Pachivanhu, vadzidzisi vaidzidzisa kuongororwa kwemuviri (PE) kune vatsva vezvekurapa (vadzidzi), pasinei nematambudziko ekutsvaga vashandi nemitengo, pamwe nematambudziko ehunyanzvi hwakajairwa.
Tinokurudzira modhi inoshandisa zvikwata zvakajairwa zvevarairidzi vevarwere (SPIs) nevadzidzi vekurapa vegore rechina (MS4s) kudzidzisa makirasi ekurovedza muviri kuvadzidzi vasati vatanga kurapwa, vachishandisa mukana wekudzidza pamwe chete uye nekubatsirana nevezera ravo.
Ongororo dzevadzidzi ve pre-service, MS4 neSPI dzakaratidza maonero akanaka nezvechirongwa ichi, vadzidzi ve MS4 vakataura nezvekuvandudzwa kukuru mukuzivikanwa kwavo sevadzidzisi. Kubudirira kwevadzidzi ve pre-practice pabvunzo dzekiriniki dzechirimo kwakaenzana kana kuti kuri nani pane kubudirira kwevamwe vavo ve pre-program.
Chikwata cheSPI-MS4 chinogona kudzidzisa vadzidzi vatsva mashandiro uye hwaro hwekiriniki hwekuongorora muviri kwevatsva.
Vadzidzi vatsva vezvekurapa (vadzidzi vasati vaenda kuchikoro chekurapa) vanodzidza bvunzo dzemuviri (PE) pakutanga kwechikoro chekurapa. Vanoita makirasi ezvidzidzo zvemuviri kuvadzidzi vechikoro chekugadzirira. Netsika, kushandiswa kwevadzidzisi kunewo matambudziko, anoti: 1) anodhura; 3) akaoma kunyoresa; 4) akaoma kuaenzanisa; 5) zvinhu zvidiki zvinogona kumuka; zvikanganiso zvisiri pachena uye zviri pachena [1, 2] 6) Vangave vasina ruzivo rwenzira dzekudzidzisa dzakavakirwa pauchapupu [3] 7) Vanganzwa kuti kugona kudzidzisa zvekurovedza muviri hakuna kukwana [4];
Mamodheru ekudzidzira maekisesaizi akabudirira akagadzirwa achishandisa varwere chaivo [5], vadzidzi vekurapa vakuru kana vagari vemo [6, 7], uye vanhuwo zvavo [8] sevarairidzi. Zvakakosha kuziva kuti mamodheru ese aya akafanana pakuti kuita kwevadzidzi muzvidzidzo zvekurovedza muviri hakuderedzi nekuda kwekubviswa kwekutora chikamu kwevadzidzisi [5, 7]. Zvisinei, vadzidzisiwo havana ruzivo rwekiriniki [9], izvo zvakakosha kuti vadzidzi vakwanise kushandisa data remitambo kuyedza fungidziro dzekuongorora. Kuti vagadzirise kudiwa kwekuenzanisa uye mamiriro ekiriniki mukudzidzisa kwekurovedza muviri, boka revadzidzisi rakawedzera maekisesaizi ekuongorora anotungamirirwa nefungidziro pakudzidzisa kwavo kwevadzidziwo zvavo [10]. PaGeorge Washington University (GWU) School of Medicine, tiri kugadzirisa chinodiwa ichi kuburikidza nemuenzaniso wezvikwata zvevadzidzisi vevarwere (SPIs) nevadzidzi vekurapa vakuru (MS4s). (Mufananidzo 1) SPI yakabatana neMS4 kudzidzisa PE kune vadzidzi. SPI inopa hunyanzvi mukuita kwebvunzo yeMS4 mukiriniki. Iyi modheru inoshandisa kudzidza pamwe chete, inova chishandiso chekudzidza chine simba [11]. Nekuti SP inoshandiswa muzvikoro zvese zvekurapa zvekuUS uye muzvikoro zvakawanda zvepasi rose [12, 13], uye zvikoro zvakawanda zvekurapa zvine mapurogiramu evadzidzi, modhi iyi inogona kushandiswa zvakanyanya. Chinangwa chechinyorwa chino ndechekutsanangura modhi iyi yakasarudzika yeSPI-MS4 yekudzidzisa mitambo yechikwata (Mufananidzo 1).
Tsananguro pfupi yemuenzaniso wekudzidza pamwe chete weMS4-SPI. MS4: Mudzidzi wezvekurapa wegore rechina SPI: Mudzidzisi wevarwere akajairwa;
Kuongororwa kwemuviri kunodiwa (PDX) paGWU chimwe chezvikamu zvekosi yehunyanzvi hwekiriniki hwepamberi pekunyora mukurapa. Zvimwe zvikamu: 1) Kubatanidzwa kwekiriniki (zvikamu zveboka zvichibva pamutemo wePBL); 2) Kubvunzurudzwa; 3) Kurovedza muviri OSCE; 4) Kudzidziswa kwekiriniki (kushandiswa kwehunyanzvi hwekiriniki navanachiremba vanoshanda); 5) Kudzidzisa kukura kwehunyanzvi; PDX inoshanda mumapoka evanhu 4-5 vanodzidziswa vanoshanda muchikwata chimwe chete cheSPI-MS4, vachisangana katanhatu pagore kwemaawa matatu ega ega. Hukuru hwekirasi hunenge vadzidzi vanosvika zana nemakumi masere, uye gore rega rega vadzidzi vari pakati pe60 ne90 veMS4 vanosarudzwa sevadzidzisi vekosi dzePDX.
Vadzidzisi veMS4 vanodzidziswa nevadzidzisi kuburikidza neTALKS (Teaching Knowledge and Skills) yedu yepamusoro yekusarudza vadzidzisi, inosanganisira maworkshops pamusoro pemitemo yekudzidza kwevakuru, hunyanzvi hwekudzidzisa, uye kupa mhinduro [14]. SPIs inopinda muchirongwa chekudzidzisa chakasimba chakagadzirwa neCLASS Simulation Center Assistant Director (JO) yedu. Zvidzidzo zveSP zvakavakirwa pamitemo yakagadzirwa nevadzidzisi inosanganisira misimboti yekudzidza kwevakuru, maitiro ekudzidza, uye hutungamiriri hweboka nekukurudzira. Kunyanya, kudzidziswa kweSPI nekugadzika kunoitika muzvikamu zvakasiyana-siyana, kutanga muzhizha uye kuenderera mberi mugore rese rechikoro. Zvidzidzo zvinosanganisira madzidzisiro, kutaurirana uye kuitisa makirasi; kuti chidzidzo chinopindirana sei mune imwe kosi yasara; maitirwo emhinduro; maitirwo ekurovedza muviri uye kudzidzisa vadzidzi. Kuti vaongorore kugona kwechirongwa ichi, SPIs inofanira kupasa bvunzo yekuisa inopihwa nenhengo yechikoro cheSP.
MS4 neSPI vakatorawo chikamu mumusangano wechikwata wemaawa maviri pamwe chete kuti vatsanangure mabasa avo anoenderana mukuronga nekushandisa chirongwa chedzidzo uye kuongorora vadzidzi vanopinda mukudzidziswa kwevadzidzi vasati vatanga basa. Chimiro chikuru chemusangano wacho chaive muenzaniso weGRPI (zvinangwa, mabasa, maitiro uye zvinhu zvinobatanidza vanhu) uye dzidziso yaMezirow yekudzidza kwekuchinja (maitiro, zvivakwa uye zviri mukati) yekudzidzisa pfungwa dzekudzidza dzakasiyana-siyana (zvimwe) [15, 16]. Kushanda pamwe chete sevadzidzisi pamwe chete kunoenderana nedzidziso dzekudzidza dzemagariro evanhu uye dzezviitiko: kudzidza kunogadzirwa mukutsinhana kwevanhu pakati penhengo dzechikwata [17].
Chidzidzo chePDX chakagadzirwa zvichienderana nemuenzaniso weCore and Clusters (C+C) [18] wekudzidzisa PE muchimiro chekufunga kwekiriniki kwemwedzi gumi nemisere, nechirongwa chechikamu chimwe nechimwe chakatarisana nekutaura kwevarwere kwakajairika. Vadzidzi vanotanga kudzidza chikamu chekutanga cheC+C, bvunzo yemuviri ine mibvunzo makumi mana inofukidza masisitimu makuru enhengo. Bvunzo yekutanga iongororo yemuviri iri nyore uye inoshanda isinganyanyi kunetsa pfungwa kupfuura bvunzo yakajairika. Bvunzo dzepakati dzakanakira kugadzirira vadzidzi ruzivo rwekutanga rwekiriniki uye dzinogamuchirwa nezvikoro zvakawanda. Vadzidzi vanobva vaenderera kune chikamu chechipiri cheC+C, Diagnostic Cluster, iro riri boka reH&Ps dzinotungamirirwa nefungidziro dzakarongwa zvichienderana nekutaura kwakajairika kwekiriniki kwakagadzirirwa kukudziridza hunyanzvi hwekufunga kwekiriniki. Kurwadziwa pachipfuva muenzaniso wekuratidzwa kwakadaro kwekiriniki (Tafura 1). MaClusters anotora mabasa epakati kubva muongororo yekutanga (semuenzaniso, basic cardiac auscultation) uye anowedzera mamwe mabasa akakosha anobatsira kusiyanisa kugona kwekuongorora (semuenzaniso, kuteerera mamwe manzwi emwoyo munzvimbo ye lateral decubitus). C+C inodzidziswa kwemwedzi gumi nemisere uye chirongwa ichi chinoenderera mberi, vadzidzi vachitanga kudzidziswa bvunzo dzemuviri dzinenge makumi mana uye, kana vagadzirira, vanopinda mumapoka, rimwe nerimwe richiratidza kushanda kwekiriniki kunomiririra module yenhengo dzemuviri. Mudzidzi anosangana nazvo (semuenzaniso, kurwadziwa pachipfuva uye kushaya mweya panguva yekuvharirwa kwemwoyo nekufema) (Tafura 2).
Mukugadzirira kosi yePDX, vadzidzi vasati vapinda chiremba vanodzidza nzira dzakakodzera dzekuongorora chirwere (Mufananidzo 2) uye kudzidziswa kwemuviri mubhuku rePDX, bhuku rekuongorora chirwere chemuviri, uye mavhidhiyo etsanangudzo. Nguva yese inodiwa kuti vadzidzi vagadzirire kosi iyi ingangoita maminetsi 60-90. Inosanganisira kuverenga Cluster Packet (mapeji 12), kuverenga chitsauko cheBates (~mapeji 20), uye kuona vhidhiyo (maminetsi 2-6) [19]. Chikwata cheMS4-SPI chinoita misangano nenzira yakarongeka vachishandisa fomati yakatsanangurwa mubhuku redzidzo (Tafura 1). Vanotanga vatora bvunzo yemuromo (kazhinji mibvunzo 5-7) paruzivo rwekutanga kwesesheni (semuenzaniso, chii chinonzi physiology uye kukosha kweS3? Chii chinotsigira kuvapo kwayo muvarwere vane kushaya mweya?). Vanozoongorora nzira dzekuongorora chirwere uye vanobvisa kusava nechokwadi kwevadzidzi vanopinda mukudzidziswa kwekutanga. Chikamu chasara chekosi iyi kurovedza muviri kwekupedzisira. Kutanga, vadzidzi vanogadzirira kudzidzira vanoita maekisesaizi emuviri kune mumwe nemumwe uye paSPI uye vanopa mhinduro kuchikwata. Pakupedzisira, SPI yakavapa chidzidzo chemuenzaniso pa "Small Formative OSCE." Vadzidzi vakashanda vari vaviri vaviri kuti vaverenge nyaya yacho uye vape pfungwa dzavo pamusoro pemabasa ekusarura akaitwa paSPI. Zvadaro, zvichibva pamhedzisiro yefizikisi, vadzidzi vepregraduate vakaisa pfungwa dzavo uye vakapa pfungwa dzekuti vangangove vakaongororwa sei. Mushure mekosi, timu yeSPI-MS4 yakaongorora mudzidzi wega wega uye yakazozviongorora uye yakaona nzvimbo dzekuvandudza pakudzidziswa kunotevera (Tafura 1). Mhinduro chinhu chakakosha chekosi. SPI neMS4 zvinopa mhinduro dzinovaka panguva imwe neimwe: 1) sezvo vadzidzi vachiita maekisesaizi mumwe nemumwe uye paSPI 2) panguva yeMini-OSCE, SPI inotarisa pamakanika uye MS4 inotarisa pakufunga kwekiriniki; SPI neMS4 zvinopawo mhinduro dzakanyorwa dzakanyorwa pakupera kwesemesita yega yega. Mhinduro idzi dzakanyoreswa dzinoiswa murubric ye online medical education management system pakupera kwesemesita yega yega uye dzinokanganisa giredhi rekupedzisira.
Vadzidzi vaigadzirira kuita internship vakagovana pfungwa dzavo nezvechiitiko ichi muongororo yakaitwa neGeorge Washington University Department of Assessment and Educational Research. Makumi mapfumbamwe nevanomwe muzana vevadzidzi vepayunivhesiti vakabvumirana zvakasimba kana kuti vakabvumirana kuti kosi yekuongorora physical diagnostics yaikosha uye yaisanganisira mashoko anotsanangura:
"Ndinotenda kuti makosi ekuongorora mafambiro emuviri ndiyo dzidzo yakanakisisa yekurapa; semuenzaniso, kana uchidzidzisa kubva pamaonero emudzidzi wegore rechina nemurwere, zvinyorwa zvacho zvine chekuita nezviri kuitwa mukirasi."
"SPI inopa mazano akanaka kwazvo pamusoro penzira dzinoshanda dzekuita maitirwo ezvinhu uye inopa mazano akanaka kwazvo pamusoro pezvinhu zvidiki zvinogona kukonzera kusagadzikana kuvarwere."
"SPI neMS4 zvinoshanda pamwe chete zvakanaka uye zvinopa maonero matsva pakudzidzisa akakosha zvikuru. MS4 inopa ruzivo rwezvinangwa zvekudzidzisa mukurapa."
"Ndinoda kuti tisangane kakawanda. Ichi ndicho chikamu chandinonyanya kufarira pakudzidza nezvekurapa uye ndinofunga kuti chinopera nekukurumidza."
Pakati pevakabvunzwa, 100% yeSPI (N=16 [100%]) uye MS4 (N=44 [77%]) vakati ruzivo rwavo semurairidzi wePDX rwaive rwakanaka; 91% uye 93%, zvichiteerana, veSPIs neMS4s vakati vane ruzivo semurairidzi wePDX; ruzivo rwakanaka rwekushanda pamwe chete.
Kuongorora kwedu maonero eMS4 pane zvavaikoshesa muzviitiko zvavo sevadzidzisi kwakaburitsa dingindira rinotevera: 1) Kushandisa dzidziso yekudzidza kwevakuru: kukurudzira vadzidzi uye kugadzira nzvimbo yekudzidza yakachengeteka. 2) Kugadzirira kudzidzisa: kuronga mashandisirwo akakodzera ekiriniki, kutarisira mibvunzo yemudzidzi, uye kushanda pamwe chete kuti uwane mhinduro; 3) Kuratidza hunyanzvi; 4) Kupfuura zvinotarisirwa: kusvika nekukurumidza uye kubva kunonoka; 5) Mhinduro: Kuisa pamberi mhinduro nenguva, ine chinangwa, inosimbisa uye inovaka; Kupa vadzidzi mazano pamusoro petsika dzekudzidza, nzira yakanakisisa yekupedzisa zvidzidzo zvemuviri, uye mazano ebasa.
Vadzidzi veFoundation vanopinda bvunzo yekupedzisira yeOSCE ine zvikamu zvitatu pakupera kwesemester yechirimo. Kuti tiongorore kushanda kwechirongwa chedu, takaenzanisa mashandiro evadzidzi vari muchikamu chefizikisi cheOSCE isati yatanga chirongwa ichi muna 2010 uye mushure mekutangwa kwacho muna 2010. Pamberi pa2010, vadzidzisi vechiremba veMS4 vakadzidzisa PDX kuvadzidzi vepasi pedduate. Kunze kwegore rekuchinja ra2010, takaenzanisa zviratidzo zvechirimo zveOSCE zvedzidzo yemuviri zve2007-2009 nezviratidzi zve2011-2014. Huwandu hwevadzidzi vaipinda muOSCE hwaibva pa170 kusvika 185 pagore: vadzidzi 532 muboka repamberi pekupindira uye vadzidzi 714 muboka repamberi pekupindira.
Zvibodzwa zveOSCE kubva pabvunzo dzechirimo dza2007-2009 na2011-2014 zvinopfupikiswa, zvichiyerwa nehukuru hwemuenzaniso wegore negore. Shandisai mienzaniso miviri kuenzanisa GPA yakaunganidzwa yegore rega rega renguva yapfuura neGPA yakaunganidzwa yenguva inotevera uchishandisa t-test. GW IRB yakabvisa chidzidzo ichi uye yakawana mvumo yevadzidzi yekushandisa ruzivo rwavo rwedzidzo vasingazivikanwe muchidzidzo ichi.
Avhareji yechikamu chebvunzo yemuviri yakawedzera zvakanyanya kubva pa83.4 (SD=7.3, n=532) chirongwa chisati chaitwa kusvika pa89.9 (SD=8.6, n=714) mushure mechirongwa (avhareji shanduko = 6, 5; 95% CI: 5.6 kusvika 7.4; p<0.0001) (Tafura 3). Zvisinei, sezvo shanduko kubva pakudzidzisa kuenda kuvashandi vasiri kudzidzisa ichienderana nekuchinja kwedzidzo, mutsauko wemapoinzi eOSCE haugone kutsanangurwa zvakajeka nekuvandudzwa.
Muenzaniso wekudzidzisa wechikwata cheSPI-MS4 inzira itsva yekudzidzisa ruzivo rwekutanga rwezvidzidzo zvemuviri kuvadzidzi vezvekurapa kuti vagadzirire kusangana nekiriniki pakutanga. Izvi zvinopa imwe nzira inoshanda nekudzivisa zvipingamupinyi zvine chekuita nekutora chikamu kwevadzidzisi. Zvinopawo kukosha kwakawedzerwa kuchikwata chekudzidzisa nevadzidzi vavo vasati vatanga kudzidzira: vese vanobatsirwa nekudzidza pamwe chete. Mabhenefiti anosanganisira kuratidza vadzidzi vasati vatanga kudzidzira maonero akasiyana uye mienzaniso yekushandira pamwe [23]. Maonero akasiyana aripo mukudzidza pamwe chete anogadzira nzvimbo yekuvaka [10] umo vadzidzi ava vanowana ruzivo kubva kuzvinhu zviviri: 1) kinesthetic - kuvaka matekiniki chaiwo ekurovedza muviri, 2) kugadzira - kuvaka kufunga kwekuongorora. MS4 vanobatsirwawo nekudzidza pamwe chete, vachivagadzirira basa remangwana rekudyidzana nenyanzvi dzehutano.
Muenzaniso wedu unosanganisirawo mabhenefiti ekudzidza nevezera ravo [24]. Vadzidzi vasati vatanga kudzidza vanobatsirwa nekunzwisisa, nzvimbo yekudzidza yakachengeteka, MS4 socialization uye role model, uye "dual learning" - kubva pakudzidza kwavo kwekutanga uye kwevamwe; Vanoratidzawo kukura kwavo mubasa nekudzidzisa vezera ravo vadiki uye vanoshandisa mikana inotungamirwa nevadzidzisi yekuvandudza nekuvandudza hunyanzvi hwavo hwekudzidzisa nebvunzo. Pamusoro pezvo, ruzivo rwavo rwekudzidzisa runovagadzirira kuva vadzidzisi vanobudirira nekuvadzidzisa kushandisa nzira dzekudzidzisa dzakavakirwa pauchapupu.
Zvidzidzo zvakadzidzwa panguva yekushandiswa kwemuenzaniso uyu. Chekutanga, zvakakosha kuziva kuoma kwehukama hwedzidzo dzakasiyana pakati peMS4 neSPI, sezvo vamwe vadzidzisi vasina kunzwisisa kwakajeka kwekuti vangashanda sei pamwe chete. Mabasa akajeka, mabhuku ekudzidzisa ane ruzivo rwakadzama uye maworkshop emapoka anobata nyaya idzi zvinobudirira. Chechipiri, kudzidziswa kwakadzama kunofanirwa kupihwa kuti mabasa echikwata agadziriswe. Kunyange zvazvo vadzidzisi vese vachifanira kudzidziswa kudzidzisa, SPI inofanirawo kudzidziswa maitiro ekuita hunyanzvi hwebvunzo hwakatove hwadzidziswa neMS4. Chechitatu, kuronga kwakanyatsonaka kunodiwa kuti pave nehurongwa hwakabatikana hweMS4 uye kuve nechokwadi chekuti timu yese iripo pachikamu chega chega chekuongorora muviri. Chechina, mapurogiramu matsva anotarisirwa kutarisana nekupikiswa kubva kuvadzidzisi nevatungamiriri, nenharo dzakasimba dzinotsigira kushanda zvakanaka kwemari;
Muchidimbu, modhi yekudzidzisa yekuongorora muviri yeSPI-MS4 inomiririra hunyanzvi hwakasiyana uye hunoshanda hwekudzidza hunogona kushandiswa nevadzidzi vezvekurapa nekubudirira kubva kune vasiri vanachiremba vakadzidziswa zvakanaka. Sezvo zvikoro zvese zvezvekurapa muUnited States nezvikoro zvakawanda zvezvekurapa zvekune dzimwe nyika zvichishandisa SP, uye zvikoro zvakawanda zvezvekurapa zvine mapurogiramu evadzidzi, modhi iyi inogona kushandiswa zvakanyanya.
Ruzivo rwechidzidzo ichi runowanikwa kubva kuna Dr. Benjamin Blatt, MD, Mutungamiriri weGWU Study Center. Ruzivo rwedu rwese rwuri muchidzidzo ichi.
Noel GL, Herbers JE Jr., Caplow MP, Cooper GS, Pangaro LN, Harvey J. Vadzidzisi vezvekurapa mukati vanoongorora sei hunyanzvi hwekurapa hwevagari? Chiremba wekudzidzira basa 1992;117(9):757-65. https://doi.org/10.7326/0003-4819-117-9-757. (PMID: 1343207).
Janjigian MP, Charap M naKalet A. Kugadzirwa kwechirongwa chekuongororwa kwemuviri chinotungamirwa nachiremba muchipatara J Hosp Med 2012;7(8):640-3. https://doi.org/10.1002/jhm.1954.EPub.2012. Chikunguru, 12
Damp J, Morrison T, Dewey S, Mendez L. Kudzidzisa hunyanzvi hwekuongorora muviri uye hunyanzvi hwepfungwa munzvimbo dzekurapa MedEdPortal https://doi.org/10.15766/mep.2374.8265.10136
Hussle JL, Anderson DS, Shelip HM. Ongorora mari nerubatsiro rwekushandisa zvinhu zvinobatsira varwere pakudzidziswa kuongorora muviri. Academy of Medical Sciences. 1994;69(7):567–70. https://doi.org/10.1097/00001888-199407000-00013, p. 567.
Anderson KK, Meyer TK Shandisa vadzidzisi vevarwere kudzidzisa hunyanzvi hwekuongorora muviri. Kudzidzisa nezvekurapa. 1979;1(5):244–51. https://doi.org/10.3109/01421597909012613.
Eskowitz ES Kushandisa vadzidzi vepakoreji sevabatsiri vekudzidzisa hunyanzvi hwekiriniki. Academy of Medical Sciences. 1990;65:733–4.
Hester SA, Wilson JF, Brigham NL, Forson SE, Blue AW. Kuenzanisa vadzidzi vekurapa vegore rechina nevadzidzisi vanodzidzisa hunyanzvi hwekuongorora muviri nevadzidzi vekurapa vegore rekutanga. Academy of Medical Sciences. 1998;73(2):198-200.
Aamodt CB, Virtue DW, Dobby AE. Varwere vane hutano hwakanaka vanodzidziswa kudzidzisa vamwe vavo, vachipa vadzidzi vekurapa vegore rekutanga kudzidziswa kwakanaka uye kusingadhuri muhunyanzvi hwekuongorora muviri. Fam Medicine. 2006;38(5):326–9.
Barley JE, Fisher J, Dwinnell B, White K. Kudzidzisa hunyanzvi hwekutanga hwekuongorora muviri: mhedzisiro kubva mukuenzanisa vabatsiri vekudzidzisa vasiri vepachikoro nevarairidzi vechiremba. Academy of Medical Sciences. 2006;81(10):S95–7.
Yudkowsky R, Ohtaki J, Lowenstein T, Riddle J, Bordage J. Maitiro ekudzidzisa nekuongorora anotungamirirwa nefungidziro ekuongorora muviri muvadzidzi vekurapa: kuongororwa kwekutanga kwechokwadi. Dzidzo yekurapa. 2009;43:729–40.
Buchan L., Clark Florida. Kudzidza pamwe chete. Mufaro wakawanda, kushamisika kushoma uye honye shoma. Kudzidzisa payunivhesiti. 1998;6(4):154–7.
May W., Park JH, Lee JP Ongororo yemakore gumi yemabhuku pamusoro pekushandiswa kwevarwere vakajairwa pakudzidzisa. Kudzidzisa nezvekurapa. 2009;31:487–92.
Soriano RP, Blatt B, Coplit L, Cichoski E, Kosovic L, Newman L, et al. Kudzidzisa vadzidzi vekurapa kudzidzisa: ongororo yenyika yezvirongwa zvevadzidzisi vekurapa muUnited States. Academy of Medical Sciences. 2010;85(11):1725–31.
Blatt B, Greenberg L. Kuongororwa kwezvirongwa zvekudzidzisa vadzidzi vekurapa mumatanho akasiyana-siyana. Dzidzo yepamusoro yezvekurapa. 2007;12:7-18.
Raue S., Tan S., Weiland S., Venzlik K. Muenzaniso weGRPI: nzira yekuvandudza timu. System Excellence Group, Berlin, Germany. 2013 Shanduro 2.
Clark P. Dzidziso yedzidzo yehunyanzvi yakaita sei? Mamwe mazano ekugadzira hurongwa hwedzidziso yekudzidzisa kushanda pamwe chete. J Interprof Nursing. 2006;20(6):577–89.
Gouda D., Blatt B., Fink MJ, Kosovich LY, Becker A., Silvestri RC Kuongororwa kwemuviri kwekutanga kwevadzidzi vekurapa: Mhedzisiro kubva kuongororo yenyika. Academy of Medical Sciences. 2014;89:436–42.
Lynn S. Bickley, Peter G. Szilagyi, naRichard M. Hoffman. Bhuku reBates reKuongorora Muviri neKutora Nhoroondo. Rakagadziriswa naRainier P. Soriano. Chinyorwa chegumi nenhatu. Philadelphia: Wolters Kluwer, 2021.
Ragsdale JW, Berry A, Gibson JW, Herb Valdez CR, Germain LJ, Engel DL. Kuongorora kushanda kwezvirongwa zvedzidzo yekiriniki zvevadzidzi vepakoreji. Dzidzo yekurapa online. 2020;25(1):1757883–1757883. https://doi.org/10.1080/10872981.2020.1757883.
Kittisarapong, T., Blatt, B., Lewis, K., Owens, J., naGreenberg, L. (2016). Musangano wekudzidzisa hunyanzvi hwepamusoro-soro hwekuvandudza kushanda pamwe chete pakati pevadzidzi vekurapa nevarairidzi vevarwere vakajairwa pakudzidzisa vanotanga kuongorora mafambiro emuviri. Medical Education Portal, 12(1), 10411–10411. https://doi.org/10.15766/mep_2374-8265.10411
Yoon Michel H, Blatt Benjamin S, Greenberg Larry W. Kukura kwevadzidzi vezvekurapa sevadzidzisi kunoratidzwa kuburikidza nekufungisisa nezvekudzidzisa mukosi yeVadzidzi seVadzidzisi. Kudzidzisa mushonga. 2017;29(4):411–9. https://doi.org/10.1080/10401334.2017.1302801.
Crowe J, Smith L. Kushandisa kudzidza pamwe chete senzira yekusimudzira kushanda pamwe chete kwevashandi pamwe chete muhutano nekuchengetedzwa kwevanhu. J Interprof Nursing. 2003;17(1):45–55.
10 Keith O, Durning S. Kudzidza nevezera ravo mudzidzo yezvekurapa: zvikonzero gumi nezviviri zvekutama kubva padzidziso kuenda pakuita. Kudzidzisa zvekurapa. 2009;29:591-9.
Nguva yekutumira: Chivabvu-11-2024