Higher education plays an exceptionally important role in socio-economic and technological progress and in the development of human potential, primarily by addressing the challenges of universal literacy, training future specialists, and shaping a generation committed to peace, mutual understanding, tolerance, and democracy.
The modern education system, in terms of its significance and its impact on other socio-economic and sociocultural spheres, is one of the most important and priority areas. UNESCO’s policy in the field of higher education includes a strategy for educational activities, its legislative and regulatory framework, and educational practice, which together make it possible to integrate educational processes at both the national and international levels.
The UNESCO meetings held in 2009 and again in October 2013 on the development of higher education emphasized that academic mobility, including the cross-border provision of educational services, constitutes an essential factor in enhancing the quality and effectiveness of higher education. It should be noted that modern education must not only rely on the latest advances in a given field of knowledge, but also be technologically oriented, ensuring the achievement of clearly defined outcomes. Such an approach is impossible without the timely acquisition of feedback and the implementation of subsequent corrective measures based on that feedback [1, 3].
Higher medical education in Ukraine is currently undergoing a period of reform. The overall direction of these reforms is guided by the political commitments of the Bologna Process. All countries participating in the Bologna Process regard the convergence and “harmonization” of national higher education systems as one of the most important components of higher education development, aimed at supporting academic mobility and joint educational programs. These, in turn, serve as key instruments for enhancing the quality of education and scientific research [2, 3].
The lack of pedagogical experience in enhancing the training process for algorithmic problem solving, as well as the challenge of effectively addressing situational tasks based on linear algorithms within the cycle of therapeutic subjects, is compounded by the absence of a unified, standardized, and high-quality textbook in Ukraine. This significantly complicates the development of various versions of situational tasks using different logical frameworks [4].
Research in the field of teaching internal medicine and therapeutic disciplines in medical universities and postgraduate education institutions demonstrates that improving interns’ scientific and humanitarian competencies requires the introduction of new approaches, the development of innovative methods, and the application of modern tools and formats of instruction. These measures aim to make the learning process more engaging and to actively enhance students’ personal knowledge systems.
Independent preparation for solving clinical tasks – taking into account the nuances of clinical, laboratory, and instrumental diagnostic indicators, as well as the subtleties involved in the initial logical selection of pharmacotherapy – enables the practitioner to determine the primary or supportive course of treatment and disease prevention for an individual patient, in both mono-therapy and complex etiopathogenetic therapy [4].
Radical changes in teachers’ attitudes toward testing students and interns according to a universally recognized standardized system occurred with the introduction of the unified state examinations “Krok 1, Krok 2, and Krok 3,” through which testing received official recognition in Ukraine. Over the years of implementation, the level of trust in test results among educational institutions and educators themselves has increased significantly, as they became convinced of the high objectivity and validity of the assessments. It has been established that the integrated use of test items with a single correct answer, combined with computer-based programs for educational purposes, makes it possible to implement the main functions of assessment (evaluative, instructional, developmental, and motivational) and to ensure its systematic, objective, and differentiated nature [1, 4].
Computer-based testing offers several advantages over traditional paper-based testing. Presenting test items on a computer helps reduce costs typically associated with printing and transporting paper test materials. Traditional methods of ongoing assessment are less effective and are primarily aimed at checking and systematically evaluating the knowledge of students and interns when the volume of educational material is limited. Computer testing, however, enhances information security and prevents test leakage due to the high speed of data transmission and the specialized protection of electronic files. The calculation of final scores is also simplified in cases where the test consists solely of multiple-choice items [3, 4].
Additional advantages of computer-based testing are evident in ongoing assessment, self-assessment, and self-directed learning for interns. The use of computer technologies allows for the immediate provision of test results and the timely implementation of corrective measures based on protocol analysis and the outcomes of diagnostic and remedial testing. The pedagogical potential of computer testing is further expanded by broadening the range of measurable abilities and skills through innovative types of test items that utilize various technological features – such as audio and video integration, interactivity, dynamic problem formulation, and the use of multimedia tools [4].
Computer-based testing also has several disadvantages. When designing computer tests, it is necessary to take into account that certain medical terms are difficult to formalize and often cannot be fully represented within the concise format of a test item. Therefore, the instructor’s work should also focus on eliminating or minimizing the influence of such features on the assessment of a physician’s fundamental knowledge. Negative reactions are often caused by various restrictions imposed during computer testing. For example, the order in which tasks are presented or the maximum allowable time for completing each item may be fixed, after which the next item appears automatically, regardless of the test-taker’s preference. In adaptive testing, interns may express dissatisfaction due to the inability to skip items, review the entire test before beginning it, or change answers to previously completed tasks [3, 4].
To enhance the theoretical and practical competencies of future physicians, modern methods of teaching clinical disciplines within the postgraduate education system rely on the use of various computer models and technologies. At the Department of Internal Medicine No. 1 of Kharkiv National Medical University, this issue is being addressed in several key areas, the most significant of which include the development and implementation of educational and assessment computer programs, as well as the integration of medical and diagnostic software. According to contemporary perspectives, medicine is fundamentally a set of technologies – diagnostic, therapeutic, pharmacological, surgical, and others – and physicians, as scientists, are expected to possess up-to-date knowledge of innovations emerging at various stages of medical development.
We contend that, in order to be competitive, an intern must not only possess the ability to think critically like a physician – distinguishing the obvious from the intriguing, probability from reality, rational reasoning from bias, facts from unsupported claims, theory from dogma, and serendipitous events from crises – but also be capable of applying acquired theoretical knowledge comprehensively and with a high level of skill and professionalism in practical settings.
The implementation of standardized computer-based testing methods, the resolution of clinical tasks related to the most common therapeutic pathologies, as well as the development of a unified program-methodological complex of training and assessment tools, and the formulation of a methodology for evaluating interns’ knowledge and skills through a computer system, will contribute significantly to enhancing the quality of medical training.
References:
1. European Ministers Responsible for Higher Education. (2009). The Bologna Process 2020 – The European Higher Education Area in the new decade: Communiqué of the Conference of European Ministers Responsible for Higher Education, Leuven and Louvain-la-Neuve. ehea.info/media.ehea.info/file/20090223-Ostend/54/2/BFUG_Board_CZ_19_4_draft_communique_200209_594542.pdf.
2. Daudet, Y., & Singh, K. (2001). The right to education: An analysis of UNESCO's standard-setting instruments. UNESCO
3. World Federation for Medical Education. (2020). Basic Medical Education WFME Global Standards for Quality Improvement: The 2020 Revision. https://wfme.org/wp-content/uploads/2022/03/WFME-BME-Standards-2020.pdf.
4. Centers for Medicare & Medicaid Services (CMS). (2024). Guidelines for Teaching Physicians, Interns & Residents (MLN006347). https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/mln-publications-items/cms1243499
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