Hasil Pencarian  ::  Simpan CSV :: Kembali

"Disertasi ini menghasilkan temuan bahwa clinical pathway yang disusun oleh berbagai profesi sesuai kompetensi, peran, tugas, dan tanggung jawab masing-masing profesi dalam perawatan pasien dapat digunakan sebagai media komunikasi, bekerja sama, berkoordinasi dalam praktek kolaborasi interprofesional. Praktek kolaborasi interprofesional dengan menggunakan clinical pathway dapat mengoptimalkan penggunaan antibiotik untuk mencegah terjadinya resistensi bakteri. Penelitian ini adalah kombinasi penelitian kuantitatif dan kualitatif dengan desain deskriptif analitik. Hasil penelitian menyarankan bahwa penyusunan clinical pathway tidak hanya berbasis bukti tetapi juga merupakan kesepakatan perawatan bersama oleh beberapa profesi tenaga kesehatan untuk meningkatkan kualitas pelayanan, terutama penggunaan antibiotik rasional.

---

The finding of this dissertation is clinical pathways prepared by various professions according to the competencies, roles, values, and responsibilities of each profession in patient care. A clinical pathway is a tool for communication, working together, and coordination in interprofessional collaborative practices. Interprofessional collaboration practices using clinical pathways can optimize the use of antibiotics to prevent bacterial resistance. This research is quantitative and qualitative research that analyzes analytics descriptively. The study suggests that the development of a clinical pathway is not only evidence based practice but also a joint agreement by several healthcare professionals to improve the quality of services, especially the rational use of antibiotics."

"Pengembangan humanisme sebagai inti profesionalisme diperlukan karena dokter profesional masa kini dituntut melakukan pelayanan berpusat pada pasien dan mengesampingkan kepentingan pribadi. Pengembangan humanisme dipengaruhi persepsi mahasiswa terhadap lingkungan pembelajaran terutama di klinik. Meskipun demikian, belum ada instrumen untuk menilai hal tersebut. Tujuan penelitian ini adalah menyusun instrumen penilaian iklim humanis lingkungan pembelajaran klinis.Penelitian ini menggunakan desain sequential exploratory mixed method dan dilakukan di Rumah Sakit dr. Cipto Mangunkusumo (RSCM) pada bulan Januari – Desember 2019. Penelitian dilakukan dalam empat tahap yaitu penyusunan instrumen, uji coba, penyusunan model iklim humanis lingkungan pembelajaran klinis dan implementasi. Tahapan penyusunan instrumen dimulai dengan sintesis konsep iklim humanis lingkungan pembelajaran klinis melalui telaah pustaka, focus group discussion dan wawancara mendalam. Dari penyusunan tersebut diperoleh konsep yang dijadikan rujukan draf instrumen Humanistic Climate Measure (H-CliM) yang terdiri atas 89 butir pertanyaan; 7 domain. Tahap kedua, dilakukan uji coba H-CliM bersama instrumen untuk menilai kompetensi humanisme Integrity Compassion Altruism Respect Empathy (ICARE). Kedua instrumen terbukti valid (r > 0,3) dan reliabel (α-cronbach > 0,7). Dilakukan analisis faktor untuk memvalidasi konstruk dan menghasilkan instrumen H-CliM final (46 butir pertanyaan; 4 domain) serta ICARE final (15 butir pertanyaan; 2 domain). Analisis receiver operating characteristic (ROC) menghasilkan titik potong ≥ 184,5 artinya, skor H-CliM ≥ 184,5 tergolong humanis. Analisis regresi logistik menghasilkan model iklim humanis yang 62% dapat menjelaskan variasi iklim humanis (R2 = 0,62). Model tersebut adalah:Logit P (iklim humanis) = 0,782 (rotasi klinis non-bedah) + 0,048 (kurikulum formal dan informal terkait humanisme) – 0,213 (hidden curriculum) + 0,036 (relasi dan fasilitas yang mendukung humanisme) + 0,044 (pengembangan kepribadian dan profesionalisme) + 0,409 (perempuan) + e.Penelitian ini berhasil mengembangkan instrumen penilaian iklim humanis yang valid dan reliabel yaitu instrumen H-CliM (α-Cronbach = 0,86). Lingkungan pembelajaran non-bedah 2 kali lebih humanis dibanding bedah (p = 0,0001). Persepsi terhadap iklim humanis lingkungan pembelajaran klinis berkorelasi lemah dengan capaian kompetensi humanisme.

---

The development of humanism as the core of professionalism is crucial, seeing that professional doctors today are expected to carry through patient-centered services and put aside their personal interests. In clinical setting, cultivating humanism is highly influenced by students 'perceptions on clinical learning climate, therefore, it is necessary to assess that perception. However, to date there is no instrument to assess clinical learning climate. The purpose of this study is to develop an instrument to assess humanistic learning climate.

This study utilizes a sequential exploratory mixed method design and is conducted at the Cipto Mangunkusumo hospital (RSCM) in January - December 2019. The research was conducted in four stages, which are the preparation of instruments, trials, development of humanistic climate models of clinical learning environments and implementation of the instrument. The stages of instrument preparation begin with the synthesis of concept of the humanistic clinical learning climate through literature review, focus group discussions and in-depth interviews. Afterward, the concept that was obtained utilized as a reference for drafting instrument of Humanistic Climate Measure (H-CliM) consisting of 89 questions; 7 domains. The second stage, an H-CliM trial was carried out along with instruments to assess the competence of the Integrity Compassion Altruism Respect Empathy (ICARE).

Both instruments proved to be valid (r > 0.3) and reliable (α-Cronbach > 0.7). Factor analysis was carried out to validate the construct and produce the final H-CliM instrument (46 questions; 4 domains) and the final ICARE (15 questions; 2 domains). Receiver operating characteristic (ROC) analysis resulted in cut-off point of 184.5, which means that the H-CliM score ≥ 184.5 was classified as humanistic climate. Humanistic climate models obtained from the logistic regression analysis could explain 62% of variation of humanistic climate (R2= 0,62). The model is:

Logit P (humanistic climate) = 0.782 (non-surgical clinical rotation) + 0.048 (formal and informal curriculum related to humanism) - 0.213 (hidden curriculum) + 0.036 (relationship and facilities that support humanism) + 0.044 (personality development and professionalism) + 0,409 (female) + e.

This research succeeded in developing a valid and reliable humanistic climate assessment instrument, the H-CliM instrument (α-Cronbach = 0,86). Compare with surgical rotation, the non-surgical learning environment is twice more humanistic (p = 0.0001). Perceptions of the humanistic climate of the clinical learning environment are weakly correlated with the achievement of humanism competencies."

"Permintaan layanan psikiatri forensik di Indonesia terus meningkat. Namun, psikiater di Indonesia merasa kurang kompeten dan kurang percaya diri dalam melakukan analisis psikomedikolegal dan melaporkan hasil pemeriksaannya, karena ketiadaan pedoman dan metode pendidikan yang belum seragam. Penelitian ini terdiri atas tiga tahap yang bertujuan untuk mengidentifikasi komponen Kemampuan Berpikir Analisis Psikomedikolegal (KBAP) dan mengembangkan modul pengajaran yang sahih dan mampu laksana. Penelitian menggunakan desain exploratory sequential mixed method. Pada tahap 1, dilakukan penelusuran kepustakaan dan penilaian kebutuhan dari pemangku kepentingan untuk mengidentifikasi komponen KBAP, dilanjutkan dengan teknik delphi melibatkan pakar psikiatri, hukum, dan bidang lain yang relevan. Hasilnya diadaptasi menjadi instrumen penilaian KBAP beserta panduan penilaiannya. Pada tahap 2, dilakukan studi potong lintang terhadap psikiater Indonesia untuk mengetahui skor KBAP dan faktor-faktor yang memengaruhinya. Pada tahap 3, dilakukan pengembangan dan uji coba Modul KBAP. Penelitian tahap 1 menghasilkan 60 butir KBAP yang dibagi empat tahap: persiapan, pemeriksaan, penulisan laporan, serta persiapan dan pemberian keterangan di pengadilan. Instrumen penilaian, berupa rubrik yang dilengkapi panduan pengisian, memiliki validitas isi dan reliabilitas antarpenilai yang baik. Median skor KBAP dari 165 subjek sebesar 37 (rentang nilai 5 sampai 89). Tidak didapatkan faktor yang berhubungan dengan skor KBAP. Modul KBAP yang dikembangkan pada tahap 3, berdasarkan temuan dari tahap 1 dan 2, berlangsung secara daring selama 6 minggu, terdiri atas kegiatan pembelajaran dan evaluasi yang dilakukan secara asinkronus dan sinkronus. Modul KBAP secara keseluruhan dinilai mampu laksana dan sahih. Selain itu, peserta menunjukkan hasil yang baik dalam evaluasi hasil pembelajaran modul. Secara keseluruhan, penelitian ini dirancang untuk dapat menjawab kebutuhan dalam peningkatan keterampilan psikiatri forensik Indonesia dengan memberikan pedoman konkret dan modul pengajaran yang berpotensi untuk dikembangkan lebih lanjut baik dalam aspek pendidikan, penelitian, maupun pelayanan.

---

Requests for forensic psychiatry assessments have consistently increased. However, Indonesian psychiatrists still view themselves as incompetent, and thus, unconfident in conducting psychomedicolegal analysis and reporting the results, which may stem from a lack of concrete guidelines and uniform teaching methods throughout the country. Furthermore, psychomedicolegal analysis as a form of clinical reasoning can be influenced by cognitive and emotional factors. Thus, this study aims to identify components of psychomedicolegal analysis competency and to develop its educational module. This study used an exploratory sequential mixed method design. In Part 1 of the study, literature review and needs analysis from stakeholders were conducted to identify components of psychomedicolegal analysis, which were then refined through Delphi technique involving experts from psychiatry, law, and other relevant fields. The components are adapted into a scoring instrument and its user manual. In Part 2, a cross-sectional study was conducted among Indonesian psychiatrists to estimate the level of psychomedicolegal analysis of competence and related factors. In Part 3, a module for psychomedicolegal analysis was developed and tested. Part 1 of this study resulted in 60 items of psychomedicolegal analysis competency, divided into 4 domains: preparation, assessment, report writing, and giving expert testimony. The scoring instrument was designed as a rubric and complemented by a manual containing item explanations and operational definitions. The instrument has acceptable content validity and inter-rater reliability. In Part 2, a sample of 165 psychiatrists had a median psychomedicolegal analysis score of 37 (range 5 to 89). No factors are significantly associated with it. In Part 3, the psychomedicolegal analysis module, formulated from the findings of Part 1 and 2, was conducted as an online course for 6 weeks, consisting of asynchronous and synchronous activities. The module was considered feasible and valid. Also the participants showed good results in evaluation of the module. Overall, the psychomedicolegal analysis scoring instrument and the resulting module were able to answer the need for skill development in Indonesian forensic psychiatry by providing concrete guidelines and teaching methods that have the potential to be further developed as educational innovation, research, and services."

"Gangguan kepribadian ambang (GKA) merupakan gangguan jiwa dengan dampak psikososial yang bermakna dan umumnya lebih sulit ditata laksana dibandingkan dengan gangguan psikiatri lainnya. Sebagian besar Peserta Program Pendidikan Spesialis Kedokteran Jiwa (PPDS-KJ) menyatakan sulit melakukan psikoterapi pada pasien GKA dan belum ada metode pengajaran psikoterapi psikodinamik yang khusus dan terstruktur untuk kasus GKA. Tujuan penelitian adalah menghasilkan Modul Pendidikan Psikoterapi Psikodinamik untuk kasus GKA (PP-GKA) beserta instrumen untuk mengevaluasi hasil pembelajaran PPDS-KJ setelah mengikuti modul pada domain pembelajaran kognitif, afektif, dan psikomotor. Penelitian dilakukan pada Januari–Desember 2023 di sembilan institusi pendidikan psikiatri di Indonesia menggunakan mixed method kualitatif dan kuantitatif dengan desain exploratory sequential, terdiri dari tahap pengembangan modul, pengembangan instrumen evaluasi, dan uji efektivitas modul. Penelitian ini juga mengadaptasi Kuesioner Kirkpatrick level 1 untuk mengevaluasi reaksi peserta terhadap modul. Pengembangan modul dan instrumen dilakukan secara saksama melalui tahapan focus group discussion, survei Delphi, diskusi panel ahli, uji validasi isi modul dan instrumen, serta uji reliabilitas instrumen dengan narasumber dari kalangan PPDS-KJ, psikiater, ahli psikoterapi, dan staf pengajar psikoterapi dari institusi pendidikan psikiatri di Indonesia. Modul yang dihasilkan bersifat valid (S-CVI/Ave = 1), berbentuk pembelajaran daring dengan durasi 12 kali pertemuan. Penelitian juga menghasilkan instrumen evaluasi hasil belajar berupa 50 butir soal pilihan ganda, rubrik penilaian formulasi psikodinamik (RP-FP), dan rubrik penilaian praktik psikoterapi psikodinamik (RP-PPGKA). RP-FP dan RP-PPGKA juga valid (S-CVI/Ave RP-FP = 0,981, RP-PPGKA = 1) dan reliabel (ICC RP-FP = 0,879, RP-PPGKA = 0,727). Uji efektivitas modul dengan pre-test post-test control group design dilakukan kepada 33 orang PPDS-KJ semester 6–7 dari sembilan institusi pendidikan PPDS-KJ di Indonesia yang direkrut berdasarkan stratified random sampling. Berdasarkan hasil analisis instrumen soal pilihan ganda, RP-FP, RP-PPGKA, dan Kuesioner Kirkpatrick level 1 versi Indonesia, Modul Pendidikan PP-GKA efektif memberikan perubahan dalam aspek kognitif, afektif, dan psikomotor serta mendapatkan reaksi yang positif dari peserta. Modul Pendidikan PP-GKA dapat diimplementasikan pada pendidikan PPDS-KJ di Indonesia sebagai panduan pengajaran dan membantu meningkatkan kompetensi PPDS-KJ dalam melakukan psikoterapi psikodinamik untuk kasus GKA di Indonesia.

---

Borderline personality disorder (BPD) is a mental disorder with significant psychosocial impacts and is difficult to manage compared to other psychiatric disorders. The majority of psychiatry residents in Indonesia stated that it was difficult to carry out psychotherapy on BPD patients and that there was no specific and structured psychodynamic psychotherapy teaching method for BPD cases. The aim of this study is to produce a Psychodynamic Psychotherapy Module for BPD cases (PP-BPD) along with the instruments to evaluate the residents’ learning outcomes in the cognitive, affective and psychomotor learning domains after receiving the module. The research was conducted in January–December 2023 at nine psychiatric educational institutions in Indonesia using mixed qualitative and quantitative methods with a sequential exploratory design, consisting of module development stages, evaluation instruments development, and module effectiveness testing. This study also adapted the Kirkpatrick Questionnaire level 1 to evaluate participants' reactions to the module. The development of the module and instruments was carried out carefully through the stages of focus group discussions, Delphi surveys, expert panel discussions, content validation testing of the module and scales, as well as inter-rater reliability testing of the scales with psychotherapy experts and teaching staff as participants. The resulting module, in the form of online learning with a duration of 12 meetings, is valid, (S-CVI/Ave = 1). The learning outcomes evaluation instruments were 50 multiple choice questions, Psychodynamic Formulation Competency Assessment scale (PF-CAS), and a Practical Competency Assessment Scale (PC-CAS) for psychodynamic psychotherapy for BPD. PF-CAS and PC-CAS were valid (S-CVI/Ave PF-CAS = 0.981, PC-CAS = 1) and reliable (ICC PF-CAS = 0.879, PC-CAS = 0.727). The module effectiveness test with a pre-test post-test control group design was carried out on 33 PPDS-KJ students in semesters 6–7 from nine psychiatric educational institutions in Indonesia who were recruited based on stratified random sampling. Analysis of the multiple choice exam, PF-CAS, PC-CAS, and Kirkpatrick Questionnaire level 1 Indonesian Version showed that the PP-BPD Education Module was effective in inducing changes in cognitive, affective and psychomotor aspects and received positive reactions from participants. The PP-BPD Education Module can be implemented in resident education in Indonesia as a teaching guide and to help improve residents’ competency in conducting psychodynamic psychotherapy for BPD cases in Indonesia."

"Lingkungan pembelajaran klinik di rumah sakit berpotensi mendorong pencapaian kompetensi IPE/IPCP mahasiswa dan meningkatkan kemampuan IPCP staf pengajar klinik. Upaya faculty development (FD) mempersiapkan staf pengajar klinik sebagai fasilitator IPE penting untuk keberhasilan implementasi kurikulum IPE. Namun, hingga saat ini belum ada model yang dapat menjadi acuan. Tujuan penelitian adalah menghasilkan model FD untuk mempersiapkan staf pengajar dari berbagai profesi kesehatan sebagai fasililitator IPE tahap klinik di rumah sakit.Penelitian ini menggunakan metode campuran dengan desain transformasi longitudinal di FKUI, FKKKMK UG, FK UII, dan FK UNS. Penelitian dilakukan dalam tiga tahap yaitu analisis kebutuhan komprehensif dan pengembangan model FD, penerjemahan model FD dalam penyusunan modul FD, dan uji coba serta evaluasi efektivitas modul. Penelitian dilakukan pada periode Januari 2023 hingga Agustus 2024. Responden penelitian adalah pimpinan institusi, IPE champion, IPE lead, staf pengajar klinik dan mahasiswa berbagai profesi kesehatan yang pernah terlibat dalam kurikulum IPE klinik. Data dikumpulkan dengan metode wawancara mendalam, FGD dan survei menggunakan kuesioner teaching competency for interprofessional education yang diadaptasi ke dalam situasi klinik di Indonesia.Penelitian telah menghasilkan kuesioner adaptasi yang valid dan reliabel untuk menilai persepsi staf pengajar dan mahasiswa tentang kompetensi fasilitator IPE klinik dan karakteristik pendidik klinik yang baik dalam konteks interprofesional. Hasil uji statistik menunjukkan tidak ada perbedaan bermakna antara persepsi staf pengajar dan mahasiswa. Penelitian menghasilkan model FIND yang terdiri atas empat prinsip meliputi to Foster optimal support from institution, to Involve IPE champions and IPE leads as initiator, innovator, communicator and coordinator, to Nurture faculty members’ competencies through an adequate needs analysis and faculty development, to Deliver faculty development with thorough preparation, targeted implementation and measured evaluation. Penerjemahan model FIND menghasilkan program FD yang dilaksanakan melalui modul pelatihan keterampilan memfasilitasi dinamika kelompok interprofesional di tatanan klinik. Prinsip pada model FIND diterapkan dengan cermat dalam penyusunan modul pelatihan. Kegiatan pelatihan berjalan lancar, partisipasi dan keterlibatan aktif peserta baik, tujuan pembelajaran yang disampaikan pada modul dapat tercapai. Peserta puas dengan pelatihan yang dilakukan, terdapat peningkatan persepsi sebelum dan sesudah pelatihan tentang berbagai kompetensi fasilitator IPE klinik. Dengan demikian dapat disimpulkan model FIND sesuai untuk pengembangan staf pengajar sebagai fasilitator IPE di tatanan klinik di Indonesia.

---

Clinical learning environment in hospitals has the potential to encourage the achievement of IPE/IPCP competencies of students and improve the IPCP abilities of clinical teaching staff. Faculty development (FD) efforts to prepare clinical teaching staff as IPE facilitators are important for the successful implementation of the IPE curriculum. However, there is no model that can be a reference. The purpose of the study is to develop an FD model to prepare teaching staff from various health professions as facilitators of IPE in the clinical stage in hospitals.

This study uses a mixed method with longitudinal transformation design in FKUI, FKKKMK UG, FK UII, and FK UNS. The research was carried out in three stages, namely comprehensive needs analysis and development of the FD model, translation of the FD model in the preparation of the FD module, and trial and evaluation of module effectiveness. This study was conducted from January 2023 to August 2024. The respondents of the study were institutional leaders, IPE champions, IPE leads, clinical teaching staff and students of various health professions who had been involved in the clinical IPE curriculum. Data were collected using in-depth interview methods, FGDs and surveys using teaching competency questionnaires adapted to clinical situations in Indonesia.

This study has produced a valid and reliable adaptation questionnaire to assess the perception of teaching staff and students about the competence of clinical IPE facilitators and the characteristics of good clinical educators in an interprofessional context. The results showed that there was no difference between the perception of teaching staff and students. This study has produced a FIND model consisting of four principles including to Foster optimal support from institution, to Involve IPE champions and IPE leads as initiator, innovator, communicator and coordinator, to Nurture faculty members' competencies through an adequate needs analysis and faculty development, to Deliver faculty development with thorough preparation, targeted implementation and measured evaluation. The translation of the FIND model resulted in a skills training module to facilitate the intreprofessional group dynamics in the clinical setting. The principles in the FIND model are carefully applied in the preparation of training modules. The training activities went smoothly, the active participation and involvement of participants was good, and the learning objectives conveyed in the module could be achieved. Participants were satisfied with the training conducted. There was an increase in perception before and after the training about the various competencies of clinical IPE facilitators. Thus, it can be concluded that the FIND model is suitable for the development of teaching staff as IPE facilitators in clinical settings in Indonesia."