The use of case method in the learning process of advanced training courses for medical workers in Ukraine and worldwide
Written by Tatiana Iarmak – http:// orcid.org/0000-0001-5371-2958; email@example.com; Lecturer of the Department of Advanced Training of Junior Medical Specialists at the Municipal Health Care Institution “Kharkiv Regional Medical Vocational College”, Kharkiv, Ukraine.
Key words: Case method, case study, interactive technologies, education, educational process, innovations, medical workers
The aim of the study:
Show the importance of applying the case method in the educational process of advanced training courses for health professionals as a method of correlation between theory and practice which activates and optimizes the educational process; develop an ability to analyze; to draw conclusions, make independent decisions in particular in critical, atypical situations; form critical thinking; build confidence in making responsible decisions which will result in improving the professional level of every health worker.
This article researches the use of case method in the learning process of advanced training courses for medical workers; displays the results of the optimization of the learning process using the case method and the prospects of their use in the learning process. The case method is an interactive technology aimed at forming new qualities and skills in students. Nowadays the case method is actively used in leading educational institutions in Europe and America and has its specifics of use in teaching of various disciplines. The case method is a specially prepared educational and methodical material which contains a structured description of situations taken from real practice. It is based on the solution of a specific problematic situation on the basis of a real case – a situational task. For medical workers, this is a real medical situation which is presented in the form of an educational task. For example, a real clinical case where a doctor or a nurse needs to diagnose a patient – prescribe tests, examination methods, treatment. Or it can be a case from medical practice during surgery, childbirth etc. The case method activates mental activity, reveals and improves students’ learning abilities, creates conditions for creativity, increases the ability to analyze information, develops professional competence, ability to solve various problems, expands the scope of understanding of real situations at work. Students learn how to communicate, discuss, express their opinion, find the most correct and effective solution to the problem. This method has a great educational potential.
The case method first originated in 1870 in Harvard Law School. In 1912 the Harvard School of Business introduced a compulsory course – a method of situational analysis called “The Art of Doing Business”. Students were given tasks and offered different solutions. It was necessary to choose the optimal one. The students were solving existing practical problems during classes. In Harvard, this method is called “situational decision-making exercises”. Today it is used in the educational process of many educational institutions around the world in almost all fields.
The Case Clearing House of Great Britain and Ireland (European Case Clearing House (ECCH) since 1991), established in 1973 at the initiative of 22 higher education institutions is the leader in collecting and distributing cases. ECCH is a non-profit organization that is affiliated with organizations located in different parts of the world which spreads and uses case studies. ECCH currently consists of about 340 organizations, including The Harvard Business School Publishing, the London Business School in England, INSEAD, Fontainebleau in France, the Institute for Management Development (IMB) in Lausanne, Switzerland, the School of Management in Cranfield IESE in Barcelona, Spain. Each of these organizations has its own collection of unique cases, which ECCH has the right to distribute.
Specialists of the School of Public Administration J. Kennedy of Harvard University at the National Academy of Public Administration under the President of Ukraine (formerly the Institute of Public Administration and Local Self- Government) presented the case method in Ukraine in 1992. In 1996, the Center for Innovation and Development introduced the case method into the Ukrainian education system. In recent years, Ukraine has been paying more and more attention to innovative technologies in education. The need for innovative interactive approaches to learning is due to the intensity of information flows. Innovation in the educational process is a necessity. Modern innovations help to increase the efficiency of the educational process. Interactive learning technologies are one of the most effective modern methods for improving the quality of education, so the introduction of the “case method” or “situational methodology” in the practice of modern education is very important. Case study is becoming one of the promising learning technologies as it is aimed at the development of professional competencies and improvement of professional skills. According to the Strategy for the Development of Higher Education in Ukraine for 2021-2031 “The mission of higher education is to ensure sustainable innovative development of Ukraine through the training of highly qualified specialists, the creation and dissemination of knowledge …”; “Priority principles of higher education development in Ukraine: professionalism, focus on achieving the highest quality of education …”.
In medical education, at the training courses for health professionals, the essence of the method consists in the following – the students are offered a real clinical situation from their professional profile which can have several solutions. The main thing is to find the best, most effective, i.e optimal solution to the problem presented. Students are divided into groups. The group analyzes the situation, discusses possible solutions to the problem for that finds out the causes of certain symptoms, makes up a plan of examination, suggests laboratory diagnostics, suggests a possible preliminary diagnosis, prescribes the most effective treatment, develops preventive measures and makes optimal decisions. When solving the problem the students are active, exchange their points of views, analyze, give advice which helps a group to come up with an optimal solution to the problem and accelerates the uptake of the material. The peculiarity of the case method is that the problematic situation is created on the basis of a real clinical case, so that the students gain practical experience in solving problems with further use in the work. Thanks to the case method, the learning process is organized in a new way that students become active participants, motivated and involved in vivid discussions. It is a creative insightful process and at the same time a complex system, which includes modeling, method of a problem-based learning, imaginary experiment, method of description. The introduction of the case method or case study changes the role of the teacher – a teacher becomes an expert – assistant guiding students in solving the proposed tasks.
The case method as an interactive method of teaching promotes the formation and development of creative clinical thinking in medical professionals. This method allows to unleash the potential of a doctor or nurse to think creatively from a professional point of view, considering the individual characteristics of each patient. Today it is necessary to make decisions quickly, especially in critical situations, to have ready-to-go methods of action, to own a situation. Every time prescribing treatment, examination diagnosing a patient, the doctor solves the case. The nurse participates in the treatment of the patient together with the doctor. She performs all medical procedures and manipulations prescribed by a doctor and is responsible for the quality of their conduct, which depends on her competence, skills and abilities. Therefore, a nurse should be able to make her “nursing diagnosis” and prescribe “nursing treatment”. Today, there are many definitions of a nursing diagnosis, which are recognized as a part of the professional activities of a nurse. “Nursing diagnosis” is “The patient’s state of health established as a result of a nursing examination and requiring intervention by a nurse” (Carlson, Kraft, & McGure, 1982). The Classification of Nursing Diagnoses (McLain) was first proposed in 1986. “A nurse must always perform her duties professionally, continuously improve their special knowledge and skills, improve their cultural level” (Article 3. “Code of Ethics for Nurses”). Competence, expertise, qualification of both the doctor and the the nurse allow to analyze clinical cases and situations in the best way and make an optimal decision. And the case method is of great help here.
The use of the case method or case study in the educational process of advanced training courses for health professionals is a necessity. It is very important in education for adults. Adults already have professional and life experience, skills, abilities, which contributes to a greater understanding of situational problems, their solution. The method allows to develop creative and critical clinical thinking in both the teacher and students; activates, stimulates, motivates to learn. The method opens prospects to significantly improve the quality of education, to fill the educational process with creative content. Advantages of use – interactivity, efficiency, optimization of educational process. Advantages of the case method – it develops problem-solving and decision – making skills, initiative, individual and collective responsibility, working with the team, argument skills to defend one’s point of view, improves communication and presentation skills, makes everyone an active participant, increases interest in the material learned, links theory with practice. The case study method brings novelty to the teaching and learning process and increases the efficiency of the educational process. The case method in the educational process performs such important functions as educational, analytical, research, training, prognostic.
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