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Designing CBC

Designing CBC. The future of our health care system. Komitmen Kita Semua Komitmen Nasional. 4 Misi Menuju Indonesia Sehat 2010. Menggerakkan Pembangunan Nasional Berwawasan Kesehatan Mendorong Kemandirian Masyarakat Untuk Hidup Sehat

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Designing CBC

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  1. Designing CBC

  2. The future of our health care system

  3. Komitmen Kita Semua Komitmen Nasional

  4. 4 Misi Menuju Indonesia Sehat 2010 • Menggerakkan Pembangunan Nasional Berwawasan Kesehatan • Mendorong Kemandirian Masyarakat Untuk Hidup Sehat • Memelihara dan Meningkatkan Pelayanan Kesehatan yang Bermutu, Berkeadilan, Merata, dan Terjangkau • Memelihara dan Meningkatkan Kesehatan Individu, Keluarga dan Masyarakat beserta Lingkungannya

  5. INDONESIA SEHAT 2010 • Model-Model • (dalam kesisteman) • (Desentralisasi) • Keluarga Sehat • Desa Sehat • Kecamatan Sehat • Kota/Kabupaten Sehat • Propinsi Sehat

  6. Sehat adalah Hak Manusia (Dasar Moral)Sehat adalah Investasi Indonesia Sehat 2010 Paradigma Sehat (Dasar Fikir) Pembangunan Berwawasan Kesehatan (Wawasan) Moral • Sistem & Manajemen • Private Goods (Kesehatan Individu & Keluarga) • Public Goods (Kesehatan Kewilayahan) Desentralisasi • Model, Sistem: • Pelayanan Kesehatan Primer • Pelayanan Kesehatan Sekunder Model, Sistem: • Pengembangan Kesehatan Wilayah Asuransi (Sosial, JPKM, Private) • Pemerintah • Lintas Sektor • UU Kesnas (Normatif) • UU SKN Baru (Implementatif) • RUU JSN • RUU Praktek Kedokteran • UU Lingk, UU Pendidikan • UU Konsumen, dll

  7. Sistem Kesehatan Nasional (2004) Untuk masa mendatang apabilaSistem Jaminan Kesehatan Nasional (SJKN) telah berkembang, pemerintah tidak lagi menyelenggarakan UKP strata pertama melalui Puskesmas. Penyelenggaraan UKP strata pertama akan diserahkan kepada masyarakat dan swasta dengan menerapkan konsep dokter keluarga, kecuali di daerah yang sangat terpencil yang masih dipadukan dengan pelayanan Puskesmas

  8. Sistem Pendidikan Berjenjang (Terstruktur) A B • Basis Kompetensi (Pendidikan) • Kewenagan Dlm Pelayanan C (Spesialis) Sehat Sakit UPAYA KURATIF PROMOTIF, PREVENTIF, PROTEKTIF (Komunikasi, Edukasi, Informasi) A = Pendidikan Dokter Umum A + B =Pendidikan Dokter Keluarga (5 Star Doctors) C = Pendidikan Dokter Spesialis

  9. Kurikulum A = KIPDI II A + B = KIPDI III (5 Stars Doctors)

  10. Ciri Khusus Dokter Keluarga(Kompetensi): • ‘Care and Cure Provider’ • ‘Decision Maker’ • ‘Communicator’ • ‘Community Leader’ • ‘Manager’ WHO

  11. Dokter Keluarga Harus Dapat Bicara Tentang Kesehatan Bukan Hanya Tentang Penyakit • Gizi • ‘ Life Style’ • Kesehatan Ibu dan Anak • Lingkungan Sehat • Olah Raga dan Rekreasi • ‘Medical Back-up’

  12. Saat mendatang Dokter Keluarga …………… (langsung) 4 tahun 2 tahun Saat ini Ko-asisten Mahasiswa Tk I Dokter Umum 5 Star Doctor, WHO Kurikulum Dokter Keluarga 7 Tahun ?

  13. Dokter Keluarga adalah Dokter Umum (Baru)

  14. What is competence and CBC?

  15. Definition of Competencies (1) • Competence includes a broad range of knowledge, attitudes, and observable patterns of behaviour which together account for the ability to deliver a specified professional service. McGaghie, et.al, 1978, WHO

  16. Definition of Competencies (2) • Competencies combine appropriate supporting knowledge and professional attitude, and they are performed reliably in natural settings without assistance. Chambers, 1993, J. Dent Educ

  17. Definition of Competencies (3) • Professional competence is the habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values, and reflection in daily practice to improve the health of the individual patient and community: • What you know • How you use what you know • How you add to what you know Epstein and Hundert, 2002, JAMA

  18. What is Competency? • seperangkat tindakan cerdas dan penuh tanggungjawab • dimiliki seseorang sebagai syarat • untuk dianggap mampu oleh masyarakat • dalam melaksanakan tugas-tugas di bidang pekerjaan tertentu (SK Mendiknas No. 045/U/2002)

  19. Features of a Competency Statement • Focuses on outcome performance • Integrates a broad range of related knowledge and skills objectives • Contextualized – related to a practical task in the field • Drawn from multiple domains, including affective and moral dimensions • Include professional behaviours relevant to the task • Indicates a level of expected ability

  20. Educational Objectives • States an aspect of knowledge, skills or attitude to be acquired • Generally discipline specific • Context-free • Professional values unaddressed • Defines knowledge, skills and attitude

  21. Educational Outcome:Competencies • Integrates related knowledge, skill and attitude objectives • Drawns from multiple disciplines relevant to the practice • Related to an actual task in the field – contextualised • Driven by professional practice and values • Defines a level of ability for an observable outcome

  22. Discipline-based Curriculum • Curriculum defines content, structure and process • Discipline-based • Exposure to specific content for a pre-assigned time • Assessment by counting • Norm-referenced

  23. Competency-based Curriculum • Curriculum defines outcomes for proficient practice • Integrative • Time and sequence derived from assessment • Assessment of actual performance • Criterion-based

  24. Building a Competency-based Program • Clinical problem, patient, task, setting • Identify essential competencies for practice • Determine competency components: objectives and performance levels • Identify learning activities and strategies • Develop assessment tools and standards for competency

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