Clinical thinking as an important element of effective professional activity of the future medical worker

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Poltava State Medical University

Clinical thinking as an important element of effective professional activity of the future medical worker

Bobukh V. V.

Andreiko S. S.

Bilanova L. P.,

Clinical thinking plays a significant role in training highly qualified medical workers, as it creates the basis for transforming acquired knowledge into the ability to apply it in practical activities. For healthcare workers, the formation of professional competence is significant, a combination of a high level of theoretical knowledge, professional skills, practical skills, the creative potential of an individual and a culture of communication. A significant role in this is played by the ability of medical workers to think "clinically", to learn to express their own opinions, to analyze and think logically, and to react quickly and highly qualified in critical situations. The formation of clinical thinking begins already during training in a medical institution and is further improved during one's professional activity. In addition, various modern teaching methods play a significant role in forming clinical thinking. These include the case method, the business game method, the "brainstorming" method, as well as the use of situational tasks. All these methods aim to teach students to fulfil their professional duties with dignity and apply the acquired knowledge in practical activities. In addition, the combination of these methods contributes not only to the formation of clinical thinking but also has a direct impact on both creative and critical thinking since it is impossible to draw a clear line between these concepts, especially when it comes to medical workers. Therefore, nurses' combination of essential, creative and clinical thinking elements is a crucial element of effective professional activity.

Key words: students of vocational pre-university education, clinical thinking, modern teaching methods.

clinical thinking healthcare worker

Introduction

The training of highly qualified medical workers remains a critical problem today. We are talking not only about doctors but also about professional junior bachelors, in particular medical nurses, who play an essential role in the health care system of Ukraine. Nurses are not only medical personnel who must perform manipulations under the guidance of a doctor but also a specialist who possesses sufficient knowledge, professional skills and practical skills to make independent decisions within their competence.

Graduates of professional pre-university education who study under the educational and professional program of Nursing speciality 223 Nursing during their studies receive a sufficient level of theoretical and practical training, which provides the opportunity for employment in the modern labour market. An essential element of the training of future specialists is the formation of their clinical thinking, which creates the basis for transforming the acquired knowledge into the ability to apply it in practical activities [1, 2]. The ability of a medical nurse to think clinically is undoubtedly a significant part of high-quality professional activity [3]. It is quite difficult to make a distinction between such concepts as "clinical thinking", "creative thinking", and "critical thinking" since they are all components of professional thinking that are inherent to medical workers. Having acquired sufficient theoretical and practical training, every specialist should be able to apply his knowledge in a particular professional niche. For healthcare workers, forming professional competence is especially important, a combination of a high level of theoretical knowledge, professional skills, practical skills, the creative potential of the individual and a culture of communication [4]. Therefore, it is an essential task for the teachers of professional preliminary education institutions, particularly the professional medical and pharmaceutical college of the Poltava State Medical University, to prepare future medical nurses to adequately fulfil their professional duties and apply the acquired knowledge in practical activities.

The aim of the study.

To determine the main principles of forming clinical thinking in the students of professional preliminary education, who are studying under the educational and professional program Nursing, speciality 223 Nursing.

Main part

Clinical thinking belongs to the most general, primary and initial concepts of medicine, based on which medical science is built and, as a result, the professional activity of medical workers is realized. There are several definitions of this concept, which characterize it as a particular type of professional thinking characteristic of healthcare workers and based on a combination of theoretical knowledge, practical skills and the application of one's own experience in caring for the health of patients. Thus, how health workers "think" when faced with a clinical problem situation is an essential element of effective clinical activity [5]. The formation of clinical thinking begins already during training in a medical institution and is further improved during one's professional activity. In our opinion, not only doctors but also other medical professionals, in particular nurses, who work directly with patients and participate in the process of their treatment, should have clinical thinking. It is not only about their professional duties, which consist of performing clinical manipulations, but also about the fact that they must learn to express their opinions, analyze and think logically, and react quickly and highly qualified in critical situations.

The first principles of clinical thinking begin to be formed at the initial stages of training in a professional higher education institution when studying general medical disciplines, such as "Human Anatomy with Physiology" [1]. This educational component provides students with the necessary amount of knowledge about the structure of the human body and the general principles of its functioning. The use of innovative technologies, which include 3D atlases, makes it possible to perfectly assimilate the material in the amount approved by the work program [6]. It is quite difficult to study anatomy from books and tables, so using models and 3D projections of internal organs provides an opportunity to clearly understand the anatomical structure and see its three-dimensional projection. Modern teaching aids provide an idea of the topographical structure of various body parts, which combines the structural elements of various systems, which in the future can be widely used during various clinical manipulations, for example, during intravenous or intramuscular injections.

In the future, the acquired knowledge will be the basis for studying professional nursing disciplines, particularly "Nursing in internal and family medicine" This educational component covers issues related to the main clinical symptoms and syndromes of various diseases and provides an opportunity to navigate multiple diagnostic methods. The formation of the nursing process, which combines nursing diagnosis and planning of nursing interventions, is an integral part of the professional activity of a nurse. In our opinion, achieving success in this without clinical thinking is impossible. Nurses who are directly involved in the diagnostic and treatment process must be able to assess the clinical situation and act accordingly. Therefore, when studying the discipline "Nursing in internal and family medicine", the thematic plan covers the anatomical and physiological features of various systems of the human body, aetiology, clinic and diagnosis of multiple diseases and the peculiarities of the nursing process in them. Each professional junior bachelor receives sufficient theoretical and practical training, which provides the opportunity to make their own balanced decisions in individual clinical cases within the limits of their competence.

Various modern teaching methods are widely used in practical classes [7]. These include the case method, the business game method, the "brainstorming" method, as well as the use of situational tasks [8]. In addition, applicants work directly with patients during industrial practice in inpatient departments and outpatient clinics of primary health care centers, which provides an opportunity to work in conditions close to future professional activities. The combination of these elements directly impacts the formation of clinical thinking in future medical professionals.

When applying the business game method, a particular clinical situation is created, which imitates the relationship between the patient and the nurse. Business games allow students to develop certain conditions that are close to the real situation in the practice of a professional junior bachelor, where it is necessary to solve questions related to the performance of certain clinical manipulations or to make independent decisions regarding a patient in an individual case. This technique provides an opportunity to increase the professional clinical training of a future nurse, helps form a specific algorithm of thinking, and teaches students to act quickly and decisively.

The next element contributing to the formation of clinical thinking is the "brainstorming" method, which models several solutions to a particular clinical problem. In this case, all students can propose their solutions, which, in their opinion, are the most appropriate. After that, they discuss all the disadvantages and advantages of the proposed methods. Through discussion, the most optimal tactic is chosen in each specific case. During the discussion and analysis of the proposed options, an indepth assessment of the essence of the modelled picture takes place. An opportunity is provided to ensure the chosen option is the most appropriate among the proposed ones. Finding different ways to solve the same problem provides an opportunity to quickly assess the situation in the future and make your own balanced decisions.

The case method is a teaching method that consists of active situational problem analysis. In this case, specific situational tasks are formed, so-called cases, which describe clinical situations related to the topic of practical training. Students thoroughly analyze the proposed problem, creating a diagnostic and a treatment algorithm. Although nurses do not directly participate in prescribing treatment tactics, they ensure its implementation and, therefore, must be able to express their own opinions and understand the essence of the proposed treatment. The teacher describes the situational task and asks several questions related to it, comments on the received answers, evaluates their advantages or disadvantages and allows other participants in the process to agree or, on the contrary, criticize the proposed options [9]. During the discussion, each future specialist can defend their point of view, reasonedly argue, and provide suggestions. This technique creates an emotional atmosphere and a comprehensive dialogue, which is impossible to achieve with the usual interview of an education seeker. As a result, analytical skills are formed, and the ability to integrate theoretical training into practical training is improved.

The combination of the described methods contributes not only to the formation of clinical thinking but also directly impacts both creative and critical thinking. As noted earlier, it is impossible to draw a clear line between these concepts, especially for medical professionals.

The creative thinking of a specialist is a type of thinking characterized by the creation of a subjectively or objectively new product. Creative thinking develops when solving professional tasks that require intellectual initiative, the search for new solutions, actions, and changes in previously established rules and patterns. The basis of the work of any medical worker is the solution to various clinical problems, which is sometimes impossible without a non-standard approach to the problem. Therefore, a medical specialist must constantly update his level of knowledge, possess practical skills, and use modern technical means. However, one of the most important practical skills that determine the professionalism and qualification of a health care worker is the development of his creative thinking, one of the essential psychological criteria of which is the emotional experience that precedes the adoption of a particular decision, which is a critical component in clinical thinking [10].

Another essential component of the effective activity of a medical worker is critical thinking, which consists in making carefully considered and independent decisions. It is purposeful, measured and logical. At the same time, cognitive strategies and skills have been used that increase the probability of a positive result [11]. Critical thinking differs from creative thinking in that it is formed due to imposing new information on a person's life experience. Everyone has critical thinking skills, but they are developed differently. For a medical worker to use critical thinking to the full, he should develop such qualities as readiness for planning, flexibility, perseverance, willingness to correct mistakes, awareness, and search for compromise solutions.

Medical professionals with well-developed critical thinking are open to innovative ideas, know how to listen, establish connections between phenomena, are tolerant, empathetic, and actively perceive information [12].

Therefore, nurses' combination of critical, creative and clinical thinking elements is an essential element of effective clinical activity. Moreover, in our opinion, the formation of these components of professional thinking, even in the process of obtaining professional preliminary education, prepares future specialists both for the possible continuation of studies in institutions of higher medical education and for work in institutions of the health care system immediately after obtaining a professional junior bachelor's diploma.

Conclusions

Highly qualified nurses must have their point of view and make optimal decisions within their competence. The use of modern teaching methods in the study of professional nursing disciplines contributes to the formation of the foundations of clinical thinking in future nurses among those who study in the speciality 223 Nursing and creates the basis for the effective performance of their professional duties in the future.

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