Медицинское образование и профессиональное развитие № 3 (47) 2022

Medical Education and Professional Development

Medical Teachers? Community Journal

TThe Journal serves to consolidate medical teachers: it addresses the issues of practical teaching at the medical and pharmaceutical Universities and colleges, tracing the most progressive trends emerging in the fields of training modes and proficiency assessment to develop effective teaching and learning.

The Journal is expected to publish the translations of some most valuable articles from the foreign journals and books on the medical education, and in particular such journals like Medical Education, Medical Teacher etc.


Topic number
3 . 2022
Simulation technologies

BUILDING DOCTOR’S COMMUNICATION COMPETENCE USING VIRTUAL PATIENTS

Abstract

The issue of developing effective technologies for teaching communication skills to doctors has been relevant over the past decades, which is confirmed by the corpus of research data from dozens of foreign and Russian authors analyzed for this study. The use of simulation technologies in this area is an innovative approach. The presented study describes the taxonomy of simulation types suitable for teaching communication skills and the selection criteria for one or another type depending on the learning objectives and technical capabilities. The subject of the study, therefore, is the virtual patient as a method of teaching communication skills to medical professionals. A virtual patient has a propaedeutic function in preparing the future doctor for an exposure to a real patient.

The authors took part in designing educational program for the specialty General Medicine and, taking into account Russian and foreign experience in this area, developed a work program for the discipline “Doctor’s Communication Skills“. The program integrates virtual patients, as well as a set of training activities for self-study and classroom work, an assessment system. The virtual patients for this course were developed based on real clinical cases, with each case redesigned according to the learning objectives of the specific module.

Blueprinting method was used to develop a set of training activities. They included online lectures, self-study work preparing presentations in small groups, work with a virtual patient, role-playing games with a standardized patient, discussions, and reflective essays.

A comparative analysis of the results of the input and output testing (n=209 students) revealed a high level of student satisfaction and made it possible to determine the prospects and directions for integrating virtual patients into the process of forming the doctor’s communicative competence.

Educational technologies

TESTING OF RESIDENTS AS A TOOL FOR ASSESSING QUALITY OF THEIR TRAINING IN THE DISCIPLINE OF PUBLIC HEALTH AND HEALTH CARE

Abstract

In this paper the authors discuss universal and professional competencies formed in the process of residency training, based on the legislation of the Russian Federation, which requires residents to be able and willing to understand the provisions of relevant regulatory legal documents and navigate the novelties of the legislation. Thus, the aim of this study is to assess the level of residents’ knowledge on the one hand and to identify the most common mistakes for development of targeted pedagogical interventions to prevent them on the other hand.

Material and methods. The authors analyzed results of 328 clinical residents with average age 24.1±1.9 years who were offered a computer based test containing 50 MSQs. The results of 922 testing attempts were considered. The ratio of successful to unsuccessful attempts to pass the test was 1 : 1.81.

The results of successful attempts were distributed as follows: 208 people (63.3%) completed the test within 71–80%, 102 people (31.2%) scored 81–90% and only 18 residents (5.5%) gave more than 91% correct answers. With high degree of reliability, the residents made more mistakes in questions related to main provisions of the healthcare legislation than in any of other four modules of the test (p≤0.05).

Conclusion. Thus, the study conducted suggests the expediency of additional training of future doctors in this field immediately prior to their primary accreditation taking into account dynamically changing legislative framework.

ORGANIZATIONAL ASPECTS OF MULTIDISCIPLINARY TEAMS: QUALITY STANDARDS, EFFICIENCY AND IMPLEMENTATION IN PRACTICE

Abstract

The multidisciplinary approach is considered to be the gold standard in clinical decision-making and can be implemented at the organizational level as a multidisciplinary team, or at the functional level – as a clinical decision-making process. In Russia, there is no practice of assessing the quality and effectiveness of multidisciplinary teams, which requires familiarization with existing approaches to its assessment, and determining the necessary competencies of specialists.

The aim – to describe the existing approaches to assessing the quality and effectiveness of multidisciplinary teams, to provide recommendations on their implementation in local clinical practice and education.

Material and methods included the historical method, analysis of regulatory information, content analysis of literature.

Results. In Russia, the need for a multidisciplinary approach is fixed in the procedures for providing medical care and is implemented at the functional level. There are seven standards for evaluating the quality of MDT, of which TEAM is the most comprehensive. The most significant factors for the success of multidisciplinary teams are the group work of its members and organizational culture, the implementation of patient–centered principles and the clinical decision-making process, which comprehensively takes into account various aspects of medical care – clinical outcome and possible complications, tariffs within the medical insurance system, hospital expenses and available resources, individual preferences of the patient.

Conclusion. Healthcare managers should be aware of the importance of assessing the quality and effectiveness of MDT work and implement appropriate assessment standards in practice. Within the framework of continuous medical education programs, special attention should be paid to the development of «soft» skills among medical specialists – teamwork, patient-centricity, organizational behavior.

METHODOLOGY AND ASSESSMENT OF THE FORMATION OF STUDENTS OF THE MEDICAL COLLEGE OF COMPETENCE IN THE APPLICATION OF THE CONCEPT OF LEAN PRODUCTION IN THEIR FUTURE PROFESSIONAL ACTIVITIES

Abstract

The article presents a methodology for assessing the formation of innovative competence in future nursing professionals with the optimal content of the criterial-diagnostic apparatus for assessing lean, communicative and informational competencies. The described results of the application of indicators for assessing the level of formation of lean-competence among students demonstrate the objectivity of the assessment and the effectiveness of the proposed model.

STUDENTS’ ATTITUDE TO BLENDED LEARNING USING THE «FLIPPED CLASSROOM» TECHNOLOGY

Abstract

The aim of this study is to conduct a comparative analysis of students’ attitudes to the «inverted classroom» technology and traditional learning.

Material and methods. To achieve the aim of the study, the method of pedagogical experiment was used. 124 students of Sechenov University, who were divided into 2 equal groups, were involved in filling out a specially designed questionnaire survey card. The experimental group of students studied using the «inverted classroom» technology, and the control group studied using the traditional form of training. The results of students’ training were evaluated based on the materials of a questionnaire survey and written answers of respondents to control questions.

Results. The successful use of the «inverted classroom» technology became possible with the development of computer multimedia technologies, which made it possible to create educational videos used by teachers instead of classroom lectures, which helps to increase the time for the practical part of classes. Most students have a positive attitude to mixed learning using the «inverted classroom» technology, due to the development of new topics independently in comfortable home conditions. In order to attract students to independent training and activate their teamwork during classroom classes, it is advisable to appoint tutors from among the most motivated students who are informal leaders in the group. In the process of independent preparation of students and during classroom classes, educational work should be carried out with them. To achieve maximum efficiency when using the «inverted classroom» technology, it is necessary to take into account objective and subjective factors that affect the quality of students’ mastering of educational material.

Conclusion. The results obtained in the course of the study indicate that the technology «inverted classroom» is a promising direction for the development of a system of mixed learning of students.

Professional Development

TEACHING THE BASICS OF THE SAFETY OF MEDICAL ACTIVITY AS A NECESSARY ELEMENT OF THE TRAINING OF HEALTH PROFESSIONALS

Abstract

Currently, World Health Organization considers the provision of unsafe medical care to be a global health problem. The inclusion of issues of ensuring the safety of medical activities in the training programs of doctors and nurses will allow graduates, based on their knowledge, to ensure the provision of safe services in healthcare, reduce the risks for medical organizations of financial and reputational losses, bringing to responsibility, including criminal. Further improvement of the regulatory framework in this area will optimize both the processes of improving patient safety and the educational process.

ARTIFICIAL INTELLIGENCE AS A NEW PHENOMENON IN THE DEVELOPMENT OF HEALTHCARE AND MEDICAL EDUCATION (LITERATURE REVIEW)

Abstract

Currently educational organizations of higher professional education are faced with the need to train qualified personnel with professional competencies that will provide medical workers with labor descriptors for the introduction of digital technologies and work with artificial intelligence in the future. In this regard, it becomes relevant to analyze the main trends in the use of artificial intelligence in healthcare, its prospects for development and problems of implementation in practice. The analysis of 36 domestic and foreign scientific articles on the problem of the introduction of artificial intelligence in healthcare, published in the period from 2002 to 2022, showed that sufficient domestic and foreign experience has been accumulated to determine the main directions for improving the system and quality of medical education in order to meet the needs of the healthcare system for the introduction of digital technologies. The presented review allows us to form an idea about the prospects of using artificial intelligence in medicine, about the need to train future medical professionals who have knowledge and skills to work with artificial intelligence when performing their professional duties in modern conditions.

Experience

ANALYSIS OF VARIOUS METHODOLOGICAL APPROACHES TO ORGANIZATION OF SUMMATIVE ASSESSMENT IN CHEMISTRY FOR MEDICAL STUDENTS DURING IMPLEMENTATION OF FSES 3

Abstract

Introduction. Applying the Federal State Educational Standards of the third generation has made it necessary to modernize the approach to teaching the discipline «Chemistry» at Medical University. First of all, modifications affected the final control at the end of the course (with reducing the discipline’s hours, it acquired the form of a test with an assessment instead of an exam).

The aim of the study was to analyze features of methods for organizing various forms of credit with an assessment in the discipline «Chemistry» as a summative assessment and to evaluate relationship between the form of assessment, rating results and quality of mastering the material to improve the level of training of medical students.

Material and methods. An analysis of various forms of final control in the discipline «Chemistry» for 10 years of the Federal State Educational Standard‑3 operation from 2011 to 2021 was carried out at the Department of General Chemistry of the Ural State Medical University using the example of the Faculty of Treatment and Prevention. The department used such forms of credit as computer testing, written ticket control and written testing, including open-ended questions. The results of specified forms of credit and the percentage of «survival» of residual knowledge after two semesters were analyzed. Statistical processing of data on the results of the exam was carried out in the Microsoft Excel program and on the MedSpace distance education platform (Moodle version adapted for Ural State Medical University). The application package Statistica 6.0, MS Excel, Vortex 5.0 and 7.0 was used. Data are presented as arithmetic means and standard error of mean (M±m).

Results and discussion. The computer test form of the final test does not reveal the depth of knowledge of students, but allows you quickly process received answers. The result is a high passing rate and a low level of residual knowledge of students. The ticket form of control is the most difficult for first-year students to perform and for faculty members to check, but the level of residual knowledge among those who passed such an examination is the highest.

Conclusion. The best form of final control in the discipline «Chemistry» is written testing, since it includes questions on all topics of the course and open-ended tasks that require detailed answers. This form of credit with assessment encourages students to prepare systematically and thoroughly, facilitates work of faculty members when checking a huge number of papers.

STUDENT RESEARCH GROUP: HOW TO ORGANIZE THE MANAGEMENT OF A DISTRIBUTED TEAM

Abstract

Background. The increasing flow of information and the epidemiological situation of recent years forces us to look for digital tools for managing a distributed team for scientific work in biomedical disciplines. We want to share our experience in finding and testing tools to solve such a problem.

Aim – to select tools for organizing productive collaboration of a distributed team of a student research group.

Material and methods. A comparative analysis of 6 tools (Trello, Office365, Meister, Bitrix24, Asana, Google Workspace) for collaboration on 12 criteria was conducted. Each tool was assessed from 4 to 6 months.

Results and discussion. A wide selection of tools for managing a distributed team allows you to flexibly organize scientific and practical work of any complexity for a team of any size. You can assemble a completely free set of tools or with a minimum cost.

Conclusion. The use of tools for collaboration of a distributed team allowed us to simplify the organization of the work of the student scientific circle and not to stop working on projects in the conditions of the lockdown of the COVID‑19 pandemic.

GRADUAL ACQUISITION OF SKILLS IN ULTRASOUND DIAGNOSTICS IN A MEDICAL UNIVERSITY

Abstract

The article recommends a step-by-step approach to the acquisition of ultrasound diagnostics skills by medical students. Ultrasound is not included as a separate discipline in the educational program, but is willingly chosen by students as an elective subject. The study of normal ultrasound anatomy using virtual ultrasound simulator when conducting independent work of students under the supervision of a teacher, is effective in the study of topographic anatomy and physiology. With the introduction to clinical practice, the use of ultrasound simulator in training helps to acquire skills in interpreting echograms. However, the analysis of clinical situational problems should also be supplemented with practical classes on mastering the technique of ultrasound in real conditions with a clinical mentor. As an effective assessment of knowledge, we offer written work on the formation of an ultrasound Protocol with a conclusion on the presented echograms, as well as an assessment of practical skills. Further self-improvement in ultrasound research can be carried out in person or remotely using a variety of domestic and foreign Internet resources.

MEDICAL STUDENTS DROPOUT PREDICTORS

Abstract

Introduction. The medical industry is experiencing a serious need for highly qualified medical personnel. The dropout of students has a negative effect associated with both financial costs for the education of students who have not completed their studies, and losses for society in need of specialists.

Aim – the study of academic predictors of dropout of medical students.

Material and methods. The sample size was about 11075 people of the federal state budgetary educational institution of higher education Orenburg State Medical University (OrSMU) for 2009–2020.

We developed an accounting document «Map of the study of predictors of obtaining medical education», which contained data on students, as well as on the results of academic performance in the learning process.

In order to analyze the predictors of student dropout during training we used Cox’s proportional hazards model. Variables that had only one unique value (no variance of values) were excluded from the «survival analysis» as well as those variables that completely determined the outcome for the group (for example, a variable that was present only in students who dropped out).

The critical level for statistical tests is 0.05.

We were indicating the p-level of significance and the risk ratio for this category of students for cases when the risk factor have a statistically significant contribution to the prediction of survival.

Results. The most significant dependent variables are: student education on a budgetary basis (hazard ratio 0.72), full-time education (hazard ratio 2.24), good knowledge of a foreign language (hazard ratio 1.55), training according to an individual curriculum (hazard ratio 1.2), training in the target area (risk ratio 1.67).

Conclusion. The risk of expulsion for students of the targeted admission is lower than for students studying at their own expense.

CHIEF EDITOR
CHIEF EDITOR
Balkizov Zalim Zamirovich
Professor of the Department of Professional Education and Educational Technologies, Associate Professor of the Department of Hospital Surgery of the N.I. Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, member of the Coordinating Council for Personnel Policy of the Ministry of Health of the Russian Federation, Adviser to the President of the National Medical Chamber, Executive Secretary of the Commission for Accreditation of Continuing Medical Education Events in the National Medical Chamber, Secretary General of the Russian Society of Medical Specialists General Representative of the Association for Medical Education in Europe, General Director of GEOTAR-Med
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