HOW I SHOULD STUDY as A MEDICAL STUDENTS? Widana Primaningtyas, dr. Medical Faculty of Sebelas Maret University

Transkripsi

1 HOW I SHOULD STUDY as A MEDICAL STUDENTS? Widana Primaningtyas, dr. Medical Faculty of Sebelas Maret University

2 NEWS

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4 WHAT S THE DIFFERENCE BETWEEN US AND THEM? WHAT WE SHOULD DO?

5 TAKE A LOOK Selection competition Pre clinic stage 3,5 y Clinical stage 1,5 y NATIONAL EXAM INTERNSHIP SPECIALISTIC SPESIFIC EXAM

6 PROCESS->TRIAL N ERROR-UNDERSTANDING- STRATEGY-TEST-RESULT HOW LONG HOW HARD HOW MUCH HOW MANY FOR WHAT REASON.?! WHAT IS YOUR AIMS?! WHAT IS THE LECTURER/UNI HOPE FOR THEIR STUDENTS?

7 Dokter Lulusan FK diharap bisa memiliki CLINICAL REASONING ( penalaran klinis )

8 DEFINITION Clinical reasoning can be defined as thinking through the various aspects of patient care to arrive at a reasonable decision regarding the prevention, diagnosis, or treatment of a clinical problem in a specific patient. (David Hawkins et al., 2010)

9 Suatu keterampilan kognitif yang diperlukan dalam proses pengambilan keputusan klinik dalam pengelolaan pasien (Barrows, 1982). Suatu aktivitas intelektual yang mensintesis informasi klinis, dan mengintegrasikannya dengan pengetahuan sebelumnya (previous knowledge), dan pengalaman klinik (clinical experience), untuk membuat keputusan diagnosis dan manajemen pasien (Newble et al., 1995).

10 Pengambilan keputusan ( decision making ) sendiri tidak cukup dengan menggunakan penalaran / reasoning saja, tetapi juga membutuhkan pengetahuan dan pemahaman yang baik mengenai fungsi tubuh manusia (baik yang normal maupun yang patologis). Pengetahuan biomedik dasar harus selalu dikaitkan dengan ilmu klinis dan epidemiologi. Data dari berbagai macam sumber tersebut (ilmu biomedik dasar,ilmu klinik dan epidemiologi) harus bisa ditampilkan secara terorganisasi dan koheren/saling bertalian / saling berkaitan dalam penggambaran suatu proses penyakit atau pemasalahan klinik ( Boshuizen & Schmidt 1992, Schmidt dkk, 1990).

11 WHY IS CLINICAL REASONING IMPORTANT? To prevent: Miss diagnose Inappropiate treatment Inappropiate management of complications failure to rescue (NSW Health Incident Management in the NSW Public Health System, 2008) How s the patient outcome???

12 Step by Step Clinical Reasoning

13 1. What problem/s is the patient presenting with? 2. What are the most likely hypotheses to account for the problem is? 3. What additional history do Ineed totest these hypotheses? 4. In light of available history do I need to reformulate the patients problems? 5. What is the differential diagnosis at this stage? 6. What particular signs will I be seeking on physical examination to help clarify the diagnosis? 7. Based on this additional information how would I refine the differential diagnosis? 8. What particular investigations will help to clarify the diagnosis? 9. How would I summarise the main problem /s? 10.What is my provisional diagnosis? 11.What are some relevant questions for which I would like more evidence from the literature in order tomake decisions about diagnosis and management 12.What are the short and long term management goals? 13.What management would I recommend?

14 How if I finally become a Doctor? What I should do if I meet my first patients?

15 Chief complain/ main complain Anamnesa Pemeriksaan fisik Pemeriksaan penunjang Differential Diagnosis Diagnosis pasti Treatment/tatalaksana based on???

16 What knowledges/theories that I should acquire? Basic-biomedic & Ilmu Klinis Normal-pathology-diagnostic-disease management-diseases prevention/promotionpublic health.

17 What skills that I should accomplish? Communication Physical examination Writing a recipe Therapheutic skills Etc

18 Belajar orang dewasa? Pembelajara orang dewasa adalah pembelajaran untuk memahami orang dewasa dalam belajar dengan kondisi yang optimum bagi orang dewasa tersebut. Smith (1982) mengungkapkan ada enam mengenai pembelajaran bagi orang dewasa ini, yaitu : Belajar berlangsung sepanjang hayat, Belajar merupakan suatu proses yang bersifat pribadi dan alamiah, tidak seorang pun yang dapat melakukan belajar untuk kita. Belajar mencakup perubahan, sesuatu yang ditambahkan atau dikurangi. Belajar dibatasi oleh tingkat perkembangan manusia. Berkaitan dengan pengalaman dan mengalami. Belajar mengandung intuitif. (Pengetahuan dapat muncul dari kegiatanbelajar itu sendiri)

19 Ilmu pre klinik + Ilmu Klinik Integrasi LONG LIFE LEARNING

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