ACİL OBSTETRİK BAKIM: OLGU TEMELLİ BİR DERS MODÜLÜ, ÖĞRENCİ GERİ BİLDİRİMLERİ

Yıl 2021, Cilt: 24 Sayı: 1, 34 - 41, 21.03.2021

Esra Çınar Tanrıverdi

https://doi.org/10.17049/ataunihem.681794

Cited By: 2

Öz

Amaç: Bu çalışma ile olgu temelli bir ders modülü ile intörn hekimlerin, postpartum kanamalar ve Acil Obstetrik Bakım konusunda bilgi ve farkındalıklarının arttırılması, hayat kurtarıcı temel yaklaşımlarının öğretilmesi, bu sayede anne ölümlerinin azaltılmasına katkı sağlanması ve ders ile ilgili öğrenci görüşlerinin değerlendirilmesi amaçlanmıştır.
Yöntem: Aile Hekimliği intörnlük dönemi stajı alan, altı grupta, 82 öğrenciye, üç bölüm halinde yapılandırılmış bir eğitim modülü uygulandı. Eğitim sonunda tüm öğrencilerden yazılı geribildirim alındı.
Bulgular: Çalışmaya katılan öğrencilerin %43’ü (n=35) kadın, %57’si (n=47) erkekti. Öğrencilerin tamamı (n=82, %100) dersle ilgili olumlu görüş belirtti. Geribildirimlerde, öğrencilerin en çok memnun kaldıkları uygulama gerçek olgular üzerinden yapılan olgu analizleri idi. Öğrenciler, kuramsal dersler sayesinde bilgi ve farkındalıklarının, olgu temelli oturumlarla derse olan ilgi ve katılımlarının, olgu analizleri sayesinde bütüncül değerlendirme ve kritik karar verme becerilerinin arttığını belirtmişlerdir. On iki öğrenci (%14.6), olumlu görüşlerinin yanında olumsuz görüş de bildirmiştir. Olumsuz görüş bildiren, on öğrenci (%12.1) kuramsal dersin uzun olduğunu, iki öğrenci (%0.02) olgular ve medikolegal değerlendirmenin cesaretini kırdığını belirtmiştir. Öğrencilerin tümü dersin sonraki yıllarda da devam ettirilmesini isterken, %80’i (n=66) olgu temelli derslere tüm stajlarda yer verilmesi, %89’u (n=73) acillerle ilgili olgu temelli derslerin arttırılması, %22’si (n=18) dersin simülasyonunun da yapılması önerisinde bulunmuştur.
Sonuç: Olgu temelli öğrenmenin öğrencilerin derse katılımı, ilgisi, öğrenmeleri ve memnuniyetleri üzerinde olumlu bir etkisinin olduğu görülmüştür. Hayati önemi olan aciller için, müfredatta olguya dayalı derslere yer verilmesi ve simülasyon eğitimlerinin de planlanmasının öğrenme sürecine katkısı olacaktır.

Anahtar Kelimeler

Acil Obstetrik Bakım, olgu temelli öğrenme, postpartum kanama

Destekleyen Kurum

yok

Proje Numarası

yok

Teşekkür

Bu dersin gerçekleştirilmesini sağlayan, Aile hekimliği Anabilim Dalı Başkanı Doç. Dr. Yasemin Çayır’a teşekkür ederim.

EMERGENCY OBSTETRIC CARE: A CASE-BASED COURSE MODULE STUDENT FEEDBACKS

Öz

Aim: In this study, it was aimed to increase the knowledge and awareness of intern physicians with a case-based course module, on postpartum haemorrhage and Emergency Obstetric Care, to teach basic life-saving approaches and thus to contribute on reducing maternal deaths.
Methods: A case-based course module structured in three parts was practised on six different internship groups of 82 students in total who took Family Medicine internship. Written feedback were received from all students at the end of the training module.
Results: 43% (n=35) of the participating students were female while 57% (n=47) were male. It was observed that all the students (n=82, 100%) participating in the case-based course module were highly satisfied. In addition to their positive opinions, twelve students (14.6%) also reported negative opinions. Ten of them (12.1%) stated that the theoretical course was long, two of them (0.02%) reported that they were discouraged by cases and medicolegal evaluation. Students recommended shortening the theoretical part of the course (n=10, 12.1%), increasing such courses related to emergencies (n=73, 89%), including case-based courses in all internships (n=66, 80%), also having simulation of the course (n=18, 22%). All of the students suggested continuing the course in the next years.
Conclusion: It was observed that case-based learning had a very positive effect on student participation, interest and satisfaction. In parallel with these results, the inclusion of case-based courses into the program, especially for important emergencies, and the planning of the simulation training for specific cases will contribute to the process.

Anahtar Kelimeler

Emergency Obstetric Care, Case-based learning, postpartum haemorrhage

Proje Numarası

yok

Kaynakça

• 1. Thistlethwaite J, Davies D, Ekeocha S, Kidd JM, MacDougall C, Matthews P, et al. The effectiveness of case-based learning in health professional education. A BEME systematic review: BEME Guide No. 23. Medical teacher. 2012;34(6):421-44.
• 2. Wassermann S. Introduction to Case Method Teaching. A Guide to the Galaxy: ERIC; 1994;187-96.
• 3. Schwartz P, Egan A, Heath C. Students' perceptions of course outcomes and learning styles in case-based courses in a traditional medical school. Academic Medicine. 1994;69(6):507-20.
• 4. Dupuis R, Persky A. Use of case-based learning in a clinical pharmacokinetics course. American journal of pharmaceutical education. 2008;72(2).1-29.
• 5. Drakeford P, Davis A, Van Asperen P. Evaluation of a paediatric asthma education package for health professionals. Journal of paediatrics and child health. 2007;43(5):342-52.
• 6. Richards P, Inglehart M. An interdisciplinary approach to case-based teaching: does it create patient-centered and culturally sensitive providers? Journal of dental education. 2006;70(3):284-91.
• 7. Stewart S, Gonzalez L. Instruction in professional issues using a cooperative learning, case study approach. Communication Disorders Quarterly. 2006;27(3):159-72.
• 8. Hakkarainen P, Saarelainen T, Ruokamo H. Towards meaningful learning through digital video supported, case based teaching. Australasian Journal of Educational Technology. 2007;23(1).87-109.
• 9. Hofsten A, Gustafsson C, Häggström E. Case seminars open doors to deeper understanding–Nursing students’ experiences of learning. Nurse education today. 2010;30(6):533-38.
• 10. Mayo J. Using case-based instruction to bridge the gap between theory and practice in psychology of adjustment. Journal of Constructivist Psychology. 2004;17(2):137-46.
• 11. Morrow J, Sepdham D, Snell L, Lindeman C, Dobbie A. Evaluation of a web-based family medicine case library for self-directed learning in a third-year clerkship. Family medicine. 2010;42(7):496-500.
• 12. Chan W, Hsu C, Hong C. Innovative" Case-Based Integrated Teaching" in an undergraduate medical curriculum: development and teachers' and students' responses. Annals Academy of Medicine Singapore. 2008;37(11):952-56.
• 13. 13. World Health Organization. Trends in maternal mortality: 1990 to 2010: WHO, UNICEF, UNFPA and The World Bank estimates. Trends in maternal mortality: 1990 to 2010: WHO, UNICEF, UNFPA and The World Bank estimates. 2012;22-30.
• 14. TC Sağlık Bakanlığı, Halk Sağlığı Genel müdürlüğü. Doğum Sonu Bakım ve Yönetim Rehberi. 2010;2-38.
• 15. Graham W, Woodd S, Byass P, Filippi V, Gon G, Virgo S, et al. Diversity and divergence: the dynamic burden of poor maternal health. The Lancet. 2016;388(10056):2164-75.
• 16. Sağlık Bakanlığı. Sağlık istatistikleri yıllığı 2019; 86-7.
• 17. TC Sağlık Bakanlığı Halk Sağlığı Genel müdürlüğü, Üreme Sağlığı Dairesi Başkanlığı. Kadın ve Üreme Sağlığı Programları. Acil Obstetrik Bakım Programı. 2018; 1-2.
• 18. Ronsmans C, Graham W, group LMSSs. Maternal mortality: who, when, where, and why. The lancet. 2006;368(9542):1189-200.
• 19. Nour N. An introduction to maternal mortality. Reviews in obstetrics and gynecology. 2008;1(2):77-81.
• 20. Shayan N, Özcebe H. Anne ölümleri: Afganistan ve komşu ülkelerin karşılaştırılması. Turkish Journal of Public Health. 2017;15(3):222-32.
• 21. Gynecologists ACoO. ACOG Practice Bulletin: Clinical Management Guidelines for Obstetrician-Gynecologists Number 76, October 2006: postpartum hemorrhage. Obstetrics and Gynecology. 2006;108(4):1039-47.
• 22. World Health Organization. WHO recommendations for the prevention and treatment of postpartum haemorrhage: World Health Organization; 2012; 15-41.
• 23. General Medical Council. Tomorrow's doctors: outcomes and standards for undergraduate medical education. Manchester, UK: General Medical Council. 2009;38-41.
• 24. Barrett T. General Medical Council: GMC's annual report gives a poor impression. BMJ: British Medical Journal. 1993;307(6904):628-29.
• 25. Ulusal Tıp Eğitimlerini Akreditasyon Kurulu (UTEAK). Mezuniyet Öncesi Tıp Eğitimi Ulusal Standartları 2018;8-9.
• 26. Mıdık Ö. Sınıf Derslerinde Olgu Kullanımı. Turkiye Klinikleri Medical Education-Special Topics. 2016;1(1):8-16.
• 27. Kulak V, Newton G. A guide to using case‐based learning in biochemistry education. Biochemistry and molecular biology education. 2014;42(6):457-73.
• 28. Sarıkaya Ö, Yıldız S. Ekiple birlikte öğrenme ve olguya dayalı öğrenme yöntem uygulamalarının karşılaştırılması Tıp Eğitimi Dünyası.34(34):19-27.
• 29. Anderson S, Helberg S. Chart-based, case-based learning. South Dakota medicine: the journal of the South Dakota State Medical Association. 2007;60(10):391-97.
• 30. Bano N, Arshad F, Khan S, Safdar C. Case based learning and traditional teaching strategies: Where lies the future? Pakistan Armed Forces Medical Journal. 2015;65(1):118-24.
• 31. Simonsohn A, Fischer M. Evaluation of a case-based computerized learning program (CASUS) for medical students during their clinical years. Deutsche medizinische Wochenschrift (1946). 2004;129(11):552-56.
• 32. Struck B, Teasdale T. Development and evaluation, of a longitudinal Case-Based Learning (CBL) experience for a Geriatric Medicine rotation. Gerontology & Geriatrics Education. 2008;28(3):105-14.
• 33. Rabe M, Cadorna‐Carlos J. Hyperlinked case presentation to promote self‐directed learning. Medical education. 2007;41(5):511-12.
• 34. Jamkar A, Yemul V, Singh G. Integrated teaching programme with student‐centred case‐based learning. Medical education. 2006;40(5):466-67.
• 35. Horsch A, Balbach T, Melnitzki S, Knauth J. Learning tumor diagnostics and medical image processing via the WWW—the case-based radiological textbook ODITEB. International journal of medical informatics. 2000;58:39-50.
• 36. Leonard J, Mitchell K, Meyers S, Love J. Using Case Studies in Introductory Psychology. Teaching of Psychology. 2002;29(2):142-44.
• 37. Williams B. Do undergraduate paramedic students embrace case based learning using a blended teaching approach? A 3-year review. Australasian Journal of Educational Technology. 2009;25(3).421-39.
• 38. Hilgenberg C, Schlickau J. Building transcultural knowledge through intercollegiate collaboration. Journal of Transcultural Nursing. 2002;13(3):241-47.
• 39. Krockenberger M, Bosward K, Canfield P. Integrated case-based applied pathology (ICAP): A diagnostic-approach model for the learning and teaching of veterinary pathology. Journal of veterinary medical education. 2007;34(4):396-408.
• 40. Patterson J, Stickle J, Thomas J, Scott M. An integrative and case-based approach to the teaching of general and systemic pathology. Journal of veterinary medical education. 2007;34(4):409-15.
• 41. Rybarczyk B, Baines A, McVey M, Thompson J, Wilkins H. A case‐based approach increases student learning outcomes and comprehension of cellular respiration concepts. Biochemistry and Molecular Biology Education. 2007;35(3):181-86.
• 42. Hoag K, Lillie J, Hoppe R. Piloting case-based instruction in a didactic clinical immunology course. American Society for Clinical Laboratory Science. 2005;18(4):213-20.
• 43. Srinivasan M, Wilkes M, Stevenson F, Nguyen T, Slavin S. Comparing problem-based learning with case-based learning: effects of a major curricular shift at two institutions. Academic Medicine. 2007;82(1):74-82.
• 44. Kaufert J, Wiebe R, Schwartz K, Labine L, Lutfiyya Z, Pearse C. End-of-life ethics and disability: Differing perspectives on case-based teaching. Medicine, Health Care and Philosophy. 2010;13(2):115-26.
• 45. Reimer S, A H, Tony H, Kraemer D, Oberück S, Betz C, et al. Assessment of a case-based training system (d3web. Train) in rheumatology. Rheumatology international. 2006;26(10):942-48.
• 46. Hudson J, Buckley P. An evaluation of case-based teaching: evidence for continuing benefit and realization of aims. Advances in Physiology Education. 2004;28(1):15-22.
• 47. Smith Jr A, Christie C. Facilitating transdisciplinary teamwork in dietetics education: a case study approach. Journal of the American Dietetic Association. 2004;104(6):959-62.
• 48. Radon K, Kolb S, Reichert J, Baumeister T, Fuchs R, Hege I, et al. Case-based e-learning in occupational medicine- the NetWoRM Project in Germany. Annals of Agricultural and Environmental Medicine. 2006;13(1):93-8.