Aile Hekimliği uzmanlık eğitiminde eğitim aile sağlığı merkezi uygulamasının değerlendirilmesi
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Dosyalar
Tarih
2022
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Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: Üçüncü basamak hastanelerine başvuran hasta profilleri ile aile hekiminin aile sağlığı merkezinde (ASM) karşılaştığı hasta profilinin bir takım farklılıklar içerdiği bilinmektedir. Üçüncü basamak hastanelere daha çok kronik hastalıkların takip ve tedavisi, bunların ileri bir merkezde araştırılması için başvuran hastalar gelirken; birinci basamak sağlık kuruluşlarına gebeler, sağlıklı çocuk izlemleri ve aşılama hizmetleri için çocuklar, periyodik sağlık taramaları için farklı yaş grubundaki kişiler, herhangi bir tanı almamış ve çeşitli ayrışmamış tanıları olan hastalar gelmektedir. Aradaki bu farklılık sebebiyle uzmanlık eğitiminde Eğitim Aile Sağlığı Merkezi (E-ASM) gerekliliği ortaya çıkmıştır. Bu çalışmada EASM'nin gerekliliğinin aile hekimliği uzmanları ve asistanları tarafından değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Araştırmamız tanımlayıcı-kesitsel bir anket çalışmasıdır. Çalışma, 23/02/2022-23/04/2022 tarihleri arasında aile hekimlerine Google formlar üzerinden ulaşılıp anket çalışması yapılarak gerçekleştirilmiştir. Bu ankette hekimlerin sosyodemografik verileri alınırken, birinci basamağa yönelik bilgi soruları da soruldu. Çalışmada EASM'de çalışma durumu ile bilgi sorularına verilen doğru cevaplar karşılaştırıldı. Çalışmanın istatistiği yapılırken tanımlayıcı istatistiklerde numerik veriler ortalama, standart sapma, minimum ve maksimum; kategorik veriler ise sayı ve yüzde olarak verildi. Numerik verilerin dağılımına histogram grafikleri ile bakıldı. İki ayrı grupta numerik veriler Man Whitney U testi, ikiden fazla grupta numerik veriler Kruskal Wallis Testi ile analiz edildi. Kategorik verilerin karşılaştırmalarına ki-kare testi ve Fisher's Exact Testi ile bakıldı. Numerik verilerin korelasyonuna Pearson korelasyon testi ile bakıldı. P anlamlılık değeri <0,05 olarak kabul edildi. Analizlerde SPSS 23.0 paket programı kullanıldı. Bulgular: Çalışmaya toplam 263 hekim katıldı. Hekimlerin %58,2'si (n=153) kadın, %41,8'i (n=110) erkekti. Çalışmaya katılanların %62'si (n=163) evli, %38'i (n=100) bekardı. Çalışmaya katılan hekimlerin %55,1'i (n=145) tam zamanlı aile hekimliği asistanıyken, %16,3'ü (n=43) sözleşmeli aile hekimliği asistanı, %28,5'i (n=75) ise Aile hekimliği uzmanıydı. Çalışmaya katılan hekimlere uzmanlık eğitimini aldığı sırada EASM'lerinin olup olmadığı soruldu. %35'inin (n=92) EASM'lerinin olduğu öğrenildi. Hekimlerin sadece % 18,6'sı (n=49) EASM'de çalışmıştı. Yine hekimlerin %15,6'sının (n=41) ise EASM'de çalışırken bir sorumlu eğiticisi vardı. Uzmanlık eğitimi sırasında EASM olup olmamasına ve burada çalışıp çalışmama durumuna göre bilgi sorularına verilmesi gereken doğru cevaplarda anlamlı farklılık saptanmadı (p=0,299; p=0,127). EASM de çalışırken sorumlu eğitimcisi olanların verdiği doğru cevap sayısı olmayanlara göre anlamlı derecede daha yüksekti (p=0,049). Saha eğitimini (EASM) gerekli gören ve göremeyenler arasında verilmesi gereken doğru cevap sayılarında anlamlı farklılık görülmedi (p=0,091). Uzmanlık eğitimini içerik açısından yeterli bulan ve bulmayan hekimler arasında da verilen doğru cevaplarda anlamlı farklılık saptanmadı (p=0,166). Sonuç: Çalışmamızda EASM gerekliliği ve EASM'de eğitici faktörünün önemi anlaşılmaktadır. Sadece üçüncü basamak hastanelerde eğitim gören asistanların kendilerini yetersiz gördüğü ve bilgi düzeylerinin düşük olduğu görüldü. Bu durumda her iki poliklinik uygulamasının da uzmanlık eğitimi için ihtiyaç olduğunu; EASM'lerin açılmasının sağlanması gerektiğini ve hastane eğitiminin birinci basamağa yönelik yapılandırılmasının uzmanlık eğitimini daha iyi yönde etkileyeceğini söylemek olasıdır. Anahtar Kelimeler: Aile hekimliği uzmanlık eğitimi, eğitim aile sağlığı merkezi
Introduction: It is known that there are some differences between the patient profiles applying to our tertiary care hospitals and the patient profile encountered by the family physician in the family health center (Education FHC). For example, patients who apply to tertiary hospitals for the follow-up and treatment of chronic diseases and to investigate them in an advanced center; Pregnant women, children for healthy child follow-up and vaccination services, people in different age groups for periodic health screenings, patients who have not been diagnosed and have various undifferentiated diagnoses come to primary health care institutions. Due to this difference, the necessity of EASM in specialization training has emerged. It is a fact that EASM is an indispensable part of family medicine residency training. In this study, it was aimed to evaluate the necessity of EASM by family medicine specialists and assistants. Materials and Methods: Our research is a descriptive-cross-sectional survey study. The study was carried out by conducting a survey on Google forms to family physicians who could be reached between 23/02/2022 -23/04/2022. While making the statistics of the study, numerical data in descriptive statistics are mean, standard deviation, minimum and maximum; Categorical data were given as numbers and percentages. Distribution of numerical data was analyzed with histogram graphics. Numerical data in two different groups were analyzed with Man Whitney U test, and numerical data in more than two groups were analyzed with Kruskal Wallis Test. Comparisons of categorical data were done with chi-square test and Fisher's Exact test. The correlation of the numerical data was checked with the Pearson correlation test. P significance value was accepted as <0.05. SPSS 23.0 package program was used in the analysis. Results: A total of 263 physicians participated in the study. 58.2% (n=153) of the physicians were female and 41.8% (n=110) were male. Of the participants in the study, 62% (n=163) were married and 38% (n=100) were single. While 55.1% (n=145) of the physicians participating in the study were full-time family medicine residents, 16.3% (n=43) were contracted family medicine residents and 28.5% (n=75) were family medicine residents. He was an expert. Physicians participating in the study were asked whether they had EASMs at the time of their residency training. It was learned that 35% (n=92) had EASMs. Only 18.6% (n=49) of the physicians worked in EASM. Again, 15.6% (n=41) of the physicians had a responsible trainer while working at EASM. There was no significant difference in the correct answers according to whether there was an EASM during the residency training and whether or not to work there (p=0.299,p=0.127) . The number of correct answers given by those who had a responsible trainer while working at the EASM was significantly higher than those who did not (p=0.049) . There was no significant difference in the number of correct answers to be given between those who deemed field training (EASM) necessary and those who did not (p=0.091). There was no significant difference in the correct answers given between physicians who found the specialist training sufficient in terms of content and those who did not (p=0.166). Conclusion: In our study, the necessity of EASM and the importance of the trainer factor in EASM are understood. It was observed that the assistants trained only in tertiary hospitals considered themselves inadequate and had a low level of knowledge. In this case, there is a need for specialization training in both outpatient clinics; It is possible to say that the opening of EASMs should be ensured and the structuring of hospital education for primary care will affect the specialty education in a better way. Keywords: Family medicine residency training, education family health center
Introduction: It is known that there are some differences between the patient profiles applying to our tertiary care hospitals and the patient profile encountered by the family physician in the family health center (Education FHC). For example, patients who apply to tertiary hospitals for the follow-up and treatment of chronic diseases and to investigate them in an advanced center; Pregnant women, children for healthy child follow-up and vaccination services, people in different age groups for periodic health screenings, patients who have not been diagnosed and have various undifferentiated diagnoses come to primary health care institutions. Due to this difference, the necessity of EASM in specialization training has emerged. It is a fact that EASM is an indispensable part of family medicine residency training. In this study, it was aimed to evaluate the necessity of EASM by family medicine specialists and assistants. Materials and Methods: Our research is a descriptive-cross-sectional survey study. The study was carried out by conducting a survey on Google forms to family physicians who could be reached between 23/02/2022 -23/04/2022. While making the statistics of the study, numerical data in descriptive statistics are mean, standard deviation, minimum and maximum; Categorical data were given as numbers and percentages. Distribution of numerical data was analyzed with histogram graphics. Numerical data in two different groups were analyzed with Man Whitney U test, and numerical data in more than two groups were analyzed with Kruskal Wallis Test. Comparisons of categorical data were done with chi-square test and Fisher's Exact test. The correlation of the numerical data was checked with the Pearson correlation test. P significance value was accepted as <0.05. SPSS 23.0 package program was used in the analysis. Results: A total of 263 physicians participated in the study. 58.2% (n=153) of the physicians were female and 41.8% (n=110) were male. Of the participants in the study, 62% (n=163) were married and 38% (n=100) were single. While 55.1% (n=145) of the physicians participating in the study were full-time family medicine residents, 16.3% (n=43) were contracted family medicine residents and 28.5% (n=75) were family medicine residents. He was an expert. Physicians participating in the study were asked whether they had EASMs at the time of their residency training. It was learned that 35% (n=92) had EASMs. Only 18.6% (n=49) of the physicians worked in EASM. Again, 15.6% (n=41) of the physicians had a responsible trainer while working at EASM. There was no significant difference in the correct answers according to whether there was an EASM during the residency training and whether or not to work there (p=0.299,p=0.127) . The number of correct answers given by those who had a responsible trainer while working at the EASM was significantly higher than those who did not (p=0.049) . There was no significant difference in the number of correct answers to be given between those who deemed field training (EASM) necessary and those who did not (p=0.091). There was no significant difference in the correct answers given between physicians who found the specialist training sufficient in terms of content and those who did not (p=0.166). Conclusion: In our study, the necessity of EASM and the importance of the trainer factor in EASM are understood. It was observed that the assistants trained only in tertiary hospitals considered themselves inadequate and had a low level of knowledge. In this case, there is a need for specialization training in both outpatient clinics; It is possible to say that the opening of EASMs should be ensured and the structuring of hospital education for primary care will affect the specialty education in a better way. Keywords: Family medicine residency training, education family health center
Açıklama
Anahtar Kelimeler
Aile hekimliği uzmanlık eğitimi, eğitim aile sağlığı merkezi, Family medicine residency training, education family health center, Aile Hekimliği, Family Medicine
