Insider Dilemmas: An Ethnographic Study on Community-Based Medical Education in Aceh, Indonesia

This journal has been published at different time periods under the following titles: Explorations: A Graduate Student Journal of Southeast Asian Studies, Explorations in Southeast Asian Studies, and The Journal of the Southeast Asian Studies Association

Community-based medical education: Exploring doctor-patient interactions in post-disaster Aceh, Indonesia

People who are affected by disaster(s) often undergo significant shifts in their lives due to physical injuries, displacement, and the loss of family members and properties. These experiences may contribute to challenges in how they interact with medical doctors, who may struggle to co-construct equitable and meaningful medical encounters with disaster survivors. At present, scant medical education research has explored the means of preparing doctors to engage sensitively with patients in post-disaster contexts. This thesis focused on the potential for community-based medical education (CBME) to familiarise physicians (both current and future doctors) with the lived experiences of disaster-affected patients. By employing a postcolonial lens, the study illuminated extant power relations and foregrounded efforts to listen to the subaltern community’s voices. The research drew on ethnographic techniques to conduct 225 hours of participant observations, 23 individual interviews, and 2 focus group discussions. The research participants included patients affected by disasters, community medical doctors with considerable experience working in these communities, and medical students completing a CBME unit. The findings from interviews with patients highlighted significant problems in medical education and practices in post-disaster areas, including asymmetrical power relations and complex cultural differences. Some community medical doctors, however, addressed these challenges by engaging the broader community, and medical students’ experiences during CBME suggested that home visits and reflective practices have the potential to enhance their preparation for work with disaster-affected patients. Based on these findings, this study offers an educational model for community engagement that could reduce asymmetrical power relations and cultural difference toward improving post-disaster community engagement in healthcare program

STUDENTS’ STANDPOINT: USING DEBATE IN A CRITICAL AND ANALYTICAL SPEAKING CLASS

This study presents a description of how the students were involved in an academic debate format for the Critical and Analytical Speaking class. The nature of this study was qualitative descriptive which used online questionnaires to the students from batch 2016 to 2018. It was found that the students initially had some anxiety for having to speak in English, let alone in the context of debate. They stated that the debate in the speaking class was exciting and challenging. Also, it was said that the class was able to enhance their speaking skill because it encouraged them to think critically, to be open minded, as they found and sorted ideas, knowledge and facts; an example of this was when then expressed their convincing arguments to tackle opponents’ standpoint. They admitted that they preferred to be in the contra side that was generally against the norms, open for possibilities to bend rules by questioning the law or contradicting society’s points of view

Analysis on the quality of test items on disaster management block

Written exam is the format most often used to assess the extent of student learning achievement. The advantages of written exam are more easily prepared and relatively more economical when compared with clinical examination test. Block’s written exam, especially on disaster management block is considered important because it will illustrate the students' competence at the end of this special block. This study is a qualitative research, aimed to evaluate the quality of test on disaster management block.  The quality of the test were evaluated using qualitative method by deep interviewing 5 criteria of students.  The result was analized using Miles and Huberman method and the themes emerged were: 1) The test item in disaster management block were fairly easy 2) Test items were in accordance with the competence of undergraduate, 3) The test item were congruent with the content material taught in this block.  However, there were some weaknesses, including: 1) There were repeated items, 2)  There were format of question that complicates matters without a clear purpose, 3) There were ‘easy to predict’ item questions, 4) Lack of variation of format.  These problems might cause low discriminant items.  Recommendation including continues improvement of item developers’ capability by integrate it within curriculum for faculty development program

Freire, dialogic feedback, and power issues: An authoethnography

The centrality of feedback is undeniable in education. However, not all feedback effectively encourages learning or improves performance due to predicaments in feedback delivery and receptivity. Several studies suggest other ways where feedback is offered in a dialogic fashion instead of a monologic one. Nevertheless, few papers do so in the context of medical education, especially when the learning processes involve marginalized people such as disaster-affected patients. This paper draws on autoethnographic experiences of providing dialogic feedback for medical students using Paolo Freire's dialogue concepts.  This feedback was given during reflective sessions in community-based medical education at post-disaster areas in Aceh, Indonesia. The findings show that Freire's dialogue concepts help assess dialogic feedback quality and offer insights into power relations between teachers and students. To achieve the aim of providing dialogic feedback --obtaining new understandings-- educators need to establish a more equal position in teacher-student relationships. In sum, the findings highlight the applicability of Freire's concept of dialogue in offering feedback for students especially when the training takes place in a context of marginalized people

STUDI TINGKAT PENGETAHUAN WANITA DEWASA TENTANG KANKER PAYUDARA DI DESA SRUNI KEC.GEDANGAN SIDOARJO

Kanker payudara mempunyai perjalanan penyakit yang sulit diramalkan, pada umumnya pasien mengalami nyeri tekan, rasa tidak nyaman pada salah satu payudara, terdapat benjolan, pembengkakan, kemerahan, bahkan terjadi perubahan seperti kulit jeruk dari pengamatan penulis, di desa Sruni kecamatan Gedangan kabupaten Sidoarjo. Pada umumnya ketika ada gejala awal yang timbul pada penyakit kanker payudara tidak langsung dibawa ke pelayanan kesehatan terdekat melainkan dibawa pada saat stadium lanjut. Tujuan penelitian ini untuk mengetahui gambaran tingkat pengetahuan wanita dewasa tentang penyakit kanker payudara di desa Sruni kecamatan Gedangan kabupaten Sidoarjo. Penelitian ini menggunakan metode Deskriptif, populasi dalam penelitian ini adalah masyarakat di desa Sruni kecamatan Gedangan, kabupaten Sidoarjo sebesar 326 KK. Besar sampel sebanyak 33 responden yang diambil dengan menggunakan teknik Non Probability Sampling jenis Purposive Sampling. Dan pengumpulan data menggunakan instrument penelitian berupa multiple choice kuesioner yang hasilnya kemudian ditabulasi dan dilaporkan sesuai dengan variable yang diteliti serta dituangkan dalam bentuk distribusi frekuensi kemudian dibahas secara deskriptif. Dari hasil pengumpulan data didapat bahwa dari 33 responden, sebagian besar 23 responden (69,7%) mempunyai tingkat pengetahuan yang kurang, sebagian kecil dan 8 responden (24,2%) cukup dan 2 responden (6, 1 %) baik. Kesimpulan dari penelitian tentang penyakit kanker payudara di desa Sruni kecamatan Gedangan kabupaten Sidoarjo, tingkat pengetahuan dengan kategori kurang. Untuk itu diharapkan kepada wanita dewasa di desa Sruni untuk lebih mencari inisiatif mengenai pengetahuan tentang penyakit kanker payudara. Melalui berbagai sumber media yang terpercaya ataupun pelayanan kesehatan

COMMUNICATION SKILLS: FACILITATING STUDENTS’ INVISIBLE BUT SIGNIFICANT SKILLS TO IMPROVE HEALTH OUTCOMES

Background: Communication skills are the core skills throughout medical professional life and embedded with cultural factors. Although students have learned communication skills in the undergraduate education, adequate training during clinical rotation and continuing professional development is necessary. Facilitating the students to build partnership relationship in the communicating with patients is challenging, considering its contexts, facilities, and opportunities. The influence of student-teacher relations in this hierarchical context is also influential. Gaps: Facilitating partnership communication skill requires blending two paradigms: medical knowledge and communication. These complex skills can be optimally facilitated by using specific strategies such as role-play, simulated patient (SP), and real-case encounter. Thus, the communication skills curriculum needs a comprehensive program planning, preparation on the students’ ability to be able to receive feedback and reflect upon it, simulated patients’ contribution for students training, and teachers to provide effective feedback. Recommendation: Facilitating students’ communication skills needs ‘two to tango,’ combining between mastery of medical knowledge and partnership communication. A better communication curriculum should consider incorporating cultural competencies and applying the principles in effective training course design such as authenticity, variability, gradually from simple to complex, integrated, and scaffolding by specific evidence. Thus, should be supported by a good faculty development program that will facilitate safe environment and constructive feedback. In addition, the need for simulated patients or even now, a virtual patient, is inevitable

PEMBELAJARAN INTERAKTIF DENGAN NEARPOD DI SEKOLAH DASAR ISLAM NURUL IMAN

The purpose of this act of community service was to improve the teacher’s proficiency with using Nearpod technology to enhance learning aactivity in the classroom. As a result, this activity has an effect on enhancing instructors' abilities and competency in engaging and imaginative learning. The workshop approach was used to conduct the activity, and the last step was to distribute surveys. The information was gathered using a questionnaire with nine questions. The findings of the questionnaire are described, and data is provided and examined. According to the findings, the Nearpod interactive learning workshop activities at Nurul Iman Islamic Elementary School received a favorable reaction, had an influence, and improved the instructors' abilities.  Keywords: Elementary School, Interactive Learning, Nearpo