Principles of Surgical Education program.pptx

principles of surgical

1. PRINSIP-PRINSIP DASAR CLINICAL EDUCATION FOR MEDICAL STUDENT CLERKSHIP Kiki Lukman KPS IPDSBU FK UNPAD/RSHS Bandung

2. Tujuan : Mendiskusikan prinsip-prinsip dan aspek dasar medical education berdasarkan standar Mendiskusikan prinsip-prinsip pendidikan klinik pada fase Pendidikan Profesi Dokter Umum .

3. Postgraduate Medical education

4. CHARACTERISTICS It is conducted according to specified regulations and rules. Setting : The young doctors work in clinical settings with more experienced colleagues who take the responsibility for their instruction and supervision .

5. Characteristics of Clinical Education Education Exposure Experi-ence Evidence Based practice Expertise Exellence Progression to

6. COMPONENTS Planned clinical/practical placements, Expert supervision , T heoretical teaching, R esearch experience, S ystematic assessments E valuation of the training programmes .

7. The Nature of Training Process

8. METODA PEMBELAJARAN DOKTER UMUM Prinsip metoda pembelajaran : S tudent Centered (Learning, not teaching) P roblem based I ntegrated C ommunity based E lective/Early exposure S ystematic

9. METODA PEMBELAJARAN DOKTER UMUM Competency Based Training : Mastery learning , Humanistik , & prinsip belajar orang dewasa. Metode Belajar Orang Dewasa : Partisipatif ( perlu motivasi ) , Relevan ( Sesuai dg latar belakang + tujuan jelas & diketahui ) Praktis ( aplikatif ) Variatif Immediate + positive feedback

10. Mission and Outcomes

11. Mission and Outcomes

12. PROFESSIONALISM

13. COMPETENCIES Patient care Medical knowledge & medical ethics and medical jurisprudence Interpersonal and communication skills Appraisal and utilisation of new scientific knowledge Function as supervisor, trainer and teacher in relation to colleagues , medical students and other health professions

14. COMPETENCIES Capability to be a scholar contributing to development and research in the chosen field of medicine Professionalism Interest and ability to act as an advocate for the patient Knowledge of public health and health policy issues Ability to understand health care, and identify and carry out system-based improvement of care.

15. TRAINING PROCESS

16. Process of Learning See, do, and learn to teach Apprenticeship Structured Educational Activities (tutorials, CPC, journal club) Practice workshop & Skills development courses Teaching medical & nursing students E-learning

17. What is clinical teaching?

18. CLINICAL TEACHING Specific Educational Characteristics Patient-centeredness Encounter specificity Unpredictability Constraint of time Clinical Reasoning ( the fundamental skill of clinical practice and clinical teaching )

19. Bagaimana metode pendidikan klinik di Program Profesi dokter umum ?

20. BAGAIMANA METODA PEMBELAJARAN PPDSI? INTI DARI CLINICAL EDUCATION PROBLEM BASED LEARNING = Kegiatan utama adalah kegiatan diskusi kelompok di kelas ( Fokus : paper work ) BEDSIDE TEACHING K = Problem solving skills P = Clinical skill : Anamnesis, PD, Prosedur A = Professional behavior

21. BAGAIMANA METODA PEMBELAJARAN PPDSI? INTI DARI CLINICAL EDUCATION COMPETENCY BASED TRAINING = Aspek psikomotor prosedur bedah = di OK, EMG, dsb. (MODUL-MODUL) Mastery learning , humanistik , Adult learning principles , dg. Tahapan: Skill Acquisition Skill Competence Skill Profi c iency

22. Bedside Teaching Ideal setting for Demonstration of Physical findings Interviewing Developing interpersonal skills Teacher, Trainee & Patient interaction Role-modeling (A Preceptor must play as a good role model).

23. Clinical PBL Transition from Paper case to Real patients in the ward and clinics Emphasized on Problem solving

24. Clinical PBL in the Ward How to conduct ? t Recommended Approach t Integration of PBL & PBT ( learner centered )

25. Tutorial 1 (PBL) One or two students clerk the patient on their own and present the findings to their group in absence of a preceptor t Step One t Patil, N., The University of Hongkong

26. Tutorial 1 (PBL) Group discuss the problem and do self / group study to find out information related to learning issues t Step Two t Patil, N., The University of Hongkong

27. Tutorial 2 (PBL + PBT) Students meet their preceptor and make formal presentation and go through learning issues. t Step Three t Preceptor, who is an expert clinician, will act as a facilitator and teacher, as and when appropriate Patil, N., The University of Hongkong

28. Case analysis: The preceptor and students discuss the case together in a separate room Patil, N., The University of Hongkong

29. Case Analysis : Problem Hypothesis Mechanism More info Don’t know Learning issues Problem solving Decision Making: Diagnosis treatment FINAL OBJECTIVES

30. Competencies to be learned History taking & consultation Clinical practice Management planning Decision making & judgement Communication & informed consent Team performance

31. Competencies to be learned Technical Critical care Teaching & learning Professional behavior Ethical practice Education of patients & their families

32. Competency Based Training The principles Training of The Trainers Clinical Skills Program Medical School of Universitas Padjadjaran

33. Definition Competency based training (CBT): Learning by doing (participatory) It focuses on the specific knowledge, attitudes, & skills needed to carry out a procedure/activity. Role of trainer: facilitator Assess the overall performance of the trainee/student

34. Why CBT? Research evidence: Learning recall related to Type of presentation Type of Presentation Percentage of material recalled After 3 hours After 3 days Verbal (one way lect.) 25 % 10-20 % Wriiten (reading) 72 % 10% Illustrated lecture 80 % 65% Participatory 90 % 70%

35. How is it done ?

36. Simple model of competence Miller GE. The assessment of clinical skills/competence/performance. Academic Medicine (Supplement) 1990; 65: S63-S7. Knows Shows how Knows how Does Professional authenticity

37. The Steps: Step I Standardization: Skills or activity is broken down to essential steps Each step is analyzed to determine the most efficient & safe way to perform and learn according to the best available evidence  Learning guide

38. The Steps: Step II Competency based development: Presentation by trainer Demonstration by trainer (behavior modeling) Practice under supervision (Coaching) Self practice Assessment

39. Components of coaching Positive feedback: before, during, & after practice Active listening Questioning Problem solving skills Encourage positive learning climate Monitor the progress

40. Maximizing the efficacy of CBT Integrated with adult learning principles Based on behavior modeling Use of anatomic models, learning aids, & standardized patient (reduce training cost & time) Incorporate with humanistic training techniques

41. Adult learning principles: Participants are ready to learn Builds on what participants already know or have experienced Participants are aware of what they need to learn Using variety of training methods & techniques

42. Adult learning principles: Opportunity for practicing skills initially in controlled or simulated situations Repetition is necessary to become proficient Learning situation is realistic Feedback should be immediate, positive and nonjudgmental.

43. Developing clinical skills: the coaching process ROLES Level of performance Skill acquisition Skill competency with models/SP Skill competency with patients Clinical Trainer Demonstrates skills Coaches & assess the participant performance Evaluate participant performance Participant Observes the demonstration Practice & perform the skills Perform the skills

44. The Reality : The dangers ! “we are asked to be professional in an environment that is not professional” The hidden curriculum (those values and behaviours which are copied by our students ) Faculty : “ Do as I say, not as I do ” David Fairholm

45. Feedback ?

46. Thank You