Topic number
2 . 2019
Editorial

Editorial

Abstract
Educational Technologies

Amee Guide # 106. Residents as teachers: near peer learning in clinical work settings

Abstract

This AMEE guide provides a framework to guide medical educators engaged in the design and implementation of Resident as Teacher programmes.

The suggested approaches are based on established models of programme development: the Program Logic model to guide programme design, the Dundee three-circle model to inform a systematic approach to planning educational content, and the Kirkpatrick pyramid which forms the backbone of programme evaluation. The guide provides an overview of resident as teacher curricula, their benefits and impact, from existing literature supplemented by insights from the authors' own experiences, all of whom are engaged in teaching initiatives at their own institutions. A conceptual description of the Program Logic model is provided, a model that highlights an outcomes-based curricular design. Examples of activities under each step of this model are described, which would allow educational leaders to structure their own programme based on the scope, context, institutional needs and resources available. Emphasis is placed on a modular curricular format to not only enhance the teaching skills of residents but also enable development of future career educators, scholars and leaders. Application of the Dundee three-circle model is illustrated to allow for a flexible curricular design that can cater to varying levels of educational needs and interests. In addition, practical advice is provided on robust assessment of outcomes, both assessment of participants and programme evaluation. Finally, the authors highlight the need for congruence between the formal and hidden curriculum through explicit recognition of the value of teaching by institutions, support for development of teaching programmes, encouragement of evidence based approach to education and rewards for all levels of teachers.

Continuous education and population ageing

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Changes in the demographic situation associated with an increase in the proportion of older people in society have led to the fact that many characteristics of the social development of society have become largely determined by the corresponding indicators of the social group of the elderly. In particular, in the context of continuous education paradigm, the problem of training for older students arises. There is a lack of development of a scientifically based system for education of this group of people. The aims of this publication were to study impact of changes in the age structure of the population on vocational education of adults, to identify trends and problems in development of older people education and to develop clinical practice guidelines (as exemplified by training medical professionals in information technologies). In the article official statistics, data from scientific publications, expert assessments and generalized practical experience are used and analyzed. A brief analysis of the population structure and age distribution of elderly people is carried out. The trends of changes in population composition and, accordingly, in contingent of adult professional development are shown. The growing share of older students leads to necessity to take into account peculiarities of their education and corresponding adjustment of the education system. Specific features of elderly and approaches to their education are considered. A two-step methodology for competencies formation in a new field for students (as exemplified by training medical professionals in information technologies) is proposed. According to the proposed method, at the first stage elderly student learns how to work with study guide and strictly perform the proposed tasks with step-by-step instructions, and at the second stage he learns how to perform exercises by analogy with typical example of finding necessary solutions for existing differences. Some practical ways of communication with elderly students are also recommended. Specificity of School Organization and Management is considered. The article contains a number of specific proposals that relate to education of older persons. It is noted that for a full-fledged education it is necessary to develop special training packages that take into account the particularities of older persons.

Relationship of academic progress, academic motivation, professional burnout with self-concept of quality of life of graduate medical students

Abstract

Aim. The aim of the study was to investigate relationship of health-related quality of life (HRQoL) with academic progress, motivation and professional burnout, taking into account influence of socio-economic, demographic conditions and objective health status of graduate medical students.

Material and methods. The study was conducted between 01.02.2017 and 01.05.2018 at the School of Biomedicine of Far Eastern Federal University and Pacific State Medical University. 394 students of V-VI courses participated in the study. With the help of comprehensive questionnaire and medical documentation data on demographic profiles, social and living learning environment and living conditions, morbidity were collected. Selfassessment of HRQoL was carried out according to the questionnaire "Self-assessment of HRQoL using MOS SF-36». When calculating sampled population volume the confidence figure of 95% and confidence interval of ±5% were adopted. Statistical significance was assessed when the two-way analysis of variance (ANOVA) was conducted.

Results. HRQoL of graduate medical students was 55.1 points, which corresponds to lower quartile of normal estimations range. Students from evaluable set estimated level of their motivation at 50.6-59.4 points, and level of professional burnout at 27.7-40.3 points. The average level of academic progress was 4.1-4.5 points. HRQoL of graduate medical students strongly correlated with academic progress (0.61; p<0.01), diet quality (0.63; p<0.01), motivation for learning (0.45; p<0.05), comorbidity index (-0.41; p<0.05). Moreover, level of academic progress strongly correlated with motivation for learning (0.72; p<0.01). In turn, the motivation level strongly correlated with morbidity rate. At the same time, high degree of negative relationship between motivation and professional burnout was noted (0.61; p<0.01).

Conclusions. Overall estimate of HRQoL can be used to study correlation of physical and mental health with other factors that are affecting academic progress of medical students. Medical students evaluate their HRQoL as satisfying, their motivation for learning is high and level of professional burnout is low. Among factors that are correlating with academic progress, strongest relationship was noted between HRQoL and academic progress, diet quality, motivation for learning, comorbidity index.

Ways of practice-oriented approach implementation in the study of microbiology

Abstract

In order to improve the efficiency of microbiology schooling, the staff of Microbiology Department develops and implements different methods of student's active practical skills acquisition for their future use in professional activity. Specificity of microbiology schooling makes it possible to form basis for medical judgment by introducing active and interactive forms of conducting classes into the educational process.

The aim of this work was to analyze usage of various methods of students' cognitive activity activization in the process of medical microbiology studying at the Prof. V.F.Voino-Yasenetsky Krasnoyarsk State Medical University in educational process. Each study session is accompanied by record-protocol completion by students. Analysis of protocol design is an effective assessment tool that allows university professor to assess level of practical skills in course of student's individual work adequately. One of the required skills for implementation of practice-oriented education at Microbiology Department of Prof. V.F.Voino-Yasenetsky Krasnoyarsk State Medical University when studying the «Private Microbiology» section is fill in the blank-direction and the blank-result of microbiological study. During the paperwork students consciously choose the material and study method which allows to confirm the diagnosis and to assign adequate antimicrobial therapy. One way to improve educational process is student's participation in research projects. The dynamics of student's activities in Student Research Society of the Microbiology Department has been studied in the period from 2008 to 2018. In the article aims, methods and possibilities of student's practice-oriented individual activity in study of medical microbiology are justified.

Professional Development

Difficulties in education and practical training of young doctor under reform of russian healthcare. Ways to solve the problem and real-life experience

Abstract

Over the last years there has been going global reformation of one of Russian health care system elements - institutional and post graduate training of health personnel. These changes are connected with questions in internship and residency, qualification improvement and replacement of specialist certification for accreditation of future doctors. A survey of more than 3000 doctors from 84 constituent territories of the Russian Federation, which was conducted by experts of the All-Russia People's Front after initiation of a new permit to work system showed that 77% of doctors are not satisfied with young professionals qualification who began to work immediately after University graduation.

While managing this survey of young doctors from Stavropol region chief problems that took place at the beginning of the career were detached: pairing not all young professionals with mentors, working places with lack of equipment, partial lack of computerize workplaces (especially in country), pairing not all general practitioners with nurses, quantity of patients exceeding the standard number for one therapeutic division. All these difficulties were associated with insufficient time for practice at the V-VI courses of the University and further internship cancellation.

To the question: "What would you change in young doctors' training system at 6th course of Medical University?" - 69% of young doctors asked for more hours of clinical practice at hospitals and 73% asked for special course of medical source records filling out.

Analysis of the young doctors' professional difficulties showed that the solutions mentioned above could help to escape up to 80% problems connected with the peoples' health. That's why the doctor who hasn't had clinical practice before rather could do harm than to help patients.

In order to revive the traditions of mentoring and increase the skill level of young district primary care physicians (graduates after 2017), the Ministry of Health and Care Services of the Stavropol Territory, together with the Policlinic therapy department of the Stavropol State Medical University organized "The school of a young therapist", which showed that improved the level of young doctors' activity in the region.

Administrative and service competence of the personnel reserve of the medical university

Abstract

The article presents the results of the assessment of the level of development of administrative and service competences of the personnel reserve of a medical university (using the example of the Pirogov Russian National Research Medical University - RNRMU). As a result of the study, a competence-based model for evaluating employees of the personnel reserve of a medical university was formed, which includes six administrative and service competencies: problem analysis, planning and organization, persuasive communication, initiative, interaction-oriented, stress resistance. It has been reliably established that the personnel reserve of a medical university is characterized by deficiency in a number of administrative and service competencies, which manifests itself in a low level of problem analysis both at the level of individual structural divisions and at the university level as a whole.

Point of veiw

About the names of qualifications assigned to residency graduates

Abstract

In the run-up to the graduation campaign for residency programs, this article addresses the issue of the revision of titles of qualifications awarded to residency graduates, which are reflected in residency diplomas and in annexes to them.

The article serve as a guideline and will be useful for educational and scientific organizations implementing residency programs, the aim of which is to harmonize information (the name of qualifications) which is contained in a number of statutory and regulatory enactments and is reflected in the issued documents on education and on qualifications.

Medical, social and ethical aspects of the doctor’s activities on the prevention of diseases in the medical institute

Abstract
In the article importance of medico-social and ethical aspects of the physician activity in primary prevention of diseases is shown. On the ground of author's analysis it was concluded that in teaching and learning activities, theranostic and educational- preventive work, future doctor should rely on the ideas of student-centered pedagogy. As a result special conditions are created for useful professional competencies formation. The article presents the author-developed organizational and methodological methods of prophylactic work training. Development of a responsible attitude to health and the prevention of iatrogenic diseases is promoted by the solution of medical and deontological tasks.

Socially-philosophical analysis in medico-pedagogical process

Abstract

Globalization of education is characterized by complexity and dynamism of occurring processes and phenomena. This requires closer definition of forms and methods of education and mentoring of medical students. Participation of medicine in human life as a phenomenon that comprise his life entirely from birth to death requires a high moral culture of doctor-patient interaction, as well as the corresponding modern scientific-technical equipment of the process of providing medical services, education and mentoring of medical students must include instructional method and heuristic approach in their reasonable and balanced attitude, reference cultural patterns of society, resulting in language and mimetic forms. Educational system in medical university requires a serious correction of ideology and methodology which are necessary for the development of clinical disciplines and theoretical material. For example, anatomy and philosophy, which are typically not connected to each other, significantly reduce motivational component of the student learning process, because they make it impossible for a student to open medicine in himself and himself in medicine. Because of this break students get the impression that they are loaded more with the theory, and less with the practical skills. It has to be noted the fact that the higher-education teaching personnel (HETP), which has substantive competence, is not always ready to work in problem mode. This reduces adaptive and competitive activity of medical graduates and leads to their sociocultural and professional disorientation in medicine and society. The truth of the matter is that at the present stage of education development in Russia the following contradictions have become aggravated: tensions between productive employment of students in academia and absorption of theoretical and practical knowledge on subjects; tensions between cultural and disciplinary competence of HETP and ability of medical students to adapt to socio-cultural and medical environment.

Aim. The aim of the study was to investigate causal relationships in education-society-medical and lecturer-student-patient systems.

Objectives. Research objectives included determination of further education development vector in continuously changing conditions of social and medicine advancement and analysis of the components that make up its content.

Conclusions. Modern educator is a navigator on socio-medical problems of the student, who studies his own, medical and social problems as a single complex of education, preserving legacy and introducing advanced technologies that contribute to normal society regeneration at the present stage of social development.

Experience

Comparative analysis of competence motivation and career facilities of students of medical and multidisciplinary universities according to the survey data

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In the article questions of career orientation of medical students and students of other specialties were considered. The differences in personal characteristics of students of various specialties were analyzed, their professional attitudes were studied, and short - and long-term career goals were estimated. Medical students are distinguished by characteristics that are necessary in their future work, such as teamwork skills and purposefulness. At the same time, self-efficacy of medical students is lower than of other respondents, which may be due to the complexity of the profession. Considerable part of students plans to continue their education after graduation, which is explained by necessity to obtain additional knowledge and experience. Future doctors are characterized by a high prevalence of «leader» and «careerist» career types. In general, it can be noted that medical profession has influence with long-term career trajectories of students, in which humanitarian goals and possibility of career growth are leading.

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CHIEF EDITOR
CHIEF EDITOR
Balkizov Zalim Zamirovich
Secretary General of the Russian Society of Medical Education Specialists, Director of the Institute of Training of Medical Education Specialists of the Russian Medical Academy of Continuing Professional Education, 125993, Moscow, Russian Federation, Professor of the Department of Vocational Education and Educational Technologies of the N.I. Pirogov RNIMU of the MOH of Russia, CEO of GEOTAR-Med, Advisor President of the National Medical Chamber, Moscow, Russian Federation

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