Case-Based

Method for HOTs

Nur Afrainin Syah

LP3M Universitas Andalas

1/9
Adult Learner
3/9
 Constructivism

• Students construct their own “meaning - knowledge” based on their

experience.
• Learning is an active process; a social activity, a contextual process, a life
experience - physical and social environment of medical practice

• The reflective application of knowledge is integrated into learning, allows

the student to develop metacognitive structures and construct meanings
• Students must use the significant knowledge that they have learned (prior
knowledge)
• Motivation plays a transcendental role

“learn to learn”, reflect on own learning process

Stages in Experiential Learning – Merdeka Belajar

Learning
environment

1. Concrete experience 2. Reflexive observation

The learner

4.Active experimentation 3. Conceptual abstract

Learning
Environment

The facilitator
TINGKAT TINGKAT
MEMORISASI KETERLIBATAN

PASSIVE
10% Reading Verbal
20% Hearing words
reciving
30% Looking at picture
Watching video
Visual
50% Looking at an exhibition reciving
Watching a demonstration
Seeing it done on location
Participating in a discussion Partici
70%

ACTIVE
Giving a talk
pating
Doing a Dramatic Presentation
Simullating the Real Experience Doing
90% Doing the Real Thing
MODEL PEMBELAJARAN

Direkonstruksi dari Dr.Vernon A. Magnesen, 1983, dalam QUATUM TEACHING.

Syamsul Arifin: Innovation Learning in Industry 4.0 era 7/9
 Three conditions that facilitate learning

1. Activation of prior knowledge

• Earlier knowledge used in understanding new information
• Everyone have prior knowledge about some problem, but at not
same level
• When the first year student of medical school got a scenario
about tuberculosis, they will remember and use their biology
science from high school
• When same scenario gave to 4-th year medical school student,
they will remember much better because they are already learn
about tuberculosis at medical school. They will know more detail
about tuberculosis and apply it to solve the problem.
 Three conditions that facilitate learning

2. Encoding specificity
• The closer the resemblance between the situation in which
something is learned and the situation in which it is applied, the
better the performance

• Encoding specificity:
– High prevalence
– Life threatening/ urgent
– potential serious oucomes
– poorly handled/ often missed
Three conditions that facilitate learning

3. Elaboration of knowledge
• Information is better understood, processed, and retrieved
if students have an opprtunity to elaborate on that
information
• Elaboration provide redundancy in the memory structure
• Paraphrase in important
 Case-Based Method

• Problem-Based Learning: The process of

acquiring new knowledge based on
recognition of a need to learn

• Problem-Solving: Arriving at decisions

based on prior knowledge and reasoning
Which one
to choose?
 PROBLEM SOLVING PROBLEM-BASED LEARNING

- The focus is on preparatory learning - The problem comes first without advance
prior to exposure to the problem. readings, lectures, or preparation.

- The teacher set the problems (case - The problem serves as a stimulus for the
history problems in a primarily lecture- need to know.
based format), and students attempt to
resolve them using previously taught - Based on their own prior knowledge and
curricular content. the identified gaps in that knowledge,
students determine the learning issues
within their own group. They then identify
and use a variety of learning resources to
study these issues and return to the group
to discuss and share what they have
learned.

Usefull for application of knowledge Usefull for basic concept

Showing relevance of basic science to
professional practice
 The case
serves as
a stimulus
for
learning
 Seven Jump
STEP 1. Clarify Unfamiliar Terms
STEP 2. Define the PROBLEM (s)
STEP 3. Brainstorm Possible Hypothesis or
Explanation
STEP 4. Arrange Explanation into a Tentative
Solution
STEP 5. Define Learning Objective
STEP 6. Information Gathering and Private Study
STEP 7. Share the Results of Information
Gathering and Private Study

BPK Fakultas Kedokteran Workshop Tutor Training

Universitas Andalas Padang, 14-17 Juli 2014
 Simulasi Tutorial FK Unand

• https://www.youtube.com/watch?v=WNlDZ
XcUBwY
 TUTOR

Tutorial
group
process
PROBLEM STUDENT
 Pucatnya Nona Anne
Nona Anne, 18 tahun dibawa ibunya konsultasi ke dokter Puskesmas dengan
keluhan sering merasakan pusing sejak 2 bulan yang lalu. Dari anamnesis
didapatkan bahwa Nona Anne sejak 4 bulan yang lalu melakukan diet ketat
dengan mengurangi semua jenis makanan. Saat ini badannya terasa gemetaran
dan telapak tangannya terlihat pucat. Sewaktu naik tangga di kampusnya, Nona
Anne merasakan lelah yang berlebihan dan berusaha menarik nafas yang panjang
untuk mengurangi rasa sesak yang dirasakannya. Dokter juga menanyakan
keadaan anggota keluarga, apakah ada riwayat yang sama dengan Nona Anne.

Dokter melihat sediaan apus darah tepi nona Anne, ditemukan eritrosit mikrositik
hipokromik. Nona Anne diberi obat tambah darah dan dianjurkan kontrol 1 bulan
yang akan datang. Ibu Anne menyampaikan kekhawatirannya kepada dokter
apakah Anne juga memerlukan rujukan dan pemeriksaan sumsum tulang seperti
yang dialami oleh saudara sepupu laki-lakinya, karena keluhan pucat dan mudah
letih yang dialaminya.

Bagaimana anda menjelaskan apa yang terjadi pada Nona Anne?

 Capaian Pembelajaran Mata Kuliah
• Menjelaskan pengertian dan jenis anemia
• Menjelaskan epidemiologi, etiologi, faktor risiko pada
anemia
• Menjelaskan patogenesis dan patofisiologi anemia
• Menjelaskan gejala dan tanda anemia
• Menjelaskan prinsip diagnosis anemia
• Menjelaskan pemeriksaan laboratorium yang diperlukan
untuk menunjang diagnosis anemia
 Concept

Basic principles, key information, or

fundamental mechanisms around
which a series of notions is organized
that permit students to analyze the
problem which is presented to them
The concepts includes its own
explanation
 …..Concept
The points that will be related (cause, result)
with an explanation, not just a title or
statement or task
The wording of a concept must be precise
enough so that a specific message is
delivered
The students have to find, and understand
the concepts which are embedded in the
problem, and it could be used for many cases
 Concepts and Mapping (1)
1. Gangguan absorpsi dan intake zat besi,
vitamin B12, asam folat, kehilangan Fe
dan peningkatan kebutuhan Fe dapat
menyebabkan anemia defisiensi
2. Penurunan jumlah sel darah merah atau
jumlah hemoglobin akan menurunkan
kapasitas pengangkutan oksigen yang
mengakibatkan timbulnya keluhan
letih,lesu dan mudah lelah
 …..Concepts and Mapping (1)

3. Penurunan kadar Hb dapat diketahui dari

pemeriksaan konjungtiva yang anemis
4. Jenis anemia dapat ditentukan oleh
gambaran mikroskopik sel darah merah
pada apusan darah tepi
5. Penatalaksanaan anemia tergantung
pada penyebab terjadinya anemia
 Concepts and Mapping (1)
Gangguan intake Peningkatan kebutuhan
Fe, B1, Asam Folat Fe, B1, Asam Folat
Gangguan absorpsi
Fe, B1, Asam Folat Kehilangan Fe
Anemia defisiensi

Penurunan jumlah Konjungtiva

sel darah dan Hb anemis

Penurunan kapasitas Gambaran mikroskopik

pengangkutan oksigen sel darah merah

Letih, lesu, mudah lelah Jenis anemia

Penatalaksanaan
 Tutorial Evaluation

Evaluation on:
Group-functioning (proses tutorial)
Students performances
Tutor performances

Using:
Checklist
Scoring (tutorial)
Block evaluation-----end of the block
BPK Fakultas Kedokteran Workshop Tutor Training
Universitas Andalas Padang, 14-17 Juli 2014
 .….Tutorial Evaluation
For example:
Each student is assessed on the
following characteristics:
1. Follows discussion actively
2. Asks relevant questions spontaneously
3. Presents hypothesis, facts and homework
done clearly
4. Analyses hypothesis critically and suggests
course of action when in difficulty.
BPK Fakultas Kedokteran Workshop Tutor Training
Universitas Andalas Padang, 14-17 Juli 2014
 .….Tutorial Evaluation
For example (cont):
The assessment:
will take the form of grading students’
performance on the scheme shown below
Characteristics demonstrated by student
All four above 4
Any three 3
Any two 2
One only 1
Absent without valid reason 0
BPK Fakultas Kedokteran Workshop Tutor Training
Universitas Andalas Padang, 14-17 Juli 2014
 Roles of Tutor

Facilitating Facilitating
Learning Self-Directed
Process Learning

Facilitating
Group
Process

BPK Fakultas Kedokteran Workshop Tutor Training

Universitas Andalas Padang, 14-17 Juli 2014
 Feedback

Descriptive
Contract
Non evaluative Tell them you are
Specific performance giving them feedback
Non personal attributes

When ?
End of tutorial No scoring

BPK Fakultas Kedokteran Workshop Tutor Training

Universitas Andalas Padang, 14-17 Juli 2014
 Pendleton’s Rules
Self assessment by learner to acknowledge what was done well

What was done well reinforced by facilitator group

Skills used to achieve successful outcomes discussed

Self-assessment by learners-what could have done

better-analyses alternative skills

Facilitator/group suggests alternatives skills is necessary

Learner feedback to the facilitator-content of feedback and skills

BPK Fakultas Kedokteran Workshop Tutor Training

Universitas Andalas Banda Aceh 8-11 Agustus 2012
 New-Innovative SPICES Traditional
Curricula  Continuum → Medical Curricula

S Student-centered Teacher-centered
P Problem-based Information gathering

I Integrated Discipline-based

C Community-based Campus/Hospital based

E Elective Standard

S Systematic Apprenticeship-based
Questions?