ПЕДАГОГІЧНІ ПІДХОДИ ДО ПОКРАЩЕННЯ ЗАСВОЄННЯ СТУДЕНТАМИ ПРАКТИЧНИХ НАВИЧОК АКУШЕРСЬКО-ПЕДІАТРИЧНОГО ПРОФІЛЮ Гвоздецька Галина Сергіївна, завідувачка сестринського відділення, викладач-методист кафедри акушерства та гінекології ім. І.Д. Ланового Івано-Франківського національного медичного університету ORCID: 0000-0003-3282-4656 Дуб Наталія Євстахіївна, кандидат державного управління, декан факультету № 2 КЗВО ЛОР «Львівська медична академія імені Андрея Крупинського» ORCID: 0000-0001-6193-9407 Глов'як Віталій Григорович, завідувач навчально-виробничої практики фахового медичного коледжу, асистент кафедри педіатрії Івано-Франківського національного медичного університету ORCID: 0000-0002-6599-0127 Жукуляк Оксана Миколаївна, асистент кафедри акушерства та гінекології ім. І.Д. Ланового Івано-Франківського національного медичного університету ORCID: 0000-0002-8060-006X У статті проаналізовано особливості засвоєння практичних навичок при вивченні акушерсько-педіатричного профілю. Велика увага приділяється індивідуалізації практичного навчання. Згідно з вимогами сучасності кількість практичних навичок і вмінь, якими повинна володіти медичні працівники, стрімко зростає, а при здійсненні освітнього процесу для відпрацювання практичних навичок не завжди є можливим забезпечити студентів тематичними пацієнтками. Звертається увага на специфіку самого об'єкта пізнання -вагітну жінку у різні терміни вагітності. Пошук нових підходів в оптимізації засвоєння практичних навичок та вмінь студентом є особливо актуальним у період реформування медичної галузі. Запропонований алгоритм пізнання: «Знаю -розумію -бачив -робив -вмію». Оптимальним варіантом засвоєння практичної навички є робота в центрі симуляційного навчання, відпрацювання навичок на фантомах . Використання симуляційних фантомів та манекенів дозволяє студентам відпрацювати окремі практичні навички або комплексне надання медичної допомоги при відповідних клінічних ситуаціях. Центри оснащені стендами, сучасними алгоритмами виконання навиків відповідно до міжнародних стандартів та вимог, інструкціями виконання навиків. У світовій медичній практиці оптимальним варіантом для засвоєння студентами практичних навичок на перших етапах вивчення дисципліни є робота з фантомами та муляжами. Студенти мають можливість допрацювати алгоритм «Знаю -бачивробив -вмію» у симуляційному центрі. Тут активна позиція студента в навчанні відіграє вирішальну роль, адже якщо хтось не зрозумів зразу, як виконати практичну навичку, то викладач на фантомі має можливість показати і перевірити її виконання в кожного студента. Підкреслена роль активної позиції студента в освітньому процесі. Глибокий аналіз якості здачі студентами ОСКІ та комплексного кваліфікаційного іспиту дозволить удосконалити методику оволодіння практичними навичками. Ключові слова: практичні навики і вміння, симуляційний центр, фантом, ділова гра, кейс-метод.Halyna Hvozdetska, Nataliya Dub, Vitaly Hlovyak, Oksana Zhukulyak. Pedagogical approaches to improving students' acquisition of practical skills of the obstetrical and pediatric pro...
The issue of the quality of educational services provided by professional preliminary education always remains relevant. In particular, they need to study the problem of assessing the quality of education not only by higher governing bodies, but also by direct participants in the educational process. This is especially important today in connection with the introduction of new requirements for the accreditation of educational programs in the field of professional preliminary education, which provides training for professional junior bachelors. In order to implement a student-centered learning system, an important task of the College's management is to provide students with the opportunity to express their opinions, suggestions or complaints. In addition, it is important to study the use of information and communication technologies in the process of assessing the quality of education, as they allow faster and more efficient organization of this process, involving much less material and human resources. The purpose of the research: to describe the experience of organizing and conducting the poll in the professional medical college of IFNMU on the quality of educational services. Research results and their discussion. To improve the educational and professional programs at the College, we use data from stakeholder polls, the introduction of a student-centered system of education, the promotion and observance of academic integrity, control and improvement of teaching quality. The purpose of the poll is to identify their satisfaction with learning, educational programs, their components and the quality of educational services, as well as transparency and objectivity of students' applications, the level of information support that fully corresponds to the student-centered system of education at the College. In order to implement a student-centered learning system, we provided an opportunity for students to express their proposals for changes in curricula, improvement of educational and professional programs through surveys. During 2021, the College conducted a series of polls using Google Forms among participants in the educational process, stakeholders. In particular, we conducted a survey among college students. 211 students of different courses and departments took part. Among the many questions we also asked a number of questions related to the organization of the educational process. As a result of the polls, we received data that will allow us to improve the quality of education, draw attention to shortcomings, make proposals to the cycle commissions and the Pedagogical Council to improve educational and professional programs and training programs. An important point in determining the degree of satisfaction with the quality of teaching is a systematic approach, rather than a one-time questionnaire. This allows for comparative analytical work, obtaining more objective information that can be used as an evaluation, and can serve as an "impetus" to improve the efficiency of the College. Conclusions. Receiving periodic feedback from students is a mandatory component of internal quality assurance of educational programs. The college should organize periodic student polls, the results of which should have a real impact on the content of teaching and learning. The lack of surveys of direct participants in the educational process or a purely formal approach to their conduct is a disadvantage.
Introduction. Early gestosis is a pathological pregnancy state linked to the development of a fertilized egg or its elements and is characterized by several symptoms. In today’s conditions, the frequency of early gestosis is observed in 60.0-80.0 % of pregnant women, and the need for hospitalization and special treatment occurs in 12.0-17.8 % of pregnant women. According to statistics, up to 90.0 % of pregnant women suffer from nausea and vomiting of varying severity. One of the main issues of medical care for pregnant women with early preeclampsia, in addition to the number of episodes of vomiting during the day, is the presence and severity of micronutrient and vitamin imbalance, which should be inevitable due to nutritional deficiencies due to incontinence and loss of micronutrients with vomiting. One of the key moments of vomiting in pregnant women is expressed misbalance in microelements, especially magnesium (Mg). Mg is necessary for vitamin D biosynthesis, transportation, and activation which is one of the key factors determining the effectiveness of our immune system. Mg participates in vitamin D metabolism, normalizes it, and increases the sensitivity of the target organs. Magnesium has a significant role in immune response as a cofactor for immunoglobulin synthesis and other processes associated with T- and B-cells function is a natural antistress factor that slows down excitation of the central nervous system. The prospects of magnesium insufficiency influencing the severity of early gestosis are poorly studied, which became the reasoning for this study. The aim of the study. To characterize clinical and laboratory indices of magnesium levels in blood serum in pregnant women with early gestosis of different severity grades. Materials and methods. We examined 150 women, 100 ones (the main group) with signs of early gestoses: 41 females with mild signs, 37 women with moderate signs, 22 ones with severe signs, and 50 females (the control group) with the physiologic course of the first trimester of pregnancy. We considered the patient’s complaints, information from case history, physical examination data, common laboratory tests, and ultrasound imaging. The evaluation of Mg deficit was performed according to an adapted standardized score that was used in the international medical practice according to the scale of deficit signs and the Mg levels in blood serum were tested. The reference values of normal Mg levels in blood serum were 0.80-0.85 mmol/L. The statistical analysis of the results was performed using methods of variability with the help of MS Excel and Statistica SPSS10.0 for Windows. Results. According to the results of the questionnaire, the women from the main group mostly presented the Mg deficit and only 17 (17.0%) of pregnant females had no Mg deficit; at the same time, the pregnant women presented Mg insufficiency in 7 (14.0%), and Mg deficit was observed only in 1 (2%) case. the gotten results showed that at increasing gestosis severity, Mg deficit frequency in blood serum increases as well. The analysis of Mg indices in blood serum and using the questionnaire for Mg deficit allowed the determination significant prevalence of magnesium deficit. Conclusion. Most women aged 18-40 years with single live intrauterine pregnancy at 4-12 weeks and signs of early gestosis present magnesium insufficiency and deficit and the frequency of such cases increases with higher severity of early gestosis.
Aim: to determine the clinical features of women with early gestosis. Materials and Methods. The retrospective study included 200 pregnant women. The main group included 150 pregnant women with early gestosis. The control group included 50 women with physiological pregnancies. Results. Among pregnant women with early gestosis, the share of unemployed women (30.0%), workers in enterprises and agriculture (24.0%) and female students (22.0%) was significant, (р<0,001). Cigarette smoking was identified in 20.0% of women in the main group. In childhood, 32.0% of women with early gestosis suffered from childhood infectious diseases. In women with early gestosis, somatic pathology was probably more common: diseases of the gastrointestinal tract (52.0%), diseases of the cardiovascular system (40.0%); anemia (38.0%); pathology of the urinary system (18.0%); endocrine diseases (20.0%), psycho-emotional disorders (38.0%), (р<0,001, c2 =13,20). Abnormal uterine bleeding are observed in 18.0% of women in the main group. The rate of inflammatory diseases of the pelvic organs among pregnant women with early gestosis was 32.0%, cervical pathology - 16.0%; the level of artificial abortions was 26.0%, (р<0,001, c22 = 22,74). Discussion. Nausea and vomiting in pregnant women is one of the most common pregnancy disorders. Symptoms occur mainly in the first trimester, although in some patients they may persist throughout pregnancy and affect a woman's quality of life. The pathogenesis of early gestosis remains unclear, but there is a consensus that these disorders are multifactorial and that various genetic, psychological, endocrine, and infectious factors may be involved. Our retrospective analysis of the premorbid background in women with early gestosis revealed its peculiarities. The high level of somatic morbidity and smoking in women with early gestosis in comparison with pregnant women of the control group corresponds to modern ideas about the importance of extragenital pathology and bad habits in the etiopathogenesis of pregnancy complications. Conclusions. The results of this study show that women with early gestosis are characterized by a high level of somatic diseases and psycho-emotional disorders, smoking, relatively unsatisfactory social conditions. Relationship with research programs, plans and topics. This work is a fragment of the scientific work of the I.D. Lanovyi Department of Obstetrics and Gynecology "Development of diagnostic tactics and pathogenetic substantiation of effective methods of preserving and restoring reproductive potential and improving the quality of life of women in obstetric and gynecological pathology" (state registration number 0121U109269).
One of the frequent complications of early terms of pregnancy is vomiting in pregnant women, which causes have not been studied sufficiently. The signs of early gestosis usually appear from the 4-9th week of pregnancy and decrease up to the 16th week. At the moment, there is no tendency for early gestoses to decrease their frequency. In the last years, huge significance for early gestosis lies in the disordered immune system in a pregnant woman. On the 4-5th week of pregnancy, the mother’s body gets antigens from the fetus that contributes to early gestosis. Aim of the research. Study features of immune-mediated inflammatory disorders during the early gestoses of different severity degrees. Materials and methods. We examined 120 females. The control group consisted of 30 women with the physiologic course of pregnancy. The main group had 90 pregnant females with present early gestoses of different severity degrees: the 1st one had 30 pregnant patients with present vomiting of a mild degree, the 2nd one – 30 females with early gestoses of moderate degree, the 3rd one – 30 women with early gestoses with the severe course. Inclusion criteria to the main group were considered the age of the patients from 18 to 40 years, present vomiting, present intrauterine singleton pregnancy, patient’s consent to the research, pregnancy term of 4-12 weeks. Exclusion criteria were gastrointestinal and hepatic diseases of different etiology in anamnesis, the patients younger than 18 years old and older than 40 years old, present oncologic diseases, ectopic pregnancy, patients with surgical intervention on the pelvic organs in anamnesis, pregnant women with IVF, present multiple pregnancy, present neuropsychiatric pathology, absent patient’s consent to the research, pregnancy term more than 12 weeks. In blood serum, the examinees had tested cytokine level, which regulated immune-mediated inflammatory response (IL-10, IL-6) on the STAT FAX 303/PLUS Microstrip Reader in the private certified laboratory PrimaMED (Ivano-Frankivsk). Results of the research. We tested levels of pro- and anti-inflammatory cytokines, vascular endothelial growth factors in blood serum in pregnant women with present early gestosis dependently on severity degree. Pregnant females with vomiting of several degrees have distorted humoral immune responses. This is seen provably by misbalanced pro- and anti-inflammatory cytokine levels in blood serum. The pro- and anti-inflammatory cytokine levels in pregnant patients with early gestoses depend on the severity of early gestoses. In the group of pregnant women with the mild course, we observed the lowest average values of IL-6 and the highest IL-10 level in blood serum. The females with moderate degree presented a probable decrease of IL-10 levels in 7.3 % and a significant increase of IL-6 levels in 5.5 % compared to the indices in females of the 1st group. The clearest misbalance in pro- and anti-inflammatory cytokines was registered in pregnant women of the 3rd group (severe degree). The women from this group presented a probable decrease of IL-10 level in 22.0% and a significant increase of IL-6 level in 14.8% compared to the indices in females from the 2nd group. Conclusions: The signs of early gestosis are associated with induction of inflammation. There are close direct correlations between severity degrees of early gestosis and IL-10 levels and inverse correlations with IL-6 levels. In females with signs of severe early gestosis in blood serum, we recorded a probable decrease of IL-10 levels and a probable increase of IL-6 levels compared to the values in females with mild and moderate early gestosis.
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