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RESEARCH ACTIVITY AS A SPHERE FOR THE FORMATION OF
CLINICAL THINKING IN FUTURE DOCTORS
Yuldashova Shakhlo Toyirovna
shaxlo.yuldashova@bsmi.uz
Bukhara State Medical Institute
Abstract: The primary function of educational activity is the maximum
reproduction of professional activity modeled by the educator, based on the student's
assimilation of knowledge, skills, and ethical principles.
Keywords: medical university, education, creative thinking, professional
activity, university students.
Innovative processes in education have introduced significant changes to the
content and methodology of professional training for specialists of all categories,
including mid-level medical workers. One of the main requirements for the quality of
a medical university graduate's professional status is the formation of their clinical
thinking. Its structural elements – symptom complex analysis, theoretical and
practical-clinical comparison, theoretical and practical-conditioned comparison-
image, technological decision-making, reflective-evaluative control – are directly
related to the basal characteristics of future professional activity. These include:
socially required quality of treatment (objectivity), its diagnostic and prognostic
support, individual methods of active-initiative interaction with the patient, aimed at
both regulating their relational reactions and the doctor's self-regulation of their own
professional decisions, actions, and behavior (subjectivity). According to
contemporary psychologists, to form a demanded personal education, it is necessary
to identify the activity that most serves its development (L.M. Vekker, P.Ya. Galperin,
B.F. Lomov). The formation of clinical thinking occurs primarily in educational
activity. It is viewed as a sequence and unity of self-learning and learning situations
(L.D. Stolyarenko). Learning can be characterized "as a process of active interaction
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between the educator and the learner, as a result of which the learner forms certain
knowledge and skills based on their own activity." Considering this approach, it can
be concluded that the main function of educational activity is the maximum
reproduction of professional activity modeled by the educator, based on the student's
assimilation of knowledge, skills, and ethical principles. Learning situations,
according to L.D. Stolyarenko, lead the development of activity from simple systems
of actions to complex ones [1]. Simple ones are realized in acts of imitation,
reproduction, repeated variable repetition of reproductive analysis (analysis by
analogy). Complex ones are realized in actions to solve problematic situations, acts
of reflection, analysis and self-assessment, and designing new situations from the
perspective of a given or independently determined goal.
Thus, learning and the development of cognitive and imitative professional
activities occur simultaneously. Their orienting basis remains the progressive mental
assimilation of professional activity based on its description, which also contributes
to its reproduction. In this regard, this function is performed by "the doctor's reflective
mental activity, ensuring the formulation and solution of diagnostic, therapeutic, and
preventive tasks through the analysis of the genesis and development of pathological
processes and their ethnological factors." Studies by I.N. Denisov, Yu.F. Isakov, V.P.
Meleshko, V.K. Ovcharov, and others have established that a specialist in real medical
activity, and therefore in the future professional work of an individual preparing for
it, demonstrates the ability, based on knowledge of normal and pathological anatomy
and physiology, to move from perceiving the external manifestations of a disease to
eliminating pathogenetic connections, to recreating the internal picture of the disease.
Analysis and generalization come down to identifying a common and at the same time
essential sign of health disorders and the corresponding principle of decision-making.
As a rule, it follows the clinical picture of the disease, including differential diagnostic
signs described in the literature. Therefore, reflective actions are associated with
understanding the content of already assimilated typical diagnostic and therapeutic
actions. The mental activity of the future specialist directed in this way allows them
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to set goals in diagnostic activity, to flexibly and constructively adjust, and to variably
determine treatment programs.
This list of components of both types of professional activity presupposes the
implementation of the following principles:
1). Clear and unambiguous description of the activity;
2). Analysis by units, where in the aspect of medical activity, units are external
manifestations of health or unhealth; their internal and external factors; mechanisms
of health preservation, disturbance, and restoration; tactics and techniques of medical
intervention; professional tasks and ways to solve them;
3). Individual strategy of activity goals. This is caused by the zone of
uncertainty in human activity, when analysis and synthesis lack knowledge support,
and the independent search for necessary information – research – is accompanied by
the creation of certain interpersonal relationships, "serving as a means to achieve a
tangible result of activity."
The content of the types of activities presented in the state educational
standard for the "Dentistry" specialty is provided by the first two principles and does
not depend on the third. The same applies to the list of student knowledge and skills.
It lacks an orientation towards search forms of professional assimilation and
communication situations. At the same time, they are of particular importance, as
medical activity consists not only in its qualitative reproduction but also in the
communication between doctor and patient, in establishing a trusting contact. In a
situation of knowledge deficit, there is a need to construct ways to acquire scientific
knowledge, including methods of communication [2]. In it, according to V.S. Merlin,
there are "such operations that simultaneously represent intermediate goals for
achieving a tangible result."
All this indicates the necessity of a special organization of student research
activity, oriented towards developing not only research skills but also professional
thinking. There are distinctions between scientific research and educational research
work of students. Scientific research refers to an independent creative study of an
undeveloped actual problem in science or practice, based on either theoretical or
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empirical analysis, or experimentation. Educational research work acts as a process
of independent acquisition of missing knowledge and skills through a creative study
of scientific information or professional practice. The goal of educational research
work is, first and foremost, to ensure a more conscious and deeper assimilation of
educational material by the student and the development of research skills necessary
for future professional activity. The difference between the two types of research
activity mentioned above lies in their goal and the degree of student independence.
The unifying characteristic is scientific rigor. In both types of research activity, there
is a methodological approach, scientifically sound analysis of specialized literature,
experience of specialists, and experimental techniques. Therefore, scientists combine
them into a single integrative designation – "student educational and scientific
research work."
The goal also becomes integrative: at the initial stage – the introduction of
elements of scientific research into the educational process of a college or university,
and later – into the independent creative professional activity of a specialist (L.A.
Petrova). Considering these positions, we have defined our scientific search for a
unifying interpretation –
student educational research activity
. In science, it is
established that research activity includes an individual's orientation in science and
practice towards research with the aim of analytical search for an information field to
solve a given problem (V.I. Mareev). In medical activity, this means diagnosis;
searching for evidence-based information for a prospective solution based on the
integration of scientific knowledge and experience (generalization), searching for
something completely new or insufficiently known (independent creativity – I.
Hardy); putting forward several diagnostic hypotheses for a differentiated diagnosis,
which requires not only a sum of knowledge but also specific mental operations:
comparison, generalization, inference (V.L. Sibryaeva).
The experience of the Samarkand and Bukhara State Medical Institutes, as
well as the Urgench branch of the Tashkent Medical Academy, was studied. The
analysis of the obtained material showed that student research work is integrated into
the educational process and acts, on the one hand, as a means of learning, and on the
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other, as its procedural part. The latter orientation is most widespread. The main
objectives of student research activity are:
1). Activation of students' professionally oriented cognitive activity;
2). Formation of the ability to continuously improve one's knowledge;
3). Acquisition by students of a creative approach to professional work;
4). Ensuring content-thematic continuity in the study of specialized
disciplines;
5). Deepening professional interests and aspirations;
6). Formation of a creative attitude towards studying the full scope of
academic disciplines throughout the entire period of study;
7). Development of students' creative activity;
8). Development of motivation for quality self-preparation of students for
future professional activity;
9). Improvement of students' cognitive processes;
10). Rationalization of educational activity;
11). Creation of a comfortable educational environment during the
organization of adaptive education based on provided conditions for self-expression
and self-realization of each student;
12). Cultivation of a value-based attitude towards health;
13). Formation of research skills.
An analysis of the content of the stated objectives indicates that they are
divided into two types: those focused on the developing professional competence of
the future specialist or its individual elements, their intellectual potential, and
organizational-stylistic creative abilities that indirectly ensure the quality of general
professional training. In general, these objectives comply with normative
requirements. However, taken separately and limited to one prospective direction in
each educational institution, they do not ensure the formation of such an integrative
education, in which abilities for active-dynamic operations (actions) are realized
based on analysis-synthesis, elimination of contradictions in various states of the
environment and its subjects, and morpho-change (modeling) of objective and
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subjective conditions of life and interaction. S.L. Rubinstein emphasized: "The
psychological characteristic of a person (personality), obviously, cannot consist of a
simple sum of properties, each of which would be expressed by a psychologically
specific response to external influences. This would mean a splitting of the personality
and would lead to a firmly mechanistic idea that each impact on a person 'singly'
determines its effect, regardless of the dynamic situation, conditioned by other
impacts, in which this impact occurs."
Such an integrative personal education for a future medical professional,
through which external influences are systematically refracted, is clinical thinking.
However, in the experience of medical universities, there is no orientation towards its
formation, not even at the level of setting tasks. Hence, the organizational forms of
student research activity are monotonous and represent basic modalities for object- or
subject-generalized reflection of real practice or the informational volume of studied
disciplines.
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