SUMMARY
At the present time, it is hard to imagine the process Ofteaching in medical schools with no use of both traditional and innovative approaches for the study of various disciplines such as obstetrics. To explore the potential of a combination of two or more educational technologies, that allows clear identification of problems, objectives and a proper structure of the content of varying complexity thereby making it understandable to different groups of students.
This article describes an application of innovative teaching methods introduced at the department of obstetrics and gynecology at KazMUCE. The residents of the first year on the specialty of "Obstetrics and gynecology an including child", in particular, "Obstetrics-I" were suggested to participate in the study. Different seminars such as professionalism and clinical skills seminar employments were conducted as CBL in order to master their skills of working as a team. The analysis showed a positive response from the residents who noted better perception and practical application of the given material.
One of the tasks of the State Health Development Program of the Republic of Kazakhstan “Den- saulyk” for 2016-2019 is the improvement of medical and pharmaceutical education, the development of medical science and pharmaceutical activities. The State Program for the Development of Education of the Republic of Kazakhstan for 2011-2020 reflects the steps to introduce this program. Moreover, improving management in education, including the introduction of corporate governance principles is one of the main strategic goals to achieve the competitiveness of our education.
Taking into account the development tendencies of the global market of educational services, the activity in the sphere of strategic planning of higher education, the introduction of innovative educational technologies and international standards becomes a priority at medical universities. However, in relation to the needs of the health system in the region, the policy of the medical university should be in line with the needs of health and society for the number and quality of training specialists, ensure the effectiveness of education, management flexibility, ensuring compliance with the development trends of the region, and competitiveness.
At present, improvement of the quality of education at higher education institutions represents one of the main challenges in the world. In the Republic of Kazakhstan, one of the main directions in the development of medical education is an introduction of innovative technologies and active teaching methods.
A combination of the group organization of the educational process with the building of a personal-oriented educational environment using the means of information and communication technologies is a core of the strategy of modem educational policy [ 1 ]. In this regard, one of the main tasks that a modem teacher should set for themselves is the provision of interactive training; increase of interest of the residents to the discipline; approximation of the learning process to the practice of everyday life, namely: the formation of communication skills, adaptation to rapidly changing living conditions, etc.
Applying active methods go in accordance with the data of experimental psychology, which claims that 10% of the teaching material is accepted aurally, 50% visually and 90% of the material learned when students assimilate the data. There are many different methods of teaching students. Among them special attention is paid to active teaching methods [4], in particular, CBL, TBL, PBL.
In modem psychological and pedagogical literature, it is noted that innovative methods are reflected in many teaching technologies that are aimed at developing and improving the teaching and upbringing process as well as training specialists for professional activities in various spheres of modem society [2, 6].
In the conditions of applying innovative forms, methods and means of organizing own studies, the residents were involved in creating, which was new to them and also helped to overcome different problems faced during performing their independent work [5].
The use of innovative methods by the tutor contributes greatly to overcoming stereotypes in teaching various disciplines, finding new approaches to professional situations as well as developing creativity in students [3].
Active training methods are widely used at the Kazakh Medical University of Continuing Education, one of which is CBL - an educational technology that allows residents to apply acquired knowledge to solve a particular clinical problem or any other problem that can easily be combined with simulation methods.
Materials and methods of research: At the Department of Obstetrics and Gynecology KazMUNO, residents of the first year of the specialty “Obstetrics and gynecology, including children” in the discipline “Obstetrics-1” for the practical training of the Department staff developed guidelines for residents, guidelines for teachers to conduct a session based on the case of CBL on the theme of “Postpartum hemorrhage.” Conducting the session involves working in small groups, where each group receives a situational task for obstetric hemorrhages. The department compiled tasks, the implementation of which required knowledge of prerequisite disciplines for diagnosing, interpreting laboratory data, conducting a differential diagnosis and prescribing treatment. To determine the level of knowledge of the residents, a preliminary check of basic knowledge of prerequisites was carried out in particular, tests and “brainstorming” methods were applied. The residents were given tests composed of 20-25 questions and 30 minutes time to fill them. In terms of quality, the tests were challenging enough to build intellectual tension, and varied to reveal the different abilities of the students such as the ability to discuss, analyze life situations and draw conclusions.
That helped with the distribution of residents by “small groups”, so that each group were composed of strong, medium and weak students. This form of conducting lessons gave the learning process a competitive character, enhanced the development of teamwork skills, public speaking and personal responsibility in each participant.
The numerical composition of the teams was approximately equal and did not change until the end of the session. Teams were given different clinical tasks of equal complexity, according to the topic of the lesson. All discussions took exactly the same amount of time, in particular, 30 minutes.
Then the tutor, motivating the work of residents in the team, chose the speaker, and depending on his/her report, the work of the whole team was evaluated. The tutor monitored that all team members were involved in the process of discussing the problem. Intra-team and inter-team discussions provided an opportunity to obtain information for the feedback. The tutor in that case was rather a facilitator, guiding the process towards the desired result. A short break followed the completion of the assignment.
After a break, the tutor chose a presenter, taking into account a group work, preferably the most inactive participant from each team. After the presentation of the clinical task, the correctness of the answers was discussed. The answer was evaluated and graded as either brilliant to incomplete, for it is awarded from 0 to 4 points. In order to monitor the progress, a feedback questionnaire was developed, ranging from “Like” to “Do not like” and filled after the sessions. The session ended with a summary and the feedback filling.
Results and discussion: During the CBL session, residents actively discussed the tactics of conducting a woman in labor with postpartum hemorrhage, answering the current questions: what methods of examination and treatment are applicable? Each team had its own task, on the correct implementation of which depended on the overall success.
Analysis showed that students obtained new knowledge to solve a particular clinical problem and showed a good level of knowledge of the provision of emergency medical care. Nonetheless the good results, the residents made mistakes and inaccuracies in solving clinical problems.
Evaluation of the results was carried out on a 4-point system: 85% of the students scored 3.33 points (B +); 10% - 3.67 points (A-) and only 5% of students showed very good results - 4.0 points (A). The average grade for the lesson was B + (Figure 1).
In conclusion, a short discussion was held to identify mistakes while solving clinical problems. Students filled out the feedback form with their suggestions. 94% of residents noted that conducting classes using the CBL method positively influences the formation of competencies such as clinical skills, teamworking, professionalism and communication skills. 96% of the surveyed noted that they ac-
quired the skill of working in a group, 92% - gained confidence while giving public speeches.
To summarize, sessions using the CBL method helped to develop not only “teamwork” and clinical skills, but also it consolidated theoretical knowledge. So, this particular educational environment can minimize potential mistakes and non-professional behavior of the residents when they will go into real practice, therefore, CBL helps to acquire necessary professionalism.
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