Topic number
1 . 2020
Editorial

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Abstract
Simulation technologies

Robot assisted versus laparoscopic suturing learning curve in a simulated setting

Abstract

Background. Compared to conventional laparoscopy, robot assisted surgery is expected to have most potential in difficult areas and demanding technical skills like minimally invasive suturing. This study was performed to identify the differences in the learning curves of laparoscopic versus robot assisted suturing.

Method. Novice participants performed three suturing tasks on the EoSim laparoscopic augmented reality simulator or the RobotiX robot assisted virtual reality simulator. Each participant performed an intracorporeal suturing task, a tilted plane needle transfer task and an anastomosis needle transfer task. To complete the learning curve, all tasks were repeated up to twenty repetitions or until a time plateau was reached. Clinically relevant and comparable parameters regarding time, movements and safety were recorded. Intracorporeal suturing time and cumulative sum analysis was used to compare the learning curves and phases.

Results. Seventeen participants completed the learning curve laparoscopically and 30 robot assisted. Median first knot suturing time was 611 s (s) for laparoscopic versus 251 s for robot assisted (p<0.001), and this was 324 s versus 165 (6th knot, p<0.001) and 257 s and 149 s (eleventh knot, p<0.001) respectively on base of the found learning phases. The percentage of ‘adequate surgical knots’ was higher in the laparoscopic than in the robot assisted group. First knot: 71% versus 60%, sixth knot: 100% versus 83%, and eleventh knot: 100% versus 73%. When assessing the ‘instrument out of view’ parameter, the robot assisted group scored a median of 0% after repetition four. In the laparoscopic group, the instrument out of view increased from 3.1 to 3.9% (left) and from 3.0 to 4.1% (right) between the first and eleventh knot (p>0.05).

Conclusion. The learning curve of minimally invasive suturing shows a shorter task time curve using robotic assistance compared to the laparoscopic curve. However, laparoscopic outcomes show good end results with rapid outcome improvement.

Professional Development

Some aspects of professional orientation of applicants for admission to higher education institutions

Abstract

In the article an overview of career-oriented work with applicants planning to enter medical universities is provided. The objectives of pre-university education at medical universities are disclosed. The positive role of small medical academies in preparatory work with the highly motivated institute applicants was noted, their effectiveness was also evaluated. Other modern methods of secondary school graduates selection to identify those who are most prepared for further study at medical universities are described.

Patient-oriented medical consultation. Doctor's perception of a patient: what can be said about it and how does it affects the interaction efficiency in providing medical care

Abstract

Doctors' practical skills for Health Care Management are distinguished by the degree of influence of physician personality on professional tasks accomplish efficiency. Communication skills in patient-doctor interactions for the purpose of collecting complaints, medical history or in order to explain medical information undergo the greatest influence from the direction of doctors' individual psychological personality characteristics on clinical outcomes in medical consultation, on level of satisfaction with patient-doctor interaction from the standpoint of both patient and physician. In our opinion doctor's perception of a patient, as part of his world view, has an unconscious pressure on effectiveness of medical consultation. In the article results of the study of doctor's perception of a patient and its effects on the nature of interaction in healthcare delivery are represented.

Point of veiw

Problems with coordination of educational and professional standards at the stage of physicians training at undergraduate level

Abstract

The aim of this work was to analyze changes in educational standards and projects of the Federal State Educational Standards of Higher Education (FSES HE 3++) of a new generation in relation to training in the field of «clinical medicine» in comparison with professional standards requirements. Allocation of controversial and intricate problems, regarding exclusion a number of fundamentally important requirements for the level of graduates' skills and competencies from educational standards, was defined as this research objective. In the article issues of FSES HE 3++ projects actualization, which are focused on Professional Practices Standards of health professionals, are discussed.

Results. Problems related to the exclusion of fundamentally important requirements for formation of professional, legal and ethical competences of medical graduates from educational standards are highlighted. Contradiction between healthcare system demand for legally qualified doctors and existing educational system, which is not oriented towards formation of their legal competence, is represented. Five generations of educational standards have been analyzed. Gradual replacement of professional, legal and ethical competences is shown. Professional, legal and ethical competences and indicators of their achievements have been grounded, formulated and proposed for introduction into training programs for doctors of all specialties.

Conclusion. Practicability of two-stage process of medical law issues teaching is shown. The first stage should be represented by the following disciplines that are studied at the Department of Forensic Medicine of Kuban State Medical University – «Professional foundations of medical practice» (second course of faculty of pediatrics) and «Legal foundations of medical practice» (second course of medical faculty and third course of public health faculty). In terms of transition to FSES HE 3++, it was proposed to include these disciplines in form of mandatory elective courses in curricula to train doctors, including future dentists, as major, that form professional, legal and ethical competences of a health care professional in accordance with occupational standards. A program for medical graduates has been developed: «Legal issues of upcoming professional activity». It was proposed to include it form of compulsory elective education at the 2nd stage of medical law study. The elective program is focused on professional standards in accordance with strategic lines of specialists training and provides for possibility of its regular processing in accordance with changing legislation.

Educational technologies

Technologies for design of humanistic training model for medical and social workers

Abstract

ln the article methodological approaches to integrated training of specialists with higher medical and social education (taking into account vector of humanization of education) developed by the authors are represented. An educational model that includes technologies for socio-humanitarian disciplines profilisation and humanization of profile disciplines of medical and social workers training was tested. The educational approach demonstrated its effectiveness when we compared the results of students mastering an integrating module using simulation technologies and performing research works in multi-profile project teams.

Experience

Foreign experience in providing medical personnel in rural areas

Abstract

In the article foreign experience in training and retaining medical personnel in rural areas is represented. Among existing programs, the following are most effective: programs that use financial incentives to attract medical personnel to areas with shortage of healthcare workers; programs that use existing or formed connections between medical students and rural areas.

Model of health-saving behavior and state of health optimization program for medical students

Abstract

The result of comparative analysis of periodical and fundamental literature data on modern health-saving technologies and formation of behavioral algorithms for medical students, which are aimed at formation of healthy lifestyle, as well as the results of previously conducted author's researches that made it possible to identify new factors affecting the students' behavioral models have become the creation of an original program of health-forming and health-saving behavior of medical students.

Opportunities of continuous professional development of medical workers at the post-diploma stage at the Kursk State Medical University

Abstract

The solution of the indicated personnel problem is based on the creation of an effective system for the continuous professional development of medical and pharmaceutical workers, aimed at the continuous improvement of professional knowledge and skills, the continuous improvement of the professional level and the expansion of competencies necessary for professional activities. The purpose of the work is to analyze the experience of implementing additional professional programs at the Kursk state Medical University and evaluate the contribution of the Kursk state Medical University to the implementation of the system of continuing medical education at the level of the constituent entities of the Russian Federation, regulated by the national project "Healthcare". The publication presents the results of an analysis of the work of the faculty of postgraduate education at Kursk State Medical University on the implementation of additional professional continuing education programs and professional retraining for 2013-2019. The authors identified the possibilities of continuous professional development and expanding the qualifications of medical workers at the postgraduate stage by implementing additional professional continuing education and retraining programs, including programs implemented through the portal of continuing medical and pharmaceutical education of the Russian Ministry of Health edu.rosminzdrav.ru, in Kursk State Medical University.

Students training quality at non-core department of Dental Faculty at the Medical University

Abstract

From the side of practical healthcare there are rather high requirements on graduates of medical universities. Students, who have chosen dentistry as a specialization, are also not an exception. Important components of training are the feedback strategy and teaching quality assessment. There are various methods for studying of learning efficiency, one of which is student survey.

The aim of the study was to assess compliance of principles of teaching «internal medicine» as a discipline with principles of Stanford training model on the example of dental students.

Material and methods. 93 students of the 3rd year of the Dental Faculty were interviewed. The questionnaire consisted of 14 questions, according to the Stanford training model.

Results. High scores (76- 90%) were registered for all points of this questionnaire, which indicates the satisfaction of dental students with quality of teaching the discipline "Internal diseases". Received data on the learning efficiency were confirmed by positive results of midterm assessment - all students, without exception, successfully passed the exam on "internal medicine" as a discipline. Conclusion. The students of the Dental Faculty trained in "internal medicine" as a discipline expressed positive assessment of the teaching staff activity. It is necessary to continue improving methods of interest stimulation in "internal medicine" as a discipline. And faculty members need to more clearly recognize limitations of dental students possibilities in such a difficult discipline as "internal medicine" mastery. Simultaneous use of several questionnaires to assess students training quality allows us to obtain standardized data on one hand and assess specific features of training in the university on the other hand.

Guide

Designing of a simulation center

Abstract

This article reveals different aspects of designing of a simulation center. Collegial approach enables to take into account various concerns influencing on this process. It describes the most common questions and mistakes arising on the planning stage. The article aims to support a team engaged in this process and provide recommendations on an optimal design of the simulation center, which will satisfy educational goals and needs of the particular institution.

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From Russia with love

Abstract
News

News (# 1, 2020)

Abstract
Announcements

Announcements (# 1, 2020)

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Information

For authous of the journal "Medical Education and Professional Development"

Abstract

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)

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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