Tun bayan bullar cutar COVID-19, kasar ta fara mai da hankali sosai kan aikin koyarwa na asibitocin jami'o'i.Ƙarfafa haɗin gwiwar likitanci da ilimi da inganta inganci da ingancin koyarwar asibiti manyan kalubale ne da ke fuskantar ilimin likitanci.Wahalar koyar da ilimin kasusuwa ya ta'allaka ne a cikin nau'ikan cututtuka iri-iri, ƙwararrun ƙwararru da ingantattun halaye, waɗanda ke yin tasiri ga himma, sha'awa da ingancin koyarwar ɗaliban likitanci.Wannan binciken ya ɓullo da tsarin koyarwa na aji da aka jujjuya bisa ra'ayin CDIO (Concept-Design-Implement-Operate) kuma ya aiwatar da shi a cikin kwas ɗin horar da ɗaliban jinya na orthopedic don haɓaka tasirin ilmantarwa mai amfani da kuma taimaka wa malamai su fahimci jujjuya makomar ilimin reno har ma ilimin likitanci.Koyon aji zai fi tasiri da mai da hankali.
Dalibai 50 na likitanci waɗanda suka kammala horon horo a sashin orthopedic na babban asibitin a watan Yuni 2017 an haɗa su cikin ƙungiyar kulawa, kuma ɗaliban jinya 50 waɗanda suka kammala horon horo a cikin sashen a watan Yuni 2018 an haɗa su cikin ƙungiyar shiga tsakani.Ƙungiya mai shiga tsakani ta ɗauki ra'ayin CDIO na tsarin koyarwa ajujuwa, yayin da ƙungiyar kulawa ta ɗauki tsarin koyarwa na gargajiya.Bayan kammala ayyuka masu amfani na sashen, an tantance ƙungiyoyi biyu na ɗalibai akan ka'idar, ƙwarewar aiki, ƙwarewar ilmantarwa mai zaman kanta da ƙwarewar tunani mai zurfi.Ƙungiyoyin malamai biyu sun kammala matakan takwas da ke tantance iyawar aikin asibiti, ciki har da hanyoyin jinya guda huɗu, ƙarfin jinya na ɗan adam, da kimanta ingancin koyarwar asibiti.
Bayan horarwa, ƙwarewar aikin asibiti, ƙwarewar tunani mai mahimmanci, ikon ilmantarwa mai zaman kanta, ka'idar aiki da aikin aiki, da ƙimar koyarwar koyarwa na ƙungiyar masu shiga tsakani sun kasance mafi girma fiye da na ƙungiyar kulawa (duk P <0.05).
The teaching model based on CDIO can stimulate nursing interns' independent learning and critical thinking ability, promote the organic combination of theory and practice, improve their ability to comprehensively use theoretical knowledge to analyze and solve practical problems, and improve the learning effect.
Ilimin asibiti shine mafi mahimmancin mataki na ilimin jinya kuma ya haɗa da sauyawa daga ilimin ka'idar zuwa aiki.Ingantacciyar koyo na asibiti na iya taimaka wa ɗaliban reno su mallaki ƙwarewar sana'a, ƙarfafa ilimin ƙwararru, da haɓaka ƙwarewar aikin aikin jinya.Hakanan shine matakin ƙarshe na canjin matsayin aiki ga ɗaliban likitanci [1].A cikin 'yan shekarun nan, yawancin masu bincike na koyarwa na asibiti sun gudanar da bincike kan hanyoyin koyarwa irin su ilmantarwa na tushen matsala (PBL), ilmantarwa na tushen shari'a (CBL), ilmantarwa na ƙungiya (TBL), da kuma ilmantarwa na yanayi da kuma ilmantarwa na yanayi a cikin koyarwar asibiti. ..Duk da haka, hanyoyin koyarwa daban-daban suna da fa'ida da rashin amfaninsu dangane da tasirin ilmantarwa na haɗin kai, amma ba su cimma haɗakar ka'idar da aiki ba [2].
“Ajujuwan jujjuya” na nufin sabon tsarin ilmantarwa wanda ɗalibai ke amfani da takamaiman dandali na bayanai don yin nazarin nau'ikan kayan ilimi daban-daban kafin aji da kuma kammala aikin gida a cikin nau'i na "ilimin haɗin gwiwa" a cikin aji yayin da malamai ke jagorantar ɗalibai.Amsa tambayoyi da ba da taimako na keɓaɓɓen[3].Ƙungiyar Sabbin Watsa Labarai ta Amirka ta lura cewa ajujuwan da aka juye suna daidaita lokaci a ciki da wajen aji kuma suna canja shawarar koyan ɗalibai daga malamai zuwa ɗalibai [4].Mahimman lokacin da aka yi amfani da shi a cikin aji a cikin wannan ƙirar koyo yana bawa ɗalibai damar mai da hankali kan aiki, koyo na tushen matsala.Deshpande [5] ya gudanar da wani nazari a kan jujjuya ajujuwa a cikin ilimin motsa jiki da koyarwa kuma ya kammala cewa jujjuyawar aji na iya inganta sha'awar koyon ɗalibai da aikin ilimi da rage lokacin aji.Khe Fung HEW da Chung Kwan LO [6] sun yi nazarin sakamakon bincike na kasidu na kwatankwacin kan ajujuwan da aka jujjuya su kuma sun taƙaita tasirin hanyar koyarwa a aji da aka jujjuya ta hanyar nazari mai ma'ana, wanda ke nuna cewa idan aka kwatanta da hanyoyin koyarwa na gargajiya, hanyar koyarwa a aji ta juye. a cikin sana'a ilimin kiwon lafiya yana da kyau sosai kuma yana inganta ilmantarwa na dalibai.Zhong Jie [7] ya kwatanta illar jujjuyawar ajujuwa ta zahiri da jujjuyawar koyo na zahiri a kan ilimin ɗalibai, ya kuma gano cewa, a cikin aiwatar da koyo na gauraye a cikin azuzuwan tarihi na jujjuyawar, haɓaka ingancin koyarwa ta yanar gizo na iya haɓaka gamsuwar ɗalibai kuma ilimi.rike.Dangane da sakamakon binciken da ke sama, a fagen ilimin jinya, yawancin malamai suna nazarin tasirin juzu'i a kan tasirin koyarwa a aji kuma sun yi imanin cewa jujjuyawar koyarwar ajujuwa na iya inganta aikin ɗaliban reno, ikon koyo mai zaman kansa, da gamsuwar aji.
Sabili da haka, akwai buƙatar gaggawa don ganowa da haɓaka sabuwar hanyar koyarwa wacce za ta taimaka wa ɗaliban renon yara su sha da aiwatar da ilimin ƙwararrun ƙwararrun tsari da haɓaka ƙwarewar aikin su na asibiti da ingantaccen inganci.CDIO (Concept-Design-Implement-Operate) samfurin ilimin injiniya ne wanda jami'o'i huɗu suka haɓaka a cikin 2000, gami da Cibiyar Fasaha ta Massachusetts da Cibiyar Fasaha ta Royal a Sweden.Babban samfurin ilimin injiniya ne wanda ke ba wa ɗaliban reno damar koyo da samun damar iya aiki a cikin aiki, hannu-kan, da tsarin halitta [8, 9].Dangane da ainihin koyo, wannan samfurin yana jaddada "ɗalibi-tsakanin ɗalibi," ba da damar ɗalibai su shiga cikin tunani, ƙira, aiwatarwa, da kuma gudanar da ayyukan, da kuma canza ilimin da aka samu zuwa kayan aikin warware matsala.Yawancin karatu sun nuna cewa tsarin koyarwa na CDIO yana ba da gudummawa don inganta ƙwarewar aikin asibiti da cikakkiyar ingancin ɗaliban likitanci, haɓaka hulɗar malami da ɗalibi, inganta ingantaccen koyarwa, kuma yana taka rawa wajen haɓaka sauye-sauyen sanarwa da inganta hanyoyin koyarwa.Ana amfani da shi sosai a cikin horarwar baiwa da aka yi amfani da shi [10].
Tare da sauye-sauyen tsarin likitancin duniya, bukatun mutane na kiwon lafiya na karuwa, wanda kuma ya haifar da karuwar nauyin ma'aikatan lafiya.Ƙwarewa da ingancin ma'aikatan jinya suna da alaƙa kai tsaye da ingancin kulawar asibiti da amincin haƙuri.A cikin 'yan shekarun nan, haɓakawa da kima na iyawar asibiti na ma'aikatan jinya ya zama babban batu a fagen jinya [11].Sabili da haka, hanya mai mahimmanci, cikakke, abin dogaro, kuma ingantacciyar hanyar tantancewa tana da mahimmanci ga binciken ilimin likitanci.The mini-clinical kimantawa motsa jiki (mini-CEX) wata hanya ce don tantance cikakken iyawar asibiti na ɗaliban likitanci kuma ana amfani dashi sosai a fagen ilimin likitanci da yawa a gida da waje.A hankali ya bayyana a fagen jinya [12, 13].
An gudanar da bincike da yawa akan aikace-aikacen samfurin CDIO, juzu'i na aji, da ƙaramin CEX a cikin ilimin jinya.Wang Bei [14] ya tattauna tasirin samfurin CDIO akan inganta takamaiman horo na ma'aikatan jinya don bukatun ma'aikatan jinya na COVID-19.Sakamakon ya nuna cewa yin amfani da tsarin horo na CDIO don ba da horo na musamman na aikin jinya kan COVID-19 zai taimaka wa ma'aikatan jinya samun ƙwarewar horar da jinya na musamman da ilimin da ke da alaƙa, da haɓaka cikakkiyar ƙwarewar aikin jinya.Masana irin su Liu Mei [15] sun tattauna yadda ake amfani da hanyar koyarwa ta ƙungiya tare da jujjuyawar aji a cikin horar da ma'aikatan jinya.Sakamakon ya nuna cewa wannan ƙirar koyarwa na iya inganta ingantaccen ƙwarewar ma'aikatan jinya na ƙasusuwa kamar fahimta.da aikace-aikacen ilimin ka'idar, aiki tare, tunani mai mahimmanci, da binciken kimiyya.Li Ruyu et al.[16] yayi nazarin tasirin amfani da ingantaccen Nursing Mini-CEX a cikin daidaitattun horo na sababbin ma'aikatan aikin jinya kuma sun gano cewa malamai za su iya amfani da Nursing Mini-CEX don kimanta duk tsarin ƙima da aikin aiki a cikin koyarwar asibiti ko aiki. ita.ma'aikatan jinya da kuma bayar da ra'ayi na ainihi.Ta hanyar tsarin kula da kai da tunani, ana koyon mahimman abubuwan kimanta aikin aikin jinya, ana daidaita tsarin karatun, an ƙara inganta ingancin koyarwar asibiti, an inganta ingantaccen aikin jinya na ɗalibai na tiyata, da jujjuya su. An gwada haɗin aji bisa ra'ayin CDIO, amma a halin yanzu babu rahoton bincike.Aikace-aikacen ƙirar ƙima na mini-CEX zuwa ilimin jinya ga ɗaliban orthopedic.Marubucin ya yi amfani da tsarin CDIO don haɓaka darussan horarwa ga ɗaliban jinya na orthopedic, ya gina aji mai jujjuya bisa ra'ayin CDIO, kuma an haɗa shi tare da ƙirar ƙima ta mini-CEX don aiwatar da koyo na uku-biyu da ƙirar inganci.ilimi da iyawa, sannan kuma sun ba da gudummawa wajen inganta ingancin koyarwa.Ci gaba da haɓakawa yana ba da tushe don koyo na tushen aiki a asibitocin koyarwa.
Don sauƙaƙe aiwatar da kwas ɗin, an yi amfani da hanyar samfur mai dacewa a matsayin batutuwan karatu don zaɓar ɗaliban jinya daga 2017 da 2018 waɗanda ke aiki a sashin kasusuwa na babban asibiti.Tun da akwai masu horar da 52 a kowane mataki, girman samfurin zai zama 104. Dalibai hudu ba su shiga cikin cikakken aikin asibiti ba.Ƙungiyar kulawa ta haɗa da ɗaliban jinya 50 waɗanda suka kammala horon horo a sashen orthopedic na babban asibiti a watan Yuni 2017, wanda 6 maza da mata 44 masu shekaru 20 zuwa 22 (21.30 ± 0.60), wanda ya kammala horon horo a wannan sashen. a cikin Yuni 2018. Ƙungiyar shiga tsakani ta haɗa da daliban likita na 50, ciki har da maza 8 da mata 42 masu shekaru 21 zuwa 22 (21.45 ± 0.37).Duk batutuwa sun ba da izini dalla-dalla.Sharuɗɗan haɗawa: (1) Daliban horon likitancin Orthopedic tare da digiri na farko.(2) Bayanin yarda da shiga na son rai a cikin wannan binciken.Ma'auni na keɓancewa: Mutanen da ba su da ikon shiga cikin aikin asibiti.Babu wani bambanci mai mahimmanci a cikin cikakken bayanin ƙungiyoyin biyu na ɗaliban ɗaliban likitanci (p>0.05) kuma suna kama da juna.
Dukansu ƙungiyoyi sun kammala aikin horo na asibiti na mako 4, tare da duk darussan da aka kammala a cikin Ma'aikatar Orthopedics.A lokacin lura, an sami jimlar ƙungiyoyi 10 na ɗaliban likitanci, ɗalibai 5 a kowace ƙungiya.Ana gudanar da horarwa daidai da shirin horarwa don ɗaliban jinya, gami da sassa na ka'ida da fasaha.Malaman kungiyoyin biyu suna da cancanta iri daya, kuma malamin nas ne ke da alhakin lura da ingancin koyarwa.
Ƙungiyar kulawa ta yi amfani da hanyoyin koyarwa na gargajiya.A cikin makon farko na makaranta, a ranar Litinin za a fara karatu.Malamai suna koyar da ka'idar a ranakun Talata da Laraba, kuma suna mai da hankali kan horar da aiki a ranakun Alhamis da Juma'a.Daga mako na biyu zuwa na hudu, kowane malami yana da alhakin ɗalibin likitanci yana ba da laccoci na lokaci-lokaci a sashen.A mako na hudu, za a kammala tantancewa kwanaki uku kafin kammala karatun.
Kamar yadda aka ambata a baya, marubucin ya ɗauki hanyar koyarwar aji da aka jujjuya bisa ra'ayin CDIO, kamar yadda aka yi cikakken bayani a ƙasa.
Makon farko na horo daidai yake da a cikin ƙungiyar kulawa;Makonni biyu zuwa hudu na horon aikin tiyata na orthopedic suna amfani da tsarin koyarwar aji da aka juye bisa manufar CDIO na tsawon sa'o'i 36.An kammala sashin tunani da zane a cikin mako na biyu kuma an kammala aikin aiwatarwa a cikin mako na uku.An kammala aikin tiyata a mako na hudu, kuma an kammala tantancewa da tantancewa kwanaki uku kafin a fitar da su.Duba Tebu 1 don takamaiman rabon lokacin aji.
An kafa ƙungiyar koyarwa da ta ƙunshi babban ma'aikacin jinya 1, jami'ar orthopedic 8 da 1 ƙwararren ma'aikacin jinya na CDIO ba na kashin baya ba.Babban ma'aikacin jinya yana ba wa membobin ƙungiyar koyarwa tare da nazari da ƙwararrun tsarin karatun CDIO da ƙa'idodi, littafin bita na CDIO da sauran ka'idoji masu alaƙa da takamaiman hanyoyin aiwatarwa (aƙalla sa'o'i 20), tare da tuntuɓar masana a kowane lokaci kan batutuwan koyarwa masu rikitarwa. .Makarantar ta tsara manufofin koyo, sarrafa tsarin karatu, da shirya darussa a daidaitaccen tsari daidai da buƙatun reno manya da shirin zama.
Dangane da shirin horarwa, dangane da shirin horar da baiwa na CDIO da ma'auni [17] kuma a hade tare da halayen koyarwa na ma'aikaciyar jinya, an saita makasudin koyo na ƙwararrun ma'aikatan jinya a cikin matakai uku, wato: manufofin ilimi (ƙwarewar asali. ilimi), ilimin ƙwararru da tsarin tsarin da ke da alaƙa, da sauransu), ƙwararrun maƙasudan (inganta ƙwarewar ƙwararrun ƙwararru, ƙwarewar tunani mai mahimmanci da ƙwarewar ilmantarwa mai zaman kanta, da sauransu) da ingantattun maƙasudai (gina ƙimar ƙwararrun ƙwararrun ƙwararru da ruhun kulawa da ɗan adam da sauransu)..).Makasudin ilimi sun dace da ilimin fasaha da tunani na tsarin karatun CDIO, iyawar mutum, iyawar ƙwararru da alaƙar tsarin karatun CDIO, da ingantattun maƙasudai sun dace da ƙwarewar taushi na tsarin karatun CDIO: aiki tare da sadarwa.
Bayan zagaye biyu na tarurruka, ƙungiyar koyarwa ta tattauna tsarin koyar da aikin jinya a cikin aji mai jujjuya bisa ra'ayin CDIO, an raba horon zuwa matakai huɗu, kuma ya ƙaddara manufa da ƙira, kamar yadda aka nuna a cikin Table 1.
Bayan nazarin aikin jinya a kan cututtuka na kasusuwa, malamin ya gano lokuta na yau da kullum da cututtuka na kasusuwa.Bari mu dauki tsarin kula da marasa lafiya da ke fama da ciwon lumbar a matsayin misali: Majiyyaci Zhang Moumou (namiji, mai shekaru 73, tsayinsa 177 cm, nauyi 80) ya koka da "ƙananan ciwon baya tare da raguwa da jin zafi a cikin ƙananan ƙafar hagu don Wata 2” kuma an kwantar da shi a wani asibitin waje.A matsayin majiyyaci ma'aikacin jinya: (1) Da fatan za a tambayi tarihin mara lafiya bisa tsari bisa ilimin da kuka samu kuma ku tantance abin da ke faruwa da majiyyaci;(2) Zaɓi tsarin bincike na tsari da hanyoyin ƙima na ƙwararru dangane da yanayin da kuma ba da shawarar tambayoyin binciken da ke buƙatar ƙarin kimantawa;(3) Yi gwajin jinya.A wannan yanayin, wajibi ne a haɗa bayanan binciken harka;rikodin ayyukan jinya da aka yi niyya da suka shafi mai haƙuri;(4) Tattauna matsalolin da ake da su a cikin kula da kai na haƙuri, da kuma hanyoyin da ake amfani da su a halin yanzu da abun ciki na bibiyar haƙuri a kan fitarwa.Buga labarun ɗalibi da jerin ayyuka kwanaki biyu kafin aji.Lissafin aiki na wannan yanayin shine kamar haka: (1) Bincika da ƙarfafa ilimin ka'idoji game da ilimin ilimin lissafi da kuma bayyanar cututtuka na lumbar intervertebral disc herniation;(2) Ƙirƙirar tsarin kulawa da aka yi niyya;(3) Haɓaka wannan shari'ar bisa ga aikin asibiti da aiwatar da aikin da aka rigaya da kuma kulawar bayan aiki sune manyan al'amuran biyu na kwaikwayo na aikin koyarwa.Daliban ma'aikatan jinya da kansu suna nazarin abun ciki na kwas tare da tambayoyin aiki, tuntuɓar wallafe-wallafen da suka dace da bayanan bayanai, da kammala ayyukan binciken kai ta hanyar shiga cikin rukunin WeChat.
Dalibai suna kafa ƙungiyoyi cikin 'yanci, kuma ƙungiyar ta zaɓi shugaban ƙungiyar wanda ke da alhakin rarraba aiki da daidaita aikin.Shugaban kungiyar na farko shine ke da alhakin yada abubuwa hudu: gabatarwar shari'a, aiwatar da aikin jinya, ilimin kiwon lafiya, da ilimin da ke da alaƙa da cututtuka ga kowane memba na ƙungiyar.A lokacin horon, ɗalibai suna amfani da lokacinsu na kyauta don bincika tushen ka'idar ko kayan don magance matsalolin shari'a, gudanar da tattaunawar ƙungiya, da haɓaka takamaiman tsare-tsaren ayyukan.A cikin ci gaban aikin, malamin yana taimaka wa jagoran tawagar wajen ba da 'yan kungiya don tsara ilimin da suka dace, haɓakawa da samar da ayyuka, nunawa da kuma gyara zane-zane, da kuma taimakawa dalibai masu jinya wajen haɗa ilimin da suka shafi aiki a cikin ƙira da samarwa.Samun ilimin kowane module.An yi nazari da haɓaka ƙalubalen da mahimman abubuwan wannan rukunin bincike, kuma an aiwatar da shirin aiwatarwa don ƙirar yanayin wannan rukunin bincike.A wannan lokaci, malamai sun kuma shirya zagayen zanga-zangar jinya.
Dalibai suna aiki a ƙananan ƙungiyoyi don gabatar da ayyuka.Bayan rahoton, sauran membobin kungiyar da membobin kungiyar sun tattauna tare da yin tsokaci kan rukunin bayar da rahoto don kara inganta tsarin kula da jinya.Jagoran ƙungiyar yana ƙarfafa membobin ƙungiyar don yin kwatancen tsarin kulawa duka, kuma malamin yana taimaka wa ɗalibai su bincika sauye-sauyen sauye-sauye na cuta ta hanyar kwaikwayo, zurfafa fahimtarsu da gina ilimin ka'idar, da haɓaka ƙwarewar tunani.Dukkan abubuwan da dole ne a kammala a cikin ci gaban cututtuka na musamman an kammala su a ƙarƙashin jagorancin malamai.Malamai suna yin sharhi kuma suna jagorantar ɗaliban jinya don yin aikin gado don cimma haɗin ilimin da aikin asibiti.
Bayan tantance kowace ƙungiya, malamin ya yi tsokaci kuma ya lura da ƙarfi da raunin kowane ɗan ƙungiyar a cikin ƙungiyar abun ciki da tsarin fasaha don ci gaba da haɓaka fahimtar ɗaliban reno game da abubuwan koyo.Malamai suna nazarin ingancin koyarwa kuma suna inganta kwasa-kwasan dangane da kimawar ɗalibin jinya da ƙimar koyarwa.
Daliban ma'aikatan jinya suna ɗaukar jarrabawar ilimin ka'idar da aiki bayan horo na aiki.Tambayoyi na ka'idar don sa baki malami ne ya yi.An raba takaddun shiga tsakani gida biyu (A da B), kuma an zaɓi rukuni ɗaya ba da gangan ba don sa baki.Tambayoyin shiga tsakani sun kasu kashi biyu: ƙwararrun ilimin ka'idar ƙwararru da nazarin shari'a, kowanne yana da darajar maki 50 don jimlar maki 100.Dalibai, lokacin da suke tantance ƙwarewar aikin jinya, za su zaɓi ɗaya daga cikin masu zuwa ba tare da izini ba, gami da dabarar inversion axial, dabarar sanya hannu mai kyau ga marasa lafiya da ke fama da rauni na kashin baya, yin amfani da fasahar maganin ciwon huhu, dabarar yin amfani da injin gyaran haɗin gwiwa na CPM, da dai sauransu Cikakken. maki shine maki 100.
A cikin mako na hudu, za a tantance Ma'auni mai zaman kansa na Ƙimar Koyo kwanaki uku kafin ƙarshen karatun.An yi amfani da sikelin kima mai zaman kansa don ƙwarewar koyo wanda Zhang Xiyan ya haɓaka [18], gami da ƙarfafa ilmantarwa (abubuwa 8), kamun kai (abubuwa 11), ikon yin haɗin gwiwa a cikin koyo (abubuwa 5), da ilimin ilimin bayanai (abubuwa 6) .Ana ƙididdige kowane abu akan ma'aunin Likert mai maki 5 daga "ba kwata-kwata" zuwa "cikakkiyar daidaito," tare da maki daga 1 zuwa 5. Jimillar makin shine 150. Mafi girman maki, mafi ƙarfin ikon koyo da kansa. .Ma'aunin alpha na Cronbach shine 0.822.
A cikin mako na huɗu, an tantance ma'aunin ƙarfin tunani mai mahimmanci kwanaki uku kafin fitarwa.An yi amfani da sigar Sinanci na Matsakaicin Ƙimar Ƙwararrun Ƙarfafa Tunani da Mercy Corps ta fassara [19].Yana da girma bakwai: gano gaskiya, buɗaɗɗen tunani, ikon nazari da iya tsarawa, tare da abubuwa 10 a kowane girma.Ana amfani da ma'auni mai maki 6 jere daga "baƙi mai ƙarfi" zuwa "ƙaƙƙarfan yarda" daga 1 zuwa 6, bi da bi.Maganganun da ba su da kyau suna komawa baya, tare da jimlar jimlar daga 70 zuwa 420. Jimlar kashi na ≤210 yana nuna rashin aiki mara kyau, 211-279 yana nuna aikin tsaka tsaki, 280-349 yana nuna kyakkyawan aiki, kuma ≥350 yana nuna ƙarfin tunani mai zurfi.Ma'aunin alpha na Cronbach shine 0.90.
A cikin mako na hudu, za a gudanar da tantance cancantar asibiti kwanaki uku kafin fitarwa.An daidaita ma'aunin ƙaramin-CEX da aka yi amfani da shi a cikin wannan binciken daga Classic Classic [20] bisa ƙaramin CEX, kuma an ci nasara daga maki 1 zuwa 3.Haɗu da buƙatun, maki 4-6 don buƙatun saduwa, maki 7-9 don kyau.Daliban likitanci sun kammala horar da su bayan sun kammala horo na musamman.Ƙididdigar alpha na Cronbach na wannan sikelin shine 0.780 kuma ƙimar amincin tsaga-rabi shine 0.842, yana nuna ingantaccen aminci.
A mako na hudu, washegarin tashi daga sashen, an gudanar da taron malamai da dalibai da tantance ingancin koyarwa.Zhou Tong ne ya kirkiro fom ɗin tantance ingancin koyarwa kuma ya ƙunshi abubuwa biyar: halayen koyarwa, abubuwan koyarwa, da koyarwa.Hanyoyi, tasirin horo da halaye na horo.An yi amfani da ma'aunin Likert mai maki 5.Mafi girman maki, mafi kyawun ingancin koyarwa.An kammala bayan kammala horo na musamman.Tambayoyin yana da ingantaccen aminci, tare da alpha na ma'aunin Cronbach shine 0.85.
An yi nazarin bayanai ta amfani da software na ƙididdiga na SPSS 21.0.Ana bayyana bayanan ma'auni azaman ma'anar ± daidaitaccen karkata (\(\strike X \pm S\)) da kuma ƙungiyar shiga tsakani t ana amfani dashi don kwatanta tsakanin ƙungiyoyi.An bayyana kirga bayanan azaman adadin lokuta (%) kuma idan aka kwatanta ta amfani da chi-square ko ainihin sa hannun Fisher.Ƙimar p <0.05 tana nuna bambanci mai mahimmanci na ƙididdiga.
An nuna kwatancen ƙididdiga na ƙididdiga da ƙididdiga na aiki na ƙungiyoyi biyu na ma'aikatan jinya a cikin Table 2.
Ana nuna kwatancen koyo mai zaman kansa da ƙwarewar tunani mai zurfi na ƙungiyoyin biyu na ƙwararrun ma'aikatan jinya an nuna su a cikin Tebur 3.
Kwatanta iyawar aikin aikin asibiti tsakanin ƙungiyoyi biyu na ƙwararrun ma'aikatan jinya.Ƙwararrun aikin jinya na asibiti na ɗalibai a cikin ƙungiyar masu shiga tsakani ya kasance mafi kyau fiye da na ƙungiyar kulawa, kuma bambancin ya kasance mai mahimmanci (p <0.05) kamar yadda aka nuna a cikin Table 4.
Sakamakon tantance ingancin koyarwa na ƙungiyoyin biyu ya nuna cewa jimlar ingancin koyarwa na ƙungiyar kulawa shine maki 90.08 ± 2.34, kuma jimillar ingancin koyarwa na ƙungiyar sa baki shine maki 96.34 ± 2.16.Bambancin ya kasance mai mahimmanci a kididdiga.(t = - 13.900, p <0.001).
Haɓaka da ci gaban magani na buƙatar isassun tarin basirar likitanci.Ko da yake yawancin hanyoyin koyarwa da kwaikwayi sun wanzu, ba za su iya maye gurbin aikin likita ba, wanda ke da alaƙa kai tsaye da ikon iyawar likitancin nan gaba don magance cututtuka da ceton rayuka.Tun bayan barkewar COVID-19, ƙasar ta fi mai da hankali kan aikin koyarwa na asibiti na asibitocin jami'a [22].Ƙarfafa haɗin gwiwar likitanci da ilimi da inganta inganci da ingancin koyarwar asibiti manyan kalubale ne da ke fuskantar ilimin likitanci.Wahalar koyar da ilimin likitanci ya ta'allaka ne a cikin nau'ikan cututtuka iri-iri, ƙwararrun ƙwararru da ingantattun halaye, waɗanda ke shafar yunƙurin, sha'awa da ikon koyo na ɗaliban likitanci [23].
Hanyar koyarwa ajujuwa da aka jujjuya cikin manufar koyarwa ta CDIO tana haɗa abun ciki koyo tare da tsarin koyarwa, koyo da aiki.Wannan yana canza tsarin azuzuwa kuma yana sanya ɗaliban jinya a tushen koyarwa.A lokacin tsarin ilimi, malamai suna taimaka wa ɗaliban jinya da kansu don samun damar bayanai masu dacewa kan batutuwan jinya masu rikitarwa a cikin al'amuran al'ada [24].Bincike ya nuna cewa CDIO ya haɗa da haɓaka ɗawainiya da ayyukan koyarwa na asibiti.Aikin yana ba da cikakken jagora, tare da haɗin gwiwar haɓaka ilimin ƙwararru tare da haɓaka ƙwarewar aiki mai amfani, da kuma gano matsaloli yayin kwaikwaya, wanda ke da amfani ga ɗaliban renon yara wajen haɓaka koyo masu zaman kansu da ƙwarewar tunani mai zurfi, da kuma jagora a lokacin masu zaman kansu. koyo.- karatu.Sakamakon wannan binciken ya nuna cewa bayan makonni na horo na 4, ilmantarwa mai zaman kanta da ƙwarewar tunani mai zurfi na dalibai masu jinya a cikin ƙungiyar masu shiga tsakani sun kasance mafi girma fiye da waɗanda ke cikin ƙungiyar kulawa (duka p <0.001).Wannan ya yi daidai da sakamakon binciken Fan Xiaoying kan tasirin CDIO tare da hanyar koyarwa ta CBL a cikin ilimin jinya [25].Wannan hanyar horarwa na iya inganta mahimmancin tunani da ƙwarewar ilmantarwa mai zaman kanta.A lokacin lokacin ra'ayi, malami ya fara raba abubuwa masu wahala tare da ɗaliban reno a cikin aji.Daliban ma'aikatan jinya sannan sun yi nazarin bayanan da suka dace ta hanyar bidiyoyi na lacca kuma sun himmatu wajen neman kayan da suka dace don ƙara haɓaka fahimtar sana'ar jinya ta orthopedic.A lokacin tsarin ƙira, ɗaliban jinya sun yi aikin haɗin gwiwa da ƙwarewar tunani mai mahimmanci ta hanyar tattaunawa ta rukuni, jagorancin malamai da yin amfani da nazarin shari'a.A lokacin aiwatarwa, malamai suna kallon kula da cututtuka na ainihi a matsayin dama kuma suna amfani da hanyoyin koyarwa na simulation don koyar da ɗaliban jinya don gudanar da wasan motsa jiki a cikin haɗin gwiwar rukuni don fahimtar kansu da kuma gano matsalolin aikin jinya.A lokaci guda kuma, ta hanyar koyar da shari'o'i na gaske, ɗalibai masu jinya za su iya koyan mahimman abubuwan da ake bukata na farko da kuma kulawa ta gaba don su fahimci a fili cewa duk abubuwan da ke tattare da kulawa ta jiki sune muhimman abubuwa a cikin farfadowa na marasa lafiya.A matakin aiki, malamai suna taimaka wa ɗaliban likitanci su mallaki dabaru da ƙwarewa a aikace.A yin haka, sun koyi lura da canje-canje a yanayi a cikin ainihin lokuta, yin tunani game da yiwuwar rikitarwa, kuma kada su haddace hanyoyin jinya daban-daban don taimakawa daliban likita.Tsarin gine-gine da aiwatarwa a zahiri ya haɗu da abun ciki na horo.A cikin wannan tsarin haɗin kai, hulɗa da ƙwarewa, ƙwarewar ilmantarwa ta ɗalibi mai kula da kai da sha'awar koyo an tattara su da kyau kuma an inganta ƙwarewar tunanin su.Masu bincike sun yi amfani da Tsarin Tsara (DT) -Conceive-Design-Implement-Operate (CDIO)) don gabatar da tsarin ƙirar injiniya a cikin darussan shirye-shiryen yanar gizo da aka ba su don inganta ƙwarewar ɗalibai da ƙwarewar ilimin lissafi (CT), kuma sakamakon ya nuna, cewa Ayyukan ilimi na ɗalibai da ƙwarewar tunani suna haɓaka sosai [26].
Wannan binciken yana taimaka wa ɗalibai masu reno su shiga cikin gabaɗayan tsari bisa ga tsarin Tambayoyi-Tsarin-tsara- Aiwatar da-Aiki-Bayyanawa.An haɓaka yanayi na asibiti.Abin da aka fi mayar da hankali shi ne kan haɗin gwiwar ƙungiya da tunani mai zaman kansa, wanda malami ke amsa tambayoyi, ɗalibai suna ba da shawarar mafita ga matsaloli, tattara bayanai, motsa jiki na yanayi, da kuma motsa jiki na gefen gado.Sakamakon binciken ya nuna cewa yawancin ɗaliban likitanci a cikin ƙungiyar masu shiga tsakani a kan kimanta ilimin ilimin ka'idar da ƙwarewar aiki sun fi na ɗalibai a cikin ƙungiyar kulawa, kuma bambancin ya kasance mai mahimmanci (p <0.001).Wannan ya yi daidai da gaskiyar cewa ɗaliban likitanci a cikin ƙungiyar sa baki sun sami sakamako mai kyau akan kimanta ilimin ka'idar da ƙwarewar aiki.Idan aka kwatanta da ƙungiyar kulawa, bambancin yana da mahimmanci a ƙididdiga (p<0.001).Haɗe da sakamakon bincike masu dacewa [27, 28].Dalilin bincike shi ne cewa tsarin CDIO ya fara zaɓar wuraren ilimin cututtuka tare da mafi yawan adadin abubuwan da suka faru, kuma na biyu, rikitarwa na saitunan aikin ya dace da asali.A cikin wannan ƙirar, bayan ɗalibai sun kammala abubuwan da suka dace, suna kammala littafin aikin aikin kamar yadda ake buƙata, sake duba abubuwan da suka dace, kuma suna tattauna ayyukan da membobin ƙungiyar don narkar da su cikin abubuwan ilmantarwa da haɗa sabon ilimi da koyo.Tsohuwar ilimi a sabuwar hanya.Haɗin ilimin yana inganta.
Wannan binciken ya nuna cewa ta hanyar yin amfani da tsarin ilmantarwa na CDIO na asibiti, dalibai masu jinya a cikin ƙungiyar masu shiga tsakani sun kasance mafi kyau fiye da dalibai masu kulawa a cikin ƙungiyar kulawa a yin shawarwari na jinya, gwaje-gwaje na jiki, ƙayyade ƙididdigar jinya, aiwatar da ayyukan jinya, da kuma kula da jinya.sakamakon.da kulawar ɗan adam.Bugu da ƙari, an sami bambance-bambance masu mahimmanci a cikin kowane ma'auni tsakanin ƙungiyoyin biyu (p <0.05), wanda yayi kama da sakamakon Hongyun [29].Zhou Tong [21] ya yi nazarin tasirin amfani da tsarin koyarwa na Concept-Design-Implement-Operate (CDIO) a cikin aikin koyarwa na aikin jinya na zuciya, kuma ya gano cewa dalibai a cikin ƙungiyar gwaji sun yi amfani da aikin asibiti na CDIO.Hanyar koyarwa a cikin tsarin jinya, ɗan adam sigogi takwas, kamar ikon jinya da sanin yakamata, sun fi na ɗaliban jinya ta amfani da hanyoyin koyarwa na gargajiya.Wannan yana iya zama saboda a cikin tsarin ilmantarwa, ɗaliban reno ba sa yarda da ilimi ba, amma suna amfani da nasu damar iya yin komai.samun ilimi ta hanyoyi daban-daban.Membobin ƙungiyar suna ba da cikakkiyar sakin ruhin ƙungiyar su, haɗa albarkatun ilmantarwa, kuma akai-akai bayar da rahoto, yin aiki, bincika, da tattauna batutuwan jinya na yanzu.Ilimin su yana tasowa daga sama zuwa zurfi, suna mai da hankali sosai ga takamaiman abun ciki na binciken dalilin.matsalolin kiwon lafiya, tsara manufofin jinya da yuwuwar ayyukan jinya.Faculty suna ba da jagora da nunawa yayin tattaunawa don samar da haɓakar cyclic na tsinkaye-aiki-amsa, taimaka wa ɗaliban jinya su kammala tsarin ilmantarwa mai ma'ana, haɓaka ƙwarewar aikin ɗalibin jinya, haɓaka sha'awar koyo da tasiri, da ci gaba da haɓaka aikin ɗalibi na asibiti - ma'aikatan jinya. ..iyawa.Ikon koyo daga ka'idar zuwa aiki, kammala haɗakar ilimi.
Aiwatar da shirye-shiryen ilimin asibiti na tushen CDIO yana inganta ingantaccen ilimin asibiti.Sakamakon bincike na Ding Jinxia [30] da sauransu sun nuna cewa akwai dangantaka tsakanin bangarori daban-daban kamar motsa jiki na ilmantarwa, ikon ilmantarwa mai zaman kansa, da ingantaccen halayen koyarwa na malaman asibiti.A cikin wannan binciken, tare da haɓaka koyarwar asibiti na CDIO, malaman asibiti sun sami ingantaccen horo na ƙwararru, sabbin dabarun koyarwa, da haɓaka iyawar koyarwa.Abu na biyu, yana haɓaka misalan koyarwa na asibiti da abun ciki na ilimin jinya na zuciya, yana nuna tsari da aiwatar da tsarin koyarwa daga mahallin maƙarƙashiya, kuma yana haɓaka fahimtar ɗalibai da riƙon abun ciki.Sake mayar da martani bayan kowace lacca na iya haɓaka wayewar kai na malaman asibiti, ƙarfafa malaman asibiti don yin tunani a kan ƙwarewar kansu, matakin ƙwararru da halayen ɗan adam, da gaske gane koyo na tsara, da haɓaka ingancin koyarwar asibiti.Sakamakon ya nuna cewa ingancin koyarwar malamai na asibiti a cikin rukunin shiga ya fi na ƙungiyar kulawa, wanda yayi kama da sakamakon binciken da Xiong Haiyang [31] ya yi.
Kodayake sakamakon wannan binciken yana da mahimmanci ga koyarwar asibiti, bincikenmu har yanzu yana da iyakoki da yawa.Na farko, yin amfani da samfurin dacewa na iya iyakance yawan waɗannan binciken, kuma samfurin mu ya iyakance ga asibitin kulawa na manyan makarantu.Na biyu, lokacin horon makonni 4 ne kawai, kuma masu aikin jinya suna buƙatar ƙarin lokaci don haɓaka ƙwarewar tunani mai mahimmanci.Na uku, a cikin wannan binciken, marasa lafiya da aka yi amfani da su a cikin Mini-CEX sun kasance marasa lafiya na gaske ba tare da horo ba, kuma ingancin aikin ma'aikatan jinya na iya bambanta daga mai haƙuri zuwa majiyyaci.Wadannan su ne manyan batutuwan da suka takaita sakamakon wannan binciken.Ya kamata bincike na gaba ya faɗaɗa girman samfurin, ƙara horar da malamai na asibiti, da kuma haɗa ma'auni don bunkasa nazarin shari'ar.Ana kuma buƙatar nazarin dogon lokaci don bincika ko ajin jujjuya bisa ra'ayin CDIO zai iya haɓaka ƙwarewar ɗaliban likitanci a cikin dogon lokaci.
Wannan binciken ya haɓaka ƙirar CDIO a cikin ƙirar kwas don ɗaliban jinya na orthopedic, ya gina ajujuwa juzu'i bisa ra'ayin CDIO, kuma ya haɗa shi da ƙaramin ƙima na CEX.Sakamakon ya nuna cewa ajujuwan juzu'i bisa ra'ayin CDIO ba wai kawai yana inganta ingancin koyarwar asibiti ba, har ma yana haɓaka ikon ilmantar da ɗalibai masu zaman kansu, tunani mai mahimmanci, da ƙwarewar aikin asibiti.Wannan hanyar koyarwa ta fi dogaro da inganci fiye da laccoci na gargajiya.Ana iya ƙaddamar da cewa sakamakon zai iya haifar da tasiri ga ilimin likita.Ajujuwan juzu'i, bisa ra'ayi na CDIO, yana mai da hankali kan koyarwa, koyo da ayyuka masu amfani kuma yana haɗa haɗin haɗin ilimin ƙwararru tare da haɓaka ƙwarewar aiki don shirya ɗalibai don aikin asibiti.Ganin muhimmancin ba wa ɗalibai damar da za su shiga ƙwazo a cikin koyo da aiki, da kuma yin la'akari da kowane bangare, an ba da shawarar cewa a yi amfani da samfurin koyo na asibiti bisa CDIO a ilimin likitanci.Hakanan za'a iya ba da shawarar wannan hanyar azaman sabuwar dabara, wacce ta shafi ɗalibi ga koyarwar asibiti.Bugu da ƙari, binciken zai kasance da amfani sosai ga masu tsara manufofi da masana kimiyya lokacin haɓaka dabarun inganta ilimin likitanci.
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.
Charles S., Gaffni A., Freeman E. Samfuran aikin likita na likitanci na tushen shaida: koyarwar kimiyya ko wa'azin addini?J Auna aikin asibiti.2011;17 (4):597–605.
Yu Zhenzhen L, Hu Yazhu Rong.Binciken wallafe-wallafe game da sake fasalin hanyoyin koyarwa a cikin darussan aikin jinya na likitanci a cikin ƙasata [J] Jarida na Ilimin Kiwon Lafiyar Sinanci.2020; 40 (2): 97–102.
Vanka A, Vanka S, Vali O. Juya aji a cikin ilimin hakori: nazari mai zurfi [J] Jaridar Turai na Ilimin hakori.2020; 24 (2): 213–26.
Hue KF, Luo KK Ajujuwan juzu'i yana haɓaka koyon ɗalibi a cikin sana'o'in kiwon lafiya: nazari na yau da kullun.BMC Ilimin Likita.2018; 18 (1):38.
Dehganzadeh S, Jafaraghai F. Kwatanta illolin lakcocin gargajiya da jujjuyawar aji akan dabi'un tunani mai mahimmanci na ɗalibai na reno: nazari na gwaji na musamman[J].Ilimin jinya a yau.2018; 71:151–6.
Hue KF, Luo KK Ajujuwan juzu'i yana haɓaka koyon ɗalibi a cikin sana'o'in kiwon lafiya: nazari na yau da kullun.BMC Ilimin Likita.2018;18 (1):1–12.
Zhong J, Li Z, Hu X, da dai sauransu.Kwatanta ingantaccen ilmantarwa ga ɗaliban MBBS waɗanda ke aikin histology a cikin azuzuwan jiki masu jujjuya da azuzuwan kama-da-wane.BMC Ilimin Likita.2022;22795.doi.org/10.1186/s12909-022-03740-w.
Fan Y, Zhang X, Xie X. Zane da bunƙasa ƙwararru da darussan ɗabi'a don kwasa-kwasan CDIO a kasar Sin.Kimiyya da aikin injiniya.2015; 21 (5): 1381–9.
Zeng CT, Li CY, Dai KS.Haɓakawa da kimanta darussan ƙirar ƙirar masana'antu na musamman bisa ka'idodin CDIO [J] Jarida ta Duniya na Ilimin Injiniya.2019; 35 (5): 1526–39.
Zhang Lanhua, Lu Zhihong, Yin amfani da tsarin ilimi-tsara-aiwatarwa-aiki-aiki a cikin ilimin aikin jinya [J] Jarida na Nursing na kasar Sin.2015; 50 (8): 970–4.
Norcini JJ, Blank LL, Duffy FD, et al.Mini-CEX: hanya don tantance ƙwarewar asibiti.Likitan ɗaki 2003;138(6):476-81.
Lokacin aikawa: Fabrairu-24-2024