Seminars Teaching Preventive Cardiology in Ufa, Bashkortostan, Russia Harald M Lipman 1 Joe Rosenthal 2 Richard Meakin 2 1 International Cardiac Healthcare & RiskFactor Modification (ICHARM) 2 Department of Primary Care & Population Health UCL Medical School [email protected] 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 . Introduction The Republic of Bashkortostan, situated to the South West of the Ural mountains has an area of 143,600 Km 2 and a population of 4,072,029 (2010). It is divided into 9 administrative regions. The capital city is Ufa, with a population of 1,064,000 (2010). Each administrative region has a Regional Medical centre. There is no formal undergraduate teaching of Preventive Cardiology in the Russian Federation. At postgraduate level Moscow and a few other cities offer this; and the National Research Centre for Preventive Medicine has developed several specialist courses. With the agreement of the President and Government of the Republic of Bashkortostan, ICHARM devised and translated a 10 Seminar interactive introductory course in Preventive Cardiology for doctors in the Republic of Bashkortostan. University College London wrote the course, which was taught, in Ufa 14th to 18th July 2014, with the assistance of a Russian interpreter, by two of the British doctors involved in its preparation. This was the first time that a comprehensive one week Preventive Cardiology course had been taught to Russian doctors in Russia by foreign doctors. The 10 Seminars were taught in an interactive manner, with frequent questions & answers, general and small group discussion and role-play. This was a novel approach to teaching in Russia and after some initial reserve, was embraced by the attendants. The teachers viewed the slides in English on their screen whilst the audience saw the same slides projected in Russian on the main screen (Figure 1). Prepared consecutive translation was broadcast over loudspeakers. One hundred & twenty Russian doctors, all involved in either primary or secondary CVD prevention, from Ufa and the 8 administrative regions attended. Attendants registered for each morning and afternoon session. Evaluation forms were completed following each session and at the end of the course. Certificates of Attendance were presented to each attendant (Figure 2) The complete presentation and text notes were made available to all attendants for a limited period, via a protected website. The course Future work During the programme,18 attendants were trained to teach subsequent courses to their colleagues in the 9 regions. They will be overseen by the Republican Cardiological Centre, Ufa. An order formally appointing them as authorised administrative regional Teachers in Preventive Cardiology will be granted by the Ministry of Health. A follow-up course in Preventive Cardiology will be taught in Ufa in 2015 and will be rolled out to other regions of the Russian Federation. A total of 445 seminar evaluation forms and 83 course forms were received. Most respondents had considerable prior knowledge of Preventive Cardiology. The overwhelming majority rated Content/Presentation/Value/ Enjoyment as 4 or 5 (scale 0-5). Examples of attendants’ comments: Course Structure Systematic approach to teaching very helpful. Method of teaching was delightful. Most interesting parts were the clinical cases which assisted with remembering the information. Courses contained a considerable amount of new information. Much information had been presented in a new and different manner. Frequent repetition of information was helpful. Audience discussions are stimulating and very helpful. Role play added an additional approach to teaching. Interactive teaching is a very useful method. Numerous requests for more frequent courses. Course Material Risk factors were the most important element of the course. How to influence patients to change habits very valuable. How to speak to patients about risk was very helpful. Step by step consultations would be very useful. Pictorial representation of alcohol units was new and helpful . Cycle of change was new and interesting. Methods of assessing and managing diet was very helpful. Prophylactic statins very useful for primary prevention. New algorithm for treating hypertension very interesting. How to manage diabetes was very useful. Mode of development of a preventive programme useful. Discussion of problems in rural areas was very useful. Social Organisation Doctors & educators should be involved in preventive cardiology. Health education for patients should be increased. Patients must be stimulated to be responsible for their own health. They would now encourage patients to help themselves to develop healthier lifestyles. Organisations such as Alcoholics Anonymous & Weight Watchers should be set up and encouraged. All patients should be asked about their lifestyles 1. ICHARM/UCL Preventive Cardiology course can be introduced successfully into Russian healthcare culture 2. Training of trainers is essential if uniform approaches in Preventive Cardiology teaching are to be instituted and sustained 3. With adjustment for local requirements, & if necessary in translation, this course could be taught in any country worldwide