Mezuniyet öncesi tıp eğitimi programlarında meme sağlığı ve hastalıklarının yeri: Bir yerleşim modeli önerisi
Küçük Resim Yok
Tarih
2024
Yazarlar
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Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmanın amacı, entegre eğitim programı uygulanan İstanbul Üniversitesi İstanbul Tıp Fakültesi (İÜ-İTF) mezuniyet öncesi tıp eğitimi (MÖTE) programında meme sağlığı ve hastalıkları konularının hangi düzeylerde ve nasıl ele alındığını belirlemek, UÇEP (Ulusal Çekirdek Eğitim Programı) ile uyumunu değerlendirmek, "Meme sağlığı ve hastalıkları" konularının entegre bir eğitim programında yerleşimine yönelik bir yerleşim modeli önerisi oluşturmaktır. Yöntem: Bu tanımlayıcı kesitsel çalışma, İÜ-İTF'de 01.06.2020 ve 01.06.2022 tarihleri arasında üç aşamalı olarak yapılmıştır. Birinci aşamada İÜ-İTF MÖTE programının analizi, literatür taraması sonucu oluşturduğumuz analiz çerçevesi kullanılarak yapılmıştır. İkinci aşamada intörn hekimlere gönüllülük esasında meme sağlığı ve hastalıkları konularında öz yeterliklerini değerlendiren 22 sorudan oluşan çevrim içi anket formu uygulanmıştır. Üçüncü aşamada ise, meme sağlığı ve hastalıkları konularında eğitim veren tüm öğretim üyelerinin davet edildiği ve gönüllü öğretim üyelerinin katılımı ile gerçekleştirilen çalıştayda SWOT analizi yapılmış, meme sağlığı ve hastalıklarının programda yerleşimine yönelik görüş ve önerileri alınmıştır. Bulgular: İstanbul Üniversitesi İstanbul Tıp Fakültesi MÖTE programında meme sağlığı ve hastalıkları ile ilgili konuların programın içerisinde tek bir tema altında toplanmadığı ve altı döneme yayılmış bir şekilde dağınık olarak yer aldığı görülmektedir. Konuların aynı dönemde farklı disiplinler tarafından ele alınması kısmen bir yatay entegrasyon olduğunu, ayrıca temel bilimlerden kliniğe geçişte bir dikey entegrasyonun varlığı ve basitten karmaşığa doğru konuların dönemler içerisinde dağılımında da spiral konfigürasyonun olduğu görülmektedir. Ayrıca eğitim programında meme muayenesi beceri eğitimi, simüle hasta uygulaması, multi-disipliner entegre oturumlar ve PDÖ (Probleme Dayalı Öğrenme) oturumları yer almamaktadır. Meme muayenesi beceri değerlendirmesine yönelik uygulama sınavı da bulunmamaktadır. UÇEP 2020'ye göre meme hastalıkları ve tümörlerinin öğrenme düzeyi ÖnT ve K (Ön tanı ve korunma) olmalıdır. İntörn hekimlerin çevrim içi anket sonuçları değerlendirildiğinde, intörn hekimlerin %65.2'si (n=159) ÖnT düzeyinde ve %37.3'ü (n=91) K düzeyinde bilgiye sahip olduklarını belirtmiştir. Ayrıca UÇEP 2020'ye göre; hekimler meme ve aksiller bölge muayenesini karmas?ık olmayan, sık go?ru?len, durumlarda/olgularda uygulabilmeli (düzey 3) ve kendi kendine meme muayenesini karmas?ık durumlar/olgular da dahil öğretebilmelidir (düzey 4). İntörn hekimlerin %64'ü (n=155) meme ve aksiller bölge muayenesini düzey 3 olarak uygulayabileceğini ve %45'i (n=109) kendi kendine meme muayenesini düzey 4 olarak öğretebileceğini ifade etmiştir. Öğretim üyeleri ile yapılan SWOT analizi sonucunda, İÜ-İTF MÖTE programında meme sağlığı ve hastalıkları konularının UÇEP 2020'de tanımlanan bilgi düzeyinin çok üstünde uzmanlık eğitimi düzeyinde ele alındığı, öğrencilerin memenin iyi huylu hastalıklarına yönelik hasta görme imkanının daha az olduğu, 1. basamağa yönelik eğitim oranının düşük ve yetersiz olduğu, bu yüzden öğrencilerin 1. basamakta karşılaşılacakları hastalıkları yeterince görüp öğrenemedikleri programın zayıf yönleri olarak karşımıza çıkmıştır. Ayrıca, meme muayenesi beceri eğitimlerinin yapılandırılmış bir şekilde verilip sınanmadığı, öğrencilerin klinik beceri eğitimlerinde dağılımları ve aldıkları eğitimin standardının olmadığı tespit edilmiş, öğretim üyelerinin eğitim alanında iş birliğine yatkın olmaması, güçlü anabilim dalı yapısının entegrasyonda zorluklara neden olduğu ve ölçme-değerlendirme sürecinin meme muayenesi beceri eğitimini kapsamadığı sonuçları da ortaya çıkmıştır. Sonuç: Meme sağlığı ve hastalıklarının eğitim programında yerleşim modeli önerisi hazırlarken, hedef entegrasyon düzeyini artırmak olmalıdır. Bu amaçla, birçok disiplin ortak hareket etmeli, yeni eğitim programında öğretme yöntemleri ve ölçme değerlendirme yöntemleri planlanırken program koordinatörünün önderliğinde programda yer alan tüm disiplinlerden öğretim üyelerinin katılımı ile disiplinlerden bağımsız tematik örüntüde bir program hazırlanması hedeflenmelidir.
Aim: The aim of this study is to analyze how breast health and diseases are handled in the undergraduate medical education (UGME) program of Istanbul University Istanbul Faculty of Medicine (IU-ITF) and to evaluate its compliance with the UÇEP (National Core Education Program) and to create a new model proposal for the placement of "breast health and diseases" in an integrated medical education program. Method: This descriptive cross-sectional study was conducted in three stages at IU-ITF between 01.06.2020 and 01.06.2022. In the first stage, the analysis of the IU-ITF UGME program was made using the analysis framework we created as a result of the literature review. In the second stage, an online survey was applied to intern physicians on a voluntary basis to evaluate their self-efficacy in breast health and diseases. In the third stage, a SWOT analysis was conducted with the participation of volunteer faculty members to whom teaching breast health and diseases in the program, their opinions and suggestions regarding the placement of "breast health and diseases" in the program were taken. Results: In the IU-ITF UGME program, subjects related to breast health and diseases are scattered throughout the program, spread over 6 terms. It is not gathered under a single theme. On the fact that these subjects were handled by different disciplines in the same period suggests that there is a partial horizontal integration, that there is a vertical integration in the transition from basic sciences to the clinic, and that the distribution of the subjects from simple to complex within the periods is a spiral configuration. In addition, the training program does not include any breast examination skills training, simulated patient practice, multi-disciplinary integrated sessions, and PBL (Problem-Based Learning) sessions. There is also no practical exam for breast examination skill assessment. According to UÇEP 2020, the learning level of breast diseases and tumors should be PreT and K (Preliminary diagnosis and prevention). When the answers given by intern physicians to the surveys were evaluated, 65.2% (n = 159) of the intern physicians stated that they had knowledge at the Pre-T level and 37.3% (n = 91) at the prevention level. Additionally, according to UÇEP 2020; Physicians should be able to perform breast and axillary examination in uncomplicated, common situations/cases (level 3) and teach breast self-examination, including complex situations/cases (level 4). As a result of the surveys; 64% (n=155) of intern physicians stated that they could perform breast and axillary area examination at level 3, and 45% (n=109) stated that they could teach breast self-examination at level 4. As a result of the SWOT analysis conducted with the faculty members, it was concluded that in the IU-ITF UGME program, breast health and diseases issues are addressed at a level of residency education well above the level of knowledge defined in UÇEP 2020, students have less opportunity to see patients for benign diseases of the breast, the rate of education for primary care is low and insufficient. The weaknesses of the program were that students were not able to see and learn enough about the diseases they would encounter in primary care. In addition, it has been determined that breast examination skill training is not given and tested in a structured way, the distribution of students in clinical skills training and the standard of the training they receive are not available, the faculty members are not prone to cooperation in the field of education, the strong department structure causes difficulties in integration and the measurement-evaluation process in breast examination did not include skill training. Conclusion: The new education program should be created to increase the level of integration. For this purpose, many disciplines should act in collaboration, and while planning the new curriculum, teaching methods, measurement and evaluation methods, should be prepared as a central program and independent of disciplines with the participation of faculty members from all disciplines in the program under the leadership of the program coordinator.
Aim: The aim of this study is to analyze how breast health and diseases are handled in the undergraduate medical education (UGME) program of Istanbul University Istanbul Faculty of Medicine (IU-ITF) and to evaluate its compliance with the UÇEP (National Core Education Program) and to create a new model proposal for the placement of "breast health and diseases" in an integrated medical education program. Method: This descriptive cross-sectional study was conducted in three stages at IU-ITF between 01.06.2020 and 01.06.2022. In the first stage, the analysis of the IU-ITF UGME program was made using the analysis framework we created as a result of the literature review. In the second stage, an online survey was applied to intern physicians on a voluntary basis to evaluate their self-efficacy in breast health and diseases. In the third stage, a SWOT analysis was conducted with the participation of volunteer faculty members to whom teaching breast health and diseases in the program, their opinions and suggestions regarding the placement of "breast health and diseases" in the program were taken. Results: In the IU-ITF UGME program, subjects related to breast health and diseases are scattered throughout the program, spread over 6 terms. It is not gathered under a single theme. On the fact that these subjects were handled by different disciplines in the same period suggests that there is a partial horizontal integration, that there is a vertical integration in the transition from basic sciences to the clinic, and that the distribution of the subjects from simple to complex within the periods is a spiral configuration. In addition, the training program does not include any breast examination skills training, simulated patient practice, multi-disciplinary integrated sessions, and PBL (Problem-Based Learning) sessions. There is also no practical exam for breast examination skill assessment. According to UÇEP 2020, the learning level of breast diseases and tumors should be PreT and K (Preliminary diagnosis and prevention). When the answers given by intern physicians to the surveys were evaluated, 65.2% (n = 159) of the intern physicians stated that they had knowledge at the Pre-T level and 37.3% (n = 91) at the prevention level. Additionally, according to UÇEP 2020; Physicians should be able to perform breast and axillary examination in uncomplicated, common situations/cases (level 3) and teach breast self-examination, including complex situations/cases (level 4). As a result of the surveys; 64% (n=155) of intern physicians stated that they could perform breast and axillary area examination at level 3, and 45% (n=109) stated that they could teach breast self-examination at level 4. As a result of the SWOT analysis conducted with the faculty members, it was concluded that in the IU-ITF UGME program, breast health and diseases issues are addressed at a level of residency education well above the level of knowledge defined in UÇEP 2020, students have less opportunity to see patients for benign diseases of the breast, the rate of education for primary care is low and insufficient. The weaknesses of the program were that students were not able to see and learn enough about the diseases they would encounter in primary care. In addition, it has been determined that breast examination skill training is not given and tested in a structured way, the distribution of students in clinical skills training and the standard of the training they receive are not available, the faculty members are not prone to cooperation in the field of education, the strong department structure causes difficulties in integration and the measurement-evaluation process in breast examination did not include skill training. Conclusion: The new education program should be created to increase the level of integration. For this purpose, many disciplines should act in collaboration, and while planning the new curriculum, teaching methods, measurement and evaluation methods, should be prepared as a central program and independent of disciplines with the participation of faculty members from all disciplines in the program under the leadership of the program coordinator.
Açıklama
Anahtar Kelimeler
Eğitim ve Öğretim, Education and Training, Genel Cerrahi
