Publication: Klinik eğitim sürecinde reflektif uygulamaların tıp fakültesi öğrencilerinin klinik karar verme yeterliklerinin gelişimine etkisi
Abstract
Amaç: Bu çalışma ile Tıp Fakültesi 5. Sınıf Kulak Burun Boğaz ve Baş Boyun Cerrahisi Stajı çekirdek hastalıkları konusunda klinik karar verebilme becerilerinin geliştirilmesinde refleksiyon uygulamalarının etkisinin değerlendirilmesi amaçlanmaktadır. Gereç ve Yöntem: Bu çalışmada öncelikle tüm öğrencilerin refleksiyon becerileri geçerli ve güvenilir olan “Reflektif Düşünme Düzeyi Belirleme Ölçeği” ve “Klinik Karar Verme Ölçeği” ile değerlendirildi. Daha sonra öğrenciler müdahale ve kontrol grubu olarak ikiye ayrıldı, kontrol grubana standart eğitim öğretim yöntemleriyle klinik uygulamalı eğitim verildi. Müdahale grubuna ise refleksiyon eğitiminin ardından eğitici ile birlikte reflektif vaka tartışmaları yapıldı ve öğrencilerin olguya dayalı klinik karar verme yeterlikleri değerlendirildi. Daha sonra her iki grubun yapılandırılmış sözlü sınavları klinik karar verme formu ile değerlendirilerek yapıldı. Öğrencilerden bu uygulama ile ilgili geri bildirimleri alındı. Bulgular: Kontrol grubu ile müdahale grubu arasında, istatistiki olarak anlamlı fark kontrol grubu lehine “Yazılı Sınav” ve müdahale grubu lehine “Genel Klinik Yeterlilik” başlıklarında görüldü (p<0,01). Refleksiyon sonrası klinik yeterlikler arasında öykü alma becerileri, klinik akıl yürütme ve klinik tanıya karar verme becerilerinde en yüksek ortalama değerlere erişildiği görüldü. Öğrenci geribildirimlerinde, eğiticilerin katılımından ve rehberliğinden memnuniyet, klinik eğitim sürecinde olgu tartışmalarının daha çok yer alması isteği en yüksek ortalama değere sahipti. Sonuç: Refleksiyonun deneyimler üzerinde derinlemesine düşünmeyi sağlayarak klinik karar verme yetkinliklerini geliştirdiğini ve mesleğe bakış açılarını değiştirdiğini bu sebeple reflektif uygulamaların tıp eğitiminin erken dönemlerinden başlayarak klinik uygulamaların gelişimini destekleyeceği belirlendi.
Objective: This study aims to evaluate the effect of reflection practices on the development of clinical decision-making skills regarding core diseases of the 5th Year Ear, Nose, Throat and Head and Neck Surgery Intern at the Faculty of Medicine. Materials and Methods: In this study, first of all, the reflection skills of all students were evaluated with the valid and reliable Reflective Thinking Level Determination Scale and Clinical Decision Making Scale. Then, the students were divided into two groups: intervention and control groups, and the control group was given clinical practical training using standard education and training methods. For the intervention group, after the reflection training, reflective case discussions were held with the trainer and the students' case-based clinical decision-making competencies were evaluated. Then, structured oral exams of both groups were evaluated using a clinical decision-making form. Feedback was received from students regarding this application. Results: A statistically significant difference between the control group and the intervention group was seen in the Written Exam headings in favor of the control group and General Clinical Competence headings in favor of the intervention group (p<0.01). After reflection, it was observed that the highest mean values were achieved in history-taking skills, clinical reasoning and clinical diagnosis decision-making skills among clinical competencies. In student feedback, satisfaction with the participation and guidance of instructors and the desire to include more case discussions in the clinical education process had the highest average value. Conclusion: It was determined that reflection improves clinical decision-making competencies and changes perspectives on the profession by allowing reflection on experiences, and therefore reflective practices will support the development of clinical practices starting from the early stages of medical education.
Objective: This study aims to evaluate the effect of reflection practices on the development of clinical decision-making skills regarding core diseases of the 5th Year Ear, Nose, Throat and Head and Neck Surgery Intern at the Faculty of Medicine. Materials and Methods: In this study, first of all, the reflection skills of all students were evaluated with the valid and reliable Reflective Thinking Level Determination Scale and Clinical Decision Making Scale. Then, the students were divided into two groups: intervention and control groups, and the control group was given clinical practical training using standard education and training methods. For the intervention group, after the reflection training, reflective case discussions were held with the trainer and the students' case-based clinical decision-making competencies were evaluated. Then, structured oral exams of both groups were evaluated using a clinical decision-making form. Feedback was received from students regarding this application. Results: A statistically significant difference between the control group and the intervention group was seen in the Written Exam headings in favor of the control group and General Clinical Competence headings in favor of the intervention group (p<0.01). After reflection, it was observed that the highest mean values were achieved in history-taking skills, clinical reasoning and clinical diagnosis decision-making skills among clinical competencies. In student feedback, satisfaction with the participation and guidance of instructors and the desire to include more case discussions in the clinical education process had the highest average value. Conclusion: It was determined that reflection improves clinical decision-making competencies and changes perspectives on the profession by allowing reflection on experiences, and therefore reflective practices will support the development of clinical practices starting from the early stages of medical education.