Metode Pembelajaran IPE – berbasis komunitas
Mora Claramita PRODI S2 ILMU PENDIDIKAN KEDOKTERAN FAKULTAS KEDOKTERAN UNIVERSITAS GADJAH MADA YOGYAKARTA
RFUMS HMTD 500 interprofessional healthcare – Didactic component Teams course objectives 1. 2. 3. 4. 5. 6. 7.
Demonstrate collaborative interprofessional team characteristics and behavior Analyze a healthcare interaction for qualities of patient centered care Reflect on service learning as a way to demonstrate social responsibility Identify other healthcare providers that may be of benefit to a particular patient Analyze a medical error situation to formulate a suggestion for solving the problem Identify situations in which individual, institution, or government advocacy may be appropriate Discuss current issues that impact all healthcare professions
RFUMS cultural course objectives – community-based component
1. Discuss the scope and definition of culture 2. Examine one’s own ethno-cultural heritage and how it impacts his/her interactions with patients, clients, and co-workers 3. Analyze one’s own personal and professional stereotypes and prejudices 4. To interpret the world of healthcare is a culture in itself 5. Become familiar with disparities in healthcare and aware of government involvement in this issue 6. Identify and discuss the impact of barriers to healthcare 7. Apply concepts related to the impact of culture, ethnicity, and religion on the health beliefs, practices, and behaviors of patients and clients
RFUMS clinical component sessions Session 1 (two hours) The assigned groups of students attend a two-hour session to observe patients at the clinic, have an interprofessional discussion after each, and choose one patient to follow Session 2 (one hour) Each group of students meets to discuss the patient history and their responses to the five interprofessional questions discussed in the clinic 1. How will medicine, physical therapy, physician assistant practice, and podiatric medicine contribute to the care of this patient? 2. What would the treatment objectives be for that care? 3. How would your profession address these objectives? What is the evidence to support the methods used to address the issue? 4. Besides medicine, physical therapy, physician assistant practice, and podiatric medicine, which other professions would you collaborate with to assist this patient? What is your rationale for these collaborations? 5. What other information will you need from the patient and how will it guide the treatment? Session 3 (3060 minutes) Each group of students returns to the clinic for a follow-up appointment with the chosen patient Session 4 (one hour) All four groups of students meet over lunch with the three course coordinators and present their patient and responses to the interprofessional questions: due to available sites to perform this clinical component, enrollment is currently limited, but we are actively seeking additional clinical sites so we can eventually offer this experience to all students
Table 1. “IPE-COM” learning design adapated from RFUMS Phase First
Instruction IPE Socialization and training
Activities Students and supervisors trained about IPE and community development in health services.
Second
Implementation IPE-COM with 7 steps: Students attach in community in order 1. Identify the stakeholders in the community to do health project 2. Approach in the community 3. Assess the needs of local communities 4. Planning project in each perspective 5. Focus project 6. Implementation of the project 7. Reflection
Third
Evaluation by IPE student’s report
Students were reported their learning experiences to supervisor Randhita et al., 2017
Masalah Mahasiswa dari praktek IPE – COM
FGD dengan Pembimbing Lapangan dan Dosen serta Dokter Puskesmas 1. Lemahnya aplikasi Keterampilan Komunikasi Mahasiswa (Sambung Rasa dan Penggalian Informasi/ BHSP) 2. Lemahnya pemahaman mahasiswa thd masalah kesehatan primer DISEASE & ILLNESS 3. Lemahnya perilaku profesional mahasiswa (Tidak tepat waktu, janji tidak ditepati, sms tidak lancar, kurangnya sopan santun)
MASALAH 1: PENGUATAN KETERAMPILAN BINA HUBUNGAN SALING PERCAYA (seting: Komunitas)
SAMBUNG RASA (GREETs & INVITEs) 1. Tujuan: Mendekatkan jarak mahasiswa dengan masyarakat 2. Peran mahasiswa? 3. Metode pendekatan: Hadir dalam identifikasi organisasi, pertemuan organisasi, membuka dialog 4. Tujuan usaha mendengarkan: Menggali masalah secara partisipatif 5. Metode: Wawancara, Observasi, Live-in (bila memungkinkan) 6. Poin 1-5 adalah FASE ASK DAN ASSESS dalam keterampilan konseling sehingga akan tercapai pemetaan masalah
INFORMED & SHARED DECISION MAKING (DISCUSSes) 7. Selanjutnya adalah proses Pemberian informasi dan pengambilan keputusan (FASE ADVICE): a. Menentukan mana masalah yang penting atau mampu ditangani terlebih dahulu (Prioritized) b. Menentukan prioritas masalah secara partisipative bersama mahasiswa dan masyarakat/ individu/ keluarga c. Memberikan informasi dan pengambilan keputusan bersama dilakukan sesuai kegiatan yang disepakatai bersama (Penyulusan/ Konseling/ Program promosi Kesehatan yang Berkelanjutan*)
MASALAH 2: PEMAHAMAN KESEHATAN PRIMER • SPIRIT DEKLARASI ALMA ATA: KESEHATAN UNTUK SEMUA • KESEHATAN PENCEGAHAN • SOCIAL DETERMINANT OF HEALTH • FAKTOR RESIKO • PENYAKIT KATASTROPIK: 1. 2. 3. 4. 5.
JANTUNG DAN KARDIOVASKULER DIABETES KANKER KECELAKAN LALU LINTAS PENYAKIT INFEKSI MENAHUN
HIRARKI KESEHATAN
KAITAN ILMU SOSIAL DAN MASALAH KESEHATAN SEBUAH CONTOH: PENYEBAB KEMATIAN ANAK
The Mandala of Health A model of human ecosystem
CULTURE COMMUNITY RELIGION
LIFESTYLE
Personal behavior SICK CARE SYSTEM
FAMILY SOUL
BODY
MIND
WORK
Physical environment
Human biology HUMAN-MADE ENVIRONMENT Dhanasari – FK UI
Psycho-socioEconomic Environment
BIOSPHERE
MASALAH 3: PENGUATAN PERILAKU PROFESIONAL (seting: Komunitas)
PERILAKU PROFESIONAL • Komponen penilaian mahasiswa: 1. Komitmen kedatangan dan jadwal Kepastian waktu Timeline, Hari dan Jam yang jelas untuk tiap-tiap fase (5 fase) 2. Jumlah minimal kontak dengan masyarakat Log Book 3. Target yang jelas (Fase 1,2,3) Instruktur membantu mengingatkan mahasiswa 4. Kontrak belajar: Memenuhi target 5. Kode Etik Perilaku 6. Kemampuan adaptasi dengan lingkungan (Proses belajar)
PERILAKU PROFESIONAL TIPS: 1. Bertanggung jawab (atas perkataan dan perbuatan) 2. Jalin Komunikasi terus menerus dg Instruktur LSM dan Instruktur Skills Lab (saat anda bisa hadir atau tidak) 3. Jalin Kekompakan Kelompok (Kehadiran tidak harus SELALU berombongan 5-10 orang justru kehadiran 1-2 orang cukup asal berkesinambungan dan program kelompok berjalan lancar)
WE ARE NOT WORKING FOR COMMUNITY WE ARE WORKING WITH THE COMMUNITY
TRANSFORM THE STUDENTS TO BE SENSITIVE TO COMMUNITY’S “HEALTH” PROBLEMS CAPACITY STRENGTHENING WORKSHOP FOR IMPROVING COMMUNICATION SKILLS - PATIENT EDUCATION AND COUNSELING SKILLS LAB OKTOBER 2011
BE SENSITIVE TO COMMUNITY’S “HEALTH” PROBLEMS CAPACITY STRENGTHENING WORKSHOP FOR IMPROVING COMMUNICATION SKILLS - PATIENT EDUCATION AND COUNSELING SKILLS LAB OKTOBER 2011
