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Aim: Writing high-quality items (questions) is a resource-intensive task. Particularly, the development of one context-rich multiple-choice question (MCQ) for assessing higher-order cognitive skills may cost hours of medical teachers. The aim of this study was to find out whether it is possible the use of Automatic Item Generation (AIG) in Turkish to generate case-based MCQs that assess clinical reasoning skills. Methods: By following the template-based AIG method developed by Gierl et al., MCQs on hypertension were generated with the help of software after the development of a cognitive model and an item model. The cognitive model and the item model was developed by a medical doctor and a cardiologist by considering Turkish Hypertension Consensus Report. The software was built as a Python-based code intended for single use without a user interface. The items were recorded in a MySQL database. Of these questions, 10 questions were randomly chosen to be reviewed by three subject matter experts (cardiologists). The evaluation was based on the quality of the questions and whether the questions assess higher-order skills such as clinical reasoning rather than factual recall. Results: In 1.73 seconds, 1600 MCQs on hypertension were generated. Although there were some minor revision suggestions in a few questions, each question was stated by all cardiologists as an acceptable item. The cardiologists also stated that the questions assess clinical reasoning skills rather than factual recall. Conclusions: This study demonstrated for the first time that AIG for assessing clinical reasoning skills in the context of medical education in Turkish is possible. This method of augmented intelligence to generate items can be used in Turkish as it has been used in other five languages. The use of this method could bring about more questions to assess clinical reasoning skills. It may also lead medical teachers to spend less amount of time and effort compared to traditional item writing.

There is no study in the literature that reveals the adequacy of obstetric ultrasonography (US) training in Turkey. We aimed to evaluate the adequacy of obstetric US training radiologists had received during their residency and determine how competent they considered themselves to be in this regard.A survey (27 items for residents, 21 items for specialists) was sent to all the radiology residents and specialists in Turkey through the mail list of the Turkish Society of Radiology.Ninety-one residents and 217 specialists participated in our study. Sixteen residents (17.6%) had received theoretical courses, 21 residents (23.1%) and 59 specialists (27.2%) had attended in-house obstetric US rotations, and 5 residents (5.5%) and 23 specialists (10.6%) had attended obstetric US rotations in another institution. When questioned separately for each trimester, only 11% to 36.3% of the residents stated that they took care of a sufficient number of patients. In general, 62.6% of the residents and 25.3% of the specialists did not consider themselves to be absolutely competent in obstetric US. The competency sources were specified as residency training by 44 residents (48.6%) and 55 specialists (25.3%), postgraduate training by 2 residents (2.2%) and 78 specialist (35.9%).In Turkey, current obstetric US training does not provide the experience that will allow physicians with radiology training to easily perform and interpret obstetric US. The main reasons for this situation include the limited number of patients the physicians took care of as a resident, insufficient rotation time, and lack of theoretical courses they attended.

Aim: We aimed to find out if there is statistically significant difference in self-reported hand hygiene compliance among Year-5 medical students, Year-6 medical students, and residents in Gazi University Faculty of Medicine between right before and after the first confirmed case of COVID-19 in Turkiye. Materials and Methods: Two cross-sectional surveys were carried out to reveal self-reported hand hygiene compliance among participants right before and after the first confirmed case of COVID-19 in Turkiye. Participants were Year-5 and Year-6 medical students and residents in Gazi University Faculty of Medicine. Convenience sampling was used. There were 833 participants in total. The survey form consists of 10 items that were constituted by examining World Health Organization guidelines on hand hygiene. The compliance scores before and after the first confirmed case were compared by performing T-Test. Results: Out of 10 items, there was significant difference in Year-5 medical students’, Year-6 medical students’ and residents’ self-reported hand hygiene compliance scores between before and after the first confirmed case of COVID-19 in 6 items, 10 items, and 8 items, respectively (p

© 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.Aim: This study aimed to reveal the current status of the literature on rational prescribing training in undergraduate medical education. Methods: This study followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. An online search using 50 keywords in four databases was performed to access the studies published between 2008 and 2020. Specific features of the training such as aims or objectives of teaching, methods or model, and evaluation of effectiveness were extracted. Kirkpatrick levels were used to evaluate the effectiveness of teaching. Results: Of 74 studies included in the full review, 16 (21.6%) of them reported the use of WHO 6-Step Model for Rational Prescribing in their educational interventions. In terms of effectiveness, only two of the studies investigated changes in learner behavior in the context for which they are being trained, and only one study showed the effect of training on patient outcomes. Conclusion: The evidence on the effectiveness of rational prescribing training has been presented mostly by using student satisfaction surveys and test of knowledge and skills. A higher level of evidence such as patient outcomes of the training needs to be reported.

The prominent method to teach clinical reasoning in preclinical years is case-based discussions. It necessitates hours of sessions. A randomised-controlled study has been conducted to determine whether preclinical students can develop illness scripts only by taking online formative testlets. A pre-test-post-test randomised-controlled design has been utilised. The intervention group (N = 20) answered general surgery questions for 18 days, while the control group (N = 19) received questions regarding urinary tract infections. These testlets were comprised of ContExtended Questions, which is a web-based tool to teach clinical reasoning. The performance was assessed by using Key-Feature Questions. While post-test scores were significantly higher than pre-test scores in the intervention group (p < 0.001), there was no statistically significant difference between the pre-test and post-test scores in the control group (p = 0.30). Taking formative case-based multiple-choice testlets without any additional teaching could assist preclinical students to learn clinical reasoning.

The paper focuses on professionalism in medicine and its integration into the medical curriculum. The review highlights that while there is no universally accepted definition of professionalism, it is widely recognized as a dynamic process involving high levels of knowledge, skills, and specialization. The article explores the historical background of professionalism in medicine, emphasizing the enduring ethical principles established by Hippocrates. It also discusses the changing values associated with professionalism over time. The review emphasizes the importance of teaching professionalism in medical schools and notes the increasing interest in studying effective teaching methods. However, it acknowledges a lack of successful implementation examples and emphasizes the need for further research. The article briefly touches on teaching models used in professionalism education and the different components of the medical curriculum: formal, informal, and hidden. Overall, the review aims to contribute to the Turkish literature on professionalism in medicine and provides an overview of the current state of research in this field. Son yıllarda tıpta profesyonelizm kavramı ile ilgili literatürde çok fazla çalışma göze çarpmaktadır. Bu çalışmalarda profesyonelizmin herkes tarafından kabul gören bir tanımı mevcut değildir, birçok tanımı yapılmaktadır. Ayrıca yapılan çalışmalar tıp fakültesi mezunlarında profesyonel mesleki davranışların oluşturulmasında öğretimin önemi konusunda nettir. Bu amaca ulaşmada yardımcı olabilecek birçok öğretim stratejisi ve değerlendirme aracıyla da karşılaşmak mümkündür. Bu nedenlerle derlememizde tıpta profesyonelizm ve müfredata entegrasyonu literatüre dayanılarak açıklanmış ve Türkçe alan yazına katkıda bulunması amaçlanmıştır. Yöntem: Geleneksel derleme yöntemi ile hazırlanmıştır. Profesyonelizm kavramının etimolojik kökeni açıklanmış, daha sonra tıp tarihinde profesyonelizm kavramı özetlenmiştir. Literatürdeki profesyonelizm tanımları tartışılmıştır. Sonraki bölümde tıp eğitimine profesyonelizm entegrasyonundaki adımlardan bahsedilmiş, kullanılabilecek öğretim yöntemleri özetlenmiştir. Bulgular: Profesyonelizm kavramı literatürde çeşitli tanımlamaları yapılan, ortak bir tanımın yapılamadığı bir kavram olarak göze çarpmaktadır. Ancak kısaca profesyonelliği dinamik bir süreç olarak tanımlayabilir, belirli bir alanda yüksek oranda bilgi, uygulama becerisi ve uzmanlaşma olarak adlandırılabiliriz. Hekimlik de eski çağlardan beri var olan sayılı profesyonel mesleklerdendir. Hala günümüzde Hipokrat tarafından gündeme getirilmiş bir takım etik ilkeler varlığını sürdürmektedir. Tarihsel olarak da hekimlikten profesyonelizm temelinde beklenen değerler zaman zaman değişiklik göstermiş, hekimlik profesyonelliği üstüne eklenen veya kaybedilen değerlerle günümüze dek gelmiştir. Sonuç: Güncel literatürde de artık profesyonelliğin tıp fakültelerinde öğretilmesi gerektiği ve nasıl öğretilebileceği ile ilgili yapılan çalışmalar artmaktadır. Ancak ilginin artmasına rağmen başarılı uygulama örneklerindeki yetersizlik göze çarpmaktadır. Bu nedenle tıp eğitiminde profesyonelizm entegrasyonunun nasıl yapılabileceği ile ilgili güncel literatürü de dikkate alarak tıpt a profesyonelizm tanımından, profesyonelizm eğitimde sıklıkla kullanılan öğretim modellerinden, resmi, yazılı olmayan ve örtük müfredattan yazımızda kısaca söz ettik. Literatürde yapılan önemli ölçüde çalışmalar bulunmaktadır, biz de bunları kısaca gözden geçirdik. Ancak buna rağmen konu ile ilgili çok daha fazla araştırmaya ihtiyaç olduğu açıktır.

Purpose:Learning the neuroanatomical structures is difficult in traditional medical education. Knowledge and visual materials in neuroanatomy books or atlases are static and limited with two dimensions. The limitation of cadaver and plastic models has been solved by the development of three-dimensional (3D) anatomical models using digital visualization technologies. Medical students are better able to understand the spatial topography of a large number of neuroanatomical structures that are condensed into a small region when they make use of 3D visualization technologies such as virtual reality (VR) and augmented reality (AR). Our study will open a new window to classical neuroanatomy education. We aimed to evaluate how much 3D neuroanatomical models based on VR application affect the success and motivation of medical school students in neuroanatomy courses. Methods:Four exams were given to the second-year medical faculty students before the classical theoretical course (1), after the theoretical course (2), after the VR training and application (3), and six months later to evaluate the long-term effects of the training (4). Results:Success averages were evaluated out of 10; It was found 3.38 in the students who participated in the evaluation after the traditional theoretical training, and 4.55 in the group who received VR training. In the long-term evaluation after six months, this average was found to be higher in the group that received VR training. Conclusion:Our study fills an important gap in the literature in terms of demonstrating the positive effects of VR-based neuroanatomy training on memory in the long term.

Preservation of the brain is important to reducing recurrent seizures and other neurological sequelae after status epilepticus (SE). Medical ozone (MedO3) shows antioxidant, anti-inflammatory and anti-apoptotic properties in the human body. In this study, it was aimed to understand the neuroprotective potential of MedO3 in the acute period after SE. Mature rats of Wistar Albino were used for the study. Group design O3 + SE: SE induced after MedO3, O3: MedO3 alone was given, SE: SE only induced, SE + O3; MedO3 given after SE, C: control and S: sham control group. SE was induced with lithium-pilocarpine experimental model and evaluated on the Racine scale. Peripheral blood samples and brain tissue samples were taken before decapitation. Histopathological evaluation of the hippocampus of the rats given medical O3 before and after SE were studied. The highest peripheral blood oxidative stress index (OSI) was found in SE group. The OSI level in O3 + SE and SE + O3 was significantly higher than SE/C/S. Gene expressions of TNF-α and IL-1β mRNA were significantly higher in SE compared to other groups. Histopathologically; eosinophilia, cellular shrinkage and interstitial oedema were detected in the most severe SE and to a lesser extent in O3 + SE/ SE + O3. MedO3 reduced SE-induced oxidative damage, neuroinflammation and neuronal injury and contributed positively to neuroprotection.

The efficacy of health professions education (HPE) is more and more reliant on leveraging new technologies as they emerge. The nascent “Web 3.0” is shifting us away from traditional centralized architectures for capture and storage of information, and aims to decentralize and distribute it. Blockchain has received a large amount of attention as a promising “Web 3.0” technology and has been applied in the HPE setting. In this paper we argue that blockchain has two core issues which have prevented its widespread adoption: scalability and environmental impact. The architecture of blockchain means that all participating nodes must store and validate all of the data. This creates a large amount of overhead, which does not scale well. Similarly, there is growing awareness that the energy requirements of validating blockchain transactions run counter to global efforts to mitigate climate change. Holochain, however, is a novel Web 3.0 technology that aims to overcome both of these issues. Its architecture is fundamentally different to blockchain, by virtue of being “agent-centric” rather than “data-centric”. That is, each piece of data does not need to be globally validated—and yet Holochain can still guarantee data validity and integrity. We identify that specific challenges in the HPE setting—tracking educational activities, accountable mechanisms for observing entrustable professional activities, and validation of third-party certification and credentialing—can all be achieved elegantly in Holochain, without experiencing any of the disadvantages evidenced in blockchain.

This research study was conducted to investigate the cardioprotective activity of alcoholic extract of Ganoderma lucidum (GL) against cyclophosphamide (CYP)-induced cardiotoxicity in rats model. Therewithal, the regulation in the expression level of Aquaporin (AQP) water channels in the heart was evaluated. Cardiotoxicity was induced in Wistar rats by administering a single-dose injection of CYP (200 mg/kg, i.p.) on the seventh day of the experimental period. GL (500 mg/kg, gavage) was administered daily for seven days. Cardiac alteration following CYP and GL administration was evaluated using electrocardiographic changes, morphological staining, AQP gene expression and western blot analysis. It was observed that the CYP administration significantly (p

Objective: Core curriculums describe the basic standard of medical education. In this study, we aimed to investigate primary care physicians’ views on the minimum level of competency required in a general practitioner about skills listed in the National Core Curriculum for Undergraduate Medical Education-2014 (NCC-2014) and whether they feel competent in these skills. Method: Between October 1, 2017 and September 1, 2018, 27652 primary care physicians who work in Turkey were surveyed about the skills listed in the NCC-2014. The participants rated the minimum competency for every skill on 0–4 level and also stated whether they felt that the primary care physicians were competent. Result: 4117 (14.9%) participants answered entire questions. Out of 136 skills, “Level3—Should be able to do the skill in cases which are frequent and not complex” was the most selected category for 123 (90.4%) skills, “Level2—Should be able to do the skill according to the guidelines in a state of emergency” was the most selected category for 10 (8.1%) skills, and “Level4—Should be able to do the skill even in complex cases” was the most selected category for 3 (2.2%) skills by participants. Conclusion: The participants are generally willing to perform skills, but according to them, some of the skills are complex. There are differences between the required competency levels in the NCC-2014 and the opinions of participants. Since physicians’ views are important for curriculum development, medical curriculum developers around the world would benefit from findings of this study.

Hypereosinophilic syndrome (HES) is a rare hematological disease that causes organ damage by eosinophil infiltration in the tissue with increased eosinophil production in the bone marrow. HES is a rare but important cause of stroke. Central nervous system involvement findings can be serious and life-threatening. Eosinophil values should be examined as the cause of stroke, and hypereosinophilia should be suspected, especially in young patients with no etiology. Reported herein is a case of a 47-year-old female patient who was followed up with the diagnosis of acute cerebrovascular disease due to idiopathic HES.

The number of patient-doctor appointments carried out using telemedicine has surpassed in-person appointments. In spite of this, it is unclear that telemedicine curricula in undergraduate medical education reflect the real importance by means of the effectiveness of these approaches. We aimed to systematically search and review the studies that are on undergraduate telemedicine curricula. We searched the Web of Science, PubMed, and Scopus using the keywords such as telemedicine, medical education, and curriculum. Our search was limited to publication dates between January 1, 2000, and February 1, 2020. We elicited the information of the curricula as to their countries, participants, aims or objectives, teaching methods, and evaluation of effectiveness. We also evaluated the quality of the studies using the Joanna Briggs Institute Qualitative Appraisal and Review Instrument. Out of 461 studies, seven articles were selected based on selection criteria for further review. The studies were mostly from the USA. The participant numbers were between seven and 268. There were several modes of delivery but lectures and patient encounters were used mostly. In four studies, the effectiveness was evaluated only by using satisfaction surveys, and the results were satisfactory. A study reported the acquisition and application of skills as a result. There is no well-established telemedicine curriculum in the undergraduate years. The methods vary but the effectiveness of the educational programs does not have a robust evidence base. It is evident that undergraduate medical education needs a curriculum backed by strong scientific data on its effectiveness.

INTRODUCTION[|]The aim of this study is to determine self-perceived competency levels and perspectives of primary care physicians on psychiatry related basic practical skills that are in Turkish National Core Curriculum 2014.[¤]METHODS[|]This is a descriptive cross-sectional study that 4117 primary care physicians participated. An electronic survey form has been sent to primary care physicians who actively work in Turkey to determine the primary care physicians' self-perceived competency levels and the level that a medical student should reach at the graduation, on the psychiatry related basic practical skills that is in National Core Curriculum 2014. The study was carried out between October 1, 2017 and September 1, 2018. Descriptive statistical methods and chi square test were performed during analysis process.[¤]RESULTS[|]Self-perceived competency levels on psychiatry related skills of primary care physicians were between 27,3% and 62,4%. The proportion of incompetent primary care physicians was statistically higher among physicians who has graduated from medical school more than five years ago (p

CP is one of the most widely used antineoplastic agents. However, its clinical application is very limited due to its severe toxic effects. The present study aimed to reveal the effects of NAC, which exhibits broad biological activities in reducing CP-induced liver damage, in consideration of biochemical, genetic, and histopathological findings. Twenty-eight wistar rats were randomly divided into four groups of seven animals. A dose of saline was administered (i.p.) to the control group for 5 days. One dose of NAC (200 mg/kg) was administered to the NAC group for 5 days (i.p.). To the NAC + CP group, a dose of CP (7.5 mg/kg) was administered on days 2 and 5 of the experiment, a dose of NAC (200 mg/ kg) (i.p.) was administered for 5 day of the experiment. CP (7.5 mg/kg) was administered to the CP group on days 2 and 5 of the experiment. At the end of the experiment, the biochemical, histological, and mRNA expression analyses of the liver tissues isolated from all the rats were performed. A statistically significant decrease was observed in the AST and ALT enzyme activities in Group NAC + CP compared to Control and CP groups. In addition, it was determined that the NAC administration reduced CP-induced inflammation by increasing the level of NF-κB and decreased CP-caused oxidative stress by decreasing the GPx level. Moreover, the histopathological analyses showed that NAC improved liver morphology. It was revealed by Western blotting analysis that NAC promoted Bcl-2 signaling and decreased p53 signaling. The findings herein showed that NAC could help alleviate hepatotoxicity, a serious therapeutic complication, by reducing CP-induced oxidative stress and playing an effective part in the regulation of apoptotic markers.

Amaç: Türkiye’deki tıp fakülteleri, mezuniyet öncesi dönemde 6 yıllık bir eğitim vermektedir. Fakülteler bu 6 yıllık sürenin ilk 3 yılını klinik öncesi dönem, sonraki 2 yılını klinik dönem, son yılını ise uygulamaya yönelik intörnlük dönemi şeklinde yapılandırmıştır. Aile hekimliği uzmanlığı eğitiminin süresi 3 yıldır. Bu çalışmanın amacı; AB (Avrupa Birliği), ABD (Amerika Birleşik Devletleri), Avustralya, Birleşik Krallık, Çin, Japonya, Kanada, Rusya, Singapur ülkelerinde tıp fakültesine başvuru şartları ve süreçlerini, mezuniyet öncesi tıp eğitimi sürecinin zamansal yapısını, uzmanlık eğitimine başlayabilmek için gereken şartları, uzmanlık eğitimlerinin ve aile hekimliği uzmanlık eğitiminin süresini sunmaktır.Yöntem: Çeşitli ülkelerdeki tıp eğitimi süreçlerine erişmek için yapılan kaynak taramaları 03.10.2019-06.01.2020 tarihleri arasında gerçekleştirilmiştir. Pubmed, Scopus, Google Scholar arama motorlarında ve veri tabanlarında anahtar kelimelerle aramalar yapılmıştır. Anahtar kelimelerle erişilen çalışmaların yanında, ülkelerin tıp eğitimi ve sağlık sistemi ile ilgili bazı düzenleyici kuruluşların ve tıp fakültelerinin internet sitelerine erişilmiştir.Bulgular: Mezuniyet öncesi tıp eğitimi genel olarak 3-6 yıl sürmektedir. Eğitim süreci çoğu ülkede, klinik öncesi dönem ve klinik dönem olarak ayrılmaktadır. ABD ve Kanada’da, tıp fakültesine başvurabilmek için lisans mezunu olma şartı vardır. Bazı ülkeler, mezuniyet sonrasında 1-3 yıl intörnlük yapılmasını zorunlu kılmaktadır. Kanada’da uzmanlık eğitimi veren bazı bölümler, öğrencilerinin “mecburi hizmet” için oluşturulmuş sözleşmeyi imzalamasını zorunlu kılar. Aile hekimliği uzmanlık eğitimi genelde 3 yıldır. Sonuç: Her ülkede, öğrencilerin tıp fakültesine başvurusundan aile hekimi olmalarına kadar yaşadıkları süreç farklılık göstermektedir. Bu çeşitliliklere rağmen ortak noktalar da mevcuttur. Yabancı ülkelerdeki eğitim ve birinci basamaktaki kariyer süreçlerinin incelenmesi ve bu ülkelerde yer alan işlevsel yaklaşımların ülkemize uyarlanması, birinci basamakta çalışacak hekimlerimizin topluma daha faydalı olabilecek niteliklere sahip bir şekilde mezun olmasını sağlayabilir.

Amaç: Doktorun hasta ile karşılaştığında zihninde gerçekleştirdiği süreçler “klinik akıl yürütme” olarak ifade edilir. Klinik akıl yürütme; öykü, fizik muayene ve hasta yönetimini içerir. Bu becerinin öğretimi ve değerlendirilmesinde olgular kullanılmaktadır. Olgu seçiminde çekirdek program dikkate alınmalıdır. Bu çalışmanın amacı Gazi Üniversitesi Tıp Fakültesi’nde Dönem 6 öğrencilerinin İç Hastalıkları intörnlük süresi sonunda klinik akıl yürütme becerisine yönelik yapılan olguya dayalı çok istasyonlu elektronik sınavın sorularının Ulusal Çekirdek Eğitim Programı-2014 ile uyumunu incelemektir.Yöntem: Çalışma, Mayıs-Aralık 2019 arasında 289 Dönem 6 öğrencisiyle İç Hastalıkları intörnlük dönemlerinin sonunda gerçekleştirilmiştir. Olgulara dayalı çok istasyonlu elektronik sınavın soruları İç Hastalıkları öğretim üyeleri tarafından hazırlanmıştır. Toplamda 5 sınav anında geri bildirim verilir şekilde SocrativeTM ile gerçekleştirilmiştir. Her sınavda üçer olgu bulunmaktaydı. Bütün sınavlar tamamlanınca sorular öykü, fizik muayene, ön tanı, tetkik, tedavi sınıflarıyla kategorize edilmiştir. Ulusal Çekirdek Eğitim Programı-2014 ile uyumu değerlendirilmiştir.Bulgular: Toplamda 14 olgu ve olgulara bağlı 74 soru değerlendirmeye alındı. Soruların 26’sı (%35,1) tetkik, 16’sı (%21,6) tedavi ile ilgiliydi. Öğretim üyelerinin sınavlarda yer verdikleri 14 olgunun 13’ünde (%92,8) en az bir soru, Ulusal Çekirdek Eğitim Programı-2014’te beklenen düzeyden ilerisini sınamaya yöneliktir. Hazırlanan 74 sorunun 31’i (%41,8) çekirdek programda beklenen düzeyin üstündeki düzeyleri sınamaktadır. Öğrencilerin ortalama puanları, çekirdek eğitim programında beklenen düzeyin üstündeki düzeyleri sınayan sorularda, düzeyine uygun sorulardaki ortalamalarına göre istatistiksel olarak anlamlı şekilde daha düşüktür (pSonuç: Öğretim üyelerinin soru hazırlama sürecinde Ulusal Çekirdek Eğitim Programı-2014’ü dikkate almadığı görülmektedir. Sınavların öğrenmeye etkisinden dolayı bu ciddi bir tehdit olarak görülebilir. Ulusal Çekirdek Eğitim Programı ve ölçme-değerlendirme konularında eğitici eğitimi bu soruna çözüm oluşturabilir.

Objective: The aim of our study is to determine the habits of 5th and 6th year undergraduate medical students and medical specialty trainees on hand hygiene through their views in a university hospital and to compare the habits of undergraduate medical students to those of medical specialty trainees to evaluate in the context of role modelling.

Giriş: Öğretim tasarımı ve program geliştirme kavramları iki ayrı sürece işaret etse de birbirleriyle ilişkilidir. Bu durum, birbirleriyle benzerlik ve farklılıklar oluşturmakta ve dolayısıyla söz konusu iki kavramın sınırları hakkında karışıklığa yol açmaktadır. Amaç: Bu çalışmanın amacı, öğretim tasarımı ve program geliştirme arasındaki ilişkiyi inceleyip bazı öğretim tasarım modellerini ifade ederek alan yazındaki açığın kapanmasına katkıda bulunmaktır. Gereç ve yöntem: Bunun için önce öğretim ve program kavramları açıklanmıştır. Daha sonra öğretim tasarımı süreci incelenmiş ve bunlarla ilgili örnekler tıp eğitimi alanından verilmiştir. Daha sonra da öğretim tasarımı ve program geliştirme arasındaki ilişki ifade edilmiştir. Makalenin son bölümünde ise sırasıyla “4C/ID” modelinden, ADDIE yaklaşımından, “Dick, Carey ve Carey”, “Keller’ın ARCS Motivasyon”, “ASSURE”, “Kemp, Morrison ve Ross” ve “Gerlach ve Ely” adlı öğretim tasarım modellerinden bahsedilmiştir.Bulgular ve sonuç: Program geliştirme, amaç ve hedeflerin ne olması gerektiğiyle ilgiliyken; öğretim tasarımı, o amaç ve hedeflere nasıl ulaşılacağı ile ilgilidir. Program geliştirme daha geniş, öğretim tasarımı ise dar kapsamlıdır. Genel olarak böyle bir ayrım yapılabilmesine rağmen öğretim tasarımı ile program geliştirme arasındaki sınırın kesin yeri belirli değildir. Çünkü literatürde bu sınırın nerede olduğuna dair çeşitli görüşler mevcuttur. 4C/ID öğretim tasarım modeli, özellikle tıp eğitimi alanında etkin bir şekilde kullanılabilen bir modeldir. ADDIE, bazı yayınlarda öğretim tasarım modeli olarak değerlendirilmiş olsa da bir model değildir, yaklaşımdır. ASSURE öğretim tasarım modelinden, öğretimde teknoloji desteği kullanılmak istendiğinde yararlanılabilir ve bu model öğretim tasarımı için çok sayıda kişi gerektirmez, tek bir eğitici bile kendi başına kullanabilir. Gerlach ve Ely öğretim tasarım modeli de profesyonel öğretim tasarımcılarını gerektirmez. Eğiticilerin içeriğin başta belirlenmesine yönelik eğilimini dikkate alarak modelin başlangıcına içeriğin belirlenmesini koyması, bu modeli farklı kılan bir özelliktir.

Chromatography has been preferred in the medical field as one of the most important analytical methods used for the identification and quantification of a drug and its metabolites in recent years. Various chromatographic techniques have been developed to differentiate drugs according to their characteristics and interaction types. Among these techniques, particularly High Performance Affinity Chromatography (HPAC), Cell Membrane Chromatography (CMC), Mixed Mode Chromatography (MMC), High Performance Liquid Chromatography (HPLC) are used for pharmaceutical purposes for bioanalysis of drugs in preclinical and clinical studies. The success of Chromatography in the development of rapid and precise analytical methods provides superior specificity and sensitivity in the research of pharmacokinetic properties of drugs in R&D. In personalized medicine, it is important how the dosage and effect of drugs varies from person to person. In recent years, chromotography has been preferred as a promising technique in the analysis of drug-protein binding and in the examination of clinical or pharmaceutical samples.

Amaç: Gazi Üniversitesi Tıp Fakültesi dönem 2 öğrencilerinin algılanan öğrenme düzeyleri, uyku kaliteleri ve içecek tüketimleri arasındaki ilişkiyi incelemek.Gereç-Yöntem: Çalışmanın evrenini Gazi Üniversitesi Tıp Fakültesi dönem 2 öğrencileri oluşturmaktadır. Çalışmanın gerçekleştirildiği 2016-2017 eğitim öğretim yılında toplam 359 dönem 2 öğrencisi vardır. Öğrencilere, sosyodemografik bilgileri ve içecek tüketimi alışkanlıklarını sorgulayan sorularla beraber Algılanan Öğrenme Ölçeği’ni ve Pittsburgh Uyku Kalitesi Ölçeği’ni (PUKÖ) içeren anket formu uygulanmıştır. Algılanan Öğrenme Ölçeği’nde daha yüksek puanlar, algılanan öğrenmenin daha iyi olduğunu gösterirken Pittsburgh Uyku Kalite Ölçeği’nden alınan puan yükseldikçe uyku kalitesi kötüleşmektedir. Verilerin istatistikî analizi SPSS v.22.0 for Windows paket programında yapılmış, anlamlılık düzeyi 0.05 olarak kabul edilmiştir.Bulgular: Evrenin %86.1’ine (N=309) ulaşılmıştır. Değerlendirmeye dâhil edilen 306 öğrencinin %16.3’ü (N=50) sigara kullanmakta, %71.5’i (N=218) her gün çay, %32.5’i (N=99) her gün kahve içmekte; %78.8’i (N=238) alkolü, %69.6’sı (N=211) enerji içeceklerini hiç tüketmemektedir. Öğrencilerin günlük uyku süreleri ortalama 7.24 ± 1.31 saattir. Öğrencilerin PUKÖ puanı ortalaması 6.02 ± 2.81 olup, %69.3’ünün uyku kalitesinin kötü (PUKÖ puanı 5 ve üzeri) olduğu belirlenmiştir. Algılanan Öğrenme Düzeyi ile PUKÖ puanı arasında negatif yönlü anlamlı ilişki vardır (r = -0.103, p

Valproic acid (VPA) is a anticonvulsant and mood-stabilizing agent used to treat epilepsy in patients of all ages. However, it can cause hepatotoxicity with increased oxidative stress. Melatonin (MEL) is known as antioxidant and antiinflammatory agent. Therefore, the present study designed to investigate the probable protective role of melatonin against VPA-induced liver toxicity. For that purpose, 28 Wistar rats were randomly selected and divided into four groups, namely the Group C (vehicle), VPA (500 mg/kg/day VPA), MEL + VPA (10 mg/kg/day melatonin + 500 mg/kg/day VPA) and MEL (10 mg/kg/day melatonin). The agents were given by oral gavage for 14 days. Blood and liver tissue samples from all the rats were harvested on the 15th day of experiment. Biochemical analyses were conducted on the blood samples. The levels of malondialdehyde (MDA), superoxide dismutase (SOD), alpha glutathione S-transferases (α-GST), nuclear factor-κB (NF-κB), myeloperoxidase (MPO) and changes in gene expression were examined in the liver tissues. Also, liver histopathological analyses were conducted. VPA administration significantly increased the levels of α-GST, MDA, NF-κB and of IL-1β, TNF-α gene expression in the liver compared to Group C. Moreover, vacuolization, hydropic degeneration, inflammatory cell infiltration, and sinusoidal congestion were commonly detected in the VPA-treated group along with the highest apoptotic index (TUNEL staining) values. Melatonin administration was revealed to exhibit powerful protective properties at cellular, inflammatory and oxidative level activities against VPA-induced liver toxicity. Therefore, melatonin administration may be used as an adjuvant therapy against to VPA-induced liver toxicity.

Medical errors are a serious public health problem and the third-leading cause of death after heart disease and cancer. Every day, the health care professionals (HCPs) practice their skill and knowledge within excessively complex situations and meet unexpected patient outcomes. These unexpected complications and unintentional errors will always be a part of the medical system due to the universal nature of human fallibility and technology. While not all errors are life-threatening, they can significantly compromise a patient's quality of life. However, the victims of medical error reach far beyond the patient. The second victim (SV), which defined for the first time by Albert Wu in his description of the impact of errors on HCPs by both personally and professionally, is a medical emergency equivalent to post-traumatic stress disorder. When the errors occur, it causes a domino effect including the four groups: the patient and family (first victim), the HCP [SV], the hospital reputation (third victim), and patients who are harmed subsequently (fourth victims). The rights of our patients to safe, reliable, and patient-centered care are critical and most important as a primary and utmost aim of medicine. However, we also have to take care of our own (SVs), especially when we have good people who mean to do well and then find themselves in an emotionally complex situation. There is a need to articulate to the public, politicians, and media how system failure leads to medical error even in hand of well-educated and competent HCPs are given an increasing clinical workload. Furthermore, despite several leading institutions in western countries have developed formal support programs that allow HCPs to cope with their emotional distress by obtaining timely support in an emphatic, confidential, non-judgmental environment, we need to raise awareness of this phenomenon and appropriate institutional responses both to harmed patients and their families and HCPs.

This study aims to reveal to what degree the preclinical medical students’ conceptualisation of health advocacy changes prior to and after the implementation of the “Roles of The Doctor” curriculum. The essay assignments obtained at the pre-and post-sessions of the health advocacy theme and the students’ feedback about the programme were used. The analyses were performed following Miles and Huberman’s guidelines on qualitative analysis. Before the elective course was implemented, very few students had conceptualizations about health advocacy. The conceptualizations that indirectly referred to health advocacy were responsibility, altruism, and justice, knowing and defending one’s rights, looking after the patient, professional political understanding, responsibility and equality. The students defined the concept of health advocacy at three levels and under eight categories after health advocacy theme. They also defined the competencies of health advocate physicians. Offering the advocacy curriculum in the preclinical period enables the development of students’ schemata related to the concept of health advocacy. This should be considered a step towards the development of professional identity. Students have dealt with health advocacy in terms of the protection of health professionals. This situation suggests that cognitive and emotional reaction arising from the increase in the cases of violence against professionals. © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group.

This study introduces ContExtended Questions (CEQ), which is a toolboth to teach and assess clinical reasoning particularly in the preclinical years,and the web-based program to implement. CEQ consists of text-based case-basedmultiple-choice questions that provide patient data in a fixed and predeterminedsequence. It enables the examinees to develop and reshape their illness scripts byusing feedback after every question. Feedback operates to transform theexaminee’s failure into a “productive failure”. The preliminary results of therandomized controlled experiment of teaching clinical reasoning to preclinicalstudents through CEQ is quite satisfactory. In the medical education literature,this would be the first time that students, who have no or very limited clinicalexperience, developed their illness scripts just by taking formative multiple-choicetests. The approach would be named “test-only learning”. The complete results ofthe experiment and then more experiments in other contexts and domains arenecessary to establish a more powerful assessment tool and software.Furthermore, by changing the content of the questions, it is possible to use CEQ inevery period of medical education and health professions education.

The COVID-19 (Coronavirus Disease of 2019) pandemic, as the modern world’s gravest health crisis, has rapidly required more health facilities and health care providers (HCPs). The education system in general and medical education, in particular, has also changed dramatically with the school closures. Teaching and learning activities are undertaken remotely and on digital platforms. Academicians, HCPs, and medical students have gained new skills and experienced to manage their own learning process online. Many sources became easily reachable, open, and free. Open and democratized medicine, as we have seen during this pandemic, offers an interactive, egalitarian educational model. Governments, global organizations, and companies collaborated in order to keep all students learning and all instructors teaching. Many societies are faced with the digital divide and exclusion of learners. In this paper, we discussed the effect of COVID-19 on medical education at all levels and its’ democratization and shared our recommendations for sustaining these achievements after the pandemic.

Amaç: Bu araştırmanın amacı; palyatif bakım hastaları, hasta yakınları ve hemşirelerinin iyi ölüme ilişkin görüşlerini belirlemektir.Yöntem: Araştırma, 01.07.2019-29.09.2019 tarihleri arasında Malatya il ve ilçe merkezlerinde bulunan Palyatif Bakım Kliniklerinde yapılmıştır. Araştırmanın örneklemini, çalışmaya katılmaya gönüllü olan 90 hasta, 90 hasta yakını ve 90 hemşire oluşturmuştur. Araştırmada veriler, literatürden yararlanılarak oluşturulan Hasta, Hasta Yakını, Hemşire Kişisel Bilgi Formu ve İyi Ölüm Ölçeği kullanılarak yüz yüze görüşme yöntemi ile toplanmıştır. İnönü Üniversitesi Sağlık Bilimleri Girişimsel Olmayan Klinik Araştırmalar ve Yayın Etik Kurulundan, Malatya il ve ilçe hastanelerinden, hastalar, hasta yakınları ve hemşirelerden yazılı izin alınmıştır.Bulgular: Hemşirelerin %65.6’sının 29-35 yaş grubunda, %85.6’sının kadın, %55.6’sının bekâr, %56.6’sının lisans mezunu, %64.4’ünün ilde yaşadığı saptanmıştır. Hastaların %55.6’sının 29-35 yaş grubunda, %61.1’inin kadın, %71.1’inin evli, %76.7’sinin lise/ön lisans mezunu, %60.0’ının ilde yaşadığı belirlenmiştir. Hasta yakınlarının %53.3’ünün 22-28 yaş grubunda, %84.4’ünün kadın, %60.0’ının evli, %62.2’sinin lisans mezunu, %68.9’un ilde yaşadığı belirlenmiştir. Araştırmaya katılanların iyi ölüm tanımlarına bakıldığında; hastaların %46.7’sinin “ağrı ve stres olmadan hayatın sonlanması”, hasta yakınlarının %61.1’inin “aile bireyleriyle birlikte süreci paylaşmak”, hemşirelerin ise % 57.8’inin “acı çekmeden süreci yaşamak” olarak tanımladıkları saptanmıştır. İyi Ölüm Ölçeği puan ortalamalarına bakıldığında; hastaların puan ortalamasının (58.77±6.50), hasta yakınlarının puan ortalamasının (58.04±6.71) ve hemşirelerin puan ortalamasının (55.80±7.94) olduğu saptanmıştır. Sonuç: Hastaların İyi Ölüm Ölçeği toplam puan ortalamasının hemşire ve hasta yakınından daha yüksek olduğu saptanmıştır., Aim: The aim of this research; to state the opinions of palliative care patients, patient relatives and nurses on good death.Methods: Research was carried out between 01.07.2019-29.09.2019 at Palliative Care Clinics in Malatya provincial and district centres. The sample of the research occurred 90 patients, 90 relatives and 90 nurses who volunteered to attend in the research. Data were gathered by face-to-face interviews using the Personal Information Form and Good Death Scale. Written permission was attained from Inonu University Health Sciences Non-Interventional Clinical Research and Publication Ethics Committee, Malatya provincial and district hospitals, patients, patient relatives and nurses.Results: It was found that 65.6% of the nurses were in the 29-35 age groups, 85.6% were female, 55.6% were single, 56.6% were undergraduate graduates and 64.4% lived in the province. It was stated that 55.6% of the patients were in the 29-35 age group, 61.1% were women, 71.1% were married, 76.7% were high school / associate degree graduates and 60.0% lived in the province. It was stated that 53.3% of the patients' relatives were in the 22-28 age group, 84.4% were women, 60.0% were married, 62.2% were undergraduate graduates and 68.9% lived in the province. Looking at the definitions of good death of the participants; it was discovered that 46.7% of the patients defined “ending life without pain and stress”, 61.1% of the patients' relatives “shared the process with their family members”, and 57.8% of the nurses defined “experiencing the process without suffering”. When the mean point of Good Death Scale; the mean point of the patients (58.77 ± 6.50), the mean point of patients' relatives (58.04 ± 6.71) and the mean point of nurses (55.80 ± 7.94) was found to be.Conclusion: It was stated that the mean total point of the good death scale of the patients was higher than the nurse and the patient's relatives.

In this study, a micro-strip implant antenna that can be used in-tissue applications was proposed. Antenna size was designed as 30mm * 28mm * 1.59mm. In the design, a FR4 substrate material was used whose permittivity is 4.3, loss tangent is 0.025 and height is 1.52 mm. The analysis of the implant antenna was simulated in the CST Microwave Studio program. After obtaining the desired performance, a tissue model was created and an implant antenna was placed in the skin tissue. Return loss and SAR value of the designed antenna were measured in the 2.45 GHz ISM band. As a result, return losses were observed as -18 dB and -33 dB and SAR was 153 W / kg inside and outside the tissue respectively. Then, the antenna was manufactured with PCB and a phantom liquid was created that provides the electromagnetic properties of the skin tissue and the antenna was placed in this liquid. Finally, the simulation and experiment results of the designed antenna were evaluated and compared with literature studies. It has been observed that the measurement results in the skin tissue are well aligned with the simulation results., Bu çalışmada doku içi uygulamalar için kullanılabilecek özgün bir mikroşerit implant anten tasarımı önerilmiştir. Anten boyutu 30 mm*28 mm*1.59 mm olarak tasarlanmıştır. Tasarımında dielektrik sabiti 4.3, kayıp tanjantı 0.025 ve yüksekliği 1.52 mm olan FR4 taban malzemesi kullanılmıştır. İmplant antenin analizi CST Microwave Studio programında gerçeklenmiştir. İstenilen değerler elde edildikten sonra ise doku modeli oluşturularak deri doku içerisine implant anten yerleştirilmiştir. Tasarlanan mikroşerit implant antenin ISM bandında 2.45 GHz’de geri dönüş kaybı ve SAR değeri ölçülmüştür. Yapılan ölçümler sonucunda doku içi ve doku dışı sırasıyla geri dönüş kaybı -18 dB ve -33 dB, SAR değeri ise 153 W/kg olarak gözlemlenmiştir. Daha sonra antenin baskı-devre teknolojisi ile gerçeklenmesi yapılıp, deri dokusunun özelliklerini gösteren bir fantom sıvı oluşturulmuş ve anten bu sıvı içine yerleştirilmiştir. Son olarak da tasarımı yapılan antenin simülasyon ve deney sonuçları değerlendirilerek literatürdeki diğer çalışmalarla karşılaştırılması yapılmıştır. Deri dokusu içerisindeki ölçüm sonuçlarının da benzetim sonuçları ile oldukça uyumlu olduğu gözlemlenmiştir.

Objectives: High emotional intelligence and leadership traits are essential for physicians in managing their responsibilities and thus building successful interactions with patients. This study explored the relationship between emotional intelligence and leadership traits among family physicians. Methods: Participants (2975 men, 972 women, mean=42.0 ages, SD=7.47) were family physicians working at family healthcare centers across the seven geographical regions of Turkey who were contacted by email. The Trait Emotional Intelligence Questionnaire (TEIQue) and Leadership Traits Tool were used to collect data. Data were analyzed concerning physicians’ sex, age, healthcare experience, and geographical region. The correlation between Trait Emotional Intelligence (TEI) and leadership was also being examined. Results: Our findings suggest that family physicians’ trait emotional intelligence differs based on sex, age, healthcare experience, and the geographical region where they work. Women had higher mean values than did men for wellbeing, emotionality, and global TEI. Physicians aged younger than 29 years had the lowest mean values for emotional intelligence. As physicians’ healthcare experience increased, they received higher scores for emotional intelligence. Physicians working in the Mediterranean had the highest mean TEI scores. There was a positive correlation between family physicians’ emotional intelligence and leadership traits. Higher emotional intelligence was correlated with increased leadership traits. Conclusion: Emotional intelligence and leadership traits play crucial roles in increasing physicians’ personal and professional development. This may also increase physicians’ caregiving competencies and thus the quality of health services, as well as potentially decreasing physicians’ burnout and health-related costs.

Amac: Bireyin e-ogrenmeye hazir bulunuslugu; bilgi ve iletisim teknolojilerinin (BIT) olanaklarindan yararlanma becerisi olarak dusunulebilir. Bu calismanin amaci tip fakultesi ogretim uyelerinin e-ogrenme hazir bulunusluk duzeylerinin belirlenmesidir. Materyal ve Metot: Bu calisma, betimsel bir arastirma olup, elverisli ornekleme yontemiyle gonullu 106 kisiden veri toplanmistir. Veri toplama formu demografik bilgiler, ogretim uyelerinin sahip olduklari teknolojiler ve bu teknolojileri kullanma durumlarini belirleyen secenekli ve acik uclu sorular icermektedir. Ayrica ogretim uyeleri icin e-ogrenme hazir bulunusluk olcegi (EOHB) kullanilmistir. Elde edilen tum veriler %95 guven araliginda ve SPSS 17.0 yazilimi ile analiz edilmistir. Bulgular: Katilimcilarin yas ortalamasi 49 civarinda olup, %58’i kadindir. Ogretim uyelerinin BIT kullanimi oz yeterligi (BITKOY: 5,91±1,08) yuksektir. Ancak e-ogrenmede kendilerine guvenleri (EOKG: 2,94±1,32) ve e-ogrenmeye yonelik tutumlari (EOYT: 3,82±1,39) oldukca dusuktur. Ayrica e-ogrenmeye yonelik egitim ihtiyaclari (EOYEI: 4,94±1,50) da yuksektir. Ogretim uyelerinin sahip olduklari teknolojik donanimlar yeterli olup, surekli internet erisimleri de vardir. Ogretim uyeleri gun icerisinde interneti daha cok bilimsel calismalar icin (%85) kullanmaktadir. EOKG alt boyutunda kadinlar erkeklerden anlamli olarak daha dusuk guvene sahiptir ( t (99) = 2,251; p

PRIOR ABSTRACT PUBLICATION: 2(nd) Medical Rehabilitation Congress; Nov 4–7, 2010; Ankara, Turkey OBJECTIVE: This study aims to investigate the process of breaking bad news from the perspective of spinal cord injury survivors. DESIGN: A cross sectional, qualitative study. SETTING: Community. PARTICIPANTS: Fourteen spinal cord injury survivors. INTERVENTIONS: Subjects participated in a semi-structured interview about ‘when’, ‘where’ ‘by whom’ and ‘how’ they received and ‘would’ prefer to receive bad news. OUTCOME MEASURES: Answers to ‘how’ questions were coded according to SPIKES protocol (Setting, Perception, Invitation, Knowledge, Empathizing, Summary). RESULTS: Eight participants (57%) reported that they received bad news from a physician, mostly during rehabilitation. All would prefer to be informed by a physician and majority preferred to be gradually informed during rehabilitation. Half were not satisfied with the content of information. Only half felt that his/her physiatrist understood his/her emotional distress. Majority of participants who received bad news from physicians reported that the setting was private and their family members accompanied them. CONCLUSION: Most spinal cord injury survivors were unsatisfied with knowledge and emotional support provided by rehabilitation physicians. Participants would prefer to receive bad news by a senior physiatrist in a planned meeting during rehabilitation.