Dole ne masu aiki su mallaki ingantattun ƙwarewar tunani na asibiti don yin dacewa, amintaccen yanke shawara na asibiti da kuma guje wa kurakuran aiki.Rashin haɓaka ƙwarewar tunani na asibiti na iya lalata amincin haƙuri da jinkirin kulawa ko jiyya, musamman a cikin kulawa mai zurfi da sassan gaggawa.Horon tushen kwaikwaiyo yana amfani da tattaunawa na koyo mai nuni da bin siminti azaman hanyar taƙaitawa don haɓaka ƙwarewar tunani na asibiti yayin kiyaye amincin haƙuri.Duk da haka, saboda yanayin multidimensional na tunani na asibiti, da yiwuwar hadarin fahimi obalodi, da kuma bambancin amfani da nazari (hypothetico-deductive) da kuma wadanda ba na nazari (ilhama) na asibiti tsarin tafiyar matakai na ci gaba da junior simulation mahalarta, yana da muhimmanci yi la'akari da gogewa, iyawa, abubuwan da suka danganci kwarara da ƙarar bayanai, da rikiɗar yanayin don inganta tunanin asibiti ta hanyar shiga cikin tattaunawar ilmantarwa mai nuna ra'ayi bayan simintin a matsayin hanyar taƙaitawa.Manufarmu ita ce bayyana ci gaban samfurin tattaunawa na koyo na nuna kwaikwaiyo bayan wasan kwaikwayo wanda yayi la'akari da abubuwa da yawa waɗanda ke tasiri ga nasarar inganta tunanin asibiti.
Ƙungiya mai aiki tare da ƙira (N = 18), wanda ya ƙunshi likitoci, ma'aikatan jinya, masu bincike, malamai, da wakilai masu haƙuri, sun haɗu ta hanyar tarurrukan bita na gaba don haɓaka samfurin tattaunawa na ilmantarwa na bayan-kwaikwaiyo don taƙaita simulation.Ƙungiyar aiki tare da ƙira ta haɓaka samfurin ta hanyar ka'idar ka'ida da tsari da kuma bitar takwarorinsu da yawa.Daidaitaccen haɗin kai na binciken kima da ƙari/rasa da harajin Bloom an yi imanin inganta tunanin mahalarta na asibiti yayin da suke cikin ayyukan kwaikwayo.An yi amfani da fihirisar ingancin abun ciki (CVI) da hanyoyin ingancin abun ciki (CVR) don kafa ingancin fuska da ingancin abun ciki na samfurin.
An ƙirƙira da gwada samfurin tattaunawa na koyo bayan kwaikwaiyo.Ana goyan bayan samfurin ta misalan aiki da jagorar rubutun.An kimanta fuska da ingancin abun ciki na samfurin kuma an tabbatar da su.
An ƙirƙiri sabon ƙirar haɗin gwiwa tare da la'akari da ƙwarewa da iyawar mahalarta ƙirar ƙira iri-iri, kwarara da ƙarar bayanai, da sarƙaƙƙiya na shari'o'in ƙirar.Ana tunanin waɗannan abubuwan zasu inganta tunanin asibiti lokacin shiga ayyukan kwaikwayo na rukuni.
An yi la'akari da dalilai na asibiti a matsayin tushen aikin asibiti a cikin kiwon lafiya [1, 2] da kuma wani muhimmin mahimmanci na ƙwarewar asibiti [1, 3, 4].Yana da tsari mai nunawa wanda masu aiki ke amfani da su don ganowa da kuma aiwatar da mafi dacewa ga kowane yanayi na asibiti da suka fuskanta [5, 6].An kwatanta dalilai na asibiti a matsayin tsari mai rikitarwa wanda ke amfani da dabarun tunani na yau da kullum da na yau da kullum don tattarawa da nazarin bayanai game da mai haƙuri, kimanta mahimmancin wannan bayanin, da kuma ƙayyade ƙimar madadin darussan aikin [7, 8].Ya dogara da ikon tattara alamu, aiwatar da bayanai, da fahimtar matsalar majiyyaci don ɗaukar matakin da ya dace ga majiyyaci a daidai lokacin da kuma dalilin da ya dace [9, 10].
Duk ma'aikatan kiwon lafiya suna fuskantar buƙatar yin yanke shawara masu rikitarwa a cikin yanayin rashin tabbas [11].A cikin kulawa mai mahimmanci da aikin kulawa na gaggawa, yanayi na asibiti da gaggawa sun tashi inda amsawar gaggawa da shiga tsakani ke da mahimmanci don ceton rayuka da tabbatar da lafiyar haƙuri [12].Ƙwararrun ƙwarewar tunani na asibiti da ƙwarewa a cikin aikin kulawa mai mahimmanci suna da alaƙa da mafi girma na kurakurai na asibiti, jinkirin kulawa ko jiyya [13] da haɗari ga lafiyar haƙuri [14,15,16].Don guje wa kurakurai masu amfani, masu aiki dole ne su kasance masu ƙwarewa kuma suna da ingantattun ƙwarewar tunani na asibiti don yanke shawara mai aminci da dacewa [16, 17, 18].Tsarin tunani mara ƙididdiga (da hankali) shine saurin aiwatar da ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararru.Sabanin haka, hanyoyin tunani na nazari (hypothetico-deductive) suna da hankali a hankali, da gangan, kuma mafi yawan ƙwararrun ƙwararrun ƙwararru [2, 19, 20].Ganin rikitaccen yanayin yanayin asibiti na kiwon lafiya da yuwuwar haɗarin kuskuren aiki [14,15,16], ana amfani da ilimin simulation na tushen (SBE) sau da yawa don ba wa masu aiki damar haɓaka ƙwarewa da ƙwarewar tunani na asibiti.yanayi mai aminci da fallasa ga lokuta daban-daban na ƙalubale yayin kiyaye amincin haƙuri [21, 22, 23, 24].
The Society for Simulation in Health (SSH) ta bayyana kwaikwaiyo a matsayin "fasaha ce da ke haifar da yanayi ko yanayi wanda mutane ke fuskantar wakilcin abubuwan da suka faru na rayuwa don manufar aiki, horo, kimantawa, gwaji, ko samun fahimtar tsarin ɗan adam ko hali."[23] Shirye-shiryen simintin gyare-gyaren da aka tsara yana ba wa mahalarta damar da za su nutsar da kansu a cikin al'amuran da ke kwatanta yanayin asibiti yayin da suke rage haɗarin aminci [24,25] da kuma yin tunani na asibiti ta hanyar damar koyo da aka yi niyya [21,24,26,27,28] SBE yana haɓaka ƙwarewar asibiti na filin, yana fallasa ɗalibai zuwa ƙwarewar asibiti waɗanda ƙila ba su samu ba a ainihin saitunan kulawar haƙuri [24, 29].Wannan ba barazana ba ne, mara zargi, kulawa, aminci, yanayin koyo mai ƙarancin haɗari.Yana haɓaka haɓaka ilimin, ƙwarewar asibiti, iyawa, tunani mai mahimmanci da tunani na asibiti [22,29,30,31] kuma zai iya taimakawa ƙwararrun ƙwararrun kiwon lafiya su shawo kan damuwa na tunanin yanayi, ta haka inganta ƙwarewar koyo [22, 27, 28] ., 30, 32].
Don tallafawa ingantaccen ci gaba na tunani na asibiti da ƙwarewar yanke shawara ta hanyar SBE, dole ne a ba da hankali ga ƙira, samfuri, da tsarin tsarin debriefing bayan simulations [24, 33, 34, 35].An yi amfani da maganganun da aka yi amfani da su bayan kwaikwayo na ilmantarwa (RLC) a matsayin fasaha na ƙaddamarwa don taimakawa mahalarta suyi tunani, bayyana ayyuka, da kuma amfani da ikon goyon bayan takwarorinsu da tunanin rukuni a cikin mahallin aikin haɗin gwiwa [32, 33, 36].Amfani da RLCs na rukuni yana ɗaukar haɗarin rashin haɓakar dalilan asibiti, musamman dangane da bambancin iyawa da manyan matakan mahalarta.Tsarin tsari na dual yana kwatanta nau'ikan nau'ikan nau'ikan tunani na asibiti da bambance-bambance a cikin haɓakar manyan ƙwararrun masu yin amfani da hanyoyin tunani na nazari (hypothetico-deductive) da ƙananan ƙwararrun masana don amfani da hanyoyin ba da hankali (ilhanci) hanyoyin tunani [34, 37].].Waɗannan matakai biyu na tunani sun haɗa da ƙalubalen daidaita ingantattun hanyoyin tunani zuwa yanayi daban-daban, kuma ba shi da tabbas da jayayya yadda za a yi amfani da hanyoyin nazari da ƙididdiga yadda ya kamata yayin da ake samun manya da ƙanana masu shiga cikin ƙungiyar ƙirar ƙira ɗaya.Daliban makarantar sakandare da ƙaramar sakandare na iyawa daban-daban da matakan gogewa suna shiga cikin yanayin kwaikwaiyo na bambancin sarƙaƙƙiya [34, 37].Halin nau'i-nau'i na nau'i-nau'i na asibiti yana da alaƙa da haɗari mai yuwuwar rashin haɓakar fahimtar asibiti da kuma nauyin nauyi, musamman lokacin da masu aiki suka shiga cikin ƙungiyar SBEs tare da bambancin yanayin yanayin da matakan girma [38].Yana da mahimmanci a lura cewa ko da yake akwai nau'ikan ƙididdiga masu yawa ta amfani da RLC, babu ɗayan waɗannan samfuran da aka tsara tare da takamaiman mai da hankali kan haɓaka ƙwarewar tunani na asibiti, la'akari da ƙwarewa, ƙwarewa, kwarara da ƙarar bayanai, da abubuwan ƙira [38].]., 39].Duk wannan yana buƙatar haɓaka samfurin da aka tsara wanda yayi la'akari da gudunmawar daban-daban da kuma abubuwan da suka shafi tasiri don inganta tunanin asibiti, yayin da ya haɗa RLC bayan-kwaikwaiyo a matsayin hanyar bayar da rahoto.Mun bayyana tsari na ka'ida da ra'ayi don ƙirar haɗin gwiwa da haɓaka RLC bayan kwaikwaiyo.An ƙirƙira wani samfurin don inganta ƙwarewar tunani na asibiti yayin shiga cikin SBE, la'akari da nau'i mai yawa na sauƙaƙewa da kuma tasiri don cimma ingantaccen haɓakar tunani na asibiti.
An ɓullo da samfurin bayan-kwaikwayo na RLC tare da haɗin gwiwa dangane da samfuran da ake da su da kuma ka'idodin tunani na asibiti, koyo mai tunani, ilimi, da kwaikwayo.Don haɓaka samfurin haɗin gwiwa, an kafa ƙungiyar haɗin gwiwar aiki (N = 18), wanda ya ƙunshi ma'aikatan jinya na 10, mai ƙarfi ɗaya, da wakilai uku na marasa lafiya na asibiti a baya na matakan daban-daban, ƙwarewa, da jinsi.Sashin kulawa mai zurfi ɗaya, mataimakan bincike 2 da manyan malaman ma'aikatan jinya 2.An tsara wannan ƙirar haɗin gwiwar tare da haɓaka ta hanyar haɗin gwiwar abokan hulɗa tsakanin masu ruwa da tsaki tare da kwarewa ta ainihi a cikin kiwon lafiya, ko dai masu sana'a na kiwon lafiya da ke da hannu wajen haɓaka samfurin da aka tsara ko wasu masu ruwa da tsaki kamar marasa lafiya [40,41,42].Ciki har da wakilai masu haƙuri a cikin tsarin haɗin gwiwa na iya ƙara ƙima ga tsarin, kamar yadda babban burin shirin shine inganta kulawar haƙuri da aminci [43].
Ƙungiyar aiki ta gudanar da tarurrukan sa'o'i shida na 2-4 don haɓaka tsari, matakai da abun ciki na samfurin.Taron ya hada da tattaunawa, aiki da kwaikwayo.Abubuwan samfurin sun dogara ne akan kewayon albarkatun tushen shaida, samfuri, ka'idoji da tsarin aiki.Waɗannan sun haɗa da: ka'idar ilmantarwa mai ginawa [44], madaidaicin madauki biyu [37], madaidaicin madauki na asibiti [10], hanyar neman godiya (AI) [45], da hanyar bayar da rahoto da / delta [46].An haɓaka ƙirar tare da haɗin gwiwa bisa ga ƙa'idodin tsarin bayyani na INACSL Ƙungiyar Ma'aikatan Jiyya ta Duniya don ilimin asibiti da na kwaikwayo [36] kuma an haɗa shi tare da misalan aiki don ƙirƙirar samfurin bayyana kansa.An ƙirƙiri samfurin a matakai huɗu: shirye-shirye don tattaunawa na ilmantarwa mai ban sha'awa bayan kwaikwayo, ƙaddamar da tattaunawar ilmantarwa mai haske, nazari / tunani da taƙaitawa (Hoto 1).An tattauna cikakkun bayanai game da kowane mataki a ƙasa.
An tsara matakin shirye-shiryen ƙirar don shirya mahalarta ta hanyar tunani don mataki na gaba da haɓaka haɓaka aiki da saka hannun jari yayin tabbatar da amincin tunani [36, 47].Wannan mataki ya haɗa da gabatarwa ga manufa da manufofin;tsawon lokacin da ake tsammanin RLC;tsammanin mai gudanarwa da mahalarta yayin RLC;daidaitawar shafin da saitin kwaikwayo;tabbatar da sirri a cikin yanayin koyo, da haɓakawa da haɓaka amincin tunani.An yi la'akari da martanin wakilai masu zuwa daga rukunin aiki na haɗin gwiwar a lokacin farkon ci gaba na samfurin RLC.Mahalarta ta 7: "A matsayina na ma'aikacin jinya na farko, idan ina shiga cikin simulation ba tare da mahallin yanayi ba kuma tsofaffi sun kasance a wurin, zan iya guje wa shiga cikin tattaunawar bayan kwaikwayo sai dai idan na ji cewa ana kiyaye lafiyar kwakwalwata. girmamawa.da kuma cewa zan guji shiga cikin tattaunawa bayan kwaikwayo."A kiyaye kuma ba za a sami sakamako ba."Mahalarta ta 4: “Na yi imanin cewa kasancewa mai da hankali da kafa ƙa'idodi da wuri zai taimaka wa xaliban bayan kwaikwayo.Haɗin kai a cikin tattaunawar ilmantarwa mai haske."
Matakan farko na ƙirar RLC sun haɗa da binciko yadda ɗan takara yake ji, kwatanta abubuwan da ke cikin tushe da gano yanayin yanayin, da jera abubuwan halayen ɗan takara masu kyau da mara kyau, amma ba bincike ba.An ƙirƙiri samfurin a wannan matakin don ƙarfafa 'yan takara su kasance masu son kai da aiki, da kuma shirya tunani don zurfin bincike da zurfin tunani [24, 36].Manufar ita ce a rage yuwuwar haɗarin haɓakar fahimi [48], musamman ga waɗanda ke sababbi ga batun ƙirar ƙira kuma ba su da ƙwarewar asibiti na baya tare da fasaha / batun [49].Neman mahalarta su yi bayanin abin da aka kwaikwayi a taƙaice kuma su ba da shawarwarin bincike zai taimaka wa mai gudanarwa don tabbatar da cewa ɗalibai a cikin rukuni suna da asali da fahimtar al'amuran gaba ɗaya kafin su ci gaba zuwa tsawaita nazari/ tunani.Bugu da ƙari, gayyatar mahalarta a wannan mataki don raba ra'ayoyinsu a cikin al'amuran da aka kwatanta zai taimaka musu su shawo kan damuwa na halin da ake ciki, ta haka ne inganta ilmantarwa [24, 36].Magance batutuwan da suka shafi motsin rai kuma zai taimaka wa mai gudanarwa na RLC fahimtar yadda ji na mahalarta ya shafi aikin mutum da na kungiya, kuma ana iya tattauna wannan da mahimmanci yayin lokacin tunani/bincike.Hanyar Plus/Delta an gina ta a cikin wannan lokaci na ƙirar azaman shiri da yanke hukunci don lokacin tunani/bincike [46].Yin amfani da tsarin Plus/Delta, duka mahalarta da ɗalibai za su iya aiwatarwa / jera abubuwan da suka lura, ji da gogewa na simintin, wanda za'a iya tattauna su aya ta aya yayin lokacin tunani / nazari na samfurin [46].Wannan zai taimaka wa mahalarta su cimma yanayi mai ma'ana ta hanyar niyya da kuma fifikon damar koyo don inganta tunanin asibiti [24, 48, 49].An yi la'akari da martanin wakilai masu zuwa daga rukunin aiki na haɗin gwiwa yayin farkon haɓaka samfurin RLC.Mahalarta ta 2: "Ina tsammanin a matsayina na majinyacin da aka shigar da shi a baya a cikin ICU, muna buƙatar yin la'akari da ji da motsin zuciyar ɗaliban da aka kwaikwayi.Na tayar da wannan batu ne saboda lokacin shigar da ni na lura da matsanancin damuwa da damuwa, musamman a tsakanin masu aikin kulawa.da yanayin gaggawa.Dole ne wannan samfurin ya yi la'akari da damuwa da motsin zuciyar da ke tattare da yin kwatancen gwaninta. "Mahalarta ta 16: “A gare ni a matsayina na malami, na ga yana da matuƙar mahimmanci in yi amfani da tsarin Plus/Delta domin a ƙarfafa ɗalibai su shiga ƙwazo ta hanyar ambaton abubuwa masu kyau da buƙatun da suka ci karo da su yayin yanayin wasan kwaikwayo.Wuraren ingantawa.”
Kodayake matakan da suka gabata na samfurin suna da mahimmanci, mataki na bincike / tunani shine mafi mahimmanci don cimma nasarar inganta tunanin asibiti.An tsara shi don samar da bincike mai zurfi / kira da bincike mai zurfi bisa ga kwarewa na asibiti, ƙwarewa, da tasiri na batutuwan da aka tsara;RLC tsari da tsari;adadin bayanan da aka bayar don guje wa wuce gona da iri;m amfani da tunani tambayoyi.hanyoyin da za a kai ga ci gaban koyo da himma.A wannan gaba, kwarewar asibiti da masaniya game da bangarorin kwaikwayo guda uku don saukar da matakan daban-daban na ƙwarewa, na biyu: ƙwarewar da ta gabata game da ilimin motsa jiki, na biyu: ƙwarewar da ta gabata, masifu da fasaha / babu.bayyanuwar baya ga batutuwan yin samfuri.Na uku: Kwarewar ƙwararrun asibiti, ilimi da ƙwarewa.ƙwararriyar / bayyanar da ta gabata ga batutuwan yin samfuri.An yi rarrabuwa don ɗaukar bukatun mutane da abubuwa daban-daban da kuma matakan iyawa a cikin wannan rukuni, don haka ya daidaita da halin da ake nufi da nazarin da ba na iya amfani da ƙwarewar da ba na bincike ba [19, 20, 34]., 37].An tsara tsarin RLC a kusa da sake zagayowar dalili na asibiti [10], tsarin ƙirar ƙira [47], da ka'idar ilmantarwa [50].Ana samun wannan ta hanyoyi da yawa: fassarar, bambance-bambance, sadarwa, ƙaddamarwa da haɗuwa.
Don guje wa wuce gona da iri, an yi la'akari da haɓaka tsarin yin magana mai kan ɗabi'a da tunani tare da isassun lokaci da dama ga mahalarta don yin tunani, tantancewa da haɗawa don cimma amincewar kai.Ana magance hanyoyin haɓakawa a lokacin RLC ta hanyar haɓakawa, tabbatarwa, tsarawa, da haɓaka hanyoyin haɗin gwiwa dangane da tsarin madauki biyu [37] da ka'idar ɗaukar nauyi [48].Samun tsarin tattaunawa da aka tsara da kuma ba da isasshen lokaci don tunani, yin la'akari da mahalarta masu kwarewa da ƙwarewa, zai rage yiwuwar haɗari na nauyin hankali, musamman ma a cikin hadaddun siminti tare da bambance-bambancen abubuwan da suka gabata, bayyanar da matakan iyawa na mahalarta.Bayan lamarin.Dabarar tambayar da ke nuna ƙirar ta dogara ne akan ƙirar haraji ta Bloom [51] da hanyoyin bincike na godiya (AI) [45], wanda mai gudanarwa da aka ƙirƙira ya tunkari batun a mataki-mataki, Socratic, da kuma tunani.Yi tambayoyi, farawa da tambayoyin tushen ilimi.da magance basira da batutuwan da suka shafi tunani.Wannan dabarar tambayar za ta inganta ingantaccen tunani na asibiti ta hanyar ƙarfafa ƙwaƙƙwaran ɗan takara da kuma tunanin ci gaba tare da ƙarancin haɗarin haɓakar fahimi.An yi la'akari da martanin wakilai masu zuwa daga ƙungiyar aiki na haɗin gwiwar a lokacin nazari / tunani na ci gaban ƙirar RLC.Mahalarta ta 13: “Don guje wa ɗimbin yawa na fahimi, muna buƙatar yin la’akari da adadin da kwararar bayanai yayin da muke shiga tattaunawar koyo bayan kwaikwaiyo, kuma don yin wannan, ina ganin yana da mahimmanci a bai wa ɗalibai isasshen lokaci don yin tunani da farawa da abubuwan yau da kullun. .Ilimi.yana fara tattaunawa da ƙwarewa, sannan ya matsa zuwa manyan matakan ilimi da ƙwarewa don cimma daidaituwa."Mahalarta ta 9: "Na yi imani da gaske cewa hanyoyin tambayar ta yin amfani da dabarun Tambayoyi na godiya (AI) da kuma yin tambaya mai ma'ana ta amfani da tsarin Taxonomy na Bloom zai inganta koyo mai ƙwazo da kuma ɗaiɗaikun ɗai-ɗai tare da rage yuwuwar haɗarin yin kiba."Tsarin bayyani na ƙirar yana nufin taƙaita abubuwan koyo da aka taso yayin RLC da tabbatar da cewa an cimma manufofin koyo.Mahalarta ta 8: "Yana da matukar muhimmanci duka xalibi da mai gudanarwa su amince da mafi mahimmancin ra'ayoyi da mahimman abubuwan da za a yi la'akari da su yayin motsawa zuwa aiki."
An sami amincewar ɗabi'a a ƙarƙashin lambobi na yarjejeniya (MRC-01-22-117) da (HSK/PGR/UH/04728).An gwada samfurin a cikin darussan kwaikwaiyo na ƙwararrun kulawa guda uku don kimanta amfani da amfani da ƙirar.An ƙididdige ingancin fuskar samfurin ta hanyar ƙungiyar haɗin gwiwar haɗin gwiwa (N = 18) da ƙwararrun ƙwararrun ilimi waɗanda ke aiki a matsayin daraktocin ilimi (N = 6) don gyara batutuwan da suka shafi bayyanar, nahawu, da tsari.Bayan ingancin fuska, manyan malamai na ma'aikatan jinya sun ƙaddara ingancin abun ciki (N = 6) waɗanda Cibiyar Ƙwararrun Ma'aikatan jinya ta Amurka (ANCC) ta tabbatar da su kuma sun yi aiki a matsayin masu tsara ilimi, kuma (N = 6) wanda ke da fiye da shekaru 10 na ilimi da kuma kwarewar koyarwa.Kwarewar Aiki Daraktocin ilimi ne suka gudanar da kima (N = 6).Kwarewar yin samfuri.An ƙididdige ingancin abun ciki ta amfani da Ma'aunin Ingantaccen Abun ciki (CVR) da Indexididdigar Ingantaccen Abu (CVI).An yi amfani da hanyar Lawshe [52] don kimanta CVI, kuma an yi amfani da hanyar Waltz da Bausell [53] don kimanta CVR.Ayyukan CVR suna da mahimmanci, masu amfani, amma ba dole ba ko na zaɓi.An ƙididdige CVI akan sikelin maki huɗu dangane da dacewa, sauƙi, da tsabta, tare da 1 = bai dace ba, 2 = ɗan dacewa, 3 = dacewa, da 4 = dacewa sosai.Bayan tabbatar da ingancin fuska da abun ciki, ban da tarurrukan aiki, an gudanar da tarurrukan daidaitawa da daidaitawa ga malaman da za su yi amfani da samfurin.
Ƙungiyar aikin ta sami damar haɓakawa da gwada samfurin RLC na baya-bayan nan don haɓaka ƙwarewar tunani na asibiti yayin shiga cikin SBE a cikin sassan kulawa mai zurfi (Figures 1, 2, da 3).CVR = 1.00, CVI = 1.00, yana nuna fuska mai dacewa da ingancin abun ciki [52, 53].
An ƙirƙiri samfurin don ƙungiyar SBE, inda ake amfani da al'amura masu ban sha'awa da ƙalubalanci ga mahalarta tare da matakan ƙwarewa iri ɗaya ko daban-daban, ilimi da girma.An ƙirƙira ƙirar ra'ayi na RLC bisa ga ka'idodin nazarin kwaikwaiyon jirgin INACSL [36] kuma mai koyo ne kuma mai bayyana kansa, gami da misalan aiki (Figures 1, 2 da 3).An ƙirƙiri ƙirar da niyya kuma an raba ta zuwa matakai huɗu don saduwa da ƙa'idodin ƙirar ƙira: farawa tare da taƙaitaccen bayani, biye da nazari/karfafa tunani, da ƙarewa tare da bayanai da taƙaitawa.Don guje wa yuwuwar haɗarin haɓakar fahimi, kowane mataki na ƙirar an tsara shi da gangan azaman abin da ake buƙata don mataki na gaba [34].
Ba a yi nazarin tasirin girma da abubuwan haɗin kai na rukuni akan shiga cikin RLC ba a baya [38].Yin la'akari da ra'ayoyi masu amfani na madauki biyu da ka'idar nauyin nauyi a cikin aikin kwaikwayo [34, 37], yana da mahimmanci a yi la'akari da cewa shiga cikin rukuni na SBE tare da kwarewa daban-daban da matakan iyawa na mahalarta a cikin rukunin kwaikwayo guda ɗaya kalubale ne.Yin watsi da ƙarar bayanai, kwarara da tsarin ilmantarwa, da kuma yin amfani da lokaci guda na matakai masu sauri da sannu a hankali ta duka makarantun sakandare da ƙananan ɗaliban makarantar sakandare suna haifar da haɗarin haɓakar fahimi [18, 38, 46].An yi la'akari da waɗannan abubuwan yayin haɓaka ƙirar RLC don guje wa rashin haɓakawa da / ko ingantaccen tunani na asibiti [18, 38].Yana da mahimmanci a la'akari da cewa gudanar da RLC tare da matakai daban-daban na girma da ƙwarewa yana haifar da tasiri a tsakanin manyan mahalarta.Wannan yana faruwa ne saboda ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun masu haɓaka don cimma fahimtar juna da kuma shigar da matakan tunani da tunani [38, 47].An tsara samfurin RLC don haɗa manyan ma'aikatan jinya da ƙananan yara ta hanyar bincike mai godiya da tsarin delta [45, 46, 51].Yin amfani da waɗannan hanyoyin, ra'ayoyin manya da ƙananan mahalarta tare da iyawa daban-daban da matakan ƙwarewa za a gabatar da su abu da abu kuma an tattauna su a hankali ta hanyar mai ba da shawara da masu daidaitawa [45, 51].Baya ga shigar da mahalarta simintin, mai gabatar da bayanai yana ƙara shigar da su don tabbatar da cewa duk abubuwan lura na gamayya sun cika kowane lokacin koyo, ta haka ne ke haɓaka haɓakawa don haɓaka tunanin asibiti [10].
Gudun bayanai da tsarin ilmantarwa ta amfani da tsarin RLC ana magance su ta hanyar tsari mai tsari da matakai masu yawa.Wannan shi ne don taimakawa masu gabatar da bayanai da kuma tabbatar da cewa kowane ɗan takara ya yi magana a fili da amincewa a kowane mataki kafin ya ci gaba zuwa mataki na gaba.Mai gudanarwa zai iya fara tattaunawa mai ma'ana wanda duk mahalarta suka shiga, kuma su kai matsayi inda mahalarta daban-daban masu girma da matakan iyawa suka yarda akan mafi kyawun ayyuka ga kowane wurin tattaunawa kafin tafiya zuwa na gaba [38].Yin amfani da wannan hanyar za ta taimaka kwangila da masu dacewa da su ba da gudummawar su / abubuwan lura, za a tantance mahalarta da ƙwarewar da ba su da mahimmanci [38].Duk da haka, don cimma wannan burin, masu gudanarwa za su fuskanci kalubale na daidaita tattaunawa da samar da dama daidai ga manya da ƙananan mahalarta.Don wannan, tsarin binciken ƙirar ƙirar an haɓaka shi da gangan ta amfani da ƙirar haraji ta Bloom, wanda ya haɗu da binciken kimantawa da hanyar ƙari/delta [45, 46, 51].Yin amfani da waɗannan fasahohin da farawa da ilimi da fahimtar tambayoyi masu mahimmanci / tattaunawa mai ma'ana zai ƙarfafa mahalarta marasa ƙwararru don shiga da kuma shiga cikin tattaunawar, bayan haka mai gudanarwa zai matsa zuwa matsayi mafi girma na kimantawa da hada tambayoyin / tattaunawa. a cikin abin da bangarorin biyu dole ne su bai wa mahalarta tsofaffi da Juniors suna da dama daidai don shiga bisa la'akari da kwarewar da suka gabata da kwarewa tare da basirar asibiti ko yanayin da aka kwatanta.Wannan hanya za ta taimaka wa mahalarta marasa ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun masu halarta za su raba da kuma shigar da mai gudanarwa.A gefe guda, an tsara samfurin ba kawai don SBEs tare da iyawar mahalarta daban-daban da matakan gogewa ba, har ma ga mahalarta ƙungiyar SBE tare da irin wannan ƙwarewa da matakan iyawa.An tsara samfurin don sauƙaƙe motsi mai sauƙi da tsari na ƙungiyar daga mai da hankali kan ilimi da fahimta zuwa mai da hankali kan haɗawa da kimantawa don cimma burin ilmantarwa.An tsara tsarin ƙirar da matakai don dacewa da ƙungiyoyin ƙirar ƙira na iyawa daban-daban kuma daidai daidai da matakan gogewa.
Bugu da ƙari, ko da yake SBE a cikin kiwon lafiya a hade tare da RLC ana amfani da su don bunkasa tunani na asibiti da ƙwarewa a cikin masu aiki [22,30,38], duk da haka, dole ne a yi la'akari da abubuwan da suka dace dangane da mawuyacin hali da haɗarin haɗari na haɓakar fahimta, musamman ma. lokacin da Mahalarta ke da alaƙa da yanayin SBE sun kwaikwaya sosai hadaddun, marasa lafiya marasa lafiya da ke buƙatar sa baki cikin gaggawa da yanke shawara mai mahimmanci [2,18,37,38,47,48].Har zuwa wannan, yana da mahimmanci a bincika halin duka biyu gogaggen da kuma ƙarancin abubuwan tunani na lokaci-lokaci lokacin shiga cikin sber da kuma sa hannu a cikin sber, kuma waɗanda ke cikin halayyar dangantakar shaida da ke bazu duka tsofaffi da ƙarami dalibai su shiga rayayye a cikin tsarin ilmantarwa.Don haka, an tsara samfurin ta yadda, ba tare da la’akari da sarƙaƙƙiya na shari’ar da aka kwatanta ba, dole ne mai gudanarwa ya tabbatar da cewa an fara rufe ɓangarori na ilimi da fahimtar fahintar manyan mahalarta da ƙananan mahalarta sannan a hankali a hankali a haɓaka zuwa ga ci gaba. sauƙaƙe bincike.kira da fahimta.bangaren kimantawa.Wannan zai taimaka wa ɗalibai ƙanana su haɓaka da ƙarfafa abin da suka koya, da kuma taimaka wa tsofaffin ɗalibai su haɗa da haɓaka sabon ilimi.Wannan zai cika ka'idodin tsarin tunani, la'akari da gogewar da ta gabata da iyawar kowane ɗan takara, kuma yana da tsari na gabaɗaya wanda ke magance halin ɗaliban makarantar sakandare da ƙaramar sakandare don motsawa a lokaci guda tsakanin tsarin tunani na nazari da ƙididdiga, ta haka ne. tabbatar da ingantawa na tunani na asibiti.
Bugu da ƙari, masu gudanar da kwaikwaiyo/masu bayyani na iya samun matsala wajen ƙware dabarun tantance simintin.An yi imanin yin amfani da rubutun bayyani na fahimi yana da tasiri wajen haɓaka ilimin ilimi da ƙwarewar ɗabi'a na masu gudanarwa idan aka kwatanta da waɗanda ba sa amfani da rubutun [54].Halin yanayi kayan aiki ne na fahimi wanda zai iya sauƙaƙe aikin ƙirar malamai da haɓaka ƙwarewar zance, musamman ga malaman da har yanzu suke ƙarfafa ƙwarewar su [55].cimma babban amfani da haɓaka samfura masu dacewa da mai amfani.(Hoto na 2 da Hoto na 3).
Har yanzu ba a magance haɗe-haɗen haɗin kai na plus/delta, binciken godiya, da hanyoyin binciken Taxonomy na Bloom's Har yanzu ba a cikin binciken kwaikwaiyo da ake da su a halin yanzu da samfuran tunani jagora.Haɗin waɗannan hanyoyin yana nuna haɓakar ƙirar RLC, wanda aka haɗa waɗannan hanyoyin a cikin tsari guda ɗaya don cimma ingantaccen tunani na asibiti da ɗabi'ar mai koyo.Malaman likitanci na iya amfana daga ƙirar ƙungiyar SBE ta yin amfani da ƙirar RLC don haɓakawa da haɓaka ƙwarewar tunani na asibiti.Yanayin ƙirar zai iya taimaka wa malamai su mallaki tsarin ba da haske da ƙarfafa ƙwarewarsu don zama masu kwarin gwiwa da ƙwararrun masu gudanarwa na zance.
SBE na iya haɗawa da nau'o'i daban-daban da fasaha daban-daban, ciki har da amma ba'a iyakance ga SBE na tushen mannequin ba, masu aikin simintin aiki, na'urar kwaikwayo na haƙuri, daidaitattun marasa lafiya, kama da gaskiya da haɓaka.Ganin cewa bayar da rahoto ɗaya ne daga cikin mahimman ma'aunin ƙirar ƙira, ƙirar RLC da aka kwaikwayi za a iya amfani da ita azaman ƙirar rahoto yayin amfani da waɗannan hanyoyin.Bugu da ƙari, ko da yake an ƙaddamar da samfurin don horar da aikin jinya, yana da damar yin amfani da shi a cikin SBE na kiwon lafiya na interprofessional, yana nuna buƙatar ƙaddamar da bincike na gaba don gwada samfurin RLC don ilimin sana'a.
Haɓaka da kimantawa na samfurin RLC na baya-bayan nan don kulawa da jinya a cikin sassan kulawa na SBE.Ana ba da shawarar kimantawa / tabbatarwa na gaba na samfurin don ƙara yawan ƙima na samfurin don amfani da su a cikin wasu nau'o'in kula da kiwon lafiya da SBE masu sana'a.
Ƙungiya mai aiki ta haɗin gwiwa ta haɓaka samfurin bisa ka'idar da ra'ayi.Don inganta ingantacciyar inganci da gamammiyar samfurin, ana iya yin la'akari da amfani da ingantattun matakan dogaro don nazarin kwatancen nan gaba.
Don rage kurakuran aiki, masu aikin dole ne su mallaki ingantattun ƙwarewar tunani na asibiti don tabbatar da aminci da dacewa yanke shawara na asibiti.Yin amfani da SBE RLC a matsayin fasaha na ƙaddamarwa yana haɓaka haɓaka ilimi da ƙwarewar aiki masu mahimmanci don haɓaka tunanin asibiti.Koyaya, nau'ikan nau'ikan tunani na asibiti, waɗanda ke da alaƙa da ƙwarewar da ta gabata da fallasa, canje-canje a cikin iyawa, girma da kwararar bayanai, da rikiɗar yanayin simintin, yana nuna mahimmancin haɓaka samfuran RLC bayan kwaikwaiyo ta hanyar abin da tunani na asibiti zai iya zama rayayye. kuma an aiwatar da shi yadda ya kamata.basira.Yin watsi da waɗannan abubuwan na iya haifar da rashin haɓakawa da ingantaccen tunani na asibiti.An ƙirƙiri ƙirar RLC don magance waɗannan abubuwan don haɓaka tunanin asibiti lokacin shiga ayyukan kwaikwayo na rukuni.Don cimma wannan burin, ƙirar a lokaci guda tana haɗa ƙari/rasa binciken kimantawa da amfani da harajin Bloom.
Rubutun bayanan da aka yi amfani da su da/ko tantancewa yayin binciken na yanzu suna samuwa daga mawallafin da ya dace akan buƙatun da ya dace.
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