M. GRZEŚKOWIAK, R. PODLEWSKI, Z. ŻABA, A. TUROWSKA-KÓSKA



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Nowiny Lekarskie 2001, 70, 7, 847 853 M. GRZEŚKOWIAK, R. PODLEWSKI, Z. ŻABA, A. TUROWSKA-KÓSKA THE EFFECTIVENESS IN TEACHING OF THE MANAGEMENT IN EMERGENCY SITUATIONS BASED ON THE REALIZATION OF TEACHING PROGRAMMES TO MEDICAL FACULTY STUDENTS OF THE K. MARCINKOWSKI UNIVERSITY OF MEDICAL SCIENCES IN POZNAŃ Department of Teaching Anaesthesiology and Intensive Therapy Karol Marcinkowski University of Medical Sciences, Poznań, Poland Head of Department: A. Łakomy M.D, PhD Summary KEY WORDS: emergency procedures, first aids, tests, resuscitation The efficacy of education with regard to the medical training in first aid and advanced life support is presented. Students were asked to solve the single choice test twice: at the commencement and after finishing up the course of first aid classes. Conclusions were drawn concerning the improvement of ' performance after completing such course. EFEKTYWNOŚĆ KSZTAŁCENIA W DZIEDZINIE PIERWSZEJ POMOCY OCENA WYNIKÓW KSZTAŁCENIA NA PODSTAWIE PROGRAMÓW NAUCZANIA NA WYDZIALE LEKARSKIM AKADEMII MEDYCZNEJ IM. K. MARCINKOWSKIEGO W POZNANIU Streszczenie SŁOWA KLUCZOWE: czynności ratownicze, pierwsza pomoc, testy, resuscytacja Praca dotyczy efektywności kształcenia w dziedzinie pierwszej pomocy oraz pomocy kwalifikowanej studentów Akademii Medycznej im. K. Marcinkowskiego w Poznaniu. Na początku i końcu zajęć z Pierwszej Pomocy studenci pisali testy, których wyniki pozwoliły na dokonanie oceny efektywności kształcenia. Wnioski, które wyciągnięto dotyczą: programu kształcenia, zainteresowania studentów przedmiotem, poziomu nabytej wiedzy. Na koniec postawiono propozycje dotyczące zmian programu na taki, który zwiększyłby zakres wiadomości z pierwszej pomocy. Introduction The goal of the study was to assess the knowledge of cardiopulmonary resuscitation and the management of some emergency procedures. This work consists of two parts: Part I The effectiveness in teaching the management (practical). Part II The effectiveness in teaching cardiopulmonary resuscitation (theoretical).

848 M. Grześkowiak et al. First year Basic Life Support Course 6 lectures 16 seminars and skill-labs Practical exam CURRICULUM Faculty of Medicine Third year Basic Life Support Refreshing Course 16 seminars and skill-labs clinical and nursing practice Practical exam Fourth year Advanced Life Support Course 6 lectures 20 seminars and skill-labs Practical exam Sixth year Anaesthesiology and Intensive Therapy Course 15 lectures 15 seminars 30 skill-labs Final practical and theoretical exam. Part I The effectiveness in teaching the management Research group: 100 Medical Faculty (from I, III, IV and VI year) Restoration of the airway End I 2,00% 92,00% III 35,00% 94,00% IV 58,00% 96,00% VI 62,00% 99,00% 157 (39,25%) 381 (95,25%)

The effectiveness in teaching of the management in emergency situations... 849 Mouth to mouth and mouth to nose ventilation mouth to mouth mouth to nose End mouth to mouth mouth to nose I 32,00% 28,00% 92,00% 85,00% III 53,00% 34,00% 95,00% 91,00% IV 65,00% 45,00% 98,00% 93,00% VI 66,00% 43,00% 97,00% 97,00% 216 54,00% 150 47,00% 382 95,50% 366 91,50% Indirect cardiac massage End I 5,00% 97,00% III 62,00% 98,00% IV 73,00% 99,00% VI 85,00% 100,00% 225 (56,25%) 394 (98,50%) Artificial ventilation by Ambu bag End IV 8,00% 98,00% VI 45,00% 100,00% 53 (26,50%) 198 (99,00%)

850 M. Grześkowiak et al. Intubation performance End IV 2,00% 87,00% VI 56,00% 92,00% 58 (29,00%) 179 (89,50%) Defibrillation performance End IV 0,00% 93,00% VI 58,00% 97,00% 38 (29,00%) 190 (95,00%) Part II - The effectiveness in teaching cardiopulmonary resuscitation Research group - 1288 Medical Faculty : I year 267 III year 254 IV year 411 VI year 356. Methods 3 different didactic tests: test A basic knowledge from cardiopulmonary resuscitation; test B basic knowledge from cardiopulmonary resuscitation and emergency situations; test C advanced level knowledge from cardiopulmonary resuscitation. The construction of the tests was based on the ABC - B. Niemierko taxonomy: A. Retaining information (W b ) B. Understanding information (R) C. Using information in typical situations (Z a ) D. Using information in untypical situations (Z p )

The effectiveness in teaching of the management in emergency situations... 851 General knowledge (W o ): W o = W b + R + Z a + Z p Didactic tests were used at the beginning of the classes and in the end. Points which received in the tests were put in formula. Effectivenes in teaching - Kazimierz Denek formula: S x = M C x 100% S x effectiveness in teaching M result (points receive in test) C x planning purpose (maximum points receive in test) Effectivenes in teaching based on the test A 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% test - I year - Final test - I test - year - III year - Final test - III test - year - IV year - Final test - VI year - General knowledge Understanding information Retaining information Using information in typical and untypical situations

852 M. Grześkowiak et al. Effectivenes in teaching based on the test B 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% test - III year - 1999/2000 Final test - III test - year - 1999/2000 IV year - 1997/1998 Final test - IV year - 1997/1998 Final test - VI year - 1997/1998 General knowledge Understanding information Retaining information Using information in typical and untypical situations Effectivenes in teaching based on the test C 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Final test - IV year - 1997/1998 Final test - IV year - Final test - VI year - 1997/1998 General knowledge Understanding information Retaining information Using information in typical and untypical situations

The effectiveness in teaching of the management in emergency situations... 853 Results The best effectiveness in teaching cardiopulmonary resuscitation (CPR) is on the first year. High year do not repeat the knowledge from CPR and they come to the classes poorer in information. Students who were tested do not know how to learn CPR, they do not feel the need to learn systematicaly. The obligatory curriculum on cardiopulmonary resuscitation at Karol Marcinkowski University of Medical Sciences in Poznań allows to receive results on the adequate level. References 1. British Association for Accident and Emergency Medicine. Directory. 1996. 2. Dale J., Green J., Reid F., Glucksman E. Primary care in the accidents and emergency department. British Medical Journal. 1995: 311 pp. 423-426. 3. Eysenbach G. Medicine and Medical Education in Europe. New York Stuttgart 1998. 4. Green J. Primary care in accident and emergency and general practice: a comparison. Social Sciences Medical 1992: 35 pp.987-95. 5. Lavy J., Koay C. First aid treadment of epistaxis are the patients well informed? Emergency Medical Journal 1996: 13 pp.193-195. 6. Wardrope J. Accident and emergency medicine. British Medical Journal. 1998, 316.