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"Latar Belakang:Presentasi kasus merupakan bagian dari experiential learning dalam Kolb's learning cylce yaitu dalam fase refleksi. Pelaksanaan presentasi kasus saat ini tidak optimal sehingga terjadi penurunan kualitas. Hal ini disebabkan karena adanya perbedaan persepsi antara peserta didik dan dosen klinik mengenai manfaat pelaksanaan presentasi kasus. Penelitian ini menggali secara mendalam proses pelaksanaan presentasi kasus dan mengidentifikasi kendala pelaksanaannya di rumah sakit pendidikan FK Unsyiah. Metode: Jenis penelitian yang dilakukan adalah penelitian kualitatif, dengan rancangan studi kasus. Penelitian dilakukan dengan melakukan wawancara mendalam terhadap 6 koordinator pendidikan dan 18 dosen klinik, Focus Group Discussion FGD terhadap 57 peserta didik, studi dokumen dan observasi dari 6 Bagian yang diteliti, yaitu Ilmu Penyakit Dalam, Ilmu Kesehatan Anak, Ilmu Bedah, Obstetri dan Ginekologi, Ilmu Kesehatan Kulit dan Kelamin dan Ilmu Penyakit Saraf. Data dianalisis melalui tiga tahapan yang meliputi reduksi data, penyajian data dan penarikan kesimpulan. Hasil: Presentasi kasus merupakan metode pembelajaran yang sangat bermanfaat bagi peserta didik dan dosen klinik. Namun, dalam pelaksanaannya terdapat kendala yang dapat mempengaruhi kualitas presentasi kasus. Kendala utama yang teridentifikasi dari dosen klinik adalah kurangnya waktu yang dialokasikan untuk pelaksanaan presentasi kasus. kendala dari peserta didik yaitu kesungguhan dalam mengerjakan dan pemahaman mengenai manfaat terhadap presentasi kasus. Kendala sarana dan prasarana berupa ruangan diskusi yang masih kurang serta format penyusunan dan format penilaian belum dimiliki oleh seluruh Bagian. Kendala dari rumah sakit berupa variasi kasus yang kurang bervariasi karena sistem rujukan bertingkat. Kesimpulan: Kendala dalam pelaksanaan presentasi kasus harus menjadi bahan evaluasi bagi pengelola program pendidikan profesi dokter, agar manfaat presentasi kasus dapat maksimal diraih oleh peserta didik tahap klinik.

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Background: Case presentation is a part of reflection in experiential learning in Kolb rsquo s learning cycle. Literatures demonstrates many benefits that students can reach with a good case presentation. But, there is a mismatch between clinical educators rsquo expectation and students rsquo perceptions of case presentation, so that the students cannot obtain an optimum benefits of case presentation. This research was conducted to explore in depth process of case presentation implementation and also to identify its implementation barriers in teaching hospital of Unsyiah Medical School.

Methods: Qualitative research with case study design was used for this research. Study casetheme used is case presentation implementation in Dr.Zainoel Abidin teaching hospital Banda Aceh. Data were taken using in depth interview with 6 education coordinators and 18 clinical teachers, focus group discussions with 57 students, observation, and documentation studies, from six departments. Followed by analysis through three stages including data reduction, data presentation, and conclusions.

Results: Case presentation is an useful and effective teaching method in clinical eduation. But, there were various barriers from clinical teacher, students, teaching hospital and learning support that can influence the benefit of case presentation identified. Factors identified in the clinical teachers are lack of time allotted. Factors identified in the students are lack of preparations about case presentation, and also lack understanding about case presentation method. Factors identified in the teaching hospitals are less variation of patients in some cases. Means of learning support in the form of modules containing learning outcomes and objectives clearly, form of assessment and also comfortable rooms supporting case presentation is yet exist.

Conclussion: There are various barrier factors of case presentation implementation which have been identified in this qualitative study. This barriers must becoming parameters on monitoring and program evaluation to improve the quality of a case presentation. "

"Latar Belakang: Umpan balik merupakan komponen penting dalam pendidikan kedokteran yang dapat meningkatkan pembelajaran. Umpan balik pada tahap akademik memegang peran penting dalam pembelajaran konsep dasar untuk persiapan tahap klinik. Banyak faktor yang mempengaruhi efektivitas proses umpan balik ini, salah satu di antaranya yaitu aspek budaya. Penelitian ini bertujuan untuk mengeksplorasi aspek budaya dalam proses umpan balik pada peserta didik dan staf pengajar di pendidikan kedokteran tahap akademik. Metode: Penelitian ini menggunakan metode kualitatif dengan pendekatan etnografi. Pengumpulan data dilakukan selama bulan Februari sampai Maret 2016 melalui Focus Group Discussion (FGD) peserta didik angkatan 2009 hingga 2014, observasi latihan KKD dan wawancara mendalam staf pengajar di Fakultas Kedokteran Universitas Tarumanagara (FK UNTAR). Hasil FGD dan wawancara dituliskan dalam bentuk transkrip verbatim, kemudian dilanjutkan dengan analisis tematik dan koding. Analisis hasil observasi dilakukan dengan analisis tematik. Selanjutnya dilakukan reduksi dan penyajian data. Hasil: Hasil penelitian ini menunjukkan banyaknya faktor yang berperan dalam proses umpan balik, baik pada saat pencarian maupun pada saat penerimaan dan pemberian umpan balik yang selanjutnya akan menentukan efektivitasnya. Aspek budaya berperan dalam beberapa hal. Budaya collectivism, high power distance dan sopan santun berperan dalam perilaku mencari umpan balik. Budaya femininity, masculinity pada peserta didik, serta terdapatnya kompetensi budaya pada staf pengajar dan dipegangnya prinsip pendidikan nasional Indonesia, Tut Wuri Handayani, berkontribusi dalam efektivitas umpan balik. Kesimpulan: Aspek budaya memegang peran penting dalam proses umpan balik. Peran budaya tampak pada perilaku mencari umpan balik dan merupakan faktor penting untuk meningkatkan efektivitas umpan balik. Institusi perlu meningkatkan kemampuan staf pengajar dan peserta didik dalam memaknai proses umpan balik yang sadar budaya. Kompetensi budaya merupakan salah satu kemampuan yang dapat mendukung hal tersebut. Selain itu, institusi perlu menyusun kebijakan untuk membudayakan umpan balik pada lingkungan pendidikan kedokteran.

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Background: Feedback is an important element in medical education since it can improve learning. Feedback has a significant role in learning in basic concepts during undergraduate medical program as a preparation for learning in the clinical years. A lot of factors influencing feedback process effectiveness, one of them is cultural aspect. This research was aimed at exploring cultural aspect related to feedback process within medical students and faculty in undergraduate medical education program.

Method: A qualitative study using an ethnography approach was applied as a research method. Data collection was conducted between February and March 2016 through Focus Group Discussion (FGD) with 2009-2014 batch of medical, direct observation of skills teaching in clinical skills laboratory and in-depth interview with the faculty members of Faculty of Medicine Tarumanagara University. Thematic analysis and coding were used to analyze FGD and in-depth interview transcripts and also observational data. Data reduction and presentation were then conducted.

Results: The themes emerged are related to influencing factors in feedback-seeking behaviour, feedback process and feedback effectiveness. Cultural aspects play an important role at some points within the feedback process. Collectivism, high power distance and politeness are cultural aspects found in feedback-seeking behaviour. Femininity-masculinity in medical students along with cultural competence of faculty members and also the principle of ?Tut Wuri Handayani? (the identity of Indonesian national education) are contributing factors in feedback effectiveness.

Conclusion: Cultural aspects are the key to understand the influencing factors in feedback-seeking behaviour and feedback effectiveness. There is a need for medical education institution to encourage faculty and medical students‟ cultural awareness within the feedback process. Cultural competence is an important component fit for that purpose. Moreover, institution needs to set a policy in order to establish feedback culture in medical education."

"ABSTRAKLatar Belakang :Karsinoma kolorektal (KKR) merupakan salah satu kanker tersering di duniadan menjadi beban kesehatan global. KKR dapat muncul melalui 4 jalur patogenenis yangberbeda, salah satu di antaranya adalah serrated pathway. Pengaktifan jalur ini mengakibatkanperubahan progresif lesi-lesi prekursor seperti polip serrated, termasuk di dalamnya sessileserrated adenoma (SSA) dan tradisional serrated adenoma (TSA), menjadi karsinoma,diantaranya adenokarsinoma serrated (AS). AS diduga memberikan prognosis yang burukterhadap pengobatan. Gambaran histomorfologi adenokarsinoma serrated lebih banyakdidasarkan pada kemiripan dengan lesi prekursor SSA atau TSA, sehingga sulit dikenali.Penelitian ini bertujuan mengetahui persentasi AS diantara kasus KKR di Departemen PatologiAnatomik FKUI/RSCM, dan mengetahui gambaran histomorfologi yang bermakna dalammenandakan AS.Bahan dan Metode :Dilakukan review slide dari kasus-kasus KKR yang tercatat di arsipDepartemen Patologi Anatomik FKUI/RSCM. Penilaian histomorfologi dilakukan berdasarkankriteria yang diajukan oleh Tuppurainen et al, meliputi epithelial serration, sitoplasmaeosinofilik, inti vesikuler, anak inti nyata, nekrosis, produksi musin, dan adanya cell balls. Kasusdikategotikan ke dalam ?Pasti? dan ?Samar? AS, serta ?Klasik?. Dilakukan juga penilaian faktorprognostik, berupa invasi limfovaskular, invasi perineural, infiltrasi limfosit, dan tumor budding.Hasil :Didapatkan 41 kasus (35%) tergolong kategori ?Pasti? AS, 11 kasus (9.4%) tergolong?Samar? AS, dan sisanya sebanyak 65 kasus (55.6%) tergolong kategori adenokarsinoma?Klasik?. Didapatkan pula bahwa kriteria histomorfologi yang dapat dijadikan penanda serratedadalah epithelial serration (p=0.029), anak inti nyata (p=0.041), dan nekrosis <10% (p=0.014).Selain itu, didapatkan pula bahwa faktor-faktor yang berhubungan dengan morfologi serratedadalah yaitu lokasi tumor (p=0.010), infiltrasi limfosit (p=0.000), dan tumor budding (p=0.012).Kesimpulan :Adenokarsinoma serrated ditemukan 35% dari kasus-kasus adenokarsinoma kolondi Departemen Patologi Anatomik FKUI/RSCM. Gambaran histomorfologi yang menandakanadenokarsinoma serrated adalah adanya epithelial serration, anak inti nyata, dan nekrosis yangsedikit.Kata Kunci :Adenokarsinoma serrated, serrated pathway, histomorfologi, karsinomakolorektal.

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ABSTRACTBackground: Colorectal carcinoma (CRC) is one of the most common cancers in the world andbecome a global health burden nowadays. CRC may arise through 4 different pathways, one ofwhich is serrated pathway. Activation of this pathway results in progressive changes of precursorlesions such as sessile serrated adenomas (SSA) and traditional serrated adenomas (TSA), intocarcinoma. One type of carcinomais serrated adenocarcinoma (SA), in which known to give apoor prognosis to patient. Histomorphology overview shows that SA has similarity with SSA orTSA, making it difficult to recognize. This study aims to determine the percentage of the SAamong cases of CRC in Department of Anatomical Pathology Faculty of Medicine UniversitasIndonesia/Cipto Mangunkusumo Hospital, and to know histomorphological features that aremeaningful in indicating SA.Materials and Methods: CRC cases were collected from archive, and review slide wasconducted using morphological criteria proposed by Tuppurainen et al. This criteria includesepithelial serration, eosinophilic cytoplasm, vesicular nuclei, prominent nucleolei, necrosis,mucin production, and cell balls. Case were categorized into the "Definite" and "Pausy" SA, aswell as the "Classic". Assessment of prognostic factors, such as limfovascular invasion,perineural invasion, infiltration of lymphocytes and tumor budding, were also conducted.Results: There were 41 cases (35%) belong to the category of "Definite" SA, 11 cases (9.4%)classified as "Pausy? SA, and 65 cases (55.6%) belong to the category of "Classic"adenocarcinoma. Histomorphological analysis found that criteria showing significancy to SAwere epithelial serration (p = 0.029), prominent nucleolei (p = 0.041), and necrosis <10% (p =0.014). Several factors showed relation to serrated morphology were location of the tumor (p =0.010), infiltration of lymphocytes (p = 0.000), and tumor budding (p = 0.012).Conclusion: Serrated adenocarcinoma were found approximately 35% among cases of colorectaladenocarcinoma in the Department of Anatomical Pathology, Faculty of Medicine/CiptoMangunkusumo Hospital. Histomorpoholigical features that indicates SA includesepithelial serration, prominent nucleolei, and scanty necrosis.Keywords: Serrated adenocarcinoma, serrated pathway, histomorphological features, colorectalcarcinoma"

"Era globalisasi mendatang menuntut adanya peningkatan mutu lulusan fakultas kedokteran negeri dan fakultas kedokteran swasta. Disamping harus meningkatkan mutu pelayanan kepada masyarakat, RSUP Fatmawati sebagai mitra pelaksana pendidikan dengan Fakultas Kedokteran Universitas Trisakti sejak tahun 1969, ditantang untuk memantapkan diri sambil memperbaiki penyelenggaraan pendidikan profesi calon dokter.Penelitian ini merupakan penelitian kualitatif formatif dan studi kasus dengan cara melakukan telaah mendalam, wawancara mendalam, pembagian /pengisian kuesioner dan melakukan observasi di empat (4) Staf Medis Fungsional atau Unit, yakni Unit Bedah, Unit Penyakit Dalam, Unit Kesehatan Anak, dan Unit Kebidanan.Hasil akhir penelitian ini berupa informasi dan pola Kepaniteraan Klinik pendidikan Program Studi Profesi Dokter, yang diharapkan dapat dipakai sebagai acuan pendidikan di sepuluh (10) rumah sakit lainnya yang dipakai sebagai lahan pendidikan profesi dokter Fakultas Kedokteran Universitas Trisakti.Saran yang diusulkan dapat dipakai sebagai rekomendasi bagi Direktur RSUP Fatmawati dan Dekan Fakultas Kedokteran Universitas Trisakti serta jajarannya untuk menyempurnakan penyelenggaraan Program Studi Profesi Dokter. Hasil penelitian ini diharapkan dapat bermanfaat bagi semua pihak. yang berkecimpung dalam pendidikan kedokteran di negeri yang kita cintai ini.

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The Analysis of Implementation the Study Program of Medical Doctor Profession of the Faculty of Medicine of Trisakti University in the Fatmawati General Hospital, Cases Study in Four Functional Medical Staff or UnitsThe coming globalization era is going to need the improvement of graduate quality of the state and private FACULTY OF MEDICINE Besides being demanded to improve the service quality to the society, the Fatmawati General Hospital as a partner of the faculty of medicine of Trisakti University to implement the education since 1969 has been being challenged to establish itself while improving the education of medical doctor candidate profession.This was a qualitatively formative research and cases study by doing a carefully examination, interview, questionnaire distribution, and carrying out an observation in the four Functional Medical Staff or Units ( Internal Medicine Unit, Surgery Unit, Pediatrics Unit, Gynecology and Obstetrics Unit). The final result of this research is to obtain the information and pattern of the Education of Study Program of Medical Doctor Profession, which is expected to be practicable or applicable as a reference of education in ten other hospitals which are used as the places of Education of Medical Doctor Profession of the faculty of medicine of Trisakti University.Suggestions proposed can be used as a recommendation for the Director of the Fatmawati General Hospital and Dean of the faculty of medicine of Trisakti University and Staff to improve the implementation of the Study Program of Medical Doctor Profession. Further, this research result is expected to be beneficial for anyone involved in the education of medicine in our beloved country."