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IMPROVEMENT OF EDUCATIONAL PROCESS IN MEDICAL UNIVERSITIES
Zhukovskyi O.
Higher State Educational Establishment of Ukraine "Bukovinian State Medical University ", Chernivtsi ABSTRACT
The issues of interactive learning as a tendency to promote cognitive activity of medical students are considered. Interactive learning possesses great educational and developing potential providing a maximum activity of students in the educational process.
Keywords: interactive learning, case-method.
The issues to promote cognitive activity of medical students have always been one of the most urgent ones in the theoretical and practical learning. In order to find the ways of their solution lecturers and tutors introduce new methods, develop original forms of classes etc.
Transformed life reality and the structure of economics caused the necessity to review many traditional approaches to organization of the teaching/learning process and education on the whole in particular. Recently the teaching staff of medical universities has become interested in implementation of active and interactive forms of learning based on activity and dialogue forms of cognition (internal and between groups). Apparently that now, educators consider practically operative activity and interaction between people as the main factors in the development of personality. Learning can be considered really effective and achieves good results in case students:
• are open for learning and cooperate actively with other participants of the educational process;
• can prepare practically for the situations they have to face in the nearest future life and professional work;
• remain their own self, are not afraid to express their opinion, to make mistakes in case they are not criticized and negatively evaluated.
Owing to the practically operative approach active cognitive activity of the student himself is a psychological basis of learning leading to the formation of ability to creative thinking, application of the knowledge, skills and abilities acquired in the process of educational activity. The issue to promote cognitive activity, develop independence and creativity of students has been and still remains one of the most urgent pedagogical tasks.
Interactive learning solves three tasks simultaneously:
• learning-cognitive (boundary specific);
• communication-developmental (associated with general emotional-intellectual background of cognitive process);
• socially oriented (which results are manifested beyond the limits of the educational time and space).
Let's consider the results and effects of interactive learning in detail. Interactive learning methods enable to intensify the process of understanding, mastering and creative application of knowledge in solution f practical tasks. The efficacy is provided at the expense of more active involvement of students into the process of both getting and application of knowledge (directs, at once). In case the forms and methods of interactive learning are regularly applied, the students form productive approaches to master information, they are not afraid to suggest something wrong (since a mistake does not provoke a negative evaluation), and confidential relations with a lecturer are built. Students are not afraid any more to answer, persist in their opinion, and advance their arguments.
Interactive leaning increases motivation and involvement of participants to the solution of the issues to be discussed. It gives an emotional promotion for further searching activity of the participants and promote them to specific deeds. Every student is successful in interactive learning, and everybody makes his contribution to the general result of a group work. The process of learning becomes more sensible and interesting.
Interactive methods of learning enable to implement theoretical methods of organization of activity into practical sphere, obtain new experience of activity and communication. Interactive earning provides not only increase of knowledge, skills, abilities, methods of work and communication, but reveal new possibilities for students. It is an essential term to establish and improve competence (competence is a proved ability to act) by means of involvement of participants of the ed-
ucational process into sensible understanding of an individual and group activity in order to accumulate experience, realization and acceptance of values.
K. Levin in his research demonstrated the effect of group discussion and situational factors on transformation of social regulations and behavior of participants.
Since interactive learning assumes the possibility to communicated with a lecturer and partners concerning educational activity, as well as cooperation in the process of various kinds of cognitive and creative activity, the system of control over the mastering knowledge and methods of cognitive activity, ability to apply the obtained knowledge, abilities and skills in different situations can be built on the basis of effective reverse relations.
One of the purposes of interactive learning is to transform the experience and purposes of participants as well as their reality, because very often interactive methods of learning imitate interactive kinds of activity applied in modern society.
Due to implementation of interactive regimen every particular student as a subject of the educational process will get the following:
• experience of active mastering of educational content in the interaction with learning surroundings;
• development of personal reflexive response;
• mastering new experience of learning interaction and worries;
• tolerance development.
Therefore, interactive learning possesses great educational and developmental potential and provides maximum activity of students in the educational process on the whole.
Modern pedagogy is rich in the whole range of interactive methods including the following ones among them:
• creative tasks, work in small groups;
• educational games (role games, imitations, business games);
• the use of social resources (invitation of specialists, excursions);
• social projects;
• interactive lectures, work with educational manuals, video and audio materials, «a student performing teacher's role», «everyone teaches everyone», mosaic (scroll saw), asking questions, Socrates dialogue);
• discussion of complicated and disputable issues and questions (in the form of TV talk-show, debates, discussion, round-table conference);
• problem solving, case-study - analysis of certain situations (brain storm).
One of the effective methods to make the educational process more active is the method of a problematic exposition. This method enables to arouse student's interest and involve him to the process of learning. The efficacy of the method is explained by the fact that certain issues can be touched upon by the students themselves. The main success of the method is that a lecturer or instructor solicits the audience "to solve on their own" the given issue.
Case-method is considered to be one of the most effective and spread methods of medical education. It
enables to make a right decision under uncertain conditions, elaborate the algorithms of decision making, plan of actions, apply the obtained theoretical knowledge in practical work etc. The main thing is this method promotes the ability to analyze situations, evaluate alternatives, and cultivate skills of practical task solving.
It is a research approach used for deep and many-sided understanding of a complicated issue in the context of real life. Case-method is radically different from the problem-oriented learning since it works on specific examples. Cases in the field of medicine are interactive means to analyze a specific situation reflecting patient's state of health, make differential diagnostics and choose therapeutic tactics. Application of case-method supplements traditional methods of education (both lectures and practical classes). It is directed to obtaining new knowledge and formation of professional competence, abilities and skills of mental activity. Case-method applied in medicine includes a set of clinical cases suggested for users in the process of learning for analysis in interactive regimen. Application of multimedia technologies in realization of medical cases assists to achieve better understanding of a patient's complicated problem, for example, in diagnostics of a rare disease. As a rule, case-method includes objective data about a patient: photo and video materials of examination with comments made by a doctor and other specialists, records with peculiar patient's voice, results of the examinations performed, and questions occurring in the process of diagnostics. Important constituents of the case-method are evaluation of the user's actions and explanation of the mistakes made.
Nowadays interactive learning cases represented in the form of web application have become more popular. Such kind of case does not require implementation on computer. Internet access is enough. And interactivity is provided by immediate reverse response. As a rule, interactive case includes illustrated material and video material giving imagination about patient's problems which are solved in the process of advancing the case. Such an approach to learning enables to think wider than usual multiple choice tests are used when one or several correct answers are chosen. Cases in the form of illustrated interactive materials are presented for the user gradually. These materials can include the findings about a virtual patient from a certain case: anamnesis, results of examination etc. First of all, the user gets many-sided information about a patient with application of video, animation, pictures, diagrams and sketches. In a certain number of steps he/she obtains the possibility to choose one or another action, indicate examination, make a preliminary diagnosis etc. The system evaluates the user's action, and sometimes it reflects right or wrong answers step-by-step. In a number of cases the final evaluation is reflected after all the stages are passed.
Foreign practice of medical education gives the evidence of case-method topicality. There are three concepts of learning by means of case-method:
• case-bedside teaching (leaning the theory in the classroom and practical work near the patient's bed),
• case-didactic teaching (learning cases are limited to minimum, in the forefront - lectures according to the topics included in the cases),
• case-iterative teaching (deep learning of complicated clinical cases "step-by-step").
The majority of students consider the case-method a useful thing to be applied. It improves their studies, and the instructors admit the case-method inspires and motivates students to study.
Therefore, interactive learning has gradually involved more and more supporters in practical work of both general and professional education, since it makes the educational process more motivated, productive, emotionally rich, personality-developing and of higher quality.
References
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LECTURING IN CLINICAL MEDICAL EDUCATION
Vasylieva N.
MD, PhD
HSEEU "Bukovinian State Medical University", Chernivtsi Department of Nervous Diseases, Psychiatry and Medical Psychology
ABSTRACT
During supervised clinical training, medical students are expected to develop their professional competence and attitudes. The present study investigates how teaching (lecturing) is carried out during medical students' clinical training. This article explores the types of narratives lecturers use, the attitudes of lecturers and students to the use of narratives in teaching, and the aspects of learning that narratives may facilitate.
Keywords: teaching, lecturing, medical students, narrative.
The literature declares that clinical medical education adheres to a master-apprenticeship system of learning and the fundamental condition for such teaching is that an expert is teaching a novice [1]. On the other hand clinical teaching is a complex learning situation influenced by the learning content, the setting and the participants' actions and interactions. Consequently, in such a system of knowledge acquisition, the clinical teachers play a crucial role as a teacher. But the master-apprenticeship model focuses the students' ability to handle clinical praxis in accordance with what the clinical teachers believe is correct and what tradition allows [2].
The master-apprenticeship structure and theory of teaching [3] are, however, not sufficient to meet modern academic educational demands. All formal education and academic teaching is aimed towards students gaining new knowledge and skills consistent with what is intended and necessary according to the curriculum. In medical education, as a consequence, everyday knowledge is expected to be left behind in exchange for scientifically-based knowledge or for knowledge based on professional experiential knowledge, useful in professional practice. Students' knowledge acquisition is, from this perspective, understood as a qualitative change from a previous kind of understanding. This means there are qualitative differences in how medical
or clinical information is understood. Furthermore, such qualitatively different kinds of student understanding of subject matter may also be found among the students exposed to clinical teaching in a clinical situation. Consequently, we might expect qualitative differences in how something is understood among students. This stresses the need for clinical teachers to identify and take advantage of the students' qualitative differences in what they learn, understand and what they remember of what is studied [4].
Consequently, the way clinical teaching is carried out will have consequences on students' abilities to study and understand. Three generic ways teachers can understand their role, each of which is related to how students are expected to learn [5]. There are:
- teaching as telling or transmission of knowledge;
- teaching as organizing student activity;
- teaching as making understanding possible.
These three methods highlight important qualitative differences in how clinical teachers could consider teaching and student learning.
The effective and excellent clinical teacher is described as an: excellent role model; effective supervisor; and dynamic and supportive educator. Kilminster and Jolly claimed that the essential aspects of clinical teaching are that it should ensure patient/client safety
