上下文阅读和分析团队对临床教育和医疗保健过程所经历的系统的叙述。

IF 0.9
Northern clinics of Istanbul Pub Date : 2025-06-20 eCollection Date: 2025-01-01 DOI:10.14744/nci.2024.94210
Merve Saracoglu, Sinem Yildiz Inanici, Mehmet Ali Gulpinar
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引用次数: 0

摘要

目的:从复杂性理论的角度理解卫生系统、临床和学习经验需要一种反思和情境化的方法。经验发生的背景由相互影响的多维因素组成,如社会文化环境、工作/教育环境、利益相关者、教育/医疗系统。在这个框架中,重要的是要在他们的语境中阅读和分析当事人的经验叙述。本研究的目的是分析在外科诊所工作的团队在“机构、临床和国家系统”方面对他们的临床教育和医疗保健经历的叙述,作为经验生活的背景因素之一。根据这一目的,研究问题被确定如下:(1)在临床教育和医疗保健过程中,团队对系统的经验和叙述是什么,(2)各方如何与系统相关,(3)不同的相关方式的结果是什么?方法:本研究在某大学附属医院外科诊所进行。自愿参与组由31名参与者组成,包括临床讲师(n=5)、外科住院医师学生(n=5)、医学生/实习生(n=15)和在诊所以团队形式工作的护士(n=6)。通过深度访谈获得的叙事使用本研究创建的“三阶段语境主题分析”进行分析。结果:从分析中出现的主题分为三个上下文类别:“临床系统:结构,功能和工作量”,“临床环境,气候和文化”,“国家,社会环境和额外的挑战情况”。与这些情境体验的后果相关的主题被分为两类:“应对/不应对的方式”和“后果/影响”。结论:体验的情境维度会导致参与者以自己的方式体验,更多地关注于自己的情境,而忽略了其他人的体验。这指出了规划、实施和评估临床教育、研究和医疗保健过程在其背景下的重要性,包括系统。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Contextual reading and analysis of the team's narratives about the system in which clinical education and healthcare processes are experienced.

Contextual reading and analysis of the team's narratives about the system in which clinical education and healthcare processes are experienced.

Objective: Understanding the health system and the clinical and learning experiences from the perspective of complexity theory requires a reflective and contextual approach. The context in which experience takes place consists of multidimensional elements that influence each other, such as sociocultural environment, work/educational climate, stakeholders, educational/healthcare system. In this framework, it is important to read and analyze the parties' experiential narratives within their contexts. The aim of this study is to analyze the narratives of the team working in a surgical clinic about their clinical education and healthcare experiences in terms of the "institutional, clinical and national system" as one of the contextual elements in which the experience is lived. In line with this purpose, the research problems were identified as follows: (1) what are the experiences and narratives of the team regarding the system in clinical education and healthcare processes, (2) how do the parties relate to the system, and (3) what are the outcomes of different ways of relating?

Methods: This narrative study was conducted in the surgical clinic of a university hospital. The voluntary participant group consisted of 31 participants, including clinical instructors (n=5), surgical residency students (n=5), medical students/interns (n=15) and nurses (n=6) working as a team in the clinic. The narratives obtained through in-depth interviews were analyzed using the "Three-Stage Contextual Theme Analysis" created for this study.

Results: The themes that emerged from the analysis were grouped under three contextual categories: "clinical system: structure, functioning and workload", "clinical environment, climate and culture", "national, social environment and extra challenging situations". The themes related to the consequences of these contextual experiences were grouped under two categories: "ways of coping/not coping" and "consequences/effects".

Conclusion: The contextual dimension of the experience can cause parties to live experiences in their own way and to focus more on their context and not see enough of what others experience. This points to the importance of planning, conducting and evaluating clinical education, research and healthcare processes within their context, including the system.

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