Pedagogical
sciences/2. specialists background
problems
Yevelson J.
The Khakas State University, Russia
Formation of the student ̓s
valuable attitude towards intercourse
at the medical college
The
author of the article pays attention to the important problem of professional modern
medical worker ̓s grounding – the necessity of special forming for
students of the medical schools and colleges developed communicative skills
based on bioethical values and realized not only in the contest of professional
medical intercourse but first of all in the intercourse with patients.
Key
words: professional medical intercourse, communicative skills and abilities,
educational-professional activity, valuable attitude, valuable bases of
the communicative skills.
The problem of forming intercourse skills with
patients especially shaped appears in specialists training at the medical
colleges because as the analysis of the literary sources and practical
experience shows in present time middle medical worker doesn’t know the
structure and medical intercourse laws, he has weak developed communicative
abilities and communicative structure as a whole. The analysis of normative and
educational-methodical medical college ̓s base shows the absolute absence
of demands in forming of the diagnostics during educational-professional activity
intercourse experiences and abilities and valuable attitude towards this intercourse.
There are no educational discipline programs, including communicative preparation
and as a result medical college ̓s students have very superficial conception
about interrelation between medical workers and patients.
Only in
the borders of facultative disciplines and unfortunately on the formal level
students get ideas about differences between doctor and patient ̓s
interrelations in different cultures and different societies. At the same time such
an important side of professional activity is the subject of social
investigations. American bioethicer R. Vitch distinguishes four “doctor -
patient” interrelation models: engineering, paternalistic, collective and
contract [1]. Native researchers S. Samigin, L. Stolarenko distinguish the
following types of “doctor - patient” intercourse: “mask ̓s contact”, primitive
intercourse, formal-part, spiritual interpersonal and manipulative intercourse
[2]. There are others orients according to which it is possible to characterize
different forms and “doctor - patient” intercourse ̓s models. And whatever
the ways of building these models are all authors mark the necessity of special
medical worker ̓s training in their assimilation.
Basing on understanding the specific of
medical worker ̓s professional activity, variety of “medical worker –
patient ̓s” interrelation, finding out valuable bases and personal
importance of the communicative part activity it is possible to characterize
some abilities dealing with the professional medical worker ̓s
intercourse, describe its indexes disclosing in activity and substantiate its
forming levels.
The
analysis of the literature about problems let bases for distinguishing the following
common professional intercourse ̓s abilities and accordingly to ground its
three forming levels: the ability to determine motives of choosing medical
profession; the ability to establish contact between people asking for help;
the ability to follow specific in intercourse between medical workers and
patients; the ability to use juridical information in intercourse with
patients.
It is
known that an intelligent choose of profession occurs with the peoples̓ orientation
on the social values. If the main thing is public prestige, profession chooses
orienting on fashion and profession ̓s prestige in the society. Many
choose profession according to material incentive or because of interest to
this particular profession as it has romantic character. But more often
romantic doesn’t improve it and reality and difficulties left. Sometimes people
must change profession because he wasn’t ready for it no morally, no
physically, no psychically. That’s why one should choose profession depending
on many circumstances but first of all take into account abilities and
inclinations so it will form valuable attitude towards future profession and to
your activity in it.
There
are more than 40,000 specialities nowadays but medical profession is the most
popular and prestige during many years. Of course everyone who chooses this
profession must have vocation to it. “The only real feeling in the life – is
sympathy”, - Frenchman suppose. And when this sympathy become necessity you may
think that man has the main condition to get medical worker’s profession
successfully.
Readiness
for intercourse as psychical persons state – is an inside mood on definite
intercourse in doing educational and labor tasks, directive on active and expedient
communicative acts. The condition of “readiness” for optimal contact with
patient determines through professional tasks intercourse understanding,
personal attitude to the result decision and interrelation results realizing,
wish to get a success.
We
finding out the intercourse necessity, the level of empathy, tendency for “man
- man” sphere in order to determine medical students valuable attention to optimal
contact with patients. It turned out that 47% respondent has low level in the intercourse
necessities. They can find out their aims and means for intercourse, take part
in it, but because of their psychical qualities (temperament, age and sex)
don’t be active. 30% showed middle level of intercourse necessities that means
forming of world-outlook, professional competence, communicative and manual
necessity in affiliation. And at last 235 has high intercourse necessity that
can be determine by inner discomfort, tenseness, fear of reject on the one
hand, and by high level of communicativeness on the other.
Sometimes
not professionalism and impartiality but medical worker’s empathy plays an
important role in choosing a doctor. We get to the conclusion: there was no
“very low” and “very high” level of empathy absolutely, 7% of the students have
low level of empathy, 63% - middle and 30% - high. In medical profession such
indexes (middle and high) can discussed in two ways. On the one hand it is
absolutely good because it’s impossible to say that medical worker is
indifferent and can’t be accused of formal attitude towards patient and nominal
fulfillment of the professional duty. On the other hand it is necessary to keep
the empathy ̓s borders, especially those doctors who work with seriously
ill patients in order not to project their illnesses on themselves.
One
more peculiarity of professional intercourse “medical workers - patients” is
the skill to regulate various interpersonal conflicts. Essence of conflicts in
the system “medical workers - patients” consists in differences of minds,
interests, ideas, points of view and participants’ expectations. L. Krouzer divides
conflicts on realistic and unrealistic [3]. Realistic conflicts are called out
by unsatisfaction of demands and expectations. Unrealistic conflicts have their
aim to express opening negative emotions, enmity, injury when sharp conflict
become not the way of concrete result but end in itself. First type of conflict
connected very often with unjustified expectations about medical worker ̓s
behavior (rudeness, impoliteness, not punctual, negligence), hospital-sanitary
conditions (mud, smell, and noise), and incorrect diagnostic. Second type of conflict
connected with preconceived patient ̓s attitude towards medical service in
general or to the concrete doctor. The ability to decide such kinds of
conflicts or not to make them at all shows us the high communicative level of
the professional medical workers̓ intercourse.
In
order to find out student ̓s level of knowledge about medical
workers̓ intercourse specific and to estimate the importance of this
knowledge we organized pedagogical observation about the students of the
medical college during their practice in hospitals. We have chosen a
group of students (36 persons). The aim of observation was to find out the ideas about
knowledge and skills of the medical workers assisted positive medical
interrelation:
·
knowledge: of the main whereabouts
in medical ethics (life respect, not to do much harm, respect for patient ̓s
person, medical mystery, respect for profession); models of interrelations
between medical workers and patients (paternalistic, engineering, colleges,
contract); the skill to dispose patient to oneself;
·
abilities: to demonstrate
kind attitude towards patient, to be patient, not to estimate patient ̓s
behavior, don’t use medical terminology talking with patients, to know patient
̓s person, his disturbance about health, to keep ones time and to follow
subordination.
As for
position “the skill to dispose patient to oneself”, “to demonstrate kind attitude
towards patient”, “to be tolerant with patients” 60% doesn’t determine this
skills as important for intercourse between medical worker and patient because
are sure that they doesn’t influenced on the treatment result (low level), 36%
demonstrated middle and 4% high levels of forming such skills and abilities. Ignorance
of the talkative rules in most cases lets patients to be the leader in the
situation that’s why it was difficult to dispose patient to oneself, to be
tolerant and to demonstrate kind attitude; patient ̓s behavior was
estimated with other staff. It means that students have no knowledge of the
main whereabouts in medical ethics (100% low level). The ability not to use medical terminology talking with patients
tells about medical worker ̓s professionalism. But in this case “100% high
level” is an elementary ignorance of the medical terminology. Students didn’t
think that to know patient ̓s person, his disturbance about health is very
important so we gave them additional special purposes. As a result 93% - low
level, 7% - middle.
In
order to determine the level of such skills as to keep ones time, to follow subordination,
to support each other in the inflectional hospital was modeled educational situation
of “food poison”. Doctors gave instructions to students but unfortunately they
couldn’t obey them. As a result in real life and real situation for patients the
mortal ending could be.
·
to use the judicial information in the intercourse with the
patients
One of
the parts of medical workers̓ competence is legal and judicial literacy.
Lawyers and doctors defend the most meaningful man ̓s values – life,
health, dignity. Man needs legal and medical knowledge. Getting an education is
only the beginning of activity and we ̓ll accumulate skills and abilities
during the whole life. Without it the main social tasks couldn’t be realized.
That’s why the first chapter of The Criminal code devoted to the “main” crimes
– against life and man ̓s health.
To master different
kinds of manipulations doesn’t mean that the job will be done perfect. That’s
why it is very important for future medical workers to forming valuable
attitude towards the results of their professional activity. This attitude as
the most important personal professional quality must formed in specialist
̓s person during the period of his professional preparation at college,
during the educational process.
Forming
by medical college student’s abilities to communicate with patients based on understanding
professional values will be effective if in the content of clinical disciplines
theoretical and practical aspects of bioethical values studding will be included,
and also if in the educational and out-of-class student’s work methods of
active study (business and imitative games, communicative trainings) will be
realized. We must pay special attention during organizing such conditions in
the college ̓s educational process; it is necessary to develop special
psychological-pedagogical program for teachers of the medical college
unswerving on forming the valuable bases of communicative skills.
In
conclusion we want to say that we don’t suppose these skills and abilities absolutely
exhaustive disclosing the specific in intercourse between medical workers and
patients, consequently, we don’t assert that their existence will prove the
valuable bases forming of the professional activity. Neated and adopted methods
help to determine in general levels of forming student’s communicative
professional skills. At the same time, it is possible to use these methods for
diagnostics professional communicative abilities at the beginning level only
(the fist-year students) and less for graduates and working specialists.
Literature
1. Introduction to Bioethics:
educ. textbook / B/ Judin, P. Tishchenko. M.,
- 1999.
2. Psychological-pedagogical
bloc / A. Krasnov. – M., 1988
3. Krouzer L. Conflictological
bases. – SPb., 1993