نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری برنامه ریزی درسی، بخش مدیریت و برنامه ریزی آموزشی، دانشکده علوم تربیتی و روان‌شناسی، دانشگاه شیراز، شیراز، ایران.

2 دکترای مطالعات برنامه درسی، دانشیار بخش مدیریت و برنامه‌ریزی آموزشی دانشگاه شیراز

3 دانشگاه شیراز

4 متخصص زنان و مامایی، دانشگاه علوم پزشکی جهرم

5 دانشجوی دکتری مدیریت آموزشی دانشگاه شهید چمران اهواز

10.22118/edc.2021.304360.1881

چکیده

رشته های پزشکی از حرفه های پیچیده و دشواری هستند که با استفاده از علوم و مهارت های خاص خود در جهت پیشبرد سلامتی از نظر جسمی، روانی و اجتماعی گام بر می دارند، استدلال بالینی به عنوان یکی از شایستگی‌های اصلی یک پزشک است که دانشجویان پزشکی باید قبل از واجد شرایط بودن در پزشکی به آن دست یابند. از این رو، هدف اصلی از انجام پژوهش حاضر، طراحی الگوی شایستگی های استدلال بالینی دانشجویان رشته پزشکی با رویکرد فراترکیب بود. این پژوهش کیفی با استفاده از روش شش مرحله‌ای ساندلوسکی و باروسو (2007) انجام شد. تیم فراترکیب متشکل از یک پزشک و سه نفر متخصص برنامه‌ریزی درسی مسلط به روش پژوهش فراترکیب بود. 18 منبع پژوهشی مرتبط، مبنای تحلیل قرار گرفت که نتیجه آن استخراج 34 مضمون پایه بود. اعتبار داده‌ها با استفاده از تکنیک‌های اعتبارپذیری و انتقال‌پذیری از طریق خودبازبینی پژوهشگرپژوهشگران و همسوهمسوسازی داده‌ها و اعتمادپذیری با هدایت دقیق جریان گردآوری اطلاعات و همسوهمسوسازی پژوهشگرپژوهشگران تأیید شد. براساس نتایج پژوهش، هشت مضمون اصلی تشخیص بیماری، به کارگیری دانش، توجه به علائم و نشانه های بیمار، اتخاذ تصمیمات صحیح، تبدیل اطلاعات بیمار به اطلاعات پزشکی(استدلال تشخیصی)، حل مسئله (تجزیه و تحلیل استدلال بالینی)، گرفتن شرح حال بیمار و معاینه فیزیکی و تفسیر آزمایشات تشخیصی، عوامل الگوی شایستگی های استدلال بالینی دانشجویان علوم پزشکی هستند، که در این زمینه پر اهمیتند. به طور کلی یافته‌های پژوهش  نشان داد که لازم است مهارت‌های استدلال بالینی به عنوان فرایندهای فکری مورد استفاده پزشکان در تدوین سؤالات و تشخیص‌های مناسب مورد توجه قرار گیرد، لذا برای ارائه مراقبت‌های بهداشتی با کیفیت ضروری است.

کلیدواژه‌ها

عنوان مقاله [English]

Designing a model of clinical reasoning competencies for medical students

نویسندگان [English]

  • solmaz khademi 1
  • mehdi mohammadi 2
  • reza Naseri Jahromi 3
  • athar rasekh jahromi 4
  • parastoo nabeei 5

1 Ph. D. student of Curriculum Development, Shiraz University, Shiraz, Iran.

2 Faculty Member, Department of Educational Planning and Management, Shiraz University, Shiraz, Iran.

3 Shiraz Uni

4 Gynecologist and obstetrician, Jahrom University of Medical Sciences PhD Student in Educational Management

5 PhD Student in Educational Management, Shahid Chamran University of Ahvaz

چکیده [English]

Medical disciplines are complex and difficult professions that use their special sciences and skills to promote physical, mental and social health. Clinical reasoning is one of the main competencies of a physician that medicine students must achieve this before being eligible in medicine. Therefore, the main purpose of this study was to design a model of clinical reasoning competencies for medical students with meta-combination approach. This qualitative study was conducted using the six-step method of Sandloski and Barroso (2007). The meta-combination team consisted of a physician and three curriculum specialists who were proficient in the meta-combination research method. 18 related research sources were used as the basis for the analysis, which resulted in the extraction of 34 basic themes. Data validation was verified using validation and transferability techniques through researchers' self-review and data alignment, and reliability was accurately guided to the process of data collection and researcher alignment. Based on the research results, the eight main themes of diagnosing the disease, applying knowledge, paying attention to the patient's signs and symptoms, making the right decisions, converting patient information into medical information (diagnostic reasoning), problem solving (clinical reasoning analysis), taking a history of patient and physical examination and interpretation of diagnostic tests are factors in the pattern of clinical reasoning competencies of medical students, which are very important in this regard. In general, the findings of this article showed that it is necessary to consider clinical reasoning skills as thought processes used by physicians in formulating appropriate questions and diagnoses, so it is essential to provide quality health care.

کلیدواژه‌ها [English]

  • Competence
  • clinical reasoning
  • Clinical Evaluation
  • meta-combination
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