Tesis

Gambaran Community Based Medical Education (CBME) Dalam Pendidikan Profesi Dokter di Fakultas Kedokteran UPN Jakarta: Suatu Pendekatan Kualitatif = Aplication of Community Based Medical Education (CBME) System In Medical Faculty UPN “Veteran” Jakarta: a Quaitatives study.

Latar belakang: CBME merupakan suatu sistem pembelajaran untuk pencapaian kompetensi mahasiswa kedokteran dalam pengelolaan masalah kesehatan. Mahasiswa FK UPN Jakarta yang mengikuti kepaniteraan IKK/IKM di FK UNDIP Semarang, melaksanakan CBME di Kecamatan Salaman Kabupaten Magelang Jawa Tengah dengan tinggal di rumah penduduk. Penelitian ini bertujuan meneliti pelaksanaan CBME tersebut sehingga dapat dijadikan bahan pengembangan pendidikan kedokteran Metode: Penelitian ini menggunakan metode kualitatif dengan Diskusi Kelompok Terarah (DKT) dan wawancara untuk mengumpulkan data dan pendapat dari Kepala Departemen IKK/ IKM, pengelola kegiatan lapangan, masyarakat Kecamatan Salaman, dan mahasiswa tentang pemahaman, pelaksanaan serta penilaiannya terhadap CBME. Observasi kegiatan secara langsung serta pengamatan dokumen juga dilakukan dan analisis tematik digunakan untuk menentukan pola data yang terkumpul. Hasil: Kegiatan CBME di Salaman diawali persiapan, pelaksanaan, penilaian, dan diakhiri evaluasi. Pada persiapan kegiatan ditemukan bahwa sasaran pembelajaran modul kepaniteraan klinik IKK/ IKM FK-UPN dan FK-UNDIP tidak persis sama, misalnya materi kedokteran kerja tidak ada pada FK-UNDIP. Pengelola kegiatan dinilai cukup baik dalam menyiapkan kegiatan, melakukan proses belajar mengajar dan ujian mahasiswa, meskipun terdapat kendala pengaturan waktu dan penggunaan panduan ujian. Pemahaman mahasiswa tentang sistim asuransi kesehatan belum memadai. Mahasiswa melakukan pengelolaan pasien dan tindakan medis di UGD dan posyandu walaupun sebenarnya tidak direkomendasikan pengelola kegiatan. Sarana dan prasarana pembelajaran seperti ruang kuliah dan diskusi, perpustakaan dan mesin cetak tidak memadai, dan sosialisasi kegiatan serta pengenalan area sebelum terjun ke Salaman tidak maksimal sehingga menjadi kendala dalam proses adaptasi termasuk perbedaan bahasa juga menjadi kendala. Pelaksanaan supervisi kepala departemen sangat minim karena masalah transportasi dan akomodasi. Pengelola kegiatan menilai mahasiswa sudah melaksanakan kegiatan dengan baik dan mencapai sasaran program. Mahasiswa merasa puas dan mendapatkan pembelajaran serta pengalaman yang berbeda dibanding kepaniteraan lainnya. Masyarakat merasa CBME mampu meningkatkan status kesehatan masyarakat, seperti pemahaman arti sehat dan perilaku hidup sehat.
Kesimpulan: Pelaksanaan CBME dapat memenuhi pencapaian kompetensi mahasiswa dalam mengelola masalah kesehatan masyarakat, serta dapat memuaskan masyarakat, mahasiswa serta pengelola pendidikan walaupun ditemukan banyak kendala. Kendala adaptasi mahasiswa, pemahaman mahasiswa terhadap perbedaa budaya, improvisasi metode pembelajaran, pengaturan waktu pembimbing, penggunaan panduan ujian, ditemukan dalam penelitian ini. Institusi diharapkan melaksanakan CBME secara mandiri untuk kesesuaian tujuan dan sasaran pembelajaran serta mempermudah supervisi sebagai monitoring dan evaluasi penyelenggara program.
Kata Kunci: CBME, kompetensi, kepuasan masyarakat.



Background: CBME system was designed for medical student to learn how to solve the health problem in one community by direct learning in the community itself. After the learning the student will have good competence and the community’s health problem resolved or decreased. Medical students of Medical Faculty of National Pembangunan University, Jakarta, do the CBME in Kecamatan Salaman Kabupaten Magelang, Central Java, Indonesia , collaborated with Community Health Department of Medical Faculty of Diponegoro University. How the CBME system had done by the students are evaluated by this study and the result will help to develop the system. Method: The method of this study is qualitative by deep interview and focused discussion group to get the data about application of CBME from students, head of departments, instructors, residents and all stake holders in Kecamatan Salaman. The author also observed directly during the students applied the CBME system and theme analysis was used to determination the collecting data. Result: CBME system application in Salaman was started by planning, processing, examination and evaluation. There is a different of objective learning between FKUPN
and FK-UNDIP, such as there is no occupation health in FK UNDIP. The faculty and instructors were good enough for preparing and doing the procedure of teaching, learning, and examination. Actually the students do not understood about health insurance systems but the community needed the information. The community usually did the discussion between them about their own problems include health problems. The students also served the emergency and polyclinic in health primary care unit, while the faculty and instructors did not asked them. There were not infrastructures for learning like big room for discussion, library and printers, and different language between students (Indonesian language) and the residents (Java language) were some problems, especially when giving the health information and education. Another problem in application of the CBME system in Salaman is limited supervised or monitoring by instructor to the area which far from office due to limited financial and accommodation. This study revealed that the faculty assessment showed the students had competence, and the teachers and students were satisfied with the experience and learning. Application of CBME system in Salaman also increased the community health state especially the understanding of the good and healthy living. Conclusion: CBME fullfilled students’ competency in dealing with the public health’s problem and satisfy public need as well as education committee without meaningfull obstacles. Students’ adaptation, cultural difference understading among students, learning method improvisation, time schedule, assessment guidance usage are the obstacles found during research. Education institution shall adopt CBME independently to adapt the eduation goals, learning objectives and easier supervision as the evaluation and monitoring program.
Keywords: CBME, competence, community satisfaction