THE PRIORITY ORIENTATION OF THE PERSON OF A YOUNG DOCTOR IN PROFESSIONAL LIFE AND PROFESSIONAL TASKS

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At the level of the Government of the Russian Federation, it is recognized that personnel in health care is the intellectual potential of the industry, which requires long-term and well-considered training and constant professional development of each personnel unit [1, 2]. According to the Decree of the President of the Russian Federation dated 07.05.2018 № 204, it is necessary to eliminate the personnel shortage in medical organizations, provide medical organizations with qualified personnel, introduce a system of continuing education for medical workers, including using distance learning technologies [3]. Along with domestic, foreign researchers in the field of organization and management of health care agree on the existence of two leading problems in the personnel potential of health care: the problem of impaired professional adaptation of a specialist and the development of professional burnout [4, 5], as well as the problem of finding the optimal forms of retention workplace, as well as the professional development of a doctor [6, 7]. In modern foreign literature, the formation and development of professionalism highlighted a number of factors that are structure-forming in the process of forming the professional identity of a young doctor, both during training and during the first years of practice [8, 9]. These factors include individual features, features of the external environment, such as shortage, time [10]. In the global medical community, in particular the European one, there is an active process aimed at developing the doctor as a professional who is constantly striving to improve his skills [11]. The priority orientation of the individual to the professional sphere of life and the solution of professional tasks are understood as the qualitative fulfillment of professional duties, business cooperation and constructive solution of business problems [12-14]. This priority orientation of the individual, meets the interests of society and is one of the most important conditions for the successful operation of the health care system [15, 16]. At the same time, the real state of the processes of professional socialization of young medical personnel is far from optimal and involves a number of issues, such as increasing interest in the medical profession, improving ways of employing young people, developing programs to retain young professionals in the field, accelerating the process of adaptation to graduates of educational institutions, their high motivation for professional development, commitment to the organization, as well as ensuring satisfaction Employers quality training of young specialists [17-19]. MATERIALS AND METHODS The ethical principles of conducting this medical research with human participation as a subject were observed in accordance with the 2013 Helsinki Declaration of the World Medical Association. Informed consent was obtained for participation from all respondents in this study. The priority orientation of the individual to the professional sphere of life and the solution of professional tasks as a component of the professional socialization of young doctors was determined by us using the psychodiagnostic methodology “Motivation in professional activities” developed by B. Bass [20]. Three scales characterizing the level of orientation of the individual: 1) to “work” - high-quality performance of professional duties, business cooperation Quality and constructive solution of business problems; 2) on “self” - direct reward and self-satisfaction, aggressiveness in achieving status, power, tendency to rivalry; 3) to “communicate” - maintaining relationships with people under any conditions, focusing on joint activities, but often to the detriment of specific tasks. In order to identify the causes and conditions that determine the priority orientation of the individual to the professional sphere of young doctors, we analyzed two groups of factors: 1) medical and social characteristics of the conditions and lifestyle of doctors (101 factors); 2) psychological characteristics of the value and motivational spheres of the doctors’ personality (40 factors). In total, the impact on the priority orientation of the individual on the professional sphere of life and the solution of the professional tasks of the factor by analyzing the distribution of their gradations in the main and control groups was analyzed. The main group consisted of young doctors, whose “business” orientation was maximal and exceeding the directivity, which had a submaximal level of 10 percent or more. The control group included doctors whose personal profile was different than in the main group. In order to eliminate the influence on the orientation of the individual in the medical organization of age and gender, the main and control groups were selected according to these characteristics on the principle of copy-pair. The significance of differences between distributions was estimated by calculating and verifying χ2. The presence of reliable χ2 allowed to consider the influence of the corresponding factor as statistically significant. In order to assess the strength of the influence of factors, the coefficient of mutual conjugacy of Chuprov (K) was used. Statistical processing of the material was carried out on a personal computer using the licensed statistical package Statistica 6.0. The purpose of the study was to study the priority orientation of the individual to the professional sphere of life and the solution of professional tasks. RESULTS AND DISCUSSION The prevalence of occurrence of persons with a priority orientation of the individual to the professional sphere of life and the solution of professional problems among young male doctors is statistically significantly higher than among women (p < 0.05), which is reflected in Figure 1. Characteristics of representative factors reflecting the priority orientation of the personality of the young doctor are shown in Table 1. Formation of the orientation of the individual “to work” contributes to a high level of health and an active desire for a healthy lifestyle. A relatively high level of health (rated as excellent or good) was noted by 83.3% of respondents from the main group. At the same time, people with a different orientation of the personality, who similarly estimated their level of health, are 7 times less. The level of alcohol consumption is relatively high (rated as daily, weekly) in the main group was noted by 38.0% of respondents. In the control group, the level of relatively high alcohol consumption is 1.3 times higher than in the group with a priority orientation of the individual towards the professional sphere of life and the solution of professional tasks. Orientation “to work” is a derivative of the level of wages and levels of tightness in the workplace. The proportion of young doctors from the main group, whose self-assessment of the level of pay is relatively high (excellent or good) is 65.7%. In the control group, in the same way, 5.5 times fewer young doctors are considered. Among young doctors, focused on the professional sphere of life and the solution of professional tasks, not fixed make up 36.7% of the number of respondents, and in the control group this indicator is 1.9 times higher. The presence of part-time work in another professional sphere is a negative factor for the formation of the priority orientation of the individual to the “cause”. In the group with the priority orientation of the individual to the “cause” not combining work in another professional sphere, 9.0%, and in the control group 3.3 times more. Fig. 1. The prevalence of the priority orientation of the individual to the professional sphere of life and the solution of professional problems among young doctors in connection with their gender (p ± m, in %) Table 1 The rating-scale of factors having a statistically significant impact (p < 0.05) on the formation of the priority orientation of the personality of young doctors Rank Factors Influence Validity Strenght (K) 1 Self-assessment of health level χ2 = 217,5 p < 0,001 0,72 2 Fixedness χ2 = 127,8 p < 0,001 0,56 3 Self-assessment of the level of remuneration χ2 = 128,1 p < 0,001 0,55 4 Good relationships with management χ2 = 156,0 p < 0,001 0,51 5 Career prospects, the opportunity to become a leader χ2 = 143,6 p < 0,001 0,49 6 Self-assessment of the level of relationship with family members χ2 = 86,4 p < 0,001 0,45 7 Value orientation “Financially secure life” χ2 = 108 p < 0,001 0,43 8 Flexible working hours χ2 = 93,0 p < 0,001 0,40 9 Work while studying at University χ2 = 68,6 p < 0,001 0,39 10 Sufficient information about what is happening in the medical institution χ2 = 78,9 p < 0,001 0,36 11 Self-assessment of the level of relationships with colleagues χ2 = 40,4 p < 0,001 0,31 12 Value orientation “Physical and mental health” in the hierarchy of values χ2 = 51,1 p < 0,001 0,29 13-14 Complex and difficult work as a factor of labor motivation χ2 = 39,1 p < 0,05 0,26 13-14 Availability of part-time work in another professional field χ2 = 27,2 p < 0,001 0,26 15 Availability of official documents of moral incentive χ2 = 25,6 p < 0,001 0,25 16 Self-assessment of academic performance in medical University χ2 = 15,4 p < 0,001 0,19 17 Self-assessment of alcohol consumption χ2 =9,9 p < 0,001 0,15 18 Value orientation “self-Confidence” in the hierarchy of values χ2 = 8,9 p < 0,05 0,11 A significant factor contributing to the strengthening of the formation of the priority orientation of the individual “for work” is the availability of official documents of moral incentives (diplomas and thanks). Thus, 21.4% of doctors from the main group have these regalia, in the group with a different orientation of the personality of such doctors, 4.5 times less. A positive influence on the formation of the priority orientation of the individual on the “matter” is exerted by the fact of working during the period of study at a medical university. In the main group, the individuals who combined work and education make up 85.7%, in the control group they are 1.8 times less. A relatively high level of academic performance in a medical university (rated as excellent, good) has a negative effect on the formation of a person’s priority orientation towards the “cause”. In the main group, relatively high rates for this criterion were noted in 35.7%, in the control group these figures were 1.5 times higher. The strong focus of the individual “on the case” contributes to the optimal level of interaction with the family and professional social environment. 69.0% of respondents identified their relationships with family members as relatively well-off (the level is rated as excellent, good); in the control group, almost 3 times less doctors gave the same assessment to family relationships. A relatively high level of relationships with colleagues (rated as excellent, good) was noted by 61.9% of young doctors with a priority orientation of the individual on the “case”, and in the compared group of such doctors 2 times less. The differences in motivational and value spheres of young doctors with a priority orientation of the individual to the “case”, on the one hand, and their peers, for whom the orientation of the individual to the “case” is not a priority, are expressed. The priority orientation of the “work” of doctors is the result of a relatively high importance for them as factors that motivate the following to work: flexible working hours (for 47.6% assigned to the main group); the amount of sufficient information about what is happening in the medical institution (for 52.3% belonging to the main group); difficult and difficult work (for 31.0% of individuals from the main group). In the control group, the proportion of those for whom these labor motivators were also strong turned out to be significantly lower: on the motivating factor of flexible working hours 5.0 times; on the motivating factor of the amount of sufficient information about what is happening in the medical institution 3.7 times; on the motivating factor of difficult and difficult work 4.4 times. The priority orientation of the individual to the “case” of doctors is also shaped by factors that play a relatively small role as tools for creating strong work motivation. The latter include: good relations with the management (among those with a priority orientation of the individual, 14.3% strongly motivated by this factor, in control - 5.0 times more); the prospect of career growth, the opportunity to become a leader (in the main group they were highly motivated only 23.8%, and in the control group 3.7 times more). The priority orientation of the individual to the “case” of young doctors in a medical organization is determined by the dominance of such terminal values as “physical and mental health” (in 71.4% of respondents from the main group, it occupies high or medium ranking positions), while in control 1.1 times less. The leading orientation of the individual on the “case” of the studied contingent is also conditioned by the relatively low significance of such values as “materially secure life” (only 42.8% of the respondents from the main group, it occupies high or medium ranking positions), for which this value orientation is a priority, 2 times more. This also applies to “self-confidence” (45.3% of respondents from the main group, it occupies high or medium ranking positions), and in the control group, the persons for whom this value orientation is a priority is 1.3 times more. FINDINGS Thus, these data indicate that the factors of the conditions and lifestyle of young doctors, such as, contribute to shaping the orientation of the individual towards the professional sphere of life and solving professional problems. ¨ high level of health and an active desire for a healthy lifestyle; ¨ relatively low consumption of alcohol; ¨ relatively high level of salary; ¨ availability of official documents of moral incentives (letters of appreciation and thanks); ¨ the fact of work in the period of study in a medical university; ¨ relatively prosperous family relationships (level assessed as excellent, good); ¨ relatively high level of relationships with colleagues (rated as excellent, good). This priority orientation of an individual is also the result of a relatively high importance for them as factors motivating the following to work: ¨ flexible working hours; ¨ the amount of sufficient information about what is happening in the medical institution; ¨ hard and difficult work. The priority orientation of the individual to the professional sphere of life and the solution of the professional tasks of young doctors in a medical organization is determined by the dominance of such terminal value as “physical and mental health”.

About the authors

S. M. Milekhin

Tver regional Maternity Hospital

Author for correspondence.
Email: serzh.milekhin@yandex.ru
SPIN-code: 6895-8703
Tver, Russia

D. P. Derbenev

Tver regional Maternity Hospital

Email: serzh.milekhin@yandex.ru
Tver, Russia

D. A. Orlov

Konakovo Central District Hospital

Email: serzh.milekhin@yandex.ru
Konakovo, Russia

References