DanarTi 32 sarezidento programa `saojaxo medicina~

M muxli 8. sarezidento programis III etapi

1. 
   profesiuli mzadebis III etapis mizani: specialobaSi `ojaxis eqimi~ rezidentebis mzadebis III etapis dasasrulisTvis rezidents aqvs specifiuri codna, flobs unar-Cvevebsa da midgomebs, romlebic mas SesaZleblobas miscemen efeqturad marTos gavrcelebuli qronikuli da mwvave mdgomareobebi, romlebic tipuria saojaxo medicinisaTvis. mocemuli droisTvis rezidents Seswevs unari ganaxorcielos damoukidebeli uwyveti samedicino daxmareba garkveuli kontingentisTvis.
   

2. profesiuli mzadebis III etapis amocanebi: mocemuli etapis specifikuri amocanebi moicavs Semdegs:

a) pirveladi jandacvis marTva:

a.a) im midgomebis codna, romelic uzrunvlyofs pacientisaTvis araseleqciuri problemebis mqone pacientisaTvis momsaxurebis advilad xelmisawvdomobas;

a.b) qronkuli mdgomareobebis marTvis organizaciuli midgomebis codna;

a.g) im prevenciuli RonisZiebebis codna, rac moeTxoveba praqtikas pirvelad jandacvaSi;

a.d) problemebis prioritetulobis gansazRvris unari;

a.e) pirveladi jandacvis dawesebulebis (klinikis) organizaciis codna;

a.v) gundis sxva wevrebTan efeqturi komunikaciis damyareba;

a.z) gunduri muSaobis Cveva;

a.T) sxva specialistebTan efeqturi TanamSromlobis unari;

a.i) konsultaciis, pacientisa da misi ojaxis wevrebis ganaTlebisaTvis saWiro sakomunikacio Cvevebi;

a.k) Canawerebis Senaxvis, sainformacio menejmentis, gunduri muSaobis, praqtikis warmmarTvisa da momsaxurebis xarisxis auditirebisaTvis saWiro saorganizacio Cvevebi;

a.l) pacientTan partnioruli kavSiris damyarebisaTvis saWiro urTierTobisa da komunikaciis unar-Cvevebis ganviTareba da SenarCuneba;

a.m) efeqturi liderobis, molaparakebisa da kompromisebis Cvevebi.

b) pirovnebaze koncentrirebuli daxmareba:

b.a) koncefciuri midgoma ojaxis da Temis faqtorebisadmi; pirovnebis damokidebulebis, faseulobebisa da rwmenis socialuri da kulturuli konteqstis gageba;

b.b) avadmyofi pacientisa da zogadad daavadebis koncefciis Camoyalibeba;

b.g) pacientze orientirebuli sakonsultacio modelis ganxorcielebis unari, pacientis Taviseburebebis/damokidebulebis gaazrebisa (magaliTad, yinulis galRoba, ideebi, interesi da molodinebi) da masTan maswavleblis damokidebulebis integrirebiT, saerTo safuZvlebis Camoyalibebisa da erTiani samomavlo gegmis formirebisaTvis;

b.d) eqimisa da pacientis urTierTobis subieqturi komponentis codna, rogorc pacientis (misi SegrZnebebi, Rirebulebebi da warmodgenebi), aseve rezidentis Tvalsawieridan (faseulobebis, midgomebisa da SegrZnebebis TviTanalizi);

b.e) pacientTan partnioruli urTierTobebis damyarebisaTvis saWiro unar-Cvevebi da midgomebi;

b.v) unar-Cvevebi da midgomebi pacientTan distancirebisa da axlo urTierTobebis dasabalanseblad;

b.z) uwyvetobis sami aspeqtis gageba/SeTviseba: pirovnuli urTierTobis uwyvetoba mTeli cxovrebis ganmavlobaSi (midgoma xangrZlivi urTierTobis Camosayalibeblad erT pirovnebasTan), informaciis miwodebis uwyvetoba – konkretuli pacientisaTvis saWiro samedicino informaciis xelmisawvdomobis uzrunvelyofa yovel saWiro momentSi, (informaciis miwodeba personalurad da eleqtronuli sistemis saSualebiT), movlis uwyvetoba mTeli dRe-Ramis ganmavlobaSi (samuSao da arasamuSao saaTebSi).

3. specifikuri problemebis gadawyvetis unar-Cvevebi:

A a) marTvis gegmaSi pacientis CarTvis survili;

b) samedicino gadawyvetilebis nabij-nabij miRebis unari, drois, rogorc sadiagnozo da samkurnalo berketis gamoyenebiT;

g) pirvelad jandacvaSi problemebis gadawyvetis procesSi gaurkveveli, saeWvo situaciebis aRmocenebis garduvalobis gageba da mis mimarT tolerantobis gamomuSaveba.

4. yovlismomcveli midgoma:

a) polinozologiurobis koncefciisa da Sedegebis misadageba yoveli calkeuli pacientisaTvis;

b) pacientis janmrTelobasTan dakavSirebuli yvela problemis erTdroulad marTvis unar-Cveva maTi identificirebis, Seswavlis, cnobis, prioritetulobis gansazRvris gziT;

g) samedicino Canawerebisa da sxva informaciis saTanadod gamoyenebis unar-Cveva;

d) saukeTeso mtkicebulebebis moZiebisa da maTi praqtikaSi gamoyenebis unari;

e) janmrTelobis koncefciis gageba mTlianobaSi, misi mravalsaxovnebis gaTvaliswinebiT;

v) janmrTelobisaTvis xelSewyoba yoveli individis doneze, rogorc yoveldRiuri saqmianobis nawili;

z) janmrTelobisaTvis xelSewyobisa da prevenciis ganxorcieleba saTanado programebis meSveobiT;

T) sxvadasxva midgomebis gamoyenebis unari calkeuli pacientis mimarT;

i) praqtikis gundis saqmianobis koordinaciis unari;

k) Temis janmrTelobis saWiroebebis gageba populaciis epidemiologiuri maxasiaTeblebis mixedviT.

5. Temze orientacia:

a) Temis jandacvis politikasTan dakavSirebul sxva profesionalebTan erToblivi saqmianoba da maTi rolis gacnobiereba;

b) praqtikaze da Temze dafuZnebul informaciis mniSvnelobis gacnobiereba praqtikis xarisxis uzrunvelyofisaTvis;

g) individebisa da Temis saWiroebebis SesabamisobaSi moyvana.

6. holistikuri midgoma:

a) pacientis, rogorc bio-fsiqo-socialuri mTlianobis gageba;

b) holistikuri gagebis praqtikul ganzomilebebSi transformaciis unar-Cveva;

g) samedicino daxmarebasTan mimarTebaSi pacientis kulturuli da egzistencialuri safuZvlebis codna;

d) tolerantoba da pacientis gamocdilebis, rwmenis, faseulobebisa da molodinebis gageba, rasac SeuZlia gavlena moaxdinos momsaxurebis miwodebaze.

7. treningis am nawilis maxasiaTeblebi SeiZleba iqnes:

a) konteqstualuri:

a.a) codna imisa, Tu ra gavlenas axdens mTlianad samuSaos moculoba mis mier konkretuli pacientisTvis gaweul samedicino daxmarebis xarisxze;

a.b) gageba imisa, Tu ra gavlenas axdens eqimis sacxovrebeli da samuSao pirobebi mis mier gaweul samedicino momsaxurebis xarisxze.

b) midgomiTi:

b.a) codna imisa, ra SesaZleblobebi da faseulobebi gaaCnia eqims – eTikuri aspeqtebis identificireba klinikur praqtikaSi (prevencia/diagnozi/Terapia/cxovrebis stilze gavlenis momxdeni faqtorebi);

b.b) sakuTari Tavis Secnoba: imisi gacnobiereba, rom sakuTari midgomebi da SegrZnebebi praqtikis mniSvnelovani ganmsazRvreli faqtorebia;

b.g) piradi cxovrebasa da profesiul saqmianobas Soris kavSiris arsebobis gacnobiereba maT Soris saTanado balansis damyareba.

8. swavlebis/Sefasebis meTodebi mzadebis III etapze

a) Catarebis adgili - programis es nawili agreTve ganxorcieldeba saojaxo praqtikaSi. TiToeuli rezidentisTvis SeiZleba gamoyenebul iqnes ori an sami saojaxo medicinis dawesebuleba araerTgvarovan pirobebSi samedicino momsaxurebis gansxvavebulobis sailustraciod (magaliTad, soflad, SedarebiT qalaqTan an dedaqalaqTan ახლოს). programis am nawilis mimdinareobisas SeiZleba daigegmos vizitebi sxva samedicino dawesebulebebSic (magaliTad, tubdispanseri, onkologiuri dispanseri, tkivilis klinika) an esa Tu is xanmokle kursebi.

b) drois ganrigi - etapis saerTo xangrZlivobaa 10 Tve, rac moicavs 10 1-Tvian moduls (ix. zemoT `sarezidento programis etapebis modulebad dayofa~).

g) swavlebis meTodebi - mswavlebis ZiriTadi meTodia rezidentis mier Catarebul konsultaciaze zedamxedveloba. swavleba auditoriaSi, sasurvelia, moicavdes sxvadasxva meTodebs: leqciebs, mcire jgufebSi diskusias, davalebebis Sesrulebas da sxva meTodebs. vizitebi klinikebSi da sxva instuticionalur dawesebulebebSi organizebuli unda iqnes rezidentebis saWiroebebis gaTvaliswinebiT, mas Semdeg, rac ganisazRvreba es saWiroebebi;

d) Sefaseba - saboloo Sefaseba unda ganxorcieldes gamocdis formiT, profesiuli mzadebis damTavrebis Semdeg. regularuli ukukavSiri ganxorcieldeba xelmZRvanelis mier rezidentis mier warmoebuli saqmianobis Sesabamisad.
Mmuxli 9. akademiuri personali, kvalifikacia da saganmanaTleblo resursebi
1. rezidentebis mzadebis adekvaturi xarisxiT uzrunvelyofisaTvis aucilebelia Semdegi personalis SerCeva, mowveva da uwyveti profesiul ganaTlebaSi CarTva:

a) maswavlebeli – e.w. `tutori~;

b) ojaxis eqimi – maswavlebeli – modulze pasuxismgebeli piri pjd centrSi;

g) maswavlebeli stacionarSi – modulze pasuxismgebeli piri stacionarSi;

2. saojaxo medicinaSi mzdebis udidesi nawili, kerZod mzadebis I da III etapi xorcieldeba ojaxis eqimi - maswavleblis monawileobiT da/an maTi meTvalyureobiT.

3. mzadebis II etapSi CarTuli arian stacionarSi momuSave eqimi-maswavleblebi.

4. tutorebi uzurnvelyofen I etapis Sesavali da daskvniTi sesiebis Catarebas, agreTve II da III etapis `ukukavSiris~ sesiebis organizebas.

5. ojaxis eqimi – maswavlebeli aris sertificirebuli eqimi specialobaSi `saojaxo medicina~, romelიc dauflebulia mozrdilTa swavlebis meTodebs. sasurvelia, rom mas gavlili hqondes ojaxis eqimTa maswavlebelTa formalizebuli kursi, romelic orientirebulia mozrdilTa swavlebis meTodebze.

6. maswavleblebis SerCevis dros gaTvaliსwinebuli unda iqnes:

a) maswavleblis profesiuli biografia;

b) misi, rogorc eqimis Sesaferisobis Sefaseba – profesiuli saqmianobis warmoebis xarisxis TvalTaxedviT da rogorc maswavleblis, sxvis ganaTlebaze pasuxismgebeli piris TvalTaxedviT;

7. 
   gasaubrebis Sedegebi;
   

d) saswavlo dawesebulebis Sefaseba. dasawyisisTvis igi unda moicavdes praqtikis dawesebulebis vizits daTvalierebis mizniT. vizitis dros yuradReba unda mieqces klinikur saqmianobas, am ukanasknelis kulturas da swavlebisaTvis saWiro garemos arsebobas.

7. sasurvelia, rom yvela maZiebels hyavdes erTi (an ori) konkretuli `maswavlebeli~/zedamxedveli mzაdebis I da III etapze, romelic pasuxismgebelia saganmanaTleblo programis ganxorcielebisaTvis. zedamxedveli unda iyos ojaxis eqimi - maswavlebeli.

1. 
   a) maswavlebeli hospitalSi: maswavlebeli hospitalSi aris Sesabamis specialobaSi sertificirebuli eqimi, romelic dauflebulia mozrdilTa swavlebis meTodebs aqvs saTanado praqtika (pacientebis raodenoba, daavadebaTa speqtri) saavadmyofoSi da aqvs ojaxis eqimTa diplomis Semdegomi mzadebis progaramaSi moanwileobis survili da motivacia. hospitlis modulze pasuxismgebeli piri pasuxismgebelia modulis gavlaze hospitalSi;
   
2. 
   b) maswavlebeli - `tutori~: tutori aris akademiuri personali (rogorc arCeuli akademiuri personali, ise mowveuli pedagogi) specialobaSi `saojaxo medicina~, romlebic uzrunvelyofen zedamxedvelobas maZiebelTa erT jgufze, romelic SeiZleba warmodgenili iyos 6-8 maZiebliT. tutori uzruvnelyofs:
   

a) mzadebis I etapze Sesavali da daskvniTi sesiebis Catarebas;

b) mzadebis II etapze `ukukavSiris~ sesiebis uzruvnelyofas;

g) mzadebis III etapze `ukukavSiris~ sesiebis uzrunvelyofas.
Mmuxli 10. programis marTva da administrireba
1. programas unda hyavdes: mmarTveli organo da sakonsultacio sabWo.

2. mmarTveli organo uSualod programis ganxorcielebaSia CarTuli da pasuxismgebelia programis ganxorcielebaze da mis xarisxze.

3. mmarTveli organo moicavs programis xelmZRvanels da programis koordinators an koordinatorebs. rezidentis raodenobis mixedviT programas SeiZleba hyavdes erTi an ramdenime koordinatori.

4. amasTan, e.w. `tutorebic~, faqtobrivad, CarTuli arian programis ganxorcielebaSi da misi xarisxis uzrunvelyofaSi, radgan maT aqvT regularuli Sexvedra maTTan mimagrebul 6-8 rezientTan/maZiebelTan.

5. sakonsultacio sabWo aucilebelia programis struqturis, misi miznebis da amocanebis, ganxorcielebis meTodebis, xarisxis, mzadebaSi CarTuli pirebis kompetenciis sakiTxebze mudmivi msjelobisTvis da programis mudmivi gaumjobesebisTvis. sabWoSi muSaoba ar aris anazRaurebadi.
Mmuxli 11. programis xangrZlivoba
1. programis xangrZlivoba saSualebas unda iZleodes kompetenturi ojaxis eqimis mzadebisTvis. dRes evropis qveynebSi mzadebis xangrZlivobis minimaluri standarti specialobaSi `ojaxis eqimi~ / `zogadi praqtikis eqimi~ 3 welia.

2. mzadebis 3 weli 36 Tve Sedgeba Semdegi komponentebisagan:

a) 6 Tve – mzadebis I etapi;

b) 17 Tve – mxadebis II etapi;

g) 10 Tve – mzdebis III etapis yvela 10 moduli (III weli)

d) 3 Tve – Svebuleba.

e) sul 36 Tve.

3. Svebulebis Tvis SerCeva damokidebulia mzadebis dawyebis TariRze da dawesebulebaze, sadac rezidenti/maZiebeli gadis mzadebas. uxSiresad es aris agvisto. Svebulebis Tve SeiZleba Seicvalos mzadebis klinikuri bazis saWiroebebis mixedviT. ar aris aucilebelia Svebulebebs Soris fiqsirebuli intervalebis (mag. zustad 11 Tvis dacva).

M muxli 12. programis ganaxlebis perioduloba
1. sasurvelia programis perioduli ganaxleba. amasTanave, programa stabiluric unda iyos, raTa SesaZlebeli gaxdes misi danergva, programis ganxorcielebaSi CarTul pirTa gaTviTcnobiereba da koordinirebuli muSaobis uzrunvelyofa da programis efeqturobis Sefaseba.

2. zemoxsenebulidan gamomdinare, agreTve programis xangrZlivobis gaTvaliswinebiT (3 weli), sasurvelia programis pirveli Zireuli ganaxlebis sakiTxi ganxiluli iqnes arauadres 5 wlisa misi aRiarebidan. pirveli Zireuli ganaxlebis SemTxvevaSi dadgindeba Semdgomi ganaxlebis vadebi.

3. ganaxlebis Sesaxeb sakiTxis dasmis Semdeg unda Sefasdes, aris Tu ara Zireuli cvlilebis saWiroeba. aRniSnulis Semdeg miRebuli iqneba gadawyvetileba programis Zireuli ganaxlebis Sesaxeb.

4. amasTan, SesaZlebelia misi calkeuli nawilis Sinaarsoblivi cvlileba, rac ar exeba programis saerTo struqturas da principebs.

5. programis ganaxlebis Sesaxeb gadawyvetilebis miRebisas aucilebelia maZiebelTa gamocdilebisa da Sexedulebebis gaziareba, maTi molodinisa da miRebuli Sedegebis analizi, radgan saboloo mizani mainc maZieblis saWiroebebisadmi maqsimalurad misadagebuli programis Camoyalibebaa.
M muxli 13. programis Sesabamisoba saerTaSorisod aRiarebul standartebTan
1. programas safuZvlad udevs Semdegi rekomendaciebi da programebi:

a) zogadi praqtikis/saojaxo medicinis evropuli organizaciis (WONCA) zogadi praqtikis/saojaxo medicinis evropuli ganmarteba (WONCA Europe [The European Society of General Practice / Family Medicine]: The European Definition of General Practice/Family Medicine; Barcelona: WONCA, 2002);

b) ojaxis eqimTa maswavleblebis evropuli akademiis (EURACT - European Academy of Teachers in General Practice) saganmanaTleblo programas Education Agenda; EURACT, Leuven 2005);

g) amerikis ojaxis eqimTa akademiis `rezidenturis programis ganmartebebi: warmatebis kriteriumebi”, me-8 gamocema, 2011 weli;

d) amerikis ojaxis eqimTa akademiis kurikulumis masalebi ojaxis eqimTa rezidenturaSi mzadebisaTvis (www.aafp.org ), 2011 weli;

e) kanadis ojaxis eqimTa kolegiis (CFPC) `kompetenciebze dafuZnebuli kurikulumi~ (Triple C Competency-based Curriculum (Triple C)), 2011 weli (marti);

v) kanadis ojaxis eqimTa kolegiis (CFPC) `kompetenciebis gansazRvra sasertifikacio gamocdisTvis kanadis ojaxis eqimTa kolegiis mier~, 2010 weli;

z) kanadis ojaxis eqimTa kolegiis (CFPC) `CanMEDS - saojaxo medicina~ (CanMEDS-Family Medicine) – kurikulumis Sefasebis samuSao jgufis angariSi, 2009 weli;

T) didi britaneTis zogadi praqtikis eqimTa samefo kolegiis (RCGP) `swavlebisa da swavlis saxelmZRvanelo~, romelic asaxavs RCGP ZiriTadi kurikulumis debulebaSi (RCGP core curriculum statement Being a General Practitioner) da RCGP mzadebis kurikulumSi (Part One: a statement on the eight PMETB standards for curricula, a submission to the Postgraduate Medical Education and Training Board; PMETB) asaxul principebs. 2007 weli.
Tavi II. programis I etapi
muxli 14.

1. 
   sarezidento programis I etapi moicavs 4 moduls (6 Tve):
   

#	modulis dasaxeleba	xangrZlivoba (Tve)
I.1	specialobisa da profesionalizmis safuZvlebi	2
I.2	jandacvis sistema da praqtikuli saqmianobis organizacia	1.5
I.3	mtkicebulebebze dafuZnebuli medicina da biosamedicino kvlevis safuZvlebi	1.5
I.4	praqtikuli unar-Cvevebi da tkivilis marTvis safuZvlebi	1

2. 
   TiToeuli moduli moicavs qvesakiTxebs, romelsac iTvaliswinebs tutori samuSaos dagegmvisa da warmarTvisas:
   

#	modulis dasaxeleba	sakiTxebi
1	specialobisa da profesionalizmis safuZvlebi	saojaxo medicinis Sesavali kursi
		komunikaciis unar-Cvevebi
		samedicino eTika ojaxis eqimis saqmianobaSi
2	jandacvis sistema da praqtikuli saqmianobis organizacia	saqarTvelos jandacvis sistema
		ojaxis eqimis praqtikuli saqmianobis organizcia
3	mtkicebulebebze dafuZnebuli medicina da biosamedicino kvlevis safuZvlebi	mtkicebulebze dafuZnebuli medicina
		biosamedicino kvlevis warmoeba saojaxo medicinis sferoSi – Sesavali kursi
4	praqtikuli unar-Cvevebi da tkivilis marTvis safuZvlebi	praqtikuli unar-Cvevebi ojaxis eqimis saqmianobaSi
		tkivilis marTvis safuZvlebi

3. pirveli etapis pirveli sami modulis sakiTxebis Seswavlis struqtura analogiuria – pirveli da bolo dRe tutorTan muSaoba da danarCeni dReebi ojaxis eqimTan muSaoba saojaxo medicinis klinikaSi.

4. TiToeuli sakiTxis pirvel dRes rezidenti/maZiebeli xvdeba Tavis tutors danarCen rezidentebTan / maZieblebTan erTad da tutori maT acnobs sakiTxis miznebs da amocanebs, aZlevs davalebas.

5. Semdeg rezidenti / maZiebeli mTels dros (garda bolo dRisa) atarebs saojaxo medicinis klinikaSi.

6. miuxedavad imisa, rom am etapze modulebis dasaxeleba da sakiTxebis Sinaarsi gansxvavdeba, praqtikuli muSaobis komponenti analogiuria da moicavs:

a) daswrebas konsultaciebze;

b) anamnezis SekrebaSi monawileobas;

g) samedicino Canawerebis warmoebaSi monawileobis miRebas;

d) referalis organizebaSi monawileobas;

e) sxvdasxva specialisebTan koordinacia-komunikacias;

v) pacientis ganaTlebaSi monawileobas;

z) ojaxis eqimis angariSebis momzadebaSi monawileobas;

T) klinikaSi organizebul klinikur garCevebze daswrebas;

i) moxsenebis gakeTebas xelmZRvanelis mier SerCeul Temaze, rac, upirveles yovlisa, moicavs moxsenebas klinikuri praqtikis gaidlainze da gaidlainis damtkicebis Semdeg dagrovil faqtebsa da axal midgomebze; amasTan, moxseneba SeiZleba exebodes ojaxis eqimis saqmianobis nebismeir aspeqts.

k) ojaxis eqimis saqmianobis sxva komponentebSi CarTulobas.

7. TiToeuli modulis miznebidan gamomdinare, rezidenti/maZiebeli agrovebs informacias tutoris mier micemuli davalebis Sesaxeb, rasac is axorcielebs ojaxis eqimTan erTad praqtikuli muSaobis procesSi.

M muxli 15.
1. moduli I.1. modulis dasaxeleba, xangrZlivoba – `specialobisa da profesionalizmis safuZvlebi~, 2 Tve.

2. modulis mizani - modulis mizania (a) rezidenti gaecnos specialobis safuZvlebs (saojaxo medicina, rogorc disciplina da specialoba), (b) gamoimuSaos pacientze orientirebuli samedicino konsultaciis Catarebis unar-Cvevebi da (g) gamoimuSaos saqarTvelos kanonmdeblobaSi gacxadebuli normebisa da biosamedicino eTikis principebis praqtikul saqmianobaSi gamoyenebis unari.

3. specifikuri amocanebi pacientze orientirebuli samedicino konsultaciis Catarebis unar-Cvevebis gamomuSavebisas:

a) pirveladi jandacvis marTva:

a.a) SeeZlos klinikur praqtikaSi profesiuli komunikaciis Cvevebis gamoyeneba (rogorc oraluri, ise weriTi) droisa da sxva resursebis efeqturi xarjvis fonze;

a.b) SeeZlos efeqturi/adekvaturi urTierTobis damyareba jandacvis profesionalebTan organizaciiis SigniT da mis gareT;

a.g) gamoimuSaos komunikaciis Cvevebi saeqimo konsultaciis Casatareblad, swavlebisaTvis, pacientebTan da maTi ojaxis wevrebTan urTierTobis dasamyareblad;

a.d) gamoimuSaos partniorobaze, TanamSromlobaze dafuZnebuli urTierTobis stili pacientebTan muSaobisas.

b) pirovnebaze koncentrirebuli daxmareba:

b.a) SeeZlos pacientis janmrTelobis problemis mimoxilva da vizitis mizezebis gansazRvra;

b.b) SeeZlos Seafasos da mimoixilos pacientis gaTviTcnobierebuloba da damokidebuleba sakuTari janmrTelobis problemisadmi da misi marTvis sakiTxebisadmi;

b.g) SeeZlos Seafasos da adekvaturad upasuxos pacientis wuxils, dards misi janmrTelobis problemebisa da am problemebis marTvis sakiTxebTan dakavSirebiT;

b.d) SeeZlos miawodos pacients Sesaferisi ganmartebebi misi janmrTelobis problemebTan dakavSirebuli mosazrebebisa da kiTxvebis Sesaxeb;

b.e) SeeZlos gansazRvra imisa, Tu ramdenad gaigo da sworad aRiqva eqimis mier miwodebuli ganmartebebi da ramdenad moaxerxa eqimma pacientis wuxilsa da dardze adekvaturad reagireba.

g) specifikuri problemebis mogvarebis unar-Cvevebi:

g.a) gamoimuSaos efeqturi komunikaciis unari gansakuTrebul situaciebSi; kerZod, rezidents unda SeeZlos: `cudi ambebis~ (pacientisaTvis arasasiamovno ambis) Setyobineba; reagireba ukmayofilebze, gaRizianebasa da agresiaze; `rTuli~ pacientis marTva;

g.b) SeeZlos pacientis CarTva misi janmrTelobis problemebis marTvasTan dakavSirebuli gadawyvetilebis miRebis procesSi;

g.g) SeeZlos, warmarTos konsultacia im saxiTa da TanmimdevrobiT, rac Seesabameba pacientis saWiroebebs; amasTan, erTi mxriv, CarTos pacienti konsultaciis procesSi, xolo meore mxriv, efeqturad gamoiyenos dro;

d) yovlismomcveli midgoma:

d.a) gamoimuSaos unari, daarwmunos calkeuli pacienti janmrTelobisaTvis xelSewyobis aucileblobaSi TiToeuli samedicino problemis marTvisas;

d.b) SeeZlos komunikaciis sxvadasxva meTodebisa da midgomebis saWiroebisda mixedviT gamoyeneba, zogjer erTsa da imave pacientTan urTierTobisas;

E e) Temze orientacia:

e.a) SeeZlos, xeli Seuwyos pacientisa da samedicino personalis mier janmrTelobis dacvis sistemaSi arsebuli resursebis gamoyenebas (pacientis gagzavna konsultaciaze – `referali~, Tanagaxdis sistemebi, avadmyofobis furceli, sxvadasxva samarTlebrivi sakiTxebi da sxv.);

e.b) axsnas, Tu rogor aris calkeuli individis saWiroeba gadajaWvuli Temis saWiroebebTan, sadac isini cxovroben;

v) holistikuri midgoma:

v.a) SeeZlos pacientTan kargi urTierTobis damyareba da mis mimarT, rogorc pirovnebisadmi, pativiscemis gamoxatva;

v.b) iqonios pacientTan adekvaturi urTierToba pacientis faseulobebis, kulturuli Taviseburebebis, tradiciebis, gamocdilebis, rwmenisa da molodinis gaTvaliswinebiT, ramac SeiZleba gavlena iqonios samedicino momsaxurebis gawevaze.

4. zemoT moxseniebulTan erTad rezidenturis kursdamTavrebuls unda SeeZlos gamoimuSaos unar-Cvevebi Semdegi maxasiaTeblebis mixedviT:

a) konteqstualuri: gaiTvaliswinos pirovnebis, ojaxis, Temis Taviseburebebi da daamyaros efeqturi urTierToba pacientebTan gansxvavebuli pirovnuli da kulturuli maxasiaTeblebiT;

b) damokidebulebiTi: sakuTari SesaZleblobebis, faseulobebisa da eTikuri principebis gaTvaliswinebiT Seafasos da gaiazros, Tu rogoria misi SegrZnebebi da damokidebuleba gansxvavebul situaciebSi; gamoimuSaos saWiro informaciisa da mxardaWeris moZiebis unari; agreTve, gamoimuSaos Cvevebi, romelic mas daexmareba iseTi situaciebSi, sadac eqimi ganicdis Zlier emociur da fsiqologiur zewolas (mag., `rTuli pacienti~, samedicino Secdomebi);

g) mecnieruli: gamoimuSaos kritikuli da mecnierebaze dafuZnebuli midgoma profesiul saqmianobaSi.

5. specifikuri amocanebi samarTlebrivi da eTikuri normebisa da principebis praqtikul saqmianobaSi gamoyenebis unaris gamomuSavebisas: modulis gavlis Semdeg maZiebels unda hqondes:

a) profesiuli saqmianobisas konkretuli SemTxvevis samarTlebrivi da eTikuri mxareebis warmoCenis unari;

b) yoveldRiuri profesiuli saqmianobis Tanamedrove samedicino eTikis principebisa da arsebuli kanonmdeblobis Sesabamisad warmarTvis unari, maT Soris, profesiuli saqmianobis procesSi samarTlebrivi koliziebisa da eTikuri dilemebis gadawyvetis unari.

6. literaturis nusxa:

a) specialobis Sesaxeb:

a.a) The European Definition of General Practice/Family Medicine; Barcelona: WONCA, 2002;

a.b) The EURACT Educational Agenda of General Practice / Family Medicine; EURACT Leuven, 2005;

a.g) Essentials of Family Medicine, (fifth edition) by Philip Sloan, 2007;

a.d) Havelock P., Hasler J., Flew R., McIntyre D., Schofield T., Toby J. (1995) Professional Education for General Practice. Oxford General Practice Series 31. Oxford University Press, Oxford, New York, Toronto;

a.e) Jones R (Ed). Oxford Textbook of Primary Medical Care Oxford: Oxford University Press, 2004;

a.v) McWhinney IR A Textbook of Family Medicine Oxford: Oxford University Press, 2004;

a.z) Rakel RE. Textbook of Family Practice 6th edition London: W.B. Saunders, 2001

a.T) Bordage G and Zacks R. The Structure of Medical Knowledge in the Memories of Medical Students and General Practitioners: Categories and Prototypes. Medical Education 1984; 18: 406–16;

a.i) Bordage G. Elaborated Knowledge: A Key to Successful Diagnostic Thinking Acad Med 1994; 69:883–5;

a.k) Little M., Midtling J.E. (1989) Becoming a Family Physician. Springer – Verlag New York.

b) komunikaciis Sesaxeb da konsultaciis meTodebis Taobaze:

b.a) Mead N, Bower P. “Patient-centredness: a conceptual framework and review of the empirical literature.” Social Science & Medicine 2000; 51: 1087–1110;

b.b) Stewart M, Brown, JB, Freeman, TR. Patient-Centered Medicine. Transforming the Clinical Method (2nd edn). Oxford: Radcliffe Medical Press, 2003;

b.g) Silverman J, Kurtz S, Draper J. Skills for communicating with patients (2nd edition). Oxford: Radcliffe Medical Press, 2004;

b.d) Kurtz S, Silverman J, Draper J. Teaching and learning communication skills in medicine (2nd edition). Oxford: Radcliffe Medical Press, 2004 ;

b.e) Maguire P, Pitceathly C. “Key communication skills and how to acquire them.” BMJ 2002; 325: 697–700;

b.v) BMA. Communication skills and continuing professional development London, BMA, 1998 ;

b.z) Midland Faculty of the Royal College of General Practitioners Consulting: Communication skills for general practitioners Birmingham: Midland Faculty of the Royal College of General Practitioners 2005;

b.T) Kjeldmand D Balint training makes GPs thrive better in their job. Patient Education and Counselling 2004; 55: 2: 230-235;

b.i) Smith RC, Marshall-Dorsey AA, Osborn GG, Shebroe V, Lyles JS, Stoffelmayr BE, Van Egeren LF, Mettler J, Maduschke K, Stanley JM, Gardiner JC. Evidence-based guidelines for teaching patient-centered interviewing. Patient Educ Couns. 2000 Jan; 39(1):27-36;

b.k) Pendleton D, Hasler J. Doctor Patient Communication, 1983 London;

b.l) Buckman R. How to Break Bad News, Macmillan Press, 1992;

b.m) Ungar L, Alperin M, Amiel GE, Beharier Z, Reis S. Breaking bad news: structured training for family medicine residents. Patient Educ Couns. 2002 Sep; 48(1): 63-8;

b.n) Smith R.C. The patient's story: Integrated patient–doctor interviewing. Little, Brown and Company (now Lippincott, Williams and Wilkins), Boston (1996);

b.o) Beckman HB, Frankel RM. The effect of physician behaviour on collection of data. Ann Intern Med, 1984; 101:692-6;

b.p) Baile,W.F.; Buckman,R.; Lenzi,R.; Glober,G.; Beale,E.A.; Kudelka,A.P. SPIKES-A six-step protocol for delivering bad news: application to the patient with cancer. Oncologist. 2000;5(4):302-311;

b.J) Newman,M.C. The emotional impact of mistakes on family physicians. Archives of Family Medicine, 1996; 5(2): 71-76;

b.r) Rubin S.B, Zoloth L. Margin of error. The ethics and mistakes in the practice of medicine. University Publishing group, Hagerstown, Maryland;

b.s) Rowland-Morin PA, Carroll JG. Verbal communication skills and patient satisfaction. A study of doctor-patient interviews. Eval Health Prof., 1990; 13(2):168-185;

g) eqimis saqmianobis samarTlebrivi da eTikuri sakiTxebis Sesaxeb:

g.a) `saqarTvelos kanonmdebloba janmrTelobis dacvis sferoSi (mokle qronologiuri mimoxilva, ZiriTadi etapebi)~; kiknaZe, javaSvili, barkalaia; jandacvis marTvis nacionaluri centris samecniero SromaTa krebuli, tomi I, 1998, 15-20;

g.b) pacientis uflebebi da maTi ganxorcielebis meqanizmebi kiknaZe, javaSvili Tbilisi, 1999;

g.g) `pacientis ombudsmeni: ideidan realizaciamde~; javaSvili, kiknaZe saqarTvelos bioeTikis da jandacvis samarT-lerivi sakiTxebis Semswavleli sazogadoeba, Tbilisi, 2001. ISBN 99928-908-1-9;

g.d) `adamianis uflebebi biomedicinis sferoSi~; javaSvili, kiknaZe, barkalaia; saqarTvelos bioeTikis da jandacvis samarT-lerivi sakiTxebis Semswavleli sazogadoeba, Tbilisi, 2001. ISBN 99928-908-0-0;

g.e) `eqimis profesiuli saqmianobis samarTlebrivi safuZvlebi~; kiknaZe, javaSvili saqarTvelos bioeTikis da jandacvis samarT-lerivi sakiTxebis Semswavleli sazogadoeba, Tbilisi, 2002. ISBN 99928-908-5-1;

g.v) `jandacvis ombudsmeni: pirveli nabijebi~; javaSvili, kiknaZe saqarTvelos bioeTikis da jandacvis samarT-lerivi sakiTxebis Semswavleli sazogadoeba, Tbilisi, 2002. ISBN 99928-908-8-6;

g.z) `pacientis mkurnaloba da movla daavadebis terminalur stadiaze: saqarTvelos kanonmdeblobis mimoxilva~; javaSvili, kiknaZe; `Tanamedrove medicina~, tomi 1, #3;

g.T) `ieRovas mowmeTaTvis mkurnalobis mizniT sisxlis gadasxmis eTikuri da samarTlebrivi sakiTxebi~; kiknaZe, javaSvili, barkalaia; `Tanamedrove medicina~, tomi 1, #1, gv. 37-44;

g.i) “Encyclopedia of Bioethics”, Warren Thomas Reich (Ed.), Simon & Schuster Macmillan, New York, 1995 (5 Volumes);

g.k) “Principles of Biomedical Ethics” (4th Ed.), T.L. Beauchamp, J.F. Childress, Oxford University Press, 1994;

g.l) “Ethical Issues in Modern Medicine” (5th Ed.), John D. Arras, Mayfield Publishing Company, 1999;

g.m) “Principles of modern medical ethics and Health care professionals; Relation between health and education: from declaration to implementation (Georgian Experience)” Kiknadze, Javashvili;

g.n) “Patients' rights legislation in Georgia” Kiknadze, Javashvili, Barkalaia; “Journal of Health Sciences and Publlic Health”, Volume 1, Number 1, 2000, 17-26;

g.o) “Ethics committees in Georgia”; Javashvili, Kiknadze “Ethics Committees in Central and Eastern Europe”, 2000, Charis – IMEB Fdn. Bratislava, Slovakia 179-185 ISBN 80-88743-40-0;

g.p) “Georgian Legislation on Human Rights in the sphere of health care and biomedicine: Current trends and harmonisation with international developments”; Javashvili, Kiknadze; in “Europe and its impact on National Healthcare systems Yearbook 2001”, 2002, Erasmus University Press, Rotterdam, The Netherlands, 60-72, ISBN 90 807503 I X;

g.J) “Treatment and care at the end-of-life: Review of Georgian Legislation” Javashvili, Kiknadze; in “Ethical Eye”, 2003, Council of Europe Publishing, Strasbourg, France, In Press;

g.r) “A Clinician’s Commentary from a Post-Soviet Society on Organizational Issues of Care for Alzheimer’s Disease”; Javashvili; in “Book on Alzheimers's Disease”, 2003, Johns Hopkins University Press. in press.

7. Sesasrulebeli samuSaos moculoba, Casatarebeli manipulaciebis raodenoba da modulis Sefasebis meTodebi:

Teoriuli kursi	profesiuli unar-Cvevebi	Sesasrulebeli manipulaciis raodenoba	Sefasebis meTodebi
pirveladi jandacva jandacvis arsi da mniSvneloba, misi miznebi; saojaxo medicinis ganmarteba, saojaxo medicina, rogorc disciplina da specialobis ZiriTadi maxasiaTeblebi da kompetenciebi; saojaxo medicinis Camoyalibeba da ganviTareba evropasa da msoflios ganviTarebul qveynebSi; saojaxo medicina saqarTveloSi.	msjeloba pirveladi jandacvis rolsa da mniSvnelobaze; msjeloba saojaxo medicinaze rogorc disciplinaze da specialobaze; ojaxis eqimis kompetenciebis da maxasiaTeblebis analizi, magaliTebis moyvana da TiToeulis mniSvnelobis dasabuTeba; konsultaciis Catareba; anamnezis Sekreba; referalis organizeba.	klinikis gacnoba – 1; daswreba konsultaciebze – 50; anamnezis SekrebaSi monawileoba – 10; vitaluri niSnebis Sefaseba (P, TA, R) – 10; samedicino Canawerebis warmoebaSi monawileoba – 50; referalis organizebaSi monawileoba – 10; sxvdasxva specialistebTan koordinacia-komunikacia – 5; pacientis ganaTlebaSi monawileoba – 10; ojaxis eqimis angariSebis momzadebaSi monawileoba – 5; klinikaSi organizebul klinikur garCevebze daswreba – 3-6; moxsenebis gakeTebas xelmZRvanelis mier SerCeul Temaze – 1. sxvadasxva.	Sesrulebuli samuSao dReebi; Catarebuli konsultaciebi; ese; modulze pasuxismgebeli piris Sefaseba; tutoris Sefaseba daskvniTi sesiis dros.

cxrili # 2

Teoriuli kursi	profesiuli unar-Cvevebi	Sesasrulebeli manipulaciis raodenoba	Sefasebis meTodebi
pacientze orientirebuli konsultacia, konsultaciis miznebi da amocanebi, konsultaciis etapebi; araverbaluri komunikacia samedicino konsulaciis dros kiTxvebis formulireba da pacientis mosmena; pacientis mosazrebebi, Sexedulebebi da molodini samedicino konsultaciasTan dakavSirebiT; axsna-ganmartebebis miwodeba, informirebuli Tanxmobis miReba da cxovrebis jansaRi wesis sakiTxebis ganixlva; konsultaciis dro da urTierToba eqimsa da pacients Soris; `cudi ambebis~ (pacientisaTvis arasasiamovno ambis) Setyobineba; reagireba ukmayofilebze, gaRizianebasa da agresiaze; `rTuli~ pacientis marTva; eqimis damokidebuleba samedicino Secdomebisadmi.	pacientze orientirebuli konsultaciis Catareba; pacientisaTvis komfortis Seqmna, piraduli garemos uzrunvelyofa; araverbaluri komunikaciis unar Cvevebi (pacientis miReba, moTavseba, distancia, eqimis poza, TvaliT kontaqti da a.S.); Ria da daxuruli kiTxvebis gamoyeneba da aqtiuri mosmenis unari; pacientis vizitis mizezis gamovlena; pacientis molodinis, Sexedulebebis gamovlena; konsultaciebis etapebis Tanmimdevruli gavla; konsultaciis Sejameba; pacientisaTvis mkafio ganmartebebis da rCevebis miwodeba; kargi urTierTobis SenarCuneba konsultaciis ganmavlobaSi dam is Semdeg.	daswreba konsultaciebze – 100; anamnezis SekrebaSi monawileoba – 30; fizikuri gasinjva – 20; samedicino Canawerebis warmoebaSi monawileoba – 100; referalis organizebaSi monawileoba – 20; sxvdasxva specialistebTan koordinacia-komunikacia – 5; pacientis ganaTlebaSi monawileoba – 20; ojaxis eqimis angariSebis momzadebaSi monawileoba – 5; klinikaSi organizebul klinikur garCevebze daswreba – 4-8; moxsenebis gakeTebas xelmZRvanelis mier SerCeul Temaze – 1; sxvadasxva.	Sesrulebuli samuSao dReebi; Catarebuli konsultaciebi; ese; modulze pasuxismgebeli piris Sefaseba; tutoris Sefaseba daskvniTi sesiis dros;

cxrili # 3

Teoriuli kursi	profesiuli unar-Cvevebi	Sesasrulebeli manipulaciis raodenoba	Sefasebis meTodebi
kanonisa da eTikis roli samedicino momsaxurebis gawevisas. samedicino eTikis principebi: pacientis individualuri uflebebi, saqarTvelos kanonmdebloba; informirebuli Tanxmoba, pacientis qmedunarianoba da mis mier gacnobierebuli gadawyvetilebis miRebis unari; sikvdilisa da evTanaziis, mkurnalobaze uaris Tqmis samarTlebrivi da eTikuri sakiTxebi; sicocxlis SemanarCunebeli mkurnalobis Sewyvetis samarTlebrivi da eTikuri sakiTxebi; usargeblo samedicino Careva/pacientis gaumarTlebeli moTxovna; pediatriuli praqtikis samarTlebrivi da eTikuri sakiTxebi; paliatiuri mzrunvelobis da tkivilis marTvis eTikuri sakiTxebi; rTuli pacienti; arasakmarisi resursebi janmrTelobis dacvis sistemaSi, organizaciuli eTika da marTvadi jandacvis sistema; pacientis uflebebis dacva samedicino dawesebulebaSi; eqimis fici, eqimis qcevis kodeqsi, eqimis qcevis wesebi; eqimis profesiuli pasuxismgebloba; specifikuri garemoebebi (pacientebi, meTodebi sxva garemoebani)	konkretuli SemTxvevis samarTlebrivi da eTikuri mxareebis warmoCenis unari; problemis analizis unari Tanamedrove eTikis principebis da kanonmdeblobis moTxovnis safuZvelze; samarTlebrivi koliziebisa da eTikuri dilemebis gadawyvetis unari; eTikuri da samrTlebrivi problemis gadaWraSi organizaciuli resursebis gamoyenebis unari; pacientis srulyofilad informirebis unari; sarwmuno (ara fiqtiuri) informirebuli Tanxmobis miRebis unari; konfidencia-lurobis dacvis unari, piradi pasuxismgeblobis da garemo pirobebis uzrunvelyofis xarjze; pacientis piradi cxovrebis (piradulobis) dacvis unari; saqmianobis warmarTva Tanamedrove samedicino eTikis principebisa da arsebuli kanonmdeblobis Sesabamisad	daswreba konsultaciebze – 75; anamnezis SekrebaSi monawileoba – 20; fizikuri gasinjva – 15; samedicino Canawerebis warmoebaSi monawileoba – 75; referalis organizebaSi monawileoba – 15; sxvdasxva specialistebTan koordinacia-komunikacia – 5; pacientis ganaTlebaSi monawileoba – 10; ojaxis eqimis angariSebis momzadebaSi monawileoba – 5; klinikaSi organizebul klinikur garCevebze daswreba – 3-6; moxsenebis gakeTebas xelmZRvanelis mier SerCeul Temaze – 1; sxvadasxva.	Sesrulebuli samuSao dReebi; Catarebuli konsultaciebi; ese; modulze pasuxismgebeli piris Sefaseba; tutoris Sefaseba daskvniTi sesiis dros;