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"Latar Belakang: Umpan balik membantu mahasiswa mencapai tujuan pembelajaran dan membantu staf pengajar menjamin pencapaian sasaran pembelajaran oleh mahasiswa. Berdasarkan penelitian, perbedaan persepsi mengenai umpan balik antara staf pengajar dan mahasiswa dapat menghambat proses pemberian dan penerimaan umpan balik. Sampai saat ini belum diketahui proses pemberian dan penerimaan umpan balik dalam diskusi Problem Based Learning (PBL) di Fakultas Kedokteran Universitas Abulyatama, sehingga perlu dilakukan eksplorasi mengenai gambaran keseluruhan pemberian dan penerimaan umpan balik pada tutor dan mahasiswa tahap pre-klinik. Pemberian umpan balik konstruktif dapat memotivasi mahasiswa, memperbaiki kinerja dan mempersiapkan diri untuk masuk ke tahap klinik. Metode : Penelitian ini menggunakan metode kualitatif dengan rancangan fenomenologi. Pengambilan data menggunakan focus group discussion (FGD) pada tutor dan mahasiswa pra klinik serta observasi kegiatan diskusi PBL dengan menggunakan daftar tilik. Hasil: Berdasarkan analisis data kualitatif ditemukan tiga faktor yang mempengaruhi pemberian umpan balik oleh tutor, yaitu; 1) Tutor kurang memahami materi pembelajaran, 2) Sikap tutor yang tidak peduli terhadap diskusi, 3) Tidak memiliki waktu untuk memberikan umpan balik. Sedangkan faktor-faktor yang mempengaruhi diterima atau tidaknya umpan balik oleh mahasiswa yaitu; 1) Sikap tutor (ramah, arogan dan tidak peduli) selama diskusi PBL, 2) Karakter mahasiswa (dapat menerima dan tidak dapat menerima umpan balik negatif) , 3) Reaksi afektif, 4) Self assessment, 5) Kepercayaan mahasiswa terhadap staf pengajar kurang dan 6) Umpan balik tidak spesifik. Kesimpulan : Faktor-faktor yang mempengaruhi proses pemberian umpan balik harus mendapat perhatian khusus dari tutor agar umpan balik yang diberikan dapat ditanggapi oleh mahasiswa. Tutor dan mahasiswa sepakat bahwa umpan balik konstruktif dapat meningkatkan motivasi belajar mahasiswa

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Background: Feedback should help student to achieve learning objectives and teacher to ensure achievement of learning objectives by student. Based on the research, the different perceptions about feedback between teachers and students can obstruct the process of delivering and receiving the feedback process. Hitherto, the process of delivering and receiving feedback in Problem Based Learning discussion at the Medical School of University of Abulyatama is not known yet. Thus, an exploration of the overall picture of delivering and receiving feedback to the tutors and the students of preclinical stage is necessary. The delivery of constructive feedback should be able to motivate students in improving their performance and prepare them to enter the Clinical Stage.

Method : This study used qualitative research methods with phenomenology study. Data was retrieved trough focus group discussion (FGD) on tutors and students and observation of PBL discussions using a checklist.

Result: Based on the qualitative data analysis it is found that three influential factors for the delivery of feedback are 1) Incomprehension of tutors upon the learning material, 2) Lack of attention on discussion, 3) Lack of time to deliver the feedback. Whereas, factors that influenced whether or not feedback was received by the students are 1) Attitude of tutors (friendly, arrogant and careless) during discussion, 2) Students’ characteristic (can or cannot receive negative feedback), 3) Affective reaction, 4) Self-assessment, 5) Lack of trust on the tutors, and 6) General feedback.

Conclusion : Factors that influence the delivery of feedback should gain special attention from the tutors, so that students can receive the feedback given. Tutors and students agree that constructive feedback can improve students’ learning motivation."

"ABSTRAKKanker kolorektal KKR dianggap sebagai masalah kesehatan utama, salah satu jenis kanker yang paling sering terjadi serta penyebab kematian kedua terbesar di negara barat dan di Indonesia. Adenokarsinoma kolorektal serrated AKS merupakan salah satu tipe dari KKR. Salah satu jalur karsinogenesis kolorektal adalah jalur serrated yang diketahui melibatkan mutasi gen KRAS. Penanda tumor lain yang juga terlibat dalam proses karsinogenesis adalah P53 dan Bcl-2. Gambaran histomorfologik yang ditemukan oleh Tuppurainen dkk. saat ini digunakan sebagai penanda AKS. Terbatasnya sarana laboratorium patologi molekular di Indonesia, menekankan pentingnya membuat model skoring gambaran histomorfologik AKS dan atau ekspresi protein P53 serta Bcl-2 untuk memprediksi mutasi KRAS.Penelitian potong lintang terhadap 39 kasus AKS didapatkan dari Arsip Departemen Patologi Anatomik FKUI/RSCM selama tahun 2013 ndash;2015. Setiap kasus dikumpulkan data klinisnya, dan dinilai ulang karakteristik histomorfologik dan penanda tumor Bcl2 dan P53 , serta dilakukan pemeriksaan status KRAS. Penelitian histomorfologik dilakukan per kasus dan per contoh yaitu terhadap 100 kelenjar/kasus.Pada penelitian ini, kasus AKS ditemukan paling banyak pada laki-laki 51,3 , usia ge; 40 tahun 71,8 , lokasi di kolon kiri 84,6 , tidak memiliki metastasis 92,3 , status mutasi KRAS 71,8 . Ekspresi protein P53 didapatkan pada 69,2 dan protein Bcl-2 51,3 , tidak didapatkan hubungan bermakna ekspresi protein tersebut dengan status KRAS. Gambaran histomorfologik status KRAS didapatkan hubungan pada epitel serrated, lokasi inti sel, kondisi inti, sitoplasma dan musin. Odds ratio tertinggi ditemukan pada epitel serrated OR 2,7; IK 95 2,30 ndash;3,07 dan musin OR 2,0; IK 95 , 1,15 ndash;3,65 . Berdasarkan uji statistik didapatkan model nilai skoring yang terdiri dari epitel serrated, keadaan lokasi inti, kondisi inti dan adanya musin CI 95 antara 61 ndash;65 . Nilai sensitivitas dan spesifisitas berdasarkan nilai titik potong pada angka 16 sensitivitasnya sebesar 72 dan spesifisitasnya sebesar 48 .Simpulan: Didapatkan model sistem skor dengan titik potong 16 untuk memprediksi adanya mutasi KRAS berdasarkan, epitel serrated, lokasi inti sel, kondisi inti, dan adanya musin.Kata kunci: Adenokarsinoma kolorektal serrated, Bcl-2, jalur serrated, Kanker kolorektal, mutasi KRAS, P53

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ABSTRACTColorectal cancer CRC is considered as major health problem, one type of cancer that most often occurs as well as the second largest cause of death in western countries and in Indonesia. Serrated colorectal adenocarcinoma SA is one type of CRC. One of colorectal carcinogenesis pathway is serrated pathway that known to involve KRAS gene mutation. Other tumor markers that also involved in the process of its carcinogenesis were P53 and Bcl 2. Histomorphological criteria found by Tuppurainen et al currently used as marker of SA. Limited facilities of molecular pathology laboratory in Indonesia emphasize the needs of making scoring model by using histomorphological features of SA and or P53 and Bcl 2 protein expression to predict KRAS mutation.A cross sectional study conducted to 39 cases of SA registered in Departement of Anatomical Pathology FMUI Ciptomangunkusumo Hospital from 2013 ndash 2015. All clinical data related to the cases were collected. Each case was reevaluated based on Tuppurainen histomorphological criteria, tumor markers Bcl 2 and P53 , and KRAS status. Histomorphological examination is conducted per case and per instance to 100 nodes case.Present study showed that most cases of SA was found in male 51.3 , aged ge 40 years 71.8 , located in left colon 84.6 , did not have metastasis 92.3 , with KRAS mutation status 71.8 . P53 and Bcl 2 protein expressions were found in 69.2 and 51.3 respectively, with no significant association with KRAS status. Histomorphological features of KRAS status found in epithelial serration, nucleus location, nucleus condition, cytoplasm and mucin. Epithelial serration has the highest odds ratio OR 2.7 IK 95 2.30 ndash 3.07 followed by mucin OR 2.0 IK 95 , 1.15 ndash 3.65 . Statistical values showed scoring models consisted of epithelial serrations, nucleus location, nucleus condition and presence of mucin CI 95 between 61 ndash 65 . The sensitivity and specificity cut off point located on the number 16, with sensitivity value was 72 and specificity 48 .Conclusion A scoring system model yielded 16 as cut off score was obtained to predict KRAS mutations based on epithelial serrations, nucleus location, nucleus condition and presence of mucin.Keywords Bcl2, Colorectal cancer, colorectal serrated adenocarcinoma, KRAS mutation, P53, serrated pathway"

"Radiasi merupakan terapi pilihan untuk kanker serviks stadium III B, namun permasalahan timbul karena adanya sifat radioresisten. Sel punca kanker SPK merupakan salah satu faktor yang diduga berkontribusi terhadap hal tersebut. SOX2 dan OCT4 merupakan faktor transkripsi yang mengekspresikan sifat-sifat SPK, yaitu mengontrol sifat pluripoten, self-renewal, berperan pada karsinogenesis, metastasis, resistensi terhadap terapi dan rekurensi tumor. Faktor apoptosis, DNA repair dan telomerase merupakan mekanisme yang berkaitan dengan radioresisten. Penelitian ini bertujuan untuk mempelajari hubungan antara SOX2 dan OCT4 sebagai penanda SPK terhadap respons terapi radiasi, serta kaitannya dengan faktor apoptosis caspase-3 , DNA repair Chk1 dan telomerase hTERT .Penelitian ini merupakan case control, terhadap 48 kasus karsinoma sel skuamosa serviks stadium III B yang telah menjalani terapi radiasi/kemoradiasi di RS Cipto Mangunkusumo/FKUI. Kasus dibagi dalam 2 kelompok, yaitu hasil terapi komplet 27 kasus dan hasil terapi inkomplet 21 kasus . Kasus dengan respons awal terapi radiasi baik dilakukan pemeriksaan bulan Pap smear dan HPV pada bulan ke-6 atau sampai ke-12 setelah terapi. Ekspresi SOX2, OCT4, caspase-3, Chk1 dan hTERT diperiksa secara imunohistokimia dari blok parafin biopsi awal.Ekspresi kuat SOX2 dan OCT4 dengan H-score masing-masing lebih dari 96,6 dan 61,9 mempunyai hubungan bermakna dengan respons awal terapi radiasi maupun respons akhir terapi radiasi SOX2 p = 0,017, p = 0,004 dan OCT4 p < 0,001, p < 0,001 . Ditemukan hubungan bermakna antara ekspresi Chk1 dan hTERT dengan respons awal terapi radiasi Chk1 p = 0,006, hTERT p = 0,029 . Tidak ditemukan hubungan yang bermakna antara ekspresi caspase-3, Chk1, hTERT dengan ekspresi SOX2 dan OCT4. Uji multivariat menunjukkan bahwa SOX2 dan OCT4 yang paling memengaruhi respons terapi OR = 5,12, p = 0,040 dan OR = 17,03, p < 0,001, secara berurutan . Uji probabilitas menunjukkan kemungkinan respons akhir terapi radiasi inkomplet sebesar 87,91 bila ekspresi kedua penanda SPK kuat.Ekspresi kuat SOX2 dan OCT4 dapat memprediksi hasil terapi radiasi inkomplet pada karsinoma serviks stadium III B.

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Radiotherapy is the main choice of treatment for stage III B cervical cancer, but radioresistance becomes a difficult matter. Cancer stem cell is one of the factors suspected involving in radioresistant cancers. SOX2 and OCT4 are transcription factors which have pluripotent cell characteristics, and self renewal ability. They also involved in carcinogenesis, metastasis, tumor recurrent, and resistance toward therapy. Apoptotic, DNA repair, and telomerase factors are mechanisms that also contribute to radioresistance. This study aims to know the role of SOX2 and OCT4 as CSC markers, apoptotic factor caspase 3 , DNA repair Chk1 and telomerase hTERT toward radiotherapy.The design of this study was case control with 48 cases of stage III B cervical squamous cell carcinoma patients who had finished receiving radiation chemo radiation therapy at Cipto Mangunkusumo Hospital FMUI, Jakarta. They were classified in 2 groups based on the final response of treatment, which were complete and incomplete one. Pap smear and DNA HPV were performed in month 6 or until month 12 after therapy for good initial therapy. Immunohistochemistry was done to analyze SOX2, OCT4, caspase 3, Chk1 and hTERT expression from the paraffin block of initial biopsy.Strong expression of SOX2 and OCT4 with each H score was higher than 96.6, and 61.9 had significant association with both initial and final therapy response SOX2 p 0.017, p 0.004 and OCT4 p 0.001, p 0.001, repectively . There was significant association between expression of Chk1 and hTERT, and initial therapy response p 0.006 for Chk1, and p 0.029 for hTERT . No significant differences were found between caspase 3, Chk1, hTERT, and SOX2 and OCT4. Multivariate analysis showed SOX2 and OCT4 were the most influenced antibodies for radiotherapy response OR 5.12, p 0.040, and OR 17.03, p 0.001, respectively . The likelihood of incomplete final therapy response was 87.91 if the expression both of CSC markers were strong.Expression of SOX2, and OCT4 could predict the incomplete radiotherapy of stage III B cervical cancer cases. "