CC BY
0TUBERCULOSIS PROGRAM FOR STUDENTS OF MEDICAL
INSTITUTIONS
1Mukhamedov K.S., 2Khojayeva M.I., 3Ongarbayev D.O., 4Kayumova S.S., 5Khojayeva N.V.
1,2,3,4Department of phthisiology and pulmonology of Tashkent medical academy
5Department endocrinology, pediatric endocrinology of Pediatric medical institute https://doi org/10.5281/zenodo. 14160695
Abstract. The government consistently places significant emphasis on the development of higher education. Presidential Decree PD-2909, dated April 20, 2017, titled "On Measures for the Further Development of the Higher Education System, " highlights substantial achievements by university teams and also sets forth new, critical tasks for the further enhancement of higher education, including in the medical field. The decree addresses fundamental improvements in scientific and methodological work within departments, the ongoing enhancement of student learning processes, the refinement of curricula and programs, and their active, creative implementation in pedagogical practice. This aims to improve the quality of education for students and future doctors, supporting the continued advancement of healthcare and the strengthening of public health.
Keywords: development of the Higher Education System, antitubercular drugs, therapy, sanitary-veterinary, lymph nodes, phthisiology, pulmonology.
Currently, at the departments and courses on tuberculosis in medical institutions, students are being trained under a new curriculum. The tuberculosis curriculum aims to establish conditions within departments for focused and standardized training and education of students, ensuring a uniform level of physician training.
The program defines the scope of knowledge in phthisiology that students must acquire and recommends general principles and methods for structuring the educational process to achieve the ultimate learning objectives. These two interconnected components of academic work in higher education institutions—content and process of learning—determine, as highlighted by higher education pedagogy, the effectiveness of teaching and the preparation of qualified physicians.
The content of education is regulated by the level of development in professional phthisiology, the needs of the future specialist's activities, and the requirements of the departments where students will continue their studies.
The curriculum for fourth-year students of the medical faculty covers the responsibilities of a general practitioner in the tuberculosis control system, methods for tuberculosis prevention and early detection, clinical and radiological laboratory diagnostic techniques for pulmonary tuberculosis, patient examination and diagnosis of typical tuberculosis forms, general principles of tuberculosis treatment, indications for prescribing antitubercular drugs and methods of their application, indications for collapse therapy and surgical interventions, as well as the tasks and organization of an anti-tuberculosis dispensary.
In the sanitary and hygiene faculty, the curriculum includes the roles of the hygienist and epidemiologist in combating tuberculosis across various age groups; planning, organizing, and implementing tuberculosis prevention measures, including specific and sanitary prophylaxis and efforts to improve tuberculosis infection sites; studying early diagnostic methods for tuberculosis
and applying them in practice; developing comprehensive tuberculosis control plans and overseeing institutions' anti-tuberculosis preventive activities; general principles for treating different forms of pulmonary tuberculosis; fundamentals of tracking epidemiological indicators of tuberculosis; and aspects of sanitary-veterinary supervision.
In the dentistry faculty, students study the semiotics of tuberculosis, diagnostic methods, general principles of chemotherapy, diagnosis of tuberculosis in the oral cavity and pharynx, subclavian and cervical lymph nodes, and jaw bones, as well as necessary anti-epidemic measures implemented when a tuberculosis patient is identified.
According to the program, students are trained in the independent management of patients with pulmonary tuberculosis, examination and treatment using modern methods and therapeutic agents; they study differential diagnosis, complex and rare forms of pulmonary tuberculosis, tuberculosis complications that require urgent medical intervention, early diagnostic methods for tuberculosis and their practical application, techniques for examining and monitoring individuals at high risk of tuberculosis, tuberculosis prevention measures, key anti-tuberculosis activities conducted upon identifying a patient with tuberculosis, and measures for those who have been in contact with the patient.
When planning the content of education, it is essential to consider the rapid advancement of science and the improvement of practice, particularly as students prepare to embark on independent medical careers.
Therefore, to eliminate potential discrepancies between the curriculum and the level of development in phthisiology, it is necessary to adjust the educational content by anticipating scientific advancements and improvements in practice. Additionally, the supplements to the curriculum should deepen and expand its main sections, which form the essence of the future physician's anti-tuberculosis work. The primary focus of any specialist's work is the ability to conduct tuberculosis prevention and early detection.
The appropriateness of forecasting in determining the content of education requires the instructor's ongoing involvement in the development of relevant scientific issues, without which it is inconceivable to enhance their scientific literacy and stimulate students' creative thinking. Additionally, while implementing the program, it is essential to consider the gap between scientific achievements and the content of education. We believe that a key aspect of the learning process is teaching students indisputable theoretical facts and practice-proven principles while adhering to the program's objectives.
The specifics of the educational plans for departments should also reflect the characteristics of the epidemiology and clinical aspects of tuberculosis in the regions and districts for which medical institutions are training specialists.
The pedagogical tasks currently addressed by the Department of Phthisiology and Pulmonology at TMA are related to implementing the curriculum in teaching practice and improving the process of students' cognitive activities based on it. Higher education pedagogy clearly defines the principles for managing students' cognitive activities. These principles include setting learning objectives, selecting the most optimal teaching methods, and conducting objective assessments of students' mastery of the educational material.
A key condition for the successful study of new educational material is the thorough, independent preparation of students for practical sessions. Assignments for extracurricular work, structured according to a specific plan with clearly defined goals, are designed to ensure the
necessary knowledge base for mastering the topic of the upcoming class. In addition to textbooks, study aids with programmed material presentations and self-assessment answers are essential as tools for self-preparation.
The most optimal form of extracurricular assignments is considered to be the completion of specific tasks that allow for the correction of students' preparation with minimal time expenditure. Various types of tasks are used in the department for students to work on independently.
An essential condition for acquiring knowledge and developing skills is the active independent engagement of students, which aligns with contemporary pedagogical requirements. This condition is met when the main educational objectives of the program are internalized through problem-solving.
In this context, a "task" refers to a problem situation that requires the resolution of specific practical or cognitive actions, such as "examining a patient," "analyzing an X-ray," "assessing a site of tuberculosis infection," "solving a clinical situational problem," and so on.
When using tasks in the educational process, it is important to consider the diversity of their functions. The primary function is to provide a basis for action when students assimilate the educational material, fostering their skills and abilities.
Example of a Typical Educational Task and Its Solution:
Patient Profile:
- Age: 40 years
- Complaints: None
- Findings: Changes in the lungs identified during fluorographic examination.
- History: Had contact with a patient with an open form of tuberculosis for the last 4 years.
Clinical Examination:
- In the right lung, in the paravertebral area, there is a shortened lung sound, with isolated dry and moist crackles audible.
- Blood analysis: Leukocytes: 8000; Eosinophils: 8%; ESR: 15 mm/h.
- Sputum analysis: Mycobacterium tuberculosis detected.
Radiographic Findings:
- In the 6th segment of the right lung, there is an oval-shaped opacity measuring 3x2 cm with clear, even contours. Within the shadow, structures of calcified density are identified, with a crescent-shaped lucency in the lower pole and small intensity foci around the focus along with dense linear shadows.
Diagnosis and Justification:
- Diagnosis: Tuberculoma of the 6th segment of the right lung in the phase of decay and dissemination; BK+.
- Justification: The tuberculosis etiology of the lung disease is indicated by the contact with a tuberculosis patient, the detection of mycobacteria in the sputum, the presence of old tuberculosis foci in the lesion, and dissemination around it. The characteristic radiological signs of a tuberculoma include an oval-shaped opacity measuring 3x2 cm with clear, even contours and peripheral lucency. The tuberculoma is active, as crackles are heard and there are indicators in the blood count; it is in the phase of decay (lucency in the focus, bacteriological discharge) and dissemination (fresh foci around the tuberculoma).
For the effective application of tasks in education, it is essential to provide students with problem-solving rules and a logic of actions that enable them to independently and correctly navigate the problem-solving process.
To facilitate this, the department has developed and employs guiding principles of activity, educational objectives, and algorithms—tools for managing and self-managing students' cognitive activities. In this context, the primary requirement of teaching management theory is met: knowledge is acquired and manifested only through independent, active, and controlled work by students.
We consider methodological guidelines for monitoring the quality of students' knowledge to be one of the most important sections of the program. Alongside the traditional question-and-answer method, the program includes the completion of practical tasks that align with the set educational goals and levels of material mastery.
The skills outlined in the program (along with the conditions for their execution) that students must acquire from various faculties and courses by the end of their studies in the tuberculosis department will not only help determine the success of their material mastery but also establish uniform requirements across all institutions regarding educational goals and effectiveness criteria.
To implement this requirement, the program anticipates the development of objective assessment tasks within the departments. The department's experience shows that the solutions to these tasks should have precise interpretations and be clearly understood by all instructors.
REFERENCES
1. Ongarbayev D. O. et al. EFFECTIVENESS OF DIAGNOSTICS AND TREATMENT OF TUBERCULOSIS IN PATIENTS WITH COVID-19 //World Bulletin of Public Health. -2023. - Т. 20. - С. 29-33.
2. Хакимов А. А. и др. Оценка распространенности бронхолегочной и сердечнососудистой патологии у больных с впервые выявленным туберкулезом : дис. - Toshkent, 2022.
3. Мирзабоев С. И. и др. Zamonaviy tibbiyot sharoitida birlamchi aniqlangan tuberkulyozning turli shakillarini barvaqt aniqlashda raqamli rentgen diagnostikasining ahamiyati. - 2023.
4. Онгарбайев Д. О., Ходжаева М. И., Каюмова С. С. Особенности развития и течения туберкулеза у женщин и мужчин в условиях пандемии COVID-19 //World of Science. -2023. - С. 250-253.
5. Онгарбайев, Д. О., et al. "COVID-19 пандемияси шароитида болалар ва усмирларда туберкулёз касаллиги клиник кечишининг узига хос хусусиятлари." (2022).
6. Nusratovna P. N. et al. A Modern View on Outpatient Treatment" From the First Day" of Patients with Pulmonary Tuberculosis in the Conditions of the City of Tashkent //Journal of Coastal Life Medicine. - 2023. - Т. 11. - С. 1291-1297.
7. Абдугаппаров, Ф. Б., et al. "The results of clinical and laboratory studies in patients with disseminated pulmonary tuberculosis [Doctoral dissertation, Toshkent]." (2023).
8. Akbarxodjayeva, F. (2021). ТИББИЁТ ТЕРМИНОЛОГИЯМ МУРАККАБ ТИЗИМ СИФАТИДА: ТИББИЁТ ТЕРМИНОЛОГИЯСИ МУРАККАБ ТИЗИМ СИФАТИДА. Журнал иностранных языков и лингвистики, 4(9).
9. AKBARXODJAEVA, F. A. (2021). Requirements for adopted terms in the field of medicine. THEORETICAL & APPLIED SCIENCE Учредители: Теоретическая и прикладная наука, 9, 230-233.
10. Rasulovna, H. M. (2023). USE OF MODERN TECHNOLOGIES IN TEACHING FOREIGN LANGUAGES. Journal of Innovation, Creativity and Art, 79-81.
11. AKBARXODJAYEVA, F. (2024). OMMAVIY AXBOROT VOSITALARIDA TIBBIYOT TERMINLARINING VOQELANISHIGA DOIR QARASHLAR. News of UzMU journal, 1(1.4), 264-270.
12. Мирсидиков М. Т. У., Онгарбаев Д. О., Эгамов Ф. И. Лапароскопическая реконструкция при параэзофагеальной грыже: как правило фундопликация не нужна //Биология и интегративная медицина. - 2018. - №. 1. - С. 37-48.
13. Абдугаппаров, Фозилхон Бахтиярович, et al. The results of clinical and laboratory studies in patients with disseminated pulmonary tuberculosis. Diss. Toshkent, 2023.
14. Парпиева Н. Н. и др. Коранавирус инфекцияси ва вирусли зотилжам кушилиб келиши : дис. - Andijon, 2022.
