders, including thrombocytopenia, are a common symptom of systemic lupus - Systemic Lupus Erythematosus (SLE). An important diagnostic and therapeutic issue is the severe and recurrent thrombocytopenia resistant to standard treatment. It requires extensive diagnostics and a multi-directional view on its causes beyond the autoimmune process. Currently, there is no single treatment regimen for these disorders. Corticosteroids (CS) are the first-line drugs, but their chronic use is a big problem, they are not always successful and often generate a number of complications, especially in moderate to high doses. In the case of thrombocytopenia associated with the activity of SLE, immunosuppressive therapy is the gold standard and may result in long-term remission of symptoms and clinical stabilization. The major problem is thrombocytopenia resulting from other causes, such as infection or medications. This study discusses severe recurrent thrombocytopenia on the basis of three clinical cases, analyzing both the various causes of disorders, and providing ways of management and treatment. Special attention is paid to the correlation of thrombocytopenia with the clinical and immunological activity of SLE. It seems that severe and refractory thrombocytopenia may be a critical point and largely determine the management and treatment possibilities of SLE.

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.