Professional training of professional medical personnel: ethical and deontological principles

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Professional training of professional medical personnel: ethical and deontological principles

Puhach S.S. Puhach Serhii Serhiyovych Doctor of Pedagogical Sciences, Professor of the Department of Jurisprudence and Humanitarian Disciplines of Vinnytsia Educational and Scientific Institute of Economics, Western Ukrainian National University, , Vizniuk I.M. Vizniuk Inessa Mykolaivna Doctor of Psychological Sciences, Professor of the Department of Psychology and Social Work, Vinnytsia State Pedagogical University named after Mykhailo Kotsiubynskyi, Paikush M.A. Paikush Marianna Andriivna Doctor of Pedagogical Sciences, Professor of the Department of Biophysics, Lviv National Medical University, Dolynnyi S.S. Dolynnyi Serhii Serhiyovych doctor of philosophy (PhD), senior lecturer at the Department of Psychology and Social Work, Mykhailo Kotsiubynskyi Vinnytsia State Pedagogical University

Abstract

The analysis of the system of professional training of medical workers in European countries made it possible to reveal the presence of a wide range of elementary specialist training programs and qualification levels for the training of junior specialist (licensee) and bachelor of medical knowledge.

The system of personal parameters of professional readiness includes such parameters as motivational, orientational, operational, volitional and evaluative. The starting motivational indicators of the studied groups turned out to be quite close, with the same preference for internal motives, focused on the content and nature of medical activity, and external, narrowly personal motives.

The orientation of the behavior of the students of these groups in professional activities was determined through four types of orientations: towards oneself; to official subordination; on the psychological climate and relationships; on business

The measurement of the operational parameter of professional readiness was carried out according to the method "Motivation for choosing a medical profession" by A. Vasylkova. The measurement of the features of the manifestation of the volitional parameter in professional activity was carried out twice - after the first industrial and pre-diploma internships. The evaluation parameter of professional readiness was carried out based on the results of the evaluation of professional readiness by three subjects after the students completed industrial practice based on the results of relevant knowledge and skills.

We consider it appropriate to introduce additional specializations (physician of a preschool (school) educational institution, medical assistant (assistant), specialist in the field of management - medical representative, etc.) and further improvement of a specialist in the field of postgraduate education, which will provide ethical and deontological opportunities for the professional readiness of medical workers and sub objective control over production situations of a narrower range.

That is why modern Ukrainian training of the future medical specialist is the most optimal option in the development of educational and professional programs, taking into account the above parameters.

Keywords: professional readiness, ethical and deontological prerogatives, dental assistant, industry standard of higher education, experimental program of managerial and pedagogical actions.

Анотація

Професійна підготовка професійного медичного персоналу: етичні та деонтологічні принципи

Пугач Сергій Сергійович доктор педагогічних наук, професор кафедри правознавства і гуманітарних дисциплін Вінницького навчально-наукового інституту економіки, Західноукраїнський національний університет,

Візнюк Інесса Миколаївна доктор психологічних наук, професор кафедри психології та соціальної роботи, Вінницький державний педагогічний університет імені Михайла Коцюбинського

Пайкуш Маріанна Андріївна доктор педагогічних наук, професор кафедри біофізики, Львівський національний медичний університет

Долинний Сергій Сергійович доктор філософії (PhD), старший викладач кафедри психології та соціальної роботи, Вінницький державний педагогічний університет імені Михайла Коцюбинського

Аналіз системи професійної підготовки медичних працівників у країнах Європи дав можливість виявити наявність широкого спектра елементарних програм підготовки фахівців та кваліфікаційних рівнів з підготовки молодшого спеціаліста (ліценціат) та бакалавра медичних знань.

До системи особистих параметрів професійної готовності відносимо такі паарметри як мотиваційний, орієнтаційний, операційний, вольовий та оцінний. Стартові мотиваційні показники досліджуваних груп виявилися досить близькими з однаковою перевагою внутрішніх мотивів, орієнтованих на зміст і характер медичної діяльності та зовнішніх вузько особистісних мотивів. Спрямованість поведінки студентів цих груп у професійній діяльності визначалася через чотири типи орієнтацій: на себе; на офіційну субординацію; на психологічний клімат і взаємини; на справу. Вимірювання операційного параметра професійної готовності проводилося за методикою «Мотивація вибору медичної професії» А. Василькової. Вимірювання особливостей прояву вольового параметра у професійній діяльності проводилося двічі - після першої виробничої та переддипломної практик. Оцінний параметр професійної готовності проводилося за результатами оцінки професійної готовності трьома суб'єктами після проходження студентами виробничої практики за результатами відповідних знань і навиків.

Вважаємо доречним введення додаткових спеціалізацій (медик дошкільного (шкільного) закладу освіти, помічник (асистент) лікаря, фахівець у сфері менеджменту - медичний представник тощо) та подальше вдосконалення фахівця у сфері післядипломної освіти, що забезпечуватиме етико-деонтологічні можливості професійної готовності медичних працівників та суб'єктивний контроль за виробничими ситуаціями більш вузького діапазону.

Саме тому сучасна українська підготовка майбутнього медичного фахівця є найбільш оптимальним варіантом у розвитку освітньо-професійних програм, з урахуванням вищезазначених параметрів.

Ключові слова: професійна готовність, етико-деонтологічні прерогативи, медичний працівник, галузевий стандарт вищої освіти, експериментальна програма управлінсько-педагогічних дій.

Abstract

Statement of the problem. New socio-economic conditions put the issue of improving the content and process of professional training, developing its models, and introducing new specialties expected by the labor market into one of the first places in pedagogical research. In particular, in the field of ethics and deontology of medical personnel during the provision of care, in the context of which there is a need for well-prepared auxiliary medical care, characterized by a high level of psychomatic health of the population and working as part of a professional team in conditions of labor-intensive technologies. Currently, the state of mental health of the population of various regions and social groups of Ukraine, according to the World Health Organization, is one of the lowest in Europe.

Analysis of recent research and publications. Professional training of specialized medical personnel in foreign countries began as early as the 20s and 30s of the 20th century. According to the traditions of each country, different models of professional training of medical workers have been formed. At the same time, in Ukraine, the demand for professional training of medical specialists is constantly growing, but insufficient attention has been paid to the study of their deontological competences in modern conditions. Given the relevance of the mentioned problem, the modern labor market is conditioned by the need for medical professionals, and the lack of special research in this field creates good reasons for studying this topic.

In his scientific works, G. Camp claims that problem-based learning is a paradigm in changing the transition program of the educational process in the training of medical professionals. The works of R. Dsouza, R. Quinonez, S. Hubbell, J. Brame are devoted to the coverage of psychosomatic health in nursing education using the interprofessional practice of joint work "Qualified experimental research project". L. Friedlander, T. Meldrum, K. Lyons contribute to the development of educational programs in nursing educational courses to increase the competence and professionalism of modern medical practice. L. Imorde, A. Moltner, M. Runschke, T. Weberschock, S. Ruttermann, S. Gerhardt-Szep conducted a pilot study on the adaptation and validation of the Berlin Evidence-Based Medicine Competency Questionnaire for dental students. M. O'Keefe, V. Wade, S. McAllister, I. Stupans, J. Miller, T. Burgess, A. LeCouteur, L. Starr reconceptualized student attitudes toward clinical supervision and patient care. On the basis of the above-mentioned works, the industry standard of higher education of a junior specialist - dental assistant was developed, which formed the basis of our experimental program of changes in dental practice [1-5].

The purpose of the article is to substantiate the professional training of professional medical personnel in the context of the study of ethical and deontological principles.

Presenting main material

According to the aim, we adapted the Berlin Questionnaire (BQ) for dental students, which evaluates their medical abilities based on their assessment results. The Berlin Questionnaire method was approved by medical residents in Germany. We have adapted it for use in dentistry. An expert panel reviewed the adapted BQ for content validity.

A cross-sectional cohort representing four levels of training (novice EbD dental students, EbD trainee dental students, and EbM/EbD dentists) completed the questionnaire. Internal reliability, item difficulty, and item discrimination were assessed. A. Vasylkova's "Motivation for choosing a medical profession" methodology was used to substantiate the indicators of the suitability of the choice of profession of those seeking education [1, 3].

The research was carried out in the conditions of the educational process of Vinnytsia National Medical University named after M. I. Pirogov Faculty of Dentistry, which was attended by 272 people, including 137 students, 135 teachers, including 73 managers at practice bases and 62 managers of dental clinics, taking into account their professional experience: at the beginning of training, during training and practices (clinical management).

During the experiment, the attitude of future dentists to practice was studied in order to increase their level of readiness for the professional - dental assistants with further professional support.

The educational process opens wide perspectives in the direction of the formation of a young person's worldview. In this vein, the problem of psychophysical health as a component of professional training in the context of the worldview orientation of future specialists in the educational process of higher education acquires special significance every year, which is explained by the constant deterioration of the health of young people, caused by unfavorable socio-economic conditions in many countries of the world and, in particular, in Ukraine [1, 3].

The history of the development of human society shows that in the event of the appearance of new, stronger sources of energy and the development of technology, the role of motor qualities of a person is definitely decreasing, while the importance of mental functions is constantly increasing. Scientists assure that the restriction of motor activity, which develops as a result of scientific and technical progress, has, first of all, a direct relationship to the psychophysical health of a person [1, 4, 5].

Table 1

Organizational and pedagogical conditions of professional training of a dental assistant № Organizational and pedagogical conditions

Statistical reliability was determined using the Pearson consistency test.

The analysis of the system of professional training of medical workers in European countries made it possible to reveal the presence of a wide range of elementary specialist training programs and qualification levels for the training of junior specialist (licensee) and bachelor of medical knowledge. Within the scope of foreign professional training of a dental assistant or dental hygienist, there are specializations (for example, medical educator, biocommunicator, scientific researcher in the field of dental hygiene). There is a tendency to define the bachelor's level of dental hygienist training as the minimum level for this profession in certain regions [2, 3].

The starting motivational indicators of students of the experimental and control groups turned out to be quite close, with the same preference for internal motives, focused on the content and nature of medical activity, and external, narrowly personal motives.

The orientation of the behavior of the students of these groups in professional activities was determined through four types of orientations: towards oneself; to official subordination; on the psychological climate and relationships; on business The measurement of the operational parameter of professional readiness was carried out according to the method "Motivation for choosing a medical profession" by A. Vasylkova. The measurement of the features of the manifestation of the volitional parameter in professional activity was carried out twice - after the first industrial and pre-diploma internships. The evaluation parameter of professional readiness was carried out based on the results of the evaluation of professional readiness by three subjects after the students completed industrial practice based on the results of relevant knowledge and skills [4, 5].

In accordance with this system, we developed an experimental program of managerial and pedagogical actions and started its implementation as a variable factor of the experiment. An interactive environment of dialogue, interaction and cooperation of subjects-organizers of educational changes was created thanks to the initiation by the educational institution of consultations, meetings, reviews, reviews, expert questionnaires, questionnaires evaluating progress and results of professional training.

Educational and practical seminars of the cycle "Implementation of international protocols in dental practice" have been implemented and dentists, children's dentists, dental surgeons, orthopedist dentists, and orthodontists are invited to attend them.

The research carried out made it possible to develop and implement educational and methodological support for the process of professional training of a dental assistant: indicative curriculum, working curricula; typical educational programs from the cycle of general scientific (fundamental) and professionally oriented disciplines; methodological recommendations for practical classes in the discipline "Prevention of dental diseases", methodological guidelines for the course "Working in four hands at a therapeutic appointment" in the discipline "Therapeutic dentistry"; method of organizing students' independent work on the educational task "Expert's Portfolio"; the method of organizing students' independent work with their performance of the educational task "Portfolio of documents of the association of dental assistants" [2, 3, 5].

Table 2

Indicators of the subjects according to the Berlin Questionnaire (BQ)

According to the Berlin Questionnaire (BQ), 65.0% (176 out of 272) of the subjects were at high risk of sleep-disordered breathing. Among men, 56.4% (44 out of 78) had a high risk of sleep apnea, among women - 43.6% (84 out of 194), p = 0.781. According to the "Sleep Apnea" scale, increased risk was found in 63.5% (172 out of 272) of people, in 47.3% (37 out of 78) of men and 52.7% (102 out of 194) of women (p = 0.471).

Excessive daytime sleepiness according to the Epworth sleepiness scale (> 11 points) was found in 23.4% (90 out of 272) of the examined. At the same time, the percentage of women with excessive daytime sleepiness was 27.6% (45 out of 194), and men - 19.7% (15 out of 78), the difference was statistically insignificant (p = 0.241), which indicates a rather high level of exhaustion of the participants of the pedagogical experiment (E) during the performance of professional duties.

According to A. Vasylkova's "Motivation for choosing a medical profession" method, we observe a high degree of compliance with regard to the choice of profession of all groups of subjects.

Table 3

The level of motivational readiness of the future dental assistant

According to its indicators, we observe after the experiment (Table 3.) the desire of the respondents to treat people (38.8% and 31.5%), the desire to alleviate the suffering of the seriously ill, the elderly and children (54.2% and 57.2%) and the readiness solve scientific and medical problems (6.9% and 11.2%). Therefore, the selection of all dentists is determined by the independent choice of the specialty and at their own will. medical postgraduate education doctor

Conclusion

Modern Ukrainian training of the future dental assistant is the most optimal option in the development of educational and professional programs, taking into account the above parameters [6-7]. We consider it appropriate to introduce additional specializations (physician of a preschool (school) educational institution, assistant (assistant) of a doctor, specialist in the field of management - medical representative, etc.) and further improvement of a specialist in the field of postgraduate education, which will provide ethical and deontological opportunities for the professional readiness of medical workers and sub objective control over production situations of a narrower range.

References

2. Dsouza, R., Quinonez, R., Hubbell, S., & Brame, J. (2019). Promoting oral health in nursing education through interprofessional collaborative practice: A quasi-experimental survey study design. Nurse education today, 82, 93-98. DOI: 10.1016/j.nedt.2019.07.010 [in England].

3. Friedlander, L. T., Meldrum, A. M., & Lyons, K. (2019). Curriculum development in final year dentistry to enhance competency and professionalism for contemporary general dental practice. European Journal of Dental Education, 23(4), 498-506. DOI: 10.1111/eje.12458 [in USA].

4.Imorde, L., Moltner, A., Runschke, M., Weberschock, T., Ruttermann, S., & Gerhardt- Szep, S. (2020). Adaptation and validation of the Berlin questionnaire of competence in evidence- based dentistry for dental students: a pilot study. BMC Medical Education, 20(1), 136. DOI: 10.1186/s12909-020-02053-0 [in England].

5.O'Keefe, M., Wade, V., McAllister, S., Stupans, I., Miller, J., Burgess, T., LeCouteur, A., & Starr, L. (2014). Rethinking attitudes to student clinical supervision and patient care: a change management success story. BMC medical education, 14(1), 182. DOI: 10.1186/1472-6920-14-182 [in USA].

6. Yuhan N. Violence in Youth Environment as a Sociopsychological Phenom. (Based on German-Lang. Dramaturgy of the 2010s). Science, technology and innovate. in the modern world: Scientific monogr.. Riga, Latvia: Baltija Publ., 2023. P. 568-628. DOI: https://doi.org/10.30525/978-9934-26-364-4-23

7. Yuhan N. Analyzing the Psychol. of Terrorism and School Shootings in Contemporary German-Lang. Drama. Liter., psychol., pedagogy in the perspect. of interaction: materials of the International Scientific and Practical Conference (Dnipro, November 9, 2023). Dnipro: GIIIM DVNZ "DDPU", 2023. P. 315-320.

Література

1. Camp G. Problem-Based Learning: A ParadigmShiftor a PassingFad? The University of Texas Medical Branch MEO, 1996. №1. Р. 2-12.

2. Dsouza R., Quinonez R., Hubbell S., & Brame J. Promoting oral health in nursing education through interprofessional collaborative practice: A quasi-experimental survey study design. Nurse education today, 2019. №82. Р. 93-98.

3. Friedlander L. T., Meldrum A. M., & Lyons K. Curriculum devel. in final year dentistry to enhance competency and professionalism for contemporary general dental practice. Europ. Jour. of Dental Education, 2019. №23(4). Р. 498-506. 4.Imorde L., Moltner A., Runschke M., Weberschock T., Ruttermann S., & Gerhardt-Szep S. Adaptation and validation of the Berlin questionnaire of competence in evidence-based dentistry for dental students: a pilot study. BMC Medical Education, 2020. №20(1). Р. 136. DOI: 10.1186/s12909-020-02053-0.

5.0'Keefe M., Wade V., McAllister S., Stupans I., Miller J., Burgess T., LeCouteur A., & Starr L. Rethinking attitudes to student clinical supervision and patient care: a change management success story. BMC medical education, 2014. №14(1). Р. 82. DOI: 10.1186/1472-6920-14-182

6. Yuhan N. Violence in Youth Environment as a Sociopsychological Phenomenon (Based on German-Language Dramaturgy of the 2010s) / Насильство у молодіжному середовищі як соціально-психологічний феномен (на матеріалі німецькомовної драматургії 2010-х років). Science, technology and innovation in the modern world : Scientific monograph. Riga, Latvia : Baltija Publishing, 2023. Р. 568-628. Yuhan N. Analyzing the Psychology of Terrorism and School Shootings in Contemporary German-Language Drama. Література, психологія, педагогіка у ракурсах взаємодії: матеріали Міжнародної науково-практичної конференції (Дніпро, 9 листопада 2023 р.). Дніпро: ГІІМ ДВНЗ «ДДПУ», 2023. С. 315-320.

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