Person: GÜLPINAR, MEHMET ALİ
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GÜLPINAR
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MEHMET ALİ
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Publication Open Access Tıp Eğitiminde İnsani Boyut ve Anlatı Tıbbının İmkânları(2019-12-30) GÜLPINAR, MEHMET ALİ; Merve YILDIZ;Mehmet Ali GÜLPINARFlexner raporu, biyomedikal görüşün tıp eğitimine yerleşmesi açısındandönüm noktası olur. Flexner sonrası dönemde tıp eğitiminde biyomedikalyaklaşım güçlenir ancak sağlık eğitiminde ve sağlık bakım süreçlerindeinsani ve sosyokültürel yön kaybedilir. İnsan ve hasta bireyler biyolojikve hatta moleküler düzeye indirgenir. İnsanların aynı zamanda anlamodaklı hayat yaşadıkları gözden kaçırılır.Zaman içerisinde “bütünlüğün kaybı” olarak değerlendirilenbiyomedikal görüşe karşı anlamlı bir direnç ortaya çıkmaya başlar.Yalnızca hastaların bedenlerini değil aynı zamanda onların psişikyaşamlarını ve sosyal bağlamlarını da dikkate alan bütüncül bir yaklaşımolan “biyopsikososyal perspektif” savunulur. Tıp akademisyenleri,yorumlayıcı paradigma çerçevesinde sosyal ve insani bilimlerin sağlıkhizmetlerinde oynayabileceği role dikkat çekerler. Sosyal ve insanibilimlerin tıp eğitimi programlarına entegrasyonu süreç içerisinde hızkazanır ve tıp eğitiminde “tıpta insan bilimleri” bu bağlamsal zemindegelişir. Tıpta insan bilimleri içerisinde yer alan tıp ve edebiyat çalışmaları, biyopsikososyalyaklaşımla birlikte, doktor-hasta anlatı etkileşimi dâhil olmak üzere, kişilerarası deneyimlerindevreye girmesiyle anlatı tıbbını ortaya çıkarır. Dolayısıyla anlatı tıbbı, tıp eğitiminde biyomedikalperspektifin göz ardı ettiği insanı bütün olarak değerlendirme yaklaşımına karşı tıpta insanbilimlerinin tıp eğitimine entegre edilmesi çalışmalarının bir sonucu olarak gelişir. Tıp ve edebiyatbağlamında anlatı tıbbı, edebiyatın sanatsal söyleminin tıp eğitimine yedirilmesi amacını güder.Hastalık hikâyelerini tanıma, özümseme, yorumlama kapasitesi olarak tanımlanan anlatı tıbbı, tıpeğitiminde bütünlüğün kaybının iyileştirilmesi imkânı doğurur. Yakın/derinlikli okuma ve anlatısal/reflektif yazım gibi eğitim etkinlikleri ile kazanılan anlatı yeterlikleri, insani duyarlılığı artmış dahanitelikli hekimler yetişmesine katkı sağlayabilir.Bu yazıda, tıp ve tıp eğitimi süreçlerine dahainsani bir çerçeve sağlanması noktasındaanlatı tıbbının imkânları nelerdir sorusu elealınmış; yurtdışı ve yurtiçi çalışmalarla anlatıtıbbı uygulamalarının tıp eğitimine katkılarıdeğerlendirilmiştir.Publication Open Access The emotions experienced by family medicine residents and interns during their clinical trainings: a qualitative study(2023-01-01) HIDIROĞLU, SEYHAN; YILDIZ İNANICI, SİNEM; GÜLPINAR, MEHMET ALİ; Tanrıöver Ö., Peker Ş., Hıdıroğlu S., Kitapçıoğlu D., Yıldız İnanıcı S., Karamustafalioğlu N., Gülpınar M. A.Background: The family medicine residents and final year medical students are challenged with increased workload and they experience various emotions during their clinical trainings. They are confronted with uncertainties in their role descriptions and they witness illness, suffering and deaths as part of their everyday duties which may lead to burnout. Only several studies have focused on these experiences to find out what the family medicine residents and medical students were literally feeling. Aim: The aim of this study was to explore the family medicine residents’ and final year medical students’ emotions during their clinical trainings. Method: This qualitative study was performed with 15 family medicine residents and 24 final-year medical students using a convenience sample from two medical faculties to explore and analyze their emotions. Data were gathered by means of focus group interviews, including six interviews conducted and recorded through online meetings. Data were analyzed for themes using a thematic analysis approach. Since the interviews reached saturation in terms of content, the interviews were terminated at the end of sixth focus group meetings. Each interview took an average of 45–60 min. Results: Three main themes emerged from the data regarding residents’ and interns’ emotions. These were the \"clinical climate’s role\", \"emotions during patient encounters\" and \"coping strategies with negative emotions\". The most commonly encountered emotions were tension and anxiety followed by frustration and uncertainty. Conclusions: The family medicine residents and final-year medical students are challenged with emotions during their clinical trainings. Therefore, medical educators have to be aware of the need to support them in reflecting their emotions by prioritizing residents’and interns’ well-beingPublication Open Access Varoluşsal hâl üzerinden ahlakiliği çerçeveleme denemesi: Hâlsel/düşünümsel etik(2022-04-01) GÜLPINAR, MEHMET ALİ; Gülpınar M. A.Bu yazıda ahlâkilik, \"varoluşsal hâl\" üzerinden temellendirilebilir mi sorusuna cevap aranmaya çalışılmıştır. Ahlâkın \"akıl\" veya \"duygu\" yerine varoluşsal hâl üzerinden çerçevelendirilmesinin gerekçeleri ve imkânları tartışılmıştır. Bu arayışta karşıtlıklar üzerinden yürütülen tekçi veya ikili düşünce yaklaşımları yerine \"farkı var’layan birlik\" düşüncesi benimsenmiştir. Yine ahlâki düşünsellikleri \"akılsallık\" veya \"akılsallaştırma\"lar ile gerçekleştirmenin beraberinde getirdiği durumlar ve sonuçlar değerlendirilmiştir. Ötekine açık akılsallıkların ahlâkilikler ve ahlâki pratikler üretirken; ötekine kapalı akılsallaştırmaların daha çok ahlâkçılık ve kategorik \"iyi\" ve \"kötü\"ler üzerinden giden ahlâkçı pratiklerle sonuçlanması üzerine düşünülmüştür. Bu düşünüm iki örnek üzerinden açılmıştır: Pandemi sürecindeki \"aşı karşıtlığı/ kararsızlığı\" ve İstanbul Sözleşmesi etrafında yürütülen kadın ve aileye yönelik tartışmalar. Hem genel hem de İstanbul Sözleşmesi tartışmaları üzerinden \"kendilik ve şahsiyet olarak kadın\" bağlamında ahlâkilik ele alınmıştır. Akılsallıklar çerçevesinde oluşturulacak ahlâk sistemlerinin, teorilerinin ve toplumsal/kültürel ahlâki pratiklerin ana hatları ile çerçevesi çizilmeye çalışılmıştır. Bu çerçevelemenin merkezi kavramları şunlardır: \"arada’lık\", \"ahlâki mesafe\", \"yönelimsellik\", \"fark\", \"kendilik\" ve \"şahsiyet\". Bu kavramlar üzerinden \"hâlsel/düşünümsel etik\", kendilik etiği, şahsiyet etiği ve meydanda etik/meydan etiği ele alınmıştır.In this article, it has been tried to find an answer to the question of whether morality can be based on the \"existential state\". The rationale and possibilities of framing morality through the existential state instead of reason or emotion have been discussed. In this quest, the idea of unity with valued diversity has been adopted instead of monist or dualistic thinking approaches carried out through oppositions. Also, the situations and results brought about by realizing moral reflections with rationality and rationalization have been evaluated. The fact that rationalities open to the \"other\" produce moralities and moral practices, while rationalizations closed to the \"other\" result in moralistic practices that go through moralism and categorical \"good\" and \"evil\" have been thought over. This reflection has been expanded through two examples: \"vaccine opposition/ indecision\" during the pandemic process and the discussions about women and families carried on over the Istanbul Convention. Morality has been tackled in the context of \"woman as self and personality\", both in general and through various discussions over the Istanbul Convention. The moral systems, theories and social/ cultural moral practices that are to be formed within the framework of open rationalities have been tried to be outlined. The central concepts of this framing are: \"inbetweenness\", \"moral distance, \"intentionality\", \"diversity/ distinctness\", \"self\" and \"personality\". Through these concepts, \"existentially stative/ reflective ethics\", selfhood and ethics, personalistic ethics and ethics in agora have been discussed.Publication Open Access Akılcı İlaç Kullanımının Boylamsal Bir Koridor Şeklinde_x000D_ Üç Yıllık Klinik Eğitim Programına Entegrasyonu(2019-12-30) GÜLPINAR, MEHMET ALİ; Berna TERZIOGLU BEBITOGLU;Mehmet Ali GÜLPINARAkılcı ilaç kullanımı ile ilgili ülkemizde ve dünyada çok sayıda eğitimfaaliyeti yürütülmektedir. Ancak yapılan çalışmalarda günümüzde halenakılcı olmayan ilaç kullanımı olduğu, hekimlerin ve özellikle yeni mezunhekimlerin bu konuda yeterliğe sahip olmadığı ve öğrencilerin kendilerinireçete yazma konusunda yeterli hissetmedikleri bildirilmektedir. Bunedenle mezuniyet öncesi eğitim döneminde başlayan ve ileri eğitimve meslek yaşamları boyunca devam eden eğitimlerle akılcı ilaçkullanımının devamlılığının sürdürülmesi önemlidir.Öğrenen merkezli eğitim modellerinde öğrenenlerin kendi öğrenmesüreçlerini yönettiği probleme dayalı öğrenme ve işbaşında öğrenmegibi aktif öğrenme yöntemleriyle rasyonel farmakoterapi eğitimininyürütülmesi, öğrenmede kalıcılığın artırılması ve doktorların ileridekiklinik pratiklerinde kendi başlarına kaldıklarında rasyonel ilaçkullanımını değişen koşullara göre uygulayabilme yeterliğini kazanmaları için gereklidir.Klinik tedavi kılavuzları ve temel ilaç listeleri ile uyumlu rasyonel farmakoterapi eğitimi iyireçeteleme alışkanlığı kazandırmak için yararlı olmaktadır. Öğrencilerin bilgi, beceri ve tutumlarıdikkate alarak, sıklıkla karşılaşılan klinik durumlar üzerinden yapılan probleme dayalı öğrenme ileişbaşında öğrenme etkinlikleri rasyonel ilaç kullanımı kazandırılması noktasında tercih edilebileceketkili yöntemlerin başında gelmektedir. Yine,toplumda sık görülen hastalıklara yönelikrasyonel farmakoterapi eğitim modülleri ile,akılcı ilaç kullanımının tıp fakültelerinde klinikeğitim dönemlerinde tüm staj programlarınaboylamsal bir koridor olarak entegre bir şekildedahil edilmesi ile, öğrencilerin karşılaşacaklarıhastalıklarda reçete yazmada kendilerinegüven duymalarına, kişisel ilaç formülerlerinihazırlayabilmelerine ve güvenli ve etkilitedavi planları oluşturabilmelerine olanaksağlayacaktır.Publication Open Access Adaptation of the professionalism mini-evaluation exercise instrument into Turkish: a validity and reliability study(2023-12-01) AKDENİZ, ESRA; GÜLPINAR, MEHMET ALİ; Taşçı A. İ., AKDENİZ E., GÜLPINAR M. A., Danacıoğlu Y. O., Sarı E. E., Yaşar L., Karandere F., Ferahman S.Background: There is an ongoing search for standardized scales appropriate for each culture to evaluate professionalism, which is one of the basic competencies of a physician. The Professionalism Mini-evaluation Exercise (P-MEX) instrument was originally developed in Canada to meet this need. In this study, it was aimed to adapt the P-MEX to Turkish and to evaluate the validity and reliability of the Turkish version. Methods: A total of 58 residents at Bakirkoy Dr. Sadi Konuk Training and Research Hospital were assessed with the Turkish version of P-MEX by 24 raters consisting of faculty members, attending physicians, peer residents, and nurses during patient room visits, outpatient clinic and group practices. For construct validity, the confirmatory factor analysis was performed. For reliability, Cronbach’s alpha scores were calculated. Generalizibility and decision studies were undertaken to predict the reliability of the validated tool under different conditions. After the administration of P-MEX was completed, the participants were asked to provide feedback on the acceptability, feasibility, and educational impact of the instrument. Results: A total of 696 forms were obtained from the administration of P-MEX. The content validity of P-MEX was found to be appropriate by the faculty members. In the confirmatory factor analysis of the original structure of the 24-item Turkish scale, the goodness-of-fit parameters were calculated as follows: CFI = 0.675, TLI = 0.604, and RMSEA = 0.089. In the second stage, the factors on which the items loaded were changed without removing any item, and the model was modified. For the modified model, the CFI, TLI, and RMSEA values were calculated as 0.857, 0.834, and 0.057, respectively. The decision study on the results obtained from the use of P-MEX in a Turkish population revealed the necessity to perform this evaluation 18 times to correctly evaluate professionalism with this instrument. Cronbach’s alpha score was 0.844. All the faculty members provided positive feedback on the acceptability, feasibility, and educational impact of the adapted P-MEX. Conclusion: The findings of this study showed that the Turkish version of P-MEX had sufficient validity and reliability in assessing professionalism among residents. Similarly, the acceptability and feasibility of the instrument were found to be high, and it had a positive impact on education. Trial registration: 2020/249, Bakirkoy Dr. Sadi Konuk Training and Research Hospital.Publication Open Access Rethinking large group lectures – how far in this format(2022-05-01) SEVİM, MUSTAFA; ERZİK, CAN; YEGEN, BERRAK; GÜLPINAR, MEHMET ALİ; AKTURAN S., SEVİM M., ERZİK C., YEGEN B., GÜLPINAR M. A.Objective: The aim of this study is to determine the perceptions, attitudes, and behaviour of medical students and lecturers regarding the lectures and their effects on students’ learning behaviour. Materials and Methods: This was a qualitative study including multi-methods. Researchers observed lecture ambiance and activities in two courses. Lectures were observed and slide-presentations were evaluated. Additionally, in-depth and focus group interviews were conducted. Results: Two researchers attended and observed 75 lectures. The average number of attendees was 51.21. Eighty percent of lecturers did not introduce any activities to attract attention and prepare students for the lecture. Only 12% of lectures were taught interactively. Of the evaluated 43 (69.80%) slide-presentations, sufficient association or integration was not made between clinical and basic sciences. Conclusion: This study revealed that the lectures created negative feelings and thoughts in students and lecturers, and led to undesirable attitudes and behaviour. It is essential to focus on giving interactive lectures which aim at developing reasoning, decision-making, and evaluation competencies. The most significant factors determining students’ attendance and appraisal of the lectures were related to the preparation of the lecturers, the intensity of the content, integration between basic science and clinical science, and the presentation skills.Publication Open Access Triple Approach to Program Evaluation and “Contextual Program Evaluation Model” Proposal(2024-03-01) GÜLPINAR, MEHMET ALİ; Gülpınar M. A.Complexity, contextuality, and reflectivity have come to the forefront in almost every field, including education. In this paper, the program evaluation process is considered within the framework of a socially complex system. In this regard, a model proposal for program evaluation is developed: Contextual Program Evalu-ation Model (CPEM). The conceptual and theoretical frameworks on which the model is based are ‘complexity theory’, ‘contextual/reflective learning and evalu-ation’, and ‘social and ecological/environmental accountability’. Taking this triple framework into account, the four evaluation domains/components of CPEM are as follows: ‘agents’, ‘context-process’, ‘emergent outputs’, and ‘impact’. Consider-ing the core concepts of the complexity system, ‘agents’ is preferred instead of ‘inputs’. Furthermore, since reflective process-orientedness is essential in educa-tion, and the experiences in the process are assumed to be ‘context-dependent’, ‘process-context’ is considered intertwined. Outputs are conceptualized as ‘emer-gent outputs’ because they are viewed as results that emerge through mutual inter-action and transformation within existing patterns and attractors in context-de-pendent reflective processes. Finally, considering the accountability approach, im-pact (institutional/societal/ecological) was identified as the fourth domain of eval-uation. By considering these factors, a program evaluation framework for the CPEM is developed. Then, a concrete example of program evaluation based on CPEM is presented. With this, an attempt has been made to provide users with a helpful guide containing steps.Publication Open Access The evaluation of the processes of problem based learning tutorials: Online or face-to-face(2023-10-01) EMRE, ÖZGE; AKDENİZ, ESRA; GÜLPINAR, MEHMET ALİ; GAYEF A., EMRE Ö., AKDENİZ E., GÜLPINAR M. A.Objective: The purpose of this research is to evaluate e-PBL tutorials and compare these sessions with face-to-face PBL sessions. Materials and Methods: This research is a program evaluation study in which quantitative methods were used. In the research, four 90-minute e-PBL sessions held between April and June 2020 were evaluated. Sessions conducted online were realised using the sevenstep approach in groups of 13-14 students and a tutor. Video recordings were analysed with the thin slicing method. In addition, various quantitative data on evaluation were analysed using multiple tools and materials, including the end-of-program evaluation form. Friedman test and Mann-Whitney U test were used in the analyses of quantitative data. Results: Upon evaluating the analyses of the feedback received from the students about the structure, content and process of the program regarding the e-PBL tutorials, the students gave a positive opinion of 80% or more. In regards with the cases, the students had positive opinions of over 80% in terms of “motivation for learning and researching”, “daily life and its relation to their individual development”, “suitability to their levels of knowledge and skills”, “reinforcement of topics”. Support, guidance and feedback received from the tutor as a group and individually during online tutorials were statistically significantly higher than the face-to-face PBL tutorials (P<0.05). Conclusion: Research on the effectiveness of e-PBL tutorials, including ours, point out that e-PBL practices may constitute a viable alternative besides face-to face ones. However, for a sounder framing and better results, the subject should be studied in different aspects and more evidences be gathered in this area. These studies will provide evidence to educational institutions and practitioners on how to adapt and modify educational practices, including PBL.Publication Open Access Rethinking large group lectures – how far in this format(2022-05-01) ERZİK, CAN; GÜLPINAR, MEHMET ALİ; YEGEN, BERRAK; Akturan S., Erzik C., Yegen B., Gülpınar M. A.Objective: The aim of this study is to determine the perceptions, attitudes, and behaviour of medical students and lecturers regarding the lectures and their effects on students’ learning behaviour.Materials and Methods: This was a qualitative study including multi-methods. Researchers observed lecture ambiance and activities in two courses. Lectures were observed and slide-presentations were evaluated. Additionally, in-depth and focus group interviews were conducted.Results: Two researchers attended and observed 75 lectures. The average number of attendees was 51.21. Eighty percent of lecturers did not introduce any activities to attract attention and prepare students for the lecture. Only 12% of lectures were taught interactively. Of the evaluated 43 (69.80%) slide-presentations, sufficient association or integration was not made between clinical and basic sciences.Conclusion: This study revealed that the lectures created negative feelings and thoughts in students and lecturers, and led to undesirable attitudes and behaviour. It is essential to focus on giving interactive lectures which aim at developing reasoning, decisionmaking, and evaluation competencies. The most significant factors determining students’ attendance and appraisal of the lectures were related to the preparation of the lecturers, the intensity of the content, integration between basic science and clinical science, and the presentation skills.Publication Open Access Evaluation of a simulation-based clinical preparation program by final-year medical students: A qualitative study on emergency patient management(2021-03-01) GÜLPINAR, MEHMET ALİ; KİTAPÇIOĞLU D., YAYLACI S., YILDIZ İNANICI S., AKSOY M. E., GÜLPINAR M. A.Background: The most common problem encountered by medical students is the management of unstable emergency patients. Simulation-based education (SBE) is widely used for improving the management of unstable patients. In this study, the aim is to evaluate the SBE Clinical Preparation Program and to understand whether our final-year medical students could transfer the skills acquired in the program to clinical encounters in their emergency medicine clerkship, with the aim of easing this transition. Materials and methods: Final-year medical students at the Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine and their educators were included in this qualitative study. After participating in the SBE Clinical Preparation Program for two weeks, interns completed a two-month emergency medicine clerkship. At the end of the clerkship, four focus group discussions with 5 or 7 interns (n=24) and in-depth interviews with two educators were held. The digital audio recordings were transcribed verbatim within 48 hours of the interviews. The texts were reviewed by two different researchers, and thematic codes were identified. Results: In this study, the effectiveness of the SBE Clinical Preparation Program was evaluated. The participants stated that the program prepared them very well for critical patient management and that the content of the program was sufficient and comprehensive. The trainers stated that the simulation program prepared the students well for the clinic and provided a strong foundation, which was very important, but the students had to overcome an emotional barrier when approaching real patients, a process that took one or two weeks. The characteristics of the students (motivation, anxiety levels), the quality of the processes experienced during the program (seeing a sufficient number of patients, communication and interaction with other healthcare professionals and patients) and the environment/context in which these practices took place (learning climate) were the important factors influencing the transfer of the learning outcomes to the clinical environment. Conclusion SBE transition programs are effective in preparing students for the management of critical patients and facilitate the transition to the clerkship. SBE programs are not sufficient by themselves and should be developed in a continuous and integrated manner with training programs in actual clinical settings