Akademik Veri Yönetim Sistemi
Palandöken Uluslararası Hemşirelik Eğitimi Kongresi, Erzurum, Türkiye, 24 - 26 Ekim 2019, ss.262-266
Abstract
Introduction and Aim:
Case-based learning is the realization of learning by analyzing a situation that has been or is likely to be experienced.It is a | learner- |
centered educational model. It offers an opportunity to discuss, analyze, analyze an event through real facts, establish the relationship between knowledge and real life and make decisions (1). Postpartum hemorrhage is still the most important and preventable cause of maternal mortality worldwide. The most important approach in the prevention of maternal deaths due to postpartum hemorrhage is the
for reducing maternal mortality is Emergency Obstetric Care (EOC) System. Accordingly, it is very important that each physician, regardless of his / her field of expertise, has gained awareness and competence to manage emergency situations (2,3).
In this study, it was aimed to increase the knowledge and awareness of intern physicians receiving Family Medicine internship with a case-based course module on postpartum haemorrhage and Emergency Obstetric Care (EOC), to teach basic life-saving approaches and thus to contribute on reducing maternal deaths.
Methods: A case-based course module was introduced to the intern physicians in Family Medicine under the title of “Approach to Postpartum Bleeding and EOC”. An education module structured in three parts was practised on six different internship groups of 82 students in total who took their Family Medicine internship in 2018-2019 academic year and their Gynecology and Obstetrics previously.
In the first part, a-30-minute-theoretical-course was delivered on the definition of maternal mortality, its reasons and significance, the changes in the condition of Turkey and the world within the years and on preventing maternal deaths. In the second part, a 30-minute theoretical course was delivered on the definition, frequency, causes, consequences, preventability and life-saving approaches of postpartum haemorrhage and delay models. In the third part, a 60-minute structured case-based session was conducted. Under the light of the theoretical framework delivered before, interactive case studies were conducted through five real cases. In these sessions, cases of maternal death due to postpartum haemorrhage were examined in detail with all its processes separately from the beginning of the pregnancy along with all the pregnancy process such as admission to health institution, treatment, intervention, referral and operation.
Delay models in the cases were defined, and each case was evaluated in terms of medicolegal. Planning whether to continue the course in the next term by following the students’ feedback, written and oral feedback were received from all students at the end of the training module.
Results: 43% of the participating students were female (n = 35) while 57% (n = 47) were male. All groups had already received Gynecology and Obstetrics Internship during their internship. It was observed that all the students participating in the EOC case-based course module were highly satisfied. It was also observed in the feedbacks that the most satisfying part was the students’ analysis through real cases. Students reported that their knowledge and awareness increased through theoretical courses, their interest and participation in case-based sessions and their holistic assessment and critical decision-making skills increased through case analysis. Among the positive opinions, the highlighted ones are as follows: “the course is very useful, they feel real, their understanding of the subject increases, they are never bored with the course, such courses should be increased, they evaluate the events better, they are more educative than theoretical courses”. In addition to their positive opinions, twelve students (%14.6) also reported negative opinions. Ten of them (12.1%) stated that the theoretical course was long, two of them (0.02%) reported that they were discouraged by cases and medicolegal evaluation. Students recommended shortening the theoretical part of the course (n = 10, 12.1%), increasing such courses related to emergencies (n = 73, 89%), including case-based courses in all internships (n = 66, 80%), also having simulation of the course (18, 22%). All of the students (n = 82, 100%) suggested continuing the course in the next years. Positive and negative opinions and suggestions on case-based EOC course module are presented in Table 1.
Conclusion: It was observed that case-based learning had a very positive effect on student participation, interest and satisfaction. For emergency crises such as postpartum haemorrhage when time is rather crucial in the critical decision-making process, case-based sessions turn to be exciting and interesting for the students, they ensures their active participation in the course, improve the analysis and decision-making processes, provide holistic approach to the facts as well as evaluate the management of the process in the case study. It provides an encouraging learning environment that students prefer and are interested since it is student-centred. In parallel with these results, the inclusion of case-based courses into the program, especially for important emergencies, and the planning of the simulation training for specific cases will contribute to the process.
Key Words: Case-based learning, feedback, emergency obstetric care