Publication: Tıp Eğitiminde İnsani Boyut ve Anlatı Tıbbının İmkânları
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Date
2019-12-30
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Abstract
Flexner 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.
Flexner report is the turning point in terms_x000D_ of establishing of biomedical perspective in_x000D_ medical education. Biomedical perspective in_x000D_ medical education gains power during the term_x000D_ after Flexner but humanistic and socio-cultural_x000D_ aspects in health education and health care_x000D_ processes are lost. Human and ill individuals are_x000D_ reduced to biological and even molecular level._x000D_ That people also live a meaning focused life is_x000D_ neglected. Over time, a meaningful resistance_x000D_ against biomedical perspective regarded_x000D_ as “integration-loss” begins to appear. An_x000D_ integrated/biopsychosocial approach, which_x000D_ not only cares for patients’ bodies but also_x000D_ psychic lives and social context is supported._x000D_ Academicians draw attention to the role that_x000D_ social and humanistic sciences play in terms_x000D_ of hermeneutics paradigm. The integration of_x000D_ social and humanistic sciences into medical_x000D_ education programs accelerates over time and_x000D_ “human in medicine” education develops on_x000D_ this contextual ground. Medicine and literature_x000D_ studies, together with biopsychosocial approach,_x000D_ which are among human in medicine make_x000D_ narrative medicine appear with the engagement_x000D_ of interpersonal experiences including doctorpatient narrative interaction. As a consequence_x000D_ of holistic/humanistic approach, narrative_x000D_ medicine develops as a result of the efforts to_x000D_ integrate humanities into medical education_x000D_ against the reductionist approach of the_x000D_ biomedical perspective. Narrative medicine,_x000D_ in the context of medicine and literature, aims_x000D_ to embed the artistic discourse of literature in_x000D_ medical education. The narrative medicine,_x000D_ which is defined as the capacity of recognizing,_x000D_ internalizing and interpreting narratives of_x000D_ disease, gives the possibility of improving the_x000D_ loss of integrity in medical education. Narrative_x000D_ competencies gained with learning activities_x000D_ like close reading and narrative writing can_x000D_ contribute to raise more qualified doctors whose_x000D_ humanistic awareness has increased._x000D_ In this study, the question “what are the_x000D_ potentialities of narrative medicine?” has_x000D_ been dealt with in terms of providing a more_x000D_ humanistic framework into medicine and_x000D_ medical education; the contributions of_x000D_ narrative medicine educational activities have_x000D_ been evaluated by means of domestic and_x000D_ abroad studies.
Flexner report is the turning point in terms_x000D_ of establishing of biomedical perspective in_x000D_ medical education. Biomedical perspective in_x000D_ medical education gains power during the term_x000D_ after Flexner but humanistic and socio-cultural_x000D_ aspects in health education and health care_x000D_ processes are lost. Human and ill individuals are_x000D_ reduced to biological and even molecular level._x000D_ That people also live a meaning focused life is_x000D_ neglected. Over time, a meaningful resistance_x000D_ against biomedical perspective regarded_x000D_ as “integration-loss” begins to appear. An_x000D_ integrated/biopsychosocial approach, which_x000D_ not only cares for patients’ bodies but also_x000D_ psychic lives and social context is supported._x000D_ Academicians draw attention to the role that_x000D_ social and humanistic sciences play in terms_x000D_ of hermeneutics paradigm. The integration of_x000D_ social and humanistic sciences into medical_x000D_ education programs accelerates over time and_x000D_ “human in medicine” education develops on_x000D_ this contextual ground. Medicine and literature_x000D_ studies, together with biopsychosocial approach,_x000D_ which are among human in medicine make_x000D_ narrative medicine appear with the engagement_x000D_ of interpersonal experiences including doctorpatient narrative interaction. As a consequence_x000D_ of holistic/humanistic approach, narrative_x000D_ medicine develops as a result of the efforts to_x000D_ integrate humanities into medical education_x000D_ against the reductionist approach of the_x000D_ biomedical perspective. Narrative medicine,_x000D_ in the context of medicine and literature, aims_x000D_ to embed the artistic discourse of literature in_x000D_ medical education. The narrative medicine,_x000D_ which is defined as the capacity of recognizing,_x000D_ internalizing and interpreting narratives of_x000D_ disease, gives the possibility of improving the_x000D_ loss of integrity in medical education. Narrative_x000D_ competencies gained with learning activities_x000D_ like close reading and narrative writing can_x000D_ contribute to raise more qualified doctors whose_x000D_ humanistic awareness has increased._x000D_ In this study, the question “what are the_x000D_ potentialities of narrative medicine?” has_x000D_ been dealt with in terms of providing a more_x000D_ humanistic framework into medicine and_x000D_ medical education; the contributions of_x000D_ narrative medicine educational activities have_x000D_ been evaluated by means of domestic and_x000D_ abroad studies.