Роль заходів післядипломної освіти в підготовці фельдшера з медицини невідкладних станів за умов реформи екстреної медичної допомоги в Україні

Abstract

Introduction. In the context of the emergency medical care (EMC) reform in Ukraine, most EMC teams are paramedic teams. Emergency medicine paramedics receive their basic education in colleges, specialize at the postgraduate level, and constantly improve their professional level through non-formal education. So far, there are no studies that would show the effectiveness of training at the undergraduate and postgraduate levels. The aim of the study – to determine the role of postgraduate education in the training of paramedics in emergency medicine in the context of emergency medical care reform in Ukraine. The main part. A questionnaire survey of 69 emergency medical assistants representing 17 regions of Ukraine was conducted. Among the respondents, 29 were female and 40 were male, of the same age and length of service. The respondents were asked to assess their level of knowledge in emergency medicine after graduation from medical college/school, after specialization and non-formal education (in points: from 1 to 100), and their sufficiency for professional activity as part of an emergency medical team. It was found that at the college level only (43.25±4.11) % of respondents mastered the skills in emergency medicine. The lowest level of skills was noted by the respondents in the examination of adults and children in an emergency, physiological delivery, as well as tracheal intubation, use of supraglottic devices, mechanical ventilation, and chest puncture in case of tension pneumothorax. At the stage of specialization, the level of mastery of skills reaches (79.99±1.98) % of respondents (p<0.001 compared to the college result). Among the respondents, 76.81 % mastered EMS in the workplace, 23.19 % – in postgraduate colleges. Respondents noted a further increase in emergency medicine skills at the stage of non-formal education (85.81±2.18) %, which was higher than in colleges (p<0.001) and tended to be higher than at the stage of specialization (p<0.10). The lowest level of mastery concerns physiological delivery and chest puncture in tension pneumothorax. Conclusions. College education does not allow to master the skills in emergency medicine at the proper level. Specialization in emergency medicine, which takes place in the workplace, can increase the level of mastery of emergency medicine skills by 1.85 times compared to undergraduate education in college (p<0.001). Further non-formal education provides greater mastery of skills, as noted by 81.45–89.54 % of respondents (confidence interval at p<0.05). At all stages of training, the lowest level of mastery concerns the ability to deliver physiological childbirth.