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Amaç: Doktorun hasta ile karşılaştığında zihninde gerçekleştirdiği süreçler “klinik akıl yürütme” olarak ifade edilir. Klinik akıl yürütme öykü, fizik muayene ve hasta yönetimini içerir. Bu becerinin öğretimi ve değerlendirilmesinde olgular kullanılmaktadır. Olgu seçiminde çekirdek program dikkate alınmalıdır. Bu çalışmanın amacı Gazi Üniversitesi Tıp Fakültesi’nde Dönem 6 öğrencilerinin İç Hastalıkları intörnlük süresi sonunda klinik akıl yürütme becerisine yönelik yapılan olguya dayalı çok istasyonlu elektronik sınavın sorularının Ulusal Çekirdek Eğitim Programı-2014 ile uyumunu incelemektir. Yöntem: Çalışma, Mayıs-Aralık 2019 arasında 289 Dönem 6 öğrencisiyle İç Hastalıkları intörnlük dönemlerinin sonunda gerçekleştirilmiştir. Olgulara dayalı çok istasyonlu elektronik sınavın soruları İç Hastalıkları öğretim üyeleri tarafından hazırlanmıştır. Toplamda 5 sınav anında geri bildirim verilir şekilde SocrativeTM ile gerçekleştirilmiştir. Her sınavda üçer olgu bulunmaktaydı. Bütün sınavlar tamamlanınca sorular öykü, fizik muayene, ön tanı, tetkik, tedavi sınıflarıyla kategorize edilmiştir. Ulusal Çekirdek Eğitim Programı-2014 ile uyumu değerlendirilmiştir. Bulgular: Toplamda 14 olgu ve olgulara bağlı 74 soru değerlendirmeye alındı. Soruların 26’sı (%35,1) tetkik, 16’sı (%21,6) tedavi ile ilgiliydi. Öğretim üyelerinin sınavlarda yer verdikleri 14 olgunun 13’ünde (%92,8) en az bir soru, Ulusal Çekirdek Eğitim Programı-2014’te beklenen düzeyden ilerisini sınamaya yöneliktir. Hazırlanan 74 sorunun 31’i (%41,8) çekirdek programda beklenen düzeyin üstündeki düzeyleri sınamaktadır. Öğrencilerin ortalama puanları, çekirdek eğitim programında beklenen düzeyin üstündeki düzeyleri sınayan sorularda, düzeyine uygun sorulardaki ortalamalarına göre istatistiksel olarak anlamlı şekilde daha düşüktür (p<0,05). Sonuç: Öğretim üyelerinin soru hazırlama sürecinde Ulusal Çekirdek Eğitim Programı-2014’ü dikkate almadığı görülmektedir. Sınavların öğrenmeye etkisinden dolayı bu ciddi bir tehdit olarak görülebilir. Ulusal Çekirdek Eğitim Programı ve ölçme-değerlendirme konularında eğitici eğitimi bu soruna çözüm oluşturabilir.
Objective: The processes that the doctor performs in his mind when he encounters the patient are expressed as "clinical mindfulness". Clinical mentality involves history, physical examination and patient management. The teaching and evaluation of this skill is used. The core program should be taken into consideration when choosing the case. The objective of this study is to study the conformity of the questions of the multi-station electronic examination based on the fact that the students of the Period 6 in the Medical Faculty of the University of Gazi have the ability to perform the clinical mind at the end of the internship period with the National Core Education Programme-2014. Method: The study was carried out at the end of the Internal Diseases internship periods with 289 Period 6 students from May to December 2019. Questions of the case-based multi-station electronic exam are prepared by the teachers of the Faculty of Internal Diseases. A total of 5 examinations were carried out with SocrativeTM in a way that feedback is given instantly. There were three exam events in each exam. When all the exams are completed, the questions are categorized by history, physical examination, pre-diagnosis, examination, treatment classes. The National Core Education Programme 2014 has been evaluated. Results: In total, 74 questions related to 14 facts and facts were taken to be assessed. 26 of the questions (35.1 percent) were examined, and 16 (21.6 percent) were related to treatment. In 13 of the 14 faculties the teachers took part in the exam (92.8%) a little question is aimed at testing the level ahead of the expected in the National Core Education Programme-2014. 31 of the 74 prepared issues (41.8%) are tested at levels above the expected level in the core program. The student's average scores are statistically significantly lower in questions testing levels above the level expected in the core training program than the average in questions matching their level (p<0,05). Result: It appears that the teachers do not take into account the National Core Education Programme 2014 in the process of questioning. Because of the impact of the exams on learning, this can be seen as a serious threat. The National Core Education Program and the educational training in measurement-evaluation subjects can create a solution to this problem.
Aim: Clinical reasoning is described as a mental process that occurs when a doctor encounter with patient in clinical environment. Clinical reasoning contains anamnesis, diagnosis, and management. Cases have been used both to teach and assess clinical reasoning. Core curriculum should be considered in the selection process of cases. The aim of this study is to evaluate the compliance with the National Core Curriculum-2014 of the questions of the case-based multistation electronic exam, which is carried out at the end of Internal Diseases internship, that is for assessing clinical reasoning skill of the Year-6 medical students in Gazi University Faculty of Medicine. Methods: The study was conducted between May-December 2019 with 289 Year-6 medical students at the end of Internal Medicine internship period. Questions of the case-based multistation electronic exam were prepared by Internist faculty members. In total, 5 exams were carried out using SocrativeTM to give immediate feedback. Every exam consisted of 3 cases. End of all the exams, questions of cases were categorized in the classes of anamnesis, physical examination, pre-diagnosis, laboratory findings, treatment. Compliance with the National Core Curriculum-2014 was evaluated. Results: In total, 14 cases and 74 questions nested in cases were evaluated. 26 (35.1%) of the questions were about laboratory findings. 16 (21.6%) of the questions were under treatment class. In 13 (92.8%) of the cases, there was at least a question expects higher levels than National Core Curriculum-2014. Out of 74 questions, 31 (41.8%) of them assessed higher levels than National Core Curriculum-2014. Mean scores of the students were significantly lower at questions that assess higher levels than National Core Curriculum-2014 (p<0.05). Conclusion: Faculty members do not take into consideration National Core Curriculum-2014. This poses a serious threat since assessment drives learning. Faculty development on National Core Curriculum and assessment could be a solution.
Alan : Sağlık Bilimleri
Dergi Türü : Ulusal
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