Profession “general doctoral practice” requires mastership in methods and means of effective patient management, communicating to their relatives and colleagues in order to achieve mutual understanding that is necessary in solving not only treatment and diagnostic objectives, but also personal and family problematic situations that can have a significant effect upon the result of a certain pathology and life quality on the whole.
Developing specialized communicative skills on treatment-diagnostic area of surgery is one of the most important problems and the primary objective in training a doctor of general practice. It provides for a doctor’s responsibility for individual and social requirements in accordance with organic unity of knowledge, skills in regard to direct interaction with people and experience in solving new and known professional situational problems.
The problem of developing specialized communicative skills is an object of scientific search in foreign and domestic literature of the XX-XXI century, especially in surgery. Activation of research in this area is related to rising attention towards psychological components of professional activity, search for new means and methods of optimizing success in aspects of diagnostics and treatment [1].
Each doctor of general medical practice must develop their specialized communicative skills towards degree in which their work responds to requirements, placed before the final result of the profession. The final result of their work is the only method of evaluating a doctor’s mastership in specialized communicative skills. For example: in differential diagnostics of surgical diseases, positioning non-complicated dislocation of shoulder joint and lower jaw, other dislocations, required according to training programme for interns of general doctoral practice (GDP).
In developed countries of Europe a concept of “International Competence Baseline” – ICB is introduced in this regard. It presents requirements towards knowledge, experience, and personal qualities that form the foundation of certification programmes.
Goal and objective of our work: in order to ensure that future doctors of GDP receive specialized communication skills in surgery and traumatology during their internship training in years 6-7 of education and know that activity of intern doctor (future doctor of general practive) implies:
– necessity to work with contingent of people that suffer from health problems and are in state of emotional discomfort;
– work in intimate area of a person (examination of rectal and vaginal areas among surgical patients) that can cause unintentional tension and resistance;
– necessity to work with patients who do not have any knowledge in medicine and are not able to understand the importance of a certain examination adequately;
– examination of a person who suffers from constant pain, fear, and anxiety (for example: before instrumental examination or direction to surgical treatment);
– influencing psychological state of general practice doctor themselves [2].
Psychological image of “ideal doctor” in eyes of patients includes a number of qualities that describe the former from the position of setting an optimal contact that serves as a guarantee of successful solution of communicative professional problems that define possibility of realizing treatment-diagnostic measures successfully.
According to the revealed specific of GDP intern profession, we can outline requirements towards their mastership in communicative skills on surgery:
- High level of communicative self-control at the foundation of developing specialized profession of doctor;
- Developed tolerant empathy towards humanist attitude to patients of different age, social groups, and status;
- Development of ability to solve conflict situations in a constructive fashion;
- Maintenance of adequate behavior in a conflict situation;
- Developed skills of extracting patients from emotional condition in order to solve medical objectives adequately;
- Trained skills of psychological influence (verbal conviction and infusion) [3].
Developing specialized communicative skills on surgery is vital for an intern during the whole process of their professional activity. Mastering specialized communicative skills is a process of continuous, purposeful, consequent, and stage-based work between doctor and their patients, and must be learned at classes and internship practice of years 6-7 [4]. Training cases “Doctor-patient” are useful in practicing situation problems on surgery, at the same time students obtain experience in diagnostics and differential diagnostics of surgical diseases and treating ambulatory surgical and traumatological diseases. During internship doctors obtain specialized communicative skills of receiving patients in first aid station, receiving rooms, in surgical and traumatological rooms. Particularly, at this stage all skills that were formed earlier, must obtain a stable nature [4–7]. In this regard practical classes also facilitate business games, analysis of solving clinical situational problems, analysis of patients with different cases. A direct observation with tutor’s comments on weak and strong aspects of practice stimulates development of specialized communicative skills of intern doctor.
Materials and methods: we have selected two groups of intern doctors who took training in surgery during years 2010 and 2016 with one assistant surgeon in different medical institutions, for example, 10 groups (100 people) in 2010 at the base of policlinic №1 that does not have a separate traumatological room, therefore, specialization in communicative skills could be received only on diagnostics and treatment of surgical diseases. From the graduation of 2016 of 10 intern groups (100 people) took practical training in receiving room, first aid station, and in policlinic rooms. According to statistic data, received in analysis of operating doctors of graduation years 2010 and 2016, 10 % of the latter have become military surgeons, organizers of first aid and policlinics in different cities of Kazakhstan. The research was organized as a phone and e-mail questioning.
Conclusion
The results of questioning (feedback) intern doctors in regard to the received practical skills in surgery, are discussed at department meetings. Doctors of general practice who took training at the base of united railroad hospital and policlinic, have mastered communicative skills in surgery and are able to implement their knowledge in different regions of Kazakhstan as military surgeons, first aid and policlinic organizers.
Sanitary enlightenment during practice, for example, reports of intern doctors on preventing purulent surgical and other types of diseases at sites of railroad production had a significant positive effect upon forming communicative skills.