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8вень - 41,7% дошкольников; средний - 58,3%; низкий - 0%).
5. Двухсложные слова со стечением согласных в середине слова (высокий уровень - 33,3% дошкольников; средний - 66,7%; низкий - 0%).
6. Двухсложные слова с закрытым слогом и стечением согласных в середине слова (высокий уровень - 33,3% дошкольников; средний - 66,7%; низкий - 0%).
7. Трехсложные слова с закрытым слогом (высокий уровень - 25% дошкольников; средний -75%; низкий - 0%).
8. Трехсложные слова со стечением согласных (высокий уровень - 25% дошкольников; средний -66,7%; низкий - 8,3%).
9. Трехсложные слова со стечением согласных и закрытым слогом (высокий уровень - 25% дошкольников; средний - 66,7%; низкий - 8,3%).
10. Трехсложные слова с двумя стечениями согласных (высокий уровень - 25% дошкольников; средний - 58,3%; низкий - 16,7%).
11. Односложные слова со стечением согласных в начале или конце слова (высокий уровень -33,3% дошкольников; средний - 66,7%; низкий -0%).
12. Двухсложные слова с двумя стечениями согласных (высокий уровень - 25% дошкольников; средний - 58,3%; низкий - 16,7%).
13. Четырехсложные слова, состоящие из открытых слогов (высокий уровень - 25% дошкольников; средний - 66,7%; низкий - 8,3%).
14. Четырехсложные слова со стечением согласных (высокий уровень - 25% дошкольников; средний - 58,3%; низкий - 16,7%).
Качественный анализ результатов диагностики позволил выявить положительную динамику показателей у дошкольников с общим недоразвитием речи.
Таким образом, сравнительный анализ обобщенных результатов эксперимента, полученных на начальном и заключительном этапах, показал, что после проведения целенаправленной логопедической работы показатели уровня сформированности слоговой структуры слова существенно улучшились: у детей выявлен высокий уровень, который до формирующего эксперимента отсутствовал; возросло количество детей со средним уровнем и уменьшилось с низким. Однако, несмотря на значительное повышение индивидуальных показателей у большинства дошкольников, мы наблюдаем детей, которым требуются дополнительные коррекцион-ные занятия.
В целом полученные результаты эксперимента свидетельствуют об эффективности проведенной нами логопедической работы по преодолению недостатков слоговой структуры слова у дошкольников с общим недоразвитием речи.
Список литературы
1. Большакова С.Е. Преодоление нарушений слоговой структуры слова у детей: Методическое пособие. - М.: ТЦ Сфера, 2007. - 56 с.
2. Психолого-педагогическая диагностика развития детей раннего и дошкольного возраста: метод. пособие; с прил. альбома «Нагляд. материал для обследования детей» / [Е.А. Стребелева, Г.А. Мишина, Ю.А. Разенкова и др.]; под ред. Е.А. Стре-белевой. - 2-е изд., перераб. и доп. - М.: Просвещение, 2004. - 164 с.
3. Ткаченко Т.А. Коррекция нарушений слоговой структуры слова. Альбом для индивидуальной работы с детьми 4-6 лет к пособиям «Учим говорить правильно». - М.: Издательство ГНОМ и Д, 2002. - 40 с.
ВНЕДРЕНИЕ ДОКАЗАТЕЛЬНОЙ МЕДИЦИНЫ - КАК КОМПОНЕНТА ПОВЫШЕНИЯ КАЧЕСТВА МЕДИЦИНСКОГО ОБРАЗОВАНИЯ
Бидучак А.С.
Высшее государственное образовательное учреждение Украины «Буковинский государственный медицинский университет», Черновцы
кандидат медицинских наук, доцент
IMPLEMENTATION OF EVIDENCE-BASED MEDICINE - AS A COMPONENT OF IMPROVING
THE QUALITY OF MEDICAL EDUCATION
Biduchak A.
Higher State Educational Establishment of Ukraine «Bukovinian State Medical University», Chernivtsi Ph.D, аssistant Professor
Аннотация
Доказательная медицина рассматривается как новый подход, направление или технология для сбора, анализа, обобщения и интерпретации научной информации с целью выбора подходящего лечения для конкретного пациента. Достаточно близко, доказательная медицина сливается с клинической фармакологией. Однако принципы доказательной медицины могут успешно применяться практически в любой области анализа результатов клинических испытаний, а также при решении задач организации оптимальной системы здравоохранения.
Abstract
Evidence-based medicine is considered as a new approach, direction or technology for the collection, analysis, generalization and interpretation of scientific information in order to select the appropriate treatment for a particular patient. Closely enough, evidence-based medicine merges with clinical pharmacology. However, the principles of evidence-based medicine can be successfully applied in almost any field of analysis of the results of clinical trials, as well as in solving problems of organizing an optimal healthcare system.
Ключевые слова: доказательная медицина, врач, лечение пациентов, оценка результатов исследования.
Keywords: evidence-based medicine, doctor, patient treatment, evaluation of research results.
The information and communication explosion that occurred in the last two decades could not but affect the development of medicine. Now information about new medical technologies almost instantly becomes available in any country in the world. But the stricter it is necessary to relate to proving the effectiveness of the new proposed technologies before putting them into practice.
In the last decade, a new paradigm of clinical medicine was born, based on the use of the best of the existing results of clinical trials (methods of clinical epidemiology) to select the technology of medical care for a particular patient. Evidence-Based Medicine is actually a results-based medicine. By evaluating the results, you can select the appropriate technology that led to the best results. In addition, the effectiveness of proven technologies should be evaluated to select the one that would guarantee the best result, but at the same time be economical. The scientific basis of this approach is clinical epidemiology, which has not yet received proper development. This is partly due to the fact that specialists who are familiar with the methods of mathematical statistics and statistical analysis are poorly involved in clinical trials, and clinicians are not always trained and use these methods. At the same time, this science allows you to statistically link the results of treatment with selected technologies and, in fact, evidence-based medicine is based on this.
Without reliable scientific, comprehensive evidence, no new technology will be accepted by practice. On the other hand, such a strict documentary evidence of the effectiveness of any technology gives doctors a guarantee that they will choose the right way to provide medical care to the patient in controversial issues with claims from the patient or the insurance company. The probability of a certain result is known, patients are introduced to this information in advance and are asked for informed consent to choose this technology.
Evidence-based medicine is a new technology for collecting, analyzing, synthesizing and using medical information to make optimal clinical decisions.
The main provisions of evidence-based medicine are as follows:
- in most clinical situations, the diagnosis, prognosis and treatment outcomes of an individual patient are uncertain and therefore must be expressed in terms of probabilities (the need for consultations has increased in recent years due to an increase in the frequency of combined and multiple pathologies, atypical cases, erased clinical picture, a sharp decrease in the proportion of classic cases of the disease);
- the results of clinical observations are distorted by bias and systematic errors;
- any research, including clinical, is influenced by chance;
- the probability of outcome for an individual patient is best estimated on the basis of clinical observations of groups of similar patients;
- dinicians are required to rely on observations based on rigorous scientific principles, including ways to reduce bias and assess the role of chance.
Evidence is determined by:
- systematic reviews of several randomized trials;
- non-randomized studies with simultaneous control;
- non-randomized research and historical control;
- cohort studies;
- case-control studies;
- evaluation of the results of observations;
- descriptions of individual cases.
The «Gold Standard» is considered randomized controlled trials, when patients are randomly assigned to groups (randomization), while the groups should not differ in parameters that affect the outcome of the disease. No new method of prevention, diagnosis, or treatment can be considered effective without the need for rigorous scrutiny in randomized controlled trials. Particular attention should be paid not only to the futility, but also to the lack of evidence-based evidence of the benefits of using various methods and techniques in clinical practice.
Scientific research of new technologies and new drugs is carried out according to strict protocols using the double (sometimes triple) blind method on randomized (random) samples to exclude systematic errors or errors associated with the influence of extraneous factors on the formation of the sample, biased estimates. A strict protocol allows comparing the results of various institutes; moreover, such parallel studies are welcome. But, according to estimates, about 40 thousand biomedical journals are currently published in the world, about 2 million articles are published annually. Practitioners, heads of medical institutions need a critical assessment of these huge volumes of information.
The methodology of evidence-based medicine involves the search, comparison, analysis, synthesis and dissemination of evidence for their use in the provision of medical care. Evidence is generated according to a certain methodology in six stages:
- definition of the main purpose of the review;
- determination of methods for evaluating (measuring) results;
- systematic information search;
- summation of quantitative data;
- summation of evidence using appropriate statistical methods;
- interpretation of the results.
It is possible to strengthen the proof of the results by combining the experimental and control groups studied in various studies using a single technique, analyzing such combined samples, and synthesizing and testing new hypotheses on the combined sample. Such a association is called a meta-analysis and is distinguished: retrospective meta-analysis (based on already conducted and published results of clinical trials), cumulative meta-analysis (adding new ratings to the constructed curve of accumulation of ratings with each new evidence), prospective meta-analysis (adherence to specified methods for conducting, evaluating and analyzing data in new studies), meta-analysis of individual data (analytical review and formalization of already conducted, but arbitrarily designed, results research in primary documents to the meta-analysis).
The combined databases of the included sources make it possible to assess the reliability of both the results of each study separately and the reliability of the combined sample. These results are presented in graphical form with the confidence limits of each sample and the combined sample.
It is advisable to begin the quality assessment with an assessment of the results of various measures or treatment of patients. For this, it is necessary to have a set of adequate scientifically based indicators and criteria for their assessment. Indicators are evaluated in the following three dimensions, but always only in comparison:
- a comparison in dynamics, that is, in the course of treatment (initial, intermediate, final and long-term results);
- comparison with other similar groups of patients in the same or in other institutions;
- comparison with predefined «standards» for each indicator.
Quality assurance consists, firstly, in the adequacy of the technology chosen for the patient (from the start of treatment to its completion, full or partial), secondly, in the proper selection and organization of the work of the patient management team and, finally, in the third necessary resource support of the selected technological process.
Conclusion. Thus, medical care will be provided qualitatively only if the most effective (in terms of results and costs) technology is selected from among those that have proven their high clinical performance. On the other hand, the selection of the most effective of the possible technologies is carried out taking into account the receipt of results that meet the «quality» standards. In other words, it is not allowed to save money for treating a patient to the detriment of other quality characteristics - accessibility, safety, etc.
References
1. Актуальные вопросы доказательной медицины: практ. рук. /под ред. Г.П. Котельникова, Г.Н. Гридасова. - Самара: Глагол, 2012. - 118 с.
2. Общая эпидемиология с основами доказательной медицины: рук. к практ. занятиям: учеб. пособие / под ред. В.И. Покровского, Н.И. Брико. -Москва: ГЭОТАРМедиа, 2010. - 400 с.
3. Хенеган, К. Доказательная: карман. справ. / К. Хенеган, Д. Баденоч; пер. с англ.; под ред. В.И. Петрова. - Москва: ГЭОТАРМедиа, 2011. - 144 с.
САМОМЕНЕДЖМЕНТ У П1ДГОТОВЦ1 МАЙБУТНЬОГО ПЕДАГОГА: ЗМ1СТ I
ТЕХНОЛОГИ
Бойко М.М.
Тернопшьський нацiональний педагогiчний утверситет доцент, кандидат педагогiчних наук
SELF-MANAGEMENT IN THE TRAINING OF FUTURE TEACHERS: CONTENT AND
TECHNOLOGIES
BoykoM.
Ternopil Volodymyr Hnatiuk National Pedagogical University Associate Professor, PhD (in Pedagogy)
Анотащя
В стати здшснено анатз сучасних концепцш, пiдходiв та принцитв самоменеджменту. Визначено сутшсть i 3MicT поняття «самоменеджмент», окреслено основш його функци у формуванш професшних компетентностей майбутнього вчителя. Обгрунтовано принципи постановки цшей та етапи процесу самоменеджменту. Окреслено переваги оволодшня технолопею самоменеджменту та 1х вплив на формування ключових навичок майбутнього вчителя, як ефективного менеджера. Наведено приклад реатзацп технологи самоменджменту в процес вивчення курсу «Менеджмент в освт», на другому мапстерському рiвнi вищо! освгги. Доведено ефектившсть самоменеджменту та його вплив на професшну траекторш саморо-звитку педагога.
Abstract
The article deals with the analysis of modern concepts, approaches and principles of self-management. The meaning of "self-management" and its functions in forming professional competences of a future teacher have been defined. The principles of goal setting and the stages of self-management have been determined. The advantages of self-management technologies and their influence on the development of basic skills of a future teacher
