Güneş KORKMAZ, Ayşen Melek AYTUĞ KOŞAN, Çetin TORAMAN

Sürekli Tıp Eğitimi ve Yaşam Boyu Öğrenme Bağlamında Grand Rounds Öğrenme Döngüsü Modeli

Amaç: Küresel anlamda birçok alanda yaşanan hızlı değişim ve bu değişimin beraberinde getirdiği dönüşüm ihtiyacı tıp bilimini de etkilemekte ve tıp eğitimi uygulamalarında güncellemeler gerektirmektedir. Bu nedenle, tıp eğitimi değişim ve yenilenmenin en hızlı olduğu bilim alanlarından biri olarak kabul edilmektedir. Bu araştırmanın amacı, sürekli tıp eğitimi ve yaşam boyu öğrenme bağlamında Grand Rounds öğrenme döngüsü modelini planlama, uygulama ve değerlendirme açısından incelemektir. Yöntem: Makale türü geleneksel derlemedir. Sürekli tıp eğitimi ve yaşam boyu öğrenme bağlamında özellikle Amerika Birleşik Devletleri’nde uygulanan grand rounds öğrenme döngüleri ile ilgili planlama, uygulama ve değerlendirme süreçlerini incelemek için kaynak taraması yapılmıştır. Pubmed, Scopus ve Google Scholar arama motorlarında öncelikle “klasik klinik öğrenme döngüsü” olarak adlandırılan “Clinical Rounds”, “Medical Rounds”, “Bedside Teaching Rounds”, “Medicine Rounds” ve “Ward Rounds” anahtar sözcükleri taranmış; sonrasında ise “Grand Rounds” öğrenme döngüsü modelinin yer aldığı çalışmalar incelenmiştir. Bulgular: Grand rounds öğrenme döngüsünün temel amaçları güncel tanı ve tedavi yöntemlerini takip etmek, öğretim üyeleri arasında paylaşımı teşvik etmek, öğrenci ve öğretim üyelerinin hayat boyu öğrenme becerisine katkı sağlamak, asistanlara ve öğrencilere birlikte aktif bir öğrenme ortamı yaratmak, fakültede edinilen deneyimleri ilgili diğer kişilerle paylaşmaktır. Yetişkin öğrenme kuramı ve yaşam boyu öğrenme bağlamında oluşturulmuş Grand Rounds öğrenme döngüsünün klinik öğrenme döngülerinden daha kapsamlı bir sürece sahip olduğu hem mezuniyet öncesi hem de mezuniyet sonrası tıp eğitiminde uygulandığı, farklı disiplinlerden sağlık profesyonellerinin katılımıyla gerçekleştiği görülmüştür. Grand Rounds öğrenme döngülerinin en önemli aşaması planlamadır. Dolayısıyla, planlamayı gerçekleştirecek komitenin göz önünde bulundurulması gereken bazı temel öğeler bulunmaktadır. Bu öğelerden en önemlisi içeriğin katılımcıların ihtiyaçlarına cevap verecek temalar etrafında şekillendirilmesi, uygun öğrenme hedeflerinin belirlenmesi ve gerçekleştirilecek sunumların öğrencilerin klinik akıl yürütme, problem çözme ve karar verme gibi becerilerinin gelişmesine katkı sağlayacak nitelikte seçilmesidir. Uygulama sürecinde katılımcıların konu hakkında tartışması, etkileşime girebilmesi ve bilgi paylaşımı yapabilmesi için yeterli süre tanınmalıdır. Uygulama sonrasında ise, hem öğrenme döngülerinde yer alan içerik hem de sunum yapan kişiler geçerli ve güvenilir araçlarla değerlendirilmelidir.Sonuç: Tıp fakültesi öğrencileri, asistanlar ve tıp eğitimcilerine yaşam boyu öğrenme fırsatı sunması nedeniyle, Grand Rounds öğrenme döngüsü modelinin Türkiye’de sürekli tıp eğitimine entegrasyonunun sağlanması önerilmektedir.

Anahtar Kelimeler:

Tıp Eğitimi, Sürekli Tıp Eğitimi, Yaşam Boyu Öğrenme, Grand Rounds Öğrenme Döngüsü

Grand Rounds Model in terms of Continuing Medical Education and Lifelong Learning

Aim: The rapid change in many fields in the global sense and the need for transformation due to this change has also affected the field of medical sciences; therefore, revisions have been required in medical education practices. For this reason, medical education is considered as one of the fields where change occurs fast. This study aims to examine the Grand Rounds model in terms of continuing medical education and lifelong learning through the analysis of its planning, implementation, and evaluation process. Methods: This traditional literature review, in the context of continuing medical education and lifelong learning, was conducted to examine the planning, implementation and evaluation processes of grand rounds, especially in the United States. In Pubmed, Scopus and Google Scholar search engines, the keywords "Clinical Rounds", "Medical Rounds", "Bedside Teaching Rounds", "Medicine Rounds" and "Ward Rounds", which are called "classical clinical learning cycle", were searched. Then, the studies that included the term “Grand Rounds” model were examined.Results: The grand rounds are designed to follow up-to-date diagnosis and treatment methods, to encourage knowledge sharing among faculty members, to contribute to the lifelong learning skills of students and faculty members, to create an active learning environment for assistants and students, and to share the faculty’s experiences with other stakeholders. It has been observed that the Grand Rounds, which was created in the context of adult learning theory and lifelong learning, has a more comprehensive process than traditional clinical rounds, is applied both in pre-graduate and postgraduate medical education and with the participation of health professionals from various disciplines. The most important stage of the Grand Rounds is planning. Therefore, there are some key elements that should be considered by the organizing committee that will carry out the planning process. These elements include shaping the content around the themes that will meet the needs of the participants, determining the appropriate learning outcomes, and deciding on the presentations that will contribute to the development of students' skills such as clinical reasoning, problem solving and decision making. During the implementation process, sufficient time should be allowed for the participants to discuss, interact, and share information about the subject. After Grand rounds, both the content in the learning cycles and the presenters should be evaluated with valid and reliable tools.Conclusions: Integration of Grand rounds into continuous medical education in Turkey is strongly recommended in terms of providing broader lifelong learning opportunities for medical students, resident physicians and medical educators.

Keywords:

Medical Education, Continuing Medical Education, Lifelong Learning, Grand Rounds,

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