Njengamazwe amaninzi, iOstreliya ijongene nokusasazwa okungalinganiyo kwabasebenzi bezempilo ixesha elide, kunye noogqirha abambalwa ngomntu ngamnye kwiindawo zasemaphandleni kunye nomkhwa wokufumana ulwazi oluphezulu. I-Longitudinal Integrated Clerkship (LIC) ngumzekelo wemfundo yezonyango onokwenzeka ngakumbi kunezinye iimodeli ze-clerkship ukuvelisa abaphumeleleyo abasebenza kwiindawo zasemaphandleni, ezikude ngakumbi nakwiindawo zokhathalelo lwempilo. Nangona olu lwazi lobungakanani lubalulekile, idatha ethile yeprojekthi yokuchaza le meko ayifumaneki.
Ukulungisa lo msantsa wolwazi, indlela yokudibanisa izinto esekelwe kwithiyori yomgangatho yasetyenziswa ukumisela indlela i-LIC yasemaphandleni edibeneyo yeYunivesithi yaseDeakin eyaba nefuthe ngayo kwizigqibo zomsebenzi zabaphumeleleyo (2011-2020) ngokubhekiselele kwiingcali zonyango kunye nendawo yejografi.
Abafundi abaphumeleleyo abangama-39 bathathe inxaxheba kudliwanondlebe olunemigangatho. Isakhelo sesigqibo somsebenzi se-LIC yasemaphandleni siyaphuhliswa, nto leyo ebonisa ukuba indibaniselwano yezinto zobuqu nezenkqubo ngaphakathi kwengcamango ephambili "yokukhetha inxaxheba" inokuphembelela izigqibo zomsebenzi zabaphumeleleyo ngokwendawo nangomsebenzi, zombini ngokobuqu nangokwahlukeneyo. Nje ukuba zihlanganiswe ekusebenzeni, iingcamango zezakhono zoyilo lokufunda kunye noqeqesho kwindawo yokusebenzela ziyandisa ukubandakanyeka ngokubonelela abathathi-nxaxheba ithuba lokuva nokuthelekisa iinkalo zokhathalelo lwempilo ngendlela epheleleyo.
Isikhokelo esiphuhlisiweyo simele izinto ezikwimeko yenkqubo ezithathwa njengenefuthe kwizigqibo zomsebenzi zabaphumeleleyo emva koko. Ezi zinto, kunye nengxelo yomsebenzi wenkqubo, zinegalelo ekufezekiseni iinjongo zomsebenzi wasemaphandleni wenkqubo. Utshintsho lwenzeka nokuba abaphumeleleyo bafuna ukuthatha inxaxheba kule nkqubo okanye akunjalo. Utshintsho lwenzeka ngokucamngca, okunokuba kucel’ umngeni okanye kuqinisekise iingcamango zabafundi abaphumeleleyo malunga nokwenza izigqibo zomsebenzi, ngaloo ndlela kuchaphazele ukwakheka kobungcali.
Njengamazwe amaninzi, iOstreliya ijongene nokungalingani okuhlala ixesha elide nokuqhubekayo ekusasazweni kwabasebenzi bezempilo [1]. Oku kubonakaliswa linani eliphantsi loogqirha ngomntu ngamnye kwiindawo zasemaphandleni kunye nomkhwa wokutshintsha ukusuka kunyango oluphambili ukuya kunyango olukhethekileyo [2, 3]. Xa zizonke, ezi zinto zichaphazela kakubi impilo kwiindawo zasemaphandleni, ngakumbi kuba unyango oluphambili lubalulekile kubasebenzi bezempilo balo luntu, lubonelela kungekuphela nje ngeenkonzo zonyango oluphambili kodwa kunye nonyango olungxamisekileyo kunye nonyango lwesibhedlele [4]. ]. I-Longitudinal Integrated Clerkship (LIC) yimodeli yemfundo yezonyango eyaphuhliswa ekuqaleni njengendlela yokuqeqesha abafundi bezonyango kwiindawo ezincinci zasemaphandleni kwaye yenzelwe ukukhuthaza ukwenziwa kwiindawo ezifanayo [5, 6]. Le njongo ifezekiswa kuba abaphumelele kwi-LIC zasemaphandleni banamathuba amaninzi kunabaphumelele kwabanye abasebenzi (kubandakanya ukujikeleziswa kwasemaphandleni) okusebenza kwiindawo zasemaphandleni, ezikude ngakumbi nakwiindawo zonyango oluphambili [7,8,9,10]. Indlela abaphumelele kwizonyango abakhetha ngayo umsebenzi ichazwe njengenkqubo enzima ebandakanya izinto ezininzi zangaphakathi nezangaphandle, njengokhetho lwendlela yokuphila kunye nolwakhiwo lwenkqubo yezempilo [11,12,13]. Akukho ngqwalasela ingako enikwe kwizinto ezikwi-undergraduate training ezinokuba nefuthe kule nkqubo yokwenza izigqibo.
Indlela yokufundisa ye-LIC yahlukile kujikeleziso lwebhloko lwendabuko kwisakhiwo nakwindawo ebekwe kuyo [5, 14, 15, 16]. Amaziko asemaphandleni anengeniso ephantsi ahlala ekwiindawo ezincinci zasemaphandleni ezinekhonkco lezonyango kwiindawo eziqhelekileyo nakwizibhedlele [5]. Into ephambili ye-LIC yingcamango "yokuqhubeka," eqhutywa kukunamathela ixesha elide, okuvumela abafundi ukuba bakhe ubudlelwane bexesha elide nabaphathi, amaqela okhathalelo lwempilo, kunye nezigulane [5,14,15,16]. Abafundi be-LIC bafunda iikhosi ngokupheleleyo nangokuhambelanayo, ngokuchaseneyo nezifundo ezilandelelanayo ezilinganiselweyo ezichaza ujikeleziso lwebhloko lwendabuko [5, 17].
Nangona idatha yobungakanani kubasebenzi be-LIC ibalulekile ekuvavanyeni iziphumo zenkqubo, akukho bungqina bucacileyo bokuchaza ukuba kutheni abafundi abaphumelele kwi-LIC yasemaphandleni benamathuba amaninzi okusebenza kwiindawo zasemaphandleni nakwiindawo zokhathalelo oluphambili xa kuthelekiswa nabafundi abaphumelele kwimisebenzi yezempilo abavela kwezinye iimodeli ze-clerkship [8, 18]. UBrown et al (2021) benze uphononongo lokuhlola ukwakheka kobume bomsebenzi kumazwe anengeniso ephantsi (ezidolophini nasemaphandleni) kwaye bacebisa ukuba kufuneka ulwazi oluthe kratya ngezinto ezibangela umsebenzi onengeniso ephantsi ukuze kubonelelwe ngeendlela ezichaphazela izigqibo zabaphumeleleyo malunga nomsebenzi [18]. Ukongeza, kukho imfuneko yokuqonda ngokuphindaphindiweyo ukhetho lomsebenzi lwabaphumelele kwi-LIC, sibabandakanye emva kokuba bebe ngoogqirha abafanelekileyo abenza izigqibo zobungcali, njengoko izifundo ezininzi zigxile kwiimbono kunye neenjongo ezibonwayo zabafundi kunye noogqirha abancinci [11, 18, 19].
Kuya kuba nomdla ukufunda indlela iinkqubo zasemaphandleni ze-LIC ezibanzi ezichaphazela ngayo izigqibo zomsebenzi zabaphumeleleyo malunga nobuchwephesha bezonyango kunye nendawo yejografi. Indlela yethiyori yolwakhiwo isetyenzisiwe ukuphendula imibuzo yophando kunye nokuphuhlisa isakhelo sengqiqo esichaza izinto zomsebenzi wabasebenzi eziphembelele le nkqubo.
Le yiprojekthi yethiyori yolwakhiwo olusemgangathweni. Le yachongwa njengeyona ndlela ifanelekileyo yethiyori kuba (i) yaqonda ubudlelwane phakathi komphandi kunye nomthathi-nxaxheba obakha isiseko sokuqokelelwa kwedatha, eyakhiwa ngokubambisana ngamaqela omabini (ii) yathathwa njengeendlela ezifanelekileyo zophando lobulungisa bentlalo. , umzekelo, ukusasazwa ngokufanelekileyo kwezixhobo zonyango, kwaye (iii) inokuchaza into efana "nokwenzakala" endaweni yokuyihlola nje nokuyichaza [20].
Isidanga seDokotela wezeMpilo kwiYunivesithi yaseDeakin (MD) (esasisaziwa ngokuba yiBachelor of Medicine/Bachelor of Surgery) sanikezelwa ngo-2008. Isidanga seDokotela wezeMpilo yinkqubo yokungena emva kweminyaka emine enikezelwa kwiindawo zasezidolophini nasemaphandleni, ikakhulu entshona yeVictoria, eOstreliya. Ngokwenkqubo yokwahlulahlula umgama weendawo yase-Australian Modified Monash Model (MMM), iindawo zezifundo ze-MD ziquka i-MM1 (iindawo zedolophu), i-MM2 (amaziko eengingqi), i-MM3 (iidolophu ezinkulu zasemaphandleni), i-MM4 (iidolophu zasemaphandleni eziphakathi) kunye ne-MM5 (iidolophu ezincinci zasemaphandleni)) [21].
Iminyaka emibini yokuqala yesigaba sangaphambi kweklinikhi (imvelaphi yezonyango) yenziwa eGeelong (MM1). Kwiminyaka yesithathu neyesine, abafundi baqeqeshwa kwiklinikhi (umsebenzi wobungcali kwezonyango) kwenye yezikolo ezintlanu zeklinikhi eGeelong, eMpuma yezeMpilo (MM1), eBallarat (MM2), eWarrnambool (MM3) okanye kwinkqubo yeLIC – Rural Community Clinical Schools (RCCS); ), eyaziwa ngokusemthethweni njengeNkqubo ye-IMMERSE (MM 3-5) kude kube ngu-2014 (Umzobo 1).
I-RCCS LIC ibhalisa malunga nabafundi abangama-20 minyaka le abasebenza kwingingqi yeGrampians kunye neSouth Western Victoria ngexesha lonyaka wabo wokugqibela (wesithathu) we-MD. Indlela yokukhetha ikwinkqubo yokukhetha apho abafundi bakhetha isikolo seklinikhi kunyaka wabo wesibini. Le nkqubo yamkela abafundi abaneenketho ezahlukeneyo ukusuka kowokuqala ukuya kowesihlanu. Izixeko ezithile emva koko zabelwa ngokusekelwe kukhetho lwabafundi kunye nodliwanondlebe. Abafundi basasazwa kuzo zonke izixeko ikakhulu ngamaqela abantu ababini ukuya kwabane.
Abafundi basebenza noogqirha bezilwanyana kunye neenkonzo zempilo zasemaphandleni zasekuhlaleni, kunye nogqirha oqhelekileyo (GP) njengomphathi wabo oyintloko.
Abaphandi abane ababandakanyekayo kolu phononongo bavela kwiimvelaphi nemisebenzi eyahlukeneyo, kodwa banomdla ofanayo kwimfundo yezonyango kunye nokusasazwa ngokulinganayo kwabasebenzi bezonyango. Xa sisebenzisa ithiyori yolwakhiwo, sijonga iimvelaphi zethu, amava, ulwazi, iinkolelo, kunye nomdla wethu ukuze sichaphazele uphuhliso lwemibuzo yophando, inkqubo yodliwanondlebe, uhlalutyo lwedatha, kunye nokwakhiwa kwethiyori. UJB ngumphandi wezempilo zasemaphandleni onamava kuphando olunemigangatho, osebenza kwi-LIC kwaye uhlala kwindawo yasemaphandleni kwindawo yoqeqesho lwe-LIC. U-LF yingcali yezonyango kunye nomlawuli weklinikhi wenkqubo ye-LIC kwiYunivesithi yaseDeakin kwaye ubandakanyeka ekufundiseni abafundi be-LIC. U-MB kunye no-HB ngabaphandi basemaphandleni abanamava okuphumeza iiprojekthi zophando olunemigangatho kunye nokuhlala kwiindawo zasemaphandleni njengenxalenye yoqeqesho lwabo lwe-LIC.
Ukuguquguquka kwengqondo kunye namava kunye nezakhono zomphandi zisetyenzisiwe ukutolika nokufumana intsingiselo kule seti yedatha ityebileyo. Kuyo yonke inkqubo yokuqokelelwa kwedatha kunye nohlalutyo, kubekho iingxoxo eziqhubekayo, ingakumbi phakathi kukaJB noMB. UHB noLF banike inkxaso kuyo yonke le nkqubo nangophuhliso lweengcamango eziphambili kunye nethiyori.
Abathathi-nxaxheba yayingabaphumelele kwizifundo zonyango kwiYunivesithi yaseDeakin (2011–2020) ababeze kwi-LIC. Isimemo sokuthatha inxaxheba kolu phando sithunyelwe ngabasebenzi abaziingcali be-RCCS ngomyalezo obhaliweyo wokuqesha. Abathathi-nxaxheba abanomdla bacelwe ukuba bacofe kwikhonkco lokubhalisa baze banike ulwazi oluneenkcukacha ngophando lweQualtrics [22], nto leyo ebonisa ukuba (i) bafunde ingxelo ecacileyo echaza injongo yolu phando kunye neemfuno zabathathi-nxaxheba, kwaye (ii) babezimisele ukuthatha inxaxheba kuphando. abaqhagamshelwe ngabaphandi ukuze balungiselele ixesha elifanelekileyo lodliwano-ndlebe. Indawo yomsebenzi wabathathi-nxaxheba nayo yarekhodwa.
Ukuqeshwa kwabathathi-nxaxheba kwenziwe ngamanqanaba amathathu: inqanaba lokuqala labaphumeleleyo ngo-2017-2020, inqanaba lesibini labaphumeleleyo ngo-2014-2016, kunye nenqanaba lesithathu labaphumeleleyo ngo-2011-2013 (Umzobo 2). Ekuqaleni, isampuli enenjongo yayisetyenziselwa ukuqhagamshelana nabaphumeleleyo abanomdla nokuqinisekisa ukwahlukahlukana kwemisebenzi. Abanye abaphumeleleyo ekuqaleni ababonakalise umdla wokuthatha inxaxheba kolu phando abazange badlalwe udliwanondlebe kuba abazange baphendule kwisicelo somphandi sokuba nexesha lokuba badlalwe udliwanondlebe. Inkqubo yokuqeshwa ehleliweyo ivumele inkqubo ephindaphindayo yokuqokelelwa kwedatha kunye nohlalutyo, ixhasa isampuli yethiyori, uphuhliso lwengqiqo kunye nokulungiswa, kunye nokuveliswa kwethiyori [20].
Inkqubo yokuqesha abathathi-nxaxheba. Abaphumelele kwi-LIC bathatha inxaxheba kwiNkqubo yoBubhalane obuDibeneyo beLongitudinal. Ukuthatha isampuli ngenjongo kuthetha ukuqesha isampuli eyahlukeneyo yabathathi-nxaxheba.
Udliwanondlebe lwenziwe ngabaphandi uJB noMB. Imvume yomlomo yafunyanwa kubathathi-nxaxheba kwaye isandi sarekhodwa ngaphambi kokuqala kodliwanondlebe. Isikhokelo sodliwanondlebe esicwangciswe kancinci kunye nophando oluhambelanayo lwaqalwa ukwenziwa ukuze kukhokelwe inkqubo yodliwanondlebe (Itheyibhile 1). Emva koko le ncwadana yahlaziywa kwaye yavavanywa ngokuqokelelwa kwedatha kunye nohlalutyo ukuze kudityaniswe imiyalelo yophando kunye nophuhliso lwethiyori. Udliwanondlebe lwenziwa ngefowuni, isandi sarekhodwa, sabhalwa ngokwelizwi, kwaye sachazwa njengoonobumba abangaziwa. Ubude bodliwanondlebe babususela kwimizuzu engama-20 ukuya kwengama-53, ubude obuphakathi bemizuzu engama-33. Ngaphambi kohlalutyo lwedatha, abathathi-nxaxheba babethunyelelwa iikopi zemibhalo yodliwanondlebe ukuze bakwazi ukongeza okanye ukuhlela ulwazi.
Iingxelo zodliwanondlebe zifakwe kwiphakheji yesoftware esemgangathweni ye-QSR NVivo version 12 (Lumivero) yeWindows ukuze incedise uhlalutyo lwedatha [23]. Abaphandi u-JB no-MB bamamele, bafunda, kwaye babhala ikhowudi kudliwanondlebe ngalunye ngabanye. Ukubhala amanqaku kudla ngokusetyenziswa ukurekhoda iingcinga ezingacwangciswanga malunga nedatha, iikhowudi, kunye neendidi zethiyori [20].
Ukuqokelelwa kwedatha nohlalutyo lwenzeka ngaxeshanye, inkqubo nganye ixelela enye. Le ndlela yokuthelekisa rhoqo isetyenziswe kuzo zonke izigaba zohlalutyo lwedatha. Umzekelo, ukuthelekisa idatha nedatha, ukwahlulahlula kunye nokuphucula iikhowudi ukuphuhlisa ezinye iindlela zophando ngokuhambelana nophuhliso lwethiyori [20]. Abaphandi uJB kunye noMB badibana rhoqo ukuze baxoxe ngekhowudi yokuqala kunye nokuchonga iindawo ekugxilwe kuzo ngexesha lenkqubo yokuqokelelwa kwedatha ephindaphindayo.
Ukubhala ikhowudi kwaqala ngokubhala ikhowudi yomgca ngomgca apho idatha "yahlulwahlulwa" kwaye kwabekwa iikhowudi ezivulekileyo ezichaza imisebenzi kunye neenkqubo ezinxulumene "nokwenzakala" kwidatha. Inqanaba elilandelayo lokubhala ikhowudi kukubhalisa okuphakathi, apho iikhowudi zomgca ngomgca zijongwa, zithelekiswe, zihlalutywe, kwaye ziqondwe kunye ukuze kuchongwe ukuba zeziphi iikhowudi ezinentsingiselo kakhulu ekuhlalutyeni idatha [20]. Okokugqibela, ukubhala ikhowudi yethiyori ende kusetyenziswa ukwakha ithiyori. Oku kubandakanya ukuxoxa nokuvumelana ngeempawu zohlalutyo lwethiyori kulo lonke iqela lophando, ukuqinisekisa ukuba ichaza ngokucacileyo le nto.
Idatha yabantu iqokelelwe ngophando olukwi-intanethi oluneenkcukacha ngaphambi kodliwanondlebe ngalunye ukuqinisekisa uluhlu olubanzi lwabathathi-nxaxheba kunye nokongeza uhlalutyo lomgangatho. Idatha eqokelelweyo ibandakanya: isini, ubudala, unyaka wokugqiba izifundo, imvelaphi yasemaphandleni, indawo yokusebenza ngoku, ubuchule bezonyango, kunye nendawo yesikolo sezonyango sonyaka wesine.
Ezi ziphumo zibonelela ngophuhliso lwesakhelo sengcamango esibonisa indlela i-LIC yasemaphandleni echaphazela ngayo izigqibo zeendawo kunye nemisebenzi yabaphumeleleyo.
Abaphumelele kwi-LIC abangama-39 bathathe inxaxheba kolu phando. Ngamafutshane, ama-53.8% abathathi-nxaxheba yayingabafazi, ama-43.6% ayevela kwiindawo zasemaphandleni, ama-38.5% ayesebenza kwiindawo zasemaphandleni, kwaye ama-89.7% ayegqibile uqeqesho okanye izifundo zonyango (Itheyibhile 2).
Esi sikhokelo sezigqibo zomsebenzi we-LIC yasemaphandleni sigxile kwizinto zenkqubo ye-LIC yasemaphandleni ezichaphazela izigqibo zomsebenzi zabaphumeleleyo, nto leyo ebonisa ukuba indibaniselwano yezinto zomntu ngamnye kunye nenkqubo ngaphakathi kwengcamango ephambili "yokukhetha inxaxheba" inokuchaphazela nendawo abaphumeleleyo kuyo njengezigqibo zomsebenzi wobuchwephesha, nokuba zezodwa okanye ezihambelanayo (Umfanekiso 3). Ezi ziphumo zilandelayo zichaza izinto zesikhokelo kwaye ziquka iingcaphuno ezivela kubathathi-nxaxheba ukubonisa iziphumo.
Izabelo zesikolo seklinikhi zigqitywa ngenkqubo yokukhetha, ngoko ke abathathi-nxaxheba banokukhetha iinkqubo ngokwahlukileyo. Phakathi kwabo bakhethe ngokusesikweni ukuthatha inxaxheba, bekukho amaqela amabini abaphumeleleyo: abo bakhethe ngabom ukuthatha inxaxheba kule nkqubo (abazikhethele bona), kunye nabo bangazange bakhethe kodwa bathunyelwa kwi-RCCS. Oku kubonakala kwiingcamango zokuphunyezwa (iqela lokugqibela) kunye nokuqinisekiswa (iqela lokuqala). Nje ukuba zihlanganiswe ekusebenzeni, iingcamango zamandla oyilo lokufunda kunye noqeqesho kwindawo yokusebenzela zonyusa ukubandakanyeka ngokubonelela abathathi-nxaxheba ithuba lokuva nokuthelekisa iinkalo zokhathalelo lwempilo ngendlela epheleleyo.
Nokuba bakhetha kangakanani na, abathathi-nxaxheba babenembono entle ngamava abo kwaye bathi i-LIC yayingunyaka wokufunda owabanceda ukuba baqonde imeko yezonyango kuphela, kodwa wabanika nethuba lokuqhubeka nezifundo zabo kunye nesiseko esiqinileyo semisebenzi yabo. Ngendlela edibeneyo yokuhambisa le nkqubo, bafunde ngobomi basemaphandleni, amayeza asemaphandleni, uqheliselo oluqhelekileyo kunye nezifundo ezahlukeneyo zonyango.
Abanye abathathi-nxaxheba baxele ukuba ukuba bebengazange baye kule nkqubo baze bagqibe lonke uqeqesho kummandla wesixeko, bebengenakuze bacinge okanye baqonde indlela yokuhlangabezana neemfuno zabo zobuqu nezomsebenzi kwindawo yasemaphandleni. Oku ekugqibeleni kukhokelela ekudibaneni kwezinto zobuqu nezomsebenzi, njengohlobo logqirha abanqwenela ukuba yilo, uluntu abafuna ukusebenza kulo, kunye neendlela zokuphila ezifana nokufikelela kwindawo engqongileyo kunye nokufikeleleka kubomi basemaphandleni.
Kubonakala kum ukuba bendisandula ukuhlala kwi-X [isikhungo sedolophu] okanye into efana naleyo, mhlawumbi besinokuhlala nje kwindawo enye, andicingi ukuba thina (amaqabane) besinokwenza oko, olu tsiba (lomsebenzi kwiindawo zasemaphandleni) belungayi kufuneka lucinezelwe (umbhalisi wemisebenzi eqhelekileyo, umsebenzi wasemaphandleni).
Ukuthatha inxaxheba kule nkqubo kunika ithuba lokucamngca nokuqinisekisa iinjongo zabaphumeleleyo zokusebenza kwiindawo zasemaphandleni. Oku kudla ngokubangelwa kukuba ukhulele kwindawo yasemaphandleni kwaye uceba ukwenza umsebenzi woqeqesho kwindawo efanayo emva kokugqiba izifundo. Kwabo bathathi-nxaxheba ekuqaleni babefuna ukungena kwi-general practice, kwacaca nokuba amava abo aye afezekisa ulindelo lwabo kwaye aqinisa ukuzinikela kwabo ekulandeleni le ndlela.
Ukuba ndikwi-LIC (ukuba ndikwi-LIC) kwaqinisa into endandicinga ukuba yeyona ndiyithandayo kwaye kwaqinisekisa isivumelwano kwaye andizange ndicinge nangokufaka isicelo sesikhundla se-metro kunyaka wam woqeqesho okanye ndicinge nangokusebenza kwi-metro (ingcali yezengqondo, iklinikhi yasemaphandleni).
Kwabanye, ukuthatha inxaxheba kuqinisekisile ukuba ubomi/impilo yasemaphandleni ayizifezekisanga iimfuno zabo zobuqu nezomsebenzi. Imingeni yomntu ngamnye ibangela umgama kusapho nakubahlobo, kunye nokufikelela kwiinkonzo ezifana nemfundo kunye nokhathalelo lwempilo. Babona ukuphindaphindeka komsebenzi owenziwa ngoogqirha basemaphandleni njengento ethintela umsebenzi.
Umphathi wesixeko sam uhlala enxibelelana nam. Ngenxa yoko, ndicinga ukuba le ndlela yokuphila ayifanelekanga kum (ugqirha kwikliniki yesixeko).
Amathuba okucwangcisa izifundo kunye nolwakhiwo lokufunda lwabafundi luchaphazela izigqibo zomsebenzi. Izinto eziphambili zokuqhubeka kunye nokuhlanganiswa kwe-LIC zibonelela abathathi-nxaxheba ngokuzimela kunye namathuba amaninzi okuthatha inxaxheba ngokukhutheleyo kukhathalelo lwezigulane, ukuphuhlisa izakhono, kunye nokwenza lula ukufunyanwa kunye nokuthelekiswa kweentlobo zonyango ngexesha langempela ezihambelana neemfuno zabo zobuqu nezomsebenzi.
Ngenxa yokuba izifundo zonyango kule khosi zifundiswa ngokupheleleyo, abathathi-nxaxheba banomlinganiselo ophezulu wokuzimela kwaye banokuzilawula ngokwabo kwaye bafumane amathuba abo okufunda. Ukuzimela kwabathathi-nxaxheba kukhula ngokuhamba konyaka njengoko befumana ukuqonda okungaphakathi kunye nokhuseleko ngaphakathi kwesakhiwo senkqubo, befumana amandla okuzibandakanya ekuzihlolisiseni nzulu kwiimeko ezahlukeneyo zeklinikhi. Oku kuvumela abathathi-nxaxheba ukuba bathelekise iinkalo zonyango ngexesha langempela, bebonakalisa umdla wabo kwiindawo ezithile zeklinikhi abadla ngokugqiba bezikhetha njengobuchwephesha.
Kwi-RCCS udibana nezi zifundo ziphambili kwangethuba uze ufumane ixesha elingakumbi lokugxila kwizifundo onomdla kuzo ngokwenene, ngoko ke abafundi abaninzi base-metro abanalo ithuba lokukhetha ixesha nendawo yabo. Enyanisweni, ndiya esibhedlele yonke imihla… oko kuthetha ukuba ndingachitha ixesha elingakumbi kwigumbi likaxakeka, ixesha elingakumbi kwigumbi lotyando, kwaye ndenze into endinomdla kuyo ngakumbi (ingcali yokubulala iintlungu, umsebenzi wasemaphandleni).
Ulwakhiwo lwale nkqubo luvumela abafundi ukuba badibane nezigulana ezingabalulekanga ngelixa bebonelela ngokuzimela okukhuselekileyo ukuze bafumane imbali yeklinikhi, baphuhlise izakhono zokuqiqa ngeklinikhi, kwaye babonise ugqirha indlela yokuxilonga eyahlukileyo kunye nesicwangciso sonyango. Olu kuzimela luhluke kakhulu ekubuyeleni kujikelezo lwebhloko kunyaka wesine, xa kuvakala ukuba amathuba ambalwa okuphembelela izigulana ezingabalulekanga kwaye kukho ukubuyela kwindima yokulawula. Umzekelo, omnye umfundi waphawula ukuba ukuba amava abo eklinikhi kuphela kuqheliselo oluqhelekileyo ebekujikelezo olulinganiselweyo lonyaka wesine, awaluchaza njengombonisi, ngewayengaqondanga ububanzi boqheliselo oluqhelekileyo kwaye wacebisa ukuba aqhubeke noqeqesho kolunye uhlobo lobuchwephesha.
Kwaye andizange ndibe namava amahle konke konke (ukujikeleza iibhloko zeGP). Ngoko ke, ndivakalelwa kukuba ukuba eli yayililo lodwa amava am ekusebenzeni ngokubanzi, mhlawumbi ukhetho lwam lomsebenzi ngelwahlukile… Ndivakalelwa kukuba kukuchitha ixesha njengoko ndijonga nje (ugqirha, umsebenzi wasemaphandleni) ukuba le yindawo yomsebenzi.
Ukunamathelana ixesha elide kuvumela abathathi-nxaxheba ukuba bakhe ubudlelwane obuqhubekayo noogqirha abasebenza njengabacebisi kunye nemizekelo. Abathathi-nxaxheba bafuna oogqirha ngenkuthalo kwaye bachitha ixesha elide nabo ngezizathu ezahlukeneyo, ezifana nexesha kunye nenkxaso abayinikiweyo, uqeqesho lobuchule, ukufumaneka, ukunconywa ngemodeli yabo yokusebenza, kunye nobuntu babo kunye neempawu zabo. Ukuhambelana nawe okanye nabanye. Umnqweno wokukhula. Iimodeli/abaqeqeshi babengabathatha inxaxheba kuphela ababelwe phantsi kweliso logqirha okhokelayo, kodwa babekwangabameli abavela kwiingcali ezahlukeneyo zonyango, kubandakanya oogqirha, oogqirha kunye neengcali zokubulala iintlungu.
Kukho izinto ezininzi. Ndikwindawo ethi X (indawo yeLIC). Kwakukho ingcali yokubulala iintlungu eyayiphethe i-ICU ngokungathanga ngqo, ndicinga ukuba yayinyamekela i-ICU kwisibhedlele i-X (emaphandleni) kwaye yayinesimo sengqondo esizolileyo, uninzi lweengcali zokubulala iintlungu endidibene nazo zazinesimo sengqondo esizolileyo ngezinto ezininzi. Yayisisimo sengqondo esingenasiphako esandenza ndachukumiseka ngokwenene. (ingcali yokubulala iintlungu, ugqirha wesixeko)
Ukuqonda okuyinyani ukudibana kobomi bobuchwephesha nobomntu ngamnye koogqirha kwachazwa njengokubonelela ngolwazi oluxabisekileyo malunga nendlela abaphila ngayo kwaye kwakukholelwa ukuba kukhuthaza abathathi-nxaxheba ukuba balandele iindlela ezifanayo. Kukwakho nombono wobomi bukagqirha, othathwe kwimisebenzi yoluntu yasekhaya.
Kuwo wonke unyaka, abathathi-nxaxheba baphuhlisa izakhono zonyango, zobuqu nezobuchwephesha ngokusebenzisa amathuba okufunda ngezandla anikezelwa ngobudlelwane obuphuhliswe noogqirha, izigulane kunye nabasebenzi bezempilo. Uphuhliso lwezakhono zonyango nonxibelelwano ludla ngokubandakanya indawo ethile yezonyango, efana nonyango oluqhelekileyo okanye i-anesthesia. Umzekelo, kwiimeko ezininzi, iingcali zokubulala iintlungu eziphumeleleyo kunye neengcali zokubulala iintlungu ngokubanzi zichaze uphuhliso lwazo lwezakhono ezisisiseko kwicandelo ukususela kunyaka wazo we-LIC, kunye nokusebenza kakuhle abaziphuhlisileyo xa izakhono zabo eziphucukileyo zaqatshelwa kwaye zavuzwa. Olu luvo luya komelezwa ngoqeqesho olulandelayo. kwaye kuya kubakho amathuba ophuhliso olongezelelekileyo.
Kuhle kakhulu. Kufuneka ndenze i-intubations, i-spine anesthesia, njl.njl., kwaye emva konyaka ozayo ndiza kugqiba ukuvuselelwa… uqeqesho lwe-anesthesiology. Ndiza kuba yi-general anesthetist kwaye ndicinga ukuba le yayiyeyona nto ingcono kumava am okusebenza apho (i-LIC scheme) (umbhalisi we-general anesthesiology, esebenza kwindawo yasemaphandleni).
Iimeko zoqeqesho okanye zeprojekthi kwindawo ethile zichazwe njengezinefuthe kwizigqibo zomsebenzi zabathathi-nxaxheba. Iindawo zichazwe njengendibaniselwano yeendawo zasemaphandleni, iindawo zokuzilolonga ngokubanzi, izibhedlele zasemaphandleni kunye neendawo ezithile zeklinikhi (umz. iindawo zokuhlinza) okanye iindawo zokuzilolonga. Iingcamango ezinxulumene nendawo, kubandakanya imvakalelo yoluntu, intuthuzelo yokusingqongileyo, kunye nohlobo lokuvezwa kweklinikhi, ziphembelele izigqibo zabathathi-nxaxheba zokusebenza kwiindawo zasemaphandleni kunye/okanye kwiindawo zokuzilolonga ngokubanzi.
Ukuziva ngathi luluntu kuye kwachaphazela izigqibo zabathathi-nxaxheba zokuqhubeka nomsebenzi ngokubanzi. Into ebangela umdla kumsebenzi ngokubanzi kukuba udala imeko-bume enobuhlobo engenazintlukwano apho abathathi-nxaxheba banokusebenzisana baze bajonge oogqirha kunye noogqirha ababonakala beyonwabela kwaye befumana ulwaneliseko emsebenzini wabo.
Abathathi-nxaxheba baqaphele nokubaluleka kokwakha ubudlelwane noluntu lwezigulane. Ulwaneliseko lomntu kunye nolwasemsebenzini lufumaneka ngokwazi izigulane kunye nokuphuhlisa ubudlelwane obuqhubekayo ngokuhamba kwexesha njengoko zilandela indlela yazo, ngamanye amaxesha kuphela kwizenzo eziqhelekileyo, kodwa zihlala zikwiindawo ezininzi zonyango. Oku kwahlukile kwizinto ezikhethwayo ezingalungelanga unyango lwe-episodic, njengakwii-ofisi zongxamiseko, apho kusenokungabikho ludwe oluvaliweyo lweziphumo zokulandelela izigulane.
Ngoko ke, uyazazi ngokwenene izigulana zakho, kwaye ndicinga ukuba eneneni, mhlawumbi into endiyithandayo kakhulu ngokuba ngugqirha wezilwanyana kubudlelwane obuqhubekayo onabo nezigulana zakho... kwaye wakhe olo budlelwane nazo, kwaye ngamanye amaxesha kungekhona kwizibhedlele nakwezinye iindawo ezikhethekileyo, unako... uzibona kube kanye okanye kabini, kwaye amaxesha amaninzi awusoze uphinde uzibone (ugqirha wezilwanyana jikelele, ikliniki yesixeko).
Ukwaziwa ngokubanzi kwezonyango kunye nokuthatha inxaxheba kwiingcebiso ezihambelanayo kwanika abathathi-nxaxheba ukuqonda ububanzi bezonyango zemveli zaseTshayina kwizonyango ngokubanzi, ingakumbi kwizonyango ngokubanzi zasemaphandleni. Ngaphambi kokuba babe ngabaqeqeshwayo, abanye abathathi-nxaxheba babecinga ukuba banokuya kwizonyango ngokubanzi, kodwa abathathi-nxaxheba abaninzi ekugqibeleni baba ngoogqirha bezonyango bathi ekuqaleni babengaqinisekanga ukuba olu nyango lolona khetho lufanelekileyo kubo, bevakalelwa kukuba umfanekiso weklinikhi wobuchule wawuphantsi kwaye ngenxa yoko abakwazi ukugcina umdla wabo wobungcali kwixesha elide.
Ekubeni ndenze umsebenzi wogqirha njengomfundi ofunda ngokuntywiliselwa, ndicinga ukuba yayikukuqala kwam ukubona uluhlu olubanzi lweengcali zonyango kwaye ndacinga ukuba ezinye izigulane zinzima kangakanani, iintlobo ngeentlobo zezigulane kunye nokuba iingcali zonyango (GP) zinomdla kangakanani, umsebenzi wemali).
Ixesha leposi: Julayi-31-2024