Postgraduate Education Of Doctors Research Articles

Knowledge levels of doctors and nurses working in surgical clinics about nutrients and food supplements, a multicentre descriptive study

PurposeThe use of nutrients and food supplements is increasing worldwide. Nutrients and food supplements frequently used in the surgical period may cause complications and side effects. This study was conducted to determine the level of knowledge about sixty-one nutrients and food supplements among doctors and nurses working in surgical clinics.DesignA multicentre descriptive, quantitative, cross-sectional study.MethodsThe study was conducted between 15 February and 31 May 2022 with a total of 410 participants, including 143 doctors and 267 nurses, working in the surgical clinics of 8 hospitals, including public, university and private hospitals, within the borders of one province in Turkey. Data were collected face-to-face using a questionnaire developed by the researchers, which included descriptive characteristics of the doctors and nurses and questions about sixty-one nutrients and food supplements.ResultsThe median overall success score of the doctors and nurses participating in the study regarding the use of nutrients and food supplements was 3.20 out of 100 points, the median success score of complications and side effects of nutrients and food supplements in the surgical period was 7.06 out of 33 points, the median success score for discontinuation of nutrients and food supplements prior to surgery was 0.21 out of 16 points, and the median success score for drug interactions of nutrients and food supplements was 1.70 out of 51 points. In addition, it was found that the overall success scores of doctors and nurses regarding nutrients and food supplements increased statistically significantly with increasing age and working years. The total success score of doctors and nurses who received training in nutrients and food supplements was statistically significantly higher than that of doctors and nurses who did not receive training.ConclusionIn conclusion, it was found that the level of knowledge of nutrients and food supplements among doctors and nurses working in surgical clinics was less than half or even close to zero. Therefore, it is recommended that training on nutrients and food supplements should be included in the undergraduate and postgraduate education of doctors and nurses in order to prevent complications, side effects, drug interactions and patient safety related to the use of nutrients and food supplements in the surgical period.

Competence-oriented program to improve the quality of continuing medical education for doctors

Background. Programs to improve the quality of higher education in recent decades have kept the lead in the relevance among researchers around the world. In this scientific work, the purpose was to highlight modern existing programs in the postgraduate education of doctors in the Republic, review the academic competencies from other countries of the world, develop recommendations for improving the organizational structure of educational methods, as well as to increase significantly the effectiveness of the additional educational process. Materials and methods. When writing the work, methods such as analysis, synthesis, review of literary sources, humanitarian and dialectical were used. Results. The results of the research were as follows: the application of competence-oriented adaptation programs in the training of graduates, the reorientation of the system of additional medical education in Kyrgyzstan, as well as the development and implementation of a learning model based on pedagogical prognosis, communication logistics, engineering technologies and the humanitarian and creative approach among all participants in the educational process. Conclusions. The result of the article included the development of recommendations for the correct and modern adaptation of a doctor to changing conditions and requirements of the labour market in the Kyrgyz Republic given the volatility of this market and its sensitivity to changes in the economy and the psychological attitudes of the society.

Training of Emergency Medical Specialists in Contemporary Realities

Relevance. In accordance with Federal Law No. 323-FZ [17], emergency medical assistance, including emergency specialized medical care, is provided in emergency form outside a medical organization, as well as on outpatient and inpatient basis. An ambulance is an emergency medical service that travels to those whose lives and health are in danger. Emergency medical assistance, including emergency specialized medical care, is provided in case of diseases, accidents, injuries, poisonings and other conditions requiring urgent medical intervention. The reasons for calling an ambulance in an emergency form are sudden acute diseases (conditions) and (or) sudden exacerbations of chronic diseases without obvious signs of a threat to life, requiring urgent medical intervention. In the training of doctors, including in postgraduate education, these factors are taken into account.Aim of the study. Improvement of the quality of theoretical and practical training of emergency medical specialists, as well as clinical residents and practical doctors of various specialties, taking into account issues of emergency and military medicine.Material and methods. A review of official documents of the Ministry of Healthcare of the Russian Federation and the literature on postgraduate education of doctors with subsequent primary specialized accreditation for 2018-2022 was carried out. The literature on modern approaches to the provision of emergency medical care to victims was studied, taking into account the specifics of military (tactical) medicine for 2020–2022.Conclusion. The training of emergency medical professionals, taking into account the realities of the present, should include issues of tactical medicine and be practice-oriented using simulation equipment. It is necessary to know and be able to work with modern means of protection and medical care available in the troops; be prepared to work in medical institutions of various levels with the mass flow of injured and wounded.

Experience of teaching doctors the principles of rational pharmacotherapy on the example of patients with a fall in a hospital

The postgraduate education of doctors in the principles of rational pharmacotherapy, conducted on the educational program «Polypragmasia in a therapeutic and preventive organization: a problem and a solution» of 36 academic hours, allowed to reduce the total number of simultaneously prescribed medications in elderly patients of a cardiological profile in a gerontological hospital (the number of medications received by patients older than 75 years before and after training, respectively 9.48±2.6 vs 7.12±1.9, p<0.001). A decrease in polypragmasia contributed to a decrease in the frequency of suspected unforeseen serious adverse reactions, which included falls associated with taking medications. The simultaneous introduction of Safety Protocols, Standard Operating Procedures for identifying patients at high risk of falling and conducting incident analysis led to the analysis of each case of an elderly and senile patient falling in a hospital and a review of the treatment received.

Trends in postgraduate education of doctors in oncology in Poland in 2010-2020 in the face of demographic and epidemiological challenges

Introduction: The system of specialization training in oncology is subject to constant shifts in response to the changing health needs in Poland. Both the specialization programs and the training mode have evolved, and the system's ability to train more specialists has increased. Epidemiological trends in cancer diseases indicate a further increase in the incidence and mortality. Moreover, the advancement at diagnosis is likely to be higher in the coming years due to neglect during the COVID-19 pandemic. Treatment of advanced neoplasms will require the availability of more specialists in oncological disciplines, especially conservative ones, as well as specialists supporting oncological care.
 Aim of the study: The study aimed to determine the quantitative changes taking place in the system of specialist education of doctors in oncological fields between 2010 and 2020 and to assess the trends of changes in relation to the growing demand and challenges of the pandemic.
 Material and methods: The material for the analysis was the data of the register of doctors undergoing specialization training conducted by the Centre of Postgraduate Medical Education of Warsaw in 2010-2020. The material analysis was quantitative.
 Results: The conducted analysis shows the constant development of specialization education in the fields of oncology in 2010-2020, aimed at covering the demand for specialists in the studied fields. The pace of growth may prove insufficient in the long term in view of the aging of the population and the associated increasing incidence and prevalence of neoplastic diseases. Worryingly, the newly formed specialists will have to deal in the near term with the post-pandemic wave of patients with advanced cancers who require more frequent treatment combined with careful palliative care during and after treatment. Detailed results are presented in Tables 1-7 and 8 in the Annex.
 Conclusions: The conducted analysis shows the constant development of specialization education in the fields of oncology in the years 2010-2020, aimed at covering the demand for specialists in the studied fields.

Analysis of expectations and satisfaction of physicians (provisors)-interns in Ukraine at the stage of primary specialization – internship training

The aim of the study is to identify the expectations of physicians (provisors)-interns for postgraduate education and assess their satisfaction with the course of primary specialization (internship). The sociological crossectional study was performed in 2021 by surveying interns of Danylo Halytsky Lviv National Medical University majoring in the following medical specialties: “Medicine” and “Pediatrics”, “Dentistry”, “Pharmacy”. The survey took place in two groups: applicants at the beginning of the internship (n=655) and after completion of the internship (n=623). Statistical methods (which are represented with confidence intervals calculated by the Fisher’s angular transformation method), structural-logical analysis and a systematic approach were used. The study revealed that the most effective form of training in the full-time internship cycle are practical classes and conferences for physicians(provisors)-interns; the least effective form is independent work. The main factors that prevented the interns from mastering the professional knowledge, skills and abilities of the internship cycle are limited opportunities for independent supervision of patients, material and technical equipment of the clinical base of the department and the interns’ own inertia. Certain shortcomings in the organization of the practical part of the internship on the basis of the hospital / pharmacy were established, namely: lack of supervision of patients, lack of practical activities, unsatisfactory material and technical equipment and disinterest of the staff in the training of interns. According to interns, the ideal model of internship should be available, that would provide the optimal amount of theoretical knowledge and relevant practical skills and would be as relevant to the future work of the physician as possible. Applicants emphasize the qualitative component of obtaining postgraduate medical education: the use of new treatment protocols, training in hospital of the third level of medical care, the possibility of doing internships abroad. Such sociological surveys among physians (provisors)-interns on their satisfaction and compliance with expectations are an important component of the development of an optimized Model of postgraduate education of doctors / provisors in Ukraine, which will improve the quality of primary specialization (internship), the ultimate goal of which is health preservation and improvement of the life expectancy of Ukrainian citizens.

Освіта медичних працівників (до- і післядипломна) з питань паліативної допомоги з метою попередження професійного вигорання

На основі аналізу статистичних даних, результатів власних досліджень та наукової літератури, що свідчить про актуальність створення в Україні системи паліативної та хоспісної допомоги (ПХД) населенню, важливість підготовки фахівців з питань ПХД, а також про низький рівень здоров’я медичних працівників, обґрунтовується необхідність оптимізації до- і післядипломної підготовки лікарів та середніх медичних працівників для забезпечення високої якості надання ПХД населенню та профілактики професійного вигорання. Мультидисциплінарна професійна підготовка медичних працівників з питань ПХД в рамках безперервної післядипломної освіти вимагає відповідного навчально-методичного забезпечення, а також залучення професорсько-викладацького складу різного профілю, що довело свою ефективність на кафедрі паліативної і хоспісної медицини Інституту сімейної медицини НМАПО імені П. Л. Шупика.

Компетентісний підхід як основний пріоритет викладання первинної спеціалізації та перепідготовки лікарів за спеціальністю загальна практика-сімейна медицина

Пріоритетним напрямом модернізації системи вищої медичної освіти є необхідність підвищення якості підготовки медичних кадрів. Компетентісний підхід вимагає від освітянської спільноти подальшої активізації модернізаційних процесів в системі безперервного професійного навчання і розвитку. Мета роботи є обгрунтування актуальності танеобхідності компетентісного підходу як засобу модернізації викладання на етапі первинної спеціалізації та перепідготовки лікарів загальної практики-сімейної медицини. Матеріали та методи дослідження. Проаналізовано наукові публікації, що визначають компетенції сімейного лікаря. Висвітлено напрями роботи та досвід кафедри терапії і сімейної медицини післядипломної освіти у підготовці висококомпетентних фахівців первинної ланки. езультати дослідження та їх обговорення. У статті визначено актуальність і доцільність застосування основних принципів компетентісного підходу при викладанні первинної спеціалізації та перепідготовки лікарів загальної практики-сімейної медицини. Висновки: компетентісний підхід до викладання первинної спеціалізації та перепідготовки є одним з пріоритетних в післядипломній освіті лікарів, професійна компетентність є показником професіоналізму, фахової майстерності, належної готовності до роботи. Перспективи подальшого вивчення теми. Вивчення досвіду інших кафедр післядипломної освіти щодо подальшого удосконалення викладання первинної спеціалізації з акцентом на ті життєві і професійні компетентності, що необхідні в професійній діяльності та перепідготовки лікарів загальної практики - сімейної медицини.

Virtual patients with cardiovascular pathology: technology for postgraduate medical education

Aim. To develop an information basis for the formation and implementation of multimedia models for the diagnosis and treatment of depersonalized cases of cardiovascular diseases (virtual patients). Material and methods. The materials of the study were completed case histories and multimedia results of investigation of fifty patients who underwent hospital treatment. After an expert assessment of the completed clinical case, it was posted on the server. To provide remote access to content, web development technologies were used. Results. An information model of the medical process in text and multimedia formats has been formed. The virtual patient interface has been implemented in the form of marks appearing as new patient information is received, affecting the decision making. The structure of text and multimedia information on marks of various types is given. The implemented version of virtual patient technology provides web access to the demonstration of depersonalized medical process. Conclusion. During the project progress, a repository of virtual patients is created as a multimedia model for the diagnosis and treatment of cardiovascular pathology provided by web access. The repository will be used to enhance the diagnostic and treatment competencies of doctors through the demonstration and detailed analysis of completed disease cases. Virtual patients can become methodological basis for postgraduate education of doctors in the continuing medical education system.

The modern concept of teaching genetics at a medical higher educational institution

Aim. To study and evaluate the peculiarities of teaching genetics in the system of higher medical education of Ukraine. Methods. Studying typical and working programs of educational disciplines of medical universities, analysis of their interconnections with the volume and depth of knowledge and achievements of genetics. Results. The worldwide rapid development of genetic technologies, that open up new possibilities for the diagnosis, treatment and prevention of many hereditary and non-hereditary diseases, requires the unification of the disparate efforts of scientists and practitioners. A significant role in solving this task should be played by higher medical school. Compact information about general genetics and the basics of anthropogenetics is received by medical students in the first year of study. This creates an appropriate basis for understanding the basic laws of the emergence of various forms of human pathologies, but does not ensure the assimilation of the genetic methodology of clinical disciplines and sections related to the organization of health protection and social medicine. Conclusions. An urgent need as of today is an inter-departmental and multi-level program on general genetics, human genetics, medical and clinical genetics, which would be compiled in accordance with the achievements of modern biology, medicine and genetics, and would penetrate all the stages of undergraduate and postgraduate education of doctors.
 Keywords: genetics, teaching in higher medical school.

Działalność samorządu lekarskiego w zakresie doskonalenia zawodowego na przykładzie Wielkopolskiej Izby Lekarskiej

The issue of the continuous improvement of professional qualifications by medical doctors is of utmost importance both from the point of view of doctors and their patients. Acquiring new knowledge and skills is an important element of a doctor’s professional career. A doctor who raises his qualifications guarantees better medical care for a patient. The professional self-governing body of doctors constitutes a significant element in the postgraduate education of doctors. It participates in the education of interns and in the procedure of acquiring the title of specialist. It also supervises and organizes the process of doctors’ mandatory continuous education. A majority of the tasks related to doctors’ professional education is performed by regional chambers. The Wielkopolska Medical Chamber organizes training sessions and courses for its members, which are one of the forms of fulfilling the requirement of professional improvement, reimburses a portion of the costs borne by the doctors in connection with improving their professional qualifications, and it establishes cooperation with domestic and foreign academic institutions to provide doctors from Wielkopolska with an opportunity to partake in training. These activities of the medical association, combined with the organs of professional liability of doctors, allow the patients to hope that when visiting a doctor they encounter a specialist who will take the utmost care of them.

АКТУАЛЬНІСТЬ ПІСЛЯДИПЛОМНОЇ ОСВІТИ МЕДИЧНИХ ПРАЦІВНИКІВ У ДЕРЖАВНИХ ЗАКЛАДАХ ОХОРОНИ ЗДОРОВ’Я УКРАЇНИ (2 повідомлення)

Мета роботи – розкриття питання програми післядипломної освіти лікарів, яка включає в себе навчальні курси, що виступають системоутворюючим чинником при розкритті сутності права охорони здоров’я та спрямовані, у свою чергу, на формування компетентного медичного працівника, здатного до постійного оновлення професійної майстерності. Основна частина. У статті розкривається суть післядипломної медичної освіти, її мета, завдання та напрямки діяльності як основа діяльності післядипломної підготовки медичних працівників у державних закладах охорони здоров’я України щодо підвищення їх кваліфікації. Також здійснено порівняння післядипломної медичної освіти у державному та приватному секторах, показано спільне і відмінне між ними й прерогативи післядипломної освіти медичних працівників у державних закладах охорони здоров’я України, що полягає у поглибленні, розширенні та оновленні професійних знань, умінь і навичок.Висновок. Систему державного управління медичною освітою можна визначити як цілісну, ієрархічну, взаємопов’язану сукупність управлінських відносин щодо реалізації певними суб’єктами структурно розподілених функцій впливу держави на зміст, форми, стан, процеси, результати і пріоритети розвитку медичної освіти.

Influence of the content of postgraduate education of radiologists on the number of diagnostic pitfalls

Background.Question about the quality and format of postgraduate education of doctors raises increasingly in recent years. Development of professional standards and transition to a system of continuing professional education have allowed professional communities to raise issues of the quality of modern education but there is no clear evidence of the dependence of the level of education and the quality of medical care in the accessible literature. Experts of Research and Practical Center of Medical Radiology carried out the identification of dependence of post-graduate education length for radiologists and the quality of their work that can serve as a rationale for amending the system of doctors training.Patients and methods.The data on education and actual work of 85 radiologists of out-patient and in-patient units of medical organizations of the Moscow Healthcare Department have been analyzed. According to the results of the audit of diagnostic studies, carried out in the “Unified Radiological Information Service” system by the specialists of the Research and Practical Center of Medical Radiology, the final assessment of the work of each radiologist was formed, which reflects the presence or absence of diagnostic discrepancies.Results.Parameters of diagnostic errors depending on the age of doctors, the general length of service and the length of service as radiologist, the duration of postgraduate education in the clinical specialty and the specialty “radiology” have been compared.As a result of the analysis, it was found that the increase in the proportion of diagnostic differences is directly related to the increase in the age of the doctor and does not depend on either the length of service or the time of work in the specialty. Differences between the groups of physicians with the largest (professional retraining after clinical residency) and the smallest (clinical education + radiology) percentage of clinically significant discrepancies are statistically significant (p = 0.05, at the normative value of the Student's test score of 2.16).Conclusion.The inverse relationship between the duration of training of the radiologist in the specialty and the proportion of diagnostic errors, which can serve as a significant justification for making proposals for the exclusion of professional retraining within 576 hours for admission to professional activities of radiologists.

ВИКОРИСТАННЯ МЕТОДИК СИМУЛЯЦІЙНОГО НАВЧАННЯ У ПІДВИЩЕННІ ПРОФЕСІЙНОЇ КОМПЕТЕНЦІЇ ЛІКАРІВ ТА ПАРАМЕДИКІВ НА КАФЕДРАХ ДЗ “ЗМАПО МОЗ УКРАЇНИ”

<p class="1reziume">У статті представлено аналіз та роль симуляційних методик, впроваджених на кафедрах ДЗ “ЗМАПО МОЗ України”, та оцінку отриманих лікарями компетенцій за класифікацією Блума. Показано, що використання симуляційних методик дозволяє відтворити тісний зв’язок навчального процесу з практикою і максимальну реалістичність клінічної ситуації у післядипломній освіті лікарів.</p>

MANAGEMENT TECHNOLOGY OF PROFESSIONAL DEVELOPMENT OF STAFF IN MEDICAL ORGANIZA TIONS

The article analyzes the mechanisms and technology management personnel professionalization of medical organizations. The question is now becoming even more relevant within the health care sector optimization, the main purpose of which is claimed to improve the quality of health care by improving the efficiency of health care organizations and their personnel, including the availability of physicians and medical staff, their skills and professionalism. The problems of improving the technology of postgraduate education of doctors examined.

Perceptions of the learning environment in higher specialist training of doctors: implications for recruitment and retention

Career choice, sense of professional identity and career behaviour are influenced, subject to change and capable of development through interaction with the learning environment. In this paper workplace learning discourses are used to frame ongoing concerns associated with higher specialist training. Data from the first stage of a multimethods investigation into recruitment into and retention in specialties in the West Midlands is used to consider some possible effects of the specialist learning environment on recruitment and retention. The aim of the study was to identify issues, through interviews with 6 consultants and questionnaires completed by specialist registrars from specialties representing a range of recruitment levels. These would inform subsequent study of attributes and dispositions relevant to specialist practice and recruitment. The data were analysed using NVivo software for qualitative data management. Participants' perceptions are presented as bipolar dimensions, associated with: curriculum structure, learning relationships, assessment of learning, and learning climate. They demonstrate ongoing struggle between different models of workplace learning. Changes in the postgraduate education of doctors seem set to continue well into the future. How these are reflected in the balance between workplace learning models, and how they influence doctors' sense of identity as specialists suggests a useful basis for examination of career satisfaction and recruitment to specialties.

Open-heart surgery for repair of congenital defects.

OVER a century ago Dr. George Shattuck, dean of the Harvard Medical School, made an out-standing contribution to postgraduate education of doctors in the New England area by making possible this an...