Проблемы обучения слушателей с ментальными нарушениями в медицинском ВУЗе

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Currently, for training and self-realization in the professional field of students with disabilities and/or HIA, comprehensive support of all interested parties is needed, using various technologies and information resources. The learning process must be built taking into account the psychophysical characteristics of this category of students, taking into account the peculiarities of various nosology’s, as well as the specifics of the educational process of a particular university, in our case, medical. An important component is a serious psychological and pedagogical training of doctors-teachers, and the creation of a special moral and psychological climate in the teaching staff and in the group of students. Here it is obviously necessary to pay attention to individual work with each student, the development and formation of his personal and professional qualities.

In the system of vocational training of students with special mental development, it is necessary to pay attention and take into account their individual work opportunities, cooperation relations with each other and with the teacher; create situations of success about the achieved result, pride in overcoming difficulties.

At the Ryazan State University named after Academician I.P. Pavlov, the Department of Nursing is training young people with mental development peculiarities aged 18 to 25 years according to an additional general development adapted program «Care in the provision of social services to the elderly, including those with disabilities».

In the course of training, the rules of ensuring a safe environment in the provision of social services, technologies for performing care manipulations and the use of technical means of rehabilitation are studied. At the final lesson, students demonstrate their knowledge and skills on mannequins. Upon completion of the training, the students shared their impressions and expressed their readiness to be included in the labor force [1, 2, 3, 4].

Students acquire skills in caring for bedridden and low-mobility patients:

- study the algorithm of hand processing;

- learn how to wear personal protective equipment correctly;

- acquire the skills of feeding a bedridden patient;

- master the skill of changing sets of bed linen in several ways;

- consider ways to help mobility-impaired patients.

Classes are held in a classroom equipped with simulation devices and mannequins. The training takes place in a group and individually with each student. In the process of vocational training, the following main tasks are solved: to teach students to navigate in various life situations; to form their skills to work in a team; to develop independence and responsibility; to form motives and interests for household activities; to increase self-esteem; to carry out professional training that allows graduates to find a job.

The achievement of these results provides purposeful and individualized pedagogical support:

- possession of psychological and pedagogical methods and technologies necessary to work with students of different nosology’s;

- psychological orientation to provide professional assistance to any student;

- individualization of the learning process;

- the ability to use special approaches, pedagogical technologies and methods of professional training.

Goal. However, as the teachers themselves note, they still do not have enough knowledge, skills and experience of working with students with special mental development. In order to identify such difficulties and improve the efficiency of the university teaching staff during the implementation of programs for the professional training of students with disabilities or HIA, a research work was carried out, in which teachers of the Department of Nursing of the Ryazan State Medical University named after I.P. Pavlov took part.

Materials and methods. The following methods were included in the diagnostic complex of the study: questionnaire, oral survey, diagnosis of professional «burnout» (K. Maslach, S. Jackson), diagnosis of the level of emotional burnout (V.V. Boyko), questionnaire «Self-feeling – activity – mood», scale of assessment of the level of reactive and personal anxiety (C.D. Spielberger, Y.L. Khanin), a test for objectivity [2, 3].

Results and their discussions. Analysis of the results of the psychodiagnostic methodology for identifying the level of professional «burnout» shows that all teachers (100 %) have low levels:

- emotional exhaustion, i.e. reduced emotional background;

- depersonalization, reflecting deformations in relationships with other people;

- reduction of personal achievements, manifested in a decrease in self-esteem, underestimation of one's professional achievements, negative attitudes towards professional opportunities or limitation of duties towards subjects of professional activity.

Thus, we can state that none of the subjects have professional «burnout» (the average age is 40 years) it has not been revealed and they can continue to successfully carry out their professional activities.

Using diagnostics of the level of emotional burnout (V.V. Boyko), we found out that the most developed symptoms of «burnout» are «inadequate selective emotional response», «reduction of professional responsibilities», «emotional detachment», «emotional and moral disorientation». The formation of these symptoms may indicate that teachers control the influence of mood on professional relationships; they have the development of indifference of professional relationships; curtailing professional activity, striving to spend as little time as possible on performing professional duties; creating a protective barrier in professional communications. Thus, it can be stated that 66 % of respondents have stress in the formation phase.

When interpreting the results of the self-assessment test of the level of anxiety at the moment (reactive anxiety as a condition) and personal anxiety (as a stable characteristic of a person), we observe that 45 % of teachers have a low level of anxiety, and 55 % have high anxiety. In our opinion, such indicators indicate the tendency of teachers to develop a state of anxiety in situations of assessing their competence, and requires the formation of a sense of confidence in success.

Analyzing the results of the «Well-being – activity – mood» methodology, which is designed for a comprehensive assessment of the prevailing mood of a person), we can draw the following conclusion: all teachers (100 %) have an average score in the range from 5 to 7, which indicates a dominant good mood among them, which should prevail among people of this profession.

The results of the objectivity test indicate that almost all teachers (99 %) objectively know how to evaluate others and are not afraid to admit their mistakes in this matter; 1 % of the subjects easily form an opinion about people and just as easily tell the person to whom this opinion applies. However, there is a lot of subjectivity and excessive self-confidence in their judgments about people. It can be concluded that almost all teachers are equally unbiased and objective towards all students, including those with disabilities and/or disabilities.

Conclusions

So, analyzing the data of test methods, it can be stated that the emotional state of teachers working in a group with students with mental disabilities is relatively stable, it is possible to manifest states of insecurity, anxiety and stress, which may affect the desire and willingness to carry out training and interaction with students with disabilities and disabilities. Therefore, a set of measures is needed to improve the skills and help teachers to reduce psycho-emotional costs and increase stress tolerance.

Based on the questionnaire and oral survey, teachers have a great need for special psychological training, pedagogical knowledge in the field of methods of organizing the educational process, providing effective training and interaction with students with mental development characteristics, and are also not always emotionally ready for the behavioral characteristics of such students, for example, in situations of anger and aggression on their part.

When implementing the program «Care in the provision of social services to the elderly, including those with disabilities», teachers must know and take into account the characteristics of students with mental disabilities. Such features include: lag in the timing and pace of development; inertia, passivity in various spheres of life; underdevelopment of motor and speech functions; decreased cognitive interest; violation of the emotional-volitional sphere, etc. [5].

Therefore, teachers should pay more attention to the development of practical skills according to the scheme of repeated repetition «repetition – manipulation – consolidation – bringing to automatism»; the development of memory and fine motor skills; the performance of collective tasks. It is necessary to include game and individual teaching methods in the learning process, to develop reference schemes and notes for home preparation.

In this regard, we can offer the following recommendations to the teaching staff of the university:

1. To bring to the attention of all teachers working in groups of students with mental development disorders, the peculiarities of their personal development, in particular the development of their cognitive sphere; the state of their emotional sphere, behavioral stereotypes. And also to acquaint teachers with the results of psychological and pedagogical diagnostics of their learning difficulties.
2. To organize professional development of teachers according to the programs of pedagogical support of students with disabilities and HIA: DPP PC Tutor support of students with disabilities and disabilities; DPP PC Organization of the educational process for teaching people with disabilities and disabilities; DPP PC Methodology of organizing the educational process for teaching disabled people and people with disabilities in medical educational organizations [1].
3. Take part in conferences and round tables in order to exchange work experience with students with disabilities and HIA.
4. To develop methodological recommendations on the use of pedagogical technologies, effective methods, techniques and tools in teaching students with mental disorders, taking into account their individual educational route.

Thus, the problem of vocational training of students with mental disabilities, their adaptation to work, the application of acquired skills in the household sphere is quite relevant today. To do this, it is necessary to create a number of psychological and pedagogical conditions that guarantee the effective and comfortable development of training programs by students themselves, as well as professionally and emotionally attuned teachers.

Additional info

Author contribution. All authors made a substantial contribution to the conception of the work, acquisition, analysis, interpretation of data for the work, drafting and revising the work, final approval of the version to be published and agree to be accountable for all aspects of the work.

Funding source. This study was not supported by any external sources of funding.

Competing interests. The authors declare that they have no competing interests.

Дополнительная информация

Вклад авторов. Все авторы подтверждают соответствие своего авторства международным критериям ICMJE (все авторы внесли существенный вклад в разработку концепции, проведение исследования и подготовку статьи, прочли и одобрили финальную версию перед публикацией).

Источник финансирования. Авторы заявляют об отсутствии внешнего финансирования при проведении исследования.

Конфликт интересов. Авторы декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с публикацией настоящей статьи.

Об авторах

Алла Николаевна Жолудова

Рязанский государственный медицинский университет им. академика И.П. Павлова

Email: a.n.zholudova@yandex.ru
ORCID iD: 0000-0003-4779-1455

кандидат педагогических наук, доцент, доцент кафедры психологии, педагогики и инклюзивного образования

Россия, Рязань

Дмитрий Николаевич Оськин

Рязанский государственный медицинский университет им. академика И.П. Павлова

Email: doctorozzz@gmail.com
ORCID iD: 0000-0001-8966-2702

кандидат медицинских наук, доцент, начальник Ресурсного учебно-методического центра по обучению инвалидов и лиц с ограниченными возможностями здоровья, декан

Россия, Рязань

Олеся Витальевна Полякова

Рязанский государственный медицинский университет им. академика И.П. Павлова

Email: kpptso@bk.ru
ORCID iD: 0000-0002-8670-9066

кандидат педагогических наук, доцент, доцент кафедры психологии, педагогики и инклюзивного образования

Россия, Рязань

Евгений Геннадьевич Вершинин

Волгоградский государственный медицинский университет

Автор, ответственный за переписку.
Email: werschinin_eugen@list.ru
ORCID iD: 0000-0002-5169-0051

кандидат медицинских наук, доцент, заведующий кафедрой медицинской реабилитации и спортивной медицины, начальник отдела инклюзивного образования

Россия, Волгоград

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