PROBLEM-BASED LEARNING (PBL) - Unandrepository.unand.ac.id/18857/1/Problem Based Learning ( PBL).pdf · Bimbingan Aktivitas Kemahasiswaan dan Tradisi Ilmiah ... Community-Oriented

PROBLEM-BASED LEARNING

(PBL)CARA BELAJAR

di Fakultas Kedokteran Universitas Andalas

Rahmatina B. HermanBagian Pendidikan Kedokteran (BPK)

Fakultas Kedokteran – Universitas Andalas

Bimbingan Aktivitas Kemahasiswaan dan Tradisi Ilmiah (BAKTI)Fakultas Kedokteran Universitas Andalas

Tahun Akademik 2013/2014

BPK FK UNAND BAKTI 2013/20134

Education

Purpose of Education

“….provide assistance to learners that enables

them to achieve levels of development (and

efficiency) that they would not be able to

achieve by themselves

Tiffin and Rajasingham


…..Education

Input

Learning

Process

Output

Outcome


Kemp

Learning is key

to success of

an education

How to succeed an education?


What is Learning?

Learning is a change in human capability, which

can be retained, and not due to the process of

growth (Gagne)

Learning is a change in behavior as a result of

experience (Haggard)

Learning is a process by which behavior is

changed, shaped, or controlled (Tiffin and

Rajasingham)


Teaching-Learning Strategy

Teacher-centered (Teaching)

Student-centered (Learning)


One-way didactic methode (Sefton, 2001)

student student student student student student student

Teacher

Teacher-Centered (Teaching)

student


……Teacher-Centered (Teaching)

Teacher is solely responsible for what the

student is expected to learn

Teacher decides what

information and skills

the student should to

learn in what sequence

and at what pace


Teacher Centered


The Learning Pyramid

Teach each others

Lecture

Discussion group

Demonstration

Audiovisual

Reading

Practice by doing

5%

10%

20%

30%

50%

75%

80%

AverageRetention Rate

National Training Laboratories, Bethel, Maine, USA


Constructivism Theory

Knowledge is constructed from experience

Learning is a personal interpretation of the world

Learning is an active process in which meaning is developed on the basis of experience

Conceptual growths comes from the negotiation of meaning, the sharing of multiple perspectives and the changing of our internal representations through collaborative learning

Learning should be situated in realistic settings; testing should be integrated with the task and not a separate activity


Adult Learning Theory(Malcolm Knowles)

Adults are autonomous and self-directed

Adults have accumulated a foundation of life

experiences and knowledge

Adults are practical

Adults are relevancy-oriented

Adults are goal-oriented

Adults need to be shown respect


Novice Expert

Educational Psychology


Teaching Learning

Teacher centered

Knowledge transfer

Reinforces passiveness

Teachers provide answers

Teachers direct students

Student centered

Knowledge acquisition

Reinforces activeness

Teachers ask questions

Teachers guide students

Teaching vs Learning


Interpersonal communication, complex interaction - facilitated by a tutor (Sefton, 2001)

facilitator

student

student

student

student

student

studentstudent

student

Student-Centered (Learning)


Student-Centered (Learning)

The student learn to determine what he needs

to know

Teacher responsibility in the beginning by

providing the student experience and guidance

It is expected that student will eventually take

full responsibility for his own learning.

Active acquisition of information and skills by

student


Enjoyable


Student-Centered Learning Strategy

Active learning

Collaborative learning

Inquiry-based learning

Cooperative learning

Problem-based learningPeer led team learning

Team-based learning

Peer instruction

Inquiry guided learning

Just-in-time teaching

Small group learning

Project-based learning

Question directed instruction

Independent learning

Adult learning

Self-directed learning

Autonomous learning

Discovery learning

Think-pair share

Experiential learning

Performance-based learning

Task-based learning

Work-based learning

Competence-based learning

Case-based learning

Etc


PBL is a learning method on principle of using

problems as a starting point for the acquisition

and integration of new knowledge (Barrows,

1982)

In PBL students work on the problem which is

explicitly used to get students themselves to

identify and search for the knowledge that they

need to obtain in order to approach the

problem (Ross, 1991).

What is PBL?


The acquisition of an integrated body

of knowledge related to the problem

and the develop or application of

problem-solving skills

The Objective of PBL


Student-Centered

Problem-Based

Integrated

Community-Oriented

Early Clinical Exposure

Self-Directed/ Selective with Core

Philosophy of Learning in PBL


PROBLEM


tutor

studentsproblem

Tutorial

group

process

Three elements of the tutorial process in PBL


The problem is the motor of the learning

The Role of Problems


New information is better processed and retained

Problem solving skills are enhanced

Integration of basic science and behavioral science

knowledge is stimulated

Students learn how to learn

Student are stimulated to undertake self-directed

activities

Student motivation is enhanced

Integration of knowledge from different discipline is

fostered

……The Role of Problems

PELAKSANAAN PBL

DI FK – UNAND

KURIKULUM

BERBASIS KOMPETENSI (KBK)



Seperangkat tindakan cerdas dan penuh

tanggung jawab yang dimiliki seseorang

sebagai syarat untuk dianggap mampu oleh

masyarakat dalam melaksanakan tugas-tugas di

bidang pekerjaan tertentu

SK Mendiknas No. 045/U/2002

Pengertian Kompetensi



Tahap Pendidikan Dokter

Pendidikan Dokter di Indonesia mengacu kepada

Standar Pendidikan Profesi Dokter dan Standar

Kompetensi Dokter yang disahkan oleh Konsil

Kedokteran Indonesia (KKI)

Pendidikan Dokter Layanan Primer terdiri atas dua

tahap:

> Tahap Akademik : S.Ked

> Tahap Profesi (Tahap Klinik): Dokter

Internship dan Uji Kompetensi untuk memperoleh

Sertifikat Kompetensi dari KKI


Kurikulum fakultas disusun kedalam blok

Menyusun matriks blok dan kompetensi

Menetapkan kordinator blok dan kordinator

tahap

Menyusun kurikulum blok

Menyusun modul dan skenario setiap blok

Menyusun strategi implementasi PBL untuk

setiap blok

Strategi Implementasi Tahap Akademik


KURIKULUM FAKULTAS

BLOK BLOK BLOK BLOK

MODUL MODUL MODUL

SKENARIOmingguan

SKENARIO

mingguan


Dilaksanakan setiap hari Sabtu

Student-Centered Learning

Tahun I : Mata Kuliah Wajib Universitas

Agama, Bahasa Inggris, Kewarganegaraan

Tahun II : Family Oriented Medicine (FOME)

Tahun III : Metodologi Riset, Skripsi

Tahun IV : Preclerkship

Pembelajaran Ekstra-Blok


1. Tutorial dengan konsep “7 jump”

2. Belajar mandiri

3. Praktikum skills lab

4. Kuliah pengantar

5. Praktikum ilmu dasar

6. Diskusi pleno

7. Clerkship (co-schaap)

8. Internship

Strategi Pembelajaran


Mahasiswa dibagi kedalam kelompok kecil (10 – 11 mahasiswa / kelompok)

Kordinator blok bertanggung jawab terhadap implementasi kurikulum blok termasuk:- Menyusun “Study Guide”- Menyusun Skenario (dari bank skenario)- Menjalankan semua aktivitas akademik di blok

Kordinator Tahun bertanggung jawab terhadap implementasi kurikulum pada tahun yang dikordinirnya

Kordinator Tahap bertanggung jawab terhadap implementasi kurikulum pada tahap yang dikordinirnya

Strategi Implementasi PBL


What is Small Group?

Small group work is characterized by student

participation and interaction (Crosby 1996)

The Goals of Small Group Learning:

- The development of communication skills

- The development of intellectual and professional

competencies

- The development of presentation skills

- The personal growth of students (and perhaps the

tutor)


Process in Small Group Learning

INCREASING

DEGREE

TIMEFORMING

STORMING

NORMING

PERFORMING

MOURNINGnnnn C.I nnnn C.I

nnnn C.I

nnnn C.Innnn C.I

wwww ACTIVE ROLE

OF THE TEACHER

uuuuINDIVIDUAL

GROWTH AND

EXPECTATIONS

GROUP 8888

GROWTH

GOAL

C.I = CRITICAL INCIDENT

OPTIMUM GROUP

GROWTH AND

INDIVIDUAL

GROWTH


Tutorial dalam konteks PBL adalah:

suatu active learning process di dalam diskusi kelompok

kecil

distimulasi oleh suatu problem (skenario)

mengaktifkan prior knowledge mahasiswa

difasilitasi oleh seorang tutor

dipimpin oleh seorang mahasiswa yang terpilih

dibantu oleh seorang sekretaris yang terpilih

Untuk mencapai tujuan belajar melalui aktivitas

terstruktur yang disebut seven-jump

1. Tutorial


………..menggunakan problem untuk

mendorong aktivitas pembelajaran

berdasarkan a need-to-know basis

(Woods, 1994)

Kunci Tutorial dalam PBL


Tutorial adalah “jantung” PBL

Bentuk dan ukuran “jantung” merupakan

gambaran tujuan belajar yang spesifik

Setiap denyut “jantung” memberi /

menyediakan informasi baru / lebih maju

“Jantung” yang sehat akan menjamin

pencapaian tujuan belajar

Peran tutorial dalam PBL


Effective Tutorial

Characteristics of an effective tutorial group:

♦♦♦♦ cohesive

♦ high motivation

♦♦♦♦ mutual helps among individuals

♦♦♦♦ have a high motivation to learning together

All members understand the tasks that must be

completed and at the same time trying to complete the

task with high spirit

(Sefton, 2001)


……Effective Tutorial

Each member of the group respect the opinion of

others, but remain critical

Discussion conducted cooperatively, not competitively

The quiet member to be encouraged to actively

participate, the dominant member to be asked to

reduce its dominance

Each member has to be helped to not having personal

stress

(Sefton, 2001)


Encourage Teamwork


Seven Jump

1. Clarifying unfamiliar terms

2. Defining problems

3. Brainstorming possible hypotheses or

explanations

4. Arranging explanations into a tentative solution

5. Defining learning objectives

6. Gathering information

7. Sharing the results of information gathering and

private study


Process

- Students identify any words whose

meaning is unclear - other group

members may be able to provide

definitions.

- Students should be made to feel

safe, enabling them to be honest

about anything they do not

understand.

Clarifying unfamiliar terms


..….Clarifying unfamiliar terms

Reason

Unfamiliar terms act as an obstacle to

understanding. Clarification of even

half - understood terms may start the

process of learning.

Written output

Words or names on which the group

cannot agree a meaning should be

listed as learning objectives.


Process

- This is an open session when

students are encouraged to

contribute their view of the

problem under discussion.

- The tutor may need to encourage

them all to contribute to a fast-

moving and wide-ranging analysis.

Defining problems


…..Defining problems

Reason

It is quite possible for every member

of tutorial group to have a different -

perspective, on a problem. Comparing

and pooling these views broadens the

intellectual horizons of those involved

and defines the task ahead.

Written output

List of issues to be explained


Process

- A continuation of the open session

- but students now try to formulate,

test and compare the relative merits

of their hypotheses or explanations

of the problem or case.

Brainstorming possible hypotheses or explanations


……Brainstorming possible hypotheses or explanations

ReasonThis is a crucial step, that prompts the use

of previous learning and memory and allows

students to test or draw on another’s

understanding; Links can be formed

between the items if incomplete knowledge

that exist within the group. If well handled by

the tutor and group, it pitches learning at the

deeper level of 'understanding' rather than

the superficial level of 'facts'.

Written outputList of hypotheses or explanations


Process- Students will have thought of as many

different explanations as possible of what

is occurring.

- The problem is scrutinized in fine detail

and compared against the proposed

hypotheses, or explanations, to see how

they will match and if further exploration is

needed.

- This starts the process of defining learning

objectives, although it is inadvisable for

them to be recorded in writing too soon

Arranging explanations into a tentative solution


……Arranging explanations into a tentative solution

Reason

- This stage actively processes and

restructures existing knowledge and

identifies gaps in understanding.

- Making written records of learning

objectives too soon hinders thinking

and short-circuits the intellectual

process, resulting in objectives that

are too broad and superficial.


Written output

- This involves organizing explanations

for problems, representing them

schematically, trying to link new ideas

with each other, with existing

knowledge and with different contexts.

- This process provides a visual output

of the relationships between different

pieces of information and facilities

storage of information in long-term

memory.

……Arranging explanations into a tentative solution


Process

- The group agrees a core set of learning objectives that all students will study.

- The tutor encourages them to be focused, not too broad or superficial and achievable within the time available. Some students may have objectives that are not shared by the whole group because of their own personal learning needs or interests

Defining learning objectives


……Defining learning objectives

Reason

- The process of consensus uses the

expertise of the entire tutorial group

(and tutor) to synthesize the foregoing

discussion into appropriate and

attainable learning objectives.

- This not only defines the learning

objectives but also pulls the group

together and concludes the discussion.

Written outputLearning objectives


BLOK HEMATOLIMFOPOEITIK

MENGAPA HARUS DINA?

Dina, 12 tahun, dibawa ibunya ke IGD RSUD setelah tertabrak motor

sepulang dari sekolah. Dari pemeriksaan ditemukan fraktur tulang

radius. Dokter merencanakan tindakan reposisi dibawah anestesi

dan meminta paramedis untuk melakukan pemeriksaan darah rutin

pasien. Ketika hasil pemeriksaan siap, dokter sangat terkejut karena

Hb Dina 5,6 gr%, padahal tidak ada perdarahan luar maupun dalam

akibat kecelakaan tersebut. Ketika dokter bertanya pada ibunya, ibu

Dina mengatakan bahwa anaknya menderita epilepsi dan sejak usia

6 tahun rutin minum obat. Dina juga termasuk anak yang susah

makan, tidak suka minum susu dan makan daging. Akhirnya dokter

meminta untuk dilakukan pemeriksaan darah lengkap serta pungsi

lumbal. Ibu Dina jadi bertanya-tanya, mengapa perlu dilakukan

pemeriksaan tersebut pada anaknya? Bagaimana anda

menerangkan permasalahan ini pada ibu Dina?


Step 2. Defining problems

1. Mengapa Dina dibawa ke IGD RSUD?2. Mengapa dokter merencanakan reposisi?3. Mengapa dokter meminta melakukan pemeriksaan

darah rutin?

4. Apa artinya Hb 5,6 gr%?5. Mengapa dokter menanyakan riwayat kesehatan

Dina masa lalu?6. Apa artinya minum obat rutin selama 6 tahun

terakhir?7. Apa artinya susah makan, tidak suka susu dan

daging?8. Mengapa dokter memutuskan pemeriksaan darah

lengkap dan pungsi lumbal?


Step 3. Brainstorming possible hypotheses or explanations (prior knowledge)

1. Dina dibawa ke IGD RSUD karena kecelakaan

2. Dokter merencanakan reposisi karena fraktur

3. Pemeriksaan darah rutin karena Dina akan dianestesi

4. Hb 5,6 gr% artinya anemia berat

5. Untuk menelusuri penyebab anemia pada Dina

6. Minum obat secara rutin bisa menekan (depresi) hematopoetik

7. Susah makan, tidak suka susu dan daging menyebabkan defisiensi nutrisi termasuk bahan untuk produksi darah

8. Pemeriksaan darah lengkap dan pungsi lumbal untuk diagnosis pasti kondisi hematopoetik dan penatalaksanaannya


Step 4. Arranging explanations into a tentative solution

Kecelakaan

Fraktur Reposisi Anestesi

Darah Rutin Anemia

Obat

Depresi hematopoetik

Anemia aplastik

Susah makan

Defisiensi

Anemia defisiensi

Tatalaksana

Anamnesis, Pemeriksaan fisik, penunjang


Step 5. Defining Learning Objectives (LO)

1. Menjelaskan pengertian dan jenis-jenis anemia

2. Menjelaskan aspek epidemiologi dan faktor-faktor yang mempengaruhi terjadinya anemia defisiensi dan anemia aplastik

3. Menjelaskan patofisiologi terjadinya anemia defisiensi dan aplastik

4. Menjelaskan gejala dan tanda anemia defisiensi dan aplastik

5. Menjelaskan diagnosis dan diagnosis banding anemia defisiensi dan aplastik (anamnesis, pemeriksaan fisik dan pemeriksaan penunjang)

6. Menjelaskan pemeriksaan laboratorium yang diperlukan untuk menunjang diagnosis anemia defisiensi dan aplastik

7. Menjelaskan penatalaksanaan anemia defisiensi dan aplastik secara komprehensif

8. Menjelaskan prognosis anemia defisiensi dan aplastik

9. Menjelaskan kasus anemia defisiensi dan aplastik yang memerlukan rujukan


Process

This could include

- finding material in textbooks,

- carrying out a computerized literature search using the Internet looking at pathological specimens,

- talking to an expert, and

- anything else that will help provide the information the student is seeking.

Gathering information


……Gathering information

Reason

Clearly an essential part of the

learning process is gathering and

acquisition of new information, which

students do on their own

Written output

Students' individual notes


Process

- Students begin by returning to their list of learning objectives.

- They first identify their individual sources of information, pool their information from private study and help each other understand and identify areas of continuing difficulty for further study (or expert help).

- After this, they attempt to undertake and produce a complete analysis of the problem.

Sharing the results of information gathering and private study


……Sharing the results of information gathering and private study

Reason

This synthesizes the work of the group,

consolidates learning and identifies

areas of uncertainty, possibly for

further study.

Written output

Students' individual notes


Feedback


2. Kuliah Pengantar

Tujuan: “mengantarkan” mahasiswa untuk

pembahasan modul/ skenario setiap minggu

Bukan bertujuan untuk transfer of knowledge

Karena itu Kuliah Pengantar harus dilaksanakan pada

minggu pelaksanaan modul/ skenario yang

bersangkutan

Dilaksanakan selama 50 menit/ topik kuliah


3. Belajar Mandiri

Belajar mandiri dilaksanakan di kampus/

perpustakaan

Sumber pembelajaran:

- Printed material: Buku ajar (textbook), jurnal ilmiah

- Internet: situs (website) yang dapat

dipertanggungjawabkan keilmiahannya

- Pakar: staf pengajar/ dosen, pakar lainnya

Hasil Belajar Mandiri harus diserahkan ke Dosen

Pembimbing dan bila perlu bisa didiskusikan


4. Praktikum Ilmu Dasar

Tujuan praktikum: membantu pemahaman teori

Dilaksanakan di laboratorium ilmu dasar yang

bersangkutan

Pelaksanaan selama 2 jam per topik praktikum per

kelompok praktikum

Dilaksanakan di bawah bimbingan instruktur dari staf

pengajar/ dosen ilmu dasar yang bersangkutan


5. Praktikum Skills Lab

Tujuan praktikum: mahasiswa memperoleh

keterampilan yang berkaitan dengan profesi dokter

Dilaksanakan di laboratorium sklills lab

Pelaksanaan selama 2 jam per topik praktikum per

kelompok praktikum

Dilaksanakan di bawah bimbingan instruktur yang

ditetapkan oleh Kordinator Blok


6. Diskusi Pleno

Tujuan Diskusi Pleno: sharing antar kelompok tutorial

Dilaksanakan setelah selesai tutorial untuk setiap

modul/ skenario, yaitu selesai tutorial hari kedua

Wajib diikuti oleh semua kelompok mahasiswa pada

Blok yang bersangkutan

Dua kelompok tutorial menyajikan hasil tutorial

mereka, kelompok lain wajib menyimak dan memberi

masukan/ sharing hasil tutorial masing-masing

kelompok


6. Diskusi Pleno…..

Diskusi dipimpin oleh staf Blok yang bersangkutan

dan dihadiri oleh dosen pemberi Kuliah Pengantar

pada modul yang bersangkutan

Tidak dibenarkan mengajukan pertanyaan yang

bersifat menguji atau untuk mencari solusi masalah

yang tidak terpecahkan sewaktu tutorial, karena

semua masalah harus dapat dicarikan solusinya pada

tutorial kedua dari setiap modul/ skenario

Dilaksanakan selama dua jam


7. Clerkship (Co-schaap)

Merupakan proses pembelajaran pada Tahap Profesi

(Tahap Klinik)

Tahap pertama dilaksanakan di Rumah Sakit

Pendidikan dan jejaringnya berupa rotasi pada

setiap Bagian Klinik dengan durasi waktu yang telah

ditentukan untuk setiap bagian dan diakhiri dengan

ujian

Tahap kedua: dilaksanakan di Puskesmas/ Layanan

Primer


8. Internship

Internship bertujuan untuk memandirikan Dokter

yang baru lulus

Dilaksanakan di wahana internship yang telah

ditetapkan

Pelaksanaan internship tidak lagi di bawah tanggung

jawab Fakultas Kedokteran


1. Evaluasi mahasiswa (ujian)

● Ujian/ penilaian blok

- Observasi oleh Tutor (Penilaian tutorial)

- Ujian tulis

- Skills lab: CEP (Checklist Evaluation of live Performance)

- Ujian praktikum

● Ujian tahunan dan ujian akhir (komprehensif):

- Ujian tulis (progress test)

- Skills lab: OSCE (Objective Structure Clinical Evaluation)

2. Evaluasi tutor

3. Evaluasi program

Evaluasi di Tahap Akademik


Penilaian Tutorial

Menggunakan borang terstruktur:

- Partisipasi

- Komunikasi

- Persiapan

- Keaktifan

- Critical thinking

- Group skills

- General comments


Tanggung Jawab Mahasiswa

Mengikuti semua proses pembelajaran

Peraturan Akademik:

- Menghadiri semua kegiatan akademik

- Tidak hadir harus dengan alasan yang dapat

diterima pimpinan

- Sanksi: tidak diizinkan mengikuti ujian blok

Mematuhi semua peraturan yang berlaku di Institusi

(Universitas dan Fakultas)

Attitude/ Prilaku


Ruang tutorial

Ruang kuliah

Library

ICT

Laboratorium: - ilmu kedokteran dasar

- skills lab

Ruang diskusi pleno

Rumah-sakit pendidikan

Sarana Pendukung


Menetapkan kredit (sks) per blok

Aktivitas akademik di dalam setiap blok

didasarkan pada sks per blok

Indeks Prestasi (IP) / Student‘s Academic

Performance

Penasihat Akademik / counselor

Efisiensi dan Produktivitas




Tell me and I will forget

Show me and I will remember

Involve me and I will understand

Step back and I will act

Chinese proverb


Creating Awareness


A safe and exciting flight

Documents

PROBLEM-BASED LEARNING (PBL) - Unandrepository.unand.ac.id/18857/1/Problem Based Learning ( PBL).pdf · Bimbingan Aktivitas Kemahasiswaan dan Tradisi Ilmiah ... Community-Oriented