The systematic approach of quality training's control in surgery

This article provides the review of training's methods which are used in Kazakh National Medical University named after S.D. Asfendiyarov.

After graduation our students with theoretical knowledge in different medical fields and practical skills become competitive specialists as in our country as well as abroad.

Background: an important element in the training of the competitive experts in a market's economy is a systematic approach in the management of the quality of education.

Improvement of quality of the medical education, that got in HEI is connected with obvious needs of increase the effectiveness' system of quality management that provides educational services. At the same time, a lot of experts connect an assessment of efficiency of such systems only with the end results of the process in education that is represented methodically incorrect. The problem of quality of education is closely connected with creation of intra university's system of ensuring quality of the specialist's training.

The object of our article is creation fundamental principles of general quality management that will be used as a uniform control system of the quality of education in many higher education institutions.

Methods. In our opinion, it is necessary to use system approach in the form of a quality triad for quality management of the educational services' production

The structural component of medical school is presented by fixed business assets of higher education institution (the building, a construction, communications, educational cases, laboratories and clinics) and resources (personnel, information, material and financial). The main business assets of HEI have to conform to the standards of construction norms and regulations that accepted in Republic of Kazakhstan. Existence of educational (university) hospital, educational policlinics, in the directions of doctor's training (family, pediatric, stomatologic) and an industrial practice drugstore, it is very important, for medical school to have a standardized component of students' training, interns, undergraduates and residents.

observance of certain standards is necessary on each category of resources, in particular teachers' characteristics have to correspond to the level of educational technologies of RK accepted in Ministry of Health, otherwise it won't be possible to achieve standard results of activity. Information resource in the form of standard electronic library of the high-quality, constantly updated publications of republican and international level. Material resources of higher education institution in the form of the standard of equipment of educational and scientific divisions (interactive boards, computers, the equipment of scientific divisions, educational exercise machines, models, etc.) also has to be strictly carried out .

Existence of the standardized structural component will allow HIE to choose and to execute standard educational, medical, innovative and information technologies that finally will allow to reach the planned (standardized) results on three main directions of doctors' training, on professional standard, on the level of consumers'' satisfaction by the qualitative characteristics of university graduates, and also on a ratio of standard's level and actual release's costs of one production's unit (university graduate).

The compliance of the quality management's mechanism of providing educational services to the models that put in the international standards operating in higher education institution that means direct use of one of generally recognized system approach when all stages of activities for providing educational services are put under the active interconnected management, it is a quality objective proof of activity of any higher education institution. Activity of all teachers and employees of medical school can be considered as processes, control which is exercised by analogy management of productions. Many kinds of activity, such as construction work, realization of services, personnel questions, data processing and documents, don't concede on complexity and a value added to productions which should be considered as a series of operations (kinds of activity) which are carried out over initial material (a process entrance), increase its value and lead to a certain result (a process exit). The value of initial material increases due to application of skilled work and knowledge.

Results. This section may be illustrated by the example set forth training module Angiology and Vascular Surgery.

Strategy of tactics of angiological patients should be integrated in the examination and treatment of patients completely as an outpatient and inpatient under obligatory control of angiosurgeon.

Enhancing the role of primary health care (PHC) in the field of health and medical science at the moment is the most important. Basic knowledge of Angiology and Vascular Surgery, by graduate students, interns, has a great value for us.

Plan of department of internship in surgery holds theoretical and practical training for the interns of the 6th and 7th courses, on the basis of the Department of Vascular Surgery. Despite the urgency now diseases of the circulatory system have only 12.5% of teaching time devoted to lectures and practical lessons on the theme of the acute and chronic arterial insufficiency, venous diseases, prevention of complications. The purpose of training of interns in the classes is to show modern features and benefits of early diagnosis and treatment of vascular diseases, the great interest of future professionals in the active screening of patients with vascular diseases at primary level, and recommendations to consult with a vascular surgeon.

In addition to the theoretical courses, there are focusing on high- tech knowledge of research methods - Doppler ultrasound, the DSS of main vessels, as well as angiography contrast with the mandatory interpretation of the results. Together with the teacher and doctor, interns clarify the clinical diagnosis, determine future tactics, reporting patients at medical conferences.

The interns have to know about principles of medicament therapy of patients with vascular diseases, rehabilitation of patients after reconstructive surgery. Future surgeons are participate in surgeries on the vessels using a video endoscope rack, toolbox «mini assistant». At weekly conferences interns report about results of surgical treatment with a demonstration on the multimedia office equipment. Thus, the main criterion of the effectiveness of the training of interns is to improve the quality of care for patients with the vascular disease using high- tech equipment. Experience on teaching of vascular surgery determines the necessity of conducting a special course of Angiology and Vascular Surgery.

First, that is the structural approach, provided hospital licensing and certification specialists.

Second approach of quality control implemented by teachers as an expert for the entire period of study. The task can be carried out by the teacher's knowledge of the development and implementation of information technology in the medical area, educational and research process, especially the development of modern educational technology.

US researchers confirm that the cost of training using modern training technologies is reduced by 30-60%. So surgical clinical conference which held in department of surgery, in interactive mode "teacher-intern" "intern-intern", helps to activate the learning process and increases its intensity.

This approach contributes to better learning and memorization of material. There is communication and dialogue between surgical brigade in the operating unit and the audience of interns and professor in the educational process.

All this factors relieve the operating room, and most importantly, create conditions for the assessment of the real situation and the choice of surgical tactics.

Promptly updated banks with information, data that include new teaching technologies and analytical data are implemented in the process of education.

Teachers, doctors, interns get access to the best international information resources - educational, scientific, methodical materials, also they can use the data of the leading surgical centers in the world. Extensive use of multimedia in teaching complex helps to ensure a single compound in the various forms of information: global and regional statistics, graphics, nonstandard situations, tactics and organize pharmacotherapy. The introduction of new educational technologies runs with increasing the skill of pedagogical creativity of employees of the department.

This process is hold by the creation of a copyright of electronic workbooks, in which there are the dynamics of teaching methodology and the results of teaching process. The manual has been widely discussed by the colleagues. In our point of view, it contributes to the generation of intelligent pulses, as well as enhances creativity in teaching areas. The computerization process of the pedagogical process helps teachers rethink of their educational function.

Third approach – is a quality control of the final result. Standards of surgical diagnosis and treatment of major diseases are developed to determine the quality of the final result at the department of surgery. These standards are made up on the system OSKE, the staged treatment of patients. All clinical activities of the department are adapted to the staged treatment of patients.

Also the group of students acquires necessary knowledge and other skills, such as communicative abilities for interaction in the solution of tasks and exchange of information, independence in judgments, upholding of the point of view, responsibility for training. Training is considered as the best method for small groups, and successfully can be used on a seminar and practical training in medical school. During training doctors - interns acquire knowledge and develop the general skills that supplement competence-based approach in training in HIE.

Conclusions. Using clinical material allows -interns to understand relevance of the main scientific knowledge and principles in clinical practice. So we can note the system approach's advantages of the training:

•ability of logically, scientifically, creatively thinking;

• independent creative search of the necessary knowledge;

• overcoming of the found difficulties;

• ability of evidential base's creation ;

• assimilation of a training material more thoroughly and strongly;

• a positive emotional spirit to the doctrine;

• formation and development of cognitive interests;

• formation of the creative specialist.

Thus, the intelligent combination of traditional teaching methods on the principle "treat the patient, not the disease" and innovative teaching methods have led to improve the quality of training and the making decision of the regional health issues.

 

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Year: 2015
City: Almaty
Category: Medicine