GAMBARAN UMUM PELATIHAN ULTRASONOGRAFI DASAR OBSTETRI GINEKOLOGI
GAMBARAN UMUM
PELATIHAN
ULTRASONOGRAFI
DASAR OBSTETRI
GINEKOLOGI
BiranAfandi
Jakarta, 25-27 Februari 2013
Key Features of Mastery
Learning
• Adult learning
• Behavior modeling
• Competency-based
• Humanistic training
techniques
JHPIEGO, 1997
Adult Learning
Means that learning is
participatory,
relevant&practical. It builds
on what the participant
already knows or has
experienced and provides
opportunities for practicing
new skills.
JHPIEGO, 1997
Behavior Modeling
• Skill acquisition Knows the steps and their
sequence (if necessary) to
perform the required skill or
activity but need assistance
• Skill CompetencyKnows the steps and their
sequence (if necessary) &can
perform the required skill or
activity
• Skill Profciency Knows the steps and their
sequence (if necessary)
&efficiently performs the
required skill or activity
JHPIEGO, 1997
What is competency
based education?
Competencybased
education focuses on
learner performance
(learning outcomes) in
reaching specifc
objectives (goals and
objectives of the
5
Competency - Based
Training
1. Competency-based training
(CBT) is learning by doing. It
focuses on the specifc
knowledge, skills and attitudes
needed to carry out a procedure
or activity.
2. How the participant performs
(I.e., a combination of
knowledge, attitudes and most
important, skills) is emphasized
rather than just what
JHPIEGO, 1997
information the participant has
3.To successfully accomplish
CBT, the clinical skill or
activity to be taught must be
broken down into its essential
steps. Each step is then
analyzed to determine the
most efficient and safe way to
perform and learn it. The
process is called
standardization.
Once a procedure, such Caesarian
section, has been standardization,
competency-based learning
JHPIEGO, 1997
LEMBAR PENILAIAN
MEMIMPIN PENGAWASAN PUERPERIUM
NORMAL
Berinilaiuntuksetiaplangkahklinikdengank
etentuansebagaiberikut:
0 :Lalai: Langkahkliniktidakdilakukan
V:Baik:
Langkahklinikdilakukandenganbenardanb
aik,
sesuaidenganurutannyadanwaktu
yang dipergunakancukupefektif
X:
Kurang:
Pelaksanaanlangkahklinikmasihdenganker
aguandanhasilpekerjaannyakurangbaik,
urutanlangkahbelumsepenuhnyaberuruta
ndanwaktu yang dipergunakanlebih lama
LEMBAR PENILAIAN
MEMIMPIN PENGAWASAN PUERPERIUM
NORMAL
PROSEDUR/LANGKAH KLINIK
KASUS
2. PEMERIKSAAN
IBU
Anamnesis:
2.1.
Menanyakankeluhanpasiendankeluhanmengenaibayi
nya
2.2. Menyanyakan:
•
Apakahdapatistirahat/tidurcukup
•
Apakahmakanandanminuman yang
disediakanselaludapatdihabiskanataumasihteras
akurang
•
Apakahobat yang diberikandiminum
•
Apakahadamasalahmobilisasi
•
Apakahbuang air kecillancar
•
Apakahsudahbuang air besar
•
Bagaimanakeadaanlokhiadanapakahadaperdara
han
•
Apakahdapatmenyusuibayinyadenganbaik
•
Apakahbayinyadapattidurtenang
•
Apakahpasienmampumerawatbayinya
(mamndikandanmemakaikanpakaian,
LEMBAR PENILAIAN
MEMIMPIN PENGAWASAN PUERPERIUM
NORMAL
PROSEDUR/LANGKAH KLINIK
KASUS
Pemeriksaanfsik:
2.3. Memperhatikan keadaan umum
pasien, kesadaran, penampilannya
2.4. Memeriksa tekanan darah, suhu,
nadi dan frekuensi pernafasan
2.5. Memeriksa status generalis sesuai
dengan keluhan yang ada
LEMBAR PENILAIAN
MEMIMPIN PENGAWASAN PUERPERIUM
NORMAL
PROSEDUR/LANGKAH KLINIK
KASUS
2.6. Meminta pasien membuka
pakaiannya di daerah yang
akandiperiksa.
2.7. Memeriksa payudara
2.8. Memberi nasihat mengenai
perawatan payudara
2.9 Memeriksa abdomen dan
memeriksa tingginya fundus uteri
serta kontraksinya
2.10. Memeriksa apakah kandung
LEMBAR PENILAIAN
MEMIMPIN PENGAWASAN PUERPERIUM
NORMAL
PROSEDUR/LANGKAH KLINIK
KASUS
2.11. Pasien dalam keadaan tidur
miring, diperiksa:
• Luka jahitan episiotomi
• Kebersihan daerah perineum
• Lokhia yang keluar
• Adakah perdarahan dan pada
anus apakah ada hemorrhoid
2.12. Mengembalikan posisi pasien
dan
bantu merapikan kembali
LEMBAR PENILAIAN
MEMIMPIN PENGAWASAN PUERPERIUM
NORMAL
PROSEDUR/LANGKAH KLINIK
KASUS
3. PEMERIKSAAN BAYI & PROSES
MENYUSUI
3.1. Cuci tangan dalam air mengalir
3.2. Perhatikan:
• Keadaan umum bayi
• Refleksnya
• Keadaan tali pusat
• Apakah apa penurunan berat badan
LEMBAR PENILAIAN
MEMIMPIN PENGAWASAN PUERPERIUM
NORMAL
PROSEDUR/LANGKAH KLINIK
KASUS
3. PEMERIKSAAN BAYI & PROSES
MENYUSUI
3.3. Perhatikan apakah ibu dapat menyusui
dalam posisi yang baik dan benar
3.4. Perhatikan apakah bayi menyusu
dalam posisi yang benar
3.5. Perhatikan cara ibu memegang bayi
dan memegang payudara
3.6. Perhatikan cara bayi mengisap dan
cakupan mulut bayi pada areola
mammae
Humanistic Training Techniques
The use of more humane (humanistic)
techniques also contributes to better clinical
training.
A major component of humanistic training is the
use of anatomic models, which closely simulate
the human body, and other learning aids.
Working with models initially allows participants
to learn and practice new skills in a simulated
setting rather than with clients.
This reduces stress for the learner as well as
risk of injury and discomfort to the client.
Thus, the effective use of models (humanistic
approach) is an important factor in improving
the quality of clinical training and, ultimately,
service provision.
JHPIEGO, 1997
Before a participant performs a clinical
procedure with a client, two learning
activities should occur:
•
•
The clinical trainer should demonstrate the
required skills and client interactions several
times using an anatomic model and
appropriate training videotape.
Under the guidance of the clinical trainer, the
participant should practice the required skills
and client interactions using the model and
actual instruments in a setting that is as
similar as possible to the real situation.
Only when skillcompetency and some degree
ofskillproficiency have been demonstrated
should participants have their first contact with a
client.
JHPIEGO, 1997
Comparison of the Traditional Years-intraining Approach to Residency Education
with Competency-based Training,
Years-in-training
approach
•
•
•
•
•
Requires specifed number of
•
years in training, geared to
attainment of specifc skills
Resident evaluated by certifying
opinion of the program director
that the trainee is ready to
•
practice; evaluation may be
supplemented by required
examinations during training
•
Board certifcation
No specifc measures for training
in each specialty; no specifc
standardized measures for
ensuring that competency has
•
been achieved in the time allotted
Concern by some trainees that
•
they may not be competent to
perform required procedural or
manage particular patients.
Competency-based
training
Time taken to acquire
knowledge and skills based on
the abilities of individual
trainees rather than on the
number of years in training
Provision of an algorithm of
the training experience as a
blueprint for trainees
No limit on numbers of years
in training (except defnition
of minimal and maximal
times)
Training in each specialty by
recognized experts
Competency judged by the
program director
supplemented
by newly
Long MD. CBT…Acad.
Med.
17
2000;75:1178–83.
developed, standardized set
Long MD. CBT…Acad. Med. 2000;75:1178–
18
83.
19 MODUL OBSTETRI DAN
Modul Judul Modul
GINEKOLOGI
1
Ketrampilan klinik dasar
2
Pengajaran, telaah dan penilaian
3
Teknologi informasi, peraturan klinis dan penelitian
4
Isu etik dan legal
5
Ketrampilan bedah inti (pra-operatif)
6
Penanganan pasca operasi (post-operatif)
7
Prosedur pembedahan (intra-operatif)
8
Asuhan antenatal
9
Kedokteran maternal
10
Penanganan persalinan
11
Asuhan kelahiran
12
Masalah pasca persalinan dan neonatus
13
Masalah-masalah ginekologi
14
Subfertilitas
15
Kesehatan reproduksi dan seksual
16
Asuhan kehamilan awal
17
Ginekologi onkologi
18
Uroginekologi
19
Pengembangan profesionalisme
Bas
ic
Basic skill and
knowledge
Materi MRCOG 1
WORKSHOP
Research
proposal
T1
T1
A
T1
B
Obstetri Safe
Motherho
od 1
Basic
surgical
skill
Basic1 CTG
Vaginal
surgery 1
Emergenc
y Team
App
Induksi
obstetri
APN, PONED, APK,
CTU, RN,
Manajemen laktasi,
PI, IVA, CMBM, EBM
T2
T2
A
T2
B
Obstetri Safe
Motherho
od 2
Basic
ultrasound
(Obs)
Perioperati
ve
medicine
Obstetric
surgical
skill
Vaginal
surgery 2
Gynecolog
y surgical
skill
Induksi
ginekologi
T3
T3
A
T4
T3
B
Ginekolog
i
Basic
ultrasound
Basic
(Gyn)
surgical
skill 2
Pengemba
ngan
Profesi
Induksi chief
Clinical training
skills
Clinical
governance
Ethico-medicolegal
Clinical and
medical audit
12 roles of
medical teacher
CEEBM
Leader in
emergency team
Family fnancial
management
JADWAL ACARA PELATIHAN USG DASAR
KOLEGIUM OBSTETRI DAN GINEKOLOGI
HARI PERTAMA
07.00-07.15
07.15-07.30
07.30-08.00
08.00-08.30
08.30-09.00
09.00-09.30
09.30-10.00
10.00-10.30
10.30-11.30
11.30-12.30
12.30-13.00
13.00-13.30
13.30-14.15
14.15-14.45
14.45-15.00
15.00-15.30
15.30-16.00
16.00-16.15
Registrasi
Pembukaan
Perkenalan, Harapan dan Kekhawatiran
Gambaran Umum Pelatihan (P)
Kuesioner Awal
Rehat Kopi
Panitia
Direktur Pelatihan
Direktur Pelatihan
Panitia
Introduksi USG (Diskusi dan Tanya Jawab)
+ Fisika Dasar USG
Peralatan, Ruang Periksa, dan Persiapan
Pemeriksaan
Teknik Dasar, Etika, Medikolegal, dan
Profesionalisme
ISHOMA
Live Demo dan hands on Ginekologi
Normal
Live Demo USG Normal trimester I (Hamil
10-12 minggu)
Panduan USG Dasar Ginekologi
Dasar-dasar pemeriksaan Doppler Obgin
(knowledge)
Rehat Kopi
Penilaian Cairan Amnion dan Plasenta
Meet the experts
Semua Pelatih
Rangkuman Hari Pertama
Tugas Baca Baca Bab ...
JADWAL ACARA PELATIHAN USG DASAR
KOLEGIUM OBSTETRI DAN GINEKOLOGI
HARI KEDUA
07.15-07.30 Agenda dan Pemanasan
07.30-08.30 Diagnosis kelainan uterus dan adnexa yang
sering ditemukan (mioma, adenomiosis, kista
ovarium simpleks, endometrioma)
08.30-09.00 Diagnosis kehamilan ganda
09.00-09.15 Rehat kopi
09.15-10.00 Diagnosis kelainan pada trimester I (KE, BO,
Missed abortion, dan mola hidatidosa
10.00-10.30 Konsep Dasar Pemantauan Kesejahteraan Janin
10.30-11.30 Dasar-dasar KTG
11.30-12.30 ISHOMA
12.30-13.00 Live Demo USG Normal TM II (hamil 20-22
minggu)
13.00-13.30 Live Demo USG TM III (hamil 30-32 minggu)
13.30-14.15 Penerapan klinis CTG dan Profl Biofsik
14.15-14.45 Disfungsi Susunan Saraf Pusat
14.45-15.00 Pembuatan Dokumentasi, Laporan USG dan
KTG serta komunikasi
15.00-15.15 Rehat Kopi
15.15-15.45 Latihan Interpretasi KTG (1 Normal, kategori 2
atau 3)
15.45-16.15 Meet the experts
Semua
Pelatih
16.15-16.30 Rangkuman Hari Kedua
JADWAL ACARA PELATIHAN USG DASAR
KOLEGIUM OBSTETRI DAN GINEKOLOGI
HARI
KETIGA
07.3008.00
08.00–
09.00
09.00–
10.00
10.00–
10.15
10.15–
11.15
11.15–
12.00
12.00–
13.00
13.00–
13.30
13.30–
15.30
15.30–
Agenda dan Pemanasan
Hands-on : ginekologi normal
Hands-on : trimester 1 normal
Semua Pelatih
Semua Pelatih
Rehat kopi
Hands-on : trimester 1 patologi
Hands-on : trimester 2 dan 3
normal
Semua Pelatih
Semua Pelatih
ISHOMA
Uji akhir : 30 soal MCQ
Hands-on : trimester 2 dan 3
normal
Rehat Kopi
Semua Pelatih
Semua Pelatih
Panitia
MODUL PELATIHAN USG
KOLEGIUM
BUKU ACUAN
CONTENTS
I INTRODUKSI PELATIHAN USG
OBGIN DASAR
II FISIKA DAN BIOSAFETY
ULTRASONOGRAFI
III PERALATAN DAN RUANG
PERIKSA
IV PERSIAPAN PEMERIKSAAN
V TEKNIK DASAR PEMERIKSAAN USG
CONTENTS
• VI ASPEK ETIKA, MEDIKOLEGAL DAN
PROFESIONALISME
• VIIPANDUAN PEMERIKSAAN USG DASAR
TRIMESTER 1
• VIII PANDUAN PEMERIKSAAN USG
DASAR OBSTETRI TRIMESTER 2 DAN 3
• IX PEMERIKSAAN USG INTRA DAN
POSPARTUM
• X DASAR-DASAR PEMERIKSAAN
DOPPLER DI BIDANG
OBSTETRIGINEKOLOGI
CONTENTS
• XI PEMERIKSAAN USG
DASARGINEKOLOGI (GAMBARAN
NORMAL TERMASUK IDENTIFIKASI VU
DAN REKTUM)
• XIIPATOLOGI JINAK GINEKOLOGI,
KEHAMILAN EKTOPIK DAN MOLA
• XIII PEMBUATAN LAPORAN USG
OBSTETRI GINEKOLOGI
• XIV KARDIOTOKOGRAFI (KTG)
Editor Ketua
Prof. Dr. dr. BiranAfandi, SpOG(K)
Editor
dr. BambangKarsono, SpOG(K)
dr. Herman Kristanto, MS, SpOG(K)
dr. Judi JanuadiEndjun, SpOG
dr. AndiDarma Putra, SpOG(K)
dr. AzenSalim, SpOG(K)
Prof. Dr. dr. Soegiharto Soebijanto,
SpOG(K)
KONTRIBUTOR
1. Prof. Dr. dr. SoegihartoSoebijanto, SpOG(K)Dep.Obgin FK-UI
2. Prof. Dr. dr. BiranAfandi, SpOG(K)-Dep.Obgin
FK-UI
3. Prof. dr. HidayatWijayanegara, SpOG(K)Dep.Obgin FK-UNPAD
4. dr. George Adriaansz, SpOG(K) -Dep.Obgin
FK-UNSRI
5. dr. Herman Kristanto, MS, SpOG(K)Dep.Obgin FK-UNDIP
6. dr. BambangKarsono, SpOG(K) -Dep.Obgin
FK-UI
7. dr. AzenSalim, SpOG(K) -Dep.Obgin FK-UI
8. dr. Judi JanuadiEndjun, SpOG -Dep.Obgin
MITRA BESTARI
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Dr. dr. M. Fidel GanisSiregar, M.Ked(OG), SpOG(K)Dep.Obgin FK-USU
dr. EdyArdiansyah, M.Ked(OG), SpOG-Dep.Obgin FK-USU
dr. JohnyMarpaung, M.Ked(OG), SpOG-Dep.Obgin FK-USU
dr. DudyAldiansyah, M.Ked(OG), SpOG-Dep.Obgin FK-USU
dr. Mohd. Andalas, SpOG-Dep.Obgin FK-UNSYIAH
dr. Rajuddin, SpOG(K)-Dep.Obgin FK-UNSYIAH
dr. TgkPuspaDewi, SpOG-Dep.Obgin FK-UNSYIAH
dr. Cut MeurahYeni, SpOG(K)-Dep.Obgin FK-UNSYIAH
dr. Af Angelia Ratnasari, SpOG, MKes-Dep.Obgin FK-UNS
dr. AsihAnggraeni, SpOG-Dep.Obgin FK-UNS
dr. M. AdrianesBachnas, SpOG-Dep.Obgin FK-UNS
dr. WisnuPrabowo, SpOG-Dep.Obgin FK-UNS
dr. Daniel Henri Usmany, SpOG-Dep.Obgin FK-UNCEN
dr. David RandelChristanto, SpOG, MKes-Dep.Obgin FKUNCEN
MITRA BESTARI
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dr. ApterPatay, SpOG-Dep.Obgin FK-UNCEN
dr. NugrahantiPrasetyorini, SpOG(K)-Dep.Obgin FKUNIBRAW
dr. Sutrisno, SpOG(K)-Dep.Obgin FK-UNIBRAW
dr. TjokGdeAgungSuwardewa, SpOG(K)-Dep.Obgin FKUNUD
dr. A.A.N. Anantasika, SpOG(K)-Dep.Obgin FK-UNUD
dr. I NyomanBayuMahendra, SpOG-Dep.Obgin FK-UNUD
dr. I Gede Mega Putra, SpOG(K)-Dep.Obgin FK-UNUD
dr. Jon Madi, SpOG(K)-Dep.Obgin FK-UNRI
dr. Ruza P. Rustam, SpOG-Dep.Obgin FK-UNRI
dr. Yanuarman, SpOG-Dep.Obgin FK-UNRI
Dr. dr. JoserizalSerudji, SpOG(K)-Dep.Obgin FK-UNAND
dr. Yusrawati, SpOG(K)-Dep.Obgin FK-UNAND
dr. Putri Sri Lasmini, SpOG(K)-Dep.Obgin FK-UNAND
dr. Bobby IndraUtama, SpOG(K)-Dep.Obgin FK-UNAND
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MITRA BESTARI
Dr. dr. DwianaOcviyanti, SpOG(K)-Dep.Obgin FK-UI
dr. Aria Wibawa, SpOG(K)-Dep.Obgin FK-UI
dr. KanadiSumapradja, SpOG(K), MSc-Dep.Obgin FK-UI
dr. FitriyadiKusuma, SpOG(K)-Dep.Obgin FK-UI
dr. FernandiMoegni, SpOG(K)-Dep.Obgin FK-UI
dr. RukmonoSiswishanto, M.Kes, SpOG(K)-Dep.Obgin
FK-UGM
dr. DiahRumektiHadiati, MSc, SpOG(K)-Dep.Obgin FKUGM
dr. Irwan T. Rachman, SpOG(K)-Dep.Obgin FK-UGM
dr. AhsanuddinAttamimi, SpOG(K)-Dep.Obgin FK-UGM
dr. Detty S. Nurdiati, MPH, PhD, SpOG(K)-Dep.Obgin FKUGM
Dr. dr. Freddy W. Wagey, SpOG(K)-Dep.Obgin FKUNSRAT
dr. John J. E. Wantania, SpOG, IBCLC-Dep.Obgin FK-
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MITRA BESTARI
dr. Julian Dewantiningrum, MSi.Med, SpOG-Dep.Obgin
FK-UNDIP
dr. EdiwibowoAmbari, SpOG(K)-Dep.Obgin FK-UNDIP
dr. InuMulyantoro, SpOG(K)-Dep.Obgin FK-UNDIP
dr. IrawanSastradinata, SpOG(K)-Dep.Obgin FK-UNSRI
dr. FirmansyahBasir, SpOG(K)-Dep.Obgin FK-UNSRI
dr. NuswilBernolian, SpOG(K)-Dep.Obgin FK-UNSRI
Dr. dr. K. Yusuf Efendi, SpOG(K)-Dep.Obgin FK-UNSRI
dr. AndiRinaldi, SpOG-Dep.Obgin FK-UNPAD
dr. Mulya Nusa A. Ritonga, SpOG, MKes-Dep.Obgin FKUNPAD
dr. AmaliaSiddiq, SpOG, MSi-Dep.Obgin FK-UNPAD
Dr. dr. AdjarWibowo, SpOG(K)-Dep.Obgin FK-UNLAM
dr. Samuel Tobing, SpOG(K)-Dep.Obgin FK-UNLAM
dr. BambangAbimanyu, SpOG(K)-Dep.Obgin FK-UNLAM
dr. RennyAditya, M.Kes, SpOG-Dep.Obgin FK-UNLAM
MITRA BESTARI
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dr. Sanny Santana, SpOG-Dep.Obgin RSPAD-GS
dr. Novi Resistantie, SpOG(K)-Dep.Obgin RSPAD-GS
dr. FebriansyahDarus, SpOG-Dep.Obgin RSPAD-GS
dr. BintariPuspasari, SpOG-Dep.Obgin RSPAD-GS
dr. GunawanDwi P., SpOG(K)-Dep.Obgin RSPAD-GS
dr. Budi Santoso, SpOG-Dep.Obgin RSPAD-GS
Dr. dr. DevianaSorayaRiu, SpOG-Dep.Obgin FK-UNHAS
Dr. dr. Maisuri T Chalid, SpOG(K)-Dep.Obgin FK-UNHAS
Dr. dr. Nusratuddin Abdullah, SpOG(K), MARSDep.Obgin FK-UNHAS
Dr. dr. IsharyahSunarno, SpOG(K)-Dep.Obgin FK-UNHAS
dr. Budi Wicaksono, SpOG-Dep.Obgin FK-UNAIR
dr. Ernawati, SpOG-Dep.Obgin FK-UNAIR
dr. Sri Pudyastuti, SpOG(K)-RS Persahabatan
dr. Dhika Prabu Armadhanu, SpOG, MKes-RS Tangerang
MITRA BESTARI
•
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dr. AmaliaSiddiq, SpOG, MSi-Dep.Obgin FK-UNPAD
Dr. dr. AdjarWibowo, SpOG(K)-Dep.Obgin FK-UNLAM
dr. Samuel Tobing, SpOG(K)-Dep.Obgin FK-UNLAM
dr. FeryArmanza, SpOG(K)-Dep.Obgin FK-UNLAM
dr. BambangAbimanyu, SpOG(K)-Dep.Obgin FK-UNLAM
dr. St. Finekri A. Abidin, SpOG(K)-Dep.Obgin RSPAD-GS
dr. Sanny Santana, SpOG-Dep.Obgin RSPAD-GS
dr. Novi Resistantie, SpOG(K)-Dep.Obgin RSPAD-GS
dr. FebriansyahDarus, SpOG-Dep.Obgin RSPAD-GS
dr. BintariPuspasari, SpOG-Dep.Obgin RSPAD-GS
BUKU PEGANGAN
PELATIH
BUKU PANDUAN
PESERTA
PELATIHAN
ULTRASONOGRAFI
DASAR OBSTETRI
GINEKOLOGI
BiranAfandi
Jakarta, 25-27 Februari 2013
Key Features of Mastery
Learning
• Adult learning
• Behavior modeling
• Competency-based
• Humanistic training
techniques
JHPIEGO, 1997
Adult Learning
Means that learning is
participatory,
relevant&practical. It builds
on what the participant
already knows or has
experienced and provides
opportunities for practicing
new skills.
JHPIEGO, 1997
Behavior Modeling
• Skill acquisition Knows the steps and their
sequence (if necessary) to
perform the required skill or
activity but need assistance
• Skill CompetencyKnows the steps and their
sequence (if necessary) &can
perform the required skill or
activity
• Skill Profciency Knows the steps and their
sequence (if necessary)
&efficiently performs the
required skill or activity
JHPIEGO, 1997
What is competency
based education?
Competencybased
education focuses on
learner performance
(learning outcomes) in
reaching specifc
objectives (goals and
objectives of the
5
Competency - Based
Training
1. Competency-based training
(CBT) is learning by doing. It
focuses on the specifc
knowledge, skills and attitudes
needed to carry out a procedure
or activity.
2. How the participant performs
(I.e., a combination of
knowledge, attitudes and most
important, skills) is emphasized
rather than just what
JHPIEGO, 1997
information the participant has
3.To successfully accomplish
CBT, the clinical skill or
activity to be taught must be
broken down into its essential
steps. Each step is then
analyzed to determine the
most efficient and safe way to
perform and learn it. The
process is called
standardization.
Once a procedure, such Caesarian
section, has been standardization,
competency-based learning
JHPIEGO, 1997
LEMBAR PENILAIAN
MEMIMPIN PENGAWASAN PUERPERIUM
NORMAL
Berinilaiuntuksetiaplangkahklinikdengank
etentuansebagaiberikut:
0 :Lalai: Langkahkliniktidakdilakukan
V:Baik:
Langkahklinikdilakukandenganbenardanb
aik,
sesuaidenganurutannyadanwaktu
yang dipergunakancukupefektif
X:
Kurang:
Pelaksanaanlangkahklinikmasihdenganker
aguandanhasilpekerjaannyakurangbaik,
urutanlangkahbelumsepenuhnyaberuruta
ndanwaktu yang dipergunakanlebih lama
LEMBAR PENILAIAN
MEMIMPIN PENGAWASAN PUERPERIUM
NORMAL
PROSEDUR/LANGKAH KLINIK
KASUS
2. PEMERIKSAAN
IBU
Anamnesis:
2.1.
Menanyakankeluhanpasiendankeluhanmengenaibayi
nya
2.2. Menyanyakan:
•
Apakahdapatistirahat/tidurcukup
•
Apakahmakanandanminuman yang
disediakanselaludapatdihabiskanataumasihteras
akurang
•
Apakahobat yang diberikandiminum
•
Apakahadamasalahmobilisasi
•
Apakahbuang air kecillancar
•
Apakahsudahbuang air besar
•
Bagaimanakeadaanlokhiadanapakahadaperdara
han
•
Apakahdapatmenyusuibayinyadenganbaik
•
Apakahbayinyadapattidurtenang
•
Apakahpasienmampumerawatbayinya
(mamndikandanmemakaikanpakaian,
LEMBAR PENILAIAN
MEMIMPIN PENGAWASAN PUERPERIUM
NORMAL
PROSEDUR/LANGKAH KLINIK
KASUS
Pemeriksaanfsik:
2.3. Memperhatikan keadaan umum
pasien, kesadaran, penampilannya
2.4. Memeriksa tekanan darah, suhu,
nadi dan frekuensi pernafasan
2.5. Memeriksa status generalis sesuai
dengan keluhan yang ada
LEMBAR PENILAIAN
MEMIMPIN PENGAWASAN PUERPERIUM
NORMAL
PROSEDUR/LANGKAH KLINIK
KASUS
2.6. Meminta pasien membuka
pakaiannya di daerah yang
akandiperiksa.
2.7. Memeriksa payudara
2.8. Memberi nasihat mengenai
perawatan payudara
2.9 Memeriksa abdomen dan
memeriksa tingginya fundus uteri
serta kontraksinya
2.10. Memeriksa apakah kandung
LEMBAR PENILAIAN
MEMIMPIN PENGAWASAN PUERPERIUM
NORMAL
PROSEDUR/LANGKAH KLINIK
KASUS
2.11. Pasien dalam keadaan tidur
miring, diperiksa:
• Luka jahitan episiotomi
• Kebersihan daerah perineum
• Lokhia yang keluar
• Adakah perdarahan dan pada
anus apakah ada hemorrhoid
2.12. Mengembalikan posisi pasien
dan
bantu merapikan kembali
LEMBAR PENILAIAN
MEMIMPIN PENGAWASAN PUERPERIUM
NORMAL
PROSEDUR/LANGKAH KLINIK
KASUS
3. PEMERIKSAAN BAYI & PROSES
MENYUSUI
3.1. Cuci tangan dalam air mengalir
3.2. Perhatikan:
• Keadaan umum bayi
• Refleksnya
• Keadaan tali pusat
• Apakah apa penurunan berat badan
LEMBAR PENILAIAN
MEMIMPIN PENGAWASAN PUERPERIUM
NORMAL
PROSEDUR/LANGKAH KLINIK
KASUS
3. PEMERIKSAAN BAYI & PROSES
MENYUSUI
3.3. Perhatikan apakah ibu dapat menyusui
dalam posisi yang baik dan benar
3.4. Perhatikan apakah bayi menyusu
dalam posisi yang benar
3.5. Perhatikan cara ibu memegang bayi
dan memegang payudara
3.6. Perhatikan cara bayi mengisap dan
cakupan mulut bayi pada areola
mammae
Humanistic Training Techniques
The use of more humane (humanistic)
techniques also contributes to better clinical
training.
A major component of humanistic training is the
use of anatomic models, which closely simulate
the human body, and other learning aids.
Working with models initially allows participants
to learn and practice new skills in a simulated
setting rather than with clients.
This reduces stress for the learner as well as
risk of injury and discomfort to the client.
Thus, the effective use of models (humanistic
approach) is an important factor in improving
the quality of clinical training and, ultimately,
service provision.
JHPIEGO, 1997
Before a participant performs a clinical
procedure with a client, two learning
activities should occur:
•
•
The clinical trainer should demonstrate the
required skills and client interactions several
times using an anatomic model and
appropriate training videotape.
Under the guidance of the clinical trainer, the
participant should practice the required skills
and client interactions using the model and
actual instruments in a setting that is as
similar as possible to the real situation.
Only when skillcompetency and some degree
ofskillproficiency have been demonstrated
should participants have their first contact with a
client.
JHPIEGO, 1997
Comparison of the Traditional Years-intraining Approach to Residency Education
with Competency-based Training,
Years-in-training
approach
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•
•
Requires specifed number of
•
years in training, geared to
attainment of specifc skills
Resident evaluated by certifying
opinion of the program director
that the trainee is ready to
•
practice; evaluation may be
supplemented by required
examinations during training
•
Board certifcation
No specifc measures for training
in each specialty; no specifc
standardized measures for
ensuring that competency has
•
been achieved in the time allotted
Concern by some trainees that
•
they may not be competent to
perform required procedural or
manage particular patients.
Competency-based
training
Time taken to acquire
knowledge and skills based on
the abilities of individual
trainees rather than on the
number of years in training
Provision of an algorithm of
the training experience as a
blueprint for trainees
No limit on numbers of years
in training (except defnition
of minimal and maximal
times)
Training in each specialty by
recognized experts
Competency judged by the
program director
supplemented
by newly
Long MD. CBT…Acad.
Med.
17
2000;75:1178–83.
developed, standardized set
Long MD. CBT…Acad. Med. 2000;75:1178–
18
83.
19 MODUL OBSTETRI DAN
Modul Judul Modul
GINEKOLOGI
1
Ketrampilan klinik dasar
2
Pengajaran, telaah dan penilaian
3
Teknologi informasi, peraturan klinis dan penelitian
4
Isu etik dan legal
5
Ketrampilan bedah inti (pra-operatif)
6
Penanganan pasca operasi (post-operatif)
7
Prosedur pembedahan (intra-operatif)
8
Asuhan antenatal
9
Kedokteran maternal
10
Penanganan persalinan
11
Asuhan kelahiran
12
Masalah pasca persalinan dan neonatus
13
Masalah-masalah ginekologi
14
Subfertilitas
15
Kesehatan reproduksi dan seksual
16
Asuhan kehamilan awal
17
Ginekologi onkologi
18
Uroginekologi
19
Pengembangan profesionalisme
Bas
ic
Basic skill and
knowledge
Materi MRCOG 1
WORKSHOP
Research
proposal
T1
T1
A
T1
B
Obstetri Safe
Motherho
od 1
Basic
surgical
skill
Basic1 CTG
Vaginal
surgery 1
Emergenc
y Team
App
Induksi
obstetri
APN, PONED, APK,
CTU, RN,
Manajemen laktasi,
PI, IVA, CMBM, EBM
T2
T2
A
T2
B
Obstetri Safe
Motherho
od 2
Basic
ultrasound
(Obs)
Perioperati
ve
medicine
Obstetric
surgical
skill
Vaginal
surgery 2
Gynecolog
y surgical
skill
Induksi
ginekologi
T3
T3
A
T4
T3
B
Ginekolog
i
Basic
ultrasound
Basic
(Gyn)
surgical
skill 2
Pengemba
ngan
Profesi
Induksi chief
Clinical training
skills
Clinical
governance
Ethico-medicolegal
Clinical and
medical audit
12 roles of
medical teacher
CEEBM
Leader in
emergency team
Family fnancial
management
JADWAL ACARA PELATIHAN USG DASAR
KOLEGIUM OBSTETRI DAN GINEKOLOGI
HARI PERTAMA
07.00-07.15
07.15-07.30
07.30-08.00
08.00-08.30
08.30-09.00
09.00-09.30
09.30-10.00
10.00-10.30
10.30-11.30
11.30-12.30
12.30-13.00
13.00-13.30
13.30-14.15
14.15-14.45
14.45-15.00
15.00-15.30
15.30-16.00
16.00-16.15
Registrasi
Pembukaan
Perkenalan, Harapan dan Kekhawatiran
Gambaran Umum Pelatihan (P)
Kuesioner Awal
Rehat Kopi
Panitia
Direktur Pelatihan
Direktur Pelatihan
Panitia
Introduksi USG (Diskusi dan Tanya Jawab)
+ Fisika Dasar USG
Peralatan, Ruang Periksa, dan Persiapan
Pemeriksaan
Teknik Dasar, Etika, Medikolegal, dan
Profesionalisme
ISHOMA
Live Demo dan hands on Ginekologi
Normal
Live Demo USG Normal trimester I (Hamil
10-12 minggu)
Panduan USG Dasar Ginekologi
Dasar-dasar pemeriksaan Doppler Obgin
(knowledge)
Rehat Kopi
Penilaian Cairan Amnion dan Plasenta
Meet the experts
Semua Pelatih
Rangkuman Hari Pertama
Tugas Baca Baca Bab ...
JADWAL ACARA PELATIHAN USG DASAR
KOLEGIUM OBSTETRI DAN GINEKOLOGI
HARI KEDUA
07.15-07.30 Agenda dan Pemanasan
07.30-08.30 Diagnosis kelainan uterus dan adnexa yang
sering ditemukan (mioma, adenomiosis, kista
ovarium simpleks, endometrioma)
08.30-09.00 Diagnosis kehamilan ganda
09.00-09.15 Rehat kopi
09.15-10.00 Diagnosis kelainan pada trimester I (KE, BO,
Missed abortion, dan mola hidatidosa
10.00-10.30 Konsep Dasar Pemantauan Kesejahteraan Janin
10.30-11.30 Dasar-dasar KTG
11.30-12.30 ISHOMA
12.30-13.00 Live Demo USG Normal TM II (hamil 20-22
minggu)
13.00-13.30 Live Demo USG TM III (hamil 30-32 minggu)
13.30-14.15 Penerapan klinis CTG dan Profl Biofsik
14.15-14.45 Disfungsi Susunan Saraf Pusat
14.45-15.00 Pembuatan Dokumentasi, Laporan USG dan
KTG serta komunikasi
15.00-15.15 Rehat Kopi
15.15-15.45 Latihan Interpretasi KTG (1 Normal, kategori 2
atau 3)
15.45-16.15 Meet the experts
Semua
Pelatih
16.15-16.30 Rangkuman Hari Kedua
JADWAL ACARA PELATIHAN USG DASAR
KOLEGIUM OBSTETRI DAN GINEKOLOGI
HARI
KETIGA
07.3008.00
08.00–
09.00
09.00–
10.00
10.00–
10.15
10.15–
11.15
11.15–
12.00
12.00–
13.00
13.00–
13.30
13.30–
15.30
15.30–
Agenda dan Pemanasan
Hands-on : ginekologi normal
Hands-on : trimester 1 normal
Semua Pelatih
Semua Pelatih
Rehat kopi
Hands-on : trimester 1 patologi
Hands-on : trimester 2 dan 3
normal
Semua Pelatih
Semua Pelatih
ISHOMA
Uji akhir : 30 soal MCQ
Hands-on : trimester 2 dan 3
normal
Rehat Kopi
Semua Pelatih
Semua Pelatih
Panitia
MODUL PELATIHAN USG
KOLEGIUM
BUKU ACUAN
CONTENTS
I INTRODUKSI PELATIHAN USG
OBGIN DASAR
II FISIKA DAN BIOSAFETY
ULTRASONOGRAFI
III PERALATAN DAN RUANG
PERIKSA
IV PERSIAPAN PEMERIKSAAN
V TEKNIK DASAR PEMERIKSAAN USG
CONTENTS
• VI ASPEK ETIKA, MEDIKOLEGAL DAN
PROFESIONALISME
• VIIPANDUAN PEMERIKSAAN USG DASAR
TRIMESTER 1
• VIII PANDUAN PEMERIKSAAN USG
DASAR OBSTETRI TRIMESTER 2 DAN 3
• IX PEMERIKSAAN USG INTRA DAN
POSPARTUM
• X DASAR-DASAR PEMERIKSAAN
DOPPLER DI BIDANG
OBSTETRIGINEKOLOGI
CONTENTS
• XI PEMERIKSAAN USG
DASARGINEKOLOGI (GAMBARAN
NORMAL TERMASUK IDENTIFIKASI VU
DAN REKTUM)
• XIIPATOLOGI JINAK GINEKOLOGI,
KEHAMILAN EKTOPIK DAN MOLA
• XIII PEMBUATAN LAPORAN USG
OBSTETRI GINEKOLOGI
• XIV KARDIOTOKOGRAFI (KTG)
Editor Ketua
Prof. Dr. dr. BiranAfandi, SpOG(K)
Editor
dr. BambangKarsono, SpOG(K)
dr. Herman Kristanto, MS, SpOG(K)
dr. Judi JanuadiEndjun, SpOG
dr. AndiDarma Putra, SpOG(K)
dr. AzenSalim, SpOG(K)
Prof. Dr. dr. Soegiharto Soebijanto,
SpOG(K)
KONTRIBUTOR
1. Prof. Dr. dr. SoegihartoSoebijanto, SpOG(K)Dep.Obgin FK-UI
2. Prof. Dr. dr. BiranAfandi, SpOG(K)-Dep.Obgin
FK-UI
3. Prof. dr. HidayatWijayanegara, SpOG(K)Dep.Obgin FK-UNPAD
4. dr. George Adriaansz, SpOG(K) -Dep.Obgin
FK-UNSRI
5. dr. Herman Kristanto, MS, SpOG(K)Dep.Obgin FK-UNDIP
6. dr. BambangKarsono, SpOG(K) -Dep.Obgin
FK-UI
7. dr. AzenSalim, SpOG(K) -Dep.Obgin FK-UI
8. dr. Judi JanuadiEndjun, SpOG -Dep.Obgin
MITRA BESTARI
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Dr. dr. M. Fidel GanisSiregar, M.Ked(OG), SpOG(K)Dep.Obgin FK-USU
dr. EdyArdiansyah, M.Ked(OG), SpOG-Dep.Obgin FK-USU
dr. JohnyMarpaung, M.Ked(OG), SpOG-Dep.Obgin FK-USU
dr. DudyAldiansyah, M.Ked(OG), SpOG-Dep.Obgin FK-USU
dr. Mohd. Andalas, SpOG-Dep.Obgin FK-UNSYIAH
dr. Rajuddin, SpOG(K)-Dep.Obgin FK-UNSYIAH
dr. TgkPuspaDewi, SpOG-Dep.Obgin FK-UNSYIAH
dr. Cut MeurahYeni, SpOG(K)-Dep.Obgin FK-UNSYIAH
dr. Af Angelia Ratnasari, SpOG, MKes-Dep.Obgin FK-UNS
dr. AsihAnggraeni, SpOG-Dep.Obgin FK-UNS
dr. M. AdrianesBachnas, SpOG-Dep.Obgin FK-UNS
dr. WisnuPrabowo, SpOG-Dep.Obgin FK-UNS
dr. Daniel Henri Usmany, SpOG-Dep.Obgin FK-UNCEN
dr. David RandelChristanto, SpOG, MKes-Dep.Obgin FKUNCEN
MITRA BESTARI
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dr. ApterPatay, SpOG-Dep.Obgin FK-UNCEN
dr. NugrahantiPrasetyorini, SpOG(K)-Dep.Obgin FKUNIBRAW
dr. Sutrisno, SpOG(K)-Dep.Obgin FK-UNIBRAW
dr. TjokGdeAgungSuwardewa, SpOG(K)-Dep.Obgin FKUNUD
dr. A.A.N. Anantasika, SpOG(K)-Dep.Obgin FK-UNUD
dr. I NyomanBayuMahendra, SpOG-Dep.Obgin FK-UNUD
dr. I Gede Mega Putra, SpOG(K)-Dep.Obgin FK-UNUD
dr. Jon Madi, SpOG(K)-Dep.Obgin FK-UNRI
dr. Ruza P. Rustam, SpOG-Dep.Obgin FK-UNRI
dr. Yanuarman, SpOG-Dep.Obgin FK-UNRI
Dr. dr. JoserizalSerudji, SpOG(K)-Dep.Obgin FK-UNAND
dr. Yusrawati, SpOG(K)-Dep.Obgin FK-UNAND
dr. Putri Sri Lasmini, SpOG(K)-Dep.Obgin FK-UNAND
dr. Bobby IndraUtama, SpOG(K)-Dep.Obgin FK-UNAND
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MITRA BESTARI
Dr. dr. DwianaOcviyanti, SpOG(K)-Dep.Obgin FK-UI
dr. Aria Wibawa, SpOG(K)-Dep.Obgin FK-UI
dr. KanadiSumapradja, SpOG(K), MSc-Dep.Obgin FK-UI
dr. FitriyadiKusuma, SpOG(K)-Dep.Obgin FK-UI
dr. FernandiMoegni, SpOG(K)-Dep.Obgin FK-UI
dr. RukmonoSiswishanto, M.Kes, SpOG(K)-Dep.Obgin
FK-UGM
dr. DiahRumektiHadiati, MSc, SpOG(K)-Dep.Obgin FKUGM
dr. Irwan T. Rachman, SpOG(K)-Dep.Obgin FK-UGM
dr. AhsanuddinAttamimi, SpOG(K)-Dep.Obgin FK-UGM
dr. Detty S. Nurdiati, MPH, PhD, SpOG(K)-Dep.Obgin FKUGM
Dr. dr. Freddy W. Wagey, SpOG(K)-Dep.Obgin FKUNSRAT
dr. John J. E. Wantania, SpOG, IBCLC-Dep.Obgin FK-
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MITRA BESTARI
dr. Julian Dewantiningrum, MSi.Med, SpOG-Dep.Obgin
FK-UNDIP
dr. EdiwibowoAmbari, SpOG(K)-Dep.Obgin FK-UNDIP
dr. InuMulyantoro, SpOG(K)-Dep.Obgin FK-UNDIP
dr. IrawanSastradinata, SpOG(K)-Dep.Obgin FK-UNSRI
dr. FirmansyahBasir, SpOG(K)-Dep.Obgin FK-UNSRI
dr. NuswilBernolian, SpOG(K)-Dep.Obgin FK-UNSRI
Dr. dr. K. Yusuf Efendi, SpOG(K)-Dep.Obgin FK-UNSRI
dr. AndiRinaldi, SpOG-Dep.Obgin FK-UNPAD
dr. Mulya Nusa A. Ritonga, SpOG, MKes-Dep.Obgin FKUNPAD
dr. AmaliaSiddiq, SpOG, MSi-Dep.Obgin FK-UNPAD
Dr. dr. AdjarWibowo, SpOG(K)-Dep.Obgin FK-UNLAM
dr. Samuel Tobing, SpOG(K)-Dep.Obgin FK-UNLAM
dr. BambangAbimanyu, SpOG(K)-Dep.Obgin FK-UNLAM
dr. RennyAditya, M.Kes, SpOG-Dep.Obgin FK-UNLAM
MITRA BESTARI
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dr. Sanny Santana, SpOG-Dep.Obgin RSPAD-GS
dr. Novi Resistantie, SpOG(K)-Dep.Obgin RSPAD-GS
dr. FebriansyahDarus, SpOG-Dep.Obgin RSPAD-GS
dr. BintariPuspasari, SpOG-Dep.Obgin RSPAD-GS
dr. GunawanDwi P., SpOG(K)-Dep.Obgin RSPAD-GS
dr. Budi Santoso, SpOG-Dep.Obgin RSPAD-GS
Dr. dr. DevianaSorayaRiu, SpOG-Dep.Obgin FK-UNHAS
Dr. dr. Maisuri T Chalid, SpOG(K)-Dep.Obgin FK-UNHAS
Dr. dr. Nusratuddin Abdullah, SpOG(K), MARSDep.Obgin FK-UNHAS
Dr. dr. IsharyahSunarno, SpOG(K)-Dep.Obgin FK-UNHAS
dr. Budi Wicaksono, SpOG-Dep.Obgin FK-UNAIR
dr. Ernawati, SpOG-Dep.Obgin FK-UNAIR
dr. Sri Pudyastuti, SpOG(K)-RS Persahabatan
dr. Dhika Prabu Armadhanu, SpOG, MKes-RS Tangerang
MITRA BESTARI
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dr. AmaliaSiddiq, SpOG, MSi-Dep.Obgin FK-UNPAD
Dr. dr. AdjarWibowo, SpOG(K)-Dep.Obgin FK-UNLAM
dr. Samuel Tobing, SpOG(K)-Dep.Obgin FK-UNLAM
dr. FeryArmanza, SpOG(K)-Dep.Obgin FK-UNLAM
dr. BambangAbimanyu, SpOG(K)-Dep.Obgin FK-UNLAM
dr. St. Finekri A. Abidin, SpOG(K)-Dep.Obgin RSPAD-GS
dr. Sanny Santana, SpOG-Dep.Obgin RSPAD-GS
dr. Novi Resistantie, SpOG(K)-Dep.Obgin RSPAD-GS
dr. FebriansyahDarus, SpOG-Dep.Obgin RSPAD-GS
dr. BintariPuspasari, SpOG-Dep.Obgin RSPAD-GS
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