Abubuwan da ke ƙayyade lafiyar jama'a (SDOH) suna da alaƙa da abubuwa da yawa na zamantakewa da tattalin arziki. Tunani yana da mahimmanci ga koyon SDH. Duk da haka, rahotanni kaɗan ne kawai ke nazarin shirye-shiryen SDH; yawancinsu nazarin ɓangarori ne. Mun yi ƙoƙarin gudanar da kimantawa mai ɗorewa na shirin SDH a cikin wani kwas na ilimin lafiyar al'umma (CBME) wanda aka ƙaddamar a cikin 2018 bisa ga matakin da abubuwan da ɗalibai suka ruwaito game da SDH.
Tsarin Bincike: Tsarin nazari na gaba ɗaya don nazarin bayanai masu inganci. Shirin Ilimi: Ana ba da horo na tsawon makonni 4 na dole a fannin likitanci na gaba ɗaya da kulawa ta farko a Jami'ar Tsukuba School of Medicine, Japan, ga duk ɗaliban likitanci na shekara ta biyar da shida. Ɗaliban sun yi makonni uku suna aiki a asibitoci da asibitoci na al'umma a yankunan karkara da karkara na Ibaraki Prefecture. Bayan rana ta farko ta laccoci na SDH, an nemi ɗalibai su shirya rahotannin shari'o'i masu tsari bisa ga yanayin da aka fuskanta a lokacin kwas ɗin. A rana ta ƙarshe, ɗalibai sun raba abubuwan da suka faru a tarurrukan rukuni kuma sun gabatar da takarda kan SDH. Shirin yana ci gaba da ingantawa da samar da ci gaban malamai. Mahalarta binciken: ɗaliban da suka kammala shirin tsakanin Oktoba 2018 da Yuni 2021. Nazari: An rarraba matakin tunani a matsayin mai tunani, mai nazari ko mai bayyanawa. Ana nazarin abubuwan da ke ciki ta amfani da dandamalin Gaskiya Mai Kyau.
Mun yi nazarin rahotanni 118 na 2018-19, rahotanni 101 na 2019-20 da rahotanni 142 na 2020-21. Akwai rahotanni 2 (1.7%), 6 (5.9%) da 7 (4.8%) na nazari, rahotanni 9 (7.6%), 24 (23.8%) da 52 (35.9%) na nazari, 36 (30.5%) bi da bi, rahotanni 48 (47.5%) da 79 (54.5%) na bayani. Ba zan yi tsokaci kan sauran ba. Adadin ayyukan Gaskiya Masu Kyau a cikin rahoton shine 2.0 ± 1.2, 2.6 ± 1.3, da 3.3 ± 1.4, bi da bi.
Yayin da ayyukan SDH a cikin darussa na CBME ke inganta, fahimtar ɗalibai game da SDH ta ci gaba da zurfafa. Wataƙila wannan ya samo asali ne daga ci gaban malaman. Fahimtar SDH mai tunani na iya buƙatar ƙarin haɓaka malamai da ilimi mai haɗaka a cikin kimiyyar zamantakewa da magani.
Abubuwan da ke ƙayyade lafiyar jama'a (SDH) abubuwa ne da ba na likita ba waɗanda ke tasiri ga yanayin lafiya, gami da yanayin da ake haihuwar mutane, girma, aiki, rayuwa da tsufa [1]. SDH yana da tasiri mai mahimmanci ga lafiyar mutane, kuma shiga tsakani na likita kaɗai ba zai iya canza tasirin lafiyar SDH ba [1,2,3]. Dole ne masu ba da kiwon lafiya su san SDH [4, 5] kuma su ba da gudummawa ga al'umma a matsayin masu ba da shawara kan lafiya [6] don rage mummunan sakamakon SDH [4,5,6].
Muhimmancin koyar da SDH a fannin ilimin likitanci na digiri na farko an san shi sosai [4,5,7], amma akwai ƙalubale da yawa da ke da alaƙa da ilimin SDH. Ga ɗaliban likitanci, mahimmancin haɗa SDH da hanyoyin cututtukan halittu [8] na iya zama sananne, amma alaƙar da ke tsakanin ilimin SDH da horon asibiti na iya zama iyaka. A cewar Ƙungiyar Likitoci ta Amurka don Saurin Canji a Ilimin Likitanci, ana ba da ƙarin ilimin SDH a cikin shekaru na farko da na biyu na ilimin likitanci na digiri na biyu fiye da na shekaru na uku ko na huɗu [7]. Ba duk makarantun likitanci a Amurka ke koyar da SDH a matakin asibiti ba [9], tsawon kwas ɗin ya bambanta [10], kuma darussa galibi zaɓi ne [5, 10]. Saboda rashin daidaito kan ƙwarewar SDH, dabarun kimantawa ga ɗalibai da shirye-shirye sun bambanta [9]. Don haɓaka ilimin SDH a cikin ilimin likitanci na digiri na farko, ya zama dole a aiwatar da ayyukan SDH a cikin shekarun ƙarshe na ilimin likitanci na digiri na farko da kuma gudanar da kimantawa mai dacewa na ayyukan [7, 8]. Japan ta kuma fahimci mahimmancin ilimin SDH a cikin ilimin likitanci. A shekarar 2017, an haɗa ilimin SDH a cikin manhajar koyarwa ta likitanci, wanda ya fayyace manufofin da za a cimma bayan kammala karatun likitanci [11]. An ƙara jaddada wannan a cikin bitar 2022 [12]. Duk da haka, ba a kafa hanyoyin koyarwa da tantance SDH a Japan ba tukuna.
A cikin bincikenmu na baya, mun tantance matakin tunani a cikin rahotannin ɗaliban likitanci na manyan likitoci da kuma hanyoyin da suke bi ta hanyar tantance kimanta aikin SDH a cikin kwas ɗin ilimin likitanci na al'umma (CBME) [13] a wata jami'a a Japan. Fahimtar SDH [14]. Fahimtar SDH yana buƙatar ilmantarwa mai canzawa [10]. Bincike, gami da namu, ya mayar da hankali kan tunanin ɗalibai kan kimanta ayyukan SDH [10, 13]. A cikin darussan farko da muka bayar, ɗalibai sun fahimci wasu abubuwan SDH fiye da wasu, kuma matakin tunaninsu game da SDH ya yi ƙasa kaɗan [13]. Dalibai sun zurfafa fahimtarsu game da SDH ta hanyar gogewar al'umma kuma sun canza ra'ayoyinsu game da samfurin likita zuwa samfurin rayuwa [14]. Waɗannan sakamakon suna da mahimmanci lokacin da ƙa'idodin manhaja don ilimin SDH da kimantawa da kimantawa ba a riga an kafa su sosai ba [7]. Duk da haka, ba kasafai ake bayar da rahoton kimantawa na tsawon lokaci na shirye-shiryen SDH na digiri na farko ba. Idan za mu iya nuna tsari akai-akai don inganta da kimanta shirye-shiryen SDH, zai zama misali don ingantaccen ƙira da kimantawa na shirye-shiryen SDH, wanda zai taimaka wajen haɓaka ƙa'idodi da dama ga ɗaliban SDH na digiri na farko.
Manufar wannan binciken ita ce a nuna tsarin ci gaba da inganta shirin ilimi na SDH ga ɗaliban likitanci da kuma gudanar da kimantawa mai ɗorewa na shirin ilimi na SDH a cikin kwas ɗin CBME ta hanyar tantance matakin tunani a cikin rahotannin ɗalibai.
Binciken ya yi amfani da hanyar da aka saba amfani da ita wajen yin nazari kan bayanai kan ayyukan da aka yi kowace shekara tsawon shekaru uku. Yana kimanta rahotannin SDH na ɗaliban likitanci da suka shiga shirye-shiryen SDH a cikin manhajar CBME. Tsarin da aka saba amfani da shi wajen yin nazari kan bayanai kan inganci wanda za a iya jagorantar nazarin ta hanyar takamaiman manufofin kimantawa. Manufar ita ce a ba da damar binciken ya fito daga jigogi masu yawa, masu rinjaye, ko mahimmanci da ke cikin bayanan da ba a saba amfani da su ba maimakon a tsara su ta hanyar tsari mai tsari [15].
Mahalarta binciken sun kasance ɗaliban likitanci na shekara ta biyar da shida a Makarantar Likitanci ta Jami'ar Tsukuba waɗanda suka kammala aikin horon asibiti na tsawon makonni 4 a cikin kwas ɗin CBME tsakanin Satumba 2018 da Mayu 2019 (2018–19). Maris 2020 (2019-20) ko Oktoba 2020 da Yuli 2021 (2020-21).
Tsarin kwas ɗin CBME na makonni 4 ya yi daidai da karatun da muka yi a baya [13, 14]. Dalibai suna ɗaukar CBME a shekara ta biyar ko shida a matsayin wani ɓangare na kwas ɗin Gabatarwa ga Magunguna, wanda aka tsara don koyar da ƙwararrun masana kiwon lafiya ilimin asali, gami da haɓaka lafiya, ƙwarewa, da haɗin gwiwa tsakanin ƙwararru. Manufofin manhajar CBME sune don fallasa ɗalibai ga gogewar likitocin iyali waɗanda ke ba da kulawa mai dacewa a wurare daban-daban na asibiti; bayar da rahoton damuwar lafiya ga 'yan ƙasa, marasa lafiya, da iyalai a cikin tsarin kula da lafiya na gida; da haɓaka ƙwarewar tunani na asibiti. . Kowane mako 4, ɗalibai 15-17 suna ɗaukar kwas ɗin. Juyawa sun haɗa da mako 1 a cikin yanayin al'umma, makonni 1-2 a cikin asibitin al'umma ko ƙaramin asibiti, har zuwa mako 1 a asibitin al'umma, da kuma mako 1 a sashen maganin iyali a asibitin jami'a. A ranakun farko da na ƙarshe, ɗalibai suna taruwa a jami'a don halartar laccoci da tattaunawa ta rukuni. A rana ta farko, malamai sun bayyana wa ɗaliban manufofin kwas ɗin. Dole ne ɗalibai su gabatar da rahoto na ƙarshe da ya shafi manufofin kwas ɗin. Manyan malamai guda uku (AT, SO, da JH) suna tsara mafi yawan darussan CBME da ayyukan SDH. Manyan malamai da malamai 10-12 ne ke gudanar da shirin, waɗanda ko dai suna da hannu a koyarwa a jami'a a lokacin da suke koyar da digiri na farko a jami'a yayin da suke gabatar da shirye-shiryen CBME a matsayin likitocin iyali ko kuma waɗanda ba likitoci ba waɗanda suka san CBME.
Tsarin aikin SDH a cikin kwas ɗin CBME ya bi tsarin karatun da muka yi a baya [13, 14] kuma ana ci gaba da gyara shi (Hoto na 1). A rana ta farko, ɗalibai sun halarci laccar SDH mai aiki da kai kuma sun kammala ayyukan SDH a lokacin zagaye na makonni 4. An nemi ɗalibai su zaɓi mutum ko iyali da suka haɗu da su a lokacin horon su kuma su tattara bayanai don la'akari da abubuwan da za su iya shafar lafiyarsu. Hukumar Lafiya ta Duniya tana ba da Tabbatattun Gaskiya Bugu na Biyu [15], takaddun aikin SDH, da samfurin takaddun aikin da aka kammala a matsayin kayan aiki na tunani. A rana ta ƙarshe, ɗalibai sun gabatar da shari'o'in SDH ɗinsu a ƙananan ƙungiyoyi, kowace ƙungiya ta ƙunshi ɗalibai 4-5 da malami 1. Bayan gabatarwar, an ba wa ɗalibai aikin gabatar da rahoto na ƙarshe don kwas ɗin CBME. An nemi su bayyana kuma su danganta shi da gogewarsu a lokacin juyawa na makonni 4; an nemi su yi bayani 1) mahimmancin ƙwararrun kiwon lafiya su fahimci SDH da 2) rawar da suke takawa wajen tallafawa rawar da ya kamata a taka a fannin lafiyar jama'a. An ba wa ɗalibai umarni don rubuta rahoton da cikakkun bayanai kan yadda za a kimanta rahoton (karin kayan aiki). Ga jarrabawar ɗalibai, kimanin malamai 15 (ciki har da manyan malamai) sun tantance rahotannin bisa ga ka'idojin tantancewa.
Bayani kan shirin SDH a cikin manhajar CBME ta Kwalejin Magunguna ta Jami'ar Tsukuba a shekarar karatu ta 2018-19, da kuma tsarin inganta shirin SDH da haɓaka malamai a shekarun ilimi na 2019-20 da 2020-21. 2018-19 yana nufin shirin daga Oktoba 2018 zuwa Mayu 2019, 2019-20 yana nufin shirin daga Oktoba 2019 zuwa Maris 2020, kuma 2020-21 yana nufin shirin daga Oktoba 2020 zuwa Yuni 2021. SDH: Abubuwan da ke tantance lafiyar jama'a, COVID-19: Cutar Coronavirus 2019
Tun lokacin da aka ƙaddamar da shi a shekarar 2018, mun ci gaba da gyara shirin SDH kuma mun samar da ci gaban malamai. Lokacin da aka fara aikin a shekarar 2018, manyan malamai da suka haɓaka shi sun ba da laccoci kan ci gaban malamai ga sauran malamai waɗanda za su shiga cikin aikin SDH. Laccar farko ta ci gaban malamai ta mayar da hankali kan ra'ayoyin SDH da zamantakewa a wuraren asibiti.
Bayan kammala aikin a shekarar makaranta ta 2018-19, mun gudanar da taron haɓaka malamai don tattaunawa da tabbatar da manufofin aikin da kuma gyara aikin daidai gwargwado. Don shirin shekarar makaranta ta 2019-20, wanda ya gudana daga Satumba 2019 zuwa Maris 2020, mun samar da Jagororin Mai Gudanarwa, Fom ɗin Kimantawa, da Sharuɗɗa ga Masu Gudanar da Malamai don gudanar da Gabatarwar Rukunin Maudu'i na SDH a ranar ƙarshe. Bayan kowace gabatarwa ta rukuni, mun yi hira da mai kula da malamai don yin tunani a kan shirin.
A shekara ta uku ta shirin, daga Satumba 2020 zuwa Yuni 2021, mun gudanar da tarurrukan haɓaka malamai don tattauna manufofin shirin ilimi na SDH ta amfani da rahoton ƙarshe. Mun yi ƙananan canje-canje ga ƙa'idodin aikin rahoto na ƙarshe da kimantawa (karin kayan aiki). Mun kuma canza tsari da wa'adin lokacin shigar da aikace-aikace da hannu da kuma shigar da su kafin ranar ƙarshe zuwa shigar da su ta hanyar lantarki cikin kwanaki 3 daga shari'ar.
Domin gano muhimman jigogi da aka saba gani a cikin rahoton, mun tantance girman yadda aka nuna bayanin SDH kuma muka fitar da ingantattun abubuwan da aka ambata. Saboda sake dubawa na baya [10] sun ɗauki tunani a matsayin nau'i na kimanta ilimi da shirye-shirye, mun ƙaddara cewa za a iya amfani da takamaiman matakin tunani a cikin kimantawa don kimanta shirye-shiryen SDH. Ganin cewa an bayyana tunani daban-daban a cikin yanayi daban-daban, mun ɗauki ma'anar tunani a cikin mahallin ilimin likitanci a matsayin "tsarin nazarin, tambayoyi da sake gina gogewa don manufar kimanta su don dalilai na koyo." /ko inganta aiki," kamar yadda Aronson ya bayyana, bisa ga ma'anar Mezirow na tunani mai zurfi [16]. Kamar yadda yake a cikin bincikenmu na baya [13], tsawon shekaru 4 a cikin 2018–19, 2019–20 da 2020–21. a cikin rahoton ƙarshe, an rarraba Zhou a matsayin mai kwatantawa, mai nazari, ko mai tunani. Wannan rarrabuwa ta dogara ne akan salon rubutu na ilimi wanda Jami'ar Karatu ta bayyana [17]. Tunda wasu nazarin ilimi sun kimanta matakin tunani ta hanya ɗaya [18], mun ƙaddara cewa ya dace a yi amfani da wannan rarrabuwa don tantance matakin tunani a cikin wannan rahoton bincike. Rahoton labari rahoto ne wanda ke amfani da tsarin SDH don bayyana wani lamari, amma wanda babu haɗin abubuwa. Rahoton nazari rahoto ne wanda ke haɗa abubuwan SDH. Ra'ayoyin Jima'i rahotanni ne waɗanda marubutan suka ƙara yin tunani game da tunaninsu game da SDH. Rahotannin da ba su faɗi cikin ɗayan waɗannan rukunan ba an rarraba su azaman waɗanda ba za a iya kimantawa ba. Mun yi amfani da nazarin abun ciki bisa ga tsarin Gaskiya Mai Kyau, sigar 2, don tantance abubuwan SDH da aka bayyana a cikin rahotannin [19]. Abubuwan da ke cikin rahoton ƙarshe sun yi daidai da manufofin shirin. An nemi ɗalibai su yi tunani a kan abubuwan da suka fuskanta don bayyana mahimmancin ƙwararrun kiwon lafiya su fahimci SDH da rawar da suke takawa a cikin al'umma. SO ta yi nazari kan matakin tunani da aka bayyana a cikin rahoton. Bayan la'akari da abubuwan SDH, SO, JH, da AT sun tattauna kuma sun tabbatar da ƙa'idodin rukuni. SO ta maimaita nazarin. SO, JH, da AT sun ƙara tattauna nazarin rahotannin da ke buƙatar canje-canje a rarrabuwa. Sun cimma matsaya ta ƙarshe kan nazarin duk rahotannin.
Jimillar ɗalibai 118, 101 da 142 ne suka shiga shirin SDH a shekarun karatu na 2018-19, 2019-20 da 2020-21. Akwai ɗalibai mata 35 (29.7%), 34 (33.7%) da 55 (37.9%), bi da bi.
Siffa ta 2 ta nuna yadda matakan tunani suka kasance a kowace shekara idan aka kwatanta da binciken da muka yi a baya, wanda ya yi nazarin matakan tunani a cikin rahotannin da ɗalibai suka rubuta a 2018-19 [13]. A cikin 2018-2019, an rarraba rahotanni 36 (30.5%) a matsayin labari, a cikin rahotannin 2019-2020 - 48 (47.5%), a cikin rahotannin 2020-2021 - 79 (54.5%). Akwai rahotannin nazari 9 (7.6%) a cikin 2018-19, rahotannin nazari 24 (23.8%) a cikin 2019-20 da 52 (35.9%) a cikin 2020-21. Akwai rahotannin tunani 2 (1.7%) a cikin 2018-19, 6 (5.9%) a cikin 2019-20 da 7 (4.8%) a cikin 2020-21. An rarraba rahotanni 71 (60.2%) a matsayin waɗanda ba za a iya kimantawa ba a tsakanin 2018-2019, rahotanni 23 (22.8%) a tsakanin 2019-2020. da rahotanni 7 (4.8%) a tsakanin 2020-2021. An rarraba su a matsayin waɗanda ba za a iya tantancewa ba. Tebur na 1 ya ba da misalai na rahotanni ga kowane matakin tunani.
Matsayin tunani a cikin rahotannin ɗalibai game da ayyukan SDH da aka bayar a shekarun ilimi na 2018-19, 2019-20 da 2020-21. 2018-19 yana nufin shirin daga Oktoba 2018 zuwa Mayu 2019, 2019-20 yana nufin shirin daga Oktoba 2019 zuwa Maris 2020, kuma 2020-21 yana nufin shirin daga Oktoba 2020 zuwa Yuni 2021. SDH: Abubuwan da ke tantance lafiyar jama'a
An nuna kaso na abubuwan SDH da aka bayyana a cikin rahoton a Hoto na 3. Matsakaicin adadin abubuwan da aka bayyana a cikin rahotannin shine 2.0 ± 1.2 a cikin 2018-19, 2.6 ± 1.3 a cikin 2019-20. da 3.3 ± 1.4 a cikin 2020-21.
Kashi na ɗaliban da suka bayar da rahoton ambaton kowace matsala a cikin Tsarin Gaskiya Mai Kyau (Bugu na 2) a cikin rahotannin 2018-19, 2019-20, da 2020-21. Lokacin 2018-19 yana nufin Oktoba 2018 zuwa Mayu 2019, 2019-20 yana nufin Oktoba 2019 zuwa Maris 2020 kuma 2020-21 yana nufin Oktoba 2020 zuwa Yuni 2021, waɗannan su ne kwanakin shirin. A cikin shekarar ilimi ta 2018/19 akwai ɗalibai 118, a shekarar ilimi ta 2019/20 - ɗalibai 101, a shekarar ilimi ta 2020/21 - ɗalibai 142.
Mun gabatar da shirin ilimi na SDH a cikin wani kwas na CBME da ake buƙata ga ɗaliban da ke karatun digiri na farko a fannin likitanci, kuma mun gabatar da sakamakon kimantawa na shekaru uku na shirin wanda ke tantance matakin tunani na SDH a cikin rahotannin ɗalibai. Bayan shekaru 3 na aiwatar da aikin da kuma ci gaba da inganta shi, yawancin ɗalibai sun sami damar bayyana SDH da kuma bayyana wasu daga cikin abubuwan da ke haifar da SDH a cikin rahoto. A gefe guda kuma, ɗalibai kaɗan ne kawai suka sami damar rubuta rahotanni masu tunani game da SDH.
Idan aka kwatanta da shekarar makaranta ta 2018-19, shekarun makaranta na 2019-20 da 2020-21 sun ga ƙaruwa a hankali a cikin adadin rahotannin nazari da na bayyanawa, yayin da adadin rahotannin da ba a tantance ba suka ragu sosai, wanda wataƙila ya faru ne saboda ci gaban shirye-shirye da ci gaban malamai. Ci gaban malamai yana da mahimmanci ga shirye-shiryen ilimi na SDH [4, 9]. Muna ba da ci gaba da ci gaban ƙwararru ga malamai da ke shiga cikin shirin. Lokacin da aka ƙaddamar da shirin a cikin 2018, Ƙungiyar Kula da Lafiya ta Farko ta Japan, ɗaya daga cikin ƙungiyoyin likitancin iyali na Japan da lafiyar jama'a, ta buga sanarwa kan SDH ga likitocin kula da lafiya ta farko na Japan. Yawancin malamai ba su saba da kalmar SDH ba. Ta hanyar shiga cikin ayyuka da hulɗa da ɗalibai ta hanyar gabatar da shari'o'i, malamai a hankali sun zurfafa fahimtarsu game da SDH. Bugu da ƙari, fayyace manufofin shirye-shiryen SDH ta hanyar ci gaba da haɓaka ƙwarewar malamai na iya taimakawa wajen inganta cancantar malamai. Wani zato mai yiwuwa shine cewa shirin ya inganta akan lokaci. Irin waɗannan gyare-gyaren da aka tsara na iya buƙatar lokaci da ƙoƙari mai yawa. Dangane da shirin 2020-2021, tasirin annobar COVID-19 akan rayuwar ɗalibai da iliminsu [20, 21, 22, 23] na iya sa ɗalibai su ɗauki SDH a matsayin matsala da ke shafar rayuwarsu kuma su taimaka musu su yi tunani game da SDH.
Duk da cewa adadin abubuwan SDH da aka ambata a cikin rahoton ya ƙaru, yawan abubuwan da ke faruwa daban-daban ya bambanta, wanda zai iya danganta da halayen yanayin aikin. Yawan tallafin zamantakewa ba abin mamaki ba ne idan aka yi la'akari da yawan hulɗa da marasa lafiya da suka riga suka sami kulawar lafiya. An kuma ambaci sufuri akai-akai, wanda zai iya faruwa ne saboda gaskiyar cewa wuraren CBME suna cikin yankunan birni ko karkara inda ɗalibai ke fuskantar yanayi mara kyau na sufuri kuma suna da damar yin mu'amala da mutane a irin waɗannan yanayi. An kuma ambaci damuwa, keɓewa a zamantakewa, aiki da abinci, wanda ɗalibai da yawa za su iya fuskanta a aikace. A gefe guda kuma, tasirin rashin daidaito na zamantakewa da rashin aikin yi ga lafiya na iya zama da wuya a fahimta a cikin wannan ɗan gajeren lokacin karatu. Abubuwan SDH da ɗalibai ke fuskanta a aikace suma na iya dogara ne akan halayen yankin aikin.
Bincikenmu yana da matuƙar muhimmanci domin muna ci gaba da tantance shirin SDH a cikin shirin CBME da muke bayarwa ga ɗaliban likitanci na digiri na farko ta hanyar tantance matakin tunani a cikin rahotannin ɗalibai. Manyan ɗaliban likitanci waɗanda suka yi karatun likitanci na tsawon shekaru da yawa suna da hangen nesa na likitanci. Don haka, suna da damar koyo ta hanyar danganta ilimin zamantakewa da ake buƙata don shirye-shiryen SDH da ra'ayoyinsu na likitanci [14]. Saboda haka, yana da matuƙar muhimmanci a samar da shirye-shiryen SDH ga waɗannan ɗaliban. A cikin wannan binciken, mun sami damar gudanar da ci gaba da kimanta shirin ta hanyar tantance matakin tunani a cikin rahotannin ɗalibai. Campbell et al. A cewar rahoton, makarantun likitanci na Amurka da shirye-shiryen mataimakin likitoci suna kimanta shirye-shiryen SDH ta hanyar bincike, ƙungiyoyin mayar da hankali, ko bayanan kimantawa na tsakiyar rukuni. Sharuɗɗan aunawa da aka fi amfani da su a cikin kimanta aikin sune amsawar ɗalibai da gamsuwa, ilimin ɗalibai, da halayen ɗalibai [9], amma har yanzu ba a kafa wata hanya mai inganci da inganci don kimanta ayyukan ilimi na SDH ba. Wannan binciken yana nuna canje-canje na dogon lokaci a cikin kimantawa na shirin da ci gaba da inganta shirin kuma zai ba da gudummawa ga haɓakawa da kimanta shirye-shiryen SDH a wasu cibiyoyin ilimi.
Duk da cewa matakin tunani na ɗalibai gabaɗaya ya ƙaru sosai a duk tsawon lokacin binciken, adadin ɗaliban da ke rubuta rahotannin tunani ya kasance ƙasa. Ƙarin hanyoyin zamantakewa na iya buƙatar haɓaka don ƙarin ci gaba. Ayyuka a cikin shirin SDH suna buƙatar ɗalibai su haɗa ra'ayoyin zamantakewa da na likitanci, waɗanda suka bambanta a cikin rikitarwa idan aka kwatanta da tsarin likita [14]. Kamar yadda muka ambata a sama, yana da mahimmanci a samar da darussan SDH ga ɗaliban makarantar sakandare, amma shirya da inganta shirye-shiryen ilimi tun daga farkon ilimin likitanci, haɓaka ra'ayoyin zamantakewa da na likita, da haɗa su na iya zama mai tasiri wajen haɓaka ci gaban ɗalibai. 'haɓaka. Fahimtar SDH. Ƙarin faɗaɗa ra'ayoyin zamantakewa na malamai na iya taimakawa wajen ƙara tunani na ɗalibai.
Wannan horon yana da iyakoki da dama. Na farko, an takaita yanayin karatun ne ga makarantar likitanci guda ɗaya a Japan, kuma yanayin CBME ya takaita ne ga yanki ɗaya a cikin yankunan karkara ko karkara na Japan, kamar yadda muka yi a cikin bincikenmu na baya [13, 14]. Mun yi bayani dalla-dalla game da asalin wannan binciken da kuma binciken da ya gabata. Ko da tare da waɗannan iyakoki, yana da kyau a lura cewa mun nuna sakamako daga ayyukan SDH a cikin ayyukan CBME tsawon shekaru. Na biyu, bisa ga wannan binciken kawai, yana da wuya a tantance yuwuwar aiwatar da koyo mai tunani a waje da shirye-shiryen SDH. Ana buƙatar ƙarin bincike don haɓaka koyo mai tunani na SDH a cikin ilimin likitanci na digiri na farko. Na uku, tambayar ko ci gaban malamai yana ba da gudummawa ga inganta shirye-shirye ya wuce iyakokin hasashen wannan binciken. Ingancin gina ƙungiyar malamai yana buƙatar ƙarin nazari da gwaji.
Mun gudanar da wani bincike na tsawon lokaci kan shirin ilimi na SDH ga ɗaliban likitanci na manyan makarantu a cikin manhajar CBME. Mun nuna cewa fahimtar ɗalibai game da SDH na ci gaba da zurfafa yayin da shirin ke girma. Inganta shirye-shiryen SDH na iya buƙatar lokaci da ƙoƙari, amma haɓaka malamai da nufin ƙara fahimtar malamai game da SDH na iya zama mai tasiri. Don ƙara inganta fahimtar ɗalibai game da SDH, ana iya buƙatar haɓaka darussa waɗanda suka fi haɗawa da kimiyyar zamantakewa da magani.
Duk bayanan da aka yi nazari a kansu a lokacin binciken na yanzu suna samuwa daga marubucin da ya dace bisa buƙata mai ma'ana.
Ƙungiyar Lafiya ta Duniya. Abubuwan da ke ƙayyade lafiyar jama'a. Akwai a: https://www.who.int/health-topics/social-determinants-of-health. An shiga Nuwamba 17, 2022
Braveman P, Gottlieb L. Abubuwan da ke ƙayyade lafiyar jama'a: Lokaci ya yi da za a duba musabbabin abubuwan. Rahoton Lafiyar Jama'a 2014; 129: 19–31.
Mutane masu lafiya na 2030. Abubuwan da ke ƙayyade lafiyar jama'a. Akwai a: https://health.gov/healthypeople/priority-areas/social-determinants-health. An shiga Nuwamba 17, 2022
Hukumar Horar da Ƙwararrun Lafiya don Magance Matsalolin Zamantakewa na Lafiya, Hukumar Lafiya ta Duniya, Cibiyar Magunguna, Kwalejin Kimiyya ta Ƙasa, Injiniyanci, da Magunguna. Tsarin horar da ƙwararrun lafiya don magance matsalolin zamantakewa na lafiya. Washington, DC: National Academies Press, 2016.
Siegel J, Coleman DL, James T. Haɗa abubuwan da ke haifar da zamantakewa na lafiya a cikin ilimin likitanci na digiri na biyu: kira zuwa aiki. Kwalejin Kimiyyar Lafiya. 2018;93(2):159–62.
Kwalejin Royal na Likitoci da Likitocin Fiɗa ta Kanada. Tsarin CanMEDS. Akwai a: http://www.royalcollege.ca/rcsite/canmeds/canmeds-framework-e. An shiga Nuwamba 17, 2022
Lewis JH, Lage OG, Grant BK, Rajasekaran SK, Gemeda M, Laik RS, Santen S, Dekhtyar M. Magance matsalolin zamantakewa na kiwon lafiya a cikin manhajojin karatun digiri Ilimi na Lafiya: Rahoton Bincike. Aikin manyan makarantun likitanci. 2020;11:369–77.
Martinez IL, Artze-Vega I, Wells AL, Mora JC, Gillis M. Nasihu goma sha biyu don koyar da abubuwan da ke haifar da lafiya a fannin likitanci. Koyarwar likitanci. 2015;37(7):647–52.
Campbell M, Liveris M, Caruso Brown AE, Williams A, Ngongo V, Pessel S, Mangold KA, Adler MD. Kimantawa da kimanta abubuwan da ke haifar da zamantakewa na ilimin lafiya: Binciken ƙasa na makarantun likitanci na Amurka da shirye-shiryen taimakon likitoci. J Gen Trainee. 2022;37(9):2180–6.
Dubay-Persaud A., Adler MD, Bartell TR Koyar da abubuwan da ke haifar da zamantakewa na lafiya a cikin ilimin likitanci na digiri na biyu: bita kan ma'auni. J Gen Trainee. 2019;34(5):720–30.
Ma'aikatar Ilimi, Al'adu, Wasanni, Kimiyya da Fasaha. Tsarin manhajar ilimin likitanci da aka gyara a shekarar 2017. (harshen Jafananci). Akwai a: https://www.mext.go.jp/comComponent/b_menu/shingi/toushin/__icsFiles/afieldfile/2017/06/28/1383961_01.pdf. An shiga: Disamba 3, 2022
Ma'aikatar Ilimi, Al'adu, Wasanni, Kimiyya da Fasaha. Tsarin Manhajar Ilimin Lafiya, Gyaran 2022. Akwai a: https://www.mext.go.jp/content/20221202-mtx_igaku-000026049_00001.pdf. An shiga: 3 ga Disamba, 2022
Ozone S, Haruta J, Takayashiki A, Maeno T, Maeno T. Fahimtar ɗalibai game da abubuwan da ke haifar da zamantakewa na lafiya a cikin kwas ɗin da ya dogara da al'umma: hanyar da za a bi wajen nazarin bayanai masu inganci. BMC Medical Education. 2020;20(1):470.
Haruta J, Takayashiki A, Ozon S, Maeno T, Maeno T. Ta yaya ɗaliban likitanci ke koyo game da SDH a cikin al'umma? Bincike mai inganci ta amfani da hanyar gaskiya. Koyarwar likita. 2022:44(10):1165–72.
Dr. Thomas. Hanya ce ta musamman ta nazarin bayanai kan kimantawa masu inganci. Sunana Jay Eval. 2006;27(2):237–46.
Aronson L. Nasihu goma sha biyu don koyo mai tunani a dukkan matakan ilimin likitanci. Koyarwar likitanci. 2011;33(3):200–5.
Jami'ar Karatu. Rubutu mai bayani, nazari da tunani. Akwai a: https://libguides.reading.ac.uk/writing. An sabunta Janairu 2, 2020. An shiga Nuwamba 17, 2022.
Hunton N., Smith D. Tunani a cikin ilimin malamai: ma'ana da aiwatarwa. Koyarwa, koyarwa, ilmantarwa. 1995;11(1):33-49.
Ƙungiyar Lafiya ta Duniya. Abubuwan da ke ƙayyade lafiyar jama'a: Gaskiya mai wahala. bugu na biyu. Akwai a: http://www.euro.who.int/__data/assets/pdf_file/0005/98438/e81384.pdf. An shiga: 17 ga Nuwamba, 2022
Michaeli D., Keogh J., Perez-Dominguez F., Polanco-Ilabaca F., Pinto-Toledo F., Michaeli G., Albers S., Aciardi J., Santana V., Urnelli C., Sawaguchi Y., Rodríguez P. Maldonado M kasashe. Jaridar Duniya ta Ilimin Kiwon Lafiya. 2022; 13:35–46.
Lokacin Saƙo: Oktoba-28-2023