Continuity of professional education: complementarity coaching and self-design of dental specialists

Kalinina Yuliya Vladislavovna ORCID: 0000-0001-7028-4991 Chief specialist of the Educational Activities Department, National Medical Research Center. Central Research Institute of Dentistry and Maxillofacial Surgery of the Ministry of Health of the Russian Federation 16 Timur Frunze str., office 324, Moscow, 119021, Russia kalinina-cniis@mail.ru Other publications by this author

Brailovskaya Tat'yana Vladislavovna Doctor of Medicine Head of Educational Activities Department; National Medical Research Center "Central Research Institute of Dentistry and Maxillofacial Surgery" of the Ministry of Health of the Russian Federation 16 Timur Frunze str., building 5, Moscow, 119034, Russia brailovsktv@mail.ru

Introduction

The continuity of professional education in medicine is determined by the growth of innovative technologies: the diagnostic and therapeutic tools available to the current doctor are incommensurable with their set, which he possessed a decade ago. In this regard, there is a need to modify the pedagogical component in providing such education and periodic accreditation of medical personnel. Their new parameters have been established since January 1, 2023 on the basis of the order of the Ministry of Health No. 709n dated 10/28/2022 "On approval of the regulations on accreditation of specialists", aimed, in particular, at ensuring that their professional activities meet the demands of the time, and their work is adequately evaluated by both the professional community and society as a whole. This encourages us to carefully follow all the steps of pedagogical support, starting from school and ending with higher levels in the framework of continuing education – up to achieving high levels of scientific research and fully mastering the social roles of a doctor-teacher. At the same time, it is important to remember that the pedagogical component significantly increases its share among dentists, as well as specialists in the field of rapidly progressing maxillofacial surgery. 

The relevance of the topic

The training of modern specialists in the field of dentistry and maxillofacial surgery is constantly being modified taking into account the latest scientific achievements in these subject areas and reliance on pedagogical innovations, including coaching and self-design practices. The relevant work is being carried out primarily at the Moscow Medical and Dental University and the Central Research Institute of Medical Sciences. The Department of educational activities of the second of them is constantly focused on the implementation of these innovations in three areas of training highly qualified specialists: residency, postgraduate studies, additional professional education (DPO). The accumulated and meaningful experience of his work is also in demand by other structures of postgraduate education at universities and research institutes of medical profile.

The study of the problem

The problem of coaching has relatively recently become the subject of research interest of the organizers of the educational process. It was only from the middle of the first decade that translated works on coaching began to be published ^{[1, 2]}, and from the middle of the second – domestic ones on its potential in the field of education ^[3]. Of interest is the work in which the pedagogical method of coaching is considered on the example of the interaction of the doctor-patient dyad during decision-making about treatment. "Treatment decision–making coaching is non-directive support provided by a qualified medical professional to help patients prepare for active participation in discussing the patient's treatment methods with the attending physician" ^{[4, p. 128]}. The author of the cited article refers to the works of Canadian ^[5] and American ^[6]. specialists who emphasize an increase in the proportion of patient judgments in such coaching. The fundamental principles of coaching are successfully used in higher and postgraduate education. They allow you to create a new approach to the learning process and assimilation of new knowledge, introduce interactive elements, give new meaning to the skills and abilities of both teachers and students, creating mutual involvement in the educational process, increasing the level of motivation and responsibility for the result ^[7].

Researchers Y.S. Milostivaya and M.V. Volik single out among coaching the search for possible solutions to the problem of increasing the level of professionalism, assessing their advantages and disadvantages. The coach who carries it out does not so much advise, as directs the student to the right area, connecting a self-realization resource so that he himself chooses ways to solve problems ^[8].

N.N. Nikulina, S.V. Berezin and I.I. Ushakov formulate the goals of coaching in the form of problematic issues, taking into account their adaptation to the tasks of mastering the specialty: what kind of support is needed; how should this be done; what is the most difficult thing here; what criteria should be used; what consequences are expected; what can be won /lost in the implementation actions; what obstacles can be encountered; who should know about success/failure ^[9].

We use the term "coaching" due to the fact that, in particular, in the field of dental education, it more clearly characterizes the increase in the share of digitalization and technological support in it.  In this perspective, the role of coaching in DPO at the Central Research Institute of Economics is largely reduced to the development of professionally important qualities, ensuring the self-design of specialists and their career growth.

Scientific novelty

The author substantiates the urgency of introducing the concepts of "coaching" and "self-designing" to concretize new approaches in the theoretical provision of postgraduate training for dentists and maxillofacial surgeons, and for the first time substantiates the complementary nature of the relationship between them. It is emphasized that the adaptation of the pedagogical techniques corresponding to them makes it possible to more clearly identify the role of the pedagogical component in the training of highly qualified specialists in these areas. Based on the already conducted developments of the issues of coaching and self-design, the ways of their mutual complementarity are substantiated.

Goals and objectives of the study

The purpose of the study is to increase the effectiveness of relevant innovations in the organization of the pedagogical process, the productivity of which is characterized by the materials of the analysis of the work of the Department of Educational Activities of the Central Research Institute of Economics. A comparative analysis of the general trends in reproduction of highly qualified medical specialists is carried out on the basis of research conducted by the Federal Research Sociological Center of the Russian Academy of Sciences in cooperation with the Ministry of Education and Science of the Russian Federation in 2017-2022, with the developments of the Department of Educational Activities of the Central Research Institute of Medical Sciences, solving the tasks of pedagogical support of this reproduction among dentists and maxillofacial surgeons. The developments were carried out mainly during the preparation and implementation of the programs of the DPO TSNIISICHLH.

Research methods and techniques

The analysis of the content of the key concepts of the work "coaching" and "self-projection" is carried out, the substantiation of the complementary relations between them is given, the role of the pedagogical components of the professional activity of dentists and maxillofacial surgeons is revealed. The results are compared

1) public opinion polls conducted in the summer of 2023 by the Public Opinion Foundation and the All-Russian Center for the Study of Public Opinion;

2) sociological research of the Institute of Sociology of the Russian Academy of Sciences in 2017-2021 on the reproduction of medical personnel;

3) author's surveys and in-depth interviews on the parameters and quality of educational processes within the framework of the Central Research Institute.

Step-by-step detailing of the processes of education and training of scientific personnel is given, taking into account the peculiarities of the digitalized material base, ensuring their success, taking into account the increasing role of the pedagogical component. 

The practical significance of the work

The regulations for the organization of the educational process developed and applied at the Central Research Institute of Medical Sciences are also applicable to other educational structures during the training of residents and graduate students, as well as those undergoing cycles of vocational training in almost most relevant centers for training and retraining of medical personnel using remote technologies. Such an educational innovation as the complementarity of coaching and self-design in the course of training a highly qualified specialist demonstrates the high importance of the pedagogical component in the introduced organizational forms of education.

The main part

Public opinion polls reflect a difficult picture in terms of evaluating the training processes of medical professionals at various stages. Judging by the data of the non-profit organization "Public Opinion Foundation" (FOM) in the summer of 2023, 41% of Russians believe that most modern doctors in the Russian Federation have an insufficient level of professional training; only 34% recognize their high qualifications. A third of respondents do not trust doctors, 55% showed a high level of trust. It was recorded that 31% of respondents had a low opinion of the prestige of the medical profession, it was high in the opinion of more than 40%, and more often it was claimed by young people (54%), and less often by the oldest of the respondents (30%). The state of Russian healthcare is assessed as poor or satisfactory by 41%, while only 12% call it good.  17% believe that it has changed for the better in the last year or two, 43% have not changed, and 29% have worsened ^[10].

The results of another summer 2023 survey by the state research organization of the All-Russian Center for the Study of Public Opinion (VTSIOM)  They showed that 30% of Russian citizens would advise their children to become medical workers, 19% would approve of their work in the field of information technology, 10% in law enforcement agencies. In this regard, future doctors pushed aside lawyers and economists who were ahead of them earlier, who ended up in 8th and 9th places, respectively ^[11]. Experts attribute this shift in preferences to an increase in the prestige of the medical profession and the importance of the factor of conscious motivation in choosing it.

Such a spread of assessment results, among other things, draws attention to the problem of their pedagogical competence. However, with any assessment, the need for doctors is unavoidable, and this competence allows you to realize this and establish acceptable relationships in the doctor–patient dyad. In dentistry and maxillofacial surgery, this is especially significant, since successful treatment is basically impossible without these relationships.    

The Department of Educational Activities of the Central Research Institute of Economics is constantly focused on the development of both pedagogical strategies for continuing education in its field and the introduction of new (distance) technologies into educational practice. These include coaching (from the English "coaching" – training and "coach" – coach, instructor, mentor) and self-designing the career growth of specialists; the first focuses on externally oriented motivational factors, while the second focuses on internally oriented ones.

Coaching is a form of development of professionally important qualities and verified competencies, in which an experienced person, called a coach, supports the student in achieving a certain personal or professional goal through training and guidance.  In the course of coaching in the DPO, a specialist with extensive experience offers advice and guidance to another; unlike mentoring, coaching is characterized by focusing on specific tasks or goals and uses a wider range of technological tools. In educational organizations, coaching also includes cooperation with fellow students or trainees in the structures of vocational training, contributes to a clearer self-assessment of oneself as a professional in the course of building a career trajectory. In the emerging system of continuous professional development, he also contributes to the self-design of a specialist based on his professionally important qualities ^[12].

In general, self-design indicates a person's readiness to pursue a professional career and further continuous special education. At the same time, it acts as the basis for building a professional's identity, based on the understanding and interpretation of his personal and socio-cultural experience, independent active access to educational resources and educational technologies.

 Coaching and self-design in their unity provide one of the most important conditions for the inclusion of a specialist in the system of continuous professional development (CPD), which is slowly but surely replacing the system of continuing professional education (NGO). The coaching philosophy proceeds from the fact that each person has a powerful (often dormant) potential and the necessary resources to achieve professional success and career growth.

Coaching is different from training, consulting, coaching and mentoring. If training is mainly the acquisition of specific problem–solving skills in a certain expert field, if mentoring is the exchange of experience within an organization, then coaching focuses on the development of professional responsibility, the ability to innovate, and personal focus on results. The term "coaching", as evidenced by the experience of the Central Research Institute of Economics, also indicates with greater certainty the extensive digitalized infrastructure of the educational process, including simulators, remote methods and forms of professional knowledge transfer, the use of artificial intelligence, etc.

When using coaching, as well as when self–designing a specialist, the focus is on the strengths of the individual, on solving the problem, and not just discussing it, on a partnership that reveals the potential of the specialist. The key psychological signs of coaching are openness and trust in order to use them in any form of the educational process. In the process of coaching, the teacher receives feedback at its highest levels, analyzing the specific results of scientific research. Here, the logic of the teacher's and student's life experience is especially important to create a joint assessment of practical situations.

In the course of productive coaching, the orientation of the assimilation of the upcoming material is determined and the ways of its application in practice are specified. In this regard, we can say that coaching is the ability to ask strong questions not in order to gather information, but in order to invite a person to "listen to himself" and help him find optimal solutions. Each listener receives feedback with the help of leading questions, finding a non-standard approach to standard problems.  Directed questions predispose to introspection, provide additional solutions and lead to creativity and insight, which serves as an effective self-design of a specialist. At the same time, it is important to find out the personal values of each individual student, to understand exactly what he needs to get from learning and how this is consistent with his personal plans.

Coaching is focused on individual support of students, but as a result, greater productivity of activities and the study group as a whole is ensured, relationships in it are improved, group decision skills are improved, the ability to respond quickly and effectively to changes in educational and practical situations. In DPO, he can constructively solve numerous psychological and pedagogical problems, including the problem of managing the motivation of students, their choice of means of using their professionally important qualities.

In accordance with the curricula, the educational process at the Central Research Institute of Economics includes lectures, seminars and practical classes and exams, the schedule of which is developed and approved in accordance with the established procedure. The introduction of coaching elements using remote technologies improves their quality, and practical classes conducted by the best doctors contribute to the assimilation of all innovations in the field of dentistry and maxillofacial surgery. Separately, it should be noted the mobile creation of programs and the provision of translation of relevant knowledge and skills by leading scientists of the Central Research Institute of Economics, taking into account their demand in special conditions; among them, a course of lectures by Professor A.I. Grudyanov on the topic "Inflammation. The wound process", which was first tested in the 2022/2023 academic year.

Elements of coaching are manifested in the implementation of postgraduate and doctoral training programs. It is also revealed that the personal self-design of specialists cannot but rely on the reception of the highest samples of the relevant types of activities, transmitted just in the course of coaching extremely saturated with the latest technologies. At the same time, the knowledge, skills and abilities of dentists and especially maxillofacial surgeons are extremely individualized and patient-oriented. As a result, it turns out that the listener/student learns general knowledge in the course of distance learning organized based on distance learning technologies, and assigns the individualized knowledge in them – in accordance with their self-development projects.

Training in the specialty "maxillofacial surgery" at the Central Medical Research Institute is characterized by differentiation of the presentation of material during the educational process with saturation of its pedagogical component. Prior to its submission, when using remote technologies, classes are held on the specifics of the reception by all students  both general tasks and specific methods of solving them; the prerequisites, course and results of facial operations have a special sensitivity in this regard, which requires the inclusion of not only a pedagogical, but also a psychological component. The existing complex of telecommunication equipment allows, in the op-line mode, to broadcast live to the classroom everything that happens in the operating room - the preparation and progress of the operation, highlighting the key points in it, the techniques of the surgeon and his assistants. Conducting classes with students is accompanied by a psychologically balanced commentary on the course of surgery based on coaching techniques, which are modified during almost every surgical intervention, especially in maxillofacial surgery.

Classes organized in a similar format at the Central Medical Research Institute reveal with extreme relief the highly significant role of a doctor-teacher with a rich set of competencies, one of the key places in which competencies saturated with psychological knowledge occupy. Turning to the history of medical education, it should be noted that it was this knowledge that determined to a large extent the effectiveness of operations of one of the founders of Russian maxillofacial surgery, N.I. Pirogov (1810-1881). Their results were discussed at his lecture "On plastic surgery in general, on rhinoplasty in particular", read at the Imperial Academy of Sciences back in 1835; during the Crimean War (1853-1856), he had to perform operations as a dental surgeon and an oral surgeon especially often. They were also conducted by N.V. Sklifosovsky (1836-1904), being, in particular, the author of the work "Resection of both jaws", which appeared in 1873.

 It should be noted that the lessons of the then "coaching", which was designated by the word "mentoring", spread extremely quickly in the professional community, were broadcast to foreign colleagues, stimulating motivation to boost the professional careers of dentists and maxillofacial surgeons. The accumulated experience in this area is in demand in the training and retraining of modern highly qualified medical personnel, and therefore, in almost all prepared courses, due attention is paid to the processes of the emergence of these areas.

The management of educational activities of the Central Research Institute of Medical Sciences demonstrates the increasing productivity of the organization of the educational process in the following parameter: the time distance between scientific developments in the field of dentistry and especially maxillofacial surgery, on the one hand, and the development of their results by residents and graduate students, as well as practitioners studying in the structures of DPO, is constantly decreasing. This is especially important at the present time, when the number of dental and complex maxillofacial surgeries performed in special conditions is increasing.   Taking into account this factor, the clinical practice programs of students, including work in military hospitals, are being adjusted at the Central Medical Research Institute; well-established professional training programs are being modified and new training programs are being developed, for example, in 2023, a cycle of classes "Radiology in dentistry" was introduced, taking into account recent scientific developments related to extreme situations.  

The material and technical base for classes at TSNIISICHLH consists of classrooms, each of which is equipped with a multimedia projector, an interactive whiteboard, computer and peripheral equipment, and mainly equipment for video conferencing sessions. The equipment of the operating unit with a telemedicine complex allows real-time display to classrooms of the image of the entire operating field from a video camera built into the operating lamp. In the future, it is planned to display images from a microscope and endoscopic equipment to demonstrate the technique of performing operations. The work of the Department of Educational Activities in this area is carried out in creative cooperation with the Department of Information Technology and Telemedicine of Scientific and Organizational Management and almost all structures of the Central Research Institute of Economics. Practical classes are held taking into account the individualized requests of students, fully meeting the needs of the modern educational process.

Postgraduate study within the framework of the Central Research Institute of Economics is an important area of research and professional development of teaching staff. Graduates are more likely than specialists in other fields of science, including medicine, to defend their dissertations, and therefore the experience of organizational work in Managing educational activities in this area deserves special attention. 

It should be noted that the situation with the training of highly professional personnel through postgraduate studies in the country as a whole is far from prosperous. Research in 2021 The Institute of Sociology of the Russian Academy of Sciences (respondents - 4,000 young specialists from 207 enterprises and institutions spoke) revealed the urgency of its reformatting. It was fixed: "Today, the postgraduate study process is aimed primarily at the formation of a university teacher. At the end of their studies, the graduates of the graduate school themselves feel this. Most people fail to prepare a completed scientific dissertation by the end of their postgraduate studies" ^{[13, p. 262]}.  The situation was complicated by the fact that the support for the career growth of young researchers in graduate school was situational in nature in the absence of both elements of self-design and career mobility plans. On the one hand, the obligations of future employers to move them horizontally and vertically after graduation were not monitored, on the other hand, the intentions of a young specialist to improve their qualifications and improve their professional skills were not supported.

This negative qualitative assessment of the graduate school was accompanied by quantitative indicators. Thus, the number of graduate students who defended their dissertations in 2019 was only 10.4% in 2019, and even less in 2020 – 8.9%, and this is even less than one in ten ^{[13, p. 254]}. According to statistically designed survey results, only 10% of graduate students were oriented towards breakthroughs in science; only a fifth of them represented, and not clearly enough, what they would do after graduating from graduate school ^{[13, p. 259]}.

The Decree of the Government of the Russian Federation dated November 20, 2021 No. 2122, which approved the "Regulations on the training of scientific and scientific-pedagogical personnel in postgraduate studies (adjunct)", is aimed at dramatically increasing the effectiveness of postgraduate studies.  A number of measures already taken demonstrate the relevance of new forms of stimulating the scientific productivity of postgraduate studies. In this regard, in a message to the Federal Assembly dated February 21, 2023, the President of the Russian Federation defined the dual task of postgraduate studies as a separate level of professional education:  targeted training of personnel for scientific and pedagogical activities.

At the Central Research Institute of Economics, the main criterion for the effectiveness of postgraduate studies is the defense of a dissertation for the degree of Candidate of Sciences. Here, the percentage of those who defended their dissertation during the study period was 42% in 2019, 44% in 2020, 40% in 2021, 41% in 2022; thus, not every tenth, as in the whole country, but four out of ten graduate students defended themselves. In 2023, the number of graduate students who defended their degree has significantly increased to 64%; it is expected to increase their share. Such a significant shift – from two-fifths to two-thirds (and in the foreseeable future - up to four-fifths) was the result of the organization of the educational process in the training program for highly qualified personnel by the Department of Educational Activities of the Central Research Institute of Economics, which, firstly, specified the requirements for graduate students, clearly organizing and controlling all stages of preparation of dissertations and their provision in the course of research activities. At each stage, delays in the organization of scientific developments on a given topic are not only identified, but also problem points and ways to eliminate them are identified. Practically none of the graduate students violates the deadlines for conducting specific research and understanding their results; their publication activity and participation in the competition of young scientists, held annually at the Central Research Institute of Economics, are especially stimulated. Secondly, the Department's specialists specifically supervise topics related to developments in the field of dentistry and maxillofacial surgery in special conditions previously created by the covid epidemic, and later related to ITS own. In their development, taking into account the immediate relevance of the results in clinical practice, the scientific potential of most structural divisions of the Central Research Institute is involved. Finally, thirdly, an important motive for such a focus of graduate students' work on achieving results is balanced scientific guidance with elements of coaching and support for self-design ^{[14, 15]}. 

Our in–depth interviews revealed that the motives for entering graduate school are primarily the desire to conduct independent scientific research, they are a key element of self-design. An important motive is also the desire to continue the research work that began while studying in residency, under the guidance of a certain supervisor - in the role of a mentor rather than a coach. For a number of graduate students, this is a desire to continue the family tradition in selected fields of scientific research.

Introducing forms and elements of coaching into the training and retraining of dentists and maxillofacial surgeons, the Department of Educational Activities of the Central Research Institute of Medical Sciences proceeds from the fact that pedagogical support for the formation of a medical scientist by a doctor-teacher is an inevitable element of his scientific career. Already upon admission to medical educational institutions, choosing a particular specialty does this to a large extent under the influence of a doctor-teacher; at the second step, the student not only acquires professionally important qualities, but also reveals a disposition to pedagogical work. The structures of the DPO are the platform where the professional qualities of doctors reach their peaks – with the assistance of the organizers of the educational process; in fact, within its framework, teachers train teachers, and scientists identify scientists ^[16].

According to our surveys, the majority of residents and graduate students at TSNIISICHLH noted that their choice of a future profession was approved by the school, but specific measures to prepare for medical schools were practically not carried out. Hopes for professional self-determination, and later self-design, were mainly pinned on the family, especially the one that included doctors. In general, according to the results of our in-depth interviews, almost two out of three who underwent dental or maxillofacial surgery took the initial steps in the profession on the advice or with the advice of their parents. Nevertheless, the learning process at school should be accompanied by a pedagogically sound search for future doctors, including dentists, based on their revealed professional preferences. Our research has shown that after graduation, the vast majority of residents, graduate students and researchers of the Central Research Institute of Economics saw the trajectories of their future research programs and developments quite clearly.

As for DPO, students acquire the latest knowledge in dentistry and maxillofacial surgery against the background of the widespread development of human sciences in general, as well as rapidly progressing medical technologies. The task of the day in the early 2020s is digitalization. As it was noted at the Week of Medical Education in April 2023, the growth rate of the pedagogical component in the training and retraining of physicians is not decreasing, but rather increasing, as indicated by its organizer, the rector of the Moscow State University. Sechenova P.V. Glybochko. 

Graduates of medical schools, judging by the results conducted in 2021. According to the Institute of Sociology of the Russian Academy of Sciences, they believe that it is necessary to improve their professional qualifications very quickly. What forms are the most preferable in this case? It is best provided by state educational organizations that provide training in vocational education programs – 62% , non–governmental institutions - 15.3%, private courses – 6.8%, distance learning – only 2%, and finally, self-education - 13.9% ^{[13, p. 302]}. At the same time, according to those medical specialists who We intend to carry out professional development through professional retraining and retraining, they need, along with professional knowledge, general humanitarian knowledge and especially pedagogical and psychological knowledge. 

 These figures help to find ways to develop pedagogical strategies and ways to increase the level of their pedagogical competence in the Central Research Institute. It is also a way to minimize the "professional ballast" among dentists and maxillofacial surgeons, which are significantly lower compared to those of engineering and technical specialists and even doctors of other specialties.

In our survey, mainly among young dentists and maxillofacial surgeons who studied at graduate school (30 people) and completed training cycles under the DPO programs (50 people), professional development activities were evaluated. Internships and internships with elements of coaching and an emphasis on self-designing career growth are approved by almost all respondents; assistance to graduate students with their consideration is emphasized by 85%; participation of teaching doctors in new forms of teaching, primarily in technologically intensive coaching by 70%; consideration of the factor of self-designing career growth in improving curricula is approved by 65%; the need for strengthening the pedagogical component during the modernization of the continuing education system is emphasized by 60% of respondents; 50% approve of joint work based on coaching during internships and internships with teaching staff of universities and research institutes.

An important function of the DPO is to attract students to teaching, if they are inclined to it. The practice of the Central Medical Research Institute in this area is characterized by the introduction of innovative forms of training future teaching doctors, especially teachers of extremely instrumentalized disciplines. This involves selection based on the propensity to transfer the acquired knowledge and skills, as well as the formation of pedagogical skills according to the chosen profile.  Teachers identify these professionally important qualities in residency and postgraduate studies, and even more so in doctoral studies. According to the results of our expert survey and the nature of the answers to the questionnaire, a doctor-teacher in the field of dentistry and especially maxillofacial surgery values his professional activity to a greater extent than representatives of other profiles. At the same time, he takes special care of innovative ways to convey knowledge, skills and abilities in the context of digitalization.

At the Week of Medical Education on April 3-7, 2023, in the plenary report of the Rector of the First Moscow State Medical University. Sechenova P. V. Glybochko "Transformation of medical education in the digital age" it was noted that the role of the doctor's personality does not decrease, but just increases.  Special emphasis was placed on this in the reports at the round table "The Digital Age in dentistry". The issues of pedagogical training of specialists within its framework were paid attention in the reports: S.V. Apresyan (RUDN) "Philosophy of digital Dentistry", D.V. Kileynikov (I.A. Evdokimov Moscow State Medical University) "Evaluation materials for external and internal assessment of the quality of educational activities: requirements, training methods, problems", O.S. Mordanov (RUDN) "Synthesis of digital technologies and artificial intelligence in dentistry" and a number of others. They specifically discussed the key problem of redirecting many teaching functions to technical means: apparently, they reduce the role of direct contacts between teachers and students, but in fact it may increase, since the proportion of pedagogically verified and psychologically balanced methods of working with them at all levels - starting from students going into the profession and up to specialists studying under DPO programs - it only increases.

The results of expert surveys at the Central Medical Research Institute show that this encourages the preparation of a new generation of teaching doctors. This is revealed during the discussion of issues of professional dialogue and polylogue, analysis of the specifics of the assimilation of educational innovations. To solve this problem, it is necessary to change the parameters of assessing their not only pedagogical, but also psychological competence, since any innovations in technology do not negate the importance of the doctor-patient relationship. Full-fledged rotation of teaching staff is ensured by mandatory completion of advanced training courses by teaching doctors. For this purpose, the course "Current aspects of maxillofacial surgery" with an enhanced pedagogical component for doctors of maxillofacial surgeons from among the teaching staff of the Departments of Surgical Dentistry and Maxillofacial surgery is included in the training program within the framework of the 144-hour accreditation cycles of advanced training. Thus, the DPO can be burdened with another important function – the recruitment of teaching staff.

Conclusion

The experience of the Central Research Institute for the Organization of educational processes allows us to assert that the propensity for various types of pedagogical activity manifests itself in the course of mastering new knowledge, skills, and skills in their profession through the complementarity of coaching and self-design. This is especially significant in dentistry, where the "gift of the teacher" manifests itself earlier than in other fields of medicine and where it is especially important that training along the line: doctor-teacher – high-class dentist (maxillofacial surgeon) continues along the line: doctor-patient.

Models of continuous dental education are being built and experimentally tested in specialized universities and research institutes based on scientific and didactic concepts of interdisciplinary integration. Among them are coaching and techniques of conscious self-design; being in a relationship of complementarity, they imply a significant increase in the level of postgraduate education, meeting such conditions as a combination of pedagogical competence with the peculiarities of the structural and substantive components of scientific activity.

The educational and scientific activities of the Central Research Institute of Economics ensure the successful modernization of such education through the concretization of its methods and didactics. The practical orientation of the educational process is determined by organizational and scientific and methodological measures; they are aimed at combining traditional and innovative forms and methods of teaching, including adapted to the implementation of specialized operations and treatment. Their use modifies the work of the relevant research units and contributes to the highly effective rotation of the teaching staff of the Central Research Institute of Economics.