Optimization of clinical lecture as a leading organizational form of training



Оптимизация клинической лекции как ведущей организационной формы обучения

Кариева Шахноза Абдукамаловна, ассистент;

Голубина Ирина Вячеславовна, ассистент;

Ортикбоева Шахноза Ортикбой кизи, ассистент

Ташкентский педиатрический медицинский институт (Узбекистан)

Opponents of the lecture put forward the following arguments:

Lecture accustoms to uncritical perception of other people's thoughts. Lecture, as a form of learning, originated even in Ancient Greece and Rome. From the time of medieval universities to this day, the lecture has been and remains the main form of transfer of knowledge to students. However, the attitude to this organizational form of training ranges from unconditional fetishism to its complete denial.

Since the middle of the XIX century, the introduction of practical and seminary classes in universities on the educational process has led to the division the organizational form into active and passive. Lecture by the majority of teachers, especially clinicians, is recognized as a passive form of instruction, subject to reduction. Even an outstanding clinician and educator N. I. Pirogov believed that lectures should be read only in two cases: if the teacher owns a new, nowhere published material and if he is a truly outstanding speaker [2].

1. The better the lecturer, then more uncritically perceive his material and believe «in word», or on the contrary stop listening to the lecturer.
2. Lectures reduce in students the desire for independent work, thinking and scientific research.
3. At the lecture students mechanically record or abstract the material, it follows that the knowledge that is generated is not strong.
4. Lecture accustoms to high school.
5. Information on the visual channel is perceived more quickly and more firmly than only through the auditory channel, hence the lectures are ineffective;
6. Lecture — a means of poverty in the absence of textbooks and literature, etc.

It is quite obvious that the last three arguments do not stand up to criticism in the age of information and literary abundance, and depend on the readiness of the department and the lecturer to read the richly illustrated lecture.

We set out to refute the first three arguments, which at first glance have an element of objectivity in themselves.

It is known that the content of the lecture, its construction and execution have a clear orientation to didactic characteristics of this organizational form of education, which are consistent, mainly with tasks, functions and methods of reading. Agreeing with A. V. Petrovsky (1989) in the definition of tasks and functions of the lecture, giving an idea of its significance and place in the general structure of the didactic process, we would like to focus on the methods of lecturing in the cycle learning system. This is due, not only to the problems of the cyclic system, which obviously generate the above arguments against the lecture, but also with many positive aspects of it, the most beneficial, in our opinion, for clinical disciplines.

In a cyclic learning system, clinical lectures can be read at the beginning of the study of the topic or at the end, after conducting the practical lessons. Proceeding from this MS. Diankina (2002) thus formulates the main didactic tasks of the lecture:

1. Formation of an approximate basis for the subsequent mastering by students of educational material on this topic or problem;
2. A final generalization of the material, as if the creation of a graphological structure of the educational theme, mastered in parts.

Traditional and block system of education allows to arrange logical lectures, and then practical lessons. We are also advocates of such a sequence of training at the clinical department. Moreover, cyclic studies, in our opinion, should begin with an introductory lecture which gives an idea of ​​the significance and place of this particular subject in the overall structure of the doctor's training.

Usually, the introductory lecture is rich in examples from the life of the clinic, memorable situations and statistical material, which determine a relatively high level of assimilation. The subsequent lectures are thematic in nature, they contain facts, their analysis, conclusions, evidence of specific scientific positions and nosologies. It is here that the problems of mastering the material heard at the lecture begin, the level of which is progressively decreasing with each subsequent lecture [4]. Moreover, the process of falling levels of mastering of lecture material can not be stopped either by the lecturer's oratorical skill, nor by the wealth of demonstrative material, it is only slightly inhibited [5]. Strong evidence of this can serve as the results of attestation of students and final exams, which clearly shows the survival of knowledge, obtained mainly in practical and seminar classes, more precisely, on «consultation-dragging».

An analysis of the causes of the current problem situation revealed the underlying «information explosion», characterized by a rigid time limit for training with a significant increase in the content of content [6, 7]. Obviously, this is one of the most violent contradictions in the educational process. On the other hand, the problem situation is defined by MS. Diankina (2000) — «the intellectual difficulty associated with the fact that students can not perform the task beforehand in a known way», i.e. The problem situation arises when there is a lack of basic knowledge for solving problems, and students understand this clearly. A problematic situation calls for a process of thinking [8]. And is the student ready to solve the problem situation that takes place on every single clinical lecture? In other words, to clinical thinking, without which he will not master the material presented by the lecturer at the proper level.

The analysis of the effectiveness of clinical lectures made it possible to identify the two most important factors needed to address this issue:

1. Selection of the contents of the clinical lecture;
2. Preparedness of the student to the perception of the lecture.

The first is largely determined by the professionalism of the clinical lecturer, which requires the elimination of duplication of both the material of the textbook and the material to be delivered to practical classes on this topic. The quality of the lecture should be oriented towards such pedagogical categories as expediency, scientificness, accessibility, novelty and visibility.

The situation is much more complicated with the second factor — the willingness of the audience to perceive the lecture material at the same level. In our opinion, this factor to a much greater extent determines the productivity of the lecturer and listeners.

Comparing the students' attention to the lectures delivered before and after the topic was passed in practical classes, we became convinced of the much greater interest and activity of the audience in the lecture, the topic of which had already been worked out in a practical lesson.

However, the analysis of mutual visits of practical classes ahead of the lecture topics testified to unjustified time losses for long theoretical discussions, and at times micro lectures of the instructor on the subject of the lesson. This is due to the different level of preparedness and knowledge of students, which forced the teacher to find the level of clarification of the topic optimal for the whole group. Unfortunately, this level often turned out to be below the average, not allowing to solve the main tasks of the practical lesson, aimed at practicing practical skills and abilities.

Analysis of our medical education system with its continuously changing curricula and programs suggests that it not only instills a superficial approach to the study of medical science in general, but also brings up an «excursion» attitude in the study of the majority and, in particular, short-term clinical disciplines.

This mood discourages not only students, but also teachers, which dictates the need to search for motivational factors that force the work of both the student and the teacher. One of such methods of pedagogy, which contains a powerful mutually motivating factor, is, in our opinion, an interactive system of conducting the lesson. And in the first place it refers to a clinical lecture — a student from a passive listener becomes an active participant in a lecture-consultation. A preliminary analysis of reading, or rather of conducting, an interactive lecture at the Department of Children's Surgery I-TashGosMI, with the participation of group teachers, showed encouraging results. Briefly, the methodology of the interactive lecture introduced at our department is the following: on the introductory lesson to students, given the task prepare for the topic of the lecture on the recommended literature. At the same time, they warn that at the lecture every student is obliged: to give at least 2 and no more than 3 questions, according to the content of which he can get up to 50 % of the total amount of the final control, lth lose them in the collection of negative points for an unsubstantiated question.

The lecture consists of 3 parts:

1. Theoretical: the lecturer, within 45 minutes, (no more), presents the main questions of the topic at the level of the elective course, using the classical («student») demonstrative material.
2. Dialogue (30 minutes): the lecturer, with the help of teachers, collects questions from students, organizes them and answers them more deeply, highlights the topic of the lecture, emphasizing the audience's attention to the most meaningful questions asked by the listeners of this cycle and by students who listened to this topic earlier. Important in the second part of the lecture is to bring examples from the practice of clinics, discussing the most common mistakes in the diagnosis and treatment of a particular patient.
3. The consultation (up to 15 minutes): the lecturer with the participation of teachers and the involvement of individual students discusses the thematic patient. At the same time the lecturer constructs a chain of judgments of his, teachers and students in such a sequence that should become an example of clinical thinking both in the formulation of the diagnosis and in determining the tactics of treatment.

The lecture concludes with a brief summary of the material read and discussed. The annual experience of reading the interactive lecture on pediatric surgery to the fifth year students of the medical faculty has shown significant advantages both in mastering the study material by students and in improving the lecturers' skills of lecturers.

The results of the anonymous questionnaire, conducted among students who attended such lectures, testified to the great interest and good orientation of listeners. More than 80 % of questioned students identified the interactive lecture as the best method of motivation, conformance and formation of clinical thinking.

References:

1. Fundamentals of pedagogy and psychology of higher education. Ed. A. V. Petrovsky. // M., 1986.
2. Pirogov N. I. Selected pedagogical compositions. // M., 1953.
3. Talyzina N. F. Management of the learning process. // M., 1984.
4. Structure of the activity of the teacher-doctor. Ed. G. M. Bairova. // M., 1989.
5. New pedagogical thinking. Ed. A. V. Petrovsky. // M., 1989.
6. Diankina M. S. Professionalism of the teacher of the higher medical school. // M., 2000.
7. Esaulov A. F. Activation of teaching and teaching activities of students. // M., 1981.
8. Rubinshtein S. L. Fundamentals of General Psychology. // M., 1989.