Development of Students-Foreigners’ Communicative Competence by Means of Information Technologies under the Conditions of the Medical University

The article deals with an urgent issue of a systematic research of foreign students studying in Ukraine. Successful learning and social adaptation of young people greatly depend on learning the Ukrainian language. In addition to the obvious advantages, it is advisable to pay particular attention to the system of theoretical and methodological support of the educational process, starting from the author’s textbooks and finishing with modern information technologies. Forming the communicative competence of a medical professional is impossible without taking into account the value-motivational side of this process. In this regard, the communicative training of the healthcare worker is viewed within an axiological approach. As a consequence, professional values are the central category. Peculiarities of future doctors’ professional values formation as a component of communicative competence are considered. The study, aimed at analysing the development of professional qualities of foreign medical students, was conducted at I. Horbachevsky Ternopil National Medical University in the 2018-2019 academic year. The study was carried out under the guidance of professors A.Vykhrushch and N. Fedchyshyn by lecturers of I Horbachevsky Ternopil National Medical University T. Khvalyboha (EdD), I. Drach (PhD), M. Rudenko (PhD) that teach students-foreigners at the Department of the Ukrainian Language and Department of Foreign Languages.


Introduction
One of the most perspective and at the same time the least studied phenomena of modern education is the systematic study of foreign students' education in Ukraine. It is no coincidence that in 2003 the Ministry of Education and Science of Ukraine created the state enterprise "Ukrainian State Centre for International Education", which offers employees not only a list of higher education institutions, but also a set of educational programs, various forms of assistance with admission, visa support. It also monitors the learning process, develops advertising and information projects and explores opportunities for international cooperation [Hantimurova, 2019: 6). Statistics is of particular interest. According to the data of Ministry of Education and Science of Ukraine, 75605 students from 154 countries of the world study in our country. Among the leaders are India -14958 students, Morocco -7390 students, Azerbaijan -6228 students, Turkmenistan -5033 students, Nigeria -3552 students, Egypt -3412 students, Turkey -3254 students, China -2721 students, Israel -2460 students, Georgia -2397 students. It should be noted that among the five most prestigious universities four are in the medical field. educational institution and finishing with advanced training, information technologies begin to occupy a dominant position (Melnychuk, 2019).

Analysis of Recent Research and Publications
It should be noted that the problem of our study is getting more attention at the state level. The Ministry of Education and Science of Ukraine proposed for discussion the state standard on the Ukrainian language as a foreign language. This is due to the fact that "within the framework of the Bologna Process, which Ukraine joined in 2005, the number of exchange programs between Ukrainian and foreign universities is increasing every year". As a result, the number of foreign students who want to master the Ukrainian language is increasing. Meanwhile an increasing number of academic units (e.g. Cambridge University, Humboldt University of Berlin, Ukrainian Institute in London, etc.) enable foreigners to study Ukrainian. The development of unified state requirements for the level of proficiency in Ukrainian as a foreign language (Standard) can be the basis for the organization and conduct of certification examination (Diagnostics) and the basis for the introduction of a document of a single sample (Certificate), which will certify the level of proficiency in Ukrainian. "(Creators of the draft "State Standards of Ukrainian as a foreign language" are Danuta Mazuryk (Ivan Franko National University of Lviv), Oleksandr Antoniv (Ivan Franko National University of Lviv, PO "Tsentr Ukraiinistyky" (Centre of Ukrainian studies), Olena Synchak (Ukrainian Catholic University), Halyna Boiko (National University "Lviv Polytechnic") (State standard …).
Back in 1993, the first International Scientific Conference "Ukrainian as a Foreign Language: Problems of Teaching Methods" was held in Yalta, where scientists outlined the main problematic aspects of it.
Since 2006, teachers of the Faculty of Philology at Ivan Franko National University of Lviv have been publishing a collection of scientific works "Theory and Practice of Teaching the Ukrainian Language as a Foreign Language" (Editor-in-Chief, Professor, Doctor of Philology Iryna Kochan). In May 2019, teachers of the Faculty of Philology of Ivan Franko National University of Lviv held an international conference "Theory and Practice of Teaching the Ukrainian Language as Foreign". The conference discussed the following issues in Ukrainian linguistics and language teaching: Ukrainian language in space and time: history, theory, practice; linguistic studies and problems of intercultural communication; lexical-semantic structure of language; problems of methodology in teaching the vocabulary of Ukrainian as a foreign language; grammatical structure of language; problems of methodology in teaching Ukrainian grammar as a foreign language; semantics and pragmatics; Ukrainian as a foreign language in teaching speech activities; educational and methodological support of the process of the Ukrainian language learning for foreigners; problems of standardization and unification of the process of the Ukrainian language learning as a foreign language, culture of language and stylistics (Bilavych, 2020).
The recent scientific papers for a PhD degree deal with topical issues of training future foreign doctors for mastering professional terminology in medical institutions of higher education (Avramenko, 2019), formation of intercultural communicative competence of foreign students in higher educational establishments of Ukraine (Kalashnik, 2015), problems of training the future foreign healthcare workers for professional communication (Rahrina, 2017), socialization of foreign students in the educational and cultural environment of higher educational establishment (Bilyk, 2018), formation of foreign students' readiness for dialogic interaction in future professional activity of a doctor by means of interactive technologies (Zaiets, 2017), characteristics of pre-professional training of foreign entrants to study at medical universities (Proskurkina, 2014).
The thesis for the Doctor degree by S. Yastremska "Theory and methodology of professional training of future masters of nursing in higher medical institutions by means of distance learning" (Yastremska, 2018) arouses considerable interest.
G. Schröder and L. Hoffman attract attention as the researchers in the context of the problem under study among foreign scientists.
According to the scientists, the purpose of studying Ukrainian as a foreign language is "to develop communicative competence, to provide communicative needs in different spheres of communication: educational and scientific (to obtain competitive training in the chosen specialty, performing scientific research), socio-political and socio-cultural (for social and cultural), proper adaptation and full orientation in the new socio-cultural environment, personal cultural growth), household (to meet the needs of everyday life) and to foster a harmonious personality that is capable of intercultural dialogue. In accordance with the aim, the following objectives have been stated: -studying the communicative needs of different categories of foreigners in accordance with different models of language learning and the language situation in Ukraine; -mastering foreign language and language skills, developing skills and abilities that are communicatively appropriate in the communication process; -formation of foreign students' abilities and skills of independent educational activity, ability to learn, to improve the cognitive-operative component of speech activity as a means of comprehensive personality development; -formation of humanistic outlook, intercultural communication skills, tolerant attitude towards representatives of other cultures and religions; -nurturing respect for the Ukrainian people, the Ukrainian culture; -development of skills for critical understanding of social problems, awareness of life values.
Mastering the Ukrainian language by foreigners should result in personal multilingualism, in which the studied language will play the role of an equal means of personal professionalism and cultural development (Fedchyshyn, 2018;Ushakova, 2014).
At the same time, there is a significant number of insufficiently solved problems, from the use of cloud technology, distance learning, to the system of training and retraining of medical universities teachers.

Unresolved Aspects of the Problem
Among the unresolved issues are the lack of research aimed at studying value system of future doctors, studying the level of their information culture, difficulties in learning the Ukrainian language, advantages and disadvantages of test methods, specific features of professional training of representatives of different countries. It is no coincidence that on May 10, 2018, the Ministry of Education and Science of Ukraine proposed for public discussion the state standard on Ukrainian as a foreign language. The document contains a clear list of communication skills at each level (from A1 to C2) for all types of speech activity (listening, reading, writing, speaking), as well as a unified approach to the development of new curricula, the creation of modern textbooks in Ukrainian as a foreign language, compiling of dictionaries, opening of Ukrainian language programs and language centres. The problem of youth adaptation from foreign countries requires an updated system of methodological support, based on information technologies.
The objective of the research is to investigate the peculiarities of foreign students' preparation for vocationally oriented communication activities.

Materials and Methods
To fulfil the tasks of the research, a complex of general scientific and special methods have been used, namely: comparative analysis, identification, selection, systematization of scientific, educational-methodical literature, documents, periodicals); historical (for definition of the degree of scientific comprehension, analysis of peculiarities of the development of theory and practice of information policy); historical-genetic (for determining factors, causal relationships of formation and development); historical comparative (comparison of the effectiveness of the use of forms, methods, means of pedagogy in different countries and at individual stages of development); expert method (analysis of problems with evaluation of results); development of a prognostic scenario; expert assessment. In the article, methods of comparison, systematic analysis and descriptive methods have been used, as well as the questionnaire survey conducted at I. Horbachevsky Ternopil National Medical University.
Particular attention was paid to the study of the opinion of foreign students about the needs of professional activities relevant to the future. The important questions of the content, forms, methods of training were analyzed. The process of professional competences formation that is a priority for successful activity of a doctor was the central focus of researchers.

Results and Discussion
I. Horbachevsky Ternopil National Medical University confirms the above trends. Currently, over 2000 representatives from other countries are studying here. Successful learning and social adaptation of young people greatly depend on learning the Ukrainian language.
In addition to the obvious advantages, it is advisable to pay particular attention to the system of theoretical and methodological support of the educational process, starting from the author's textbooks and finishing with modern information technologies.
Forming the communicative competence of a medical professional is impossible without taking into account the value-motivational side of this process. In this regard, the space of communicative training of the healthcare worker is viewed through the prism of an axiological approach. As a consequence, professional values are the central category.
Let us consider the peculiarities of doctors' professional values formation as a component of communicative competence. The initial construct that determines the nature of the professional behaviour of a specialist is professional beliefs. They are a complex formation, formed mainly under the educational influence of the learning environment. Society in which the personality of the specialist develops also plays a significant role in established professional beliefs. Cultural, socio-economic, religious characteristics are often reflected in the complex beliefs of the specialist.
Professional beliefs are characterized by relative versatility, but there may be some variations within different cultures and communication situations. For example, a study conducted by American scientists in 2010 found that most American doctors were convinced that personal beliefs should never conflict with professional ones. In confirmation of this, scientists cite the negative answers of the respondents (95%) to the question "Is the doctor obliged to perform an action that is considered correct within the limits of his practice but contradicts his personal understanding of the concept of "goodness"? (Lawrence, 2009). Scientists say that for American doctors, the main professional beliefs are a positive understanding of personal duty, awareness of the rule of law and respect for the rules and regulations within the health care system, the patient's vision as a fully-fledged, deserving personality, regardless of his physical and psychological state Professional beliefs are the basis for professional values. They are a somewhat more complex psychological construct, to some extent influenced by the conditions where the doctor develops professionally. By professional values, we mean a complex of interrelated moral and ethical settings of a cultural and professional ethical nature, which have universal characteristics of humanistic orientation and priority of public service and variant characteristics of cultural and social-communicative conditionality. This complex is the regulator of role interaction in the professional environment and the basic mechanism of personal and professional development of the healthcare worker (Kornauhova, 2015). Professional values are part of an important mechanism that shapes the professional behaviour of a specialist. The definition of the professional values of medicine is based on the interpretation of the problems of medicine in the communicative aspect.
Professional values are updated in professional attitudes. In American educational tradition, the distinction between the concepts of value and attitude is clearly provided. According to American scholars (Difference between…], value is the concept of a desirable, internalized criterion, or standard of appreciation of one's own actions and other people's actions. A mindset is a fixed way of responding to other people or to a situation that has evolved based on our values. In addition to directly professional values, settings are formed under the influence of working and living conditions. Successful situations, a sense of respect from colleagues and patients, the priorities of the work environment, the criteria of professionalism inherent in a particular team determine the nature of the doctor's professional settings, which are, in fact, the final directive to action. It is the set of professional units, determined situationally, that represents the professional behaviour of the specialist (Fig. 1). These ideas are important for Ukrainian medical universities as they take into account global trends. Taking into account the achievements of foreign scientists, we conducted a study aimed at analysing the formation of professional values of foreign medical students. The study was conducted at I. Horbachevsky Ternopil National Medical University in the 2018-2019 academic year. A total of 420 first year students from the medical, dental and pharmaceutical faculties and the Institute of Nursing participated in the survey. Let us consider the results of the survey in details.
When being asked what qualities a successful doctor should have (Fig. 2), most foreign students answeredintelligence (71), kindness (46), honesty (33), social skills (31), and practical skills (31). This demonstrates the students' awareness of the significant role of communication skills in the clinical environment. More than 50 fiction and non-fiction works have been mentioned in total, including "Viruses. Drivers of evolution" by Michael Cordingley, "How not to die prematurely" by Michael Greger, "Surgeon", "Assistant" by Tess Gerritsen, "It will hurt" by Alan Curtis Kay, "Plant paradox" by Steven Handry, "Book about the body" by Nathan Donald Diaz, "Listen to Your Body" by Barry Beupert, testifying to the broad reader's interests of a modern medical student.
The formation of the specialist's communicative competence mostly occurs through the prism of Internet communication. When being asked, "To socialize with your friends, which social network do you use most?" Students named the social platform Instagram (111) and messaging apps Viber (84) and Telegram (65). Establishing a core environment for student's communication online is valuable for utilizing online resources to educate and identify likely threats and obstacles to the formation of a future professional.
The benefits of distance learning are not sufficiently used by foreign students. It is important to take this into account in the pre-university stage, in the process of preliminary acquaintance of foreigners with the university, during communication training, and after graduation with the purpose of advanced training, individual professional consultations provision.
In Ukraine, distance learning has officially been part of the education system since 2004, after the adoption of the relevant Regulation; in the Law on Higher Education of the latest version (from 09.08.2019) it is a form of education in higher education institutions (Article 49). Having emerged as a way of teaching by mail, today, distance learning makes the most of all information technologies, in turn stimulating their development. The popularity of this method of acquiring knowledge, particularly in the study of foreign languages, requires a special methodological adaptation by the teacher and the student, taking into account all specific circumstances and peculiarities, in order for the transfer and learning process to be successful.
Among the features of distance learning, there is a difficulty in developing student's communicative competencies, because speech is mostly a live communication and exchange of thoughts, and conversation is more than just the transmission and reception of information, and the action and reaction that must be practiced in the audience. However, for today's generation new technologies are natural as they have been in contact with them since the early years of their lives. This is a generation that finds it difficult to communicate without using "natural" multimedia tools. Therefore, it is necessary to adapt the forms and methods of teaching to the real tools that students use in everyday life (computer, internet), and the teacher should be an inspirer and scientific advisor for the student. Distance learning of Ukrainian language for foreign students using information and communication technologies may include different teaching methods that will allow them to practice all language skills based on the exercises and tasks created for this form of knowledge acquisition. The use of educational platforms in teaching and learning the languages is still a challenge for didactics, since it entails many problems for which methodological solutions have not yet been developed.
Development of communicative competence by means of distance learning is a technique with its own special tools. It uses all available electronic media, including the Internet, audio and video, interactive television, multimedia programs and e-learning, that also complement and refine traditional methods. Learning through e-learning platforms has several benefits: unlimited access to the content of the course, the ability to return to certain materials at any convenient time for the student, the ability to choose the pace of study. Participants can use many electronic materials posted on the platform. The work of the student is fixed by the platform and controlled by the teacher, who can see the start time, the time spent studying, etc. If necessary, it may be able to remind the student that he/she has not used the platform for too long or spends too little time on modules that he/she has problems with. Teachers can advise, comment, and evaluate works.
A student has the opportunity to communicate not only with the teacher, but also with other members of their group. They can use their own e-learning, email, online forums or chats to communicate.
In order to develop communication skills, it is best to use activation methods such as: discussion, project, case study, didactic game. Despite the possibility of "live" communication through high-speed Internet and the communicator program, video communication during distance learning remains mostly a form of individual rather than group lessons, since in this case all participants will have to study simultaneously, which partially negates the idea of distance education.
One of the interesting ways to develop writing communication skills is patricipations in discussions in online forums. The main problem that the teacher has to solve is conducting a discussion (conversation) between two people or the whole group. In the first case, the teacher can get a quick read and answer and respond immediately to the mistakes, in the second case, the teacher can get more activity and attention from students. Also, the opinions of researchers about the expediency of conducting this exercise online do not coinside, as spontaneous statements contribute to the development of natural foreign language communication skills, and, conversely, an "asynchronous" discussion, allows reflection on the thoughts of other participants (Pelka, 2010). Asynchronous communication has its pros and cons. On one hand, it gives each student the opportunity to think and prepare their answer, which is undoubtedly useful when learning a foreign language. On the other hand, the long waiting time for a teacher's response may deactivate the conversation. In turn, the teacher will not be able to plan his work productively if he responds to students' on a 24-hour basis.
E-learning also makes it possible to use innovative teaching methods, such as interactive computer language games, thus introducing game-based learning elements. Learning to play is the concept of transferring knowledge electronically using entertainment elements. Delivering educational content online or offline, and combining it with entertainment, is the method of activating a student that enhances his/her motivation, facilitates learning and memorization, increases the efficiency of both processes, and enables them to succeed in communication faster. Educational computer game combines a form of entertainment with educational content, focuses on clearly defined learning goals, and its use facilitates the learning process. In addition, games allow to solving various interactive tasks, such as crosswords, puzzles, charades, quizzes, dominoes with images and words, etc. They increase students' concentration and attention, significantly support interest in didactic content and increase motivation. Also they affect assimilation activity (perception, especially memory). In addition, as they focus on learning foreign languages, they allow help develop all four skills (speaking, reading, writing and listening) simultaneously.
Other types of work aimed at developing communication skills through distance learning include: virtual excursions -an exercise based on visiting websites to view objects in virtual reality, followed by a discussion of what has been seen; ask an expert -an exercise based on gathering information from specialists in a particular field; information gap -an exercise based on finding the information needed to complete a task, text or audio.
Distance learning at I. Horbachevsky Ternopil National Medical University is implemented on the basis of Moodle platform, specialized software that works with all devices that have Internet connection and is connected with the development of network interaction. Specificity of the study material takes into account the opportunity to study regardless of place and time, including after course studies. The educational materials for the discipline "Ukrainian as a Foreign Language" are aimed at developing students' communication skills and prepared in the form of electronic textbooks, characterized by interactivity (the ability to change individual curriculum), hyperlinks in the text, illustrative materials, group tasks for each topic; video and audio.
In order to develop communicative competence, as well as to explain complicated tasks to student's, to provide answers to their questions, teachers conduct remote consultations that provide for the review and clarification of the educational material. Online consultations take place individually and in groups, in the form of asynchronous and synchronous remote consultation. During asynchronous remote consultation, the student-teacher interaction is carried out consistently at different times. Types used at TSMU include: web forum (open forum consultation) and e-mail consultation, which help think over and edit the reply, to analyse (learn, write something) the reply of a teacher or classmate. Synchronous remote consultation is conducted in the form of a chat consultation via text messaging or video conferencing. Video lectures and media library of video materials from various fields of medical activity and special didactic films add practical value to the development of communicative competences of foreign students.
The acquisition of communicative competences by means of distance learning is time consuming. Computers, television, and the Internet that are used to convey various types of information that contains text, graphics, sound, or video, significantly helping the students at all levels of education. The use of these devices and technologies in higher education alters the educational process, teaching methods and, therefore, may change their quality.
High quality textbooks play a particularly important role in teaching foreign students. The publication of the author's manual "Ukrainian as a foreign language for medical specialties" by teachers of the university is predetermined by current approaches to teaching Ukrainian as a foreign language and the language of the profession in particular, which provide for the skills formation to communicate in various fields: industrial, professional, business, etc.
Mastering the phonetic, lexical, grammatical richness of the language is one of the basic prerequisites for integrating foreigners into the Ukraininan cultural environment. To learn the basics of the Ukrainian language better, students need to focus on the correct use of lexical units, expanding the active vocabulary, developing the ability to use them in oral and written professional language. The author's manual "Ukrainian as a Foreign Language for Medical Specialties" contains 45 topics, which are structured in two blocks: 1) topics aimed at developing skills of everyday communication -"Catering establishments", "In the city", "At the station", "At the bank", "Virtual tour of Ternopil", "Months. Seasons, Dates, Weather. The phenomena of nature", "Gifts. Birthday", "Holidays in Ukraine", "My favourite holiday", "My work day", "My day off", "Occupation"; 2) topics aimed at developing professional communication skills -"What are you? Occupations", "My future profession", "I got sick", "In the clinic", "Diseases. Injuries", "A talking between a doctor and a patient", "Business game 'Doctors'", "Medicine. Medical specialties. Medical Staff, Hospital Departments, First Aid, Hygiene and Healthy Lifestyle, Pharmacy. Medicines", "Prescription. Medical Certificate", "Medical Card", "Modern Medical Technologies".
The proposed theoretical and practical material leads students to complete tasks that contribute to mastering logical connectivity. The manual combines the visual and casual types of training material: in addition to the usual textual exercises for teachers and students, some original forms of work are presented: crossword puzzles, drawings, etc. The guide contains differentiated tasks for both individual and group performance. Interesting and versatile tasks, rich lexical content, unusual forms of activity, offered in the manual, help to improve understanding of foreign languages, to prepare them for communication in the Ukrainian professional environment.
At the end of each topic of the tutorial, there are sample test assignments that allow students to evaluate their knowledge of a particular topic and to prepare for daily and semester tests. The textbook "Ukrainian as a Foreign Language for Medical Specialties" helps foreign students not only master the basic spelling, spelling, lexical, grammatical and stylistic forms of modern Ukrainian literary language, but also develop proficiency and skills. Each topic involves the use of modern information technology? video and audio materials.

Conclusions
In a pandemic, the attention to distance learning technologies as well as the study of its advantages and disadvantages is significantly increasing. The information culture of teachers and students is gradually becoming one of the priorities for the development of professional competence. It is important to combine the experience of past years and the achievements of modern science.
Summarizing the aspects mentioned above, a number of perspective studies can be identified. In our opinion, the experience of the past years has not sufficiently been used in Ukrainian medical universities yet, in particular the unique technology inherent in the Socratic dialogue, the didactic system of Ya. A. Comenius, the best practices of classical universities in the development of professional language culture. It is interesting to practice the presentation of electronic culture of their native countries in Ukrainian. The method of projects does not lose its relevance. The specifics of future doctors' activities require special attention to the anamnesis, which is based primarily on empathy, the ability to ask logical questions, to hear the patient, communication aimed at improving the health of the patient. The technique in which the student acts as a doctor and a teacher is promising. Business games help to prepare for medical consultations. Studying medical terminology in the context of a cognitive-orientation paradigm requires updating established technology to accomplish its tasks. Methods of using mind map, project method, preparation of comparative tables to determine the essence of the system of basic concepts, case method, development of questionnaires by students, preparation of letters to experts, literature review, in particular dictionaries, peer review, self-assessment, brainstorming, student scientific conference, portfolio. All of these proposals imply the widespread use of modern information technologies.
In medical universities the attention should be paid to the understanding of a unified system of basic concepts by students and teachers. Among the most important should be mentioned the concept of health, especially for self-assessment of future doctors, successful communication with patients, promotion of a healthy lifestyle. It is important to pay attention to the level of students' speech culture. An interesting trend has been observed in recent years. Responding to the rules of admission, medical students, that are usually the best students in secondary schools, successfully solve tests. At the same time, while reading original works in front of the audience, significant difficulties occur with the main ideas identification, understanding the author's idea, the need to evaluate the speeches of colleagues, dialogues on the given topics. According to our observations, only twenty percent of first year students successfully solve problems of such level. It is not just about the culture of speech and communication.
After all, the essence of communication between a doctor and a patient, as the basis of diagnosis, is the ability to ask questions, the ability to listen, empathy, generalizations and conclusions. No wonder a famous doctor Avicenna considered a word, grass and a knife to be the main tools of a good doctor. As we see a word, the culture of communication takes the first place.