Accreditation of specialists with higher medical and pharmaceutical education

The issue of reforming not only the healthcare system as a whole, but also the system of training medical and pharmaceutical personnel is relevant today. The main direction of the National Project "Healthcare" is the solution of the issue of providing healthcare institutions with qualified personnel, the introduction of a system of continuing medical education (the National Project "Healthcare", the federal project "Providing medical organizations of the healthcare system with qualified personnel"). In this regard, the requirements for persons who have mastered educational programs and are engaged in medical activities on the territory of Russia have changed. Admission to medical activity, according to modern trends, should be objective, uniform and universal throughout the country. The aim of this article is familiarization of specialists with higher medical and pharmaceutical education with the legislative framework and methodology for conducting the accreditation procedure for specialists. Primary, primary specialized and periodic accreditation is a complex organizational, methodological and engineering process that requires a competent approach in terms of planning, organization and implementation. The training of employees of accreditation centers according to the programs of training specialists in medical simulation training, as well as close interaction with the accreditation commission, certainly allows us to solve these problems and flawlessly ensure that all stages of accreditation of specialists are carried out.

Efference information flow during skill acquisition mediates its interaction with medical simulation technology

Despite substantial progress towards establishing virtual reality (VR) simulators as a replacement for physical ones for skill training, its effect on the brain network during skill acquisition has not been well addressed. In this study, we employed portable optical neuroimaging technology and Granger causality approach to uncover the impact of the two medical simulation technologies on the directed functional brain network of the subjects with two different skill levels. The mobile brain-behavior relantionship was evaluated using functional near-infrared spectroscopy (fNIRS) while right-handed subjects performed well-established fundamentals of laparoscopic surgery (FLS) pattern cutting task. A multiple regression path analysis found that the cognitive-action information flow from the right prefrontal cortex to the supplementary motor area statistically significantly predicted the FLS task performance. Here, the skill level (expert vs novice) affected the cognitive-action information flow from the right prefrontal cortex and the efference copy information flow from the left primary motor cortex via supplementary motor area as hub to the cognitiveperception at the left prefrontal cortex, i.e., the action-preception link. The simulation technology (physical vs VR simulator) affected solely the cognitive-action information flow from the right prefrontal cortex to the left primary motor cortex; however, the interaction between the medical simulation technology) and the skill level affected the efference information flow from the left primary motor cortex to the right prefrontal cortex and from the supplementary motor area to the left prefrontal cortex. These discriminative findings are crucial since our VR simulator had face and construct validity. Therefore, our study highlighted the importance of efference information flow within the framework of the perception-action cycle when comparing medical simulation technology for visuomotor skill acquisition.

Simulation Training and Coordination of the Results of Mastering Educational Programs in a Medical University

Trends to improve international quality standards for medical education dictate the need for the proper application of methods for coordinating the results of the development of educational programs.The introduction of methodological approaches for coordinating the results of mastering educational programs, as well as the founding of two medical simulation training centers and their functional integration into the educational system of the Yerevan State Medical University after M. Heratsi served as a serious help for improving the quality of educational services.

Stress responses in high-fidelity simulation among anesthesiology students

Simulation sessions can produce high-fidelity emergency situations that facilitate the learning process. These sessions may also generate a complex stress response in the learners. This prospective observational study assessed psychological, physiological, immunological, and humoral levels of stress during high-fidelity simulation training. Fifty-six undergraduate medicine students who took part in a medical simulation session were assigned team roles (physician, nurse or assistant). Subsequently, each participant was assessed before the scenario (T0), after the procedure (T1), and two hours later (T2). Psychological stress and anxiety were measured at T0 and T1, using the State-Trait Anxiety Inventory (STAI) and Dundee Stress State Questionnaire (DSSQ). Cortisol, testosterone, secretory immunoglobulin class A (sIgA), alpha-amylase, and oxygen saturation level were measured at T0, T1, and T2, as was the physiological response indicated by heart rate (HR) and blood pressure (BP). It was found that the onset of task performance was related to increased anticipatory worry and higher oxygen saturation. The participants reported decreased worry, followed by increased emotional distress after the simulation training (T1). Participants trait anxiety predicted the intensity of worry, distress and task engagement. In contrast, no clear relationships were found between trait anxiety and biological stress markers. Testosterone levels were growing significantly in each phase of measurement, while physiological responses (BP, HR) increased at T1 and declined at T2. The levels of stress markers varied depending on the assigned roles; however, the trajectories of responses were similar among all team members. No evidence for prolonged cortisol response (T1, T2) was found based on psychological stress at the onset of simulation (T0). Regression analysis followed by receiver operating characteristics analyses showed uncertain evidence that initial state anxiety and worry predicted the levels of sIgA. Medical students are relatively resilient in terms of stress responses to medical simulation. The observed stress patterns and interrelationships between its psychological, physiological, hormonal, and immunological markers are discussed in accordance with theoretical concepts, previous research work, and further recommendations.

WHAT IMPACT CAN SIMULATIONS HAVE IN ADVANCING MEDICINE?

Simulation, defined broadly, refers to an artificial representation of a real-world object, event or process. The representation of organ systems and pathology through art, literature and theatre, can be viewed as the earliest predecessors to medical simulation.

Modern technologies in teaching obstetrics. About students' attachment to simulation training

The authors of this article describe the experience of applying of simulation technologies in the curriculum in a medical university. The article discusses the methodology of practical training in obstetrics on the platform of a simulation center. The article also presents the results of the study that reveals students ' opinion about the role of the medical simulation training and its place in the educational process.

Development of a novel global rating scale for objective structured assessment of technical skills in an emergency medical simulation training

Background Medical simulation trainings lead to an improvement in patient care by increasing technical and non-technical skills, procedural confidence and medical knowledge. For structured simulation-based trainings, objective assessment tools are needed to evaluate the performance during simulation and the learning progress. In surgical education, objective structured assessment of technical skills (OSATS) are widely used and validated. However, in emergency medicine and anesthesia there is a lack of validated assessment tools for technical skills. Thus, the aim of the present study was to develop and validate a novel Global Rating Scale (GRS) for emergency medical simulation trainings. Methods Following the development of the GRS, 12 teams of different experience in emergency medicine (4th year medical students, paramedics, emergency physicians) were involved in a pre-hospital emergency medicine simulation scenario and assessed by four independent raters. Subsequently, interrater reliability and construct validity of the GRS were analyzed. Moreover, the results of the GRS were cross-checked with a task specific check list. Data are presented as median (minimum; maximum). Results The GRS consists of ten items each scored on a 5-point Likert scale yielding a maximum of 50 points. The median score achieved by novice teams was 22.75 points (17;30), while experts scored 39.00 points (32;47). The GRS overall scores significantly discriminated between student-guided teams and expert teams of emergency physicians (p = 0.005). Interrater reliability for the GRS was high with a Kendall’s coefficient of concordance W ranging from 0.64 to 0.90 in 9 of 10 items and 0.88 in the overall score. Conclusion The GRS represents a promising novel tool to objectively assess technical skills in simulation training with high construct validity and interrater reliability in this pilot study.