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MINISTRY OF EDUCATION AND TRAINING VINH UNIVERSITY NGUYEN QUOC DAT DEVELOPING THE TEAM OF CLINICAL VISITING LECTURERS OF THE MEDICAL UNIVERSITY Specialization: Educational Management Code: 9140114 SUMMARY OF DOCTORAL DISSERTATION OF SCIENCE AND EDUCATION NGHE AN - 2018 The dissertation was completed at: VINH UNIVERSITY Science instructors: Assoc.Dr NGUYEN BA MINH Dr PHAN QUOC LAM Reviewer 1: Reviewer 2: Reviewer 3: The dissertation will be protected before the doctoral dissertation evaluation board at Vinh University - 182 Le Duan, Vinh City At on The dissertation can be found at: - National Library - Library of Vinh University INTRODUCTION Reason for choosing the topic Teachers and administrators play an important role in determining the quality and effectiveness of education and training Developing the team of teachers is the responsibility of training institutions and State management levels in the field of education and training The training of medical staff is very specific, up to 50% of teaching time at the hospital (clinical studying); Participating in lecturing students at the hospital (clinical teaching) includes not only the faculty members of the university but also the staff of the hospital called Clinical Visiting Lecturers (CVL) In recent years, Medical Universities have used the team of CVL to participate in their training activities, but have not paid much attention to the development of this team effectively From the above reasons, with the desire to gradually standardize the team of CVL to meet the requirements, tasks and improve the training quality of Medical Universities, the author selected the issue: "Developing the team of Clinical Visiting Lecturers of Medical Universities"for study Purpose ofthe study Based on the theoretical and practical study of the development of the CVL team in terms of their positions on employment, roles and labor characteristics, the thesis proposes solutions for the development of the CVL team,aim to "standardize" this team, thereby contributing to the improvement of the training quality of human resources for health, meet the requirements of fundamental and comprehensive innovation in education and training Object and subject of the study 3.1 Object of the study: Management activities for the CVL team at Medical Universities 3.2 Subject of the study: Activities to develop the CVL team of the Medical Universities Scientific hypothesis The CVL team of Medical Universities will be developed in the way of quantitative sufficiency and synchronous structure, with high quality They can satisfy the requirements of quality, ability,suitability for job position if management solutions based on labor characteristics, qualitative requirements and the capacity of the CVL are proposed as well as the management functions are adhered Tasks and scope of the study 5.1 Research tasks - Studying the theoretical basis on the development of the CVL team of Medical Universities - Surveying and assessing the current status of the CVL team and the actual development of the CVL team at Medical Universities - Proposing solutions to develop the CVL team of Medical Universities; Surveying the necessity and feasibility of proposed solutions; Experimenting with a solution to develop the CVL team of the Medical University 5.2 Research scope Surveying onthe status, necessity and feasibility of proposed solutions in some Medical Universities (Hanoi, Hai Phong, Thai Binh, Thai Nguyen, Hue); Experimenting with a proposed solution at Vinh Medical University Methodology and Research Methods 6.1 Methodology Approach viewpoint:Based on the systematic-structural approach; operational approach; approaching to human resource development; approaching to employmentplacement; practical approach 6.2 Research Methods - Group of theoretical research methods:Synthetic analytical method of theory; Method of generalizing independent statements; Modeling method - Group of practical research methods: Survey method; Interview method; Professional solution; Method of summarizing experience; Experimental method - Complementary method: Mathematical statistical methods for processing quantitative data Points to protect in the thesis - Developing the CVL team means developing human resources for training medical staff Therefore, the content and the way to developthe CVL team must base onthe theoretical - practical basisof human resource development in general - In recent years, the CVL team has gradually affirmed their position and role in the training of human resources for health However, the activities to develop the CVL team at medical universities have not been paid much attention.The reality requires to have solutions to build the CVL team that is enough in quantity as well as ensure the quality and framework This is a necessary requirement for ensuring and improving the quality of training of Medical Universities - In order to develop the CVL team of Medical Universities effectively, the system of solutions should be synchronously applied: Organizing to raise awareness of the subject in the development of the CVL team; Formulating a set of standards for the qualification and competence of the CVL team; Planning, selecting, using the CVL team scientifically and effectively; Organizing training and upgrading pedagogical capacity for the CVL team; Formulating remuneration policies for theCVL team to motivate and promote their role Contribution of the dissertation - Systematizing and building the theoretical basis for the development of the CVL team of Medical Universities; Building the basic capacity framework of the CVL team of Medical Universities - Assessing the reality of the CVL team and development of the CVL team at Medical Universities; Pointing out the shortcomings of the CVL team and the development of the CVL team of Medical Universities in the current period; Indicating to some factors that influence the development of the CVL team of Medical Universities - Proposing solutions to develop the CVL team of Medical Universities based on their job positions and their professional standards Structure of the dissertation Apart from the introduction, conclusion, references, research appendix, the dissertation consists of chapters: Chapter 1:Theoretical basis for developing the team of Clinical Visiting Lecturers of Medical Universities Chapter 2: Practical basis of developing the team ofClinical Visiting Lecturers of Medical Universities Chapter 3:Solutions to develop the team of Clinical Visiting Lecturers of Medical Universities Chapter THEORETICAL BASIS FOR DEVELOPING THE TEAM OF CLINICAL VISITING LECTURERS OF MEDICAL UNIVERSITIES 1.1 Overview of the studied issues 1.1.1 Researches on the development of faculty members The issue of faculty membersand development of faculty membershas been studied in many countries around the world Typical projects are as follows: - Researches on the quality of faculty members: authors, Raja Roy Singh (1991), International Conference on Higher Education in the 21st Century "Vision and Action" (1998), OECD members (2005), Sakarneh and Nair (2014), Pham Xuan Hung, Hoang Tam Son (2010), etc have analyzed the necessary qualities and capacities of a faculty, including: respecting and sympathizing with learners; having professional knowledge, teaching skills, the capacity to manage students, scientific research capacity - Researches on criteria for evaluating the faculty: Ramli et al (2010), Ghonji et al (2013), Costa et al (2012), Le Duc Ngoc (2004), Dang Quoc Bao, Do Quoc Anh, Dinh Thi Kim Thoa (2007), Tran Xuan Bach (2010), etc have formed the professional standard framework, criteria for assessing the faculty,assessment preparation steps,general process when evaluating - Researches on solutions for the development of faculty members: The Universal Declaration on Higher Education for the 21st Century - Vision and Action of UNESCO (1998), K.B Everard, Geofvey Morris, Ian Wilson (2007), Daniel R.Beerens (2003), Pham Thanh Nghi (1993), Phan Van Kha (2008), Nguyen Huu Chau (2008), Duong Minh Quang (2010), Nguyen Van De Tran Thi Hong Van (2012), Nguyen Thi Thu Huong (2012), Nguyen Danh Nam (2014), Nguyen Bach Thang (2015), etc The authors have pointed out solutions to develop the faculty members to ensure sufficiency in terms of quantity, reasonable structure and quality standards to well achieve the objectives, content and training plan such as attracting, creating sources, selecting, policy, training, fostering, examination, comment and evaluation for university lecturers - Researches on the factors influencing the development of faculty members: Victir Minichieloo (2008), Rama (2011), Bui Viet Phu (2010),etc indicate factors influencing quality and development of faculty members including: elements of the individual lecturer; work environment; market economy 1.1.2 Researches on the development of the CVL team The issue of developing the CVL team is mentioned by some domestic and foreign authors such as Huggins (2017), Zawati et al (2015), Russell et al (2014), Nguyen Dinh Chung, Luong Xuan Hien (2010), Luong Hoai Nga (2012), Nguyen Van Khai (2013), Cao Truong Sinh (2013), etc The authors talked about the role and position of the CVL team as well as the need to attract this team to involve in the training of human resources for health Experiences in the United States: They attach much importance to clinical teaching for medical students, only top-level doctors or doctors with high professional quality are licensed to instruct for students to practice In European countries (England, France, Germany, etc.) and Australia, with the trend of popularization, the number of medical students has rapidly increased, therefore, the number of lecturers has also increased This requested Medical Universities to make use of important and professional human resources at hospitals Consequently, the CVL team have rapidly increased in number In some Southeast Asian countries: Due to the changing patterns of disease, the demand for medical examination and treatment with good quality of services has continuously increased, which requires a large team of qualified health staff to meet them The size of Medical Universities increases, leading to an increase in the number of faculty members and visiting lecturers In terms of science, the author has not found any research working directly on the development of the CVL team In fact, these issues have only been exchanged at scientific conferences, in the form of scientific reportsor appeared in the regulations of managers, macro-policy-making or becomethe talked and exchanged issues of internal science In general, it has not really been studied by scientists 1.2 Some basic concepts Clinical: "Clinical" is a medical term, referring to what is involved, occurring in patients at the hospital In other words, what is directly related to the patient is called clinical Clinical Teaching: is an activity organized for students in contact with patients at the hospital (Practice Facility), to help students apply knowledge, form skills and job attitudes Clinical Visiting Lecturers: are medical staff of hospitals,who not belong to the staff of the Medical University, but they are enough qualified and conditional to be used by the Medical University as a lecturer to provide practical training for students in hospitals, in the form of service contracts to perform tasks The team of clinical visiting lecturers: is the team of medical staff of Practice Hospitals, take responsibility for clinical guidance for students of Medical Universities They are linked together, together carry out the objectives and tasks of training, directly teach and educate students to form skills, techniques, professional operations and professional ethics Developing the team of Clinical Visiting Lecturers: is the development of human resources for health working as clinical guide for the Medical University It is a process that makes the CVL team change and be better at quantity, structure and quality, in order to best meet the requirements, the mission of healthcare and teaching students at the hospital 1.3 The Clinical Visiting Lecturer of the Medical University 1.3.1 Position, role of the Clinical Visiting Lecturer The position of the CVL was promulgated by the Government's Decree No 111/2017 / ND-CP dated 05/10/2017: The CVL is a force of the Medical University, assigned to teach students at the hospital Total teaching time of the CVL is 50% - 80% of the total duration of the hospital practice program The CVL is the person who directly organizes the clinical teaching activities for students of Medical University and contributes importantly, creating the qualified training products to meet the requirements of the task.What is more, they directly help form and practice skills, techniques, professional operations,emotion and professional ethics of the physician 1.3.2 Mission of the Clinical Visiting Lecturer The CVL: both the duty of the physicianand the task of the teacher - Performing the role of the physician: The CVL is the physician of Practice Hospitals, so they must perform the tasks of the physician according to the provisions of Joint Circular No 10/2015 / TTLT- BYT-BNV dated 27/05/2015 by the Ministry of Home Affairs and Ministry of Health - Performing the duty of the teacher: The CVL is the person who directly teaches the practice and does other work related to the teaching practice at the hospital Therefore, the duties of lecturers must be fulfilled in accordance with the provisions of Joint Circular No 36/2014 / TTLT-BGDDT-BNV dated 28/11/2014 by Minister of Education and Training and Minister of Home Affairs 1.3.3 Labor characteristics of the Clinical Visiting Lecturer - Carrying out the “dual” objectives and tasks: Labor of the CVL aims to provide medical examination and treatment for patients and at the same time, ensure the teaching of students - Linking between health science and education science: The work of the CVL is a harmonic and rhythmic connectionbetween health science and the education science The work of the CVL is a combination between the work of the "physician" and the work of the "teacher" 1.3.4 Qualitative requirements of the Clinical Visiting Lecturer Medical profession and teaching profession which are related, directly impact on people, are honored by the society, so the CVL should have moral qualities of the physician and the teacher - The ethical qualities of the physician: The physician must have good heart, love people, enjoy the joy of the sick, suffer from the pain of the sick and sympathize, share the compassionwith the relatives of the sick It can be said, professional conscience is the best and most basic quality that the physician must have - The moral qualities of the teacher:The teacher must be really exemplary to teach people, vocational training: teachers not only propagate knowledge, methods and skills for learners, but also model in learning to improve professional qualifications; they must constantly cultivate, practice morality, are good examples for students to follow - Criteria for the moral quality of the CVL: On the basis of the ethical qualities of the teacher and the physician; Based on the standards of professional ethics of doctors (as defined in Joint Circular No 10/2015 / TTLT-BYT-BNV dated 27/05/2015 of the Ministry of Home Affairs and the Ministry of Health) and Regulations on teacher morality (According to the Decision No 16/2008 / QDBGDDT dated 16/04/2008 of the Ministry of Education and Training), we built the standards of ethical qualities of the CVL including:(1) dedicating to the profession, being aware of the honor, the conscience of the physician and the teacher;(2) devoting to teaching activities,to the cause of care, protection and improvement of people's health; (3) Practicing the profession in accordance with the rules, regulations, technical procedures;(4) Continuing education to improve professional qualifications and capacity; (5) Being honest, objective, fair, responsible, solidary, respectful and cooperating with colleagues in professional practice as well as in teaching and educating learners 1.3.5 Qualification requirements of the Clinical Visiting Lecturer The CVL must congregate the capacity of the physician and the capacity of the teacher, can be specific by the following diagram: Professional competence Capacity to develop educational program Teaching capacity Capacity framework for the CVL Capacity of scientific research Communication capacity 1.3.6 Qualification criteria of the Clinical Visiting Lecturer Based on the capacity framework of the CVL and the reference to two legal documents: Joint Circular 36/2014 / TTLT-BGDDT-BNV dated 28/11/2014 by Ministry of Home Affairs and Ministry of Education and Training on stipulating codes and the criteria for professional titles of teaching staff in educational institutions; Joint Circular No 10/2015 / TTLT-BYT-BNV dated 27/5/ 2015 by the Minister of Home Affairs and the Minister of Health regulating the codes and standards of professional titles of doctors, we built the capacity standards of the CVL including: (1) Criteria for the trained and fostered level; (2) Qualification Criteria; (3) Criteria for pedagogical competence A set of standards with 12 criteria is both an important basis for assessing the team of the CVL and the conditions for recruiting and training medical staff of the Practice Hospital to become a CVL 1.4 Developing the team of the Clinical Visiting Lecturer 1.4.1 The role of Clinical Visiting Lecturers The CVL team plays an important role in Medical Universities, as shown by the following contents: The CVL team are the people who directly organize the clinical teaching activities for students,thus directly affecting the training quality of the Medical University; Clinical teaching is a part in the program of training medical students,so the CVL team are contributing to perfect the training process of students of the Medical University;The CVL team is a part of human resources for the human resource development strategy of Medical Universities 1.4.2 Significance of the development of the CVL team The development work for the CVL team is very necessary, help Medical Universities implement the training program for medical staff, assure quality On the other hand, the development of the CVL team helps Medical Universities solve the human resource problem, with the increase in the number of students, followed by the increase in clinical positions Developing the CVL team is to standardize the teaching staff and increase the connection between the practice facility and the training facility, creating a favorable environment for students to study 1.4.3 Objective for development of the CVL team The development work of the CVL team for students must achieve the following specific criteria: - Enough in quantity: ensuring the ratio of 10 students / a CVL and at least each department of the hospital with clinical students must have at least CVL - Assurance of structural balance: The CVL team teach clinical practice in accordance with the professional, promote their strengths and abilities the most effectively Ensuring age, seniority and employment status - Quality assurance: The CVL must meet enough and harmonize both quality standards: the good physician and the good teacher 1.4.4 Content of the development of the CVL team - Forming the development plan of the CVL team: The development plan of the CVL team is an important step in order to maintain sufficient quantity, structural balance and quality assurance - Selecting the CVL:Recruiting qualified medical personnel who have capacity and qualifications as required to teach for Medical Universities - Using the CVL: Arranging, appointing positions, professional titles the best suitably to the capacity of each CVL, giving them the environment and motivation to maximize their potential - Training and fostering the CVL team: The process of training and fosteringthe CVL team is focused on the following contents: Training in professional and pedagogical skills, fostering soft skills, training in foreign language and information technology - Evaluating the CVL team: The assessment of the CVL team must be based on their functions, tasks and standards of quality and capacity The requirements in the assessment must be accurate, objective, fair and consistent from individual, department to university and hospital - Remunerating the VCLaccording to capacity:The remuneration must be based on the capacity and work effectiveness that each CVL expressed Remunerating the VCL is to provide opportunities for advancement, make adequate payment and create a working environment based on the capacity and dedication of each CVL This is the motivation to encourage them to enhance the capacity to perform tasks 1.4.5 Development subject of the CVL team The CVL team is managed by the Director of Hospitals and the Headmaster of Medical Universities Thus, the development subject of this team is also the Director of Hospitals and the Headmaster of Medical Universities, in which the Headmaster of Medical Universities plays the leading role, is responsible for coordinating with the Director of Hospitals to develop the CVL team 1.5 Factors affecting the development of the CVL team 1.5.1 Subjective factors - Individual awareness, passion and sense of responsibility in the teaching of the CVL - Collaboration between Medical Universities and Practice Hospitals - Remuneration policy for the CVL team 1.5.2 Objective factors - Trend in the sub-sectorsof Medical Universities - Impact of the market economy CONCLUSION OF CHAPTER The CVL team are excellent physicians of the hospital, participating in teaching, helping shape and train skills, techniques, professional operations and professional ethics for students of Medical Universities, and they are also a special team in Medical Universities When analyzing research works of authors in the country and abroad, there are many studies on the subject of lecturers, the development of university lecturers Researches have provided theoretical and practical basis as well as current Medical Universities meet the standards as prescribed Of which, the rate of the foreign language proficiency level B2 or higher is 49.23%,level B1 makes up 39.23% and level A2 is 11.54%, there is no case of level A1 - Informatics level of the CVL team: 100% the CVL of Medical Universities have level of informatics, meet the requirements as prescribed Of which, level C holds up 32.05%, level B is 50.51% and level A is 17.44% 2.3.3 Current status of the professional capacity of the CVL team The survey results show that: the professional capacity of the current CVL team is evaluated from the fairly high level It is interesting that the majority of evaluation is very good and good Specially, 100% of learners (Object 5: Students) evaluated the criteria of professional competence of the CVL team are at good and very good level This result shows that the learner (student) accepts the professional competence of the instructor (the CVL) 2.3.4 Current status of the pedagogical capacity of the CVL team - Current status of teaching capacity:Ability to prepare for teaching:Very good level makes up only 7.08%; good level accounts for 28.08%; fairly good level accounts for 26.6% In addition, 28.71% rated averageand 9.53% rated weakness; Ability ofteaching organization of the CVL team is rated as very good and good accounting for 39.8%.In addition, 24.66% rated average and 5.78% rated weakness; the capacity to test and evaluate students of the CVL team is rated as good only accounting for 22.55%; at the fairly good level of 38.47%;average level is 34.02%, especially 4.97% at the weak level - Current status of communication capacity of the CVL team:is rated as very good and good accounting for 66.78% and only 9.36% rated at average level There is no assessment at weak level This shows that the current CVL team is capable of communicating to perform their teaching tasks - Current status of capacity to develop training program of the CVL team:is rated as good and very good accounting for 40.66% , 33.26% rated as fairly good, 26.08% rated average level, no one rated as weak - The current status of capacity for scientific research and scientific research guideline of the CVL team:is rated as good and very good accounting for 51.51%, 40.37% rated as fairly good, only 8.13% rated average, no one assessed the weak level Among them, the capacity to guide students to scientific research has reached 40.64% of rating the average level, only 5.02% is rated as very good 2.3.5 Current status of theethical qualities of the CVL team The ethical qualities of the CVL team are rated as very good accounting for 31.42%; good level accounting for 47.35%, only 21.23% rated as quite good, no one rated the average level and the weak level In particular, criterion (Passion for careers, consciousness of preserving the honor and the conscience of the physician and the teacher) are highly rated (89.27% is rated as very good and good) 2.4 Reality of the development of the CVL teamof Medical Universities 2.4.1 Reality of planning work for the CVL team - Survey on building development plan for the CVL team: The results showed that among the surveyed universities, only universities (66.67%) had plans to develop the CVL team, while two universities (33.33%) had no plans to develop the CVL team Although the number of surveyed universities is not large enough to evaluate all Medical Universities, this also shows us that planning work for the development of the CVL team has not been focused - Survey on the content of the development plan for the CVL team Survey at Medical Universities which have the development plan for the CVL team showed that: this work was assessed at a decent level (2.92 points) 2.4.2 Current status of the selection work of the CVL team The survey results show that: the selection work of the CVL team is rated as good (4.03 points) In particular, the organizing work to select is the most appreciated (4.36 points), the content of the selection criteria is lower (3.31 points) 2.4.3 Current status of arranging and using the CVL team Survey results show that: arranging and using the CVL team are rated at a fairly good level (3.68 points) In particular, the correct placement of specialties, the use of the CVL in teaching, testing and evaluating students are highly appreciated (over 4.0 points) In addition, there are two items that have been underestimated: the use of the CVL to guide students to scientific research (2.35 points) and the use of the CVL in building the training curricula (2.07 points) 2.4.4 Current status of training and fostering work of the CVL team The training and fostering work of the CVL team is evaluated at the moderately good level (average score 3.22) In particular, the training and fostering work of professional qualifications are the most appreciated and at the good level (4.08 points);the training and fostering work of informatics and foreign languages are rated at thefairly good level (3.30 points); particularly, the training and fostering work of pedagogical profession is only rated at the average level (2.29 points) 2.4.5 Current status of inspecting and evaluating the CVL team The inspection and evaluation of the CVL team at the medical universities was rated at the fairly good level (3.31 points) Through the exchange, it is known: despite this assessment,in fact, universities implement this contentimpulsively and to cope with the requirement.They have no clear criteria, so it is less effective It has not really been the basis for regulating teaching, learning activities and educational management 2.5 Current status of factors affecting the development of the CVL team 2.5.1 Assessment of the impact of factors on the development of the CVL team The results show that the given factors strongly influenced on the development of the CVL team (synthesis point 4.36) In particular, the issues that belonged to the CVL team and the collaboration between medical universities and practice hospitals were considered thevery strong influences (4.58 points - 4.75 points respectively); Next is the remunerative policy of the CVL team and the impact of socio-economic development (4.36 points - 3.92 points respectively) Thus, once again, we can confirm the impact of the above factors on the development of the CVL team, especially the subjective factors 2.5.2 Current status of the factors affecting the development of the CVL team - The factors belong to the CVL themselves The results show that, in general, the factors belonging to the CVL team themselves are rated as very good (4.55 points) This is the greatest advantage for Medical Universities when using this team to improve the quality of training It is the foundation for building a quality teaching staff in Medical University and is also an important factor contributing to the quality of the training - The collaboration between Medical Universities and Practice Hospitals in the development of the CVL team: the collected data show that the work of combining the Medical University and the Practice Hospital in the development of the CVL team is assessed at the average level (2.06 points) In particular, the combination of training and fostering is the weakest (1.74 points), then is the combination in the management of the CVL team (1.88 points) The highest rating is the combination in the planning, selection and use, but also only reached the moderate level (2.56 points) This is a gap that Medical Universities need to care about - Current status of theremuneration policyfor the CVL team:The results show that the remuneration policy for the CVL team is performedquite well by universities (3.42 points) The contents: "participating in professional activities at the Medical University" and "Paying adequate remuneration for the CVL" are only assessed above average level (2.96 - 2.66 points) 2.6 General assessment on the reality of the development of the CVL team 2.6.1 Strengths - Perception: Medical Universities and Practice Hospitals all believe that the CVL team play an important role in the training of human resources for health, and the development of this team is essential - The quality of professional ethics, professional qualifications and professional capacity of the CVL team are well appreciated - In some universities, the planning work of the CVL team has been paid attention.In the planning, attention was paid to the number and the trained professional qualifications of the CVL team The selection, placement and use of the CVL have been taken notice by Medical Universities, especially the selection and placement of the right speciality to teach students are highly appreciated; Professional training and fostering are taken notice by hospitals and highly appreciated The training and fostering in informatics and foreign languages have also been evaluated quite well - Medical Universities have also identified the factors that influence the development of the CVL team 2.6.2 Drawbacks In addition to the achievements, the development work ofthe CVL team still has the following shortcomings: - The current number of the CVL team is missing, (average rate is 14 students / a CVL, while the regulation is 10 students / a CVL); Structure of the CVL team is not balanced; Quality of the CVL team has not met the requirements, there are many shortcomings in pedagogical capacity - Some universities have not had plans to develop the CVL team, somehave had plans but they only concernabout solving immediate problems without longterm strategy They have not been active and have not cooperated well with Practice Hospitals in building development planning of the CVL team New selection work only bases on professional capacity, not interested in pedagogical capacity; Training and fostering pedagogical capacity have not been paid attention The work of testing and evaluating the activities of the CVL team has not been effective, still focus on form; Evaluation criteria are general, subjective - The combination of Medical Universities and Hospitals to develop the CVL team has not been good The payment of remuneration for this team has been implemented but not satisfactory 2.6.3 Causes of the current situation - Causes of the strengths: Medical Universities have strictly implemented the guidelines of the Party, policies and laws of the State The Ministry of Health issued Circular No 09/2008 / TT-BYT dated 01/08/2008 guiding the combination of Medical Staff Training Centers and Practice Hospitals in training, scientific research and people's healthcare; Recently, on October 5, 1977, the Government issued Decree No 111 / ND-CP stipulating the organization of practical training in health sector training, creating a legal corridor for Medical Universities and Practice Hospitals to perform With the increasing number of students in the trend, Medical Universitieshave been interested in using the CVL team in teaching activities with the support of Practice Hospitals With heart, enthusiasm, professional capacity, efforts of the CVL team, they are ready to overcome many difficulties and pressures to accomplish two tasks: Healing the patients and clinical teaching for students This is factor to make the clinical teaching effective - Causes of shortcomings: Because the work of developing the CVL team at the medical universities in Vietnam is implementing the model of "Personnel Management", not approaching and implementing the model of "Human Resource Management"according to employment position This is the main reason for the restrictions, shortcomings analyzed Some managers of Medical Universities have not been fully aware of the subject role of the university in the development of the CVL team, so not active in building the plan and havenot done well the number of stages in the selection process, use, training the CVL team Despite having the legal basis, the support of Practice Hospitals, deployment was still embarrassing, so the coordination between University - Hospital is not close andtight; The negative side of the market economy has also contributed to the shortcomings and limitations mentioned above CONCLUSION OF CHAPTER Clinical teaching activity in Practice Hospitals is a unique activity of Medical Universities The survey again confirms the important role of the CVL team for teaching medical students and the development of this team is very necessary From theoretical basis, the author proposed the set of standards for the CVL including 12 criteria, which were verified during the survey This is the basis for selection, training, fostering, testing and evaluating the CVL team In addition to its strengths, such as high professional qualifications and good morals, willingness to take on teaching duties and guide students to practice in hospitals, there are still shortcomings that need to be solved, such as: the missing number, The structure of the CVL team in faculty groups is different and unbalanced; The majority of the CVL are evaluated in terms of pedagogical capacity at low level, the rate of the CVL trained and fostered in pedagogy is still low The planning, selection, arrangement, use, training, fostering, inspection, evaluation and screening of the CVL team of Medical Universities have been implemented but not yet active,in the form of coping, efficiency is not high The factors that strongly influence the development process of the CVL team are: (1) issues that belong to the CVL team; (2) Collaboration between Medical Universities and Practice Hospitals in the development of the CVL team; (3) Remuneration policyfor the CVL team; (4) Impact of socio-economic development From the above analysis, it is important to propose solutions for the development of the CVL team presented in Chapter Chapter SOLUTIONS TO DEVELOP THE TEAM OF CLINICAL VISITING LECTURERS OF MEDICAL UNIVERSITIES 3.1 Proposed principles of solution 3.1 Principles for proposing solutions The proposed solutions for the development of the CVL team of the Medical University ensure the following basic principles: Ensuring the objectives, ensuring the system, ensuring practicality, ensuring feasibility, ensuring efficiency 3.2 Solutions to develop the team of Clinical Visiting Lecturers of Medical Universities 3.2.1 Organizing awareness raising on the subject in the development of the team of Clinical Visiting Lecturers The goal of the solution: 100% of leaders, managers of the Medical University and Practice Hospital are well aware of the fact that the CVL is a position of employment in the Medical University, the subject of the development of the CVL team is the Medical University Meaning of the solution: When determining the CVL as a job position in the Medical University, it will bring about changes that affect leaders, administrators, especially the CVL team.Therefore, this solution is decisive for the planning, selection, use, training and fostering capacity as well as to build a policy for the development of the CVL team Contents and methods of implementation:Leaders of the Medical University actively work with hospital leaders to exchange, discuss, unify and determine the responsibilities of the university and the hospital in the development of the CVL team At the same time, advising the superior management agencies to issue guiding and directingdocuments for the activities of developing the CVL team; Training of the management staff of the Medical University; organizing the annual clinical conference, thereby to receivethe feedback from the Practice Hospital, to overcome the misconceptions, insufficient awareness of the task of developing the CVL team Conditions for implementation: The University Managing Board must preside over, but directly the Rector must guide and urge The Education Department is thefocal point, the Organization Department and the Finance Department are the coordinating units In addition, there must be the participation of the Board of Directors and functional departments of the Practice Hospital 3.2.2 Planning, selecting, using the CVL team Objectives of the solution:The development plan of the CVL team is to ensure sufficient and stable quantity in the ratio of 10 students / a CVL, reasonable structure, quality assurance; On the planning basis to set plan and implement the selection of the CVL team according to standard, capacity and quality; Arranging, promoting the CVL in suitable positions and titles Significance of the solution: This is a decisive solution for the entire development of the CVL team, at the same time it impacts and dominates the planning, quality and effectiveness of the training of the Medical University Content and method of implementation -Planning the CVL team: Building forecast of demand and source of recruitment of the CVL; Planning on the age structure, level structure, sex structure, clinical position structure; Planning on quality of the CVL team: Based on the standards of quality, ethics, qualification, professional competence, pedagogicalskills to develop the training plan, fostering to meet the requirements, task and job placement of the CVL team in the immediate and long term - Selection and use of the CVL: Based on the planning and standards of the CVL team, Universities coordinate with Practice Hospitals to form specific plans, processes and criteria for implementation Conditions for implementation: Based on the policy of the State, development orientation, objectives and tasks of the Medical University and the Practice Hospitals of the Medical University;Assessing correctly the current status, the forecast must be accurate; There must be close coordination between the Medical University and the Practice Hospital, especially at the management level; The Medical University must define the development plan for the CVL team as a part of the overall development plan of the university 3.2.3 Shaping standards of quality and capacity of the Clinical Visiting Lecturer Objectives of the solution: Developing a set of standards on quality and capacity of the CVL, based on labor characteristics, capacity structure of the CVL, in accordance with the regulations of the Ministry of Education and Training, Ministry of Health; In order to meet the requirements of quality and job placementthat the CVL team is undertaking, contributing to improve the training quality of human resources for health at Medical Universities Meaning of the solution: This solution is very important The set of standards is the basis for the planning, selection, training, fostering, testing, evaluation and screening the CVL team Contents and methods of implementation: Defining the basis for building the set ofcriteria ofquality and capacity for the CVL team (legal basis, labor characteristics, job placement, capacity framework of the CVL team);Definingregulations tobuildtheset of quality and capacity standards of the CVL team In the scope of this study, we have developed a set of qualification and competence standards for the CVL team as follows: Criteria for ethical qualities of the CVL team:(1) working with the heart, having the sense of preserving the honor and conscience of the physician and the teacher; (2) devoting to teaching activities, serving the cause of caring for, protecting and improving the people's health; (3) Practicing the profession in accordance with the rules, regulations, technical procedures and other provisions of the law; (4) Continuing learning to improve professional qualifications and professional pedagogical capacity; (5) Honesty, objectivity, fairness, responsibility, solidarity, respect and cooperation with colleagues in professional practice as well as in teaching and educating learners Criteria for the qualification of the CVL team:(6) Graduating postgraduate in the specialized field (specialist doctor level 1, or master's degree in medicine or higher);); (7) Having a pedagogic certificate; (8) Having the level (A2) or higher level of foreign language as prescribed in the Ministry of Education and Training's Circular No 01/2014 / TT-BGDDT onJanuary 24, 2014 promulgating a six-level foreign language ability framework for Vietnam; (9) Having informatics qualification that meets skill standards of using basic information technology as stipulated in the Circular No 03/2014 / TT-BTTTT dated 11/03/2014 by the Ministry of Information and Communication Criteria for professional capacity of the CVL team: (10) Understanding the viewpoints and guidelines of the Party, policies and laws of the State on the protection, care and improvement of the people's health; Mastering professional knowledge and specialized techniques; (11) Having the skills to diagnose, manage, monitor and prevent common diseases and specialist emergency; (12) Carrying out the consulting work and education of the people's health; Criteria for pedagogical capacity of the CVL team: (13) Mastering the basic knowledge of the subjects assigned to teach; (14) Firmly grasping the objectives, plans, contents and programs of subjects assigned in the specialized field; (15) Compiling lesson plans, gathering relevant reference materials of subjects, participating in compiling textbooks, practical guidebook; (16) Having effective teaching methods,which is suitable to the content of the subject; (17) Being able to participate in scientific research and organizing students for scientific research; Applying, deploying scientific and technological research results into education and training, production and life On the basis of the proposed standards, Medical Universities in particular and higher education institutions in general, can consult to build a separate set of standards for the specific conditions and characteristics of each institution Conditions for implementing the solution: Medical Universities should consider building standards of qualities and capacities of the CVL as a necessary activity in order to standardize the CVL team, thus contributing to ensure the quality of training; This activity should be conducted regularly and need to arrange time, funding sources to implement It may be periodical or irregular, which is adjusted in line with reality 3.2.4 Organizing pedagogic capacity training for the CVL team Objectives of the solution: Ensuring that the CVL team are equipped with the knowledge, skills and methods to perform teaching tasks and issues related to teaching work to perform the function of the teacher Meaning of the solution: The solution to improve the pedagogical capacity of the CVL team is an important solution, in order to form the pedagogical concepts and skills for teaching and instructing students in clinical practice This solution has a direct impact on students, helping students form skills, professional attitude and deciding on the quality of training human resources for health as well as the effectiveness of the development of the CVL team Contents and methods of training: Training and fostering the CVL team are carried out in a scientific way, tightly assuringthe requirements:analyzing the training needs, planning training, implementing and evaluating the training and fostering of the CVL team From the results of the analysis of the current status, we designedthe pedagogic capacity training program for the CVL team consisting of modules: (i) ability to build curriculum and develop training curriculum (4 days); (ii) teaching capacity (5 days); (iii) scientific research capacity (6 days) The program is open, depending on the subject under the review and the actual survey It can be only studied a part or select a number of appropriate lessons, which is both saving time, money, and ensuring quality for the CVL team Conditions for implementation:Forming the needs of learning to improve capacity of the CVL team; the management levels need to pay attention to staff training, which is reflected through the specific plans and policies to encourage the CVL to participate in learning; the university should coordinate with the hospitals to facilitate the participants 3.2.5 Implementing policies for the CVL team Objectives of the solution: Proposing policies for the CVL team, in accordance with the law and the ability of the Medical University; at the same time, ensuring the implementation of the policies for the CVL, creating the relative fairness to the work that the CVL is undertaking andcreating favorable conditions to maximize the capacity, strength of the CVL Meaning of the solution: This solution is well done, which will attract the medical staff of the Hospital Practice This is the basis to create a source of selection, maintaining a stable source of quality for the Medical University, contributing to achieving the goal of developing the CVL of Medical Universities that is sufficient in quantity, balanced structure and in accordance with the position of employment they undertake Contents and methods of implementation:Based on the current situation, together with the objective of developing the CVL team, we propose a number of policies as follows: (1) Creating opportunities for advancement of the CVL; (2) Remuneration policy through teaching activities; (3) Renovating the management of CVL team at Medical Universities; (4) Financial treatment policy Conditions for implementation:Having awareness of the meaning and importance of the motivational system to the development of the individual capacity of the CVL; Taking advantage of the interest of the leaders of the provinces and cities, the Ministry of Education and Training and the concerned branches in material and spiritual matters; Implementing financial autonomy in accordance with Decree 43/2006 / ND-CP dated 25/4/2006 Shaping internal expenditure regulations to ensure the utmost and effective promotion of all resources All members and functional departments of the university strictly implement the contents set out in the regulations 3.2.6 Relationship among solutions The solutions presented above have a close relationship with each other, supporting each other to achieve the common goal of developing the CVL teamthat is sufficient in quantity, balanced in terms of structure and quality assurance.We can model relationships among solutions by the following diagram: Planning, selecting and using the CVL team 5.Implementingremuneration policies for theOrganizing CVL team to raise awareness of developing the Building CVL team standards for quality and capacity of the CVL Organizing fostering of the pedagogic capacity for the CVL team The position of the solutions for the development of the CVL team can be described in the following diagram: Solution Condition Solution Amount Solution Quality Structure Solution Solution 3.3 Surveying the necessity and feasibility of the proposed solutions 3.3.1 Purpose of the survey: To confirm the scientific and practical nature of the proposed solutions to develop the CVL team of the Medical University 3.3.2 Contents of the survey: Surveying on the necessity and feasibility of the proposed solutions for the development of the CVL team in the dissertation 3.3.3 Survey method: Asking for opinions through the questionnaire Evaluating the survey results by scoring with levels: - Necessity: Very necessary - points; Necessary - points; Normal - points; Not necessary - points; Completely unnecessary - point - Feasibility: Very feasible - points; Feasible - points; Normal - points; Not feasible - points; Completely impossible - point 3.3.4 Subjects of the survey: Asking for opinions by the questionnaire in target groups: Management staff and experts; The CVL; Students of Medical Universities Total number of respondents: 450 3.3.5 Results of the survey: - Necessity of the proposed solutions: The survey results show that: The solutions are evaluated above the necessary level, with the average score of 4.42 In particular,solution was the most appreciatedwith average score of 4.46 points, followed by solution with average score 4.55 points,solution with average score of 4.44 points The least needed solutions were solution with average score of 4.25 points and solution with average score of 4.38 points As such, the proposed solutions are necessary, especially solutions to develop the remuneration policy and organize training of pedagogical capacity for the CVL team - Feasibility:The survey results show that: The feasibility of the proposed solutions was highly appreciated, with an average score of 4.32 points In particular, solution was considered to be the most feasible with 4.47 points; the nextwas solution with 4.37 points Option was rated the lowest feasible, but with a relatively high score (4.07).Thus, once again, we can confirm that the solutions proposed by the thesis are highly feasible 3.4 Experimenting the proposed solutions 3.4.1 Overview of experimenting the proposed solutions Purpose of the experiment: Verifying effectiveness, feasibility, impact of solution "Organizing training to improve pedagogical capacity for the CVL team" for the development of the CVL team Content of the experiment:Organizing "Fostering teaching capacity for the CVL team" is tested in the form of training Subjects of the experiment:Experimenting for the CVL of Vinh Medical University in the groups of internal medicine, external medicine, obstetrics, pediatrics of Nghe An General Hospital, Nghe An Obstetric Hospital A total of 42 people Method of the experiment: Organizing training for the CVL team: We used the proposed program for fostering teaching capacity, conducted a 5-day training course (40 hours) for the experimental CVL team Organizing the experiment:Experimental organization: The test consists of seven steps: (1) Preparation for testing; (2) Organizing for the CVL to teach the students of the control group (class 2011YA); (3) (3) Surveying before testing; (4) Organizing the training for the CVL to test under the program "Fostering teaching capacity for the CVL team"; (5) Experts assess the teaching capacity of the CVL after testing; (6) Organizing for the CVL to teach students of test group; (7) Students of test group (2012YA class) assess the teaching capacity of the experimental CVL team through questionnaires 3.4.2 Results of the experiment - Teaching capacity of the CVL:After theexperiment,the rate of lecturers ranked at level of fairly good capacity accounting for 57.14%, and the average level of the CVL was reduced by more than half Specially, before the test, none of the CVL was rated good teaching capacity, after the test, 19.05% were rated good teaching capacity.Combined with the actual observation during the training course, we found that this solution is easy to implement, the teaching capacity of the CVL changed significantly, costing less money and effort - Student assessment of teaching capacity of the CVL:Before the experiment, the control group assessed the teaching capacity of the CVL team atmoderatelevel (2.75 points) After the test, students of test group evaluated the teaching capacity of the teaching staff at quite good level (3.48 points) The results showed that, after the experiment, the CVL team was evaluated better, proving the positive impact of fostering teaching capacity for the CVL team - The learning result of students under the influence of the experimental CVL team: Similar starting points but under the influence of scientific tests have made a difference in the learning result between the test class and control class.Specifically: The average test score of the control class is lower than that of the test class (6.91 vs 6.27), this difference is significant ( = 6.06 > Impact level ES = 1.72> 1.00 (using Cohen's criteria table):Demonstrating thatthe influence of scientific experiment on students' learning result is huge Thus: Under the impact of the experiment, the learning results of the experimental class is higher than that of the control class CONCLUSION OF CHAPTER On the basis of respecting the principle of proposing solutions,combined with the research results on theoretical and practical aspects of the development of the CVL team, we have proposed 05 solutions for the development of the CVL team: 1) Organizing to raise awareness of the subject in developing the CVL team; (2) Planning, selecting and using the CVL team; (3) Organizing training and fostering of pedagogical capacity for the CVL team; (4) Forming standards of quality and capacity of the CVL team; (5) Implementing policies, motivating to promote the role of the CVL team We investigated the necessity and feasibility of the solutions The results suggest that the proposed solutions are considered essential for the practical development of the CVL team What is more, it is highly feasible Experimental results of the "Training and fostering of pedagogical capacity for the CVL team" at Vinh Medical University confirmed once again the urgency, practicality, feasibility and effectiveness of proposed solutions CONCLUSIONS AND RECOMMENDATIONS Conclusion: Based on the viewpoint of approaching to human resource management and human resource development, the study has clarified the nature of the development process of the CVL team at the Medical University About current status of the CVL team of Medical Universities, in addition to its strengths, such as: high professional qualifications and abilities, good morals, willingness to take on teaching and guidingduties to students, the limitations are: the number is missing compared to the requirements, the structure of the CVL team in faculty groups is not balanced; Most of the CVL team have not been trained in pedagogics, pedagogical capacity Medical Universities have not recognized their responsibilities in the development of the CVL team The work of planning, selection, arrangement, use, training and fostering in the profession of the CVL team still has many disadvantages such as: Medical Universities have not really been interested in fostering pedagogy for the CVL team,the use of the CVL team is limited The work of monitoring and evaluating the activities of the CVL team have not been effective yet, still heavy in form There are four factors that strongly influence the process of developing the CVL team, namely: (1) issues belong to the CVL team; (2) Collaboration between Medical Universities and Practice Hospitals in the development of the CVL team; (3) Remuneration policy for the CVL team; (4) Impact of socio-economic development It should be noted that the collaboration between Medical Universities and Practice Hospitals in the development of the CVL team has not been good The compensation for this team has been implemented but not satisfactory The above reality shows that the development of the CVL team is an urgent requirement of ensuring and improving the quality of training of Medical Universities On the basis of theory and analyzing the current development of the CVL team, the thesis proposes five solutions for the development of the CVL team These are: (1) Organizing to raise awareness of the subject in developing the CVL team; (2) Developing a set of competency standards for the CVL team; (3) Planning, selecting and using the CVL team to meet the needs of training medical staff; (4) Organizing training and upgrading of pedagogical capacity for the CVL team; (5) Implementing policies and creating motivation to promote the role of the CVL team The results of the assay and the experiment confirmed the urgency, feasibility and effectiveness of the solutions proposed by the thesis, confirming the research results of the thesis Recommendations: For the Ministry of Education and Training: to promulgate documents regulating conditions of quality assurance in training human resources for health, in which the CVL is identified as a job placement of Medical Universities For the Ministry of Health: to promulgate documents regulating the coordination between Practice Hospitals and Medical Universities in training For Medical Universities: to survey and select Practice Hospitals; to be active in the development of the CVL team For Practice Hospitals: to coordinate with Medical Universities and create conditions for the CVL to participate in training in Medical Universities PUBLICATIONS OF SCIENTIFIC WORKS Nguyen Quoc Dat (2016), Some qualification and capacity requirements of Clinical Visiting Lecturers at Vietnamese Medical Universities, Journal of Educational Sciences No 130 Nguyen Quoc Dat (2016), The impact of the market economy on the Physician's personnel and Clinical Visiting Lecturers, International Workshop on "Developing professional capacity for teachers and education manager trends in Vietnam and the world” Nguyen Quoc Dat (2016), The impact of the market economy on the Physician's personnel and Clinical Visiting Lecturers, Journal of Education management, November 2016 Nguyen Quoc Dat (2016), Current status of the quality of Clinical Visiting Lecturers for students in Vietnamese Medical Universities, Journal of Education No 377 Nguyen Quoc Dat (2016), Solutions for the Development of Clinical Visiting Lecturers for students in Medical Universities in Vietnam, Journal of Educational Sciences No 128 Nguyen Quoc Dat (2016), Experiment on some solutions to develop Clinical Visiting Lecturers at Vinh Medical University, Journal of Education, April 2016 ... survey results by scoring with levels: - Necessity: Very necessary - points; Necessary - points; Normal - points; Not necessary - points; Completely unnecessary - point - Feasibility: Very feasible... ofquality and capacity for the CVL team (legal basis, labor characteristics, job placement, capacity framework of the CVL team);Definingregulations tobuildtheset of quality and capacity standards... University, Hai Phong Medical University, Thai Binh Medical University, Thai Nguyen Medical University , Hue Medical University , Vinh Medical University 2.1.3 Subjects of the survey: (1) Managers
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