Seminars

Teaching Preventive Cardiology in Ufa, Bashkortostan, RussiaHarald M Lipman1 Joe Rosenthal2 Richard Meakin2

1 International Cardiac Healthcare & RiskFactor Modification (ICHARM)2 Department of Primary Care & Population Health UCL Medical School

intcardiachealth@aol.com www.i-charm.co.uk

ICHARM

Conclusions

1.The Causes of Cardiovascular Disease (CVD)

2. Risk Factors for CVD

3. Clinical Risk Assessment for CVD

4. Lifestyle Modifications i: Smoking, Physical Activity

5. Lifestyle Modifications ii: Alcohol, Diet, Weight

6. Management of Medical Problems i: Hypertension & Cholesterol

7. Management of Medical Problems ii: Diabetes Mellitus

8. Management of Medical Problems iii: Secondary & Tertiary Prevention

9. Programme Planning/Implementing Change

10. Case discussions/Summary/Assessment

Evaluation

.

IntroductionThe Republic of Bashkortostan, situated to the SouthWest of the Ural mountains has an area of 143,600 Km2

and a population of 4,072,029 (2010). It is divided into 9administrative regions. The capital city is Ufa, with apopulation of 1,064,000 (2010). Each administrativeregion has a Regional Medical centre.

There is no formal undergraduate teaching of PreventiveCardiology in the Russian Federation. At postgraduatelevel Moscow and a few other cities offer this; and theNational Research Centre for Preventive Medicine hasdeveloped several specialist courses.

With the agreement of the President and Government ofthe Republic of Bashkortostan, ICHARM devised andtranslated a 10 Seminar interactive introductory course inPreventive Cardiology for doctors in the Republic ofBashkortostan.

University College London wrote the course, which wastaught, in Ufa 14th to 18th July 2014, with the assistanceof a Russian interpreter, by two of the British doctorsinvolved in its preparation.

This was the first time that a comprehensive one weekPreventive Cardiology course had been taught to Russiandoctors in Russia by foreign doctors.

The 10 Seminars were taught in an interactive manner,with frequent questions & answers, general and smallgroup discussion and role-play. This was a novelapproach to teaching in Russia and after some initialreserve, was embraced by the attendants. The teachersviewed the slides in English on their screen whilst theaudience saw the same slides projected in Russian onthe main screen (Figure 1). Prepared consecutivetranslation was broadcast over loudspeakers.

One hundred & twenty Russian doctors, all involved ineither primary or secondary CVD prevention, from Ufaand the 8 administrative regions attended. Attendantsregistered for each morning and afternoon session.Evaluation forms were completed following each sessionand at the end of the course. Certificates of Attendancewere presented to each attendant (Figure 2)

The complete presentation and text notes were madeavailable to all attendants for a limited period, via aprotected website.

The courseFuture work

During the programme,18 attendants were trained toteach subsequent courses to their colleagues in the 9regions. They will be overseen by the RepublicanCardiological Centre, Ufa. An order formally appointingthem as authorised administrative regional Teachers inPreventive Cardiology will be granted by the Ministryof Health.

A follow-up course in Preventive Cardiology will betaught in Ufa in 2015 and will be rolled out to otherregions of the Russian Federation.

A total of 445 seminar evaluation forms and 83 courseforms were received. Most respondents hadconsiderable prior knowledge of PreventiveCardiology. The overwhelming majority ratedContent/Presentation/Value/ Enjoyment as 4 or 5(scale 0-5).

Examples of attendants’ comments:

Course StructureSystematic approach to teaching very helpful. Methodof teaching was delightful. Most interesting parts werethe clinical cases which assisted with remembering theinformation. Courses contained a considerable amountof new information. Much information had beenpresented in a new and different manner. Frequentrepetition of information was helpful. Audiencediscussions are stimulating and very helpful. Role playadded an additional approach to teaching. Interactiveteaching is a very useful method. Numerous requestsfor more frequent courses.

Course MaterialRisk factors were the most important element of thecourse. How to influence patients to change habitsvery valuable. How to speak to patients about risk wasvery helpful. Step by step consultations would be veryuseful. Pictorial representation of alcohol units wasnew and helpful . Cycle of change was new andinteresting. Methods of assessing and managing dietwas very helpful. Prophylactic statins very useful forprimary prevention. New algorithm for treatinghypertension very interesting. How to managediabetes was very useful. Mode of development of apreventive programme useful. Discussion of problemsin rural areas was very useful.

Social OrganisationDoctors & educators should be involved in preventivecardiology. Health education for patients should beincreased. Patients must be stimulated to beresponsible for their own health. They would nowencourage patients to help themselves to develophealthier lifestyles. Organisations such as AlcoholicsAnonymous & Weight Watchers should be set up andencouraged. All patients should be asked about theirlifestyles

1. ICHARM/UCL Preventive Cardiology course can beintroduced successfully into Russian healthcare culture

2. Training of trainers is essential if uniform approachesin Preventive Cardiology teaching are to be institutedand sustained

3. With adjustment for local requirements, & ifnecessary in translation, this course could be taught inany country worldwide