The motivation-goal component of surgical disciplines training in a higher medical educational institution

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The motivation-goal component of surgical disciplines training in a higher medical educational institution

Barannyk Serhiy

doctor of medical sciences, professor, professor of the department of general surgery, surgery No. 3, orthopedics and traumatology of the FPO "Dnipro State Medical University”, Ukraine

KorpusenkoIhor

"Dnipro State Medical University", Ukraine

Barannik Kostyantyn

candidate of medical sciences, assistant of the Department of Surgery No. 1 "Dnipro State Medical University", Ukraine

Summary

The article highlights the modern problems of forming the motivational and target component of teaching surgical disciplines in a higher medical educational institution. The vision of the peculiarities of the presentation of educational materials and the organization of students' independent formation of abilities and skills in the conditions of the modern special state are presented. The theoretical substantiation of the technology of forming the motivational-target component of the meaningful procedural stage provides positive changes in the motivational sphere of students: the growth of the personal importance of learning, the ability to achieve the set goal, the importance of internal motives, the desire to achieve success in educational activities; decreasing the importance of external motives and the motive of avoiding failure.

Keywords: teaching, educational surgical disciplines, students, motivation, practical skills. teaching educational surgical discipline

One of the most important tasks of education today is the creation of favorable conditions for the intellectual development of the subjects of the educational process, which is focused on mastering the means of independent acquisition of knowledge, the formation of abilities and skills of educational work. In this regard, considerable attention is paid to the formation of the general culture of a modern student, the core of which is the culture of intellectual work. That is why the main task of higher educational institutions is not only the organization of the process of acquiring knowledge from various surgical disciplines, but also the formation of students' ability to independently acquire new knowledge. All this requires looking for new, more effective ways of organizing the educational process, namely: the creation of a technology for forming the culture of mental work of students, taking into account the resource approach, which involves relying on the individual potential of the individual and taking it into account for the organization of mental actions, which ensure an increase in the level of the culture of mental work (effectiveness of work in a shortened period, maintenance of sufficient vitality of the human body, etc.) [1].

Pedagogical practice of higher education institutions daily confronts teachers with the need to solve a number of methodological issues related to the preparation and conduct of lectures, classes, and the compilation of their methodological developments. Preparation and conducting of lectures, practical, seminar classes, compilation of their methodological developments in a higher medical school requires a certain system of professional psychological and pedagogical knowledge, skills and abilities that meet the modern requirements of pedagogical activity from the teacher.

Regarding the ratio of the processes of "learning" and "teaching" in modern learning technologies, their specific weight, and the dynamics of development, it is interesting to mention a not new thesis: "the world has been learning for a long time, but we are still teaching." The priority of the student's active cognitive activity, its modern organization is one of the main progressive factors in the development of modern professional education. The approach to "learning" as a central factor in professional development is confirmed by centuries-old pedagogical practice, which stubbornly proves that there are no other ways of mastering knowledge, skills, and abilities other than the active, purposeful, intense cognitive activity of the student himself. The role of the teacher in this process is also important, but secondary and limited to the functions of organization, management, control, that is, the pedagogically justified direction of the main process - the student [3].

The technology of forming the culture of intellectual work of students of higher educational institutions involves the implementation of three main stages of work: preparatory-organizational, content-procedural (motivational-target, content- operational, personal) and control-corrective. All these stages are interconnected and require a clear selection of appropriate forms, methods and methods of work for their formation, which should lead to the expected result - the formation of a culture of intellectual work of students of higher educational institutions.

The choice of a medical profession according to one or another motive (for what?) also determines the motives of study. If we take into account that the motive is a subject of need, then for future doctors such subjects have a purely cognitive interest, an effort to better prepare for independent professional activity, a sense of responsibility, or an effort to stand out among fellow students through education, to occupy a prestigious position in collective, getting rid of complaints from teachers and relatives, trying to earn respect, get an increased scholarship, etc. The subdivision of motives into leading (dominant) and situational (stimulus motives), external and internal allows to predict with a high level of probability that both for future doctors in training and for working doctors, their activities run as a chain of situations, some of which act as purposeful attraction The purpose of the activity and the motive here coincide. Other situations are perceived as purposeful coercion, when the goal and motive do not match. In this case, the doctor may feel awkward and even negative about the goal of medical activity [2, 4].

The relationship to the chosen profession, in the personality of the doctor, is a complex integral phenomenon that reflects the degree of involvement of the individual in professional activity. This dynamic property, or relation, arises, is formed and is rebuilt at different stages and in different situations of activity. This is an expression of the integral position of a young specialist, because the relationship to the profession of a doctor cannot be separated from the entire system of his life values and orientation. Finding a favorable and unfavorable attitude to the profession gives a good reason to consider how to form, consolidate and develop love for the profession, how to rebuild and change the negative attitude towards it.

The formation of a system of orientation and a professional position based on it stabilizes the professional choice of a young doctor. In professional behavior, as in human behavior in general, the dependence of a person's actions on the social situation presupposes "an inner moment of self-determination, loyalty to oneself."

A person oriented towards the profession, who loves his work and has mastered the "spirit" of modern medicine, will rather become able to "master himself" in any, even difficult, unforeseen situations. She "looks for and finds more and more new motives." Young doctors, with a zealous approach to their business, in all situations seek confirmation that this business is interesting, necessary, useful. The development of their position is connected with the consolidation of positive motives. If the creative path begins with a note of dissatisfaction, any difficult situation goes to the basket of negative arguments [5].

The attitude towards the profession is an internal catalyst of external influences and, at the same time, a measure of the doctor's personal responsibility for making a decision. It is in this second meaning that the relationship becomes a regulator of professional behavior. The dynamics of motivation in the mode of selfregulation (when the person himself seeks confirmation of the correctness of his position and carries out selection activities) and in the mode of "external determination only" (when certain actions are performed as a direct implementation of the norm) are fundamentally different.

Behind them are different styles of professional behavior, and since then, different personalities of specialists. Therefore, it is reasonable to define "personal, psychological conditions for the formation of a certain relationship and evaluation criteria." The professional training of a medical worker aims to form not only a system of knowledge, abilities, and skills, but also the development of specific personality traits that meet the requirements of future professional activity. That is, we are talking about the formation of a complete personality, the development of which is professionally oriented. Moreover, the medical university faces a serious problem of integral development of the personality, which has not only a professional orientation, but also involves its involvement in the system of universal, humanistic values.

The processes of education and upbringing cannot be separated, they are inextricably linked precisely because the first one, putting increasingly difficult tasks before the student and immersing him in the real space of professional activity, causes an active push in the development of mental processes and certain personality qualities. Therefore, depending on the content, forms, methods, complexity, intensity, orientation, nature, process of learning, we get one or another result in terms of personality development in terms of its compliance with modern requirements of the profession and society.

Thus, the process of learning in a higher medical institution, in the context of the effectiveness of its organization, causes the professional-oriented development of mental processes of the future medical worker, specific purely medical ones: perception and memory (visual, auditory, tactile, sensorimotor, etc.), clinical thinking and imagination, professional attention, etc. In addition, a successfully constructed learning process objectively stimulates the development of a system of professionally significant personality traits, such as: responsibility, sociability, restraint, tolerance, empathy, endurance and mobility in extreme professional situations.

The development of personality as a whole and its professional substructure in youth is a complex process, because it involves penetrating into its value, attitude, moral and ethical, motivational structures, which are core, deep features, sufficiently stable, masked, protected and those that rarely manifest themselves directly. That is why they belong to the category of difficult to diagnose and difficult to access in terms of pedagogical influence.

The success of a specialist's personality development is largely determined by the socio-economic status of the medical profession. In the presence of a high status of the profession, and in fact, a high motivation to master it, a professional spectrum of personal qualities is formed quite easily, because these traits are perceived as significant, which will affect the level of professional achievements. The low socioeconomic status of medical professions, the ineffectiveness of mechanisms for stimulating quality work and education in domestic conditions leads to a sharp decrease in the level of motivation, and as a result, causes serious difficulties in the development of the necessary range of professionally important qualities in students.

Ensuring the motivational and goal-oriented component of the technology for the formation of a culture of mental work involves: firstly, students' awareness of the goal of forming a culture of mental work, defined by the teacher, awareness of the goals related to the acquisition of knowledge, skills and abilities, or their improvement in the learning process based on a specific a certain level of internal personal resources, which is detected by means of diagnostics for the purpose of further development; secondly, stimulation of students' self-promotion of the goal of mastering the culture of mental work and its specific components, determination

of ways to achieve this goal. Purposeful organized work should contribute to the realization of the goal and its formation, determined by the teacher [6].

Providing the motivational and target component of the formation technology is aimed at maintaining a constant motivational mechanism of cognition - interest as a cognitive motive, thereby stimulating students to master the system of knowledge, abilities, skills and development of internal resource capabilities and taking into account external (material and technical, time, information, stimulating, communicative, psychological-pedagogical and organizational) factors. Educational material should be selected in such a way that its content affects the needs of students, their motivational sphere, is accessible and complex at the same time, and is based on the knowledge and life experience that students already have and that contributed to their development.

The next step in the formation of the motivational and goal-oriented component is the purposeful bringing of students to the confidence in the importance and necessity of mastering mental work for every individual who is engaged in mental work, and therefore to the awareness, definition and setting of one's own goal, which was supposed to orient and activate all the resource capabilities of the individual on its achievement by directing and organizing daily mental work, which, in turn, contributed to the formation of a positive attitude towards the implementation of this activity.

Since the mastery of the culture of mental work is successful in the presence of a specific goal of educational activity based on positive motivation, the teacher directs the students' activities so that the goal, which performs a regulatory function in educational activity and regulates the actual implementation of mental work, is aimed at changing the nature of motives on at each stage of its formation.

With the help of problematic questions, leading students to understand that they do not possess important qualities and skills, giving examples of overcoming this inability, the teacher leads students to a clear understanding of the purpose of each task they performed, to an understanding of the meaning of each component of mental work in the process of carrying out the educational activity and the importance of controlling one's own actions during mental work, to the identification of persistent interest in mental work and the desire to systematically work on the acquisition and use of relevant skills and abilities.

In the learning process, each student must achieve the set goal of forming mental work individually, but this happens in different ways, the choice of which depends on the individual level of knowledge, abilities and skills, as well as the resource capabilities of each student, and on this basis, the individual path of forming mental work is modeled, which has the form of a detailed plan with three components: what should be known, what should be learned, what should be developed, with the determination of priorities and deadlines for achievement.

Types of motivation for educational activities. By itself, the knowledge that a student receives at a university can be for him only a means to achieve other goals (getting a diploma, earning praise, preventing displeasure of relatives, etc.). In this case, the student is motivated not by interest, curiosity, efforts to master specific skills, enthusiasm for the process of acquiring knowledge, but what will be obtained as a result of training. Several types of motivations related to learning outcomes are identified:

• motivation, which can conditionally be called negative. Negative motivation refers to the student's efforts due to the awareness of certain inconveniences and disadvantages that may arise if he does not study (reprimands from relatives, teachers, fellow students, etc.). Such motivation does not lead to a successful result;

• motivation, which has a positive character, but is also related to motives that lie outside the educational activity itself. This motivation appears in two forms.

In one case, such positive motivation is due to social efforts that are significant for the individual (a sense of civic duty to the country, to loved ones). Education is considered as a way to master the great values of culture, as a way to fulfill one's purpose in life. Such an attitude in education, if it is stable enough and occupies a significant place in the student's personality, gives him the strength to overcome known difficulties, to show patience and resilience. This is the most valuable motivation. However, if such an attitude is not supported by other motivating factors during the learning process, then it will not provide the maximum effect, since it is not the activity as such, but only what is related to it, that motivates.

The second form of motivation is determined by narrowly personal motives: the approval of others, the path to personal well-being, etc. In addition, the motivation that underlies the educational activity itself can be determined, for example, motivation directly related to the learning goals. Motives of this category: satisfaction of interest, acquisition of certain knowledge, broadening of horizons. Motivation can be embedded in the very process of educational activity (overcoming obstacles, intellectual activity, realization of one's abilities, etc.).

Two large groups of educational motives are defined: cognitive (related to the content of the educational activity and the process of its implementation) and social (related to various social interactions of the student with other people).

Cognitive motives include:

1) broad cognitive motives, which consist in the orientation of students to acquire new knowledge.

2) educational and cognitive motives, which orient students to mastering methods of obtaining knowledge.

3) motives of self-learning, directing students to self-improvement of methods of obtaining knowledge.

In addition to general approaches to the formation of motivation, which should be implemented in students, special tasks should be used in classes on individual clinical disciplines, for example: to justify the necessity and importance of performing such a task; determine the forms of organization of cognitive activity (frontal, collective, group, pair, individual); to prove the necessity of using different composition of subgroups (ratio of the formation of the motivational sphere, taking into account abilities, interests, level of independence, pace of work capacity, level of formation of mental work of the individual) depending on the tasks set for the rational organization of mental work; carry out peer review and self-review, mutual evaluation and self-evaluation, etc.

Of great importance in ensuring the motivational and target component of the formation technology is the impact on the volitional sphere of students. After all, it is known that students often have such a type of volitional reaction as an impulse to a

certain activity, which disappears when the first signs of difficulties appear. That is why the teacher's task is to form students' readiness to persistently overcome obstacles on the way to the defined goal.

A special place in the formation of positive motivation is the selection of tasks with elements of novelty and unpredictability, which contributed to the formation of interest in the process of their implementation, or providing the opportunity to freely choose the complexity of the task and its scope in accordance with the student's capabilities.

It is important to note that according to the theory of competence, an important need of the individual is the desire for mastery. Note that, depending on the level of formation of the culture of mental work at which the student is, creating a situation of feeling of own competence and efficiency increases the general state of motivation. That is why it is important to notice even the smallest successes of the student and to trust the independent performance of certain activities in order to consolidate success.

Thus, during the entire period of study of a certain discipline, the teacher sets certain requirements for students, motivates, directs their efforts to teach selfcontrol, self-education.

Motivation in mastering surgical disciplines by medical students is of particular importance. From the activities of a surgeon, life requires not only the ability to work hard to master the future specialty, but also to have sufficiently high mobility, the ability to tolerate various stresses and avoid them, the ability to establish business contacts and develop them productively. Therefore, the teacher also faces the question of an individual attitude to each foreign student, taking into account his personality, level of language and special training at previous departments in order to most effectively build an educational process for the student to master the scope of the curriculum of the studied subject. The sequence of teaching surgery at all specialized departments allows optimal training of the future doctor, which is of particular importance for the formation of a general practitioner. Keeping the basic principles of traditional, domestic teaching in the general practitioner training program, it is necessary to widely introduce elective courses in the relevant sections of this specialty into the educational process, using an individual approach to teaching. Existing teaching programs for various sections of surgery should be real, purposeful and more pragmatic, i.e. contain a list of only those tasks that, in the conditions of the existing relationship between the number of teachers and students in the group, the pedagogical load and the teacher's employment, taking into account the capacity and equipment of clinical bases, have be fully assimilated. Ways to optimize the teaching of general surgery are proposed to be carried out in three directions: vertical integration with medical and biological departments, rationalization of medical work and unification of visual aids. Teaching general surgery has its own characteristics and poses additional challenges for each teacher.

The value of the course of general surgery is also determined by the fact that this subject is the initial stage of mastering the entire course of surgical diseases in the mastering program of higher medical education. The problems that arise before the teacher and the student are that the course is taught according to the study program at the university in the third year, when the student is at the stage of final mastering of theoretical disciplines but has not yet fully mastered the amount of necessary basic knowledge. This leaves a certain imprint on the complete assimilation of the material. The textbook of general surgery carries a sufficient amount of knowledge provided by the curriculum, but the large amount of material that sometimes needs to be learned for each session becomes an obstacle due to the difficulty of determining the main basic provisions of the topic and the lack of clinical experience. This also applies to the lecture material, because it is he who carries the main assimilation of the knotty issues of general surgery. Therefore, lectures should be accompanied by easy-to-facilitate and at the same time expressive visual aids (tables, slides, windows, etc.). A special impression on the promotion of the material and the effect of its expedient assimilation is provided by the lectures composed and delivered in multimedia.

To prepare for practical classes, the department uses self-developed manuals on issues of general surgery and care of surgical patients, which contain material that is condensed, but corresponding to the curriculum in terms of essential volume. The manuals contain not only educational material relevant to the topic, but also samples of test control of knowledge, as well as typical situational problems, the solution of which helps in mastering the topic and practical application of the acquired knowledge. Each student is provided with such manuals. As visual material, we widely use multimedia provision of lectures and the use of high-quality educational films on the technique of examining a surgical patient, performing practical examination skills, providing assistance to victims and treating thematic patients. The acquired experience of teaching at the University shows that it is most expedient to teach the subject under the conditions of formation of "incomplete dozens" (student groups of 6-7 people), which allows classes to be conducted with the maximum possible individual principle of learning. The latter is of quite significant importance for better assimilation of the required level of practical skills. This especially applies to issues of applied importance that every doctor should learn and be able to use, regardless of the future specialty (desmurgy, providing first aid for trauma, burns, stopping bleeding, issues of intensive care, determining blood groups and the Rh factor, rules and techniques for examining a surgical patient). However, the boundaries of the curriculum do not always coincide with the requirements of teaching.

The use of test control of the level of knowledge acquisition among students also has its own characteristics. The time limit should not delay the time of the practical session, therefore it does not allow to fully use a sufficient number of tests. Linguistic communication in the form of a conversation with the participation of all students present at the class allows more adequately to determine the level of learned material and practical acquisition of skills based on their subsequent assessment. It is advisable to use test control at final stages and seminars. Individual work with students during a practical lesson structured in this way, especially in conditions of certain rivalry and adequate encouragement among them for the level of mastery of the material, acts as a special factor for the emergence of active motivations to master a new subject, which for them is general surgery.

An important stage in mastering the course of general surgery is also the creation of an opportunity for the student to work independently. Due to certain

reasons, they are not able to widely use individual shifts in the clinic to learn practical skills. However, the use of new progressive learning technologies allows solving these problems. Created and accordingly equipped classes for the acquisition of practical skills, which operate in extracurricular time under the supervision of the teacher on duty, allow you to more deeply learn the necessary list of practical acquisition in your free time. It turned out to be effective to use electronic versions of manuals on the technique of examining a surgical patient and performing special diagnostic tests for some surgical diseases, which are available not only in the computer classroom at the department, but also in the corresponding classrooms of the dormitories where students live. This helps them better learn the practical techniques of examining a surgical patient and feel more confident at the patient's bedside.

Taking into account the problems that arise for students during independent preparation for practical classes, the department has developed and constantly operates advisory days outside of school hours and on Saturdays, during which the teacher on duty provides the necessary pedagogical assistance to master the material of the missed class and practice practical skills.

In order to consolidate the acquired level of knowledge and practical skills from the course of general surgery, at the students' own request, they can actively participate in the work of the scientific student group permanently operating at the department, participate in night shifts in the clinic, which is based in the emergency hospital. Teaching general surgery also bears educational responsibility for students' choice of future specialty. This is not only the first acquaintance with the clinical discipline, but also the laying of the first bricks for the process of formation of the future specialist. Individual work with each student, especially with those who wish to connect their future medical specialty with surgery, is aimed at professional education of the future specialist. The success of a surgeon's professional activity primarily depends on his experience and knowledge of his specialty, the basics of modern medical science in general, but his natural data, features of character, suitability for medical activity are of no less importance. Sincere sympathy for the patient, which should dominate the pre- and postoperative period of the patient's treatment, recedes into the background, yielding to careful composure during the operation. But this is only on the outside, because even during this stage, the surgeon's professional activity is aimed at restoring health and preserving the patient's life.

Conclusions

The results of the formation of the motivational and target component of training at various stages allow us to conclude that students have a need for the formation of personal improvement, a desire to improve the mental and physiological resources of the body, a thirst for knowledge, but there is not enough knowledge about how to achieve a positive result in mastering the culture of mental work. Implementation of the developed technology gives positive results. The theoretical substantiation of the technology of forming the motivational-target component of the meaningful procedural stage ensures positive changes in the motivational sphere of students: the growth of the personal importance of learning, the ability to set goals, the importance of internal motives, the desire to achieve success in educational activities; decreasing the importance of external motives and the motive of avoiding failure.

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