Njengamazwe amaningi, i-Australia ibhekene nokusatshalaliswa okungalingani kwabasebenzi bezempilo isikhathi eside, odokotela abambalwa ngomuntu ngamunye ezindaweni zasemakhaya kanye nokuthambekela kochwepheshe abaphezulu. I-Longitudinal Integrated Clerkship (LIC) iyimodeli yemfundo yezokwelapha okungenzeka kakhulu kunezinye izindlela ze-clerkship ukukhiqiza abafundi abaphothule abasebenza emiphakathini yasemakhaya, ehlala kude kakhulu kanye nasezindaweni zokunakekelwa okuyisisekelo. Nakuba le datha yokulinganisa ibalulekile, idatha ethile yephrojekthi yokuchaza lesi simo ayitholakali.
Ukuze kuxazululwe leli gebe lolwazi, kwasetshenziswa indlela yokwakheka esekelwe kumbono wekhwalithi ukuthola ukuthi i-LIC yasemakhaya ehlanganisiwe yaseDeakin University ithonye kanjani izinqumo zomsebenzi zabafundi abaphothule (2011-2020) maqondana nobuchwepheshe bezokwelapha kanye nendawo.
Abafundi abaphothule izifundo zabo abangama-39 bahlanganyele ezingxoxweni ezisezingeni eliphezulu. Kusungulwa uhlaka lwezinqumo zomsebenzi we-LIC yasemakhaya, olusikisela ukuthi inhlanganisela yezici zomuntu siqu nezezinhlelo ngaphakathi komqondo oyinhloko "wokukhetha ukubamba iqhaza" ingathonya izinqumo zomsebenzi zabaphothule izifundo zendawo nezomsebenzi, kokubili mathupha nangokuhambisana. Uma sekuhlanganiswe ekusebenzeni, imiqondo yamakhono okuklama okufunda kanye nokuqeqeshwa endaweni kukhulisa ukuzibandakanya ngokunikeza ababambiqhaza ithuba lokuzwa nokuqhathanisa imikhakha yokunakekelwa kwempilo ngendlela ephelele.
Uhlaka oluthuthukisiwe lumelela izici zomongo zohlelo ezibhekwa njengezinethonya ezinqumweni zomsebenzi zabafundi abaphothule kamuva. Lezi zinto, zihlanganiswe nesitatimende somsebenzi wohlelo, zinegalelo ekufezeni imigomo yabasebenzi basemakhaya yohlelo. Ushintsho lwenzeka kungakhathaliseki ukuthi abafundi bafuna ukuhlanganyela ohlelweni noma cha. Ushintsho lwenzeka ngokuzindla, okuphonsela inselelo noma okuqinisekisa imibono yabafundi abaphothule kusengaphambili mayelana nokwenza izinqumo zomsebenzi, ngaleyo ndlela kuthonye ukwakheka kobunikazi bobungcweti.
Njengamazwe amaningi, i-Australia ibhekene nokungalingani okuhlala isikhathi eside nokuqhubekayo ekusatshalalisweni kwabasebenzi bezempilo [1]. Lokhu kufakazelwa inani eliphansi lodokotela ngomuntu ngamunye ezindaweni zasemakhaya kanye nomkhuba wokushintsha kusuka ekunakekelweni okuyisisekelo kuya ekunakekelweni okukhethekile kakhulu [2, 3]. Uma zihlanganiswa, lezi zici zithinta kabi impilo ezindaweni zasemakhaya, ikakhulukazi ngoba ukunakekelwa kwezempilo okuyisisekelo kuyisihluthulelo sabasebenzi bezempilo bale miphakathi, abahlinzeka hhayi ngezinsizakalo zokunakekelwa kwempilo okuyisisekelo kuphela kodwa futhi nokunakekelwa komnyango ophuthumayo kanye nezibhedlela [4]. ]. I-Longitudinal Integrated Clerkship (LIC) iyimodeli yemfundo yezokwelapha eyasungulwa ekuqaleni njengendlela yokuqeqesha abafundi bezokwelapha emiphakathini emincane yasemakhaya futhi yadalelwa ukukhuthaza umkhuba wokugcina emiphakathini efanayo [5, 6]. Lo mgomo ufezwa ngoba abaphothule ama-LIC asemakhaya banamathuba amaningi kunabaphothule abanye abasebenzi (kufaka phakathi ukujikeleziswa kwabasemakhaya) okusebenza emiphakathini yasemakhaya, eqhele kakhulu kanye nasekunakekelweni kwezempilo okuyisisekelo [7,8,9,10]. Indlela abaphothule ezokwelapha abakhetha ngayo umsebenzi ichazwe njengenqubo eyinkimbinkimbi ehilela izici eziningana zangaphakathi nezangaphandle, njengokukhetha indlela yokuphila kanye nesakhiwo sohlelo lwezempilo [11,12,13]. Akunakwanga kakhulu izici ezitholakala ekuqeqeshweni kwezokwelapha kwe-undergraduate ezingase zithonye le nqubo yokwenza izinqumo.
Indlela yokufundisa ye-LIC ihlukile ekujikelezweni kwebhulokhi yendabuko ngesakhiwo kanye nokubekwa [5, 14, 15, 16]. Izikhungo zasemakhaya ezinemali ephansi zivame ukutholakala emiphakathini emincane yasemakhaya enezixhumanisi zemitholampilo kokubili emitholampilo evamile kanye nezibhedlela [5]. Isici esibalulekile se-LIC umqondo "wokuqhubeka," okwenziwa lula ukunamathela isikhathi eside, okuvumela abafundi ukuthi bakhe ubudlelwano besikhathi eside nabaphathi, amaqembu okunakekelwa kwezempilo, kanye neziguli [5,14,15,16]. Abafundi be-LIC bafunda izifundo ngokuphelele nangokuhambisanayo, ngokungafani nezifundo ezilandelanayo zesikhathi esinqunyelwe ezichaza ukujikeleziswa kwebhulokhi yendabuko [5, 17].
Nakuba idatha yobuningi ngabasebenzi be-LIC ibalulekile ekuhloleni imiphumela yohlelo, kunokuntuleka kobufakazi obuqondile bokuchaza ukuthi kungani abafundi abaphothule i-LIC yasemakhaya benamathuba amaningi okusebenza ezindaweni zasemakhaya nasezindaweni zokunakekelwa okuyisisekelo uma kuqhathaniswa nabafundi abaphothule emisebenzini yezempilo kwamanye amamodeli okusebenzela [8, 18]. UBrown nabanye (2021) benze isibuyekezo sokuhlola ukwakheka kobunikazi bomsebenzi emazweni anengeniso ephansi (emadolobheni nasemakhaya) futhi basikisela ukuthi kudingeka ulwazi olwengeziwe ngezinto ezithinta umsebenzi onengeniso ephansi ukuze kunikezwe ukuqonda ngezindlela ezithonya izinqumo zabafundi mayelana nomsebenzi [18]. Ngaphezu kwalokho, kunesidingo sokuqonda ngokubheka emuva ukukhetha umsebenzi kwabafundi abaphothule i-LIC, sibabandakanye ngemuva kokuba sebengodokotela abafanelekayo abenza izinqumo zobungcweti, njengoba izifundo eziningi zigxile emibonweni nasezinhlosweni ezibonwayo zabafundi nodokotela abancane [11, 18, 19].
Kungaba mnandi ukutadisha ukuthi izinhlelo zasemakhaya eziphelele ze-LIC zithonya kanjani izinqumo zomsebenzi zabaphothule ngokuphathelene nobuchwepheshe bezokwelapha kanye nendawo yezwe. Indlela yethiyori yokwakhiwa yasetshenziswa ukuphendula imibuzo yocwaningo nokuthuthukisa uhlaka lomqondo oluchaza izakhi zomsebenzi wabasebenzi ezithonye le nqubo.
Lena iphrojekthi yethiyori yokwakhiwa kwekhwalithi. Lokhu kuhlonzwe njengendlela efanele kakhulu yethiyori ngoba (i) yaqaphela ubudlelwano phakathi komcwaningi nomhlanganyeli obakha isisekelo sokuqoqwa kwedatha, okwakhiwe ngokubambisana yizinhlangothi zombili (ii) kwakubhekwa njengezindlela ezifanele zocwaningo lobulungiswa bezenhlalo. , isibonelo, ukusatshalaliswa okufanele kwezinsiza zezokwelapha, kanye (iii) kungachaza into efana nokuthi “kwenzekeni” kunokumane nje kuhlolwe futhi kuchazwe [20].
Iziqu zeDokotela Wezokwelapha (MD) zaseDeakin University (ezaziwa ngokuthi yiBachelor of Medicine/Bachelor of Surgery) zanikezwa ngo-2008. Iziqu zeDokotela Wezokwelapha uhlelo lokungena lweminyaka emine lwe-postgraduate olunikezwa ezindaweni zasemadolobheni nezasemakhaya, ikakhulukazi entshonalanga yeVictoria, e-Australia. Ngokusho kohlelo lokuhlukaniswa kwebanga lendawo lwe-Australian Modified Monash Model (MMM), izindawo zezifundo ze-MD zifaka phakathi i-MM1 (izindawo zedolobha), i-MM2 (izikhungo zesifunda), i-MM3 (amadolobha amakhulu asemakhaya), i-MM4 (amadolobha asemakhaya aphakathi nendawo) kanye ne-MM5 (amadolobhana amancane asemakhaya) [21].
Iminyaka emibili yokuqala yesigaba sangaphambi kokwelashwa (isizinda sezokwelapha) yenziwa eGeelong (MM1). Ngonyaka wesithathu nowesine, abafundi baqeqeshwa ngokwezokwelapha (umkhuba wobungcweti kwezokwelapha) kwesinye sezikole ezinhlanu zezokwelapha eGeelong, e-Eastern Health (MM1), eBallarat (MM2), eWarrnambool (MM3) noma ohlelweni lwe-LIC – Rural Community Clinical Schools (RCCS); ), olwaziwa ngokusemthethweni ngokuthi uhlelo lwe-IMMERSE (MM 3-5) kuze kube ngu-2014 (Isithombe 1).
I-RCCS LIC ibhalisa abafundi ababalelwa ku-20 minyaka yonke abasebenza esifundeni saseGrampians kanye neNingizimu Ntshonalanga yeVictoria ngesikhathi sonyaka wabo wokugcina (wesithathu) we-MD. Indlela yokukhetha iwukusebenzisa uhlelo lokukhetha lapho abafundi bekhetha khona isikole somtholampilo onyakeni wabo wesibili. Uhlelo lwamukela abafundi abanezinketho ezahlukene kusukela kowokuqala kuya kowesihlanu. Amadolobha athile abelwa ngokusekelwe kulokho abafundi abakuthandayo kanye nengxoxo. Abafundi basatshalaliswa kuwo wonke amadolobha ikakhulukazi ngamaqembu abantu ababili kuya kwabane.
Abafundi basebenza nodokotela bezingane kanye nezinsizakalo zezempilo zasemakhaya zasendaweni, kanti udokotela ojwayelekile (GP) ungumqondisi wabo oyinhloko.
Abacwaningi abane abahilelekile kulolu cwaningo bavela ezizindeni nasemisebenzini ehlukene, kodwa banesithakazelo esifanayo emfundweni yezokwelapha kanye nokusatshalaliswa ngokulinganayo kwabasebenzi bezokwelapha. Uma sisebenzisa ithiyori yokwakhiwa, sicabangela izizinda zethu, okuhlangenwe nakho, ulwazi, izinkolelo, kanye nezintshisekelo zethu ukuze kuthonye ukuthuthukiswa kwemibuzo yocwaningo, inqubo yokuxoxisana, ukuhlaziywa kwedatha, kanye nokwakhiwa kwethiyori. U-JB ungumcwaningi wezempilo wasemakhaya onolwazi ocwaningweni lwekhwalithi, osebenza e-LIC futhi ohlala endaweni yasemakhaya endaweni yokuqeqeshwa ye-LIC. U-LF unguchwepheshe wezokwelapha kanye nomqondisi wezokwelapha wohlelo lwe-LIC eDeakin University futhi uhilelekile ekufundiseni abafundi be-LIC. U-MB no-HB bangabacwaningi basemakhaya abanolwazi lokuqalisa amaphrojekthi ocwaningo lwekhwalithi kanye nokuhlala ezindaweni zasemakhaya njengengxenye yokuqeqeshwa kwabo kwe-LIC.
Ukuguquguquka kwengqondo kanye nolwazi kanye namakhono omcwaningi kwasetshenziswa ukuhumusha nokuthola incazelo kulolu hlu lwedatha olucebile. Kuyo yonke inqubo yokuqoqwa kwedatha nokuhlaziywa kwayo, kwaba nezingxoxo eziningi, ikakhulukazi phakathi kuka-JB no-MB. U-HB no-LF banikeze ukwesekwa kuyo yonke le nqubo kanye nokuthuthukiswa kwemiqondo ethuthukisiwe kanye nethiyori.
Abahlanganyeli kwakungabafundi abaphothule izifundo zobudokotela eDeakin University (2011–2020) ababese-LIC. Isimemo sokubamba iqhaza ocwaningweni sathunyelwa ngabasebenzi abangochwepheshe be-RCCS ngomyalezo wombhalo wokuqasha. Abahlanganyeli abanentshisekelo bacelwe ukuthi bachofoze isixhumanisi sokubhalisa futhi banikeze ulwazi oluningiliziwe ngocwaningo lwe-Qualtrics [22], okubonisa ukuthi (i) bafunde isitatimende solimi olulula esichaza injongo yocwaningo kanye nezidingo zabahlanganyeli, futhi (ii) babezimisele ukubamba iqhaza ocwaningweni. abathintwa abacwaningi ukuhlela isikhathi esifanele sezingxoxo. Indawo yomsebenzi wabahlanganyeli nayo yaqoshwa.
Ukuqashwa kwabahlanganyeli kwenziwa ngezigaba ezintathu: isigaba sokuqala sabaphothule ngo-2017-2020, isigaba sesibili sabaphothule ngo-2014-2016, kanye nesigaba sesithathu sabaphothule ngo-2011-2013 (Umfanekiso 2). Ekuqaleni, ukusampula okuhlosiwe kwasetshenziswa ukuxhumana nabaphothule abanentshisekelo nokuqinisekisa ukuhlukahluka kwemisebenzi. Abanye abaphothule ekuqaleni abaveze intshisekelo yokubamba iqhaza ocwaningweni abazange baxoxwe ngoba abazange baphendule esicelweni somcwaningi sesikhathi sokuxoxisana. Inqubo yokuqasha ehleliwe yavumela inqubo ephindaphindayo yokuqoqwa kwedatha nokuhlaziywa, ukusekela ukusampula kwethiyori, ukuthuthukiswa komqondo kanye nokuhluzwa, kanye nokukhiqizwa kwethiyori [20].
Uhlelo lokuqasha abahlanganyeli. Abaphothule i-LIC bangabahlanganyeli kuHlelo Lokubhalisa Oluhlanganisiwe Lwesikhathi Eside. Ukusampula okunenjongo kusho ukuqasha isampula ehlukahlukene yabahlanganyeli.
Izingxoxo zenziwa ngabacwaningi u-JB no-MB. Imvume yomlomo yatholakala kubahlanganyeli futhi umsindo waqoshwa ngaphambi kokuqala kwengxoxo. Umhlahlandlela wengxoxo ohlelekile kancane kanye nezinhlolovo ezihlobene nawo zaqalwa ukuqondisa inqubo yengxoxo (Ithebula 1). Incwadi yabuyekezwa futhi yahlolwa ngokuqoqwa kwedatha nokuhlaziywa ukuze kuhlanganiswe iziqondiso zocwaningo nokuthuthukiswa kwethiyori. Izingxoxo zenziwa ngocingo, umsindo waqoshwa, wabhalwa phansi ngokwezwi nezwi, futhi wangaziwa. Ubude bengxoxo babusukela kumaminithi angu-20 kuya kwangu-53, ubude obumaphakathi bemizuzu engama-33. Ngaphambi kokuhlaziywa kwedatha, abahlanganyeli babethunyelwa amakhophi emibhalo yengxoxo ukuze bakwazi ukwengeza noma ukuhlela ulwazi.
Imibhalo yengxoxo ilayishwe kwiphakheji yesofthiwe yekhwalithi ye-QSR NVivo inguqulo 12 (Lumivero) ye-Windows ukuze ihambisane nokuhlaziywa kwedatha [23]. Abacwaningi u-JB no-MB balalele, bafunda, futhi babhala ikhodi yengxoxo ngayinye ngabanye. Ukubhala amanothi kuvame ukusetshenziselwa ukurekhoda imicabango engakahleleki mayelana nedatha, amakhodi, kanye nezigaba zethiyori [20].
Ukuqoqwa kwedatha nokuhlaziywa kwenzeka ngesikhathi esisodwa, inqubo ngayinye ikwazisa enye. Le ndlela yokuqhathanisa eqhubekayo yasetshenziswa kuzo zonke izigaba zokuhlaziywa kwedatha. Isibonelo, ukuqhathanisa idatha nedatha, ukubola nokulungisa amakhodi ukuthuthukisa iziqondiso zocwaningo ezengeziwe ngokuhambisana nokuthuthukiswa kwethiyori [20]. Abacwaningi u-JB no-MB bahlangana njalo ukuze baxoxe ngokufaka ikhodi kokuqala futhi bathole izindawo okugxilwe kuzo ngesikhathi senqubo yokuqoqwa kwedatha ephindaphindayo.
Ukubhala ikhodi kwaqala ngokubhala ikhodi kokuqala komugqa nomugqa lapho idatha “yahlukaniswa khona” futhi kwabekwa amakhodi avulekile achaza imisebenzi nezinqubo ezihlotshaniswa “nokwakwenzeka” kudatha. Isigaba esilandelayo sokubhala ikhodi ukufaka ikhodi okuphakathi, lapho amakhodi omugqa nomugqa ebuyekezwa, aqhathaniswe, ahlaziywe, futhi ahlanganiswe ndawonye ukuze kunqunywe ukuthi yimaphi amakhodi anencazelo eningi ngokuhlaziya ekuhlukaniseni idatha [20]. Okokugcina, ukubhala ikhodi okunwetshiwe kwethiyori kusetshenziswa ukwakha ithiyori. Lokhu kuhilela ukuxoxa nokuvumelana ngezakhiwo zokuhlaziya zethiyori kulo lonke ithimba locwaningo, ukuqinisekisa ukuthi ichaza ngokucacile lesi simo.
Idatha yabantu iqoqwe ngocwaningo oluku-inthanethi olunezibalo ngaphambi kwengxoxo ngayinye ukuqinisekisa ukuthi kuba khona abantu abaningi ababambe iqhaza kanye nokuhambisana nokuhlaziywa kwekhwalithi. Idatha eqoqwe ifaka: ubulili, ubudala, unyaka wokuphothula, imvelaphi yasemakhaya, indawo yokusebenza yamanje, ubuchwepheshe bezokwelapha, kanye nendawo yesikole somtholampilo sonyaka wesine.
Okutholakele kwazisa ukuthuthukiswa kohlaka lomqondo olubonisa ukuthi i-LIC yasemakhaya ithonya kanjani izinqumo zomsebenzi zabaphothule ezindaweni kanye nasemisebenzini.
Abaphothule izifundo ze-LIC abangamashumi amathathu nesishiyagalolunye bahlanganyele kulolu cwaningo. Ngamafuphi, ama-53.8% abahlanganyeli kwakungabesifazane, ama-43.6% ayevela ezindaweni zasemakhaya, ama-38.5% ayesebenza ezindaweni zasemakhaya, kanti ama-89.7% ayeqede izifundo zobudokotela noma ukuqeqeshwa (Ithebula 2).
Lolu hlaka lwezinqumo zomsebenzi we-LIC yasemakhaya lugxile ezintweni zohlelo lwe-LIC lwasemakhaya ezithonya izinqumo zomsebenzi zabaphothule, okuphakamisa ukuthi inhlanganisela yezici zomuntu ngamunye kanye nohlelo ngaphakathi komqondo oyinhloko "wokukhetha ukubamba iqhaza" ingathinta nendawo yabaphothule njengezinketho zomsebenzi wobungcweti, kungakhathaliseki ukuthi zodwa noma ziyahambisana (Isithombe 3). Okutholakele okulandelayo okunekhwalithi kuchaza izici zohlaka futhi kufaka phakathi izingcaphuno ezivela kubahlanganyeli ukuze kuboniswe imiphumela.
Izabelo zesikole semitholampilo ziqedwa ngohlelo lokukhetha, ngakho abahlanganyeli bangakhetha izinhlelo ngendlela ehlukile. Phakathi kwalabo abakhethe ngokuzikhethela ukubamba iqhaza, kwakukhona amaqembu amabili abaphothule: labo abakhethe ngamabomu ukubamba iqhaza ohlelweni (abazikhethele bona), kanye nalabo abangazange bakhethe kodwa bathunyelwa ku-RCCS. Lokhu kubonakala emiqondweni yokusetshenziswa (iqembu lokugcina) kanye nokuqinisekiswa (iqembu lokuqala). Uma sekuhlanganiswe ekusebenzeni, imiqondo yamakhono okuklama okufunda kanye nokuqeqeshwa endaweni kukhulisa ukuzibandakanya ngokunikeza abahlanganyeli ithuba lokuzwa nokuqhathanisa imikhakha yokunakekelwa kwempilo ngendlela ephelele.
Kungakhathaliseki ukuthi bazikhethela kanjani, abahlanganyeli babevame ukuba nethemba ngokuhlangenwe nakho kwabo futhi bathi i-LIC yayingunyaka wokufunda owabafundisa hhayi nje kuphela ukuthi bafinyelele endaweni yezokwelapha, kodwa futhi wabanikeza ukuqhubeka kwezifundo zabo kanye nesisekelo esiqinile semisebenzi yabo. Ngendlela ehlanganisiwe yokuletha uhlelo, bafunde ngempilo yasemakhaya, imithi yasemakhaya, umkhuba ojwayelekile kanye nobuchwepheshe obuhlukahlukene bezokwelapha.
Abanye abahlanganyeli babike ukuthi ukube bebengazange baye kulolu hlelo futhi baqede konke ukuqeqeshwa endaweni yasedolobheni, bebengeke bacabange noma baqonde ukuthi bangahlangabezana kanjani nezidingo zabo zomuntu siqu nezomsebenzi endaweni yasemakhaya. Lokhu ekugcineni kuholela ekuhlanganiseni kwezici zomuntu siqu nezomsebenzi, njengohlobo lodokotela abafisa ukuba yilo, umphakathi abafuna ukusebenza kuwo, kanye nezici zendlela yokuphila njengokufinyelela endaweni ezungezile kanye nokufinyeleleka empilweni yasemakhaya.
Kubonakala kimi ukuthi ukube bengisanda kuhlala e-X [esikhungweni sedolobha] noma into efana naleyo, ngabe mhlawumbe besizohlala endaweni eyodwa, angicabangi ukuthi thina (abalingani) besizokwenza lokho, lokhu kugxuma (komsebenzi ezindaweni zasemakhaya) bekungeke kudingeke kucindezelwe (umbhalisi womsebenzi ojwayelekile, umkhuba wasemakhaya).
Ukubamba iqhaza kulolu hlelo kunikeza ithuba lokuzindla nokuqinisekisa izinhloso zabaphothule ukusebenza ezindaweni zasemakhaya. Lokhu kuvame ukubangelwa ukuthi ukhulele endaweni yasemakhaya futhi uhlose ukwenza umsebenzi wokufundela umsebenzi endaweni efanayo ngemva kokuphothula. Kulabo abahlanganyeli ababehlose ukungena emsebenzini ojwayelekile ekuqaleni, kwakusobala nokuthi ulwazi lwabo luhlangabezane nokulindela kwabo futhi lwaqinisa ukuzibophezela kwabo ekuphishekeleni le ndlela.
Ukuba yi-LIC (njengoba ngisebenza e-LIC) kwaqinisa lokho engangikucabanga ukuthi ngikuthanda kakhulu futhi kwaqinisekisa isivumelwano futhi angizange ngicabange ngisho nokufaka isicelo sesikhundla se-metro ngonyaka wami wokuqeqeshwa noma ngisho nokucabanga ngakho ngokusebenza e-metro (udokotela wezifo zengqondo, umtholampilo wasemakhaya).
Kwabanye, ukubamba iqhaza kuqinisekisile ukuthi impilo/impilo yasemakhaya ayihlangabezananga nezidingo zabo zomuntu siqu nezomsebenzi. Izinselele zomuntu ngamunye zibangela ukuqhelelana nomndeni nabangane, kanye nokufinyelela izinsizakalo ezifana nemfundo nokunakekelwa kwempilo. Babheka ukuvama komsebenzi owenziwa odokotela basemakhaya njengento evimbela umsebenzi.
Umphathi wedolobha lami uhlala exhumana nami. Ngakho-ke, ngicabanga ukuthi le ndlela yokuphila ayingifanele (udokotela emtholampilo omkhulu).
Amathuba okuhlela izifundo kanye nesakhiwo sokufunda sabafundi kuthonya izinqumo zomsebenzi. Izinto eziyinhloko zokuqhubeka nokuhlanganiswa kwe-LIC zinikeza ababambiqhaza ukuzimela kanye namathuba ahlukahlukene okuhlanganyela ngenkuthalo ekunakekelweni kweziguli, ukuthuthukisa amakhono, kanye nokwenza kube lula ukuthola nokuqhathaniswa kwezinhlobo zezokwelapha ngesikhathi sangempela ezihambisana nezidingo zabo zomuntu siqu nezobungcweti.
Ngenxa yokuthi izifundo zezokwelapha ezifundweni zifundiswa ngokuphelele, abahlanganyeli banezinga eliphezulu lokuzimela futhi bangaziqondisa futhi bathole amathuba abo okufunda. Ukuzimela kwabahlanganyeli kuyakhula phakathi nonyaka njengoba bethola ukuqonda okungaphakathi nokuphepha ngaphakathi kwesakhiwo sohlelo, bethola ikhono lokuzibandakanya ekuzihloleni okujulile ezindaweni ezahlukene zezokwelapha. Lokhu kuvumela abahlanganyeli ukuthi baqhathanise imikhakha yezokwelapha ngesikhathi sangempela, okubonisa ukukhanga kwabo ezindaweni ezithile zezokwelapha abavame ukuzikhetha njengochwepheshe.
Kwa-RCCS ubhekana nalezi zifundo ezinkulu kusenesikhathi bese uthola isikhathi esengeziwe sokugxila ezifundweni ozithandayo ngempela, ngakho-ke abafundi abaningi base-metro abanalo ikhono lokukhetha isikhathi nendawo yabo. Eqinisweni, ngiya esibhedlela nsuku zonke… okusho ukuthi ngingachitha isikhathi esiningi egumbini lezimo eziphuthumayo, isikhathi esengeziwe egumbini lokuhlinza, futhi ngenze lokho engikuthandayo kakhulu (udokotela wezinzwa, umkhuba wasemakhaya).
Isakhiwo sohlelo sivumela abafundi ukuthi bahlangane neziguli ezingahlukile ngenkathi behlinzeka ngezinga eliphephile lokuzimela ukuze bathole umlando wezokwelapha, bathuthukise amakhono okucabanga ngokwezokwelapha, futhi bethule uhlelo lokuxilongwa okuhlukile kanye nokwelashwa kudokotela. Lokhu kuzimela kuyahluka nokubuyela ekujikelezweni kwebhulokhi ngonyaka wesine, lapho kuzwakala sengathi kunamathuba ambalwa okuthonya iziguli ezingahlukile futhi kukhona ukubuyela endimeni yokuphatha. Isibonelo, omunye umfundi waphawula ukuthi ukube ulwazi lwabo lwezokwelapha kuphela emsebenzini jikelele beluwukujikeleza kwesikhathi esinqunyelwe sonyaka wesine, akuchaza njengomqapheli, ubengeke aqonde ububanzi bomsebenzi ojwayelekile futhi wasikisela ukuthi aqhubeke nokuqeqeshwa kolunye uhlobo lochwepheshe.
Futhi angizange ngibe nesipiliyoni esihle nhlobo (ukushintshanisa amabhlogo e-GP). Ngakho-ke, nginomuzwa wokuthi ukube lokhu bekuwukuphela kwesipiliyoni sami emsebenzini ojwayelekile, mhlawumbe ukukhetha kwami umsebenzi ngabe kuhlukile… Nginomuzwa nje wokuthi kuwukuchitha isikhathi njengoba ngibheka nje (udokotela, umkhuba wasemakhaya) ukuthi le indawo yomsebenzi injani.
Ukunamathelana isikhathi eside kuvumela ababambiqhaza ukuthi bakhe ubudlelwano obuqhubekayo nodokotela abakhonza njengabeluleki kanye nezibonelo. Ababambiqhaza bafuna odokotela ngenkuthalo futhi bachitha isikhathi eside nabo ngezizathu ezahlukahlukene, njengesikhathi nokusekelwa abakunikezayo, ukuqeqeshwa kobuchwepheshe, ukutholakala, ukuhlonishwa kwemodeli yabo yokusebenza, kanye nobuntu babo kanye nezindinganiso zabo. Ukuhambisana nawe noma nabanye. Isifiso sokuthuthuka. Ababambiqhaza/abeluleki kwakungebona nje ababambiqhaza ababelwe ngaphansi kokuqondisa kukadokotela oholayo, kodwa futhi nabameleli abavela kochwepheshe bezokwelapha abahlukahlukene, okuhlanganisa odokotela, odokotela abahlinzayo kanye nodokotela ababulala izinzwa.
Kunezinto eziningana. Ngise-point X (indawo ye-LIC). Kwakukhona udokotela wezinzwa owayephethe ngokungaqondile i-ICU, ngicabanga ukuthi wayenakekela i-ICU esibhedlela i-X (emakhaya) futhi wayenesimo sengqondo esizolile, odokotela bezinzwa abaningi engihlangane nabo babenesimo sengqondo esizolile ngezinto eziningi. Kwakuyilesi simo sengqondo esingenakunyakaziswa esangithinta kakhulu. (udokotela wezinzwa, udokotela wedolobha)
Ukuqonda okungokoqobo kokuhlangana kwezimpilo zobungcweti nezomuntu siqu kodokotela kwachazwa njengokunikeza ukuqonda okubalulekile endleleni yabo yokuphila futhi kwakukholelwa ukuthi kukhuthaza ababambiqhaza ukuba balandele izindlela ezifanayo. Kukhona futhi nokuthuthukiswa kokuphila kodokotela, okususelwa emisebenzini yomphakathi yasekhaya.
Kuwo wonke unyaka, abahlanganyeli bathuthukisa amakhono ezokwelapha, awomuntu siqu kanye nawobungcweti ngamathuba okufunda ngezandla anikezwa ngobudlelwano obuthuthukiswe nodokotela, iziguli kanye nabasebenzi bezempilo. Ukuthuthukiswa kwala makhono ezokwelapha kanye nokuxhumana kuvame ukuhilela indawo ethile yezokwelapha, njengomuthi ojwayelekile noma i-anesthesia. Isibonelo, ezimweni eziningi, odokotela abaphothula izifundo zokubulala izinzwa kanye nodokotela abajwayelekile be-anesthesia bachaze ukuthuthukiswa kwabo kwamakhono ayisisekelo emkhakheni kusukela onyakeni wabo we-LIC, kanye nokuzikhandla abakuthuthukisile lapho amakhono abo athuthukile eqashelwa futhi evuzwa. Lo muzwa uzoqiniswa ngokuqeqeshwa okulandelayo. futhi kuzoba namathuba okuthuthukiswa okuqhubekayo.
Kuhle impela. Kufanele ngenze i-intubations, i-sneezing yomgogodla, njll., futhi ngemva konyaka ozayo ngizoqeda ukuvuselelwa… ukuqeqeshwa kwe-anesthesiology. Ngizoba udokotela we-anesthesiologist ojwayelekile futhi ngicabanga ukuthi lokho bekuyingxenye engcono kakhulu yesipiliyoni sami sokusebenza lapho (uhlelo lwe-LIC) (umbhalisi we-anesthesia ojwayelekile, ngisebenza endaweni yasemakhaya).
Izimo zokuqeqeshwa endaweni noma zephrojekthi zichazwe njengezinethonya ezinqumweni zomsebenzi zabahlanganyeli. Izindawo zichazwe njengenhlanganisela yezindawo zasemakhaya, izindawo zokusebenzela ezijwayelekile, izibhedlela zasemakhaya kanye nezindawo ezithile zemitholampilo (isb. izindawo zokuhlinza) noma izindawo. Imibono ehlobene nendawo, okuhlanganisa nomuzwa womphakathi, induduzo yemvelo, kanye nohlobo lokuchayeka emtholampilo, yathonya izinqumo zabahlanganyeli zokusebenza ezindaweni zasemakhaya kanye/noma emzileni ojwayelekile.
Umuzwa womphakathi uthonye izinqumo zabahlanganyeli zokuqhubeka nomsebenzi ojwayelekile. Ukukhanga komkhuba ojwayelekile njengomsebenzi ukuthi kudala indawo enobungane enezigaba ezincane lapho abahlanganyeli bengaxhumana khona futhi babuke odokotela kanye nodokotela ababonakala bejabulela futhi bethola umuzwa wokwaneliseka emsebenzini wabo.
Abahlanganyeli baphinde baqaphela ukubaluleka kokwakha ubudlelwano nomphakathi weziguli. Ukwaneliseka komuntu siqu kanye nochwepheshe kutholakala ngokwazi iziguli nokuthuthukisa ubudlelwano obuqhubekayo ngokuhamba kwesikhathi njengoba zilandela indlela yazo, ngezinye izikhathi kuphela emtholampilo ojwayelekile, kodwa ngokuvamile ezindaweni eziningi zezokwelapha. Lokhu kungafani nezintandokazi ezingathandi ukunakekelwa kwezimo ezithile, njengaseminyangweni yezimo eziphuthumayo, lapho kungase kungabi khona umjikelezo ovaliwe wemiphumela yeziguli ezilandelanayo.
Ngakho-ke, uyazazi ngempela iziguli zakho, futhi ngicabanga ukuthi empeleni, mhlawumbe engikuthanda kakhulu ngokuba udokotela ubudlelwano obuqhubekayo onabo neziguli zakho... nokwakha lobo budlelwano nazo, futhi hhayi ngezinye izikhathi ezibhedlela nakwezinye izindawo ezikhethekile, ungakwazi... uzibone kanye noma kabili, futhi kaningi awusoze uzibone futhi (udokotela ojwayelekile, ikliniki yedolobha).
Ukuchayeka ekwelashweni okuvamile kanye nokubamba iqhaza ekubonisaneni ngasikhathi sinye kwanika ababambiqhaza ukuqonda ububanzi bemithi yendabuko yaseShayina ekwelashweni okuvamile, ikakhulukazi ekwelashweni okuvamile kwasemakhaya. Ngaphambi kokuba babe abaqeqeshwayo, abanye ababambiqhaza babecabanga ukuthi bangase baye ekwelashweni okuvamile, kodwa ababambiqhaza abaningi abagcina sebengodokotela bathi ekuqaleni babengaqiniseki ukuthi ngabe lo msebenzi wawuyisinqumo esifanele yini kubo, benomuzwa wokuthi isithombe sezokwelapha sokusebenza kahle sasiphansi kakhulu ngakho-ke abakwazi ukusekela intshisekelo yabo yobungcweti esikhathini eside.
Njengoba ngenze umsebenzi wodokotela njengomfundi ozinikele, ngicabanga ukuthi kwakuwukuqala kwami ukubonana nodokotela abaningi abahlukahlukene futhi ngacabanga ukuthi ezinye iziguli zazinzima kangakanani, izinhlobonhlobo zeziguli nokuthi odokotela abangodokotela (GP) bangaba mnandi kangakanani, umkhuba wokusebenza ngemali).
Isikhathi sokuthunyelwe: Julayi-31-2024