Business game as a factor of increasing the effectiveness of the educational process in the professional retraining of doctors

Rogacheva Ol'ga Viktorovna ORCID: 0000-0002-5961-2576 Assistant of the Department of Public Health and Public Health (with courses in Law and History of Medicine), Saratov State University named after V.I. Razumovsky 410012, Russia, Saratovskaya oblast', g. Saratov, ul. Ul. B. Kazach'ya, 112 766saratov.olga@mail.ru

Introduction

The requirements for the professional activities of employees, including doctors, are constantly changing, which encourages them to actively self- and responsibly improve and replenish knowledge and skills. Training and self-development are the most important factors of human development, both as an individual as a whole and as a qualified employee, which in turn contributes to the improvement of professional productivity and economic efficiency of Russian society.

To date, additional professional adult education involves the expansion and updating of knowledge, as well as the acquisition of new professional skills and competencies. In modern conditions, the formation of competencies is a priority activity of almost all educational institutions ^[1].

The demands on the part of the population for the quality of medical care, the use of the latest methods and technical means of treatment are increasing, which in turn requires the training of medical personnel at a new, modern professional level.

Theoretical analysis

New requirements for professional retraining programs lead to the search and improvement of methods and forms of its organization. As a result of professional retraining, through the development of additional professional educational programs, the specialist receives additional qualifications based on the previously obtained specialty ^[2].

To implement the goals set for professional retraining, it is necessary to take into account organizational and pedagogical conditions, which are a set of forms, methods of organizing the learning process and conditions that ensure its implementation.

The study of the issues of professional retraining of doctors shows that the forms and methods are not always focused on the formation of personal responsibility and the involved attitude of students in the educational process. Often, active training methods based on rethinking one's own experience are not fully justified and implemented in professional retraining.

It can be assumed that it is active teaching methods that encourage trained doctors to independently understand complex professional issues and develop optimal solutions for their application in practice. But not always when using active teaching methods in the organization of the retraining process of doctors, attention is paid to the degree of their interest and involvement in the educational process.

Do not forget that professional retraining is a learning process.

Thus, in the process of professional retraining of doctors, all the main elements of the pedagogical system according to V. P. Bespalko can be distinguished: the student, the teacher, the content of training, the goals of training, the learning process ^[3].

However, this description is not enough to identify resources for solving the tasks assigned to professional retraining, such as: improving practical orientation, analyzing one's own experience.

Based on this, we have proposed to the trained doctors an algorithm of the business game using the method of analysis of products of activity.

In the process of professional retraining, the research aspect of the application of the product analysis method is quite rare, although it would allow the researcher to compare his own experience with the experience of colleagues. Therefore, we have developed tasks and applied them in the process of training doctors, in the form of a business game.

Studying the experience of many domestic and foreign authors in the practical application of business games, we came to the conclusion that there are a large number of varieties and conditions for the use of games.

The first American business games modeled the activities of enterprises producing a product, these were mainly "market games" that did not reflect the decision-making process, and attention was paid to choosing from several ready-made solutions. Decisions in such games were calculated according to certain mathematical models, as a result, players were informed about the results of their actions.

Business games are actively used in the UK, Germany, Canada, France, Poland, Japan and in some other countries.

Currently, the use of business games is very common all over the world.

More and more new reference books on business games, manuals, catalogs are being published, conferences and seminars are regularly held. The International Association for Simulation Modeling and Business Games has been established and is actively developing.

The game is considered from the standpoint of philosophy, psychology, pedagogy and sociology. Even the ancient Greek philosophers Plato and Aristotle drew attention to the phenomenon of play as a pedagogical technique ^[4].

Business games are also used very actively in the education system.

The business game in training has been used for many stages of human development, but more actively the business game began to manifest itself as a form of learning since the early 1960s. Yu.K.Babinsky believed that the cognitive game, which relies on the creation of game situations in the educational process, is a valuable method of stimulating interest in learning, that is, a means of arousing interest in studying. ^[5].

David Kolb's classical theory of learning through experience can be applied to cognitive activity in business games ^[6]. It is a kind of cycle, or rather, learning through experience, reflection and analysis of existing experience and knowledge, acquisition of new experience, evaluation of acquired experience, assimilation of new knowledge and skills and their application in practice ^[7].

If we apply David Kolb's theory to our business game, then the first step will be to realize that some knowledge or experience is missing, then the acquisition of knowledge through learning something new, followed by an analysis of the results obtained. At this moment, the trained doctors have the birth of new knowledge from newly acquired experience. The next step is to understand that this knowledge and experience can be applied when planning the next steps in the work. And, finally, the application of acquired knowledge in practice, and the acquisition of subsequent experience.  

An important element of the learning model or (the Flask cycle) is reflection.

In many foreign and domestic psychological and pedagogical studies, reflection is shown as a characteristic of human thinking, which includes rethinking personal experience by drawing conclusions, generalizations, comparisons and assessments, as well as reflecting states, relationships, experiences, when performing actions, and discussing any processes. That is, it includes conceptual (cognitive), emotional and behavioral parts.

For example, according to the outstanding Soviet and Russian philosopher and methodologist, G.P. Shchedrovitsky, reflection is an act of activity about the connection or structure of communication between two, at least, individuals ^[8], in our case, activity is understood as the educational process.

Reflection is an element of great importance in learning, and, consequently, in the application of educational business games.

Having analyzed the complex of gaming technologies of V. P. Bespalko, we see that business games are an effective and efficient method of teaching, which contributes to the rapid assimilation and consolidation of new material, increases the development of creative abilities, and also allows you to study the material from different positions.

Researchers Ya.M. Belchikova A.A., Verbitsky, V.M. Efimova, V.N. Burkova, R.F. Zhukova, V.Ya. Platova, V.F. Komarova, V.I. Marsheva and others also made a great contribution to the development of the game method.

Consequently, the business game can occupy a worthy position in the process of professional training and retraining of employees and increasing their human potential.

An important point in conducting a business game in the professional retraining of doctors is the modeling of processes, issues and problems of professional activity in conditional or real situations of their professional activity. The main motive of the business game is not the result, but the process itself, in which the participants will be involved.

The use of business games based on the analysis of difficult professional issues in the training of doctors can serve as a tool for involvement in the educational process, enhance the degree of activity of students, thereby increasing the effectiveness of training ^[9].

Empirical analysis

Considering that any business game consists of a number of stages: the preparatory stage, the stage of entering the game, the game itself and exiting the game, we have developed and conducted a business game according to a pre-prepared plan.

As a problem field, doctors were offered, as experts, the difficult situations assumed by medical students that they may encounter in their professional activities, identified as a result of their questionnaire. The students' answers were just offered as products of activity in a business game. The students were fourth-year students of the medical faculty of the Saratov State Medical University named after V.I.Razumovsky (N=200) and already had practical experience in providing medical care in medical organizations during their internship. At the same time, 72% of respondents indicated the presence of certain difficulties, in their opinion. The expert doctors had to confirm or refute the presence of situational difficulties that the students stated and assess their degree of significance: low, below average, medium, above average and high. 

We have selected six main and frequently repeated problematic situations according to the answers of the student questionnaire: difficulties in diagnosis; underestimation (decrease in the prestige of the doctor's profession); the degree of commitment of patients to follow the recommendations in treatment from a doctor (ungrateful patient); complexity, intensity of professional activity (psychological difficulties); the likelihood of encountering problems related to the characteristics of patients (communication difficulties); responsibility in the medical profession ^[10].

In a comfortable and friendly environment, doctors undergoing professional retraining on the basis of the Center of the Saratov State University named after V.I. Razumovsky, Department of Public Health and Public Health (with courses in Law and History of Medicine) (N=20) were asked to divide into two teams of 10 people, analyze and evaluate the preliminary responses of students in groups ^[11].

Then there were intra-group discussions of problematic issues. Doctors, in the role of experts, assessed how true the difficulties noticed by the students were.

We assumed that doctors might disagree with the difficulties that the students identified. It was a risk that our experimental business game could have ended at this stage. But this did not happen, all the participants confirmed the presence of certain complex issues encountered in the medical profession, left their comments and actively suggested solutions. This indicates that they were interested in the process, and the immersion in the game was successful.

The next stage was a general discussion between the groups, in which doctors shared their opinions based on their professional experience. During the discussion, teachers were asked for help and explanations of certain difficulties, which indicates their own initiative in obtaining new professional knowledge, that is, it is an indicator of the cognitive aspect ^[12].

The presence of difficulties in diagnosis was confirmed by 80% of doctors, assessing this problem as medium–significant – 60% and highly significant - 20%.

Underestimation (decrease in the prestige of the medical profession) was confirmed by 87% of doctors, where they chose the average value of the degree of significance of this problem – 40%, it was rated above average – 20% and high – 27%.

The degree of patients' adherence to the doctor's recommendations during treatment (ungrateful patient) was confirmed by 74% of experts, assessing the problem as medium–significant – 40%, above average – 7%, high - 27%.

The complexity and intensity of professional activity (psychological difficulties) were confirmed by 100% of doctors, while 60% of them indicated the significance of this problem above average.

In professional medical activity, 80% of experts confirmed the probability of encountering problems related to the characteristics of patients, with limited reception time and communication difficulties, while they rated the problem as medium–significant 27%, above average – 33%, highly significant - 20%.

The problem of responsibility for the results of a doctor's professional activity was confirmed by 100% of experts, assessing it in 87% of cases as highly significant, 6% as average significant and 7% above average significant.

According to the responses of the participants of the business game, we see confirmation of the presence of problems in the professional activity of doctors in average values, above average and of a high degree of significance. And this once again confirms their presence.

As a result, the business game is a general reflection. In our study, all aspects of general reflection are observed: analysis of one's own experience; desire to learn more; involvement in the discussion; emotional discussion; suggested solutions; active participation of doctors in the role of experts.

It is also important to note the role of teachers who helped the participants to connect all aspects of reflection together. Teachers participated in discussions, helped to sort out difficult and controversial issues, and generally maintain a friendly atmosphere. Thanks to this, the exit from the game was with positive emotions, despite the fact that problematic issues were discussed.

Our business game was used to create communicative training models. We achieved a positive result, because all participants showed their involvement in the learning process, and also confirmed the existence of problems that were proposed as a problem field.

Conclusion and conclusions

A business game using the analysis of products of activity has proved to be an effective method of teaching doctors.

According to our observations of the process of training doctors undergoing professional retraining, students are more actively involved in the educational process in practical classes held in the form of business games. It is at such classes that doctors have the opportunity to express their opinions, share professional experience, discuss work situations and difficult moments that arise in the course of professional activity. The lecture material is certainly interesting and enriches knowledge, but doctors note the positive side of the training sessions, which help to link theoretical knowledge with practical activities.

In addition, the business game served as an incentive for the reflection of doctors who used their experience and the experience of colleagues in the process of expert activity in the business game. This method of training helps to increase their interest and increase their interest in the process of professional retraining, which is an indicator of the effectiveness of the educational process.

The results of the business game confirmed the existence of problems identified by medical students in their questionnaires, which will be further taken into account and used by the teachers of the department in the process of teaching students and forming their professional competencies, which is new and interesting in the application of such practices.