Njengamazwe amaningi, i-Australia ibhekene nokusatshalaliswa okungalingani kokungalingani kwabasebenzi bezempilo, abanodokotela abambalwa nge-capita ezindaweni zasemakhaya kanye nomkhuba obhekela ubuchwepheshe obuphakeme. I-Clerkship ehlanganisiwe ye-Longitudinal Ngenkathi le mininingwane ye-qualitative ibalulekile, idatha eqondene nephrojekthi yokuchaza le nto iyantula.
Ukubhekana nalesi sikhala solwazi, indlela yokwakhiwa yokwakheka isekelwe emcabangweni wokufaneleka yayisetshenziselwa ukuthola ukuthi ilayisense yasemakhaya ehlanganiswe kanjani ehlanganiswe kanjani ye-Dedeakin University ithonya izinqumo zomsebenzi weziqu zabafundi (2011-2020) ngokuya ngendawo ekhethekile yezokwelapha nendawo.
Ama-alumni angamashumi amathathu nesishiyagalolunye ahlanganyele ezingxoxweni ezifanele. Kwakhiwa uhlaka lwezinqumo zomsebenzi wasemakhaya, luphakamisa ukuthi inhlanganisela yezinto eziphakathi nendawo ezingenamiphakathi emcabangweni oyisisekelo "wokuzibandakanya Uma kuhlanganiswe nokusebenza, imiqondo yamakhono okuklama okufunda nokuzibandakanya okuku-inthanethi ukukhuphuka kokubandakanyeka ngokunikeza ababambiqhaza nethuba lokuhlangabezana nethuba lokuthola nokuqhathanisa impilo ngendlela ephelele.
Uhlaka oluthuthukisiwe lumela izinto zombuso zohlelo ezithathwa njengethonya ezinqumweni zokuthola amafutho. Lezi zinto, ezihlanganiswe nesitatimende semishini yezohlelo, zinomthelela ekufezeni izinhloso zezisebenzi zasemakhaya zasemakhaya. Ukuguqulwa kwenzeka ukuthi abafundi bathola ukuhlanganyela kulolu hlelo noma cha. Ukuguqulwa kwenzeka ngokuzindla, okuthi kukhona izinselelo noma okuqinisekisa ukuthi ama-Abutho atholakele aphothule mayelana nokwenza izinqumo zomsebenzi, ngaleyo ndlela athonye ukwakheka kobunikazi bobuchwepheshe.
Njengamazwe amaningi, i-Australia ibhekana nokungalingani okuhlala isikhathi eside nokungalingani ekusatshalalisweni kwabasebenzi bezempilo [1]. Lokhu kufakazelwa inani eliphansi lodokotela nge-capita ezindaweni zasemakhaya nasenkambisweni yoshintsho kusuka ekunakekelweni okuyisisekelo ukuze unakekele kakhulu [2, 3]. Ithathwe ndawonye, lezi zinto zithinta kabi impilo ezindaweni zasemakhaya, ikakhulukazi ngoba ukunakekelwa kwezempilo okuyisisekelo kubalulekile kubasebenzi bezokunakekelwa kwempilo kwale miphakathi, hhayi kuphela izinsizakalo zokunakekelwa kwempilo okuyisisekelo kodwa noMnyango Wezimo Ezibhedlela [4]. ]. I-Clerkship ehlanganisiwe ye-LongKhinaged Clerkshite (LIC) imodeli yezemfundo yezokwelapha eyasungulwa njengendlela yokuqeqesha abafundi bezokwelapha emiphakathini emincane yasemakhaya futhi yadalelwa ukukhuthaza ukuzijwayeza okufanayo emiphakathini efanayo [5, 6]. Le ndlela ekahle iyatholakala ngoba abathweswe iziqu emaphandleni amathuba amaningi kunokuba abathole iziqu abanye abasebenzi (kufaka phakathi ukujikeleza kwezindawo zasemakhaya) ukusebenza emaphandleni, ngokuya ngokunakekelwa kwezempilo okuyisisekelo [7,8,9, 10]. Iziqu zezokwelapha zichazwe kanjani njengenqubo eyinkimbinkimbi ebandakanya izici eziningi zangaphakathi nangaphandle, njengokukhetha kwendlela yokuphila kanye nokwakheka kohlelo lokunakekelwa kwempilo [11,12,13]. Ukunakwa okuncane kukhokhelwe ezintweni zokuqeqeshwa kweziqu zezokwelapha ezingathonya le nqubo yokwenza izinqumo.
I-pedagogy ye-LIC yehlukile ekujikelezeni kwendabuko kwendabuko ngesakhiwo nokubeka [5, 14, 15, 16]. Izikhungo zasemakhaya eziphansi ngokuvamile zitholakala emiphakathini emincane yasemakhaya ngezixhumanisi zemitholampilo kuzo zombili ukuzijwayeza okujwayelekile kanye nezibhedlela [5]. Into esemqoka yelayisense ngumqondo "wokuqhubeka," okuhambisana nokunamathiselwe okude, okuvumela abafundi ukuthi bathuthukise ubudlelwano besikhathi eside nabaphathi, amaqembu okunakekela ezempilo kanye neziguli [5,14,15,15,16]. Izifundo ze-LIC zifunda ngokufanayo futhi zifana, ngokungafani nezifundo ezilandelanayo ezilinganiselwe ezibonisa ukujikeleza kwendabuko [okungu-17].
Yize idatha yobuningi ebanzi bakwa-LIC ibalulekile ekuhloleni imiphumela yohlelo, kunokuntuleka kobufakazi obuthile bokuchaza ukuthi kungani amasethingi okunakekela ama-Riseral maningi aqhathaniswa namanye amamodeli wezempilo [8, 18]. UBrown et al (2021) wenze ukubuyekezwa okwenziwa ngumsebenzi emazweni angenayo impahla (emadolobheni nasemakhaya) futhi waphakamisa ukuthi imininingwane engaphezulu iyadingeka ezintweni ezitholwa phansi ukuhlinzeka ngokuqonda ngezindlela ezitholwayo ' Izinqumo ngomsebenzi [we-18]. Ngaphezu kwalokho, kunesidingo sokuqonda kabusha izinqumo zomsebenzi weziqu zeLL, ukuzibandakanya ngemuva kokuba sebeye baba nezinqumo zochwepheshe, njengoba izifundo eziningi zigxile emibonweni ebonakalayo nezinhloso zabafundi nodokotela abangu-11, 18, 19].
Kungaba okuthakazelisa ukutadisha ukuthi izinhlelo eziphelele zeL L LELL ROUNTETH eziphelele zithonya izinqumo ze-Create Reduates maqondana nezokwelapha kanye nendawo. Indlela yokwakhiwa kwethiyori yokwakha i-appletical yasetshenziselwa ukuphendula imibuzo yocwaningo futhi yakha uhlaka lomqondo oluchaza izinto zomsebenzi wabasebenzi ezithonya le nqubo.
Le yiphrojekthi yokwakhiwa kwe-showlivist efanelekile. Lokhu kukhonjwe njengendlela efanelekile ye-Theory ye-Theory ye-Terrory ngoba (i) Ibukele ubudlelwano phakathi komcwaningi kanye nomhlanganyeli owakha isisekelo sokuqoqwa kwedatha, ebikade ebikhiwe ngezindlela ezifanele zobulungiswa bezenhlalo Cwaninga. , ngokwesibonelo, ukusatshalaliswa okulungile kwezinsizakusebenza zezokwelapha, futhi (iii) kungachaza into efana ne- "Kwenzekani" kunokumane uyihlole futhi uyichaze [20].
Udokotela we-Deakin University (MD) degree (MD) Degree (I-Bachelor of Medicine / I-Bachelor of Medicine / I-Bachelor of Southy) yanikezwa ngo-2008. Udokotela Wezokwelapha Uhlelo Lokungena Kweminyaka emine enikelwa ezindaweni zasekuqaleni nasezindaweni zaseNtshonalanga, ikakhulukazi entshonalanga yeVictoria, E-Australia. Ngokusho kwe-Australia Modified Monash Model (MMM) I-Geographical Clate system, izindawo ze-MD Calserations zifaka phakathi i-MM1 (izindawo zedolobha), MM3 (amadolobha amakhulu asemakhaya), MM4 (Amadolobhana Asemakhaya aphakathi nendawo) kanye ne-MM5 (amabanga amancane amadolobha)) [21].
Iminyaka emibili yokuqala yesigaba sokubhala (ingemuva) kwenziwa eGeelong (MM1). Eminyakeni yesithathu neyesine, ukuzijwayeza ngochwepheshe kwezokwelapha) kwesinye sezikole ezinhlanu zomtholampilo eGoelong, ezempilo yaseMpumalanga (MM1), i-Ballanar (MM3), izikole zomphakathi wasemakhaya ( Uhlelo lwe-RCCS); ), yaziwa ngokusemthethweni njengohlelo lokunye (mm 3-5) kuze kube ngu-2014 (Fig. 1).
I-RCCS LIC ibhalisa cishe abafundi abangama-20 unyaka nonyaka isebenza kuma-Grampis naseSouth Welly Victoria ngesikhathi sayo (yesithathu) ngonyaka we-MD. Indlela yokukhetha isebenzisa uhlelo lokuthanda lapho abafundi bekhetha khona isikole somtholampilo ngonyaka wabo wesibili. Uhlelo lolu lwamukela abafundi ngezinhlobonhlobo zokuncamelayo kusuka ekuqaleni kuya kwesihlanu. Amadolobha athile abese anikezwa ngokusekelwe ekukhetheni kwabafundi kanye nengxoxo. Abafundi basatshalaliswa emadolobheni aphesheya kakhulu ngamaqembu abantu ababili kuya kwabane.
Abafundi basebenza nge-GPS kanye nezinsizakalo zezempilo zasendaweni zasendaweni, enomsebenzi ojwayelekile (GP) njengomphathi wazo oyinhloko.
Abacwaningi abane ababambe iqhaza kulolu cwaningo bavela ezizindeni nasemisebenzini ehlukene, kodwa babelane ngentshisekelo ejwayelekile eMfundweni Yezokwelapha kanye nokusatshalaliswa ngokulinganayo kwabasebenzi bezokwelapha. Lapho sisebenzisa i-Corntivist theory, sibheka izizinda zethu, okuhlangenwe nakho, ulwazi, izinkolelo, kanye nezintshisekelo zokuthonya ukuthuthukiswa kwemibuzo yocwaningo, inqubo yokuxoxisana, kanye nesakhiwo sedatha. I-JB ngumcwaningi wezempilo yasemakhaya enesipiliyoni ekucwaningeni okuvela ngokufaneleka, esebenza kwilayisense nokuhlala endaweni yasemakhaya yendawo yokuqeqesha ilayisensi. I-LF ngudokotela wezokwelapha kanye nomqondisi wemitholampilo yohlelo lwe-LIC eDeakin University futhi ibandakanyeka ekufundiseni abafundi be-LIC. I-MB ne-HB bangabacwaningi basemakhaya abanolwazi ekusebenziseni amaphrojekthi okucwaninga afanelekile futhi abahlala ezindaweni zasemakhaya njengengxenye yokuqeqeshwa kwabo ama-LIC.
I-Reslexivivity kanye nokuhlangenwe nakho kanye namakhono okucwaninga kwasetshenziswa ukutolika nokuthola okushiwo kuleyo datha ecebile. Kuyo yonke iqoqo ledatha nenqubo yokuhlaziya, izingxoxo ezivame njalo kwenzeka, ikakhulukazi phakathi kwe-JB ne-MB. I-HB ne-LF enikezwe ukwesekwa kuyo yonke le nqubo nangokuthuthukiswa kwemiqondo ethuthukile kanye nethiyori.
Ababambiqhaza kwakunguDeakin University Graduates (2011-2020) abakhona ukulalela ilayisense. Isimemo sokubamba iqhaza ocwaningweni sathunyelwa ngabasebenzi be-RCCS abaqeqeshiwe ngomyalezo wombhalo wokuqasha. Ababambiqhaza abanentshisekelo bacelwa ukuthi bachofoze kwisixhumanisi sokubhalisa futhi banikeze imininingwane eningiliziwe ngocwaningo lwe-Quaturics [22], okukhombisa ukuthi (i) babefunde isitatimende solimi olusobala esichaza inhloso yezifundo zocwaningo kanye nezimfuneko ezibambiqhaza, futhi (ii) babezimisele ukubamba iqhaza ocwaningweni. othintwe abaphenyi ukuhlela isikhathi esifanele sezingxoxo. Indawo yomsebenzi wababambiqhaza nayo yaqoshwa.
Ukuqashwa kabusha kwababambiqhaza kwenziwa ngezigaba ezintathu: Isigaba sokuqala sabathola iziqu ku-2017-2020, isigaba sesibili sabathola iziqu ku-2014-2016, kanye nesigaba sesithathu sabathola iziqu ngo-2011-2013 (Fig. 2). Ekuqaleni, i-sampling enenhloso yasetshenziselwa ukuxhumana neziqu ezinentshisekelo futhi iqinisekise ukwehlukahluka kwemisebenzi. Abanye abathweswe iziqu ababezizwa ekuqaleni bazwakalise isifiso sokubamba iqhaza ocwaningweni bekungaxoxwa nabo ngoba bengasabeli esicelweni somcwaningi isikhathi esizoxoxwa ngaso. Inqubo yokuqashwa kwesikhashana ivunyelwe inqubo yokuqoqwa kwedatha kanye nokuhlaziywa, ukusekela isampula le-theory, ukuthuthukiswa komqondo kanye nokuhlaziywa, kanye nesizukulwane se-theory [20].
Ababambiqhaza baqashe uhlelo lokuqashwa. AbakwaLig iziqu ababambiqhaza ohlelweni lwe-Clerkship olude oluhlanganisiwe. ISampling enenhloso isho ukuqasha isampula ehlukahlukene yabahlanganyeli.
Izingxoxo zaqhutshwa ngabacwaningi i-JB ne-MB. Imvume yomlomo yatholakala kubabambiqhaza kanye nokulalelwayo okurekhodiwe ngaphambi kokuqala kwengxoxo. Umhlahlandlela wengxoxo ohlelwe kabusha ohlelwe kanye nezinhlolovo ezihambisanayo ekuqaleni kwasungulwa ukuqondisa inqubo yengxoxo (ithebula 1). Le ncwajana yasheshiswa ngemuva kwalokho yahlolwa ngokuqoqwa kwedatha nokuhlaziywa ukuhlanganisa izinkomba zocwaningo nge-Theory Development. Izingxoxo zenziwa ngocingo, okulalelwayo okurekhodiwe, zibhalwe phansi nge-verbatim, futhi azivezwanga. Ubude bengxoxo busuka emizuzwini engama-20 kuye kwangama-53, ngobude obuphakathi kwemizuzu engama-33. Ngaphambi kokuhlaziywa kwedatha, ababambiqhaza bathunyelwa amakhophi okubhaliwe kwengxoxo ukuze bangeze noma bahlele imininingwane.
Ukuhanjiswa kwengxoxo kufakwe kwi-software yesoftware yesoftware QSR NVIVE Version 12 (LumiverO) ngeWindows To Ukuhlaziywa Kwedatha [23]. Abaphenyi jb no-MB balalele, bafundze, bafaka amakhodi ngakunye ngamunye. Ukubhala kwenothi kuvame ukusetshenziselwa ukuqopha imicabango engekho emthethweni ngedatha, amakhodi, kanye nezigaba ezingama-20].
Ukuqoqwa kwedatha nokuhlaziywa kwenzeka ngasikhathi sinye, ngenqubo ngayinye yazisa enye. Le ndlela yokuqhathanisa njalo yasetshenziswa kuzo zonke izigaba zokuhlaziywa kwedatha. Isibonelo, ukuqhathanisa idatha nedatha, ukubola kanye namakhodi wokucolisa ukuthuthukisa izinkomba ezingemva kokucwaninga ngokuya ngokuthuthukiswa kwethiyori [20]. Abaphenyi jb no-MB bahlangana kaningi ukudingida amakhodi okuqala futhi bakhombe izindawo zokugxila ngesikhathi senqubo yokuqoqwa kwedatha yedatha.
Amakhodi aqale ngokufaka amakhodi okuqala ngomugqa-ngomugqa lapho imininingwane "ephukile phansi" futhi amakhodi avulekile abelwe echaza imisebenzi nezinqubo ezihlotshaniswa nedatha. Isigaba esilandelayo se-Coding singamakhodi aphakathi nendawo, lapho kubuyekezwa khona amakhodi we-Line-by-line, kuqhathaniswa, kuhlaziywe, futhi kuhlazikwe, futhi kuhlazikwe ndawonye ukuthola ukuthi yimaphi amakhodi anenjongo yokuhlaziya imininingwane [20]. Ekugcineni, amakhodi we-theoretical anwebekile asetshenziselwa ukwakha umbono. Lokhu kufaka ukuxoxa nokuvuma izakhiwo zokuhlaziya zombono kulo lonke iqembu lokucwaninga, kuqinisekiswe ukuthi lichaza kahle into.
Idatha yabantu yaqoqwa ngocwaningo lwe-inthanethi oluningi ngaphambi kwengxoxo ngayinye ukuze kuqinisekiswe ababambiqhaza ababanzi nokuhambisana nokuhlaziywa kwezimo. Idatha eqoqwe ifakiwe: ubulili, ubudala, unyaka wokuthweswa iziqu, imvelaphi yasemakhaya, indawo yamanje yokuqashwa, okukhethekile kwezokwelashwa, nendawo yesikole semitholampilo yesine.
Ukutholwa kwazisa ukuthuthukiswa kohlaka lomqondo olubonisa ukuthi amathoni e-lima asemakhaya athola kanjani 'izinqumo zomsebenzi wokusebenza kwezindawo kanye nomsebenzi.
Iziqu ezingamashumi amathathu nesishiyagalolunye zibambe iqhaza ocwaningweni. Kafushane nje, ama-53.8% ababambiqhaza abesifazane, ama-43.6% ayeqhamuka ezindaweni zasemakhaya, ama-38,5% asebenze ezindaweni zasemakhaya, kwathi abangama-89.7% base baqede ubuchwepheshe bezokwelapha noma ukuqeqeshwa (Ithebula 2).
Lo hlaka lwezinqumo zomsebenzi zasemakhaya lugxile ezintweni zohlelo lwe-Rulnal Lic ezithonya izinqumo zabasebenzi abathweswe iziqu, ziphakamisa ukuthi inhlanganisela yezinto eziphakathi nendawo nezohlelo "nayo ingathonya indawo yokuthola iziqu. Njengezinqumo zomsebenzi we-Professional, kungaba zodwa noma i-Sybbiotic (Umdwebo 3). Lokhu okutholakele okulandelayo okutholakele kuchaza izinto zohlaka futhi kufaka izingcaphuno ezivela kubahlanganyeli ukufanekisa okushiwo.
Izabelo zesikole zomtholampilo ziphothulwa ngohlelo lokuthanda, ngakho ababambiqhaza bangakhetha izinhlelo ngendlela ehlukile. Phakathi kwalabo abakhethe ngokuqokwa ukubamba iqhaza, kwakukhona amaqembu amabili abathweswe iziqu: Labo abakhethe ngamabomu ukuthi babambe iqhaza kulolu hlelo (abazikhethile), nalabo abangazange bakhethe kodwa babhekiselwa kuma-RCC. Lokhu kuboniswa emibonweni yokuqalisa (iqembu lokugcina) nokuqinisekiswa (iqembu lokuqala). Uma kuhlanganiswe nokusebenza, imiqondo yamakhono okuklama okufunda nokuzibandakanya okuku-inthanethi ukukhuphuka kokubandakanyeka ngokunikeza ababambiqhaza nethuba lokuhlangabezana nethuba lokuthola nokuqhathanisa impilo ngendlela ephelele.
Kungakhathalekile ukuthi zingakanani izinga lokuzikhethela, ababambiqhaza ngokuvamile babenomuzwa ngesipiliyoni sabo futhi bathi unyaka wokulahliwe wokufunda akazange abethule emtholampilo kuphela ezifundweni zabo kanye nesisekelo esiqinile se imisebenzi yabo. Ngendlela ehlanganisiwe yokwethula uhlelo, bafunda ngempilo yasemakhaya, umuthi wasemakhaya, umkhuba ojwayelekile kanye nobungcweti bezokwelapha obuhlukahlukene.
Abanye ababambiqhaza babike ukuthi ukube bebengayanga kulolu hlelo futhi baqeda konke ukuqeqeshwa endaweni yedolobha, bebengeke bakuqonde noma baqonde ukuthi bahlangabezana kanjani nezidingo zabo zomuntu siqu nezingcweti endaweni yasemakhaya. Lokhu kugcina kuholela ekuguqulweni kwezici zomuntu siqu nezobuchwepheshe, njengohlobo lodokotela afisa ukuba yilo, umphakathi lapho afuna ukuzijwayeza khona, nezici zokuphila ezifana nokufinyelela emvelweni nasekutholeni impilo yasemakhaya.
Kubukeka kimi ukuthi ukube bengisanda kuhlala e-X [Metropolitan Diadicility] noma okuthile okunjalo, kungenzeka ukuthi besingahlali nje endaweni eyodwa, angicabangi ukuthi thina (abalingani) besingakwenza, lokhu kugxuma ( Emsebenzini ezindaweni zasemakhaya) bekungeke kucindezelwe (Umbhalisi Ojwayelekile Wokuzijwayeza, umkhuba wasemakhaya).
Ukubamba iqhaza kulolu hlelo kuhlinzeka ithuba lokubonisa nokuqinisekisa izinhloso zokuthola iziqu ukuze zisebenze ezindaweni zasemakhaya. Lokhu kuvame ngenxa yokuthi wakhulela endaweni yasemakhaya futhi uhlose ukwenza umsebenzi we-internship endaweni efanayo ngemuva kokuthweswa iziqu. Kulabo abahlanganyeli ekuqaleni okuhlose ukungena ngokujwayelekile, bekucacile nokuthi isipiliyoni sabo sasihlanganele saso sasilindele futhi saqinisa ukuzibophezela kwabo ekuphishekeleni le ndlela.
(Ukuba nelayisense) kusanda kuqiniswa lokho ebengicabanga ukuthi kuyinto engikuthandayo futhi kusanda kuvamisa isivumelwano futhi angizange ngicabange ngisho nokufaka isicelo sesikhundla seMetro kunyaka wami wangaphakathi noma ngacabanga ngakho. Mayelana nokusebenza kuMetro (udokotela wezifo zengqondo, umtholampilo wasemakhaya).
Kwabanye, ukubamba iqhaza kuqinisekisile ukuthi impilo yasemakhaya / impilo ayizange ihlangabezane nezidingo zabo zomuntu siqu nezingcweti. Izinselelo ngazinye zibangela ibanga kusuka kumndeni nabangane, kanye nokuthola izinsizakalo ezifana nemfundo nokunakekelwa kwempilo. Babheka imvamisa yomsebenzi wokubingelela owenziwe ngodokotela basemakhaya njengento yokuvimbela umsebenzi.
Imenenja yami yedolobha ihlala ixhumana. Ngakho-ke, ngicabanga ukuthi le ndlela yokuphila ayilungele mina (GP emtholampilo omkhulu).
Amathuba wokuhlola nokufunda kwabafundi abathonya izinqumo zomsebenzi. Izici ezibalulekile zokuqhubeka nokuhlanganiswa kweLi L lic .
Ngenxa yokuthi izifundo zezokwelapha esifundweni zifundiswa ngokufanele, ababambiqhaza banezinga eliphakeme lokuzimela futhi bangazichaza futhi bathole amathuba abo okufunda. Ukuzimela kwabahlanganyeli kukhula phakathi nonyaka njengoba bethola ukuqonda okungaphakathi nokuphepha ngaphakathi kohlelo, bethola amandla okuzibandakanya ekuzihloleni okujulile kuzilungiselelo ezahlukahlukene zokwelashwa. Lokhu kwavumela ababambiqhaza ukuthi baqhathanise iziqondiso zokwelashwa ngesikhathi sangempela, kukhombisa ukuheha kwazo ezindaweni ezithile zemitholampilo ezivame ukuqeda ukukhetha njengokukhethekile.
Ku-RCCS uvezwa yilawa ma-majors phambilini bese empeleni uthola isikhathi esengeziwe sokugxila ezihlokweni ozithandayo ngempela, ngakho-ke ngokweqiniso abafundi bakaMetro abanakho ukuguquguquka kokukhetha isikhathi sabo nendawo. Eqinisweni, ngiya esibhedlela nsuku zonke ... okusho ukuthi ngikwazi ukuchitha isikhathi esithe xaxa egumbini lezimo eziphuthumayo, isikhathi esithe xaxa egumbini elisebenzayo, futhi ngenze lokho engikuthandayo (futhi ngenze konke engikuthandayo.
Isakhiwo sohlelo luvumela abafundi ukuthi bahlangabezane neziguli ezingahambisani nalokhu ngenkathi behlinzeka ngezinga eliphephile lokuzimela ukuze bathole umlando wemitholampilo, ukuthuthukisa amakhono okubonisana emtholampilo, futhi banikeze ukuxilongwa okuhlukile kanye nokwelashwa kohlelo lodokotela kanye nokwelashwa komtholampilo. Lokhu kuzimela kuqhathaniswa nokubuyiselwa kokujikeleza kwe-block ngonyaka wesine, lapho kuzwakala ukuthi kunamathuba ambalwa okuthonya iziguli ezingahambisani futhi kukhona ukubuyela endimeni yokugada. Isibonelo, omunye umfundi waphawula ukuthi uma kuphela okuhlangenwe nakho kwabo kwemitholampilo kuvame ukujikeleza okwesine, okwakuchazwa njengobukele, ubengeke aqonde ububanzi bokuzijwayeza okujwayelekile futhi waphakamisa ukuphishekela ukuqeqeshwa kwenye into ekhethekile . .
Futhi anginaso isipiliyoni esihle nhlobo (ukujikeleza amabhlogo we-GP). Ngakho-ke, nginomuzwa wokuthi uma lokhu bekuwukuphela kokuhlangenwe nakho kwami okujwayelekile, mhlawumbe umsebenzi wami wokukhetha umsebenzi ngabe wawuhlukile ... Ngivele ngizwe sengathi ngingukuchitha isikhathi njengoba ngibona nje indawo yomsebenzi. .
Ukunamathiselwa okude kuvumela ababambiqhaza ukuthi bathuthukise ubudlelwano obuqhubekayo nodokotela abasebenza njengabeluleki kanye nezibonelo. Ababambiqhaza bafuna odokotela bafunwa ngodokotela futhi basebenzise isikhathi eside nabo ngenxa yezizathu ezahlukahlukene, njengesikhathi nokusekelwa abakunikezile, ukuqeqeshwa, ukuncoma, ukuthandwa yimodeli yabo yokwenza, nobuntu babo kanye namagugu. Ukuhambisana ngokwakho noma kwabanye. Isifiso sokukhulisa. Amamodeli / abalingisi abalingiswa bekungekhona nje ababambiqhaza ababelwe ngaphansi kokuqondisa kwe-GP yezokwelapha, kodwa futhi nabamele izinhlobonhlobo zobungcweti bezokwelapha, kubandakanya nodokotela, odokotela abahlinzayo kanye nabasosayensi.
Kunezinto eziningana. NgisePhoyinti X (indawo yelayisense). Kwakunodokotela obulala izinzwa ngokuqondile owayephethe i-ICU ngokungaqondile, ngicabanga ukuthi wayinakekela i-ICU esibhedlela i-X (Rural) esibhedlela futhi waba nesifo somoya esizolile, iningi lama-anesthesiloologists engihlangane naye linesimo sokuzola ngezinto eziningi. Kwakuyisimo sengqondo esingafinyeleleki kahle. (isazi sokubulala izinzwa, udokotela wedolobha)
Ukuqonda okungokoqobo kokuhlangana kwezimpilo zobungcweti bodokotela kanye nokwethu siqu kwachazwa njengokuhlinzeka ukuqonda okubalulekile kwizindlela zabo zokuphila futhi kukholakala ukuthi kukhuthaza ababambiqhaza ukuba balandele izindlela ezifanayo. Kukhona futhi okuhle kwempilo kadokotela, odonswe emisebenzini yezenhlalo yekhaya.
Kuwo wonke unyaka, ababambiqhaza bakhulisa amakhono emitholampilo, abomuntu nangobuchwepheshe ngokusebenzisa amathuba okufunda anikezwe ngobudlelwano obuthuthukisiwe nodokotela, iziguli kanye nabasebenzi bezempilo. Ukuthuthukiswa kwalawa makhono okuxhumana nemitholampilo kuvame ukubandakanya indawo ethile yomtholampilo, efana nemithi ejwayelekile noma i-anesthesia. Isibonelo, ezimweni eziningi, abaphothula izalukazi kanye nama-anesthesiologists ajwayelekile bachaza ukuthuthukiswa kwabo amakhono ayisisekelo esiyalweni esivela kuLawoti lawo, kanye nokuzisebenza ngokusebenza kwazo ngokwengeziwe kwamukelwa futhi kwavuzwa. Lo muzwa uzoqiniswa ngokuqeqeshwa okulandelayo. Futhi kuzoba namathuba okuthuthuka okwengeziwe.
Kuhle impela. Kufanele ngithole iminjunju, i-anesthesia yomgogodla, njll., Nangemva konyaka olandelayo ngizogcwalisa ukuvuselelwa ... Ukuqeqeshwa kwe-anesthesiology. Ngizoba ngumsakazi omkhulu wokubulala izinzwa futhi ngicabanga ukuthi leyo bekuyingxenye engcono kakhulu yesipiliyoni sami esisebenza lapho (i-LIC Scheme) (General Anesthesia Registrian, esebenza endaweni yasemakhaya).
Ukuqeqeshwa kusayithi noma izimo zephrojekthi kuchazwe ngokuthi kunomthelela ezinqumweni zomsebenzi wababambiqhaza. Izilungiselelo zichazwe njengenhlanganisela yezilungiselelo zasemakhaya, ukuzijwayeza okujwayelekile, izibhedlela zasemakhaya kanye nezilungiselelo ezithile zemitholampilo (isib. Ukusebenza kweshashalazi) noma izilungiselelo. Imiqondo ehlobene nendawo, kufaka phakathi umqondo womphakathi, ukunethezeka kwezemvelo, kanye nohlobo lokuvezwa komtholampilo, izinqumo zabahlanganyeli abatholile ukusebenza ezindaweni zasemakhaya kanye / noma umkhuba ojwayelekile.
Umuzwa womphakathi awutholile izinqumo zabahlanganyeli ukuqhubeka ngokuzilolonga okujwayelekile. Ukudluliswa kwesicelo sokuzijwayeza okujwayelekile njengomsebenzi ukuthi kudala indawo enobungane enobuhle obuncane lapho abahlanganyeli bengasebenzisana khona futhi babone ochwepheshe kanye ne-GPS ababonakala bejabulela futhi bathole umuzwa wokwaneliseka emsebenzini wabo.
Ababambiqhaza baphinde babona ukubaluleka kokwakha ubudlelwano nomphakathi wesiguli. Ukwaneliseka komuntu siqu nokwakheza kufinyelelwa ngokwazi iziguli nokwakha ubudlelwano obuqhubekayo ngokuhamba kwesikhathi njengoba belandela indlela yabo, kwesinye isikhathi kuphela ngokuzijwayeza okujwayelekile, kepha kaningi kuzo zonke izilungiselelo zemitholampilo eziningi. Lokhu kuqhathaniswa nokuthanda okuncane okungathandeki ekunakekelweni kwe-episodic, njengaseminyangweni yezimo eziphuthumayo, lapho kungahle kungabi khona i-loop evaliwe yemiphumela yeziguli elandelayo.
Ngakho-ke, uthola ngempela ukwazi iziguli zakho, futhi ngicabanga ukuthi empeleni, mhlawumbe lokho engikuthanda kakhulu ngokuba yi-GP ubudlelwane obuqhubekayo onabo neziguli zakho, futhi hhayi ngezinye izikhathi ezibhedlela nakwamanye amakhono , unga ... Ubabone kanye noma kabili, futhi kaningi awukaze ubabone (uchwepheshe Jikelele, iMetropolitan Clinic).
Ukuvezwa kokuzijwayeza okujwayelekile nokuzibandakanya ekubonisaneni ngokufana kunikeze ababambiqhaza ukuqonda ububanzi bemithi yendabuko yaseChina ngokujwayelekile, ikakhulukazi emkhakheni ojwayelekile wasemakhaya. Ngaphambi kokuba abaqeqeshwayo, abanye ababambiqhaza bacabanga ukuthi bangase bahlanganyele okujwayelekile, kepha abahlanganyeli abaningi abagcina bathi bangu-GPS, bazizwa bengasebenzi kahle, ngakho-ke bekungasho lutho inzalo yobungcweti esikhathini eside.
Njengoba sekwenziwe umkhuba we-GP njengomfundi wokucwilisa, ngicabanga ukuthi kwakuwukuchayeka kwami kokuqala kwe-GPS ehlukahlukene futhi ngacabanga ukuthi ezinye iziguli zaziyinselele kanjani, izinhlobo zeziguli (GP) zingaba kanjani, zingenza imali enkulukazi). ).
Isikhathi Seposi: Jul-31-2024