Kudria I. P., Kulishov S. K., Tretiak N. G.

MEDICAL EDUCATION

Scentific article

The purpose of the work was to analyze the importance of simulation technologies in the modern training of future physicians. Simulation training and assessment of practical skills, competences and knowledge are based on realistic modeling. Biological, mechanical, electronic, and virtual (computer) models may be used for this purpose. The division of simulation techniques comes down to certain levels, in particular: the initial (zero – 0) include “written simulations”, in particular clinical situational tasks; up to the 1st level – a group of volumetric models: low-realistic dummies, phantoms, simulator skills; 2nd – products that have a “screen”, that is, computer situational tasks, test programs, videos, and virtual reality simulators; 3rd – standardized patients and role-playing games; 4th – a midrange dummy with electronic or computer controls; 5th – high-end patient real-life computer dummies. These technologies contribute to students’ creative activity: diagnostic, treatment, prophylaxis decisions may be as straightforward, but as – nonlinear, fractal, anti-fractal. The use of “fuzzy logics” promotes a better understanding of pathogenetic and sanogenetic processes, opens up the possibility of compiling and applying algorithms, models, programs in the clinic of internal diseases. Using systemic and anti-systemic, fractal and anti-fractal comparisons; genetic algorithm, including quantum like variant, allows to improve the possibilities for individual diagnostics and correction of treatment effectiveness. On the example of clinical understanding of the patient as a fractal object, as according to anatomy, physiology and pathophysiology, learners may assign an appropriate plan of examination and treatment. This approach contributes to the development of clinical thinking that boils down to the use of modern information technology. An important part of simulation training is debriefing, which helps prevent future mistakes from a future doctor. An important part of simulation training is debriefing, which helps prevent future mistakes. Debriefing is a further analysis of the benefits and disadvantages of the learners, and a discussion of their experience. This activity determines reflective thinking in medical students, gives feedback to evaluate the quality of the simulation task, consolidate the skills and knowledge. Future physicians have a limited understanding of what happens with them when they are at the center of the event. Simulation training has such positive characteristics as: clinical experience in a virtual environment without risk to the patient, especially when working out invasive diagnostic and therapeutic procedures; trainings at a convenient time, regardless of the work of the clinic and the presence of the patient, working out of actions with rare pathology; an unlimited number of repetitions of skills development to bring them to automatism; reduction of “stress-contact” with the patient; conducting a real detailed pedagogical certification with an objective assessment of the skill level achieved. Thus, the introduction of simulation technologies in higher medical institutions of Ukraine is one of the promising ways to improve the training by combination of theoretical knowledge and practical skills. The effectiveness of mathematical approaches, in particular “fuzzy logics”, fractal fundamentals in understanding pathogenetic and sanogenetic processes, contributes to the modeling of individual diagnosis and treatment.

simulation technologies, debriefing, practical skills.

1. Kudria IP, Kulishov SK. Formuvannia profesiinoi osobystosti likaria cherez zastosuvannia v navchanni pryncypiv vnutrishnoi medycyny, informatyky, neliniinoi matematyky. Materialy navch.-metod. konf. Yevropeiskyi vybir – nevidiemna skladova rozvytku vyshchoi medychnoi osvity Ukrainy; 2013 Travm 23; Poltava. Poltava: Ukrainska medychna stomatolohichna akademiia; 2013. s. 101-2. [in Ukrainian].
2. Khaniukov ОO, Yehudina YeD, Hetman MH, Kalashnykova OS. Imlementatsiia symuliatsiinoho treninhu nadannia nevidkladnoi dopomohy dlia studentiv 6 kursu pry vyvchenni dystsypliny «vnutrishnia medytsyna» (ohliad literatury ta vlasnyi dosvid). Medychna osvita. 2019;1:124- 30. [in Ukrainian].
3. Korda MM, Shulhai AH, Zaporozhan SY, Kritsak MYu. Symuliatsiine navchannia u medytsyni – skladova chastyna u protsesi pidhotovky likaria-spetsialista. Medychna osvita. 2016;4:17-20. [in Ukrainian].
4. Shchastnyi AT, Rednenko VV, Konevalova NYu, Fomin AV, Poplavets YeV. Sostoianiie i napravleniie razvitiia simuliatsionnogo obucheniia v Vitebskom gosudarstvennom meditsinskom universitete. Vestnik VGMU. 2015;14(3):107-17. [in Russiаn].
5. Sabatovska IS, Seleznov MA. Pedahohichni umovy vykorystannia aktyvnykh metodiv navchannia u protsesi pidhotovky fakhivtsiv medychnoho profiliu. Medychna osvita. 2017;4:48-52. [in Ukrainian].
6. Gaba DM. Training and nontechnical skills: the politics of terminology. Simul. Healthc. 2011;6(1):8-10.
7. Zaporozhan VM, Tarabrin OO. Symuliatsiina medytsyna. Dosvid. Zdobuttia. Perspektyvy. Praktychnyi poradnyk. Sumy: Universytetska knyha; 2018. 240 s. [in Ukrainian].
8. Alinier G. A typology of educationally focused medical simulation tools. Med. Teach. 2007;29(8):243-50.
9.  Abdulmohsen Al-Elq H. Simulation-based medical teaching and learning. J. Family Community Med. 2010;17(1):35-40.
10. Artomenko VV, Semchenko SS, Yehorenko OS, Novikov DA, Karakonstantin DF, Berlinska LI, ta in. Symuliatsiine navchannia v medytsyni: mizhnarodnyi ta vitchyznianyi dosvid. Odeskyi medychnyi zhurnal. 2015;6:67-74. [in Ukrainian].
11. Díez-Goñi N, Guillén S, Rodríguez-Díez MC, Pineda L, Alcázar JL. Use of the Learning Curve-Cumulative Summation Test for Leopold Maneuvers Assessment in a Simulator: A Pilot Study. Simul. Healthc. 2015;10(5):277-82.
12. Kulishov SK, Kudria IP, Tretiak NG. Interaktyvne navchannia vnutrishnoi medytsyny yak tekhnolohiia vkliuchennia studentiv upravlinnia navchalnym protsesom. Materialy navch.-nauk. konf. z mizhnarodnoiu uchastiu. Suchasni tekhnolohii upravlinnia navchalnym protsesom u vyshchykh medychnykh nachalnykh zakladakh; 2014 Lyst 22; Poltava. Poltava: Ukrainska medychna stomatolohichna akademiia; 2014. s. 114-6. [in Ukrainian].
13. Kosagovskаia II, Volchkova YeV, Pak SG. Sovremennye problemy simuliatsionnogo obucheniia v meditsine. Epidemiologiia i infektsionnyie bolezni. 2014;1:49-61. [in Russian].
14. Pian-Smith MC, Simon R, Minehart RD, Podraza M, Rudolph J, Walzer T, et al. Teaching residents the two-challenge rule: a simulationbased approach to improve education and patient safety. Simul. Healthc. 2009;4(2):84-91.
15. Scalese RJ, Obeso VT, Issenberg SB. Simulation technology for skills training and competency assessment in medical education. J. Gen. Intern. Med. 2008;23(1):46-9.
16. Margan PJ, Cleave-Hogg D. Simulation technology in training students, residents and faculty. Curr. Opin. Anaesthesiol. 2005;18(2):199- 203.
17. Kubyshkina VA, Svistunova AA, Gorshkov MD, Balkizov ZZ, redaktory. Spetsialist meditsinskogo simuliatsionnogo obucheniia. M.: ROSOMED; 2016. 320 s. [in Russian].

«Bulletin of problems biology and medicine» Issue 2 (156), 2020 year, 198-201 pages, index UDK 378:614.25

10.29254/2077-4214-2020-2-156-198-201