Swimming to improve medical specialist training quality

PhD, Associate Professor E.G. Vakhnina1
PhD, Associate Professor N.A. Vakhnin1
PhD, Associate Professor O.A. Moiseev2
1St. St. Petersburg Mining University, St. Petersburg
2St. Petersburg State Marine Technical University, St. Petersburg

Keywords: medical university students, swimming, physical fitness, functional fitness, mental/ emotional wellbeing.

Introduction. Special vocational physical training is a subsystem of physical education that best provides for the formation and improvement of properties and qualities that are essential for a particular professional activity  [2, 4, 6].
The most common means of professional-applied physical training of future specialists in a higher educational institution are applied sports events having an integrated effect on students’ personality [2, 9].
Objective of the study was to improve the level of professional skills of future specialists, as well as their physical health and mental/ emotional wellbeing by swimming.
Methods and structure of the study. Shortly before the educational experiment, a survey was conducted between the physicians to study the physical load modes and psychological recreation patterns in the process of organization of physical education and sports activities in university. The survey involved 20 physicians of the department of thoracic surgery of Municipal multi-field hospital No 2 in St. Petersburg.
The educational experiment was conducted at the premises of the First Pavlov State Medical University of St. Petersburg swimming pool in the period of October 1, 2017 to April 15, 2018. The experiment was intended to test benefits of the new swimming training model by an analysis of the pre- versus post-experimental health and physicality test rates of the female students. The educational pilot experiment included strength, speed-strength and endurance exercises; biomedical observations - the respiratory and cardiovascular system functionality rates, physiological working capacity. The test results were rated on a five-point scale Contrex-2 [5].
The summative assessment of the academic performance as well as the degree of assimilation of the proposed program were determined using the following formula [3]:

h= ((5a+4b+3c+2d) -2m)/ 3mn X 100 %,
where а – numbers "5", "4", "3", "2" and "1".
m – number of control standards, n – number of students, h – degree of assimilation of the program material.

During the study, the Experimental Group subjects were trained in accordance with the program aimed to develop their swimming skills (4 hours a week), general and special physical fitness, as well as the track and field athletics program, while the female students of the Control Group were trained according to the academic physical education curriculum. During the training sessions with the Experimental Group, a special set of exercises was used to develop their general endurance as one of the fundamental factors of professional-applied orientation of physical fitness of medical students. The programs corresponded to the requirements of the state educational standard on physical culture both in terms of the number of hours and orientation.
Results and discussion. Physicians of various profiles were surveyed taking into account the requirements for the body condition. As a result, we compiled a list of preferential level of development of physical qualities (general and static endurance, dexterity, strength, flexibility), special physical qualities (attention concentration and span, body resistance to adverse effects of environment, speed of visual discrimination and mobility of the nervous processes, static stability, accuracy of spatial and strength differentiation, preservation of general working capacity during long-term hypokinesia, improvement of thermoregulation, improvement of the ability to relax muscles and eliminate fatigue, resistance to hypodynamia). We singled out the main muscle groups that were most significant for performing professional duties: back muscles (upper and lower groups), abdominal muscles (rectus muscle, obliques), muscles of the shoulder girdle and upper limbs, lower limb muscles [7].
A future physician should possess a certain level of development of psychological qualities: discipline, emotional stability and will, concentration and attention switch, thinking, self-command, endurance, perseverance, self-determination.
Differences in the strength, speed, endurance qualities between the female students of the Control and Experimental Groups were insignificant at the beginning of the experiment. At the end of the experiment, the level of physical fitness of the female students of the Experimental Group was significantly different from that of the subjects of the Control group (Table 1).

Table 1. Strength, speed-strength, and endurance test rates at the end of the experiment

Group

Back muscle strength (upper group), sec

Back muscle strength (lower group), sec

Standing long jumps, m

Sit-ups, number of times

100m sprint, sec

1000m race, sec

Control

132.1±5.8

108.6±7.1

1.56±0.15

55.4±4.5

16.5±1.2

5.15±0.21

Experimental

153.4±6.3

122.1±9.5

1.61±0.21

57.7±3.9

16.3±1.1

5.02±0.16

Table 2 presents the cardiovascular and respiratory system functionality rates that characterize the level of physical working capacity of future physicians. These rates were higher in the Experimental Group rather than in the Control one, since swimming practices contribute to the development of higher hypoxia tolerance and lowers the threshold pulse level as well as blood pressure response threshold [1].

Table 2. Functional fitness test rates

Group

Martine test, %

Genche’s test, sec

Stange’s test, sec

Control

153.3±5.7

26.2±5.7

51.2±6.3

Experimental

140.4±7.4

37.5±8.4

62.6±5.6

The results presented in Table 3 indicate that the swimming practices had a positive effect on physical working capacity of the female students, which was reflected in the high results demonstrated in the standard strength, track and field and swimming tests and high functional status of the female students of the Experimental Group.

Table 3. Summative assessment of academic progress and degree of assimilation of proposed program by female students, %

Group

Standard strength and track and field tests

Swimming tests

Control

57.50

60.00

Experimental

58.50

75.50

During the study, we singled out and analyzed the main qualities of mental/ emotional wellbeing of the future physicians and the possibility to correct them by means of swimming practices.
The "Wellbeing, activity, mood" test [8] was carried out twice: at the end of a hard working day (after surgical operations) and after the swimming practices – and different rates were obtained.
In the first case, we obtained the rates indicating emotional stress: a decrease in the level of wellbeing (0±0.2), health (1.2±0.4), physical working capacity (1.2±0.3), mood (0.7±0.5), increased anxiety (0.8±0.2), fatigue (1.7±0.4), excitation (2.1±0.5), exhaustion (0.5±0.3). The low rates of mental/ emotional wellbeing can be explained by severe academic environment and high emotional stress.
The data obtained after the swimming practices showed a high level of wellbeing, activity, and mood. The high test rates can be explained by the positive effect of physical activity in water on man’s higher nervous activity.
The Experimental Group subjects emphasized that swimming practices made them feel more vigorous, reduced emotional fatigue, improved attention, memory, increased vitality, and enhanced psychological control.
Conclusions. Improvement of swimming skills was found highly beneficial for the level of physical fitness of the female students as well as their functional and mental/ emotional wellbeing. Based on the research findings, it is advisable to introduce in the training process the programs that include swimming practices.

References

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Abstract
Special vocational physical training is a subsystem of physical education that best provides for the formation and improvement of properties and qualities that are essential for a particular professional activity. Modern special vocational physical education service offered by the national medical universities is designed to build up the job-specific physical qualities and skills for success of the health service. It is highly important to apply the most relevant and efficient training tools to meet the physical fitness requirements to the future health specialist. Having analyzed the job responsibilities, missions and environments in the national health sector, we have developed a new special vocational physical education model to build up the key physical and mental qualities in the future medical officers by swimming practices viewed as the unique tools of multiple positive health effects.
The new special vocational physical education model testing experiment was run at the First Pavlov State Medical University of St. Petersburg swimming pool in the period of October 1, 2017 to April 15, 2018. The experiment was intended to test benefits of the new model by an analysis of the pre- versus post-experimental health and physicality test rates of the female students.
The model was tested beneficial as verified by the trainees’ progress in the working capacity, strength, endurance and functionality tests. In addition, the special swimming practices were found highly beneficial for the mental and emotional wellbeing of the trainees.