Tesis

Gambaran Efek Pelatihan “Resident as Teacher (RaT)” terhadap kemampuan membimbing chief resident: suatu pendekatan kualitatif di Program Pendidikan Dokter Spesialis Penyakit Dalam Fakultas Kedokteran Universitas Indonesia = Effect of Resident as Teacher Training to Improve Teaching Skills of Internal Resident Chief Resident: a Qualitative Study in Internal Medicine Residency Program Faculty of Medicine Universitas Indonesia

Latar belakang: Chief resident merupakan bagian penting dalam proses pendidikan di program studi pendidikan dokter spesialis (PPDS). Salah satu kompetensi chief resident adalah membimbing residen juniornya, namun kompetensi ini jarang diajarkan secara formal. Telah dilakukan program pelatihan Resident as Teacher dengan durasi 5 jam untuk 20 chief resident di PPDS Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Indonesia. Penelitian ini bertujuan mengevaluasi efek pelatihan tersebut terhadap kemampuan membimbing chief resident.dengan menggunakan metode Kirkpatrick tingkat 1 hingga 3. Metode: Penelitian kualitatif dengan dengan rancangan fenomenologi. Rancangan fenomenologi ini berupa deskripsi perspektif chief resident dan senior mengenai peningkatan kemampuan membimbing chief resident PPDS IPD FKUI setelah mengikuti pelatihan RaT. Sesuai dengan metode evaluasi Kirkpatrick, dilakukan evaluasi kepuasan peserta pelatihan, peningkatan pengetahuan pasca pelatihan, dan Focus Group Discussion untuk chief dan residen junior. Dilakukan pula triangulasi berupa observasi ronde chief dan observasi acara ilmiah siang serta analisis kasus negatif berupa in depth interview serta studi dokumen. Hasil: Berdasarkan hasil kuesioner kepuasan peserta pelatihan, materi pelatihan RaT bermanfaat untuk chief, praktis untuk diterapkan, sesi dalam pelatihan menarik dan instruktur dapat membawakan materi dengan baik. Hasil pre dan post test serta FGD menunjukkan peningkatan pengetahuan chief resident mengenai teknik microskills dan pemberian umpan balik efektif. Materi pelatihan RaT mampu laksana namun hambatan yang didtemui adalah kesulitan mencari waktu membimbing di antara beban pelayanan di Rumah Sakit Cipto Mangunkusumo (RSCM) dan kesulitan memberi umpan balik positif. Simpulan: Pelatihan RaT yang telah dilakukan sesuai dengan kebutuhan chief resident dan mampu meningkatkan pengetahuan serta keterampilan membimbing chief resident. Sebagian besar chief resident belum dapat memberi umpan balik positif. Selain itu, waktu membimbing terbatas karena tugas pelayanan yang banyak di RSCM
Kata kunci: resident as teacher, teknik membimbing, umpan balik


Background: Teaching junior resident and medical student is one of the responsibilities of chief resident. However, teaching skill is rarely trained formally to them. A format of Resident as Teacher (RaT) training program was developed and conducted for 20 chief residents in Internal Medicine Residency Program. The aim of this study is to evaluate the improvement of chief’s teaching skill after joining this training program, based on the first three steps of Kirkpatrick evaluation program . Methods: Qualitative research based on phenomenology study was performed within two months after the training. Program questionnaire and pre-post test were conducted to evaluate the first (reaction) and second (learning) step of Kirkpatrick evaluation method respectively. The third step (behavior change) was evaluated by performing Focus Group Discussion for chief residents and junior residents. To increase the validity of the study, triangulation by doing indirect observation or rounds, classroom based activities and document study were done. Negative case analysis was also performed to explore further about the result of FGD. Result: Based on the questionnaire, the participants were satisfied by the RaT program. Pre and post test evaluation and FGD show that there is improvement of knowledge about teaching and giving effective feedback. FGD results supported by observations and document study show that chiefs applied the microskills technique but had difficulty in giving positive feedback, as well as finding appropriate time for discussion within very busy schedule of junior resident in the main teaching hospital. Conclusion: The training fulfills the need of chief resident, improves knowledge of teaching method and giving constructive feedback. However the chief residents was not used to give positive feedback to the junior residents and the busy clinical situation was identified as barrier to effective chief to junior resident learning process.
Keywords: Resident as teacher, microskills in clinical teaching, feedback