Ảnh hưởng của nơi làm việc đến việc học kỹ năng khám lâm sàng

BMC Medical Education - Tập 14 - Trang 1-11 - 2014
Robbert Duvivier1, Renée Stalmeijer2, Jan van Dalen1, Cees van der Vleuten2, Albert Scherpbier3
1Skillslab, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
2Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
3Institute for Medical Education, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands

Tóm tắt

Các thực tập sinh tại bệnh viện được coi là cực kỳ quan trọng để đạt được những năng lực như lý luận chuẩn đoán và kỹ năng lâm sàng. Quá trình học tập thực tế tại bệnh viện vẫn chưa được hiểu rõ. Nghiên cứu này điều tra cách mà sinh viên học kỹ năng lâm sàng tại nơi làm việc và các yếu tố ảnh hưởng đến điều này. Sáu buổi nhóm tập trung với 32 sinh viên đang thực tập tại Khoa Nội (4–9 sinh viên mỗi nhóm; mỗi buổi kéo dài 80–90 phút) đã được thực hiện. Các bản sao chép từng từ đã được phân tích theo các chủ đề xuất hiện và được mã hóa độc lập bởi ba nhà nghiên cứu, tiếp theo là so sánh liên tục và mã hóa trục. Sinh viên báo cáo rằng họ học được hệ thống của việc khám lâm sàng, có được sự linh hoạt và trở nên có khả năng nhận diện các dấu hiệu bệnh lý. Quá trình học tập kết hợp giữa làm việc cùng nhau và làm việc độc lập với trách nhiệm ngày càng cao trong việc chăm sóc bệnh nhân. Những hành vi hữu ích bao gồm việc làm rõ các phát hiện qua hồ sơ bệnh nhân hoặc trong quá trình quan sát, phản hồi từ các phát hiện bất thường và chủ động. Các yếu tố ảnh hưởng tiêu cực đến quá trình này bao gồm thiếu sự giám sát, sự không chắc chắn về các nhiệm vụ và mong đợi, và bối cảnh xã hội như hệ thống thứ bậc của người học và môi trường học tập được cảm nhận. Mặc dù trải nghiệm cá nhân của sinh viên khác nhau rất nhiều giữa các bệnh viện khác nhau, dường như tính chủ động và sự tham gia là những động lực chính cho việc học. Những kết quả này có thể cải thiện chất lượng của các chương trình hiện có và giúp thiết kế những cách mới để học kỹ năng khám lâm sàng.

Từ khóa

#khám lâm sàng #kỹ năng #học tập #bệnh viện #sinh viên y khoa

Tài liệu tham khảo

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