Congestive heart failure (CHF) is the fi nal stage in several heart diseases. The diagnosis of CHF in older patients is a challenge. Preserved left ventricular systolic function is a characteristic type of CHF in seniors. The purpose of the study was to characterize elderly patients with CHF and to highlight specific features of the conditions in seniors. The most common etiology of HF in this group of patients is hypertension and coronary heart disease. In seniors atypical presentations of chronic heart failure is much more common than in younger patients. Malnutrition, limitations of exercise and sedentary lifestyles or comorbid diseases have an influence on asymptomatic, early stage of HF. Th ere are better outcomes of treatment in obese individuals. It is called the obesity paradox. Open communication with a patient and his/her family may improve their response to therapy. When heart failure becomes an incurable disease and aggressive treatment is ineffective, palliative care should be considered in end-of-life heart failure patients. The goal of treatment in the remaining moments of life last moments of life should be maximizing the patient’s comfort.

Background: The aim of the study was to determine the predominant learning style and type of intelligence based on the VARK questionnaire and Multiple Intelligences Questionnaire respectively in second year medical students. Determining the relationship between individual preferences of students, based on their learning style and predominant type of intelligence and the perception of the modified Peyton’s four-step approach used to teach cardiac auscultation.

Methods: The opinion of participants 236 of the modified four-step approach was attained through the use of anonymous questionnaires. Using the VARK questionnaire, the participants’ learning style was defined. The predominant type of intelligence was determined by the Multiple Intelligences Question-naire.

Results: The kinesthetic style was the predominant unimodal learning style in second year medical students (in Polish and international students). The most predominant type of intelligence in Polish students was visual-spatial and mathematical and logical, while in international students the predominant types were visual-spatial and mixed type of intelligence. Quantitative analysis indicated that the modified Peyton’s approach is a valuable learning and teaching method for most students, independent of their predominant learning style or intelligence type. The exception was a small group of students with lin-guistic intelligence predominance according to the Multiple Intelligence Questionnaire, for which the Peyton method was more difficult.

Conclusions: This study proves that the modified Peyton’s approach is useful and effective didactic tool and can be successfully applied to most students. This is a new learning strategy for teaching cardiac auscultation in laboratory conditions in classes for a significant majority. Due to the fact that a group of students with a predominance of linguistic intelligence more often perceived the Peyton method to be difficult, it is worth combining traditional methods with new ones in class so that all students, regardless of unimodal learning style or prevailing type of intelligence, are taught satisfactorily.

B a c k g r o u n d: The aim of the study was to evaluate the usefulness of the modified Peyton’s four-step approach in the teaching of cardiac auscultation and to determine students’ perception of Peyton’s four-step approach.

Me t h o d s: The opinion of the participants on the usefulness of the modifi ed four-step approach was attained through the use of anonymous questionnaires, voluntarily completed by students, and on the basis of semi-structured interviews conducted with a subset of students. 187 second-year students of our 6-year long curriculum were enrolled. They attended an obligatory Laboratory Training of Clinical Skills course. The average group size was 16 students.

R e s u l t s: The survey findings identified that 88.1% of participants found it helpful in developing their understanding of cardiac auscultation. 89.8% of all participants claimed that the new modified four-step approach facilitated memorization. The modified Peyton’s four-step method allows for better organization of classes in the opinion of 87.6% students. The advantages of the method were noticed by the majority of students.

C on c l u s i o n s: The modified Peyton’s four-step approach in the teaching of cardiac auscultation under laboratory conditions was perceived by students to be a comprehensible method that facilitates understanding and memorization. Th is approach allows for improved organization of classes. From the student’s perspective this method allows one to master the technique of cardiac auscultation in the classroom, through the increased demand of the participants’ attention, activity and involvement.

Objectives: The OSCE (Objective Structured Clinical Examination) is a common method of assessing clinical skills used at many universities. An important and simultaneously difficult aspect of good examination preparation is obtaining a properly trained and well-motivated group of assessors. To effectively recruit and maintain cooperation with assessors, it is worth knowing their opinion. The aim of this study was to investigate the opinions of teacher-examiners about the OSCE and to identify the factors that could shape this opinion and influence on motivation.

Methods: A cross-sectional study was conducted using a questionnaire on teachers who participated as OSCE examiners. This questionnaire consisted of 21 questions about their perceptions. Answers were rated in a five-point Likert-type scale. Chi-square or Fisher’s exact test was used to analyze the data.

Results: A total of 49 (out of 52) teachers participated in this study. Nearly 90% of examiners believed that it is fair, and more than 90% that it is transparent. Despite the fact that 67% of examiners believe that the examination is difficult to organize and 71% believe it is stressful for students; according to 72% of respondents the OSCE has a positive effect on learning. More than 91% of examiners believed that the OSCE is an appropriate test to assess students’ skills. Opinions about the examination were independent of specialty, seniority, gender or having taken the OSCE as students.

Conclusion: Teacher-examiners viewed the OSCE as a fair and transparent examination, adequate for the assessment of skills and, despite it being difficult to organize, worth doing as it is appropriate to assess practical skills and positively influences students’ motivation to learn tested skills.