Continuous professional development and personal development of dental specialists and maxillofacial surgeons

Kalinina Yuliya Vladislavovna ORCID: 0000-0001-7028-4991 Chief specialist of the Educational Activities Department, 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

Introduction

Modern scientific and technological progress implies the urgency of ensuring the personal and professional growth of specialists, which is of particular importance both for the industry in which they are employed and for society as a whole. This is especially true for medical specialists, who not only master the knowledge accumulated by the sciences of man and his development, but also create conditions for their application in their professional activities. This dictates the introduction of methods of continuous professional development (CPD) primarily in the life-supporting areas of education and healthcare for any society, which in turn urgently requires the self-development of a specialist. The NPR system, which is being formed on a global scale, creates that self-developing information and educational environment, which precisely ensures the self-development of a highly qualified specialist, building his individualized educational trajectories and supporting career growth.

The relevance of the topic

 Strategically, the NPR is designed to replace the system of continuing professional education, which happens differently in different countries and regions - and a number of pedagogical justifications for this transition claim their own ways of dominating this system, taking into account historical circumstances and local traditions. They seem to slow down the pace of transition, but in fact they are the determining factors not only of its relevance, but also of its success.

This situation is particularly evident in the example of medical education, for which NPR is primarily an imperative.  The transition to it covers, to varying degrees, key educational structures within its framework, mainly in medical universities (including the specialized Moscow Dental University), at medical faculties in a number of universities (including Moscow State University) and in research institutes of various profiles with a powerful educational component.

The study of the problem

In the Russian scientific literature, the definition of continuous professional development is just being formed. There is reason to recognize as sufficiently balanced that which is set out in the Guidelines on education and training of specialists in the field of aviation meteorology approved by Roshydromet on 12.09.2008: "Systematic acquisition of knowledge, experience, skills and improvement of personal qualities necessary to perform professional duties during the period of employment" ^[1]

Linking a definition to a document in this rather narrow subject area should not be surprising: it ensures flight safety, and through this saves people's lives, therefore it is constantly saturated with new knowledge from a wide variety of sciences, including the humanities. It also implicitly contains an assessment of the role of the human factor in the vision of the situation and decision-making during the professional activity of pilots and support services.

Earlier approaches to NPR in pedagogy were outlined in the works of 2004 by B.S. Karamurzov ^[2] and T.I. Shamova ^[3]. Later, they were developed in a number of articles mainly in the regions, an overview of which is given in the monograph on the methodological foundations of continuous professional development of teachers in the context of informatization of education, as well as the creation of an integrated information and educational environment ^[4]. Thus, the self-development of teachers and students are closely linked.

The tasks of the NPR in medicine are expressed in the most articulate way in an article by leading specialists in the organization of continuing medical education, published in 2019 and summarizing the relevant experience in this area.  "In the late twentieth and early twenty-first centuries, the concept of three L (Life-Long Learning — "lifelong learning") became the dominant vector of educational reforms in all fields of activity… It is noted that professional development of specialists is achieved through the development of their independence, determination and responsibility, which ultimately allows them to take a more advantageous position in the labor market" ^{[5, p. 3]}. Postgraduate education in the health care system is constantly developing through the introduction of achievements in biological sciences, providing all new medical discoveries, effective methods of prevention and treatment of various diseases, high-precision methods of their diagnosis. At the same time, it is emphasized: "The formation of a new system of professional medical development in our country is complicated by the fact that currently there is no generally accepted opinion on which educational methods in this area are the most effective" ^{[5, p.4]}.  

Speaking at a conference at Pirogov University in February 2024, one of the authors of this article, L.K. Moshetova, emphasized distance learning methods during the NPR. She noted that, in general, DPO is in demand by specialists aged 41-50 years with about 15 years of work experience; they just need to master innovative NPR techniques based on already mastered professionalism. About 20 training programs for medical teachers in all areas are largely focused on this, NPR techniques are developed and implemented by the structural unit of the Federal State Budgetary Educational Institution of the Russian Ministry of Health "Institute for Training Specialists in Medical Education", as well as the Association of Teachers of Medical Education. Both organizations ensure the staffing of teaching doctors, as well as their self-development, especially in the context of the spread of translational medicine.

Scientific novelty

The article contains the results of empirical research conducted for the first time in December 2023 among residents, postgraduates and students of the Central Research Institute of Economics. The scientifically based conclusions serve as the basis for recommendations on the introduction of innovative NPR techniques into the educational practice of both this national medical research center and similar research centers in other medical fields. It is shown that the personal and professional growth of specialists is the main goal of the NPR, and its implementation in Russia should be based on local traditions of the formation of its human resources and become an integral part of the state social policy. The practice of introducing structural elements of the NPR for the training of dentists and maxillofacial surgeons indicates that this generation is trained with an increased degree of efficiency.

The purpose and objectives of the study

 The purpose of the article is to describe the contours of the leading areas of NPR in the Central Research Institute, whose training structures represent the points of growth of NPR in the field of healthcare.

The purpose of the article is to show that: 1) NPR is the future that will cover the entire education system of the country and the world, 2) the idea of NPR, presenting itself as global, nevertheless adjusts its forms of manifestation taking into account local traditions and has its own "growth points", 3) its implementation is clearly visible in the systematically organized training of residents and graduate students, as well as students of the DPO cycles in the Central Research Institute of Economics.

At the same time, the key idea is carried out: the values of the NPR should not be imposed, they should be brought to them and they should be instilled through explanatory procedures, taking into account the fact that the points of its growth are present, at least implicitly, in the educational system of any country. In addition, the main ideas and techniques of NPR should be instilled taking into account the professional profile of specialists, their work experience, educational status, as well as the competencies of teaching doctors.

Methodological foundations and research methods

A comparative analysis of the concepts of NPR and self-development is carried out. Based on the methods of historical analysis, the points of growth of NPR in educational activities are identified. The program of research of the peculiarities of perception and evaluation of the NPR by residents, graduate students and students of the cycles of DPO at the Central Research Institute of Economics based on the methods of questioning and interviewing is substantiated and implemented

Theoretical significance

In general, the NPR focuses on a developed personality capable of self-affirmation in a professional career. In the context of increasing informatization, only NPR contributes to the rapid assimilation of both the necessary relevant knowledge and the development of professional skills, which is especially important for dentists and maxillofacial surgeons. In this regard, the information and educational environment being built, as the experience of its organization in the Central Research Institute of Economics shows, contributes to increasing the didactic effectiveness of classes, activating self-educational efforts. This confirms the effectiveness of the specialist's self-development resource through his involvement in independently organized and expedient activities in various fields of knowledge.

NPR in this regard is not so much a continuous flow of new information, as the ability to implement and improve already acquired knowledge and skills in the practice of wellness.

Practical significance

The practice of implementing NPR techniques shows that it is advisable not to impose attitudes on them, but to instill them, addressing both historical examples and local traditions, and relying on the achievements of modern natural sciences and humanities. This is important in the field of continuous dental training and especially maxillofacial surgery. Since the NPR focuses on the activation of horizontal scientific links, to the extent that residents, graduate students and students of the DPO establish them based on their research and educational structures. In this direction, it is advisable to create organizationally organized groups of students and young scientists at the Central Medical Research Institute, as well as in other similar national medical research centers.

The main content

1. Complementarity of NPR and self-development

 Personal and professional development go hand in hand and include a set of interrelated components: value-semantic, reflexive and regulatory. The main factor influencing the self-development of specialists is an indicator of their comprehension not only of their vocation, but also of the specialist's life path, which is largely related to the willingness to join the NPR.

Additional problems in connection with supporting the processes of self-development and realizing the potential of each specialist are related to the digitalization of the education sector: it is necessary to create not only for him, but also for his colleagues an acceptable digital information and educational environment designed to provide independent access to educational resources and self-education technologies. This opens up the possibility of so-called "self-regulated learning" based on materials from the Internet, computer programs, reproducible printed materials, computer graphics, etc. Such training, as N. writes. Davis and his co-authors have a number of advantages:  "The student chooses the schedule and pace of training himself, based on the time he has at his disposal. In addition, such training is beneficial from an economic point of view, since the student does not need to interrupt practical activities..." ^{[6, p. 27]}.

Human-oriented information technologies and training systems proceed from the fact that professional activity in the field of healthcare combines organizational, research and creative activities, at the center of which is a living person - a patient in need of medical care. Therefore, in the conditions of the modern digital environment, the clinician should be especially receptive to innovations, and at the same time be quite selective in their selection, remembering that for a doctor the main thing is not to harm the patient's health.  

New knowledge and past experience can turn into a synergistic working level of a holistic organization of a specialist's personality, passing through his reflection, enriched with critical assessments, providing a thoughtful choice of strategies and means of development. As a result, an optimal system of actions is developed; they gradually become the psychological foundations of professionalism. The NPR of a medical specialist in this regard is not so much a continuous flow of new knowledge, as the ability to implement acquired skills and abilities in the practice of wellness.            Then motivation begins to work at full strength, and the specialist achieves positive results in what he feels professionally capable of, for which he has natural inclinations ^{[7, 8]}.

The self-development of a specialist's personality is focused on professional growth and a business career through building one's own identity, based on understanding the already existing professional experience and its replenishment through independent access to educational resources and self-education technologies. This is taken into account during the postgraduate education of dental specialists, ensuring the quality of their professional activity as an opportunity for free navigation in order to correct possible errors ^{[9, p. 241]}.

The NPR process of a specialist continues throughout his active life through self-education as a purposeful activity, work to expand and deepen his knowledge and acquire appropriate skills and abilities. In conjunction with it, self-development proceeds from the requirements of society and the professional community for the personality of a specialist, and later in its course, external requirements turn into internal regulators of behavior. Self-development, by encouraging initiative and creativity, involves the individual in a situation that  it puts him in front of the need to solve difficult life and professional problems. It is accompanied by productive reflection, which implies a clear vision of their professional advantages, achievements and disadvantages. In this regard, the NPR is individualized precisely through self-development, changing for the better throughout its working life.

Development as self-movement does not eliminate the tasks of pedagogical adjustment of this process; it, based on an individual approach and creative relationships during training, allows you to create external and internal conditions for the professional growth of an individual, increasing the number of his competencies. This job does not tolerate formalism, especially since professional growth is determined by the ability to learn throughout life. Therefore, it is so important to teach not only medical students, but also residents, graduate students and students of the vocational school to constant personal self-improvement and at the same time the formation of their communication skills throughout all years of study. It is useful, along with educational classes and professional communication trainings, to develop an elective course "How to form and develop a medical career" with the involvement of practicing doctors in its teaching for discussions on how to realize oneself in the medical field and build a medical career.

NPR is hampered by insufficient awareness of career orientations in combination with the requirements of the chosen professional activity; self-development in this regard encourages the construction of highly significant qualities and makings to ensure the competitiveness of a specialist in the modern labor market.

This is a socially important task and part of public policy, which is activated in the course of new and often unexpected challenges, especially significant in modern healthcare. If we turn to the examples, it is impossible not to admit that one of them was the COVID epidemic, during which residents, graduate students and even medical students were forcibly involved in medical activities in complicated conditions, ranging from volunteering and ending with participation in the implementation of many specific procedures.  Under these conditions, what can be called accelerated self-development of a medical specialist took place, orienting him to boost self-education programs. Its goal is to develop the means to achieve a high level of professionalism. A whole generation of doctors has appeared in almost every area of healthcare. This made it possible to consciously build a promising business career, taking into account the experience acquired in extreme conditions. At the same time, it turned out that readiness for successful professional activity is associated with the formation of a positive image of a young specialist and his personal brand; he saw his future more clearly in the medium and even long term.

2. "Points of growth" of the domestic NPR

Although the NPR concept is characterized by novelty in terms of restructuring educational processes, especially at the postgraduate level, its sprouts have been implicitly present in the educational system of any country throughout its history. As for domestic education, they are found in fact in every century, even difficult to interpret; these sprouts, which can also be called "growth points", and today serve as a subject for imitation. Without claiming to be fully evidence-based, we will present our own vision of some of them, as well as consider historical figures who manifest the NPR in one way or another.

For the 18th century, these are the figures of Peter I and M.V. Lomonosov; dental knowledge and skills they independently mastered also included. Thus, in the Kunstkammer (the first Russian museum) there is a bag with 73 teeth pulled out by the tsar, in the Hermitage there are tongs belonging to him; in 1718 the tsar established an "instrumental hut" in which such tools were made. Lomonosov also gave recommendations on overcoming scurvy to northern navigators.

For the 19th century, the dialogue between K.D. Ushinsky and N.I. Pirogov about the potential of a "wise childhood" in a review of pedagogical articles is noteworthy  Pirogov during his work as a trustee of the Odessa and Kiev educational districts; his pedagogical thought and educational activities covered all levels of education, including his native medical education. It was supposed to pave new paths in this area, providing, in particular, elements of continuity and spiritual development of specialists. And for this, it is necessary to rely on what both great teachers called the values of "a wise childhood, ... which only children like Shakespeare, Newton and Socrates were capable of… The eternal childhood of the soul is the deepest foundation of true human self-education" ^{[10, pp. 17-18]}. This refers to such development and self-education, which covers all people and lasts all their lives, avoiding gaps between primary schools, gymnasiums and universities, as well as the system of training associate professors and professors. This idea, in our opinion, implicitly containing contours and NPR, characterizes the views of two of the greatest Russian teachers. Appeals to this kind of wisdom, which breaks off new paths in the course of adult development, are found in many works by both Pirogov and Ushinsky.

It remains to add that Pirogov made a significant contribution to the initial development  just maxillofacial surgery. So, back in 1835, before the members of the St. Petersburg Academy of Sciences, they gave a lecture on rhinoplasty – the audience was, of course, not only doctors. He personally performed many jaw surgeries during the Crimean War and scientifically summarized their effectiveness. As if following Peter I, Pirogov invented a number of surgical instruments for dentistry, in particular, the famous "goat's foot", and he developed his unique professional skills and abilities until the end of his life.

It is equally productive to identify traces of the idea of NPR from the psychologist and teacher V.V. Davydov. In his works, in particular, in lectures on age-related patterns of thinking development, he emphasized the interaction of reason and reason as two types of thinking with the strengthening of the second in the course of professional education, as well as within the framework of the theory of educational activity on its own basis. At the same time, it was emphasized that not every training has a developmental value, but only that which is aimed at productive activity. He wrote: "It is impossible to reveal the true depths of a person's human potential, remaining only within the established forms of his activity and already accepted systems, since in other conditions and in other systems of education and upbringing this potential can change significantly.  The purpose of developing education is precisely to deepen and expand it" ^{[11, p. 142]}. It remains to add that the Siberian Institute of Developmental Education in Tomsk produces a whole library of books in this area, and the techniques of developmental education are actively being introduced into the practice of medical education ^[12].

Finally, our century is characterized by adaptations to the NPR of the concept of a reflexive-developing environment, developed by V.E. Lepsky and his followers. Such an environment emphasizes the subject–subject relationship for a more conscious interaction in the subject–object relationship, it is constantly focused on the production and transfer of new knowledge.  At the same time, the NPR acts as one of the key goals; it is successfully formed based on IT technologies, but it is unimaginable even without the self-development of the subject of science and education. Back in 2010, a book about this environment recorded that "the state of the education system clearly does not meet the requirement of putting the country on the path of innovative development" ^{[13, p. 11]}. At the same time, it outlined ways to overcome the crisis based on the polysubject principles of design, management and development of sociotechnical systems in the field of education ^{[13, p. 155]}.

It was emphasized that the modern content of the concept of "subject" implicitly assumes the continuity of its self-development, and the polysubject active–reflective environment is the production and dissemination of knowledge based on the latest information technologies and even knowledge about these technologies themselves ^[14].

Special attention was paid to the problems of education at the conference on reflexive management in 2023. One of the articles in the collection of its materials concerned the modeling of active-reflexive environments in the organization of educational processes on new grounds ^[15]; the second revealed the potential of the reflexive approach in substantiating the processes of assimilation of healing models ^[16].

A variant of the project for the development of education in a reflective and developing environment is introduced in the article, which also focuses on the self-development of the subject. This environment is used for "the growth of self-awareness, creative thinking and reflective culture of students as subjects of all the main stages of personality-oriented continuing professional education" ^{[17, p.95]}; the level of NPR is not discussed in the article.

The possibilities of the reflexive approach, including methods for creating a polysubjective active-reflective environment in the medical education system, are not fully involved, despite the fact that they best meet the needs of its digitalization. 

The work of the educational structures of the Central Medical Research Institute is also being built in this direction, the samples of which are important for structures of this kind in other national medical research centers.

3. An empirical study of the processes of perception and evaluation of NPR

All of the above regarding the relationship of NPR with the self-development of a medical specialist was taken into account by us when compiling and implementing the program of an empirical study conducted in December 2023. Within its framework, a survey was conducted of three groups of students at the Central Research Institute of Economics with in-depth interviews of a number of their members.

In total, 109 students were covered by the study, of which about a sixth of the total number of interns studying at TSNIISICHLH (48), half of graduate students (26) and a third of DPO students (33). There were approximately equal numbers of men and women in the group of residents and graduate students, and the number of men among the DPO students was three fifths. The age structure of the interviewees is as follows: residents are mostly 24-26 years old, graduate students are 27-30 years old, DPO students range from 30 to 60 years old. Representatives of all three groups, who were subjected to in-depth interviews, made it possible to better understand the specifics of the perception of the NPR. 

According to the results of the survey, it turned out that the residents recognize that currently all opportunities have been created for postgraduate and, in principle, continuous dental education, but they do not present the possibilities of the NPR with due clarity. The following answers to the question of whether there is a significant difference between continuing professional education and NPR are dominant: "I think we are talking about the same thing," there is also a large proportion of answers "I have never thought about it." At the same time, residents are more likely than representatives of the other two groups to appreciate the activity of mentors, including teaching doctors; they are also more aware of career opportunities in connection with the development of the digital learning environment. Nevertheless, according to the results of the questionnaire survey, it is clear that for them the concept of NPR is poorly connected with the intentions of professional development and business career. They differ from graduate students, to whom much is "clear" due to the fact that their studies are motivated by conducting scientific research in their chosen direction.

Nevertheless, residents are in some respects more inquisitive in mastering some parameters of the NPR and are attuned to critical judgments about others. So, in an in-depth interview, the first-year resident O. (a woman, born in 1998, with 1 year of work experience), giving detailed positive answers to key questions, notes that it is still impossible to unambiguously assess the potential of NPR in dentistry. She admits that it is also difficult for graduate students and students of DPO to realize this, and believes that "it is necessary to talk about this potential in different ways." This legitimate remark prompts a more differentiated consideration of the second position in the answer to the question about the differences between NPR and continuing professional education. In particular, this continuity is assessed one way when transferring directly from the student bench to the residency, requiring direct presence in clinics and laboratories, and another way by those who have at least several years of work experience between these two types of educational activities.

The interviewed graduate students come to study after an average of 3 to 5 years of work experience, characterized by an attitude towards scientific generalization of their work experience. These are graduates of various medical universities who consider professional development in combination with scientific developments to be a sign of NPR. Career growth is important for them if it is related to research activities in the chosen direction. They highly value pedagogical competence, both on the part of mentors and as a professionally important quality acquired by themselves.

It should be emphasized that the experience of the Central Research Institute in organizing and conducting independent scientific research by graduate students with the results in the form of PhD theses is highly productive precisely because of the combination of scientific activity and diverse clinical practice. The scientific career of graduate students in this perspective appears to be a dominant, but not self-sufficient motive, growing out of requests for original approaches in various areas of dentistry and maxillofacial surgery.

In an in–depth interview, a second-year graduate student P., who is preparing a dissertation on surgical dentistry, believes that its defense is an important, although not the only element of professional development and even career growth. The main thing is that the achieved results of scientific developments in the course of its preparation should be applied in practical reality and expand the knowledge base in dentistry. As for the role of a doctor-teacher, in his opinion, during the preparation of a dissertation, some competencies are exchanged: a graduate student who has thoroughly mastered the digital environment and the use of some artificial intelligence functions can inform his supervisor about this, building joint trajectories of scientific research more clearly. The interviewee evaluates the accreditation processes as an opportunity to acquire new knowledge and skills, it should not act as a purely formal procedure, but be a kind of innovation exchange point. He emphasized that the achievement of significant scientific results is the most important component of a doctor's prestige: the inscription "Candidate of medical sciences" is a kind of competitive advantage in terms of reasonableness of decisions and increasing the effectiveness of medical practice.

The most meaningful reception of the NPR is carried out by the students of the DPO, who quite clearly see the need to clarify its parameters, too, regardless of the accreditation procedures. They have quite clearly expressed requests for educational programs within the framework of the Central Research Institute of Economics, a number of which, in their opinion, need to be adapted to the requirements of professional growth in the context of digitalization. There is a higher proportion of interest in maxillofacial surgery among this group of students compared to the other two groups.

In an in-depth and extensive interview dated December 26, 2023, a student of the M. DPO cycle with 26 years of clinical practice experience, who graduated from the Maxillofacial Surgery program, noted that the concepts of "continuing professional education" and "NPR" have hardly distinguishable meanings. The first one can be understood as building professional competencies, which leads to professional development. The second involves understanding the goals of one's professional activity in broader contexts, it is more often correlated not only with the profession, but also with the vocation. You can think about this at different stages of your medical career, but a clear awareness of your vocation comes during a period of professional viability and social maturity.

 The interviewee noted: "I recently got acquainted with a book by a St. Petersburg teacher and psychologist under the interesting title "Psychological development of a person: birth and life." It turned out that a full-fledged "birth" occurs most often in the period of middle adulthood – at the age of 40 to 60 years. Why? Because at this age there is a reassessment of professional career as a way of life realization, and this implies the inevitable manifestations of what can be called "altruistic orientations" ^{[18, p. 388]}. During the interview, it turned out that M. recognized the depth of this thought and even wrote it out. It is at this age that the assessment of one's professionally important qualities is expressed in such words: "Do I need something and someone?" - and the answer to this question requires expanding the horizons of vision. This is a moment of full-scale awareness not only of the importance of your profession, but also of the extent to which people need it. At the same time, preparation for the next accreditation, in the opinion of the interviewee, should begin on the second day after passing the primary one; for all the imagery of this expression, it reflects just the moment of the NPR.

Noteworthy in the interview is the high assessment of the role of teaching doctors in the development of professional knowledge - even if mentoring is carried out remotely through the latest technologies. It is also indispensable in the course of mastering skills and techniques during learning in a digital environment, being in a relationship of mutual complementarity with self-development. Only in this way can an accessible environment for professional growth be created for practitioners, especially those working on the periphery, as a key prerequisite for NPR.

At the end of the interview, M. noted: "TSNIISICHLH should be the center of NGOs and NPR in Russia, since the potential of its educational innovation is very high, the departments use the latest technologies, and doctors have extensive experience in managing patients of any complexity. It is necessary to invite teachers of dental faculties of Russian universities to study in order to raise the level of education of students at medical universities – the basis of knowledge is laid in them. The state needs to support medical school teachers – there are already so few of them. At the legislative level, it is time to prohibit the training of doctors only under an educational license by any educational institutions. We need to stop formally training doctors and selling points for accreditation over the Internet. There is no need to destroy the system of medical education that has been created over the years, it is necessary to develop it, preserving the traditions of the medical school. To become a doctor, to adopt clinical experience, to be responsible for the health and life of another person, you need to be "at the bedside", seeing his experiences and suffering from the disease, empathize with him. Recently, young doctors have been evaluating themselves and their capabilities with this in mind. In the first years of practice, mentoring and communication with a highly qualified specialist are necessary for a young doctor."

With certain variations, similar thoughts are contained in other in-depth interviews of DPO listeners. They emphasize the importance of measures to ensure NPR in the practical activities of doctors, especially maxillofacial surgeons, since it should be correlated with the latest scientific achievements and modifications of the pedagogical component.

Conclusion

In general, the NPR begins to act as a leading direction in the training of highly qualified medical specialists, replacing many elements of continuing professional education, supplementing them with self-development attitudes. The introduction of their joint parameters into the educational practice of dentists and maxillofacial surgeons contributes to improving the effectiveness of their professional training.

Self-development activates all aspects of professional activity and scientific activity of doctors of this profile within the educational structures of medical research centers.

 Residents, graduate students and students of the DPO FSBI NMIC "TSNIISICHLH" of the Ministry of Health of the Russian Federation perceive NPR in different ways: residents more often consider it a kind of continuing professional education, graduate students identify its techniques with the vectors of their scientific searches. It is the students of the DPO who are most aware of the values of the NPR, first of all those who have mastered the basics of professional skills.

Both the theoretical understanding of the NPR issues and the empirical studies we have conducted confirm the validity of the idea expressed at the beginning of the article that the appropriate techniques and values inherent in it should not be imposed, it is desirable to bring them to them, based on the points of their growth present in the history of education in any country. They can be interpreted in different ways, but one cannot rely only on "imported" explanatory procedures regarding the NPR.