Dole ne masu aikin su kasance suna da ƙwarewar tunani mai inganci don yanke shawara mai kyau da aminci a asibiti da kuma guje wa kurakuran aiki. Ƙwarewar tunani mai kyau na asibiti na iya yin illa ga lafiyar majiyyaci da kuma jinkirta kulawa ko magani, musamman a sassan kulawa mai tsanani da gaggawa. Horarwa bisa ga kwaikwayo tana amfani da tattaunawa mai zurfi bayan kwaikwayo a matsayin hanyar bayani don haɓaka ƙwarewar tunani ta asibiti yayin da take kiyaye lafiyar majiyyaci. Duk da haka, saboda yanayin tunani mai yawa na asibiti, haɗarin yuwuwar yawan aiki na fahimta, da kuma bambancin amfani da hanyoyin tunani na asibiti (hypothetico-deductive) da waɗanda ba na nazari ba (fahimta) ta hanyar mahalarta kwaikwayo na ci gaba da ƙananan yara, yana da mahimmanci a yi la'akari da ƙwarewa, iyawa, abubuwan da suka shafi kwararar bayanai da yawan bayanai, da kuma sarkakiyar shari'a don inganta tunanin asibiti ta hanyar shiga cikin tattaunawar ilmantarwa mai tunani ta rukuni bayan kwaikwayon a matsayin hanyar bayani. Manufarmu ita ce bayyana haɓaka samfurin tattaunawar ilmantarwa mai tunani bayan kwaikwayo wanda ke la'akari da abubuwa da yawa waɗanda ke tasiri ga cimma nasarar inganta tunanin asibiti.
Ƙungiyar aiki mai haɗin gwiwa (N = 18), wadda ta ƙunshi likitoci, ma'aikatan jinya, masu bincike, malamai, da wakilan marasa lafiya, sun haɗu ta hanyar bita daban-daban don haɓaka tsarin tattaunawa na koyo mai tunani bayan kwaikwayo don bayyana kwaikwayon. Ƙungiyar aiki mai haɗin gwiwa ta haɓaka samfurin ta hanyar tsarin nazari da tunani da bita na matakai da yawa. Ana kyautata zaton haɗakar binciken kimantawa da ƙari/rage da kuma tsarin Bloom zai inganta tunanin mahalarta kwaikwayon yayin da suke shiga cikin ayyukan kwaikwayo. An yi amfani da hanyoyin ingancin abun ciki (CVI) da rabon ingancin abun ciki (CVR) don tabbatar da ingancin fuska da ingancin abun ciki na samfurin.
An ƙirƙiro kuma an gwada samfurin tattaunawa mai tunani bayan kwaikwayo. An tallafa wa samfurin ta hanyar misalan da aka yi aiki da kuma jagorar rubutun. An tantance kuma an tabbatar da ingancin fuskar da abun ciki na samfurin.
An ƙirƙiri sabon tsarin haɗin gwiwa ne bisa la'akari da ƙwarewa da iyawar mahalarta zane-zane daban-daban, kwararar bayanai da yawansu, da kuma sarkakiyar shari'o'in zane-zane. Ana tsammanin waɗannan abubuwan za su inganta tunanin asibiti yayin shiga cikin ayyukan kwaikwayo na rukuni.
Ana ɗaukar tunanin asibiti a matsayin tushen aikin asibiti a fannin kiwon lafiya [1, 2] kuma muhimmin sashi ne na ƙwarewar asibiti [1, 3, 4]. Tsarin tunani ne da masu aiki ke amfani da shi don gano da aiwatar da mafi dacewa ga kowane yanayi na asibiti da suka fuskanta [5, 6]. An bayyana tunanin asibiti a matsayin tsari mai rikitarwa na fahimta wanda ke amfani da dabarun tunani na yau da kullun da na yau da kullun don tattarawa da nazarin bayanai game da majiyyaci, kimanta mahimmancin wannan bayanin, da kuma tantance ƙimar wasu hanyoyin aiki [7, 8]. Ya dogara da ikon tattara alamu, sarrafa bayanai, da fahimtar matsalar majiyyaci don ɗaukar matakin da ya dace ga majiyyacin da ya dace a lokacin da ya dace da kuma dalilin da ya dace [9, 10].
Duk masu ba da sabis na kiwon lafiya suna fuskantar buƙatar yanke shawara mai sarkakiya a cikin yanayi mai matuƙar rashin tabbas [11]. A cikin kulawa mai tsanani da ayyukan kulawa ta gaggawa, yanayi na asibiti da gaggawa suna tasowa inda amsawa da sa baki cikin gaggawa suke da mahimmanci don ceton rayuka da tabbatar da lafiyar majiyyaci [12]. Rashin ƙwarewar tunani na asibiti da ƙwarewa a cikin ayyukan kulawa mai tsanani suna da alaƙa da yawan kurakuran asibiti, jinkiri a kulawa ko magani [13] da haɗarin lafiyar majiyyaci [14,15,16]. Don guje wa kurakurai masu amfani, masu aiki dole ne su kasance masu ƙwarewa kuma suna da ƙwarewar tunani na asibiti don yanke shawara mai aminci da dacewa [16, 17, 18]. Tsarin tunani mara nazari (mai fahimta) shine tsari mai sauri da ƙwararrun masu aiki suka fi so. Sabanin haka, hanyoyin tunani na nazari (mai hankali-mai hankali) suna da jinkiri, sun fi hankali, kuma galibi ana amfani da su ta hanyar ƙwararrun masu aiki marasa ƙwarewa [2, 19, 20]. Ganin sarkakiyar yanayin asibiti na kiwon lafiya da yuwuwar haɗarin kurakuran aiki [14, 15, 16], ilimin da aka dogara da kwaikwayo (SBE) galibi ana amfani da shi don ba wa masu aiki damar haɓaka ƙwarewa da ƙwarewar tunani na asibiti. muhalli mai aminci da kuma fuskantar matsaloli iri-iri yayin da ake kiyaye lafiyar marasa lafiya [21, 22, 23, 24].
Ƙungiyar Kwaikwayo a Lafiya (SSH) ta bayyana kwaikwayon a matsayin "fasaha da ke ƙirƙirar yanayi ko yanayi inda mutane ke fuskantar wakilcin abubuwan da suka faru na gaske don manufar yin aiki, horarwa, kimantawa, gwaji, ko fahimtar tsarin ko ɗabi'ar ɗan adam." [23] Zaman kwaikwayo mai kyau yana ba wa mahalarta damar nutsewa cikin yanayi waɗanda ke kwaikwayon yanayin asibiti yayin da suke rage haɗarin aminci [24,25] da kuma yin tunanin asibiti ta hanyar damar koyo da aka yi niyya [21,24,26,27,28] SBE yana haɓaka ƙwarewar asibiti a fagen, yana fallasa ɗalibai ga ƙwarewar asibiti waɗanda ƙila ba su taɓa fuskanta a ainihin saitunan kulawa da marasa lafiya ba [24, 29]. Wannan yanayi ne na koyo wanda ba shi da barazana, mara zargi, kulawa, aminci, kuma mai ƙarancin haɗari. Yana haɓaka haɓaka ilimi, ƙwarewar asibiti, iyawa, tunani mai zurfi da tunani na asibiti [22,29,30,31] kuma yana iya taimaka wa ƙwararrun kiwon lafiya su shawo kan damuwar motsin rai na wani yanayi, ta haka inganta ƙwarewar koyo [22, 27, 28]. , 30, 32].
Domin tallafawa ingantaccen ci gaban tunani na asibiti da ƙwarewar yanke shawara ta hanyar SBE, dole ne a mai da hankali kan ƙira, samfuri, da tsarin tsarin ba da bayani bayan kwaikwayo [24, 33, 34, 35]. An yi amfani da tattaunawar koyo mai tunani bayan kwaikwayo (RLC) a matsayin dabarar ba da bayani don taimaka wa mahalarta su yi tunani, bayyana ayyuka, da kuma amfani da ƙarfin goyon bayan takwarorinsu da tunani na rukuni a cikin mahallin aikin haɗin gwiwa [32, 33, 36]. Amfani da RLCs na rukuni yana ɗauke da haɗarin yuwuwar rashin ci gaba da tunani na asibiti, musamman dangane da iyawa daban-daban da matakan girma na mahalarta. Tsarin tsari biyu ya bayyana yanayin tunani na asibiti da bambance-bambance a cikin yuwuwar manyan masu aiki don amfani da hanyoyin tunani na nazari (hypothetico-deductive) da ƙananan masu aiki don amfani da hanyoyin tunani marasa nazari (fahimta) [34, 37]. ]. Waɗannan hanyoyin tunani guda biyu sun ƙunshi ƙalubalen daidaita hanyoyin tunani mafi kyau zuwa yanayi daban-daban, kuma ba a fayyace ba kuma ana jayayya kan yadda ake amfani da hanyoyin nazari da waɗanda ba na nazari ba yadda ya kamata lokacin da akwai manyan da ƙananan mahalarta a cikin ƙungiyar ƙira ɗaya. Ɗaliban makarantar sakandare da ƙananan sakandare masu ƙwarewa da matakan ƙwarewa daban-daban suna shiga cikin yanayin kwaikwayo na rikitarwa daban-daban [34, 37]. Yanayin tunani mai girma da yawa na asibiti yana da alaƙa da yuwuwar haɗarin rashin ci gaba da tunanin asibiti da yawan aiki, musamman lokacin da masu aiki ke shiga cikin ƙungiyoyin SBEs tare da rikitarwa daban-daban na shari'o'i da matakan girma [38]. Yana da mahimmanci a lura cewa kodayake akwai samfuran bayani da 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 yawan bayanai, da abubuwan rikitarwa na ƙira [38]. ], 39]. Duk wannan yana buƙatar haɓaka tsarin tsari wanda ke la'akari da gudummawa daban-daban da abubuwan da ke tasiri don inganta tunanin asibiti, yayin da yake haɗa RLC bayan kwaikwayo azaman hanyar bayar da rahoto. Mun bayyana wani tsari na nazari da tunani da aka tsara ta hanyar ka'ida da kuma manufa don tsara haɗin gwiwa da haɓaka RLC bayan kwaikwayo. An ƙirƙiri wani tsari don inganta ƙwarewar tunani na asibiti yayin shiga cikin SBE, tare da la'akari da abubuwa da yawa na sauƙaƙewa da tasiri don cimma ingantaccen haɓaka tunani na asibiti.
An haɓaka samfurin RLC bayan kwaikwayo tare da haɗin gwiwa bisa ga samfuran da ake da su da ka'idojin tunani na asibiti, koyo mai tunani, ilimi, da kwaikwayo. Don haɓaka samfurin tare, an kafa ƙungiyar aiki tare (N = 18), wanda ya ƙunshi ma'aikatan jinya 10 masu kulawa mai zurfi, mai ƙarfin gwiwa ɗaya, da wakilai uku na marasa lafiya da aka kwantar a asibiti a baya waɗanda suka bambanta a matakai, gogewa, da jinsi. Sashen kulawa mai zurfi ɗaya, mataimakan bincike 2 da manyan malamai na ma'aikatan jinya 2. An tsara wannan sabon abu tare da haɓaka shi ta hanyar haɗin gwiwa tsakanin masu ruwa da tsaki tare da ƙwarewar gaske a fannin kiwon lafiya, ko dai ƙwararrun kiwon lafiya da ke da hannu a cikin haɓaka samfurin da aka gabatar ko wasu masu ruwa da tsaki kamar marasa lafiya [40,41,42]. Haɗa wakilan marasa lafiya a cikin tsarin ƙira tare na iya ƙara ƙima ga tsarin, kamar yadda babban burin shirin shine inganta kula da marasa lafiya da aminci [43].
Ƙungiyar aiki ta gudanar da bita shida na awanni 2-4 don haɓaka tsari, tsari da abubuwan da ke cikin samfurin. Bitar ta ƙunshi tattaunawa, aiki da kwaikwayo. Abubuwan da ke cikin samfurin sun dogara ne akan albarkatu daban-daban na tushen shaida, samfura, ka'idoji da tsare-tsare. Waɗannan sun haɗa da: ka'idar koyon gini [44], ra'ayin madauki biyu [37], madaurin tunani na asibiti [10], hanyar bincike mai godiya (AI) [45], da kuma hanyar bayar da rahoto da ƙari/delta [46]. An haɓaka samfurin tare da haɗin gwiwa bisa ga ƙa'idodin tsarin bayani na INACSL na Ƙungiyar Ma'aikatan Jinya ta Duniya don ilimin asibiti da kwaikwayo [36] kuma an haɗa shi da misalan da aka yi aiki don ƙirƙirar samfurin bayani kai tsaye. An haɓaka samfurin a matakai huɗu: shiri don tattaunawa ta ilmantarwa mai tunani bayan kwaikwayon, fara tattaunawar ilmantarwa mai tunani, bincike/tunani da bayani (Hoto na 1). An tattauna cikakkun bayanai na kowane mataki a ƙasa.
An tsara matakin shirye-shiryen samfurin don shirya mahalarta don mataki na gaba ta hanyar tunani da haɓaka shiga da saka hannun jari yayin da ake tabbatar da amincin tunani [36, 47]. Wannan matakin ya haɗa da gabatarwa ga manufa da manufofin; tsawon lokacin da ake tsammani na RLC; tsammanin mai gudanarwa da mahalarta a lokacin RLC; daidaitawar wurin da saitin kwaikwayo; tabbatar da sirri a cikin yanayin koyo, da haɓaka da haɓaka amincin tunani. An yi la'akari da amsoshin wakilai masu zuwa daga ƙungiyar masu tsara haɗin gwiwa a lokacin matakin haɓakawa na samfurin RLC. Mahalarta 7: "A matsayina na ma'aikacin jinya na farko, idan ina shiga cikin kwaikwayon ba tare da mahallin wani yanayi ba kuma manya suna nan, da alama zan guji shiga cikin tattaunawar bayan kwaikwayon sai dai idan na ji cewa ana girmama lafiyar kwakwalwata. kuma zan guji shiga cikin tattaunawa bayan kwaikwayon. "A kare ni kuma babu wani sakamako." Mahalarta 4: "Ina ganin cewa mai da hankali da kafa ƙa'idodi na asali tun da wuri zai taimaka wa ɗalibai bayan kwaikwayon. Shiga cikin tattaunawar ilmantarwa mai tunani."
Matakan farko na samfurin RLC sun haɗa da bincika yadda mahalarta ke ji, bayyana hanyoyin da ke cikinsa da kuma gano yanayin, da kuma lissafa abubuwan da mahalarta suka fuskanta masu kyau da marasa kyau, amma ba nazari ba. An ƙirƙiri samfurin a wannan matakin ne domin ƙarfafa 'yan takara su kasance masu son kai da kuma aiki, da kuma shirya kansu don zurfafa bincike da zurfafa tunani [24, 36]. Manufar ita ce rage haɗarin da ke tattare da yawan aiki [48], musamman ga waɗanda ba su da ƙwarewa a fannin ƙira kuma ba su da wata gogewa ta asibiti a baya game da ƙwarewa/batu [49]. Neman mahalarta su bayyana yanayin da aka kwaikwayi a takaice kuma su ba da shawarwarin bincike zai taimaka wa mai gudanarwa ya tabbatar da cewa ɗaliban da ke cikin ƙungiyar suna da fahimta ta asali da ta gabaɗaya game da lamarin kafin su ci gaba zuwa matakin nazari/tunani mai tsawo. Bugu da ƙari, gayyatar mahalarta a wannan matakin su raba ra'ayoyinsu a cikin yanayin da aka kwaikwayi zai taimaka musu su shawo kan damuwar motsin rai na yanayin, ta haka ne za su haɓaka koyo [24, 36]. Magance matsalolin motsin rai zai kuma taimaka wa mai gudanarwa na RLC ya fahimci yadda motsin mahalarta ke shafar aikin mutum ɗaya da na rukuni, kuma ana iya tattauna wannan sosai a lokacin lokacin tunani/nazarin. An gina hanyar Plus/Delta a cikin wannan matakin na samfurin a matsayin matakin shiri da yanke shawara don matakin tunani/bincike [46]. Ta amfani da hanyar Plus/Delta, mahalarta da ɗalibai za su iya aiwatarwa/lissafa abubuwan da suka lura, ji da abubuwan da suka faru na kwaikwayon, wanda za a iya tattauna shi daki-daki a lokacin matakin tunani/bincike na samfurin [46]. Wannan zai taimaka wa mahalarta su cimma yanayin metacognitive ta hanyar damar koyo da aka tsara da fifiko don inganta tunanin asibiti [24, 48, 49]. An yi la'akari da amsoshin wakilai masu zuwa daga ƙungiyar aiki tare a lokacin haɓaka samfurin RLC. Mahalarta 2: "Ina tsammanin a matsayina na majiyyaci wanda a da aka shigar da shi cikin ICU, muna buƙatar la'akari da ji da motsin zuciyar ɗaliban da aka kwaikwayi. Ina tayar da wannan batu saboda a lokacin shigata na lura da yawan damuwa da damuwa, musamman tsakanin masu kula da marasa lafiya masu mahimmanci. da yanayi na gaggawa. Wannan samfurin dole ne ya yi la'akari da damuwa da motsin zuciyar da ke tattare da kwaikwayon ƙwarewar." Mahalarta 16: "A gare ni a matsayina na malami, ina ganin yana da matukar muhimmanci a yi amfani da hanyar Plus/Delta don a ƙarfafa ɗalibai su shiga cikin himma ta hanyar ambaton kyawawan abubuwa da buƙatun da suka ci karo da su a lokacin yanayin kwaikwayo. Yankunan da za a inganta."
Duk da cewa matakan da suka gabata na samfurin suna da mahimmanci, matakin nazari/tunani shine mafi mahimmanci don cimma ingantaccen tunani na asibiti. An tsara shi don samar da ci gaba da bincike/haɗawa da zurfin bincike bisa ga ƙwarewar asibiti, ƙwarewa, da tasirin batutuwan da aka tsara; tsari da tsari na RLC; adadin bayanai da aka bayar don guje wa yawan aiki na fahimta; amfani da tambayoyi masu tunani mai kyau. hanyoyin cimma burin mai koyo da kuma ilmantarwa mai aiki. A wannan lokacin, ƙwarewar asibiti da sanin batutuwa na kwaikwayo an raba su zuwa sassa uku don ɗaukar matakai daban-daban na ƙwarewa da iyawa: na farko: babu ƙwarewar asibiti da ta gabata/babu fallasa ga batutuwa na kwaikwayo, na biyu: ƙwarewar asibiti, ilimi da ƙwarewa/babu. fallasa ga batutuwa na ƙira. Na uku: Ƙwarewar asibiti, ilimi da ƙwarewa. Bayyanar ƙwararru/ta baya ga batutuwa na ƙira. An yi rarrabuwar ne don biyan buƙatun mutanen da ke da ƙwarewa daban-daban da matakan iyawa a cikin rukuni ɗaya, don haka daidaita yanayin ƙwararrun da ba su da ƙwarewa don amfani da tunanin nazari tare da halayyar ƙwararrun ƙwararru don amfani da ƙwarewar tunani mara nazari [19, 20, 34]., 37]. An tsara tsarin RLC ne bisa ga zagayowar tunani na asibiti [10], tsarin samfurin tunani [47], da kuma ka'idar ilmantarwa ta gogewa [50]. Ana samun wannan ta hanyar hanyoyi da dama: fassara, bambance-bambance, sadarwa, fahimta da kuma hadawa.
Domin gujewa yawan aiki da fahimta, an yi la'akari da haɓaka tsarin magana mai mai da hankali ga ɗalibi da kuma mai tunani tare da isasshen lokaci da damammaki ga mahalarta don yin tunani, nazari, da kuma haɗa kai don cimma kwarin gwiwa. Ana magance hanyoyin fahimta yayin RLC ta hanyar haɗa kai, tabbatarwa, tsarawa, da kuma haɗa kai bisa ga tsarin madauki biyu [37] da ka'idar nauyin fahimta [48]. Samun tsarin tattaunawa mai tsari da kuma ba da isasshen lokaci don tunani, la'akari da mahalarta masu ƙwarewa da marasa ƙwarewa, zai rage yuwuwar haɗarin nauyin fahimta, musamman a cikin kwaikwayon rikitarwa tare da bambance-bambancen gogewa a baya, fallasa da matakan iyawa na mahalarta. Bayan yanayin. Tsarin tambayoyin tunani na samfurin ya dogara ne akan tsarin Bloom na taxonomic [51] da hanyoyin bincike mai godiya (AI) [45], inda mai gudanarwa mai ƙira ya kusanci batun a mataki-mataki, Socratic, da kuma hanyar tunani. Yi tambayoyi, farawa da tambayoyi masu tushen ilimi. da kuma magance ƙwarewa da batutuwan da suka shafi tunani. Wannan dabarar tambayoyi za ta inganta inganta tunanin asibiti ta hanyar ƙarfafa mahalarta masu aiki da tunani mai ci gaba tare da ƙarancin haɗarin yawan aiki da fahimta. An yi la'akari da waɗannan amsoshi masu wakilci daga ƙungiyar aiki tare a lokacin nazarin/tunani na haɓaka samfurin RLC. Mahalarta 13: "Domin guje wa yawan fahimi, muna buƙatar la'akari da adadin bayanai da kwararar bayanai yayin shiga cikin tattaunawar koyo bayan kwaikwayo, kuma don yin wannan, ina ganin yana da mahimmanci a ba wa ɗalibai isasshen lokaci don yin tunani da farawa da abubuwan asali. Ilimi. yana fara tattaunawa da ƙwarewa, sannan ya koma zuwa manyan matakan ilimi da ƙwarewa don cimma fahimtar juna." Mahalarta 9: "Ina da yakinin cewa hanyoyin yin tambayoyi ta amfani da dabarun Enquiry Inquiry (AI) da tambayoyin tunani ta amfani da samfurin Bloom's Taxonomy za su haɓaka koyo mai aiki da mai da hankali kan mai koyo yayin da suke rage yuwuwar haɗarin yawan fahimi." Matakin yin bayani na samfurin yana da nufin taƙaita abubuwan koyo da aka ɗaga a lokacin RLC da kuma tabbatar da cewa an cimma manufofin koyo. Mahalarta 8: "Yana da matukar muhimmanci cewa mai koyo da mai gudanarwa duka su yarda kan mahimman ra'ayoyi da mahimman fannoni da za a yi la'akari da su yayin shiga aiki."
An sami amincewar ɗabi'a a ƙarƙashin lambobin yarjejeniya (MRC-01-22-117) da (HSK/PGR/UH/04728). An gwada samfurin a cikin kwasa-kwasan kwaikwayo na ƙwararru guda uku na kulawa mai zurfi don kimanta amfani da amfani da kuma amfani da samfurin. An tantance ingancin fuskar samfurin ta hanyar ƙungiyar masu aiki tare (N = 18) da ƙwararrun ilimi waɗanda ke aiki a matsayin daraktocin ilimi (N = 6) don gyara matsalolin da suka shafi kamanni, nahawu, da tsari. Bayan ingancin fuska, manyan malamai na ma'aikatan jinya (N = 6) waɗanda Cibiyar Ba da Shaidar Ma'aikatan Jinya ta Amurka (ANCC) ta ba da takardar shaida kuma suka yi aiki a matsayin masu tsara ilimi, da kuma (N = 6) waɗanda suka yi shekaru sama da 10 na ilimi da koyarwa. Ƙwarewar Aiki Daraktocin ilimi ne suka gudanar da kimantawar (N = 6). Ƙwarewar yin samfuri. An tantance ingancin abun ciki ta amfani da Ratio Ingancin Abun Ciki (CVR) da Ma'aunin Ingancin Abun Ciki (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 lallai ba ne ko zaɓi. Ana ƙididdige CVI akan ma'auni mai maki huɗu bisa ga dacewa, sauƙi, da haske, tare da 1 = ba shi da mahimmanci, 2 = ɗan dacewa, 3 = dacewa, da 4 = mai matukar dacewa. Bayan tabbatar da ingancin fuska da abun ciki, ban da bita na aiki, an gudanar da zaman gabatarwa da gabatarwa ga malamai waɗanda za su yi amfani da samfurin.
Ƙungiyar aikin ta sami damar haɓaka da gwada samfurin RLC bayan kwaikwayo don inganta 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 ingancin fuska da abun ciki da ya dace [52, 53].
An ƙirƙiri samfurin ne don rukunin SBE, inda ake amfani da yanayi masu ban sha'awa da ƙalubale ga mahalarta masu matakai iri ɗaya ko daban-daban na ƙwarewa, ilimi da kuma matsayi. An ƙirƙiri samfurin ra'ayi na RLC bisa ga ƙa'idodin nazarin kwaikwayon jirgin sama na INACSL [36] kuma yana mai da hankali kan koyo kuma yana bayyana kansa, gami da misalan aiki (Figures 1, 2 da 3). An ƙirƙiri samfurin da gangan kuma an raba shi zuwa matakai huɗu don cika ƙa'idodin ƙira: farawa da taƙaitaccen bayani, sannan sai nazarin tunani/haɗin kai, sannan ya ƙare da bayanai da taƙaitawa. Don guje wa haɗarin ɗaukar nauyi na fahimta, kowane mataki na samfurin an tsara shi da gangan azaman abin da ake buƙata don mataki na gaba [34].
Ba a taɓa yin nazarin tasirin matsayi da kuma abubuwan da suka shafi daidaiton rukuni a kan shiga cikin RLC ba [38]. Idan aka yi la'akari da ra'ayoyin aiki na madauki biyu da ka'idar ɗaukar nauyi a cikin aikin kwaikwayo [34, 37], yana da mahimmanci a yi la'akari da cewa shiga cikin rukunin SBE tare da ƙwarewa daban-daban da matakan iyawa na mahalarta a cikin rukunin kwaikwayo ɗaya ƙalubale ne. Sakaci da yawan bayanai, kwarara da tsarin koyo, da kuma amfani da hanyoyin fahimta cikin sauri da jinkiri a lokaci guda ta ɗaliban makarantar sakandare da na sakandare na iya haifar da haɗarin ɗaukar nauyi a hankali [18, 38, 46]. An yi la'akari da waɗannan abubuwan lokacin haɓaka samfurin RLC don guje wa rashin ci gaba da/ko rashin ingantaccen tunani na asibiti [18, 38]. Yana da mahimmanci a yi la'akari da cewa gudanar da RLC tare da matakai daban-daban na girma da ƙwarewa yana haifar da tasiri mai rinjaye tsakanin manyan mahalarta. Wannan yana faruwa ne saboda mahalarta masu ci gaba suna guje wa koyon ra'ayoyi na asali, wanda yake da mahimmanci ga matasa mahalarta don cimma metacognition da shiga cikin manyan tunani da hanyoyin tunani [38, 47]. An tsara tsarin RLC don jan hankalin manyan ma'aikatan jinya da ƙananan ma'aikata ta hanyar yin bincike mai kyau da kuma hanyar delta [45, 46, 51]. Ta amfani da waɗannan hanyoyin, ra'ayoyin manyan da ƙananan ma'aikata masu ƙwarewa daban-daban da matakan ƙwarewa za a gabatar da su kowane abu kuma a tattauna su ta hanyar mai kula da bayanai da masu gudanarwa [45, 51]. Baya ga shigar da mahalarta kwaikwayon, mai gudanarwa yana ƙara gudummawarsu don tabbatar da cewa duk abubuwan da aka lura tare sun rufe kowane lokacin koyo, ta haka yana haɓaka fahimtar juna don inganta tunanin asibiti [10].
Ana magance kwararar bayanai da tsarin koyo ta amfani da tsarin RLC ta hanyar tsari mai tsari da matakai da yawa. Wannan don taimakawa masu gudanarwa su yi bayani da kuma tabbatar da cewa kowane mahalarta yana magana a sarari da kwarin gwiwa a kowane mataki kafin ya ci gaba zuwa mataki na gaba. Mai gudanarwa zai iya fara tattaunawa mai zurfi wanda dukkan mahalarta za su shiga, kuma ya isa ga inda mahalarta masu matsayi daban-daban da matakan ƙwarewa suka yarda kan mafi kyawun ayyuka don kowane batu na tattaunawa kafin ya ci gaba zuwa na gaba [38]. Amfani da wannan hanyar zai taimaka wa mahalarta masu ƙwarewa da ƙwarewa su raba gudummawarsu/lurawarsu, yayin da za a tantance da tattauna gudummawar/lurawar mahalarta marasa ƙwarewa da ƙwarewa [38]. Duk da haka, don cimma wannan burin, masu gudanarwa za su fuskanci ƙalubalen daidaita tattaunawa da samar da damammaki daidai ga manyan da ƙananan mahalarta. Don wannan dalili, an ƙirƙiri hanyar binciken samfurin da gangan ta amfani da samfurin Bloom's taxonomic model, wanda ya haɗa binciken kimantawa da hanyar ƙari/delta [45, 46, 51]. Amfani da waɗannan dabarun da kuma farawa da ilimi da fahimtar tambayoyin da aka mayar da hankali/tattaunawar tunani zai ƙarfafa mahalarta marasa ƙwarewa su shiga da kuma shiga cikin tattaunawar sosai, bayan haka mai gudanarwa zai matsa zuwa wani mataki na kimantawa da haɗa tambayoyin/tattaunawar da ɓangarorin biyu za su bai wa mahalarta Tsofaffi da Matasa damar shiga daidai gwargwado bisa ga ƙwarewarsu ta baya da ƙwarewarsu ta ƙwarewa a asibiti ko yanayin da aka kwaikwayi. Wannan hanyar za ta taimaka wa mahalarta marasa ƙwarewa su shiga cikin aiki da kuma amfana daga gogewar da mahalarta masu ƙwarewa suka raba da kuma shigar da mai gudanarwa na tattaunawa. A gefe guda kuma, an tsara samfurin ba wai kawai ga SBEs masu ƙwarewa da matakan ƙwarewa daban-daban ba, har ma ga mahalarta ƙungiyar SBE masu irin wannan ƙwarewa da ƙwarewa. An tsara samfurin don sauƙaƙe motsi mai santsi da tsari na ƙungiyar daga mai da hankali kan ilimi da fahimta zuwa mai da hankali kan haɗawa da kimantawa don cimma burin koyo. Tsarin samfurin da hanyoyin an tsara su ne don dacewa da ƙungiyoyin kwaikwayo na iyawa daban-daban da daidaito da matakan ƙwarewa.
Bugu da ƙari, kodayake ana amfani da SBE a fannin kiwon lafiya tare da RLC don haɓaka tunani 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 rikitarwar shari'o'i da yuwuwar haɗarin yawan aiki na fahimta, musamman lokacin da Mahalarta suka shiga cikin yanayin SBE sun kwaikwayi marasa lafiya masu rikitarwa, masu fama da rashin lafiya mai tsanani waɗanda ke buƙatar shiga tsakani nan take da yanke shawara mai mahimmanci [2,18,37,38,47,48]. Don haka, yana da mahimmanci a yi la'akari da yanayin mahalarta masu ƙwarewa da waɗanda ba su da ƙwarewa su canza tsakanin tsarin tunani na nazari da wanda ba na nazari ba yayin shiga cikin SBE, da kuma kafa hanyar da ta dogara da shaida wacce ke ba wa manyan ɗalibai da ƙananan damar shiga cikin tsarin koyo. Don haka, an tsara samfurin ta yadda, ba tare da la'akari da sarkakiyar shari'ar da aka gabatar ba, mai gudanarwa dole ne ya tabbatar da cewa an fara rufe ɓangarorin ilimi da fahimtar asali na manyan da ƙananan mahalarta sannan a hankali kuma a hankali don sauƙaƙe bincike. haɗawa da fahimta. ɓangaren kimantawa. Wannan zai taimaka wa ƙananan ɗalibai ginawa da haɗa abin da suka koya, da kuma taimaka wa tsofaffin ɗalibai su haɗa da haɓaka sabbin ilimi. Wannan zai cika buƙatun tsarin tunani, idan aka yi la'akari da gogewa da iyawar kowane mahalarci a baya, kuma yana da tsari na gaba ɗaya wanda ke magance yanayin ɗaliban makarantar sakandare da ƙananan makarantun sakandare na canzawa a lokaci guda tsakanin tsarin tunani na nazari da wanda ba na nazari ba, don haka tabbatar da inganta tunanin asibiti.
Bugu da ƙari, masu gudanarwa/masu ba da shawara kan kwaikwayo na iya samun matsala wajen ƙwarewa a fannin nazarin kwaikwayon. Ana kyautata zaton amfani da rubutun nazarin fahimtar juna yana da tasiri wajen inganta ilimin da ƙwarewar ɗabi'un masu gudanarwa idan aka kwatanta da waɗanda ba sa amfani da rubutun [54]. Yanayi kayan aiki ne na fahimta wanda zai iya sauƙaƙe aikin ƙira na malamai da kuma inganta ƙwarewar yin bayani, musamman ga malamai waɗanda har yanzu suna haɗa ƙwarewar yin bayani [55]. suna samun ƙarin amfani da kuma haɓaka samfuran da suka dace da mai amfani. (Hoto na 2 da Hoto na 3).
Ba a magance haɗakar da aka yi a lokaci guda tsakanin plus/delta, binciken godiya, da hanyoyin binciken Taxonomy na Bloom ba tukuna a cikin nazarin kwaikwayo da samfuran tunani mai jagora. Haɗakar waɗannan hanyoyin yana nuna sabuwar hanyar samfurin RLC, inda aka haɗa waɗannan hanyoyin a cikin tsari ɗaya don cimma inganta tunanin asibiti da kuma mai da hankali kan koyo. Masu koyar da likitanci na iya amfana daga ƙungiyar SBE ta yin amfani da samfurin RLC don inganta da haɓaka ƙwarewar tunani na asibiti na mahalarta. Yanayin samfurin na iya taimaka wa malamai su ƙware kan tsarin yin bayani mai zurfi da ƙarfafa ƙwarewarsu don zama masu gudanarwa masu ƙwarewa da kwarin gwiwa.
SBE na iya haɗawa da hanyoyi da dabaru daban-daban, gami da amma ba'a iyakance ga SBE mai tushen mannequin ba, na'urorin kwaikwayo na aiki, na'urorin kwaikwayo na marasa lafiya, marasa lafiya na yau da kullun, da kuma gaskiyar da aka ƙara. Idan aka yi la'akari da cewa rahoto yana ɗaya daga cikin mahimman sharuɗɗan ƙira, ana iya amfani da samfurin RLC da aka kwaikwayi a matsayin samfurin bayar da rahoto lokacin amfani da waɗannan hanyoyin. Bugu da ƙari, kodayake an ƙirƙiri samfurin don fannin aikin jinya, yana da yuwuwar amfani da shi a cikin SBE na kiwon lafiya na ƙwararru, yana nuna buƙatar shirye-shiryen bincike na gaba don gwada samfurin RLC don ilimin ƙwararru.
Haɓakawa da kimantawa na samfurin RLC bayan kwaikwayo don kula da ma'aikatan jinya a cikin sassan kulawa mai zurfi na SBE. Ana ba da shawarar kimantawa/tabbatar da samfurin nan gaba don ƙara yawan amfani da samfurin a wasu fannoni na kiwon lafiya da kuma SBE na ƙwararru.
An ƙirƙiro wannan samfurin ta hanyar ƙungiyar aiki ta haɗin gwiwa bisa ga ka'ida da ra'ayi. Domin inganta inganci da kuma fahimtar tsarin gabaɗaya, ana iya la'akari da amfani da ingantattun ma'aunin aminci don nazarin kwatantawa a nan gaba.
Domin rage kurakuran aiki, dole ne masu aiki su mallaki ingantattun dabarun tunani na asibiti don tabbatar da aminci da dacewa da yanke shawara na asibiti. Amfani da SBE RLC a matsayin dabarar yin bayani yana haɓaka ci gaban ilimi da ƙwarewar aiki da ake buƙata don haɓaka tunani na asibiti. Duk da haka, yanayin tunani mai girma da yawa na asibiti, wanda ya shafi gogewa da fallasa a baya, canje-canje a cikin iyawa, girma da kwararar bayanai, da kuma sarkakiyar yanayin kwaikwayo, yana nuna mahimmancin haɓaka samfuran RLC bayan kwaikwayo wanda za a iya aiwatar da tunanin asibiti da kyau. Yin watsi da waɗannan abubuwan na iya haifar da ƙarancin ci gaba da rashin ingantaccen tunani na asibiti. An haɓaka samfurin RLC don magance waɗannan abubuwan don inganta tunanin asibiti lokacin shiga cikin ayyukan kwaikwayo na rukuni. Don cimma wannan burin, samfurin a lokaci guda yana haɗa binciken kimantawa da ƙari/rage da amfani da tsarin Bloom.
Bayanan da aka yi amfani da su da/ko aka yi nazari a kansu a lokacin binciken na yanzu suna samuwa daga marubucin da ya dace bisa ga buƙata mai ma'ana.
Daniel M, Rencic J, Durning SJ, Holmbo E, Santen SA, Lang W, Ratcliffe T, Gordon D, Heist B, Lubarski S, Estrada KA. Hanyoyin tantance dalilan asibiti: Bita da shawarwarin aiki. Kwalejin Kimiyyar Likitanci. 2019;94(6):902–12.
Young ME, Thomas A., Lubarsky S., Gordon D., Gruppen LD, Rensich J., Ballard T., Holmboe E., Da Silva A., Ratcliffe T., Schuwirth L. Kwatanta adabi kan tunani na asibiti tsakanin sana'o'in kiwon lafiya: bita kan ma'auni. BMC Medical Education. 2020;20(1):1–1.
Guerrero JG. Tsarin Hulɗar Aikin Jinya: Fasaha da Kimiyyar Hulɗar Asibiti, Yanke Shawara, da Hukunci a Aikin Jinya. Buɗe littafin ma'aikacin jinya. 2019;9(2):79–88.
Almomani E, Alraouch T, Saada O, Al Nour A, Kamble M, Samuel J, Atallah K, Mustafa E. Tattaunawar ilmantarwa a matsayin hanyar koyo da koyarwa na asibiti a cikin kulawa mai mahimmanci. Jaridar Medical Qatar. 2020; 2019; 1 (1): 64.
Mamed S., Van Gogh T., Sampaio AM, de Faria RM, Maria JP, Schmidt HG Ta yaya ƙwarewar ganewar asali na ɗalibai ke amfana daga aiki tare da shari'o'in asibiti? Tasirin tunani mai tsari akan gano cututtuka iri ɗaya da sababbi nan gaba. Kwalejin Kimiyyar Likitanci. 2014;89(1):121–7.
Tutticci N, Theobald KA, Ramsbotham J, Johnston S. Binciken ayyukan masu lura da kuma dalilan asibiti a cikin kwaikwayon: bita kan nazarin ma'auni. Aikin Ilimi na Ma'aikatan Jinya 2022 Janairu 20: 103301.
Edwards I, Jones M, Carr J, Braunack-Meyer A, Jensen GM. Dabaru na tunani na asibiti a fannin ilimin motsa jiki. Ilimin motsa jiki. 2004;84(4):312–30.
Kuiper R, Pesut D, Kautz D. Haɓaka ikon sarrafa kai na ƙwarewar tunani ta asibiti a cikin ɗaliban likitanci. Buɗe Mujallar Ma'aikaciyar Jinya 2009;3:76.
Levett-Jones T, Hoffman K, Dempsey J, Jeon SY, Noble D, Norton KA, Roche J, Hickey N. “Hakkoki Biyar” na Dalilan Asibiti: Tsarin Ilimi don Inganta Ƙwarewar Asibiti ga ɗaliban jinya wajen gano da kuma kula da marasa lafiya da ke cikin haɗari. Ilimin jinya a yau. 2010;30(6):515–20.
Brentnall J, Thackray D, Judd B. Kimanta tunanin asibiti na ɗaliban likitanci a cikin wurin aiki da saitunan kwaikwayo: bita mai tsari. Mujallar Duniya ta Binciken Muhalli, Lafiyar Jama'a. 2022;19(2):936.
Chamberlain D, Pollock W, Fulbrook P. Ka'idojin ACCCN don Kula da Jinya Mai Muhimmanci: Bita Mai Tsari, Ci gaban Shaida da Kimantawa. Gaggawa ta Ostiraliya. 2018;31(5):292–302.
Cunha LD, Pestana-Santos M, Lomba L, Reis Santos M. Rashin tabbas a cikin tunanin asibiti a cikin kulawar bayan an yi maganin sa barci: bita mai haɗaka bisa ga samfuran rashin tabbas a cikin saitunan kiwon lafiya masu rikitarwa. J Perioperative Nurse. 2022;35(2):e32–40.
Rivaz M, Tavakolinia M, Momennasab M. Yanayin aikin ƙwararru na ma'aikatan jinya masu kulawa mai mahimmanci da alaƙarsa da sakamakon aikin jinya: nazarin ƙirar tsarin daidaito. Scand J Caring Sci. 2021;35(2):609–15.
Suvardianto H, Astuti VV, Ƙwarewa. Mujallar Musayar Mujallar Kula da Jinya da Ayyukan Kulawa Masu Muhimmanci ga Ma'aikatan Jinya na Ɗalibai a Sashen Kulawa Masu Muhimmanci (JSCC). MUJALLAR STRADA Ilmia Kesehatan. 2020;9(2):686–93.
Liev B, Dejen Tilahun A, Kasyu T. Ilimi, halaye da abubuwan da ke da alaƙa da kimantawar jiki tsakanin ma'aikatan jinya na sashin kulawa mai zurfi: nazarin sassa daban-daban. Aikin bincike a cikin kulawa mai mahimmanci. 2020;9145105.
Sullivan J., Hugill K., A. Elraush TA, Mathias J., Alkhetimi MO Tsarin gwaji na aiwatar da tsarin ƙwarewa ga ma'aikatan jinya da ungozoma a cikin yanayin al'adun ƙasar Gabas ta Tsakiya. Aikin ilimin ma'aikatan jinya. 2021;51:102969.
Wang MS, Thor E, Hudson JN. Gwaji ingancin tsarin amsawa a cikin gwaje-gwajen daidaiton rubutu: Hanyar tunani mai ƙarfi. Mujallar Duniya ta Ilimi kan Lafiya. 2020;11:127.
Kang H, Kang HY. Tasirin ilimin kwaikwayo kan ƙwarewar tunani na asibiti, ƙwarewar asibiti, da gamsuwar ilimi. J Korea Academic and Industrial Cooperation Association. 2020;21(8):107–14.
Diekmann P, Thorgeirsen K, Kvindesland SA, Thomas L, Bushell W, Langley Ersdal H. Amfani da samfura don shiryawa da inganta martani ga barkewar cututtuka masu yaduwa kamar COVID-19: nasihu da albarkatu masu amfani daga Norway, Denmark da Burtaniya. Tsarin ƙira na zamani. 2020;5(1):1–0.
Liose L, Lopreiato J, Wanda ya kafa D, Chang TP, Robertson JM, Anderson M, Diaz DA, Spain AE, editoci. (Mataimakin Edita) da Ƙungiyar Aiki ta Kalmomi da Manufofi, Ƙamus na Tsarin Kula da Lafiya - Bugu na Biyu. Rockville, MD: Hukumar Bincike da Inganci na Lafiya. Janairu 2020: 20-0019.
Brooks A, Brachman S, Capralos B, Nakajima A, Tyerman J, Jain L, Salvetti F, Gardner R, Minehart R, Bertagni B. Gaskiyar da aka ƙara don kwaikwayon kiwon lafiya. Sabbin ci gaba a cikin fasahar zamani ta marasa lafiya don jin daɗin haɗin kai. Gamification da kwaikwayo. 2020;196:103–40.
Alamrani MH, Alammal KA, Alqahtani SS, Salem OA Kwatanta tasirin kwaikwayon kwaikwayo da hanyoyin koyarwa na gargajiya akan ƙwarewar tunani mai zurfi da kuma amincewa da kai ga ɗaliban aikin jinya. J Nursing Research Center. 2018;26(3):152–7.
Kiernan LK Kimanta iyawa da kwarin gwiwa ta amfani da dabarun kwaikwayo. Kulawa. 2018;48(10):45.
Lokacin Saƙo: Janairu-08-2024