Using Simulation-Based Education to Improve Residents’ Clinical Decision Making Skills in Developing Countries

Öz

Background: Recently, a significant increase occured in the use of medical simulation technology for teaching and assessment. Improved patient safety during medical education has driven simulation-based education (SBE), particularly in resident education. Although many countries have integrated SBE into their undergraduate programs, some developing countries, including Turkey, have been slow to apply SBE into their graduate programs. We propose a review of existing examples of SBE used which may promote the implementation of similar curricula in developing countries. Methods: To derive a representative sample of relevant curricula, we performed a web-based literature review using the search terms “simulation” and (“ graduate, resident”) and (“clinical decision-making” or „„clinical reasoning”) and “training‟‟. Results: Of the 83 original articles, ten resulting articles were relevant to SBE used to support residents‟ clinical decision-making in six clinical areas. We summarize the ten curricula and discuss them in the context of three primary considerations (course administration, content development, and assessment program evaluation) so they may be applied in similar graduate curricula in Turkey and others.Conclusions: It is obvious that simulation-based education offers benefits. In particular, graduate-level training programs used to support clinical decision-making are critical to the development of competent physicians around the world.

Anahtar Kelimeler

• Simulation,resident,curriculum,clinical decision-making

Gelişmekte Olan Ülkelerde Asistanların Klinik Karar Verme Becerilerini Geliştirmek İçin Simülasyon Temelli Eğitim Uygulaması

Öz

Amaç: Son zamanlarda, eğitim ve değerlendirme için tıbbi simülasyon teknolojilerinin kullanımı önemli bir derecede artış göstermektedir. Tıp eğitimi sırasında hasta güvenliğinin önemli hale gelmesi özellikle asistan eğitiminde, simülasyon temelli uygulamaları harekete geçirdi. Çoğu ülkelerin mezuniyet öncesi eğitim programlarının içine simülasyon temelli uygulamalar
entegre olmasına rağmen, Türkiye‟nin de içinde olduğu bazı gelişmekte olan ülkelerin mezuniyet sonrası programlarına simülasyon temelli eğitim uygulamalarının dahil olması yavaş olmuştur. Gelişmekte olan ülkelerin benzer müfredat uygulamalarını desteklemek için, varolan simülasyon temelli eğitim örneklerinin derlenmesi amaçlanıldı. Yöntem: Müfredat ile ilgili sunulan literatür örneklerini araştırmak için “simülasyon‟‟ ve (“mezuniyet sonrası, asistan‟‟) ve (“klinik karar verme ya da klinik akıl yürütme‟‟ve “eğitim‟‟ kelimelerinden oluşan web tabanlı bir literatür taraması yapıldı.Sonuç: Altı klinik alanda, asistanların klinik karar verme becerilerini destekleyen simülasyon temelli eğitim ile ilgili 83 orijinal makaleden on tanesinin sonuçları derlenildi. Türkiye ve diğer ülkelerde benzer mezuniyet sonrası eğitim müfredatları içerisinde uygulanılabilmesi için özetlenen bu on müfredat üç temel başlıkta (kurs yönetimi, müfredat geliştirme ve ölçmedeğerlendirme programı) tartışıldı. Tartışma: Simülasyon temelli eğitimin sunduğu yararlar açıktır. Özellikle, mezuniyet sonrası eğitim programlarının kullanımı, dünyadaki klinisyenlerin yeterliliklerinin gelişimi için gerekli klinik karar verme sürecinde kritik bir öneme sahiptir.

Anahtar Kelimeler

• Simülasyon, asistan, müfredat, klinik karar verme

Kaynakça

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