The experience of introducing new technologies for training medical workers in the educational process in the conditions of the COVID-19 pandemic

Introduction

One of the prerequisites for the efficient performance of a health worker is the constant improvement of existing and the acquisition of new professional competencies and knowledge, and the improvement of the professional level within the framework of the existing qualifications.

Increasing the level of knowledge of health workers is a specially organized controlled process of interaction between a teacher and a student, aimed at mastering expertise and knowledge and obtaining practical skills.

During the pandemic of the new coronavirus infection COVID-19, knowledge about the epidemiology and prevention of this infection, the organization and implementation of efficient preventive and anti-epidemic measures aimed at anticipating and eliminating the risks of the disease have become especially in demand. In the context of the pandemic, along with traditional teaching methods, modern pedagogical methods, including information and telecommunication technologies, have been actively introduced into the teaching practice.

Since 2020, with the outbreak of the pandemic of the new coronavirus infection COVID-19, when various social and professional groups of the population were separated in order to prevent infection, such technologies have gained particular importance and received a powerful impetus for development. The necessary experience exchange and regularly updated knowledge of health workers of various specialties involved in the fight against COVID-19 became possible due to IT technologies. This was implemented by means of e-learning which combined advanced teaching methods and technologies, as well as knowledge management for both mature and novice doctors [1][2].

The COVID-19 pandemic required a major improvement in the system of training medical staff and primarily of those specialists who were directly involved in the fight against a new coronavirus infection, as well as the introduction of new forms and methods of advanced training for health workers performing their duties in conditions of increased risk of infection [3][4].

The current epidemiological situation has set the task to promptly organize training of health workers on epidemiology, methods of diagnosis and prevention of the new coronavirus infection COVID-19 [5].

At the first mention of cases of pneumonia of unknown etiology in the People's Republic of China (Wuhan, Hubei Province), the Russian Federation began the preparations for the organization of preventive and anti-epidemic measures connected with the possible importation of a dangerous etiological agent. The Rostov Region was no exception. In the first ten days of January 2020, the Federal Government Health Institution Rostov-on-Don Anti-Plague Scientific Research Institute of Rospotrebnadzor (hereinafter referred to as the Institute) in cooperation with the Office of Rospotrebnadzor for the Rostov Region, the Federal Budgetary Institution of Health Center for Hygiene and Epidemiology in the Rostov Region, the Ministry of Health of the Rostov Region and the staff of the department of epidemiology of Rostov State Medical University (RSMU) urgently developed a plan of necessary measures. As a basis for the development of this plan, the experience of performing anti-epidemic (preventive) measures in preparation for the 2018 FIFA World Cup in Rostov-on-Don was used [6].

The comprehensive plan included two objectives:

• prompt analysis and forecast of the epidemiological situation on COVID-19 in the Rostov Region;
• provision of advisory and methodological assistance to healthcare organizations in the training of medical staff on biological safety issues.

However, it should be mentioned that the purposefulness and efficiency of anti-epidemic (preventive) measures to ensure the biological safety of the population are ensured not only by the readiness of Rospotrebnadzor institutions and healthcare organizations but also by a high level of professional competence of health workers of all specialties.

The epidemic situation that has developed in Russia and the Rostov Region required the involvement of students and medical residents in healthcare organizations. In order to increase the level of special knowledge, the department of epidemiology of RSMU organized training for students and medical residents on all topical issues of epidemiology and prevention of COVID-19. Medical residents, students of RSMU studying at the department of epidemiology, as well as having practice under the guidance of leading specialists at the Institute acted as assistants to the epidemiologists, providing the necessary assistance to specialists of the Office of Rospotrebnadzor for the Rostov Region, the Federal Budgetary Institution of Health Center for Hygiene and Epidemiology in the Rostov Region, and the Ministry of Health of the Rostov Region.

The developed program of seminars was later used to train specialists from healthcare organizations and clinical diagnostic laboratories of the Rostov Region at cluster training seminars and in the format of video conferences. In addition to updating the knowledge of health workers on biological safety and skills in working in personal protective equipment (PPE), in accordance with dynamically changing regulatory documents, the main provisions of the epidemiology, prevention, and diagnosis of COVID-19 were considered.

Throughout the entire period of the pandemic development in the Rostov Region, the specialists of the Institute together with medical residents and students of the department of epidemiology of RSMU took an active part in performing active anti-epidemic measures.

The research was aimed at summarizing the experience of providing modern training on epidemiology, prevention, and biological safety in healthcare organizations to improve the skills of specialists involved in measures to counter the spread of the novel coronavirus infection COVID-19.

Materials and methods

The staff of the Institute and the department of epidemiology of RSMU jointly prepared a training program that included the following methodology:

• development of curricula for seminars,
• conducting lectures,
• holding seminars with practical exercises,
• development of leaflets, memos, and questionnaires,
• conducting training sessions,
• organization of cluster training seminars for medical specialists of the Rostov Region.

The normative support of the program was established by means of the current regulatory legal acts and regulatory documents; the methodological basis was a modular-competence approach.

A universal questionnaire for collecting the necessary epidemiological history data for the diagnosis of a new coronavirus infection 2019-nCoV was developed and submitted to the Office of Rospotrebnadzor for the Rostov Region in Russian and English.

Relevant and timely leaflets and memos for specialists of healthcare organizations and the public have been developed. The following leaflets were posted on the official website of the Institute free to access: “Coronavirus infection caused by the 2019-nCoV virus” (name at the time of creation), “Basic principles of quarantine at home”, “Prevention of coronavirus infection for older people”, etc.

The Institute together with the Department of Epidemiology of RSMU developed a training program for seminars on the topic “Biological safety and ensuring anti-epidemic preparedness of healthcare organization in the event of the introduction or occurrence of a disease caused by a new coronavirus (2019-nCoV)” which was adopted by the Academic Council of the Institute and included the following sections:

• modern requirements for ensuring biological safety when working with patients with suspected COVID-19 disease;
• epidemiology and prevention of COVID-19;
• symptoms and signs of COVID-19;
• organizing and ensuring anti-epidemic preparedness to perform activities in the case of the introduction or occurrence of a disease caused by a new coronavirus.

A feature of the consultative seminars was the prompt updating of information in accordance with the constantly updated regulatory framework.

Due to the high workload of employees of healthcare organizations and in order to maximize the coverage of specialists from different regions, the training was conducted in the format of video conferences. This work was performed by the Institute together with the Office of Rospotrebnadzor for the Rostov Region and the Ministry of Health of the Rostov Region.

During the training, the presented material was divided into three blocks, which could later be used in the work and for the “fan” training of health workers.

The first block included information about the current and newly developed regulatory documentation.

The second block included information about the nature of the development of the epidemic process in Russia, in the world, about the clinical manifestations of the new coronavirus infection COVID-19. When considering the medical model of the disease, special attention was paid to the symptoms and signs necessary for differential diagnosis.

The third block provided information on preventive measures when working with patients with COVID-19.

The training material on the new coronavirus infection was promptly updated, in accordance with the Temporary guidelines “Prevention, diagnosis and treatment of the new coronavirus infection (COVID-19)” and included up-to-date regulatory documents, resolutions and orders, as well as data on the number of infected, the spread of a new coronavirus infection in the Rostov Region, the Russian Federation, and other countries. Detailed information was provided on numerous members of the coronavirus family, including viruses that could cause fatal illnesses: severe acute respiratory syndrome (SARS-CoV coronavirus) and Middle East respiratory syndrome (MERS-CoV coronavirus).

Considering the target audience, the information material for specialists included issues of biological safety when working with PBA of pathogenicity groups I–II, as well as such topics as “Biological safety” and “Requirements for ensuring biological safety when working with patients with suspected infectious diseases”. This information allowed increasing the level of knowledge of specialists and preparing them to work with biological material contaminated with COVID-19 pathogens.

The training was aimed at developing knowledge about the rules for PPE use by health workers, the method of sampling biological material from the oropharynx, packaging and transporting samples to a specialized laboratory. During training, students had the opportunity to make themselves aware of the rules for PPE use.

In order to control the information assimilation, students were offered situational problems, which considered the potential risks of emergency situations when sampling clinical and autopsy material, as well as during putting on/removing PPE. The main feature of this learning activity was the possibility of simultaneous training and obtaining analysis of errors when putting on/removing PPE, aimed at minimizing the risk of infection of a health worker when leaving the “contagious” zone. In the online format, under the supervision of specialists, a demonstration of all stages of putting on/removing PPE was performed with parallel control of students performing similar actions. Training for the sampling of clinical material was performed with simultaneous commentary and assessment of compliance with the rules for the sampling of clinical material. During cluster seminars, the issues of reprofiling various departments into single-infection hospitals were considered in detail. The medical staff of healthcare organizations received up-to-date information on the epidemiology, symptoms and signs, diagnosis, treatment of COVID-19, and personal and public safety measures.

Discussion

Considering the high workload of specialists of healthcare organizations associated with the tense epidemiological situation and new coronavirus infection COVID-19, training health workers using IT technologies has become relevant. The use of such technologies allows reducing the volume of off-the-job classroom training and completely replacing it with distance learning, thereby creating the possibility for an employee to receive information at the workplace and at a convenient time.

The digitalization of the training process allowed students to acquire new professional knowledge and competencies. For increasing the level of knowledge and exchange of experience, highly qualified specialists and scientists were invited to participate in the training process. Health workers received up-to-date information on all issues of interest. The active use of modern educational technologies made it possible to:

• constantly update educational content;
• present information in an accessible and visual form;
• provide constant access of the student to educational resources.

Conclusion

At present, when providing further professional education for specialists, new teaching methods using modern IT technologies should be actively introduced, which will allow students to receive information about the latest achievements in science and practice in the field of epidemiology and prevention of the new coronavirus infection COVID-19. The teacher in such conditions must acquire professional competencies that will allow him/her to take on the role of not only a lecturer and teacher but also the role of a tutor.

The rapid change in the epidemiological situation, the development of modern diagnostic technologies, and the new realities of prompt response to the challenges that have arisen in the context of the epidemic spread of a new coronavirus infection require constant professional development of specialists in the field of ensuring sanitary and epidemiological well-being of the population when working with pathogens of human infectious diseases, which determined the need of introducing new technologies into the educational process.

Authors contribution:

N.L. Pichurina, S.Y. Vodyanitskaya, F.V. Logvin, - obtaining and analysis of the data;

A.A. Kononenko, V.V. Batashev. N.G. Tyutyunkova - writing the text of the manuscript;

E.G. Soboleva - review of publications on the topic of the article.

Conflict of interest.

Authors declares no conflict of interest.