Pediatri Asistanlarının Çocuk Gelişimine ve Gelişimsel Zorluklara Yaklaşımlarının Değerlendirilmesi

Year 2025, Volume: 24 Issue: 74, 180 - 188, 22.12.2025

Şenay Güven Baysal

https://doi.org/10.25282/ted.1762987

Abstract

Amaç: Bu çalışmada pediatri asistanlarının çocuk gelişimi ve erken çocukluk dönemi ile bilgilerinin öğrenilmesi ve gelişimsel zorluğu olan çocuklarının takibindeki deneyimleri, izlemde karşılaştıkları zorlukların belirlenmesi amaçlanmaktadır.
Gereç ve Yöntem: Nitel bir araştırma olup, üçüncü basamak bir sağlık merkezinde yürütülmüştür. Gelişimsel pediatri uzmanı tarafından pediatri asistanları ile yarı yapılandırılmış derinlemesine görüşmeler yapılmıştır. Görüşmelerde yöneltilen açık uçlu sorular, ilgili alan taraması sonrasında hazırlanmıştır. Mevcut literatüre dayalı olarak, odaklanmış bir araştırma sorusu, yinelemeli bir analiz süreci ve nispeten homojen bir örneklem ile doygunluğa ulaşana kadar, yeni temalar tanımlanmadığında çalışma sonlandırılmıştır. On iki katılımcı görüşmesinden sonra çalışma doygunluğa ulaşmıştır.
Bulgular: Çalışmaya 12 pediatri asistanı dahil edilmiş olup yaş ortalaması 33 ± 5.33’ idi. Katılımcıların altısı bayan, altısı erkekti. Katılımcıların hekimlik süreleri 8,2 ± 5.65 yıl olup asistanlık süreleri 24,6 ± 9,5 olarak tespit edildi. Görüşmeler ortalama 30- 55 dakika arasında sürdü. Sorulara ilişkin asistanların verdiği cevaplar temalara ayrıldı ve dört ana tema belirlendi. Pediatri asistanlarının çoğu, çocuğun gelişimi ile ilgili yeterli bilgiye sahip olmadığını, gelişimsel gecikmeleri tanımak ve uygun ileri değerlendirmede neler yapıldığını öğrenmek istediklerini bildirdiler. Gelişimsel zorluğu olan hastaları takip ettiklerini ancak bu çocukları izleyemedikleri ve nasıl izlenmesi gerektiğini bilmediklerini ifade ettiler. Gelişimsel izlemin önündeki çeşitli engellerden bahsettiler. Tıp fakültesinde ve pediatri asistanlığında gelişimsel konulara yer verilmemesinden rahatsızdılar ve bu konuda önerilerde bulundular.
Sonuç: Pediatri asistanlarının erken çocukluk dönemindeki gelişimsel gecikmeleri tanımasını ve tespit etmesini sağlayacak müdahaleler ve gelecek çalışmalar açısından önemlidir.

Keywords

gelişim , gelişimsel izlem , pediatri asistanı , gelişimsel pediatri

Evaluation of Pediatric Residents' Approaches to Child Development and Developmental Disorders

Abstract

Aim: This study aims to learn the knowledge of pediatric residents about child development and early childhood development, and to determine their experiences in the follow-up of children with developmental disorders and the difficulties.
Materials and Methods: It is a qualitative research and was conducted in a tertiary health center. Semi-structured in-depth interviews were conducted with pediatric residents by a developmental pediatrician. The open-ended questions asked in the interviews were prepared after scanning the relevant field. Based on existing literature, with a focused research question, an iterative process of analysis, and a relatively homogeneous sample until saturation was reached, the study was terminated when no new themes were identified.
Results: Twelve pediatric residents were included in the study and the average age was 33 ± 5.33 years. Six of the participants were female and six were male. The duration of the participants' practice as a physician was 8.2 ± 5.65 years, and their residency period was 24.6 ± 9.5 years. Four main themes were determined. Most pediatric residents reported that they did not have sufficient information about the child's development and that they wanted to recognize developmental delays. They talked about various obstacles to developmental monitoring. They were disturbed by the lack of coverage of developmental issues in medical school and pediatric residency and made suggestions on this issue.
Conclusion: It is important for interventions and future studies that will enable pediatric residents to recognize and detect developmental delays in early childhood.

Keywords

development , developmental monitoring , pediatric assistant , developmental pediatrics

References

• 1. Sices L. Use of developmental milestones in pediatric residency training and practice: time to rethink the meaning of the mean. Journal of developmental and behavioral pediatrics : JDBP. 2007;28(1):47-52.
• 2. Lipkin PH, Macias MM, Norwood KW, Brei TJ, Davidson LF, Davis BE, et al. Promoting optimal development: identifying infants and young children with developmental disorders through developmental surveillance and screening. 2020;145(1).
• 3. Council on Children With Disabilities; Section on Developmental Behavioral Pediatrics; Bright Futures Steering Committee; Medical Home Initiatives for Children With Special Needs Project Advisory Committee. Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening. Pediatrics. 2006 Jul;118(1):405-20. doi: 10.1542/peds.2006-1231.
• 4. Hastings EA, Lumeng JC, Clark SJ. Primary care physicians' knowledge of and confidence in their referrals for special education services in 3- to 5-year-old children. Clinical pediatrics. 2014;53(2):166-72.
• 5. Nicol P. Using the Ages and Stages Questionnaire to teach medical students developmental assessment: a descriptive analysis. BMC Medical Education. 2006;6(1):29.
• 6. Tokatly Latzer I, Grossman Z, Sachs N, Yahal O, Even-Zohar D, Carmon L, et al. Failure of Israeli pediatric residency curricula to cover child development and special education issues: results of a national survey on levels of knowledge. 2021;10:1-10.
• 7. Regalado M, Halfon NJAop, medicine a. Primary care services promoting optimal child development from birth to age 3 years: review of the literature. 2001;155(12):1311-22.
• 8. Carraccio C, Englander R, Wolfsthal S, Martin C, Ferentz K. Educating the pediatrician of the 21st century: defining and implementing a competency-based system. Pediatrics. 2004 Feb;113(2):252-8.
• 9. Senecky Y, Inbar D, Diamond G, Grossman Z, Apter A, Kahan E. Pediatricians' satisfaction with their abilities to care for children with developmental, behavioral and psychosocial problems. Pediatr Int. 2007 Aug;49(4):472-8.
• 10. Çelen Yoldaş T, Şenel S, Abuş H, Yücel H, Özmert E. Gelişimsel Konuların Pediatri Asistanlarının Eğitim ve Klinik Uygulamalarındaki Yeri ve Etkileyen Faktörlerin Belirlenmesi. Türkiye Çocuk Hast Derg. 2021;15(1):59-64.
• 11. Rhodes A, Sciberras E, Oberklaid F, South M, Davies S, Efron, et al. Unmet developmental, behavioral, and psychosocial needs in children attending pediatric outpatient clinics. JDBP. 2012;33(6):469-78.
• 12. Sand N, Silverstein M, Glascoe FP, Gupta VB, Tonniges TP, O'Connor KG. Pediatricians' reported practices regarding developmental screening: do guidelines work? Do they help? Pediatrics. 2005 Jul;116(1):174-9.
• 13. Ertem IO, Pekcici EB, Gok CG, Ozbas S, Ozcebe H, Beyazova U. Addressing early childhood development in primary health care: experience from a middle-income country. J Dev Behav Pediatr. 2009 Aug;30(4):319-26.
• 14. Black MM, Walker SP, Fernald LCH, Andersen CT, DiGirolamo AM, Lu C, et al. Lancet Early Childhood Development Series Steering Committee. Early childhood development coming of age: science through the life course. Lancet. 2017 Jan 7;389(10064):77-90.
• 15. Fox G, Katz DA, Eddins-Folensbee FF, Folensbee RW. Teaching development in undergraduate and graduate medical education. Child Adolesc Psychiatr Clin N Am. 2007 Jan;16(1):67-94, viii-ix.
• 16. Yeleswarapu S. Padmini PKA, Lourdes M. Daniel. Evaluation of a developmental paediatrics teaching programme for medical students. The Asia Pacific Scholar. 2019;Vol. 4, no. 2 pp. 25 – 31.
• 17. Boreman CD, Thomasgard MC, Fernandez SA, Coury DLJCp. Resident training in developmental/behavioral pediatrics: where do we stand? 2007;46(2):135-45.
• 18. Türkiye Cumhuriyeti Sağlik Bakanliği Tipta Uzmanlik Kurulu, 2019, Available from: https://tuk.saglik.gov.tr/TR-84694/v-24-dokumanlari.html
• 19. Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, Nelson textbook of pediatrics. Edition 21. ed. Philadelphia, PA: Elsevier; 2020; Part2 Chapter 28 Developmental and Behavioral Surveillance and Screening .
• 20. Thompson LA, Tuli SY, Saliba H, DiPietro M, Nackashi JA. Improving developmental screening in pediatric resident education. Clin Pediatr (Phila). 2010 Aug;49(8):737-42.
• 21. Glascoe FP. Parents' evaluation of developmental status: how well do parents' concerns identify children with behavioral and emotional problems? Clin Pediatr (Phila). 2003 Mar;42(2):133-8.
• 22. Baysal ŞG, Doğan D, Arslan FN, Canaloğlu SK. Evaluation of Child Development Knowledge Among Medical Students. Türkiye Çocuk Hastalıkları Dergisi 1-7.
• 23. Trollor JN, Ruffell B, Tracy J, Torr JJ, Durvasula S, Iacono T, et al. Intellectual disability health content within medical curriculum: an audit of what our future doctors are taught. BMC Medical Education. 2016;16(1):105.
• 24. McDonald J. Twelve tips for teaching child development and disability to medical students. Medical teacher. 2018;40(2):135-9.
• 25. Ryan TA, Scior K. Medical Students' Attitudes Towards Health Care for People with Intellectual Disabilities: A Qualitative Study. J Appl Res Intellect Disabil. 2016 Nov;29(6):508-518.
• 26. Comley L, Janus M, Marshall D, Niccols A. The early years: child development in undergraduate medical school training. Can Fam Physician. 2008 Jun;54(6):876, 876.e1-4.
• 27. McCain MN, Mustard JF. The early years study three years later: From early child development to human development: Enabling communities: Founders' Network of the Canadian Institute for Advanced Research; 2011; 1-98.
• 28. Hagan JF, Shaw JS, Duncan PM. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents: American Academy of Pediatrics; 2017; 15-65.
• 29. Wolraich M, Aceves J, Feldman H, Hagan Jr J, Howard B, Navarro A, et al. American Academy of Pediatrics. Committee on Psychosocial Aspects of Child and Family Health. The child in court: a subject review. 1999;104(5 Pt 1):1145-8.
• 30. Olson LM, Inkelas M, Halfon N, Schuster MA, O’Connor KG, Mistry RJP. Overview of the content of health supervision for young children: reports from parents and pediatricians. 2004;113(Supplement_5):1907-16.
• 31. Pediatrics AAo. American Academy of PediatricsPeriodic Survey of Fellows, PS# 90.
• 32. Olson AL, Kemper KJ, Kelleher KJ, Hammond CS, Zuckerman BS, Dietrich AJ. Primary care pediatricians' roles and perceived responsibilities in the identification and management of maternal depression. Pediatrics. 2002 Dec;110(6):1169-76.
• 33. Kogan MD, Schuster MA, Yu SM, Park CH, Olson LM, Inkelas M, Bethell C, Chung PJ, Halfon N. Routine assessment of family and community health risks: parent views and what they receive. Pediatrics. 2004 Jun;113(6 Suppl):1934-43.