Kocaeli University Faculty of Medicine

Kocaeli University Faculty of Medicine
 

Medical History and Ethics

Kocaeli University faculty of medicine started medical education in 1996; also the Department of History of Medicine and Medical Ethics started medical ethics and history education in the same year.

Our aim is to educate medical students to create “a better physician” for good medicine. To reach this purpose the students are educated about the role and ethical responsibilities of physician through history, the value of human and human values and they are prepared to new responsibilities which raised rapid developments in medical science and technology. With Medical Deontology, Bioethics, Medical Ethics and Clinical Ethics lectures and practices future physicians are become aware of the ethical aspects of the decisions about contemporary biomedical ethics; gain the ability of ethical decision-making and their ethical sensitivity is increased.

Good medical practices, more satisfied patients and more satisfied health care professionals could only be reached by patients who are aware of and be able to protect their rights. Hospital Ethics Committee of the Faculty of Medicine continues training programs towards health care professionals, patients and patient relatives, since the year 2000. The Committee also support developing hospital policies and admitting of patient / patient relatives complaints via Hospital Patient Rights Office.

Human Research Ethics Committee and Animal Research Ethics Committee are aimed to ensure appropriateness of the researches high scientific and ethical standards. To reach this aim Faculty members of Department attended and guided both committees. Activities of faculty members include informing researchers about their responsibilities, counselling researches from planning to publishing a research, protecting rights of animals as well as rights of volunteer research participants.

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Education
Under Graduation

I. Year, I. Course Committee

Title of the course: History of Medicine

Program: Evaluation of medicine – Medicine in Prehistoric Era – in Ancient Civilizations: Mesopotamia – Egypt – China – India – Old Greek (Mythological era, Hippocratic era) – in Middle Ages: Europe (Dark Ages) – Eastern Medicine (wrote in Arabic Language) – Renaissance: between 14 and 16 centuries in Europe – Medicine after 17. century in Europe – Medicine in Old Turks and Anatolian Seljuk’s – in Ottoman Empire: between 14 and 19. century – Medicine in Republic of Turkiye – Medical education and medical schools in Turkiye


I. Year, II. Course Committee

Title of the course: Introduction to medical ethics

Program: Definition of ethics, functions, importance and meaning in medicine; The relationship between ethics, law and morality; Ethics values, values of medicine; Ethics virtues, virtues of physicians; Introduction to theories of medical ethics (Utilitarianism and Kantianism); Introduction to principles of medical ethics: autonomy and beneficence; Introduction to principles of medical ethics: non-maleficence and justice; The concept of rights, introduction to ethical rights


I. Year

Title of the course: “Being a good physician” preparatory program

6 hours practice with first year students in 4 groups.

Program: Hospitals and medical schools in Anatolia through history; Pioneer physicians in evaluation of medicine; Major discoveries; Medicine – art relation; values and virtues of physician / medicine in literature and art; reasons of medical development; moral aspect of medical tradition; importance of ethical / human rights.


III. Year, 8. Course Committee

Title of the course: Medical Ethics

Program: Medical ethics training; philosophical backgrounds of medical ethics; the relationship between ethical theories, ethical principles and rules; Principles of medical ethics: Principle of respect for persons/autonomy and Principle of justice; Principles of medical ethics: Principle of beneficence and Principle of non-maleficence; Ethical issues about knowledge: Informed consent, truth-telling, disclosure, Medical confidentiality: keep to secret, disclosure to secret; Ethical doctrines: ordinary-extraordinary treatment, double effect, acting-refraining; Ethical issues about beginning of life: Family planning, abortion, Artificial insemination, New reproductive techniques; Ethical issues about advanced medical technology: Genetics, cloning, etc; Ethical issues about end of life: Withholding and withdrawing of life-sustaining treatment, right to die.


IV. Year

Title of the course: Clinical Ethics Clerkship (Three hours practices at four clinical clerkships in IV. Year: Paediatrics, General Surgery, Internal Medicine and Gynaecology & Obstetrics Clinical Clerkships)

Program: Ethics case analyzing: Decision-making; Indications for medical intervention, preferences of patients, quality of life and contextual features of case; Recognising ethical problem and identifying ethical issues of cases; Group discussion for solution of ethical problems with specific ethical cases (For each Paediatrics, General Surgery, Obstetric and Gynaecology, Internal Medicine Clinical Clerkships)

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Graduation
MASTER

INSTITUTE OF HEALTH SCIENCES
HISTORY OF MEDICINE AND ETHICS MASTER OF SCIENCE PROGRAM


OBJECTIVE OF THE PROGRAM:

To inform health care professionals about their ethical responsibilities, to develop their ethical sensitivity, and to ensure ability and knowledge on identification of clinical ethical problem, discovering solutions, solving and making a ethical decision.


LESSONS OF THE PROGRAM:

Code

Name

Theoretical

Practice

Credits

ECTS

1ST SEMESTER

M*

TTE501

Seminar

0

0

0

4

TTE503

Bioethics

3

0

3

6

TTE505

General History of Medicine

3

0

3

6

TTE507

Clinical Ethics I

2

2

3

6

TTE509

Legal Liability

2

0

2

3

E**

TTE511

Philosophy of Science

2

0

2

3

1st Semester Total

12

2

13

28

2ND SEMESTER

M*

TTE502

Medical Ethics

3

0

3

6

TTE504

History of Turkish Medicine

3

0

3

6

TTE506

Clinical Ethics II

2

2

3

6

TTE508

Deontology

2

0

2

3

TTE510

Research Methods

2

0

2

4

E**

TTE512

Research Ethics

2

1

3

5

2nd Semester Total

14

3

16

30

Total

26

5

29

58

*M: Must
**E: Elective


Contents:

Seminar: To determine a research subject about medical ethics and history of medicine, searching and using literature, developing research methods, acquiring theoretical knowledge about planning a research, developing methods and study management. Besides that experience is to be gained by giving responsibility on subject finding, studying, writing and presentation.

Bioethics: Definition and scope of bioethics. General concepts in bioethics. Historical development of bioethics. Disciplines related with bioethics. Ethical reason of bioethics- ethics theories, principles, doctrines-. bioethics and social policies. Health-care policies. allocation of health-care resources. Protection of life and ethics. Rights of embryo and fetus. new reproduction techniques and ethics. Ethics of genetics. Rights of animal. ethical dimensions of animal research. Bioethics lectures to be given based on theoretical ethics

General History of Medicine: Necessity and purpose of historical point of view of medicine. Research methods of history of medicine. Developments and changes of concepts of health and illness since prehistoric era. Physician types through history. Medicine, medical practice, health-care institutes and beliefs about health in the periods of Prehistoric era, Middle-age and Renaissance. Development of medicine from Renaissance to current age. Pioneer physicians and their inventions contributing on medical development and medical education

Clinical Ethics I: Definition, purpose and functions of clinical ethics, decision making process and the factors effecting decision making, clinical ethical decision making process and methods, goals of medicine and meaning of these goals in clinical ethics, identification of ethical issues, examination of those with different dimensions. Developing ethical sensibility with case studies including ethical problems; Group studies on identification of ethical problem.

Practise: Each student subjected to attend Clinical Ethics Practises at KOU Faculty of medicine in 4th semester

Legal Liability: Legal dimension of physicians’ rights and ethical responsibilities, the legal importance of patients’ rights (right to access health-care services, right to privacy, right to die…)

Philosophy of Science: History of philosophical thinking. Philosophical knowledge and dogma. Doctrines of philosophy. Science, philosophy and art: definitions and methods. Image, perception and reasoning. Concept of value. Scientific methods. Philosophical methods. Responsibility. Problem of personality. Concepts of person and individual

Medical Ethics: Definition and functions of medical ethics. Philosophical backgrounds of medical ethics. Relationship between ethics, law and moral. Principles and rules of medical ethics. Ethical rights. Codes of medical ethics. Physician-patient relationship models. Ethical concepts and issues about abortion, euthanasia, organ transplantation, epidemic…etc. the student must attend 3rd semester “Medical Ethics” lectures at KOU Faculty of Medicine

History of Turkish Medicine: Ancient Turks Medicine, Age of Translation and Reform in Islamic Medicine. Anatolian Seljuk, Ottoman, New Turkish Republic Medicine. Concepts and beliefs about health and illness, health policies. Health-care institutions. Medical education in Turkey

Clinical Ethics-II: Methods of handling ethical problems confronted daily clinical practice (methodology of applied ethics). Decision making process exercises with case studies. Case studies are used about ethical problems that often confronted daily practice (informed consent, truth telling, respect for privacy, secret, withdrawing of life support systems, allocation of scarce resources, genetic screening, right to die…exc.) for acquiring ability of ethical evaluation and sufficiency for making decision.

Practice: Each student subjected to attend at least one ethical consultation

Deontology: Definition, functions and scope of deontology. Responsibilities of physician. Development of responsibility concept through history. Duties of physician in different cultures. Regulations, laws and rules about physician responsibility in different countries. Examination of Turkish medical legislations and “Code of Turkish Medical Deontology”

Research Methods: Methods of acquiring scientific knowledge. Definition, concepts, purpose and importance of biostatistics. Definition, process and techniques of research. Selecting subject, determining aim, selecting methods, collecting research data, evaluation, statistical methods in scientific research. Using statistical analysis techniques

Research ethics: Definition, scope and importance. Ethical backgrounds and principles of research ethics. Research ethics in practice: 1. Informed consent, 2. evaluating risks and benefits 3. Selecting subjects. Ethical and legal regulations about researches: 1. Biomedical researches: Clinical, laboratory and screening researches, 2. Ethical dimensions of human tissue and cell researches, 3. Ethical dimensions of animal researches. Humanistic problems of science: responsibility of researchers. Ethics evaluation of research project, research ethics committee: definition, purpose, members and functions.

Practise: Student have to prepare the project on human being research and to evaluate at least 10 research projects with permission of researchers

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DOCTORATE

INSTITUTE OF HEALTH SCIENCES
HISTORY OF MEDICINE AND ETHICS DOCTORATE PROGRAM


OBJECTIVES OF THE PROGRAM:

  1. To provide students ethical knowledge and ability on coping with ethical issues in offering health-care services and about advanced medical technology,
  2. To educate specialists of medical ethics or professional ethics who could give lessons and could educate others on medical ethics. To educate academics on medical ethics with multi-discipliner approach
  3. To educate specialists of medical ethics/clinicians for acquiring ability of evaluating ethical issues confronted in health-care services, of finding unique solutions, and applying ethical decision-making process,
  4. To educate specialists of medical ethics/clinicians to recognize ethical dimensions of institutional and national politics and able to establish policies.

LESSONS OF THE PROGRAM:

Code

Title

Theoretical

Practice

Credits

ECTS

1st SEMESTER

M*

TTE601

Seminar

0

0

0

4

TTE603

Philosophy of Science

2

0

2

4

TTE605

History of Medicine

3

0

3

6

HLS501

Concepts in Public Health HLS

3

0

3

3

HLS505

Biostatistics

HLS

2

2

3

3

E**

TTE607

Ottoman Language (Grammer)

2

0

2

4

TTE609

History of Science

2

0

2

3

TTE611

Philosophy and Sociology of Law

2

0

2

3

1st Semester Total

16

2

17

30

2nd SEMESTER

M*

TTE602

Theoretical Ethics (Philosophical Ethics)

3

0

3

6

TTE604

History of Medicine II

3

0

3

6

TTE606

Medical Deontology

2

0

2

5

E**

TTE608

Old-Turkish Manuscripts

1

2

2

5

HLS502

Principles of Epidemiology and research techniques HLS

3

0

3

3

HLS504

Planning and practices of the scientific research HLS

2

2

3

3

2nd Semester Total

14

4

16

29

3rdSEMESTER

M*

TTE701

Medical Ethics-I

4

0

4

6

TTE703

Clinical Ethics-I

2

2

3

6

TTE705

Research Ethics-I

2

0

2

5

TTE707

Health Law

2

0

2

4

E**

TTE709

Civil Law

2

0

2

3

3rd Semester Total

12

2

13

24

4th SEMESTER

M*

TTE702

Medical Ethics-II

4

0

4

6

TTE704

Clinical Ethics-II

1

2

2

6

TTE706

Research Ethics-II

0

2

1

6

E**

TTE708

Forensic Medicine

2

0

2

3

4th Semester Total

7

4

9

21

Total

49

12

55

104

*M: Must,
**E: Elective,
HLS Vide MS Program of Public Health Department for the lessons with HLS Codes

E. THE NECESSARY NUMBER OF CREDITS FOR GRADUATION: 37 credits (must lessons) + 6 credits (elective lessons) total 43 credits.


Contents:

Seminar: Through doctorate program each student subjected to present at least one seminar on current subject about theoretical or applied ethics (bioethics, medical ethics, research ethics, clinical ethics…).

Philosophy of Science: What is philosophy? Thinking in mythological civilization. Development of philosophical thinking. Distinction between dogma and doctrine. To escape of prejudgement. Importance of knowledge theory in philosophy (distinction between realism and idealism). Scientific thinking and philosophical thinking; distinction between theory and action. Theory: hypothetical thinking. Source of knowledge: image and perception. Judgement: existence and value judgements. Value: high purpose of human being: economic value, moral value, aesthetic value. Image to concept: What is consciousness? Basic of consciousness: memory and intelligence. Basic of methods: deduction and induction. Importance of comparison in scientific research. Personality problem: distinction between person and individual

History of Medicine I: Importance and goals of history of medicine. Prehistoric Medicine. Mesopotamia and Ancient Egypt. Ancient China and Hind. Ancient Greek: Mythological era. Ancient Greek: Hippocratic era. Rome and Byzantium. Middle-age West Medicine. Renaissance (14th-15th century). West Medicine between 16th -19th century. Characteristics of 20th century medicine. Development of different health professions through history

Ottoman Language (Grammar): Letter of the alphabet, grammar, structure and writing types of Ottoman Language. Reading of Old Turkish especially hand-writing manuscripts

History of Science: Definition, importance, meaning and scope of science. The relationship between science, religion, language and philosophy. Introduction to history of science. Introduction to philosophy of science. Real science and its meaning. Science and objectiveness. Knowledge, science and relativism. Realism, rationalism and scientific methods. Concept of scientific phenomenon. Observation and experiment. Measuring: importance, structure, reliability. Principle of causality in science. Historical development of science

Philosophy and Sociology of Law: Relationship between philosophy and law. Philosophy of law: Definition and importance. Relationship between philosophy of law and ethics. Justice value and its characteristics as a value. Moral and legal part of justice value. General issues of sociology of law

Philosophical ethics: Morality and Moral Philosophy - Classical Ethics Theories - Mill and Utilitarian Theories - Kant and Deontological Theories - Contemporary Ethics Theories - Aristotle and Virtue Theories - Ethics of Virtues - Ethics of Values - Meta-ethics - Normative Ethics- Applied Ethics - Ethics of Rights – Justice – Freedom

History of Medicine-II: Ancient Turks Medicine - Islamic medicine between 9th – 10th centuries - Important Physicians of Islamic Medicine - Anatolian Seljuk - Anatolian states, Ottoman (14th-15th) – Ottoman (16th-17th) – European Medicine’s effects of Ottoman Medicine – Ottoman (18th-19th) – Modernism in Turkish Medical Education – 20th century Turkish Medicine and developments: Hospitals, university reform –epidemic struggle and health policies

Medical Deontology: Definition of medical deontology and its importance in medical education - Physicians oaths - Physicians duties and responsibilities to patients, public, institutions and colleagues - Physicians’ deontological responsibilities about diagnosis and treatment – medical confidentiality- patients and physicians rights - Code of Turkish Medical Deontology - Etiquette rules of physicians

Ottoman Medical Manuscripts: Searching and reading some old Turkish medical manuscript and hand writing medical books

Medical Ethics-I: Principles and rules of medical ethics - Principles of Autonomy, Nonmaleficiency, Beneficence, and Justice. Values of medicine. Virtues of medicine. Codes of medical ethics. Rights in medicine, Duties-obligations-responsibilities in medicine, Relationship of ethics and law. Ethics, bioethics and medical ethics)

Clinical Ethics-I: Definition and functions of clinical ethics. Methods of handling ethical issues that confronted daily practise. Methodology of applied ethics. Process of making medical-ethical decision. Methods of identifying and solving ethical problems.

Practice: Each theoretical issue to be discussed with case studies

Research Ethics-I: Classical Ethics Theories. Basic ethical principles, values and codes of research ethics. International and national declarations, national regulations and law on human research

Law in Health: Concept of individual. Rights of personality. Right to health. Right of reproduction. Right to privacy. Right to live and die. Rights of patients. Legal dimensions of rights and responsibilities of patients in international and national regulations

Common Law: The doctrines in common law. Some basic concepts of civil law: concept of legal right, sort of legal rights, basic legal rights of person, acquiring and losing of rights, role of good intention in entitlement rights, using and defending of rights

Medical Ethics-II: Concepts of health and illness. Ethics Doctrines. Ethical issues about beginning of life (curettage, new reproductive techniques). Ethical issues about end of life (withholding and withdrawing of life support systems, assisted suicide, euthanasia). Patient-physician relationship. Informed consent. Telling the truth. Privacy. Allocation of health care resources and health policies. Organ and tissue transplantation. Genetic and ethics: cloning exc. Ethical counselling. Ethical consultation.

Clinical Ethics-II: Ethics competency and sensitivity expected a physician. Ethical case discussions about ethical problems often confronted at clinic: informed consent, telling the truth, respect to privacy and its limits, confidentiality and its limits, withholding and with drawing of life support systems, allocation of scarce medical resources, treatment refusal. Ethical case studies and discussions on genetic tests, diagnostic prenatal tests, screening tests. Each ethical subject will be discussed with case scenarios using ethical decision-making process. Hospital Ethics Committees.

Research Ethics II: Rules of drafting, management, ending and publishing human and animal research project. Ethics evaluation of research project. Each student have to prepare the project on human being research and to evaluate at least 10 research project with permission of researchers.

Forensic Medicine: Legal liability on medicine for health-care professional. Relationship between treatment and legal responsibility. Malpractice, misconduct on diagnostic and treatment, responsibility of government about health care services and other health providers’ liability.

Seminaries

Speaker

Subject

2002-2003 Academic year

Dt. Necla Aktan (Master student)

Alternative Medicine and Hypnosis

Research Assistant Sedat Bağdaçiçek (resident)

Triage in Emergency Department

Research Assistant Aslıhan Akpınar (master student)

Triage in Disaster Medicine

2003-2004 Academic year

Research Assistant Aslıhan Akpınar (master student)

Justice in distributing intensive care unit resources

2004-2005 Academic year

Rahime Aydın (Doctorate student)

Historical development of midwifery to nineteenth century

Müesser Şenses (Doctorate student)

Midwifery in Nineteenth century Ottomans

2005-2006 Academic year

Research Assistant Aslıhan Akpınar (Doctorate student)

Contemporary theories of justice

Research Assistant Aslıhan Akpınar (Doctorate student)

Ethical doctrines about end of life

Müesser Şenses (Doctorate student)

Measuring quality of life

Rahime Aydın (Doctorate student)

Informed consent and privacy

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Projects
Ongoing Study Subjects
  • Ethical issues in family medicine
  • Ethical issues in obtaining informed consent in hospital services
  • Health Care Services in Kocaeli through history
  • Old Turkish Medical Manuscript from fifteenth century
  • Pediatric assent / consent / family permission
  • End of life decisions in pediatric intensive care units
  • Competency of psychiatric patients
  • Vaccination through Turkish history
Completed Study Subjects
  • Ethics sensitivity of physicians and nurses
  • History of forensic medicine in Turkey
  • Clinical Ethics education
  • Informed consent in surgery
  • Justice in distributing intensive care resources
  • Informed consent in dentistry
  • Cholera epidemics in Kocaeli through history
  • Attitudes of intensive care nurses towards end of life decisions in PICU
  • Triage decisions of emergency physicians in Kocaeli
  • Attitudes of pregnant women and antenatal prenatal health care professionals towards prenatal HIV testing
  • International sanitary conferences
  • Old Turkish Medical Manuscript from seventeenth century
  • Midwifery and nursing through Turkish history

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Publications
Selected Publications:
  1. Ersoy N, Altun İ, Beşer A. Tendency of nurses to undertake the role of patient advocate. Eubios Journal of Asian International Bioethics 1997;7(6):167-170.
  2. Ersoy N, Altun İ. Professional and personal values of nursing in Turkey . Eubios Journal of Asian International Bioethics. 1998;8(3):72-75.
  3. Altun İ, Ersoy N. Perspectives on old age in Turkey . Eubios Journal of Asian International Bioethics 1998;8(5):43-145.
  4. Ersoy N. Attitudes of Turkish people to the truth-telling issue. Eubios Journal of Asian International Bioethics 2001;11(3):68-74.
  5. Ersoy N, Göz F. Ethical Sensitivity of Nurses in Turkey . An International Journal for Health Care Professionals Nursing Ethics 2001;8(4):299-312.
  6. Ersoy N, Gündoğdu ÜN. A Study of the Ethical Sensitivity of Physician in Turkey . An International Journal for Health Care Professionals Nursing Ethics 2003;10(5): 472-484.
  7. Altun İ, Ersoy N. Undertaking The Role of Patient Advocate: A Longitudinal Study of Nursing Students. An International Journal for Health Care Professionals Nursing Ethics 2003;10(5):462-471.
  8. Gündoğmuş UN, Erdoğan MS, Şehiraltı M, Kurtaş Ö. A descriptive study of medical malpractice cases in Turkey. Ann Saudi Med;25(5):404-408.
  9. Ersoy N, Akpınar A. Özdem A. Triage decisions of pre-hospital and hospital emergency health care providers, using a multiple casualty scenario in Kocaeli, Turkey (abstract). Prehospital and Disaster Medicine 2007;22(2):55.

Selected Proceedings:
  1. Şehiraltı M.: Saint Pantaleon and Panteleemon Monastery. 38th International Congress on the History of Medicine, İstanbul, 1-6 September 2002. 38th International Congress on the History of Medicine Absract Book, 2002: pp. 219.
  2. Ersoy N., Güven T.: Darüşşifa (hospital) of Gebze Çoban Mustafa Paşa Külliyesi 38th International Congress on the History of Medicine , İstanbul, 1-6 September 2002. 38th International Congress on the History of Medicine Absract Book, 2002.
  3. Şehiraltı M., Gündoğmuş Ü. N., Karataş M.: The High Medical Council in Turkey and its Activities in Dentistry. 5th International Congress on Dental Law and Ethics, Omaha, Nebraska, USA, July 31-August 3, 2003. 5th International Congress on Dental Law and Ethics Abstract Book, pp. 22, Omaha, Nebraska USA, 2003.
  4. Ersoy N, Akpınar A. Özdem A. (poster) Triage decisions of pre-hospital and hospital emergency health care providers, using a multiple casualty scenario in Kocaeli, Turkey. 15th World Congress on Disaster and Emergency Medicine, 13-16 May 2007, Amsterdam.
Announcements
  1. Clinical ethics courses which aim to prepare students to ethical problems that they can come across during their clinical practice initially was taught to fifth year students within a week in total 30 (thirty) hours. All the students took this course were able to practice decision-making about ethical cases. The usefulness of this course was evaluated by Assistant Prof. Dr. Mine Sehiralti and Prof. Dr. Nermin Ersoy. The study was conducted in 2003 and shown that the knowledge and attitudes of the students were positively affected by clinical ethics education. Although the course was giving to the fifth year students in the beginning and was much more effective the Committee of Under Graduation Education replaced the course to the fourth year with fewer hours
  2. History of Medicine and Medical Ethics doctorate program was started in 2004–2005 academic year and 3 doctorate students are studying their doctorate thesis.
  3. Kocaeli University and Kocaeli District Health Authority were planned a conference series in the year 2007. The aim of the conferences was to inform health care professionals and public about patient’s rights. At least a thousand patient/patient relatives and health care professionals will be attended the eight Patients Rights Conferences of Kocaeli (KOHAK’2007: http://www.kou.edu.tr/genel/KOHAK'2007.htm).
  4. Ersoy N, Akpınar A, Özdem A. “Triage Decisions of Pre-hospital and Hospital Emergency Physicians Using a Multiple Casualty Scenario in Kocaeli, Turkey” was elected the best poster presentation at the “15th World Congress on Disaster and Emergency Medicine” 13 – 16 May 2007.

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Academic Staff:

Professor.Dr.Nermin ERSOY

Associate.Professor.Dr.Mine ŞEHİRALTI

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Kocaeli Üniversitesi Umuttepe Yerleşkesi
41380, Kocaeli
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