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Abstract

B a c k g r o u n d: The digital rectal examination (DRE) is a part of the standard physical examination and a useful diagnostic tool for detecting various lower gastrointestinal tract abnormalities. However nowadays it has been observed that medical students might not be properly prepared for performing and interpreting of DRE. The purpose of the study was to evaluate the knowledge and experience of Polish medical students about DRE. Ma t e r i a l a n d M e t h o d s: A prospective study was carried out using a questionnaire accessible via internet platform. The survey consisted of 12 questions and considered experience as well as practical and theoretical knowledge about DRE. 976 responses from nine Polish medical universities were included in the study. R e s u l t s: 38.68% of students have never performed DRE with “lack of opportunity during courses” (71.09%) as the most common reason. Among responders who performed this examination only 12.72% had done it more than two times. Usefulness of DRE was mostly assessed as high and very high (55.63%). Students in the self-assessment part indicated low and very low (18.72% and 39.61%) technical abilities and also low (25.34%) interpretation skills. C on c l u s i o n: The knowledge of Polish medical students about DRE is insuffi cient. Medical universities should pay particular attention to this fi eld of examination to improve theoretical as well as practical skills of future doctors.
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Abstract

O b j e c t i v e s: Patient-centered care (PCC) is associated with better doctor-patient relationships, resulting in a decrease in symptoms, hospitalizations and health costs. However, studies analyzing factors infl uencing patient-centered attitudes show ambiguous results. The purpose was to assess the impact of the Clinical Communication Course (CCC) in Jagiellonian University, Cracow and other factors on Patient-Centered Attitudes (PCA) and Attitude toward Clinical Skills Learning (CSLA). M e t h o d s: We retrospectively compared Polish-speakers (CCC+, n = 160), English-speakers (CCCen+, n = 55) aft er the CCC and upperclassmen Polish-speakers without it (CCC–, n = 122). Validated questionnaires to measure PCA (Leeds Attitude Toward Concordance II and Patient-Practitioner Orientation Scale (PPOS)) and for CSLA (Communication Skills Attitude Scale with negative subscale (CSAS-N)) were used. The higher the scores, the more PCA, and negative CSLA respectively. Students completed questionnaires and answered questions regarding age, sex, motivation to study (coded as humanitarian — MotHUM, financial — MotFIN, combination — MotMIX) and considered specialization — coded as with more human contact (family medicine, psychiatry, pediatrics — SpecHUM) and others (SpecNHUM). Statistics were prepared in R. R e s u l t s: CCC+ scored higher in PPOS (2.91 vs. 2.74; p = 0.003) than CCC– and higher in CSAS-N than CCCen+ (31.22 vs. 28.32; p = 0.004). In CCC+ SpecHUM scored lower than SpecNHUM in PPOS (2.65 vs. 2.94, p = 0.012). MotFIN scored higher then MotMIX in PPOS (3.01 vs. 2.7, p = 0.036). Correlations were statistically significant. C o n c l u s i o n: CCC improved PCA in CCC+. Th ey showed more negative CSLA than CCCen+. Among CCC+, surprisingly, SpecNHUM presented more PCA than SpecHUM as well as MotFIN compared to MotMIX.
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