Continuing Medical Education System Research Articles

Educational trajectory of forensic medical expert in the system of continuous medical education

The objective of the study is to determine the possibility and the right to choose the directions of self-education and self-development by forensic medical experts within the framework of personal and professional development program in the educational trajectory formation. The materials of special and encyclopaedic literature including pedagogical and sociological sciences, as well as legal framework regulating the processes of continuing medical education have been studied. The choice of educational trajectory of forensic physician depending on personal benchmarks, self-education building and participation in educational activities has been defined.

Forms of interaction between the National Medical Research Center for Anesthesiology and Critical Care Medicine (for adults) and the regions of the Russian Federation

In order to implement the Federal Project “Development of a Network of National Medical Research Centers and Implementation of Innovative Medical Technologies”, the National Medical Research Center (NMRC) on the “Anesthesiology and Intensive Care (for adults)” was established in 2021 on the basis of the Sechenov First Moscow State Medical University (Sechenov University), designed to perform organizational and methodological management of specialized units of medical organizations of regions of the Russian Federation. Aim. Evaluate the contribution of Sechenov University to the implementation of the federal project “Development of a network of medical research centers and the introduction of innovative medical technologies” using the unique experience of the NMRC as an example.. Materials and methods. Analysis of the results of NMRC visits to the regions of the Russian Federation. Reports review of medical organizations of the regions of the Russian Federation. The involvement of medical personnel of the regions in the system of continuous medical education, including scientific and practical events carried out by NMRC, and the demand for the use of telemedical consultations were assessed. Results. During 17 months of the NMRC work 15 of on-site inspections in the regions of Russian Federation were carried out in order to analyze the level of anesthesiology and intensive care services in the regions of Russian Federation, 2577 telemedical consultations were provided, and 15 interactive educational modules for the portal of continuous medical and pharmaceutical education of Ministry of Health of Russia were prepared. Conclusion. The main forms of NMRC’s interaction with the regions of the Russian Federation are organizational and methodological, scientific and educational support of the representatives of healthcare practitioners and regional healthcare authorities. The NMRC activities are aimed at improving the quality of medical care in the field of anesthesiology and intensive care in the regions of the Russian Federation and the formation of a value-oriented approach in modern health care.

Designing, Installing, and Commissioning an Electronic Continuing Medical Education System at Hamadan University of Medical Sciences Integrated with National CME System

Electronic learning has changed the continuing medical education (CME) methods. For the first time, we aim to design, install, and launch an electronic CME (e-CME) system at our university, to integrate it with our National Continuing Medical Education Center of the Ministry of Health, to determine its effects on the midwives’ knowledge and problem-solving skills in postpartum hemorrhage (PPH), and their satisfaction with the electronic content and attitude toward the e-CME method. First, we designed and installed the learning management system (LMS) and integrated it with the national system. In the second phase, by the census, we applied it to 32 midwives through a quasiexperimental with a single-group pretest-posttest design. So, midwives used the electronic system in all five sessions and completed the research tools such as PPH knowledge, skills in solving problems, satisfaction with the content, and attitude toward e-CME before and after these sessions. Data were analyzed using the SPSS-16 software by the paired t-test, Wilcoxon, Friedman’s, and Pearson’s tests with a 95% confidence level. The levels of midwives’ PPH knowledge and problem-solving skills were both significantly improved ( p < 0.05 ). The total attitudes toward using e-learning CME for most participants were positive both before and after the intervention. After the intervention, there was a high satisfaction level (4.04 ± 0.16) with the electronic content among participating midwives. The positive results and successful use of e-learning by midwives lead to the achievement of the university’s mission of continuing medical education.

Some aspects of distance learning in the system of continuing medical education of doctors in Russia

Introduction. The article is devoted to the consideration of the directions of continuing education in healthcare. Of course, the development of a system of continuous medical education (further – CME) and its various forms, such as distance learning, is a necessary and timely measure for the development of healthcare in the Russian Federation.
 Purpose. to consider the current aspects of the development of distance learning in the system of continuing professional education of doctors. The article discusses statistical data in the field of distance learning in the system of continuing education of medical workers. There are a number of problems in this direction and the ways to solve them depend not only on the functioning of the system itself, but also on the recognition of its importance by practitioners.
 Materials and methods. Statistical indicators from the websites of Rosstat, the Ministry of Health of the Russian Federation and other medical structures, including medical educational institutions, were used as materials in the study.
 Results and discussion. The NMO increases the speed with which information reaches doctors. In electronic form, in the format of webinars, seminars and trainings, new knowledge gets into medical offices faster than with the help of approved training programs, which often do not meet the needs of practical healthcare.

Formation of an integrated educational space in the system of continuous professional development of medical workers in the region

The material deals with issues related to the formation of a single educational space in the system of continuous professional development of medical workers in the region, issues of motivation to enter the system of continuous medical education, issues of the quality of education and its independent assessment, issues of forming a personal educational trajectory in the specialty and the role of the University, the executive authority of the subject, the institute of chief freelance specialists as integrators of these processes.

Analysis of learning motivation of listeners of the system of professional development of medium medical workers

The paper presents the results of a study of the motivation for professional development of students of advanced training courses for nursing staff in the modern system of continuous medical education. Proposals for increasing educational motivation are formulated.

Impact of COVID-19 on Continuing Medical Education-Results of an Online Survey Among Users of a Non-profit Multi-Specialty Live Online Education Platform.

Background: The Coronavirus Disease-2019 (COVID-19) pandemic accelerated digitalization in medical education. Continuing medical education (CME) as a substantial component of this system was relevantly affected. Here, we present the results of an online survey highlighting the impact on and the role of online CME.Methods: An online survey of 44 questions was completed by users of a German online CME platform receiving an invitation via newsletter. CME habits, requirements, personal perception, and impact of the pandemic were inquired. Standard statistical methods were applied.Results: A total of 2,961 responders took the survey with 2,949 completed surveys included in the final analysis. Most contributions originated from Germany, Austria, and Switzerland. Physicians accounted for 78.3% (57.5% hospital doctors) of responses followed by midwives (7.3%) and paramedics (5.7%). Participating physicians were mainly board-certified specialists (69%; 55.75% hospital specialists, 13.25% specialists in private practice). Frequent online lectures at regular intervals (77.8%) and combined face-to-face and online CME (55.9%) were favored. A duration of 1–2 h was found ideal (57.5%). Technical issues were less a major concern since the pandemic.Conclusion: A shift from face-to-face toward online CME events was expectedly detected since the outbreak. Online CME was accelerated and promoted by the pandemic. According to the perception of users, the CME system appears to have reacted adequately to meet their demand but does not replace human interaction.

QUALIFICATION ASSESSMENT OF MEDICAL SPECIALISTS IN ASPECT OF DEVELOPMENT OF CONTINUING MEDICAL EDUCATION

Continuing medical education (CME) is embedded in the structure of the institutes of qualification assessment. These are institutes of accreditation of specialists and their certification for obtaining a qualification category. CME has become an element of accreditation. So far, an absolute minority of specialists have been accredited. Therefore, the study focuses on the analysis of the implementation of CME. The materials of the expert survey of medical personnel were used. It was found that respondents generally have a positive opinion of the CME system. But its organization has significant drawbacks. Their impact on the provision of high-quality medical services to the population and on the social security of doctors in the field of professional development is negative. Specialists bear the main share of responsibility for the choice of programs and forms of training. And their supply and quality do not always meet the needs of doctors. The system of scoring participation in the CME often forces specialists to make a choice in favor of a set of points, but at the expense of real knowledge. It is revealed that the CME is not built into the institute of certification for qualification category, although the level of qualification of specialists certainly depends on it. This is caused by an unjustified decline in the prestige of this institution.

Methodological aspects of programs’ updating for advanced training of doctors

An important component of improving the healthcare system is providing medical institutions with highly qualified personnel. In the era of evidence-based medicine, clinical guidelines developed by the expert community and approved by regulatory authorities are the cornerstone of maintaining the knowledge and skills of medical personnel at a high level. In modern medicine, new data are accumulating very quickly, which requires regular changes in the algorithms for managing specialized patients. Frequent updating of clinical guidelines and their increasing importance as a document regulating the provision of medical care to patients with various diseases necessitate the intensification of additional professional education of doctors. Doctors’ awareness of the current provisions of clinical guidelines and readiness to implement them in everyday practice is an important condition for the compliance of real medical care with modern requirements. Under the conditions of the system of continuous medical education, the programs for improving the skills of doctors should be constantly improved. The article discusses the methodology for updating educational programs based on the analysis of the results of an anonymous survey of doctors on the main aspects of the current clinical guidelines. Identification of questions, the answers to which turn out to be incorrect more often than others, and quantitative analysis of the distribution of incorrect answers allow to correct programs in order to achieve a higher level of knowledge of trainees in the most difficult sections of clinical guidelines. Information about the changes that were made to the advanced training programs for doctors in the diagnosis and treatment of cardiovascular diseases on the basis of the data obtained during the questionnaire is presented. It is expected that the discussed methodology for updating the advanced training programs for doctors will help to improve the provision of the needs of modern healthcare for highly qualified personnel.

Problems of integrating medical science, image and practical health care: focus on personalized medicine

On the example of technologies of personalization of pharmacotherapy based on biomarkers of the processes of absorption, distribution, metabolism and excretion of drugs (ADME-processes), the methodology of the results of scientific research into the educational process within the system of continuous medical education of doctors into the real clinical practice is presented. This methodology has been developed and implemented in the Russian Medical Academy of Continuing Professional Education.

Present status and constitutional remedies of continuing medical education in Korea

The purpose of this study is to identify the historical background and status of continuing medical education (CME) in Korea, and to establish a method for improving CME in the future. Currently, the CME in Korea presents several problems that need to be addressed, such as the appropriateness of the annual required credits, maintenance of simple refresher training, insufficient online education, and evaluation and accreditation of educational institutions. Solutions are offered in the form of increased time for the required credits, introduction of social competency topics and education methods, improvement of online education, evaluation to improve the quality of CME, and introduction of a systematic and appropriate evaluation and accreditation system. CME and continuing professional development (CPD) are not only obligations stipulated in the medical law, but also professional requisites in terms of securing autonomy through self-development and self-regulation. It aims to enlighten the high level of professionalism required by the international community. It is an essential requirement and ultimately promotes and protects the physical, mental, and social health of people worldwide. In order to cope with the international standards of CME/CPD that ensure high quality treatment and patient safety, it is crucial to reform the continuing medical education system by securing the physicians’ professionalism. To this end, authors propose the improvement and implementation of CME system in Korea based on internal review and benchmarks of the internationally recognized CME/CPD systems that meet global standards.

Training Family Doctors and Primary Care Nurses in Evidence-based Prevention, Screening and Management of Cardiovascular Risks in Western Ukraine: A Longitudinal Study.

IntroductionThe Ukrainian primary healthcare programme of preventive and screening recommendations has not been evidence-based. The traditional system of continuous medical education in Ukraine places participants in the role of passive listeners. This study explored the effects of an interactive training course on evidence-based prevention and screening of cardiovascular risks, on changes in Ukrainian family doctors’ (FDs) and primary care nurses’ (PCNs) knowledge and readiness to change practice over time.MethodsThree hundred and seven FDs and PCNs participated in the study. Changes in participants’ knowledge were assessed with 20 multiple choice questions, and their readiness to change practice with a five-item questionnaire. These were administered before, immediately after, three and twelve months after training.ResultsThe mean pre-course knowledge score was 6.1 (SD 1.8) out of 20, increasing to 14.9 (SD 2.3) immediately afterwards (p<0.001). Three months later it was 10.2 (SD 3.2) and at one year it was 10.4 (SD 3.3), both of which were significantly higher than the pre-training level (p<0.005). The percentage of participants that were highly motivated to change their practice increased from 18.4% before the training to 62.3% immediately afterwards (p<0.001). Three months later, this fell to 40.4%. At 12 months it further reduced to 27.4%, but was still significantly higher than the baseline level (p<0.001).ConclusionsThe interactive training was effective in increasing both participants’ knowledge and their readiness to change their clinical practice. The impact of the training diminished over time, but was still evident a year later.

Системы непрерывного медицинского образования в мире: практика, проблемы, пути развития

The Continuing Medical Education (CME) is one of the forms of post-diploma medical specialists’ education, is gradually becoming a standard in Russia. The article focuses on CME practices in various countries, as much as ways of its development or alternatives. The article observes the established CME systems and emphases the complex Continuing Professional Development (CPD) as far as successful examples of CME absence. Some changes in traditional CME/CPD formats are described. The most actual problems of the nowadays CME are pointed out. The examples of Japan, Iran, and Germany are illustrating how the effectiveness issue has stated and solved. The main directions of CME development are as following: competency-based approach, feedback wide usage, non-standard learning formats, unified system of accreditation.

Certain issues of the Medical Aid Quality Assessment at the Healthcare Institutions

Today, the effectiveness of any healthcare system is determined by three groups of indicators: public health indicators, public quality of life indicators and indicators of access to and quality of health care. Ensuring the quality health care for patients is one of the most important prerequisites for public health maintenance and reproduction. The problems of the healthcare quality and effectiveness are the most relevant and directly connected with the final results of the system performance and costs of its constantly limited resources. Achievement of a high level of healthcare quality (HCQ) is one of the priority tasks of the state-building. The objective of the article is to determine to what extent the orders on the healthcare quality control are valid, as well as what approaches should be used for the formation of the HCQ control and assurance system in each medical organisation. The authors suppose that the work in this field should be started, firstly, from creating the proper local regulatory acts on the basis of the federal regulatory and legal documents, and, secondly, from ensuring their mandatory fulfilment by the medical staff due to the continuous medical education system at the post-degree courses, seminars, conferences and master classes.

Experience of organizing work in the system of continuous medical education on the example of a multidisciplinary healthcare organization

The article is devoted to the problem of changing the Russian system of professional development for doctors and nurses. The author describes the experience of organizing such work in a multidisciplinary healthcare organization by the HR service, and indicates the problems and prospects of transition to a new system of continuous medical education.

ОРГАНИЗАЦИЯ ЦИКЛОВ ПОВЫШЕНИЯ КВАЛИФИКАЦИИ В СИСТЕМЕ НЕПРЕРЫВНОГО МЕДИЦИНСКОГО ОБРАЗОВАНИЯ НА КАФЕДРЕ ТЕРАПИИ ИМ. ПРОФ. А.И. ДЯДЫКА ФИПО ГОО ВПО ДОННМУ ИМ. М.ГОРЬКОГО – НАЧАЛО

Система непрерывного медицинского образования обеспечивает непрерывное совершенствование знаний и навыков, умений в течение всей профессиональной жизни врача, постоянное повышение профессионального уровня и расширение профессиональных компетенций. В статье рассматриваются цели, задачи, пути реализации вышеуказанной системы последипломного образования. Описаны основные принципы обсуждаемой системы, этапы ее внедрения на кафедре терапии им. проф. А.И. Дядыка ФИПО.

Editoriale: Facite ‘a faccia feroce

This long editorial, based on the example of healthcare, highlights the contradiction between ideology of control and the real situation in a democracy that still today, in many areas, thinks that it is possible to govern according to the logics of corporations. Some aspects of the Continuing Medical Education (CME) system in Italy are critically discussed, pointing out some inner con-tradictions and the inefficiency of lifelong learning of mental health professionals, and the low forecasting ability of those who planned this CME system. An Editorial by Pier Francesco Galli which appeared in issue no. 4/2001 of the Giornale Italiano di Psicologia (GIP) [Italian Journal of Psychology], in which the main critical aspects of the CME system were emphasized, is re-printed; then some extended quotations of the article by Ulrich Wienand titled Professional accreditation: Prospects and risks for Italian psychologists, which appeared in the same issue (4/2001) of the Giornale Italiano di Psicologia (GIP), are also reprinted. Finally, parts of two articles that appeared in September 2019 in the Italian on-line journal Quotidiano Sanita [Daily Healthcare Newspaper], by Massimilano Zaramella and Marco Castioni, respectively, who refer to the analysis made by the jurist Luca Benci, are reproduced. (The title of this Editorial - Give them a mean face - was the command shouted in the 18th century to the Bourbon Army in order to frighten the enemy, and here is used ironically to refer to those who try to put into effect the CME system in Italy. In a way, it reminds the haka, the ceremonial Māori dance performed by the New Zealand rugby team - the All Blacks - before their international matches; this dance, however, did not prevent defeat by England at the 2019 Rugby World Cup Semi-final)

The intraorganizational training in ambulatory polyclinic organizations

The intraorganizational training can be an efficient addition to modern system of continuous medical education. The purpose of study is to theoretically substantiate and to develop an intraorganizational system of continuous professional education of medical personnel, to implement intraorganizational system of continuous professional education of medical personnel into medical organizations providing out-patient medical care and to assess its efficiency. The study was organized at the base of three non-state medical organizations of Moscow providing out-patient medical care. Two out of them had net organizational structure, one was represented by single medical organization. The study implemented such research methods as organizational experiment, expertise, sociological survey, test control, analytical and statistical methods. The system of continuous professional education of medical personnel including "Adaptation", "Correction" and "Development" levels was developed and tested. The system of continuous professional education of medical personnel comprises intraorganizational training center, intraorganizational system of remote training, form of long-term cooperation with educational organization, application of target training programs focused on adjustment of deficiency of knowledge and skills and acquirement of new professional competences by medical personnel. The intraorganizational system of continuous professional education of medical personnel can be used as an addition to modern form of continuous medical education. It can be used in state and non-state medical organizations. The study proved positive effect of intraorganizational training on the level of professional qualification, increase of satisfaction of medical personnel and increase of quality of medical care.

The development of the system of continuous medical education under the present-day conditions

The authors consider the selected stages in the development of the system of continuous medical education in the field of forensic medicine and forensic medical expertise as well as the contribution of the Department of Forensic Medicine of N.I. Pirogov Russian National Research Medical University to its practical implementation. The relevant conceptual problems and topical issues are discussed together with certain approaches to their solution.

Continuous Medical Education in Pediatric Oncology As Successful Approach for Improvement of Early Diagnostics and Treatment

Background and context: Continuous medical education (CME) is very important in improvement of knowledge in all field of pediatrics. CME in pediatric oncology could be aimed both for oncologists and pediatricians. Aim: We aimed to organize CME system in the field of pediatric oncology for oncologists and pediatricians. Strategy/Tactics: Continuous education for improvement of knowledge for all pediatric oncologists and pediatricians based on Russian CME system. This system was organized by the Ministry of Health and National Medical Chamber and based on continuous work of professional medical societies. Each society could propose their educational activities and receive accreditation (participants receiving educational credits). Specialist required receiving education in pediatric oncology participating this system, obtaining credits and getting new knowledge. Program/Policy process: The National Society of Pediatric Hematologists and Oncologists (NSPHO) organized a system of educational seminars in pediatric oncology with CME status and approved credits in different regions of the Russian Federation. NSPHO organizing one seminar per month, 12 seminars per year. Each seminar has three major components: organization (meetings with governments of regions), education (lectures and discussions) and workshops. These seminars are free of charge for all regions and organized with the help of resources of NSPHO. A special report with recommendations for improvement of pediatric cancer care prepared after each seminar and transferred to the Government and Ministry of Health. NSPHO organized also online CME courses with accreditation. To estimate the effectiveness of seminars we are doing surveys and estimation of quality of cancer treatment. Outcomes: All 86 centers and departments of pediatric hematology/oncology in Russia participating this system. All members of NSPHO (about 1200 participants) are studied within the single educational program including governmental certification and Russian CME educational meetings/seminars as well as online CME seminars. CME education in pediatric hematology/oncology and immunology for pediatricians allowed studying more than 1000 specialists during 2017. Estimation by surveys and quality control showed high effectiveness of seminars in early diagnostics and treatment. What was learned: CME platform for online and off-line education in Russia developing rapidly. Nowadays we involved all Russian regions to this work. Results showed high effectiveness of this approach.