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Dışsal Geribildirimin Kardiyopulmonar Resustasyon Beceri Kazanımına Etkisi: Eşzamanlı ve Nihai

Year 2017, Volume: 17 Issue: 72, 83 - 106, 20.11.2017

Abstract

Problem Durumu: Çeşitli nedenlere bağlı olarak yaşanan kalp durması, özellikle zamanında ve yeterli müdahale yapılmadığında, insan yaşamını tehdit eden ciddi sağlık sorunlarından biri halini almaktadır. Kalp durması vakalarında, 30 kalp masajı ve 2 suni solunum içeren kardiyopulmonar resustasyon (KPR) uygulanabilecek ilk ve en önemli müdahaledir. Yaralının beyin hasarı ve ölümünü geciktirmek ya da engellemek amacı ile uygulanan KPR, yasamsal fonksiyonların sürdürülmesi için gereksinim duyulan kanın ve oksijenin hayati organlara ulaştırılmasını amaçlar. Kalp durması vakalarında çağırılan ambulansın olay yerine ulaşması zaman aldığından, olay yerinde bulunanların vakit kaybetmeden KPR uygulamasına geçmesi önemlidir. Bu yüzden toplumda KPR uygulaması konusunda bilgi ve beceri açısından donanımlı bireylerin sayısının ve uygulanacak KPR’nin niteliğini arttırılmasına yönelik eğitimler ve bilimsel araştırmalar gün geçtikçe yaygınlaşmaktadır. Ancak araştırmalar, KPR’nin nicel ve nitel özelliklerinin arttırılmasına yönelik yapılan eğitimlerin amacına ulaşmadığını ortaya koymuştur. Bu duruma neden olarak da; alıştırma için ayrılan süre ve düzeltici geribildirimin yetersiz, değerlendirmenin verimsiz, eğitmen ve öğretim yöntemlerinin etkinliğinin düşük olması gibi durumlar gösterilmiştir. Araştırmacılar tarafından özellikleri incelenerek, KPR’nin dokuz algısal-devinişsel, sekiz fiziksel yeterlik ve özellikle de uzun süre uygulandığında fiziksel uygunluk (fitnes) gerektiren karmaşık bir beceri olduğu ortaya konmuştur. Beceri öğreniminde önemi ve yeri pek çok araştırma ile ortaya koyulan geribildirimin, özellikle KPR öğreniminde eğitmen ya da geliştirilmiş araçlar tarafından sağlanan geribildirimin beceri öğrenimini arttırdığı da vurgulanmıştır. Geribildirim genel olarak içsel ve dışsal olarak gruplandırılmaktadır. İçsel geribildirim performansın kendisinden ortaya çıkan duyusal bilgi; dışsal geribildirim ise harekete yönelik dış kaynaklardan sağlanan bilgi olarak tanımlanmaktadır. Dışsal geribildirimin de çeşitleri olmakla birlikte, bu çalışmada eşzamanlı (DE) ve nihai sonuç bilgisi (DN/SB) içeren geribildirim türleri üzerinde durulmuştur. KPR becerisinin karmaşık ve fiziksel uygunluk gerektiren yapısından ötürü içsel geribildirimin tek başına yeterli olmayacağı düşünülmüş ve bu çalışma kapsamında

Leyla SARAC / Eurasian Journal of Educational Research 72 (2017) 83-106 105

KPR beceri öğreniminde 2 farklı dışsal geribildirimin (DE, DN/SB) etkisi incelenmiştir.

Araştırmanın Amacı: Bu çalışmanın amacı iki farklı geribildirim türünün KPR becerileri üzerindeki etkisinin incelenmesidir.

Araştırmanın Yöntemi: Araştırma kapsamında, üniversite 2. sınıfta öğrenim gören ve İlkyardım dersini seçmeli olarak alan 80 öğrenci kolayda örnekleme yöntemi ile seçilmiş, 1 öğrenci özellikleri uygun olmadığı için örnekleme dahil edilmemiş ve 3 öğrenci de çalışmaya devam etmediği için çalışmadan çıkarılmıştır. Katılımcıların yaş aralığı 18-24 arasında iken, yaş ortalaması da 21.33±1.44’tür. Araştırmada katılımcılara 4 saatlik (haftada 2 saat) KPR eğitimi verilmiş ve eğitimden 1 hafta sonra da ön-test yapılmıştır. Ön-test, solunum ve göğüs basısının birlikte uygulandığı 10 setlik (1 set= 30 göğüs basısı + 2 nefes) KPR uygulamasını içermiştir. Ön-test sonunda katılımcılar performansları ve cinsiyetleri göz önünde bulundurularak homojen bir dağılım gösterecek biçimde amaçlı olarak kontrol, DE ve DN/SB gruplarına atanmıştır. Ön-testten 4 hafta sonra son-test kapsamında, 3 gruptaki katılımcılardan 10 setlik KPR uygulamasını tekrarlaması istenmiştir. Son-test öncesinde, DE grubundaki katılımcılar KPR maketi tarafından sağlanan görsel eşzamanlı geribildirim eşliğinde 10 set KPR uygulamışlar; DN/SB grubundaki öğrenciler yine KPR maketi tarafından sağlanan ön-test performanslarına yönelik yazılı bilgi içeren nihai geribildirim almışlar ve sonrasında 10 set KPR uygulamışlar; kontrol grubundaki öğrenciler ise herhangi bir geribildirim almadan 10 set KPR uygulamışlardır. On setlik KPR uygulaması sonrasında tüm katılımcılara 5 dakika dinlenme süresi verilmiş ve 10 setlik KPR içeren son-test uygulanmıştır.

Araştırmanın Bulguları: Cinsiyet (kadın, erkek) X Grup (kontrol, DE, DN/SB) X Test (ön-test, son-test) karışık faktöriyel ANOVA sonuçları, KPR performansının 4 saatlik KPR eğitimi sonrasında düşük düzeyde olduğunu ortaya koymuştur. Bağımlı değişkenlerden göğüs basısı performansı 9 ayrı beceri dikkate alınarak ayrı incelendiğinde ise, bazı değişkenlerde kadın ve erkekler arasında fark bulunmazken, fark yaratan bağımsız değişkenin katılımcılara sunulan geribildirim olduğu ortaya çıkmıştır. Ek olarak, kontrol grubuna kıyasla, DE ve DN/SB grubundaki öğrencilerin kurtarıcı nefes performansları bazı kurtarıcı nefes değişkenlerinde daha başarılı düzeyde bulunmuştur. Benzer şekilde 11 ayrı beceriden oluşan göğüs basısı becerilerinin bir kısmında cinsiyetin etkisi gözlenmezken, her iki geribildirim grubundaki katılımcıların performansları kontrol grubundakilere oranla daha başarılı bulunmuştur. Araştırmada ayrıca, nefes hacmi gibi bazı parametrelerde sağlanan iki farklı geribildirimin etkisinin olmadığı da ortaya konmuştur.

Araştırmanın Sonuçları ve Önerileri: KPR eğitimi sonrasında performansın istenen düzeyde olmaması literatürde desteklenen bir bulgudur. Bu çalışmadaki benzer bulgunun nedeni olarak da, KPR gibi karmaşık bir becerinin, geleneksel yöntemle ve eğitmen tarafından yönetilen eğitimle kazandırılması gösterilebilir. KPR eğitimlerinde uygulama esnasında sağlanması gereken geribildirimin, beceriyi çıplak gözle izleyen eğitmen tarafından verilmesinin olumsuz yanları araştırmalarla ortaya konmuştur. KPR eğitimlerinde eğitmen yerine, geribildirimin özel olarak geliştirilmiş

106 Leyla SARAC / Eurasian Journal of Educational Research 72 (2017) 83-106

çeşitli teknolojik araçlar tarafından sağlanmasının kazanımı arttırdığı da çeşitli araştırmalarda ortaya çıkmıştır. Benzer biçimde bu çalışmada, eğitim boyunca olmasa da, yalnızca eğitim sonrasında gelişmiş teknolojik araçlarla sağlanan görsel eşzamanlı ve nihai geribildirimin performansı arttırdığı bulunmuştur. Araştırma kapsamında ortaya çıkan ve 2 farklı geribildirimin etkisinin olmadığı değişkenlerden biri nefes hacmidir. Yaşam kurtarmada etkili olması için 500-600 ml. olarak belirlenen nefes hacminin uygulayıcı tarafından belirlenmesinin zorluğundan ötürü geribildirimin etkisinin gözlenmediği düşünülmektedir. Araştırmalarda göğüs basısı uygulamasında, sağlık personeli tarafından uygulandığında bile, sıklıkla görülen problemler basının sığ uygulanması ve ellerin göğüs kafesinde yanlış yerleştirilmesi olduğu bulunmuştur. Bu araştırmada kullanılan 2 farklı geribildirimin bu iki sorunu ortadan kaldırmakta etkili olduğu görülmüştür. Sonuç olarak bu çalışmada DE ve DN/SB geribildirimlerinin KPR kurtarıcı nefes ve göğüs basısı becerisinin kazanımında etkili olduğu bulunmuştur. Buradan hareketle, KPR eğitimlerinde geribildirimleri sağlayan teknolojik araçların, geleneksel eğitmen merkezli uygulamalara alternatif olarak kullanılması önerilmektedir.

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Effects of Augmented Feedback on Cardiopulmonary Resuscitation Skill Acquisition: Concurrent Versus Terminal

Year 2017, Volume: 17 Issue: 72, 83 - 106, 20.11.2017

Abstract

Purpose: While various approaches, methods, and devices have been employed to foster maximum learning of CPR skills, researchers have suggested external feedback as a crucial source for the improvement of these skills. Purpose: The purpose of this study was to determine the effects of augmented concurrent (AC) and augmented terminal knowledge of results (AT-KR) on cardiopulmonary resuscitation (CPR) skill acquisition. Method: A sample of 76 second-year university students participated in the study. All study participants, who were determined to be eligible, completed a total of four hours of CPR training (two hours a week). Immediately after the training, the pre-test (ten sets of CPR) was administered to determine the participants’ baseline CPR skill level. Participants were then assigned into three groups, one control and two experimental groups (AC and AT-KR), according to their sex and baseline CPR skill level. Participants in the AC group received a simultaneous visual feedback during CPR practice; participants in the AT-KR group received a printed report of their performance after they completed the CPR practice; and students in the control group received no feedback related to their CPR performance. Upon completion, effects of the feedback were measured to show CPR performance improvement at post-test relative to the pre-test. Findings: Students in the AC and AT-KR group performed better in some ventilation and compression skills than the students in the control group. Implications for Research and Practice: Usage of advanced technical feedback devices are recommended to enhance CPR skill acquisition.

References

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There are 61 citations in total.

Details

Primary Language English
Journal Section Articles
Authors

Leyla Sarac

Publication Date November 20, 2017
Published in Issue Year 2017 Volume: 17 Issue: 72

Cite

APA Sarac, L. (2017). Effects of Augmented Feedback on Cardiopulmonary Resuscitation Skill Acquisition: Concurrent Versus Terminal. Eurasian Journal of Educational Research, 17(72), 83-106.
AMA Sarac L. Effects of Augmented Feedback on Cardiopulmonary Resuscitation Skill Acquisition: Concurrent Versus Terminal. Eurasian Journal of Educational Research. November 2017;17(72):83-106.
Chicago Sarac, Leyla. “Effects of Augmented Feedback on Cardiopulmonary Resuscitation Skill Acquisition: Concurrent Versus Terminal”. Eurasian Journal of Educational Research 17, no. 72 (November 2017): 83-106.
EndNote Sarac L (November 1, 2017) Effects of Augmented Feedback on Cardiopulmonary Resuscitation Skill Acquisition: Concurrent Versus Terminal. Eurasian Journal of Educational Research 17 72 83–106.
IEEE L. Sarac, “Effects of Augmented Feedback on Cardiopulmonary Resuscitation Skill Acquisition: Concurrent Versus Terminal”, Eurasian Journal of Educational Research, vol. 17, no. 72, pp. 83–106, 2017.
ISNAD Sarac, Leyla. “Effects of Augmented Feedback on Cardiopulmonary Resuscitation Skill Acquisition: Concurrent Versus Terminal”. Eurasian Journal of Educational Research 17/72 (November 2017), 83-106.
JAMA Sarac L. Effects of Augmented Feedback on Cardiopulmonary Resuscitation Skill Acquisition: Concurrent Versus Terminal. Eurasian Journal of Educational Research. 2017;17:83–106.
MLA Sarac, Leyla. “Effects of Augmented Feedback on Cardiopulmonary Resuscitation Skill Acquisition: Concurrent Versus Terminal”. Eurasian Journal of Educational Research, vol. 17, no. 72, 2017, pp. 83-106.
Vancouver Sarac L. Effects of Augmented Feedback on Cardiopulmonary Resuscitation Skill Acquisition: Concurrent Versus Terminal. Eurasian Journal of Educational Research. 2017;17(72):83-106.