Educational suprematism: frameless spase in education

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Ternopil National Medical University named after Ivan Horbachevsky, Ministry of Health of Ukraine

Educational suprematism: frameless spase in education

Volodymyr Bilous PhD, MD, Assistant Professor of the department

of Psychiatry, Narcology, and Medical Psychology,

Tetiana Ivanitska MD, Assistant Professor of the department

of Psychiatry, Narcology, and Medical Psychology,

Ukraine

Аннотация

Образовательный супрематизм: бескаркасное пространство в образовании

Цель. Совершенствовать учебные программы для интернов-психиатров.

Summary

Introduction

Despite the rapid development of technology in medicine, the accumulation of new knowledge about diseases, about biological processes in the human body, medical education remains the most conservative compared to other fields of science. The field of education is extremely competitive these days, and there is a struggle for the best minds of young Ukrainians. We, as educators and citizens, are primarily interested in the most intelligent, most worthy students choosing the medical field. The future of Ukrainian medical education is now in our hands. It depends on the decisions we make today what kind of doctors and scientists we will see in 5-1020 years, so it is very important to focus on what the educational process is filled with, instead of trying to adapt the old system to a new form. The challenge that now stands before us is to find the courage and bravery to reject the old, outdated system of education, built on the principle of collective irresponsibility. The world tends towards a system that gives the learner much more tools for more directed, conscious, comfortable consumption of knowledge in terms of pace, speed, and duration. And here we are talking not so much about problematic learning, when the structure of comprehensive/multidisciplinary study of some issue is chosen for the educational process, but about the position of the student in relation to the process. So, in the case of a strictly structured curriculum, this position is passive and involves the acquisition of the information flow that is provided by the schedule/plan and does not allow influencing this process. The opposite of this position is an active position, when the student himself determines which subjects he wants to study in what order and has the opportunity to individually build a schedule of the educational process.

The ability to freely choose inevitably leads to the need to choose. The advantages of such an approach lie in a significantly higher level of responsibility for the learning process on the part of the student, a higher level of motivation and understanding of their role, as well as the inevitability of the need to acquire certain knowledge. An active position in learning promotes the development of selforganization skills, discipline, and allows for the smooth filtering out of people who do not demonstrate such abilities. Of course, to implement such ideas, a clear and fair evaluation structure is needed, and a high level of trust in the people who will implement such an approach, because it should be guided not so much by rules as by principles. Seeing the high potential and benefits of proactive learning, we have decided to implement its elements into the educational process in our department. The position of higher education institutions towards the learner is often seen as a form where you need to place the material and bring it in line with the standards, when in fact, they should be a set of tools from which the learner has the opportunity to create their own individual form.

The modernization of education is aimed at bringing the entire learning process from the goal to the result in accordance with the demands of modern times. Equally important is the consideration of this result not only in the form of traditional evaluation, but also in the form of a document that records the creative successes (personal achievements) of an intern doctor. The future doctor, who will soon have to take responsibility for their activities in the context of working with patients, needs to be able to adequately evaluate their knowledge, skills, and abilities. One of the technologies that contribute to the formation of the necessary reflective skills, i.e., self-observation, is a portfolio. Therefore, the question arises: how was the conceptual portfolio of an intern doctor formed and how can such a technique be useful? Objective: To systematize and improve educational programs for psychiatry interns and students studying at the Department of Psychiatry, Narcology, and Medical Psychology at the Ternopil National Medical University, taking into account the need for the development of high-quality personal self-reflection skills in future doctors.

Materials and Methods: The study utilized a bibliographic method and a method of structural-logical analysis. The systematic approach was the methodical basis.

Results and Discussion

After analysing the available literature, we found that the international community considers a portfolio as an organized collection of materials gathered for a specific purpose [1]. If we view the concept of "portfolio" as more than just a complex of documents or a collection of materials, then we can say that this method is an effective means of objectively accounting for and reflexively accumulating one's personal competencies, ability to compete in the job market, and prospective professional and creative growth.

We believe that an intern's portfolio is a tool for self-evaluation of the cognitive work of a future specialist, reflection on their personal activities, self-control, and selfassessment of their achievements, analysis, argumentation, and planning for further actions and decisions, and as a result - the development and control of personal success (or belief in personal success). This is a kind of educational suprematism, the main goal of which is to seek harmony in generalizing educational achievements.

Currently, in higher education medical institutions in Ukraine, formation of portfolios for students and postgraduate students is almost not practiced. The main task of working on portfolio filling is to realize from the first days of enrolment in a higher education institution or internship that the student or postgraduate student is responsible for their future. If all the activities of the student are recorded in the portfolio, we believe that this will stimulate the development of thinking, creative abilities, high achievements in the educational process, participation in the public life of the institution and the country.

The interest in the portfolio is also increased by the fact that it is used in some medical institutions during employment. Its advantages over traditional control methods lie in the fact that the portfolio is a real method of self-organization, self-discovery, self-assessment, self-development, and self-presentation of the individual both in higher education institutions and in the professional business environment. Psychologists and educators recognize the urgent need for the creation and implementation of a personalized approach to education as one of the principles of organizing educational work [2]. A radical change in the educational goal reorients the learning process towards the individual. This form of learning organization involves moderating the process based on deep respect for the student's personality, taking into account the peculiarities of individual development, treating them as a conscious responsible subject of educational interaction, and transferring responsibility for their professional development to them.

The principles of the portfolio technology have been formulated by scientists as self-assessment of results, systematic and regular self-monitoring. We agree with this view and identify the following principles of this method:

- purpose and motivation (defining the goals and tasks of creating the portfolio, aligning the objectives, and recognizing the need for learning activities by the subjects of the educational process);

- systematic approach (the tasks should be part of an objective assessment of the intern's abilities, planning and achieving higher results);

- correspondence (the goals and tasks should be in line with the structure of the portfolio);

- heterogeneity (the portfolio should have a diverse structure with tasks of different forms);

- scientific justification and objective evaluation (the selection of samples for the implementation of the portfolio technology of different purposes - individual, university, national).

1. Diagnostic - records the real state, changes, and growth of the intern's learning outcomes.

2. Predictive - identifies the strategy and tactics of developing professional competencies.

3. Management - influences the goals, information, forecasts, decisions, organization, and implementation of knowledge and skills.

4. Organizational - organizes the conditions for creating a portfolio.

5. Informational - creates a credible database of information regarding learning outcomes.

6. Analytical - involves the selection and processing of credible information on the intern's learning outcomes.

7. Rating - shows the range of skills and abilities of the future doctor.

8. Motivation - stimulates interns to achieve learning outcomes.

9. Content - shows the mastery of fundamental concepts, principles, and laws and reveals the entire spectrum of intern's work.

10. Developmental - ensures continuity of the learning process and the development of thinking and communication skills.

11. Adaptation - minimizes the negative consequences of the existing system of trainee development and facilitates their adaptation to society and the acquisition of business competitiveness skills.

a) a shift in focus from the shortcomings of knowledge and skills of interns to specific achievements in the indicated topic, section, or subject;

b) integration of quantitative and qualitative assessments;

c) development of the intern's communicative abilities;

d) predominance of self-assessment regarding external evaluation.

During our research, the question arose: what should the portfolio of an intern studying in the "Psychiatry" specialty consist of? It should record the multifaceted achievements of the intern, both personal and those that correspond to the necessary competencies of a psychiatrist. In 2021, the Department of Psychiatry, Narcology, and Medical Psychology made a decision to introduce an experimental version of an educational portfolio for interns studying at the department. Our developed portfolio consists of a title page that contains basic information about the intern's higher education and fields for indicating the trainee's personal achievements (where it is recommended to list additional specialized education, thematic courses, and other informal training that the intern has undergone for personal development).

The first appendix of the portfolio includes information about the intern's scientific and research activity and is divided into three parts:

1. Participation in the work of a scientific circle (for admission to the final exam, an intern doctor must attend at least 5 meetings of this initiative).

2. Participation in Ukrainian and international scientific and practical conferences, congresses, forums, interdisciplinary meetings (during the intern's training period, it is proposed to attend at least 5 scientific and practical events and certify participation with a copy of the certificate with the corresponding number).

3. Individual scientific research of the intern doctor (for admission to the final exam during the training period, the applicant must complete at least one scientific research and present its results at the Congress of Students and Young Scientists).

This appendix emphasizes the intern's need for continuous education and evidence-based interaction in patient relationships. At the same time, the freedom to choose the vector of scientific activity and the sphere of personal preferences motivates the intern to work more enthusiastically and perform the proposed minimum portfolio. psychiatry intern educational portfolio medical

The second appendix contains information about attending lectures. For admission to the final exam, an intern must additionally attend 9 thematic lectures, which are offered to higher education students and summarize the current working program. The following topics are included: "The subject and objectives of psychiatry and narcology. The history of the development and the current state of psychiatry. Classification of mental disorders and illnesses", "Disorders of thinking, intelligence. Disorders of the motor-volitional sphere, disorders of impulses. Disorders of the emotional sphere", "Disorders of consciousness. Basic psychopathological syndromes", "Mental disorders in exogenous brain damage. Mental disorders in vascular brain damage", "Medical and social problems of psychoactive substance use", "Post-traumatic stress disorder", "Acute and prolonged reactive psychoses. Psychiatry of disasters and natural disasters. Problems of ecological psychiatry", "Schizophrenia. Basic hypotheses of pathogenesis. Clinical forms and course types. General principles of schizophrenia treatment", "Affective disorders. Masked depression", "Epilepsy. Etiology and pathogenesis. Classification. Epileptic psychoses.

Personality changes in patients with epilepsy." The attending physician- intern should confirm attendance of the lectures by the lecturer's signature in the specified record. This practice is necessary for trainees to review the basic theoretical information, identify possible gaps in their own knowledge, and plan further directions for studying psychiatry. The third appendix contains information on organizational and educational work, which includes moderation and participation in educational, creative, and charitable events (for admission to the final exam, the physician-intern must actively participate in 3 thematic events with the department team). This item is important for developing creativity, original thinking, and organizational skills of future doctors; because during practical activities, these skills may be critically necessary in nonstandard clinical cases.

In the fourth appendix, interns fill out a form about their work as part of a multidisciplinary team based in a healthcare facility. They record the psychotherapeutic interventions provided to patients in the wards, such as art therapy sessions, Mindfulness meditation practices, psychoeducational meetings, group work using techniques such as "Metaphorical Associative Cards," and more. To be eligible to take the final exam, interns must participate in at least 10 meetings of the multidisciplinary team during their training period. The organized activity must be confirmed with signatures from the supervisors of the wards where the intern was trained. This appendix is relevant in that it emphasizes the psychotherapeutic support, allowing future psychiatrists to develop skills in non-pharmacological treatment and rehabilitation of patients with relevant pathologies. This will give them an idea of various additional methods of influence and make them more competitive mental health professionals. The final section of the portfolio contains a list of recommended literature, which is limited to 20 textbooks (allowing the intern to thoroughly familiarize themselves with the necessary theoretical information during the training period). The list includes fundamental works on psychiatry, psychotherapy, psychology, child psychiatry, addiction medicine, forensic psychiatry, sexology, and other professionally important areas. Each achievement of the intern must be documented and confirmed. Supporting documents may include signatures of teachers, examination records, certificates, diplomas, reviews from practice supervisors (trainers), publications etc.