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Standart Hasta-Tıp Öğrencisi Etkileşiminde Ön Bilgi İddiaları ve Etkileşimsel Sorunlar

Year 2015, Volume: 12 Issue: 2, 4 - 25, 07.12.2015

Abstract

Tıbbi etkileşim çerçevesinde yapılan araştırmalar sağlık hizmetlerindeki başarının hasta-hekim etkileşimindeki başarı ile bağlantılı olduğunu göstermiştir (Drew, Chatwin ve Collins, 2001). Buna bağlı olarak, tıp eğitimi veren üniversitelerde hasta-hekim iletişimi üzerine eğitimler yoğunlaşmış, dünyada birçok üniversitede hekimleri gerçek hayata yakın klinik ortamlara alıştırmak için “standart hasta-tıp öğrencisi” etkileşim örnekleri kullanılmaya başlanmıştır. Bu araştırmada Türkiye’deki bir üniversitede mezuniyet öncesi tıp eğitiminde kullanılan bir standart hasta-tıp öğrencisi etkileşim veri tabanından açığa çıkan ilk bulgular sunulacaktır. Araştırmanın bütüncesi video kayıt altına alınmış simülasyon ortamındaki 71 etkileşim örneğinden oluşmaktadır. Veri analizinde Konuşma Çözümlemesi yönteminden yararlanılmış, katılımcıların etkileşim içindeki sözlü ve sözsüz katkıları mikro analitik ve dizisel açılardan incelenmiştir. Veri tabanlı çözümlemeden ortaya çıkan temalardan birisi, tıp öğrencilerinin görüşmelerde hastanın durumuyla ilgili önbilgilerinden bahsettikleri anlarda ortaya çıkan etkileşimsel sorunlardır. Bulgular, bu bilgi iddialarından hemen sonra onarım dizileri, uzun süreli sessizlikler ve standart hastaların konuşmayı bitirme girişimleri gibi etkileşimsel sorunların ortaya çıktığını göstermektedir. Bu bulgular, olası etkileşimsel sorunları işaret ettiği için ülkemizde hekimlerin yetiştirilmesinde düzenlenecek eğitim programlarına önemli katkılar sağlayacak niteliktedir.

 

Anahtar Sözcükler: Konuşma Çözümlemesi, Tıp Eğitimi, Standart Hastalar, Hasta-Hekim Etkileşimi  

References

  • Ainsworth-Vaughn, N. (2003). The Discourse of Medical Encounters. D. Schiffrin, D. Tannen ve H. E. Hamilton (Haz.) içinde, The Handbook of Discourse Analysis (s. 453-469). Malden: Blackwell.
  • Barrows, H. S. (1987). Simulated (standardized) patients and other human simulations: A comprehensive guide to their training and use in teaching and evaluation. Chapel Hill, NC: Health Sciences Consortium.
  • Barrows, H. S. (1993). An overview of the uses of standardized patients for teaching and evaluating clinical skills. Academic Medicine, 68(6), 443-453.
  • Beeke, S., Wilkinson, R., & Maxim, J. (2003). Exploring aphasic grammar 1: a single case analysis of conversation. Clinical linguistics & Phonetics. 17(2), 81-107.
  • Clayman, S. E. (2013). Conversation Analysis in the News Interview. J Sidnell, T. Stivers, (Haz.) içinde, The Handbook of Conversation Analysis (s. 630-656). West Sussex: Blackwell.
  • Collins, P. ve RM Harden, J. (1998). AMEE Medical Education Guide No. 13: real patients, simulated patients and simulators in clinical examinations. Medical Teacher, 20(6), 508-521.
  • Çiftçioğlu, B. & Ordun, G. (2010). Hastaların Hekimlerin Kendileri ile Kurdukları İletişimden Memnuniyet Düzeylerinin Ölçümüne Yönelik Bir Araştırma, Öneri Dergisi, 9(34), 109-118.
  • DePaulo, B. M., Lindsay, J. L., Malone, B. E., Muhlenbruck, L., Charlton, K., & Cooper, H. (2003). Cues to deception. Psychological Bulletin, 129, 74 –118
  • Drew, P., Chatwin, J., & Collins, S. (2001). Conversation analysis: a method for research into interactions between patients and health‐care professionals. Health Expectations, 4(1), 58-70.
  • Elçin, M., Odabaşı, O. , Turan, S. , Sincan, M. & Başusta, N. B. (2010). Tıp Eğitiminde İletişim Becerilerinin Standart Hastalar ve Yapılandırılmış Değerlendirmelerle Geliştirilmesi. Hacettepe Tıp Dergisi, 41(4), 219-230.
  • Elçin, M., Turan, S. , Odabaşı, O. , Abay, E., Onan, A. & Sezer, B. (2014). İyi Hekimlik Uygulamaları. Ankara: Hacettepe Üniversitesi Basımevi. Fatigante, M. & Orletti, F. (2013). Laughter and smiling in a three-party medical encounter: negotiating participants; alignment in delicate moments. P. Glenn, E. Holt,
  • E. (Haz.) içinde, Studies of Laughter in Interaction (s.161-183). Bloomsbury: London. Firth, A. (1995). ‘Accounts’ in negotiation discourse: A single-case analysis. Journal of Pragmatics. 23(2), 199-226.
  • Garcia, A. C. ve Parmer, P. A. (1999). Misplaced mistrust: The collaborative construction of doubt in 911 emergency calls. Symbolic Interaction, 22(4), 297-324.
  • Goodwin, C. (1981). Conversational organization: Interaction between speakers and hearers. New York: Academic Press.
  • Halonen, M. (2006). Life stories used as evidence for the diagnosis of addiction in group therapy. Discourse & Society, 17(3), 283-298.
  • Heritage, J. (2013). Epistemics in conversation. J. Sidnell, T. Stivers, (Haz.) içinde, The Handbook of Conversation Analysis (s. 370-394). West Sussex: Blackwell.
  • Jacknick, C.M. (2013). ‘‘Cause the text book says...’’: laughter and student challenges in the ESL classroom. P. Glenn, E. Holt, E. (Haz.) içinde, Studies of Laughter in Interaction (s.185-200). Bloomsbury: London.
  • Jones, A. (2003). Nurses talking to patients: exploring conversation analysis as a means of researching nurse–patient communication. International Journal of Nursing Studies. 40(6), 609-618.
  • Koole, T. (2010), ‘Displays of epistemic access: Student responses to teacher explanations’, Research on Language and Social Interaction, 43(2), 183-209.
  • Komter, M. (2013). Conversation Analysis and Communication. J. Sidnell, T. Stivers, (Haz.) içinde, The Handbook of Conversation Analysis (s. 612-629). West Sussex: Blackwell.
  • Kurtz, S., Silverman, J. ve Draper, J. (1998). Teaching and Learning Communication Skills in Medicine. Radcliffe Medical Press: Oxon.
  • McCabe, R., & Lavelle, M. (2012). Participation in multiparty interaction: A single case analysis of a patient with schizophrenia. Video Analysis on Work, Interaction and Technology: A Festshrift for Christian Heath Sempozyum Bildirileri. Bayreuth, Landratesaal, 97-108.
  • Mondada, L. (2008). Using video for a sequential and multimodal analysis of social interaction: Videotaping institutional telephone calls. Forum: Qualitative Social Research, 9(3), http://www.qualitativeresearch.net/index.php/fqs/article/view/1161/2571
  • Montgomery, M. (2011). The accountability interview, politics and change in UK public service broadcasting. M. Ekström & M. Patrona (Haz) içinde, Talking politics in broadcast media: Cross-cultural perspectives (s. 33-55). Amsterdam: John Benjamins .
  • Mori, J. (2004). Negotiating sequential boundaries and learning opportunities: A case from a Japanese language classroom. The Modern Language Journal, 88(4), 536-550.
  • Murtagh, G. M. (2015). Simulated Interaction and Authentic Interaction- a place for Conversation Analysis?. D. Nestel, ve M. Bearman (Haz.) içinde, Simulated Patient Methodology: Theory, Evidence and Practice (s. 46-52), West Sussex: Wiley Blackwell.
  • Nishino, T., & Atkinson, D. (2015). Second language writing as sociocognitive alignment. Journal of Second Language Writing, 27, 37-54.
  • Peräkylä, A. (2013). Conversation Analysis and Psychotherapy. J. Sidnell, T. Stivers, (Haz.) içinde, The Handbook of Conversation Analysis (s. 551-574). West Sussex: Blackwell.
  • Pilnick, A., Hindmarsh, J., & Gill, V. T. (2009). Beyond ‘doctor and patient’: developments in the study of healthcare interactions. Sociology of Health & Illness, 31(6), 787-802.
  • Roter, DL. & Hall, J.A. (2006). Doctors Talking with Patients/ Patients Talking with Doctors. Westport : Praeger Publishers,.
  • Sacks, H., Schegloff, E. A., & Jefferson, G. (1974). A simplest systematics for the organization of turn-taking for conversation. Language 50 (4), 696–735.
  • Schegloff, E. A., Jefferson, G., & Sacks, H. (1977). The preference for self-correction in the organization of repair in conversation. Language, 361-382.
  • Schegloff, E. A. (1992). Repair after next turn: The last structurally provided defense of intersubjectivity in conversation. American journal of sociology. 9, 1295-1345.
  • Schegloff, E. A. (2000). Overlapping talk and the organization of turn-taking for conversation. Language in Society, 29(1), 1-63.
  • Sert, O. (2011). A Micro-Analytic Investigation of Claims of Insufficient Knowledge in EAL Classrooms, Yayınlanmamış Doktora Tezi, Newcastle University, UK.
  • Sert, O. (2013). ‘Epistemic Status Check’ as an interactional phenomenon in instructed learning setting. Journal of Pragmatics, 45(1), 13-28.
  • Sert, O. (2014). Hasta-Hekim etkileşiminde ve Tıp eğitiminde Konuşma Çözümlemesi yöntemi. Tıp Eğitimi ve Bilişimi Anabilim Dalı Eğitim Semineri. Hacettepe Üniversitesi, Ankara http://www.medinfo.hacettepe.edu.tr/images/olcaysert.wmv.
  • Sert, O. (2015). Social interaction and L2 classroom discourse. Edinburgh: Edinburgh University Press.
  • Sert, O. & Balaman, U. (2015). Çevrimiçi Görev-temelli Etkileşimde Ortaklaşa Bilgi Yapılandırmasının Konuşma Çözümlemesiyle İncelenmesi. Dil ve Edebiyat Dergisi.
  • Sert, O., Balaman, U., Can Daşkın, N., Büyükgüzel, S., & Ergül, H. (2015). Konuşma Çözümlemesi Yöntemi. Dil ve Edebiyat Dergisi. 12(2).
  • Sert, O. & Jacknick, C. (2015). Student Smiles and the Negotiation of Epistemics in L2 Classrooms. Journal of Pragmatics. 77(1), 97-112.
  • Sert, O. & Seedhouse, P. (2011). Conversation analysis in applied linguistics. Novitas-ROYAL (Research on Youth and Language). 5(1), 1-14. http://www.novitasroyal.org/Vol_5_1/sert_seedhouse.pdf
  • Sert, O. & Walsh, S. (2013). ‘The interactional management of claims of insufficient knowledge in English language classrooms’. Language and Education, 27(6), 542-565.
  • Sidnell, J. & Stivers, T. (2013). The handbook of conversation analysis. West Sussex: Blackwell.
  • Silverman, J., Kurtz, S. & Draper, J. (1999). Skills for Communicating with Patients. Radcliffe Medical Press, Oxon.
  • Sneijder, P. (2014). The embedding of reported speech in a rhetorical structure by prosecutors and defense lawyers in Dutch trials. Text & Talk, 34(4), 467-490.
  • Svensson, M. S., Luff, P., & Heath, C. (2009). Embedding instruction in practice: contingency and collaboration during surgical training. Sociology of Health & Illness, 31(6), 889-906.
  • Teas Gill V., & Roberts, F. (2013). Conversation analysis in medicine. J. Sidnell, T. Stivers, (Haz.) içinde, The Handbook of Conversation Analysis (s. 575-592). West Sussex: Blackwell.
  • Turan S., Elçin M., Üner S., Odabaşı O., Sayek İ, Senemoğlu N. (2009). The impact of clinical visits on communication skills training. Patient Education and Counseling, 77 (1):42-47.
  • Turan S., Üner S., Elçin M. (2010). The impact of standardized patients’ feedback on the students’ motivational levels. Balkan Medical Journal, 28: 43-48.
  • Wallace, P. (1997). Following the threads of an innovation: the history of standardized patients in medical education. Caduceus-Springfield-, 13, 5-28.
  • Walsh, S. (2003). Developing interactional awareness in the second language classroom through teacher self-evaluation. Language Awareness, 12(2), 124-142.
  • Waring, H. Z. (2009). Moving out of IRF (Initiation‐Response‐Feedback): A Single Case Analysis. Language Learning, 59(4), 796-824.
  • Weathersbee, T., & Maynard, D. W. (2009). Dialling for donations: practices and actions in the telephone solicitation of human tissues. Sociology of Health & Illness, 31(6), 803-816.
  • Webb, H. (2009). ‘I’ve put weight on cos I’ve bin inactive, cos I’ve’ad me knee done’: moral work in the obesity clinic. Sociology of Health & Illness, 31(6), 854-871.
Year 2015, Volume: 12 Issue: 2, 4 - 25, 07.12.2015

Abstract

References

  • Ainsworth-Vaughn, N. (2003). The Discourse of Medical Encounters. D. Schiffrin, D. Tannen ve H. E. Hamilton (Haz.) içinde, The Handbook of Discourse Analysis (s. 453-469). Malden: Blackwell.
  • Barrows, H. S. (1987). Simulated (standardized) patients and other human simulations: A comprehensive guide to their training and use in teaching and evaluation. Chapel Hill, NC: Health Sciences Consortium.
  • Barrows, H. S. (1993). An overview of the uses of standardized patients for teaching and evaluating clinical skills. Academic Medicine, 68(6), 443-453.
  • Beeke, S., Wilkinson, R., & Maxim, J. (2003). Exploring aphasic grammar 1: a single case analysis of conversation. Clinical linguistics & Phonetics. 17(2), 81-107.
  • Clayman, S. E. (2013). Conversation Analysis in the News Interview. J Sidnell, T. Stivers, (Haz.) içinde, The Handbook of Conversation Analysis (s. 630-656). West Sussex: Blackwell.
  • Collins, P. ve RM Harden, J. (1998). AMEE Medical Education Guide No. 13: real patients, simulated patients and simulators in clinical examinations. Medical Teacher, 20(6), 508-521.
  • Çiftçioğlu, B. & Ordun, G. (2010). Hastaların Hekimlerin Kendileri ile Kurdukları İletişimden Memnuniyet Düzeylerinin Ölçümüne Yönelik Bir Araştırma, Öneri Dergisi, 9(34), 109-118.
  • DePaulo, B. M., Lindsay, J. L., Malone, B. E., Muhlenbruck, L., Charlton, K., & Cooper, H. (2003). Cues to deception. Psychological Bulletin, 129, 74 –118
  • Drew, P., Chatwin, J., & Collins, S. (2001). Conversation analysis: a method for research into interactions between patients and health‐care professionals. Health Expectations, 4(1), 58-70.
  • Elçin, M., Odabaşı, O. , Turan, S. , Sincan, M. & Başusta, N. B. (2010). Tıp Eğitiminde İletişim Becerilerinin Standart Hastalar ve Yapılandırılmış Değerlendirmelerle Geliştirilmesi. Hacettepe Tıp Dergisi, 41(4), 219-230.
  • Elçin, M., Turan, S. , Odabaşı, O. , Abay, E., Onan, A. & Sezer, B. (2014). İyi Hekimlik Uygulamaları. Ankara: Hacettepe Üniversitesi Basımevi. Fatigante, M. & Orletti, F. (2013). Laughter and smiling in a three-party medical encounter: negotiating participants; alignment in delicate moments. P. Glenn, E. Holt,
  • E. (Haz.) içinde, Studies of Laughter in Interaction (s.161-183). Bloomsbury: London. Firth, A. (1995). ‘Accounts’ in negotiation discourse: A single-case analysis. Journal of Pragmatics. 23(2), 199-226.
  • Garcia, A. C. ve Parmer, P. A. (1999). Misplaced mistrust: The collaborative construction of doubt in 911 emergency calls. Symbolic Interaction, 22(4), 297-324.
  • Goodwin, C. (1981). Conversational organization: Interaction between speakers and hearers. New York: Academic Press.
  • Halonen, M. (2006). Life stories used as evidence for the diagnosis of addiction in group therapy. Discourse & Society, 17(3), 283-298.
  • Heritage, J. (2013). Epistemics in conversation. J. Sidnell, T. Stivers, (Haz.) içinde, The Handbook of Conversation Analysis (s. 370-394). West Sussex: Blackwell.
  • Jacknick, C.M. (2013). ‘‘Cause the text book says...’’: laughter and student challenges in the ESL classroom. P. Glenn, E. Holt, E. (Haz.) içinde, Studies of Laughter in Interaction (s.185-200). Bloomsbury: London.
  • Jones, A. (2003). Nurses talking to patients: exploring conversation analysis as a means of researching nurse–patient communication. International Journal of Nursing Studies. 40(6), 609-618.
  • Koole, T. (2010), ‘Displays of epistemic access: Student responses to teacher explanations’, Research on Language and Social Interaction, 43(2), 183-209.
  • Komter, M. (2013). Conversation Analysis and Communication. J. Sidnell, T. Stivers, (Haz.) içinde, The Handbook of Conversation Analysis (s. 612-629). West Sussex: Blackwell.
  • Kurtz, S., Silverman, J. ve Draper, J. (1998). Teaching and Learning Communication Skills in Medicine. Radcliffe Medical Press: Oxon.
  • McCabe, R., & Lavelle, M. (2012). Participation in multiparty interaction: A single case analysis of a patient with schizophrenia. Video Analysis on Work, Interaction and Technology: A Festshrift for Christian Heath Sempozyum Bildirileri. Bayreuth, Landratesaal, 97-108.
  • Mondada, L. (2008). Using video for a sequential and multimodal analysis of social interaction: Videotaping institutional telephone calls. Forum: Qualitative Social Research, 9(3), http://www.qualitativeresearch.net/index.php/fqs/article/view/1161/2571
  • Montgomery, M. (2011). The accountability interview, politics and change in UK public service broadcasting. M. Ekström & M. Patrona (Haz) içinde, Talking politics in broadcast media: Cross-cultural perspectives (s. 33-55). Amsterdam: John Benjamins .
  • Mori, J. (2004). Negotiating sequential boundaries and learning opportunities: A case from a Japanese language classroom. The Modern Language Journal, 88(4), 536-550.
  • Murtagh, G. M. (2015). Simulated Interaction and Authentic Interaction- a place for Conversation Analysis?. D. Nestel, ve M. Bearman (Haz.) içinde, Simulated Patient Methodology: Theory, Evidence and Practice (s. 46-52), West Sussex: Wiley Blackwell.
  • Nishino, T., & Atkinson, D. (2015). Second language writing as sociocognitive alignment. Journal of Second Language Writing, 27, 37-54.
  • Peräkylä, A. (2013). Conversation Analysis and Psychotherapy. J. Sidnell, T. Stivers, (Haz.) içinde, The Handbook of Conversation Analysis (s. 551-574). West Sussex: Blackwell.
  • Pilnick, A., Hindmarsh, J., & Gill, V. T. (2009). Beyond ‘doctor and patient’: developments in the study of healthcare interactions. Sociology of Health & Illness, 31(6), 787-802.
  • Roter, DL. & Hall, J.A. (2006). Doctors Talking with Patients/ Patients Talking with Doctors. Westport : Praeger Publishers,.
  • Sacks, H., Schegloff, E. A., & Jefferson, G. (1974). A simplest systematics for the organization of turn-taking for conversation. Language 50 (4), 696–735.
  • Schegloff, E. A., Jefferson, G., & Sacks, H. (1977). The preference for self-correction in the organization of repair in conversation. Language, 361-382.
  • Schegloff, E. A. (1992). Repair after next turn: The last structurally provided defense of intersubjectivity in conversation. American journal of sociology. 9, 1295-1345.
  • Schegloff, E. A. (2000). Overlapping talk and the organization of turn-taking for conversation. Language in Society, 29(1), 1-63.
  • Sert, O. (2011). A Micro-Analytic Investigation of Claims of Insufficient Knowledge in EAL Classrooms, Yayınlanmamış Doktora Tezi, Newcastle University, UK.
  • Sert, O. (2013). ‘Epistemic Status Check’ as an interactional phenomenon in instructed learning setting. Journal of Pragmatics, 45(1), 13-28.
  • Sert, O. (2014). Hasta-Hekim etkileşiminde ve Tıp eğitiminde Konuşma Çözümlemesi yöntemi. Tıp Eğitimi ve Bilişimi Anabilim Dalı Eğitim Semineri. Hacettepe Üniversitesi, Ankara http://www.medinfo.hacettepe.edu.tr/images/olcaysert.wmv.
  • Sert, O. (2015). Social interaction and L2 classroom discourse. Edinburgh: Edinburgh University Press.
  • Sert, O. & Balaman, U. (2015). Çevrimiçi Görev-temelli Etkileşimde Ortaklaşa Bilgi Yapılandırmasının Konuşma Çözümlemesiyle İncelenmesi. Dil ve Edebiyat Dergisi.
  • Sert, O., Balaman, U., Can Daşkın, N., Büyükgüzel, S., & Ergül, H. (2015). Konuşma Çözümlemesi Yöntemi. Dil ve Edebiyat Dergisi. 12(2).
  • Sert, O. & Jacknick, C. (2015). Student Smiles and the Negotiation of Epistemics in L2 Classrooms. Journal of Pragmatics. 77(1), 97-112.
  • Sert, O. & Seedhouse, P. (2011). Conversation analysis in applied linguistics. Novitas-ROYAL (Research on Youth and Language). 5(1), 1-14. http://www.novitasroyal.org/Vol_5_1/sert_seedhouse.pdf
  • Sert, O. & Walsh, S. (2013). ‘The interactional management of claims of insufficient knowledge in English language classrooms’. Language and Education, 27(6), 542-565.
  • Sidnell, J. & Stivers, T. (2013). The handbook of conversation analysis. West Sussex: Blackwell.
  • Silverman, J., Kurtz, S. & Draper, J. (1999). Skills for Communicating with Patients. Radcliffe Medical Press, Oxon.
  • Sneijder, P. (2014). The embedding of reported speech in a rhetorical structure by prosecutors and defense lawyers in Dutch trials. Text & Talk, 34(4), 467-490.
  • Svensson, M. S., Luff, P., & Heath, C. (2009). Embedding instruction in practice: contingency and collaboration during surgical training. Sociology of Health & Illness, 31(6), 889-906.
  • Teas Gill V., & Roberts, F. (2013). Conversation analysis in medicine. J. Sidnell, T. Stivers, (Haz.) içinde, The Handbook of Conversation Analysis (s. 575-592). West Sussex: Blackwell.
  • Turan S., Elçin M., Üner S., Odabaşı O., Sayek İ, Senemoğlu N. (2009). The impact of clinical visits on communication skills training. Patient Education and Counseling, 77 (1):42-47.
  • Turan S., Üner S., Elçin M. (2010). The impact of standardized patients’ feedback on the students’ motivational levels. Balkan Medical Journal, 28: 43-48.
  • Wallace, P. (1997). Following the threads of an innovation: the history of standardized patients in medical education. Caduceus-Springfield-, 13, 5-28.
  • Walsh, S. (2003). Developing interactional awareness in the second language classroom through teacher self-evaluation. Language Awareness, 12(2), 124-142.
  • Waring, H. Z. (2009). Moving out of IRF (Initiation‐Response‐Feedback): A Single Case Analysis. Language Learning, 59(4), 796-824.
  • Weathersbee, T., & Maynard, D. W. (2009). Dialling for donations: practices and actions in the telephone solicitation of human tissues. Sociology of Health & Illness, 31(6), 803-816.
  • Webb, H. (2009). ‘I’ve put weight on cos I’ve bin inactive, cos I’ve’ad me knee done’: moral work in the obesity clinic. Sociology of Health & Illness, 31(6), 854-871.
There are 55 citations in total.

Details

Primary Language Turkish
Journal Section Makaleler
Authors

Olcay Sert This is me

Merve Bozbıyık This is me

Melih Elçin This is me

Sevgi Turan This is me

Publication Date December 7, 2015
Published in Issue Year 2015 Volume: 12 Issue: 2

Cite

APA Sert, O., Bozbıyık, M., Elçin, M., Turan, S. (2015). Standart Hasta-Tıp Öğrencisi Etkileşiminde Ön Bilgi İddiaları ve Etkileşimsel Sorunlar. Dil Ve Edebiyat Dergisi, 12(2), 4-25.