Scientific-Methodological Approaches to Improving the Information Base of Postgraduate Education for Specialist Physicians

The dissertation is dedicated to the development of scientific-methodological approaches to improving the information base of postgraduate medical education (PME) for specialist physicians. The research analyzes the history and state of informatization of the postgraduate training system, identifies the information needs of medical workers, and assesses the degree of integration of information technologies into the educational process. The author substantiates the necessity of transitioning to new forms of instructional material based on the achievements of information and communication technologies and argues the relevance of creating information versions of clinical tests as an instrument for controlling the level of professional knowledge.

Relevance of the Problem. One of the principal tasks of contemporary health care is to ensure a high professional level of medical personnel working in the industry. In numerical terms, as of the beginning of 2002, this contingent comprised specialists with higher (604.4 thousand physicians of all specialties) and secondary specialized (1,376.8 thousand) medical education (Statistical Materials, 2002, p. 95).

The system of postgraduate medical education (PME), formed over the years, requires further development in order to meet the needs of, on the one hand, health care personnel in the improvement of their professional knowledge, skills, and abilities, and, on the other hand, the industry itself in highly qualified personnel.

Internal reserves within the framework of traditional forms of education (full-time, part-time) and the presentation of instructional material (the book in its many manifestations) have been largely exhausted and require development based on the achievements of scientific and technological progress.

However, the specifics of medical specialties and the mentality of the medical community in the protection of citizens' health have for many years restrained the implementation of general educational efforts toward the informatization of the PME system.

The principal attention of specialists in the field of informatization was focused on solving the problems of practical activity — the works of S.A. Gasparyan (1973); Yu.P. Lisitsyn (1979); D.D. Benediktov (1982); Ye.N. Shigan, S.F. Ostapyuk (1988); Ye.V. Gubler (1990); Yu.M. Komarov (1992); V.K. Gasnikov (1997); V.V. Bessonenko et al. (1998); G.A. Khay (1998); V.G. Kudrina (1999); V.F. Martynenko (1999); V.A. Groisman, 2000); B.A. Kobrinsky (2000); V.I. Starodubov (2000); O.E. Zekiy, 2001); G.I. Chechenin (2002), et al.

And only from the mid-1990s did instructional materials dedicated to the introduction of ideas of medical informatics into the educational process begin to be published (V.K. Gasnikov et al., 1996, 1997; G.A. Khay, 1998; V.G. Kudrina, 1999; V.Ya. Gelman, 2001; V.P. Omelychenko, A.A. Demidova, 2001).

To a lesser extent, the development of achievements in informatization in the process of training industry personnel affected clinical disciplines. Attempts to extrapolate general pedagogical norms onto medical education found a weak response due to the absence of analogs to clinical data and the measure of responsibility for their use in other scientific disciplines.

The necessity of using weakly structured information, including medical images and signals from various sensors and diagnostic equipment, as noted by A.P. Stolbov (1999), is one of the trends of comprehensive informatization of health care institutions.

Scientific publications investigating how such information could be used to activate the educational process in the PME system are extremely scarce. They are fragmented and unsystematized in nature. At the same time, the "Concept for the Development of Telemedicine Technologies in the Russian Federation" adopted in 2001 particularly emphasizes the importance of implementing distance education, and the Order of the Ministry of Health of the Russian Federation "On the Main Directions of Informatization of Health Protection of the Population of the Russian Federation for 1999-2002" dated July 14, 1999, No. 279 identifies as a priority the informatization of the personnel training and postgraduate education process, including the creation of information and educational systems for rendering medical assistance by various categories of medical workers. Thus, tasks related to a new approach to the information resource in the PME system and the search for ways to optimize its use have come to the forefront. This determined the relevance of the research topic.

Research Objective: the development and implementation of modern informational instructional materials and testing technologies for the improvement of the control of physicians' level of professional knowledge in the system of postgraduate medical education.

Research Tasks:

1. To study the retrospective experience of using the capabilities of informatization for the improvement of physician training in the PME system.

2. To assess the information needs of medical workers.

3. To scientifically substantiate and practically implement the concept of control and assurance of the quality of instructional material in the contemporary conditions of industry informatization.

4. To organize and conduct an experiment on the creation of information versions of tests with the activation of primary clinical material for instructional purposes.

5. To determine the prospects for the use of tests of a new generation and to propose mechanisms for such use.

6. To create a Federal Automated Registry of Experts in the Scientific and Technical Sphere (Medical Direction).

The scientific novelty of the research consists in the fact that, for the first time:

- the needs of industry personnel for the use of information technologies in the development of professionally oriented instructional materials have been determined;

- the theoretical basis (terminological foundation, concept, and methodological principles) for the use of a new technology for the formation of instructional information for physicians of the clinical profile has been substantiated;

- the expectations of clinical physicians regarding the introduction of information versions of tests have been assessed based on questionnaire survey data;

- a technology for the "activation" of clinical material has been proposed and implemented during the experiment on the creation of tests of a new generation;

- the viability of information versions of test items has been proven on an experimental example (cardiology — cardiac insufficiency), including with remote access;

- the Expert Registry "Scientific Potential" has been developed to support information and educational technologies.

The practical significance of the work lies in the development and implementation of a new approach to the formation of instructional material in the PME system and its access in remote mode.

The technology for compiling tests of a new generation was used in the development of the industry standard "Technology for the Development of Test Items for the Control of Knowledge in the System of Postgraduate Medical Education".

Information about experts involved in the creation of test items and information and educational systems for medical specialties was used in the formation of the registry of Federal experts in the scientific and technical sphere.

Propositions for Defense

1. Ensuring the contemporary level and accessibility of instructional material in the system of continuous education of medical workers.

2. The creation of information versions of clinical test items as the foundation for a new approach to the formation of instructional material in the PME system.

3. The use of information and telecommunication capabilities for the development of the PME system.