Managing the complexity of doing it all : an exploratory study on students' experiences when trained stepwise in conducting consultations

Background: At most medical schools the components required to conduct a consultation, medical knowledge, communication, clinical reasoning and physical examination skills, are trained separately. Afterwards, all the knowledge and skills students acquired must be integrated into complete consultations, an art that lies at the heart of the medical profession. Inevitably, students experience conducting consultations as complex and challenging. Literature emphasizes the importance of three didactic course principles: moving from partial tasks to whole task learning, diminishing supervisors' support and gradually increasing students' responsibility. This study explores students' experiences of an integrated consultation course using these three didactic principles to support them in this difficult task. Methods: Six focus groups were conducted with 20 pre-clerkship and 19 clerkship students in total. Discussions were audiotaped, transcribed and analysed by Nvivo using the constant comparative strategy within a thematic analysis. Results: Conducting complete consultations motivated students in their learning process as future physician. Initially, students were very much focused on medical problem solving. Completing the whole task of a consultation obligated them to transfer their theoretical medical knowledge into applicable clinical knowledge on the spot. Furthermore, diminishing the support of a supervisor triggered students to reflect on their own actions but contrasted with their increased appreciation of critical feedback. Increasing students' responsibility stimulated their active learning but made some students feel overloaded. These students were anxious to miss patient information or not being able to take the right decisions or to answer patients' questions, which sometimes resulted in evasive coping techniques, such as talking faster to prevent the patient asking questions. Conclusion: The complex task of conducting complete consultations should be implemented early within medical curricula because students need time to organize their medical knowledge into applicable clinical knowledge. An integrated consultation course should comprise a step-by-step teaching strategy with a variety of supervisors' feedback modi, adapted to students' competence. Finally, students should be guided in formulating achievable standards to prevent them from feeling overloaded in practicing complete consultations with simulated or real patients

Understanding attitude of health care professional teachers toward interprofessional health care collaboration and education in a Southeast Asian country

Endang Lestari,1 Renée E Stalmeijer,2 Doni Widyandana,3 Albert Scherpbier2 1Department of Medical Education, Medical and Health Allied Education Unit, Faculty of Medicine, Universitas Islam Sultan Agung, Semarang, Indonesia; 2Department of Educational Development and Research, School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands; 3Department of Medical Education, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia Background: Faculty members play crucial roles as facilitators of learning for effective interprofessional education (IPE). However, faculty attitudes are reported to be barriers to successful implementation of IPE initiatives within health care education settings. This study aimed to investigate the following: 1) health care faculty members’ attitudes toward interprofessional collaboration (IPC) and IPE; 2) factors affecting faculty members’ perception toward IPC and IPE; and 3) health care professionals’ perceptions toward factors that hamper the quality of IPC, and whether IPE is a possible remedy for the situation.Methods: A survey was administered to medicine, nursing, midwifery, and dentistry faculty members at 17 institutions in Central Java Province, Indonesia. Respondents were asked to rate their attitudes toward IPC and IPE using a previously validated “Attitude toward Interprofessional Health care Collaboration and Education” scale. To help interpretation of the survey results, 4 monoprofessional focus groups (FGs) were conducted and 3 key participants who could not be present at the FG meetings were interviewed. We conducted a statistical analysis on the quantitative data and performed a thematic content analysis of the qualitative data using ATLAS Ti (version 7).Results: The total response rate was 74.1%. Nurses’ mean scores for attitudes toward IPC and IPE were higher than those of other health care professionals. The main problems of IPC identified from the FG were as follows: 1) differing perceptions of the needs of patients among professionals; 2) unequal participation in decision-making; 3) lack of face-to-face interaction; and 4) overlapping of roles and responsibilities. Faculty members agreed that IPE has the potential to remedy these challenges as long as opportunities are provided to inculcate equal power and contribution in meeting patients’ needs.Conclusion: These findings indicate the necessity of convening faculty development programs regarding IPC and IPE. Additionally, innovative strategies must be developed for the implementation of IPC and IPE in a variety of academic settings. Keywords: attitude of health care professionals, interprofessional education, interprofessional health care collaboratio

Penguatan Konsep Bangun Datar dan Satuan Panjang pada Siswa Tunanetra melalui Media Blind's Playpad

Pembelajaran matematika berbasis game saat ini sangat diminati oleh siswa SD terlebih lagi oleh siswa SD penyandang tunanetra, sehingga dapat mempermudah siswa-siswi tunanetra dalam memahami materi. Memperhatikan permasalahan yang ada, dilakukan program pengabdian masyarakat melalui media BLIND'S PLAYPAD sebagai upaya dalam inovasi media pembelajaran matematika di SDLB-A YPAB Surabaya. Tujuan dari program ini adalah untuk menarik minat siswa tunanetra di SDLB-A YPAB Surabaya pada pembelajaran matematika sehingga dapat meningkatkan kemampuan siswa dalam belajar matematika, serta mengenalkan media BLIND'S PLAYPAD sehingga dapat digunakan dalam pembelajaran matematika secara mandiri. Metode pelaksanaan program ini dilakukan secara luring dengan mematuhi protocol Kesehatan dan daring melalui video conference (zoom). Pada program ini terdiri dari lima kegiatan. Pertama, tahap persiapan yang terdiri dari melakukan diskusi tim dengan mitra hingga tahap terakhir yakni membahas keberlanjutan program. Hasil yang dicapai dari program Blind's Playpad adalah adanya media BLIND'S PLAYPAD, laporan, serta publikasi pada media elektronik dan artikel ilmiah. Program ini berhasil dilaksanakan karena siswa mampu menyelesaikan soal-soal yang diberikan dan mendapat nilai lebih dari sama dengan 70, dimana 70 itu merupakan satuan ketentuan mata pelajaran SDLB-A YPAB. Kemudian adanya peningkatan keaktifan siswa minimal 80 persen