Medical Education and Professional Development

Relevance. Clinical thinking (CT) in modern conditions is becoming a trainable skill and can be acquired not only with experience, but also using virtual reality simulators with an infinite number of options for various nosologies, which allows developing a doctor’s professional thinking systematically and purposefully.

Objective. Comparison of the effectiveness of two training methods: standard in the conditions of classes at the department and in the clinic (group 1) and combined using the XR-Clinic medical simulator (group 2) for the effective formation of CT in residents of the final year of study in a prospective comparative, randomized, controlled study with blinded data analysis.

Material and methods. The study was conducted in January–May 2024. The research participants (RP) are volunteers – second-year residents. The total number of research participants (RP) (screening) is 118 people, 107 are included in the study. All scenarios are based on the model of a planned outpatient appointment with a patient. The study design included a training stage for one of the 2 groups using the XR-Clinic complex – a virtual clinic based on virtual reality. The source of feedback is the expert assessment data and the Smart Center of the XR-Clinic complex with an assessment of the results of the research participants’ actions. After signing the informed consent, randomization was carried out using the random number method. The UI of groups 1 and 2 diverged along their trajectories, and data exchange between them was not possible. Three scenarios were used, audio/video recording was used at all stages and the range of indicators of the actions performed was assessed by categories: safety (wash hands, use soap, use an antiseptic, use a towel), dialogue (collection of complaints and anamnesis), examination (palpation, percussion, auscultation), laboratory and instrumental examination (completeness and necessary sufficiency), treatment and the overall result of the CM. The results are presented, with the correct distribution, as M±SD, where M is the arithmetic mean, SD is the standard deviation, and as Me – median, CI – confidence intervals, minimum-maximum values, Q1–Q3 quartiles for an informative presentation of the studied sample. Dichotomous and ordinal qualitative data are expressed as frequencies (n) and percentage distribution of features. The difference was considered statistically significant at p<0.05.

Results. The groups of research participants did not have significant differences in gender composition, age and length of practical work experience. When comparing the groups in the performance of the «Safety» skill, statistically significant differences were determined between groups 1 and 2 (M₁=7.89; 95% CI 1.48–14.30 and M₂=23.50; 95% CI 11.46–35.54 points, p=0.019). Comparative subanalysis of critical survey points in the Dialogue section showed significant differences with an advantage in favor of group 2. The total score in the Inspection section of the actions performed was significantly better in group 2: Me=200, Q1–Q3=70–240 versus group 1: Me=110, Q1–Q3=50–205 points, p=0.007. The average percentage of necessary requested actions from the Additional Examinations section in the RPs (research participants) of the two groups were comparable and very close, p=0.147. In the Diagnosis section, the RPs of group 2 demonstrated a slightly higher average score: M₁=71.93; 95% CI₁ 59.90–83.96 points and M₂=86.00; 95% CI₂ 76.04–95.96, p=0.079. In the Treatment section, the average number of points on the UI in the groups was distributed as follows: M₁=57.89; 95% CI 44.68–71.11 versus M₂=86.00; 95% CI 76.04–95.96 points, p=0.012.

Conclusion. The group of students who completed even a single clinical case training on the XR-Clinic complex compared to group 1 (traditional training): fully completed the hygienic safety algorithm 4 times more often, asked key questions in the Dialogue section of the case on Arterial Hypertension: 1.5 times more often (presence of bad habits), 5.2 times more often (history of diabetes); made the wrong choice of treatment tactics 3 times less often and achieved 100% results, identifying the genetic predisposition to complications in standardized patient, which is extremely important for determining the risk of complications, formulating a diagnosis and choosing patient management tactics. In the second group, a single case study allowed for a 5-fold improvement in the examination result of one of the key abdominal examination positions in the presence of a jaundice symptom and motivated 15% more UI to palpate the lymph nodes in a patient with cancer. UI demonstrated a high percentage of correct diagnosis in both groups, with a 14% advantage in the group that worked with the virtual patient.

Thus, even after completing the case study once in virtual reality on the XR-Clinic simulator, the research participants demonstrated a better result in many aspects when working with a standardized patient.

The article suggests approaches for the implementation of the educational process in the master’s degree in the field of training 32.04.01 Public health, contributing to the formation of universal competencieswithout which the task of strengthening the health of the country’s population becomes prob, lematic.

The article examines modern features of the formation of a professional communicative culture of a future doctor during the process of studying at a university. The aim of the presented study was to analyze current problems associated with the formation of communication skills among medical students of Medical University. Psychological and organizational problems in the formation of communicative abilities of medical students were identified. The author notes that distance learning during the pandemic had a negative impact on the formation of communicative competence. This analysis made it possible to develop practical recommendations for optimizing the educational process and socio-psychological support of medical students to improve their communicative competence.

Currently, an increasing number of students are combining work and study. The analysis of the results of a survey of 5^th year students of the Faculty of Medicine on the basis of the Department of Hospital Therapy named after R.G. Mezhebovsky Orenburg State Medical University is presented. Based on the results obtained, the leading reasons for the employment of students were identified and the choice of a job was analyzed. It has been established that the presence of work experience does not affect the desire to pursue a professional career in medicine or the choice of a sub-specialization. In the course of the study, data were obtained that students, who combine work and study, devote significantly less time to preparing for practical classes, are more likely to be late and use copying answers to get a positive assessment.

The article analyzes methodological approaches to organizing a blended learning model using the example of the elective course “Pathochemistry of Toxic Environmental Factors” for students majoring in “Medical and Preventive Care” at the Ural State Medical University. The integration of the electronic educational environment is shown through synchronization, supplementation or substitution in the classroom and extracurricular work of the teacher and students. To assess the effectiveness of the blended learning model in the elective course “Pathochemistry of Toxic Environmental Factors”, a performance criterion was taken, including an analysis of each student’s academic achievements in this discipline and the degree of satisfaction with the learning conditions. The analysis of academic performance was carried out on the basis of the rating scores of students studying in 2021–2022 (10 groups, 130 students) and 2022–2023 (8 groups, 118 students), it was revealed that the percentage of failing students decreased by 7.5, and the percentage of students who passed the test for the maximum score increased by 22.6. A survey of students showed a high degree of satisfaction with the quality of electronic resources (96% of respondents) and the frequency of their use in the learning process (99% of respondents).

Current trends in pharmaceutical education require the development of approaches that help maintain students’ sustainable motivation, since their professional interest has a significant impact on their academic success and readiness for their future profession. However, the key factors influencing the motivation of students in pharmaceutical specialties have not been sufficiently studied, especially in the context of various pedagogical and educational strategies. The relevance of this study is due to the need to identify the determinants of motivation and develop recommendations for optimizing the educational process, which will increase the professional interest and academic success of students in pharmaceutical specialties.

The aim of the study is to identify the key factors influencing the motivation of students in pharmaceutical specialties and to develop recommendations for improving the educational process to increase their professional interest and academic success.

Material and methods. The study reviewed existing models for motivating students, and also conducted a survey involving students of different courses of pharmaceutical specialties in order to take into account motivational changes at different stages of training. The questionnaire included scales for assessing intrinsic and extrinsic motivation, the level of satisfaction with the educational process and students’ expectations from training. Quantitative data were analyzed to identify relationships between motivation levels and academic performance.

Results. Data analysis showed that key motivation factors include teaching methods, availability of practical classes, and the ability to provide timely feedback. Interactive teaching methods and mentoring development were found to be the most motivating for students. It was noted that students satisfied with the teaching conditions demonstrated higher academic performance and professional interest.

Conclusion. Based on the data obtained, recommendations were proposed to improve the educational process, including the introduction of interactive teaching methods and the development of an effective feedback system. These recommendations help maintain and increase student motivation, which is important for the formation of professionally trained specialists in the field of pharmacy.

Studying at a medical university in biological subjects is inherently linked to working on living biological objects, which allows students to acquire the necessary skills to independently conduct scientific research in the field of translational biomedicine. The article presents specific methodological approaches developed by the authors to improve the level of research work of students at a medical university, effectively contributing to the development of knowledge of biological objects and their role in extrapolating data from scientific experiments to methods of treating various pathologies in humans.

The article examines problematic use of the Internet, which can adversely affect all areas of medical students’ lives. It is hypothesized that one of the resources for solving maladaptive Internet use can be the development of mindfulness and reflection skills. A study was conducted of the relationships between the characteristics of mindfulness and problematic use of the Internet in first-year medical students (65 study participants). Close inverse relationships were found between the Five-Factor Mindfulness Questionnaire and the Problematic Internet Use Scale. Recommendations are proposed aimed at developing mindfulness in order to expand the range of self-understanding and self-regulation of students, and to form greater involvement in living their own lives.

The aim of the work is to analyse the education in medical schools through the eyes of students and professors in order to find reasoned solutions to some of the problems faced by the Ministry of Health of the Russian Federation, students and professors.

Students and professors of medical universities created a digital questionnaire which was filled in by 454 students of I–VI courses from different faculties of medical universities of our country (medical business 58.5%, paediatric 12.3%, stomatological 13.0%, etc.).

In this paper, the authors analysed the forms of education (budget – 46%, off-budget –30%, target – 24%) and the result of Unified state examination at admission, which was the maximum (Me=272) in budget students, the least (Me=214) in contract students. The authors analysed the reasons for choosing medical education; the main reason was an independent conscious desire to become doctors or work in biomedical specialties (75%), the second place (21%) was taken by the answer “it just so happened”, the third place – the prestige of the profession/university from the point of view of students. It was determined that one third of students manage to combine study with work, the main reason for this is the insufficient level of scholarship, which does not provide a subsistence minimum (38% of students do not receive a scholarship, 51% of students have a monthly scholarship of less than 5 thousand rubles, 5% – 5–10 thousand rubles, 4% – 11–20 thousand rubles, and only 2% – above 20 thousand rubles/month). When payments are higher than the minimum wage, students do not work part-time and devote more time to their studies. The authors also analysed the plans after graduation: 47% are going to go to residency, 20% are ready to work immediately as a clinician; 11% are going to undergo postgraduate training or combine clinical and research activities; 8% have not yet decided, and 5% have already decided to leave the profession. Only 11% of target students are going to return to the territories, the remaining 89% do not plan to work out the target direction.

In the presented work, the authors reflect the results of the study of the attitude of students of Russian medical universities to research and development work (R&D), as well as to the prospects for further professional activity in the considered area of socio-economic relations. The introduction to the article reflects some significant theoretical and statistical aspects of the problem under consideration. The work also presents the data of a sociological study conducted among students of the Samara State Medical University and the South Ural State Medical University on some aspects of their attitude to R&D. The obtained data can be applied in the process of forming a university innovation infrastructure and developing ways to improve the efficiency of the R&D sector in the system of Russian higher medical education.

At the present stage, mentoring is considered, on the one hand, as a personnel technology that ensures the systematic transfer of knowledge, skills and attitudes from a more experienced employee to a less experienced one, or, on the other hand, as a pedagogical technology that ensures the formation of the personality of a future specialist, a harmonious entry of a person into work. The article presents the experience of implementing a mentoring program for graduates of a medical university. The author describes his own developments on monitoring the dynamics of educational outcomes of the mentoring program through an assessment of the motivational, personal, competence, and professional growth of mentees. Recommendations for improving the quality and effectiveness of the mentoring process in medical education are considered.