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PEDAGOGICAL SCIENCES
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Liliia Hulei
phd, assistant professor, Dermatovenereology Department Higher State Educational Establishment of Ukraine "Bukovinian State Medical University " DOI: 10.24411/2520-6990-2020-11988 FEATURES OF PRACTICAL TRAINING IN DERMATOVENEREOLOGY DURING THE COVID19
PANDEMIC
Лилия Гулей
кандидат медицинских наук, ассистент кафедры дерматовенерологии Высшее государственное учебное заведение Украины «Буковинский государственный медицинский университет»
ОСОБЕННОСТИ ПРАКТИЧЕСКОЙ ПОДГОТОВКИ ПО ДЕРАТОВЕНЕРОЛОГИИ ВО ВРЕМЯ
ПАНДЕМИИ COVID19
Аннотация.
С того времени, как во всем мире вспыхнула эпидемия короновируса COV1D-19, медицинское образование в Украине кардинально изменилось. Результатом этого есть активное использование современных цифровых технологий в учебном процессе, в том числе телемедицины, в Буковинском государственном медицинском университете (Черновцы, Украина). Цель исследования - усовершенствовать знания и отработать практические навыки студентов медицинского факультета №1, 2, 3 четвертого курса обучения по дисциплине «Дерматология. Венерология» благодаря современным подходам. Подводя итоги, можно сказать, что в нашем учебном заведении было обеспечено не только непрерывное обучение студентов, а и был продемонстрирован его огромный потенциал относительно практической их подготовки.
Abstract.
Since the coronavirus disease 2019 (COVID-19) pandemic has broken out all over the world, medical education in Ukraine has changed drastically. As result, contemporary training methods have been started actively to be introduced by using the digital technology, e.g. telemedicine, in the Bukovinian State Medical University (Chernivtsi, Ukraine). Aim of the research was to improve the knowledge and practical skills in fourth-year students' of the medical faculty №1, 2, 3 in the discipline "Dermatology. Venereology" using a modern approach. Summing up, our university has provided continuous training for students, and used teaching approach showed great potential in terms of practical training.
Ключевые слова: практическая подготовка, медицинское образование, дисциплина «Дерматология. Венерология», современные технологии, телемедицина.
Keywords: practical training, medical education, discipline "Dermatology. Venereology", modern technology, telemedicine.
The Ukrainian National Healthcare System is currently passing through an unpredictable situation owing to the rapid spread of COVID-19 across the country. Consequently, our Government has passed emergency laws (March 2020), intending to prevent widespread the novel disease among the people. Since 3 March 2020 till nowadays many new cases of patients with COVID-19 are confirmed: incidence (the number of new cases of COVID-19 in the last 7 days per 100 000 population) is less than 12 cases per 100 000 population (on 14 June 2020) [11]. This situation involves all segments of the population as well medical community including medical students. All thing considered, medical education has undergone several modifications. Following the decision of Ministry of Education and Science of Ukraine, our university Bukovinian State Medical University (Chernivtsi, Ukraine) has introduced quarantine [1] what means the attendance of medical
students in the Dermatology Department has been temporarily suspended. Therefore, Dermatovenereology Department of BSMU has developed a program in concordance with curriculum to continue the uninterrupted study for the fourth-year students in discipline "Dermatology. Venereology" by making use of up-to-date technology. Taking into account the fact that online learning is by no means a complete replacement for traditional learning and nothing can fully replace communication with a teacher or the atmosphere that develops in the classroom between students [2]. However, our students were forced as well as others to be in isolation and carry on studying because it is mandatory to control the infection during the COVID -19 pandemic [8].
Aim of the research was to improve the knowledge and practical skills in fourth-year students' of the medical faculty №1, 2, 3 in the discipline "Dermatology. Venereology" using a modern approach.
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Material and methods. This study included the fourth-year medical students of the medical faculty N°1, 2, 3 at the Bukovinian State Medical University (Cher-nivtsi, Ukraine). None of them had prior experience in online dermatology training. Hangouts Meet app [4], which was made up by G Suite for Education and formalized, was used for our video-conferencing. All students who were registered in Google Classroom were available to join the class and continue their studying remotely. An open educational resource Moodle was used as an e-learning program for students' off-class training. The recent data of literature, practice guidelines, podcasts, training tests and clinical case images, which addressed the same content as the face-to-face e-activities, were reviewed by participants. Telemedicine was used due to messengers and the medical communication system Helsi, where the tutor had to be previously registered as a dermatologist.
Research results and discussion. We used modern interactive teaching methods, such as presentation, "brainstorming session", the method of "critical thinking", "blitz-questionnaire". Different variants of the case method [3], such as Case-study method, Case-problem method, the case-case method - Incident Method, Stated-problem method were instigated. Activities of the distance-learning class comprised face-to-face online seminars and virtual patient care. In addition to these activities, students in the online group completed their knowledge with quizzes, spark discussions about virtual cases, precisely to make a provisional diagnosis, manage the patients. We have used a Telemedicine, to hold the attention of the audience, because some medical schools consider eHealth to be important [6, 7]. We have focused on providing online material for medical students in our department to improve knowledge about how these specific outpatient or inpatient services work [5]. Every class we try to agree on an appointment online with real patients accordingly to the theme and allow every student to make up for at least some portion of what they were missed. First, the patient had to make an appointment for a consultation with a dermatologist and choose a video consultation for a telemedicine examination. Students conducted a clinical examination of patients supervised by tutors. Then all participants discussed in the online-classroom about the introduced case (patient's complaints, anamnesis, history of present illness, status localis), analyzed specific issues and made constructive decisions. Afterwards, division of the group into subgroups with subsequent management of the case discussion (preliminary diagnosis, preparation of a follow-up plan, doing a differential diagnosis, making a final diagnosis, prescribing treatment) to make the most correct decision was run by the tutor. Besides, students must evaluate alternatives and choose the most optimal action plan. Moreover, they should be prepared to present their views during the discussion in the audience, defend them and, if necessary, reconsider the initial decision. The student should realize that they can turn their practical skills to very good account from the case only if they will take an active part in the discussion, by posing questions and developing solutions to determine the tactics for further management of the patient. This side
of the distance learning class on Dermatovenereology was very significant because it lasted for 5 academic hours. At the end of the practical class, students assessment by analyzing their decisions and answers were carried out. Telemedicine gives an opportunity as students as patients to use, for example, their smartphones to connect to the presentation where they could communicate and, consequently, we got immediate feedback. What is more, the visualized students' responses in real-time led to interaction between the students and the teacher. All students who participated in online discussion seminars could converse with the tutor by sending direct messages to the class tutor. The teacher will be able to compare and analyze problem-solving ability regarding the management of patients. One of the most prominent advantages of our subspecialty is an image-centric aspect which enables us to observe our patients online [9]. According to Edirippulige S. et al. (2018) [6], universities may be a logical place to provide education and training of eHealth, provided that the workforce was being adequately educated to achieve competence to work with eHealth. Telemedicine was considered by us as one of the possible ways to go out temporarily of this angle. Also, due to it, we can provide high-quality online medical services for taking care of our patients suffered from skin diseases [6]. Although, dermatological consultation requires close contact with some patients, because of reducing the quality of performance that could lead to postponing some medical procedures could be lethal to some patients [8]. So, regardless social distancing forbids classical lectures, seminars, and bedside teaching tutors help students sufficiently assimilate practical material such as new knowledge, skills and competencies to make the best use of e-learning owing to up-to-date technology during the COVID-19 pandemic. One reason behind this is the extremely effective type of educational work as the case method, known in education as a method of situational learning on specific examples [3]. Overall, teledermatology helps to provide aforesaid in dermatology education [5, 9].
Conclusions:
1. Our experience shows that remote e-learning may be hold over the video-conference platform Google Hangouts with using telemedicine provided that the tutor is competent [7].
2. The majority of fourth-year medical students in discipline "Dermatology. Venereology" has gained extensive experience in dealing with challenging cases and even real patients.
3. Modern technology and remote learning tools help tutors to provide high-quality teaching by trying the case method.
4. The significant disadvantage of telemedicine was its limitations, such as the lack of possibility to do palpation, diascopy, dermoscopy etc.
5. We support the opinion by Прокофьева ГЮ. [2], as it is believed that e-learning was most effective when it was used as a supplement that enriched the formal educational process and replaced 40-60% of pedagogical material and it, in any case, will replace that.
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