Ova Emilia

Measuring students' approaches to learning in different clinical rotations.

BackgroundMany studies have explored approaches to learning in medical school, mostly in the classroom setting. In the clinical setting, students face different conditions that may affect their learning. Understanding students’ approaches to learning is important to improve learning in the clinical setting. The aim of this study was to evaluate the Study Process Questionnaire (SPQ) as an instrument for measuring clinical learning in medical education and also to show whether learning approaches vary between rotations.MethodsAll students involved in this survey were undergraduates in their clinical phase. The SPQ was adapted to the clinical setting and was distributed in the last week of the clerkship rotation. A longitudinal study was also conducted to explore changes in learning approaches.ResultsTwo hundred and nine students participated in this study (response rate 82.0%). The SPQ findings supported a two-factor solution involving deep and surface approaches. These two factors accounted for 45.1% and 22.5%, respectively, of the variance. The relationships between the two scales and their subscales showed the internal consistency and factorial validity of the SPQ to be comparable with previous studies. The clinical students in this study had higher scores for deep learning. The small longitudinal study showed small changes of approaches to learning with different rotation placement but not statistically significant.ConclusionsThe SPQ was found to be a valid instrument for measuring approaches to learning among clinical students. More students used a deep approach than a surface approach. Changes of approach not clearly occurred with different clinical rotations.

Students’ understanding of “Women-Centred Care Philosophy” in midwifery care through Continuity of Care (CoC) learning model: a quasi-experimental study

BackgroundThe philosophy of midwifery education is based on the ‘Women-centred care’ model, which provides holistic care to women. Continuity of care (CoC) is integral to the concept of holistic women-centred care and fundamental to midwifery practice. The objective of this study was to determine any differences in students’ understanding of midwifery care philosophy between students who underwent the CoC learning model and those who underwent the fragmented care learning model.MethodWe used a quasi-experiment design. This study was conducted by all final year midwifery students at two schools of midwifery in Indonesia. Fifty four students from one school attended 6 months of clinical training using the CoC learning model. The control group was comprised of 52 students from the other school. These students used the conventional clinical training model (the fragmented care learning model). The independent T-test using SPSS was used to analyse the differences between the two groups of students in terms of understanding midwifey care philosophy in five aspects (personalized, holistic, partnership, collaborative, and evidence-based care).ResultsThere were no significant differences between the groups before interventon. There were significant differences between the two groups after clinical training (p < 0.01). The mean post-clinical score of students using all five aspects of the CoC clinical learning model (15.96) was higher than that of the students in the control group (10.65). The CoC clinical learning model was shown to be a unique learning opportunity for students to understand the philosophy of midwifery. Being aligned with midwifery patients and developing effective relationships with them offered the students a unique view of midwifery practice. This also promoted an increased understanding of the philosophy of women-centred care. Zero maternal mortality rate was found in the experiment group.ConclusionThe results of this study suggest that clinical trainingwith a CoC learning model is more likely to increase students’ understanding of midwifery care philosophy. This in turn improves the quality ofclinical care, thereby enhancing overall health benefits for women.

Client Satisfaction After Family Planning Counseling by Trained Medical Students

Latar Belakang: Program keluarga berencana mengalami tren penurunan di Indonesia dikarenakan adanya kendala pengetahuan, hambatan budaya, dan ketidakpuasan klien terhadap efek dari penggunaan alat kontrasepsi. Konseling keluarga berencana oleh penyedia layanan kesehatan memainkan peran yang penting dalam memberikan informasi mengenai metode program keluarga berencana. Tujuan: Mengetahui kepuasan klien terhadap konseling keluarga berencana yang dilakukan oleh mahasiswa kedokteran yang telah dilatih. Metode: Penelitian ini merupakan pre-experiment design with posttest only. Dua puluh lima mahasiswa kedokteran yang mengikuti progam ditugaskan untuk memberikan konseling keluarga berencana kepada klien program keluarga berencana di Kabupaten Sleman, Yogyakarta. Modifikasi kuisioner dari William dkk digunakan untuk menilai kepuasan klien. Analisis deskriptif dilakukan dengan program SPSS versi 21. Hasil dan Pembahasan: Dari 69 klien yang mendapatkan pelayanan,secara umum lebih dari 97% klien merasa puas dengan pelayanan yang diberikan kecuali pada poin waktu tunggu dimana ketidakpuasan klien 11,8%. Kepuasan pada poin merasa dihormati, durasi konseling, metode pemberian informasi, kesempatan bertanya, dan kesesuaian antara informasi yang dibutuhkan dengan yang diberikan mencapai 98,5-100%. Kesimpulan: Sebagian besar klien merasa puas dengan konseling yang diberikan oleh mahasiswa kedokteran. Kata kunci: kepuasan, keluarga berencana, konseling, mahasiswa kedokteran

Profil Primigravida Muda dan Luaran Persalinan di Rumah Sakit Dr.Oen Surakarta

Background: Pregnancy at a young age has become an important health problem both in developed and developing countries. Pregnancy at a young age increases the risk of maternal and perinatal morbidity and mortality. This is because adolescent women who are not ready both physically and psychologically to get pregnant. Obsjective: This study aims to identify and analyze labor in young primigravida (<20 years) with pathological labor in hospital Dr.Oen Surakarta. Method: This was an observational analytic study without intervention in the form of comparative cross sectional study conducted in young primigravida group age <20 years and primigravida group age 20 to 34 years old, who underwent labor in hospital delivery room. Dr.Oen Surakarta. This study used secondary data from the medical record of pregnant women who gave birth at RS.Dr.Oen Surakarta from January 1, 2011 to December 31, 201. A comparison between young primigravids (<20 years) in which pathologic pathways were performed with primigravida of reproductive age (20-34 years) experienced pathological labor were conducted. Result and Discussion: The number of deliveries in young primigravida (<20 years) was 61 people (6.65%) whereas in primigravida (21-35 years) there were 856 people (93.34%). Younger primigravids have lower levels of education than the primigravida age of reproductive age (p 0.00, CI 3.557 - 11.227). The younger primigravida has a tendency to give birth outside its residence area compared to primigravida of reproductive age (p 0.00; CI 0.050,178). Unmarried status in the young primigravida is greater than that of primigravida of reproductive age (p 0.00, CI 0.011 - 0,229) .An Antenatal Care on Primigravida reproductive age is more regular than young primigravida (p 0.03; CI 0.255 - 0.97) . Young primigravida tended to have anemia (p = 0.00, OR 8.4 CI 3.22 - 21.93) The risk of prematurity was higher in young primigravids than in the reproductive age primigravida (p 0.01, OR 2.9 CI 1, 16 - 7.25). Younger primigravids have a higher risk for pathologic delivery compared to primigravida of reproductive age (p 0.05 OR 0.56 CI 0.315 - 1.01). Conclusions: There are differences in terms, level of education, marital status, residence, regularity of ANC between young primigravida and prmigravida of reproductive age. The study found that young primigravids have a higher risk of occurrence of anemia, prematurity and pathologic delivery compared with healthy reproductive age primigravids. Keywords: young primigravida, primigravida healthy reproductive age, risk factors

Clinical workplace learning: perceived learning value of individual and group feedback in a collectivistic culture

BackgroundFeedback is essential for workplace learning. Most papers in this field concern individual feedback. In collectivistic cultures, however, group feedback is common educational practice. This study was conducted to investigate the perceived learning value and characteristics of individual and group feedback in a collectivistic culture.MethodsDuring two weeks, on a daily basis, clerkship students (n = 215) from 12 clinical departments at Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia, recorded individual and group feedback moments by using a structured form: the providers, focus and perceived learning value of feedback. Data were analysed with logistic regression and multilevel techniques.ResultsStudents reported 2687 group and 1535 individual feedback moments. Group feedback more often focused on history taking, clinical judgment, patient management, patient counselling, and professional behaviour (OR ranging from 1.232, p < .01, to 2.152, p < .001), but less often on physical examination (OR = .836, p < .01). Group feedback less often aimed at correcting performance deficiencies (OR = .523, p < .001) and more often at comparing performance to the standard (OR = 2.447, p < .001) and planning action to improve performance (OR = 1.759, p < .001). Group feedback was perceived as more valuable than individual feedback (M = 4.08 and 3.96, respectively, βgroup = .065, SE = .026, p < .01).ConclusionIn collectivistic cultures, group feedback may add to the array of educational measures that optimize student learning. Congruence between culture and type of feedback may be important for the effectiveness of feedback.

Perbandingan Kejadian Retensi Urin antara Persalinan dengan Vakum Ekstraksi dan Persalinan Normal

Background: Urinary retention after vaginal delivery is a common problem with incidence 1.7% - 17.9%. Assissted vaginal delivery is one risk factor for the occurence of urinary retention. Objective: to compare urinary retention between normal vaginal delivery and assissted vaginal delivery using extraction vacum, and evaluate factors related to urinary retention. Method: The study was prospective cohort design, conducted in 3 hospitals and 2 primary health centres during 6 month period since September 2013- February 2014. Subjects were divided into two groups i.e. normal delivery and assissted delivery using extraction vacum, each 118 subjects. Events of urinary retention was assessed and also related factors were identified. Analysis used Chi-Square test, Fisher test and also logistic regression analysis. Result and Discussion: In total 236 subjects were involved, there was no difference in age and parity among the subjects. Incidence of urinary retention among extraction vacum delivery group was higher (32.2%) compare to normal delivery (11.9%). Multivariate analysis using logistic regression showed that extraction vacum (p=0.074; OR 2.71; 95% CI 1.55-4.73), baby weight (p= 0.230; OR 1.95; 95% CI 0.655.84) and perineal injury (p= 0.614; OR 1.35; 95% CI 0.41-4.36) were not significant risk factors for urinary retention. Length of labour (p=0.003; OR 3.71; 95% CI 1.55-8.86) and parity (p= 0.023; OR 2.29; 95% CI 1.2-4.66) were significant risk factors for urinary retention. Conclusion: Urinary retention is higher among vaginal delivery with extraction vacum compare to normal delivery. Length of labour and parity are external factors related to urinary retention. Keywords: Assissted vaginal delivery, extraction vacum, normal delivery, urinary retention, postpartum

Hubungan Pelaksanaan Standar Pelayanan Antenatal oleh Bidan di Desa dengan Kejadian Anemia di Kabupaten Purworejo

Background: It is estimated that 20.000 Indonesian women die annually due to ob-stetric complication. Bleeding, preeclampsia or eclampsia and infection were found to be the major causes of maternal death. This maternal death can be effectively pre-vented if communities are well informed about emergency signs as well as the provi-sion of qualified health service in primary care. Objectives: This study was conducted to know the relationship between implementa-tion of antenatal service standard done by village midwife and the incidence of ane-mia. Methods: This was an observational study with historical cohort design. Two methods were used: quantitative methods to examine the effect of antenatal service standard implementation on the incidence of anemia.The subjects were interviewed after having antenatal service. Qualitative method was used to confirm the study results by doing focus group discussion in which midwives from primary health care of Purworejo and Kutoarjo involved. The group discussion was focused on the implementation of antena-tal service standard according to Department of Health 2000. Data were analyzed us-ing univariate, bivariate, stratification, and multivariate analysis. Qualitative data were analyzed using thematic analysis. Results: The result showed that pregnant mothers who received non-standard antena-tal service had risk of anemia with OR=3.404 (95% CI: 1.303