Family Medicine approach

Report
FAMILY MEDICINE
SYSTEM
UNDERGRADUATE MEDICAL DEGREE PROGRAM
FACULTY OF MEDICINE
UNIVERSITAS PADJADJARAN
2012
Rasionalisasi
KIPDI II
KIPDI III
Kurikulum berbasis
kompetensi
Kurikulum Berbasis
Kompetensi
• Standar Kompetensi dokter yang disusun mengacu pada
gambaran dokter yang dibutuhkan
7 AREA KOMPETENSI
1.
2.
3.
4.
5.
6.
7.
Keterampilan komunikasi efektif
Keterampilan klinik dasar
Keterampilan penerapan dasar-dasar ilmu biomedik, klinik,
perilaku & epidemiologi dalam praktek kedokteran keluarga
Keterampilan pengelolaan masalah kesehatan individu, keluarga
ataupun masyarakat dengan cara yang komprehensif, holistik,
bersinambung, terkoordinir & bekerja sama dalam konteks
pelayanan kesehatan primer
Keterampilan pemanfaatan, penilaian secara kritis dan
pengelolaan informasi
Mawas diri dan pengembangan diri/belajar sepanjang hayat
Etika, moral & profesionalisme dalam praktek
4 – Pengelolaan Masalah Kes.
Individu, Keluarga & Masy.
Kompetensi Inti:


Diagnosa, pengelolaan & pencegahan mslh
individu yg umum dlm konteks hub. keluarga &
masy. scr komprehensif, holistik,
berkesinambungan serta dg bekerja sama
Mengelola mslh kes. individu mll keterampilan
clinical reasoning utk menjamin hsl maksimal
Educational Objectives of Medical
Doctor Program
(at Unpad)
1. to communicate effectively with patient,
family, community, and other health
professionals
2. to perform basic clinical skills
3. to apply principles of basic biomedical,
clinical, behavioral sciences and
epidemiology in the practice of medical
profession
Educational Objectives of Medical
Doctor Program
(at Unpad) (cont’d)
4.
5.
6.
to manage professionally and ethically common
health problems at individual, family and community
level in a comprehensive, holistic, and continuous
manner
to access, critically appraise and manage medical
and health information to improve his/her quality
professional task leading to be a lifelong learner
to be self-aware, self-care and self-developed
professional.
Curriculum Structure 2008
I
II
III
IV
FBS I (4) RPS (10)
EMS
(7)
DMS
(8)
FBS II (4)
NBS
(10)
FBS III (4) CSP I (2)
CSP II
(2)
CSP III
(2)
CSP IV
(2)
CSP V
(2)
CSP VI
(2)
PHOP IV
(1)
PHOP V
(1)
PHOP VI
(2)
PHOP VII
(1)
HIS
V
(8)
VI
VII
CVS (8) GUS (7)
RS
(7)
GIS
(7)
TM
(7)
FM
(7)
FBS IV
(4)
PHOP I
(1)
PHOP II
(2)
PHOP III
(1)
CRP I (1)
CRP II (2)
CRP III
(1)
BHP I (2)
BHP II
(3)
BHP III
(1)
BHP IV
(1)
BHP V
(1)
BHP VI
(1)
BHP VII
(1)
20
19
22
21
20
21
20
CRP IV (1) CRP V (1) CRP VI (2)
CRP VII
(2)
FAMILY MEDICINE APPROACH TO MANAGE
THE CASES
Personal
A care delivered with a close rapport
b/w patient and the doctor
Primary
First contact care
Continuing
Care of chronic medical problem, care
of complications
Comprehensive
Preventive, promotive, curative and
rehabilitative
The Principles
DEDICATED TO THE
PERSON
MANAGER OF
RESOURCES
UNDERSTAND THE
CONTEXT OF ILLNESS
SUBJECTIVE ASPECTS OF
MEDICINE (SENSITIVITY TO
FEELINGS, EMOTIONAL ETC)
FAMILY
PHYSICIAN
ALL CONTACT WITH PATIENTS
AN OPPORTUNITY FOR
PREVENTION & HEALTH
EDUCATION
HOME VISITS (SEES PATIENTS
AT HOME)
LIVE IN COMMUNITY/ A PART OF
THE COMPLEX OF FAMILY
RELATIONSHIP
THE PRACTICE AS A
POPULATION AT RISK
DOES COMMUNITY
NETWORKING
THE HEALTH OF
THE FAMILY AS
AN UNIT
BIO – PSYCHO –SOCIAL
ECONOMY MODEL OF
ILLNESS
INDIVIDU IS A PART OF THE
FAMILY, AND FAMILY AS A PART
OF THE COMMUNITY
LIFE CYCLE CARE
FAMILY DOCTOR
Culture
The Mandala of Health
A model of human ecosystem
Community
lifestyle
Personal
behavior
Sick
care
system
spirit
body
Human
biology
Psycho-socioEconomic
Environment
work
mind
Physical
environment
Human-Made Environment
Biosphere
The health enhancement continuum
Before man is involved
The course of the disease in man
Interrelation of the various:
- AGENT
- HOST
- ENVIRONMENT factors
DEATH
Chronic state
Defect
Disability
Illness
Signs & symptoms
(known & unknown)
which
bring AGENT & HOST
together, or
produce a disease-provoking
STIMULUS
Tissue & physiologic
changes
STIMULUS & AGENT becomes
established & increases by
multiplication or increment
Immunity &
resistance
RECOVERY
in the
Interaction of
human HOST & STIMULUS
HOST
Discernable early
Early pathogenesis
lesions
Pre-pathogenesis
HOST reaction
Advanced
disease
Convalescence
Pathogenesis
Health promotion & Spesific
protection
Early detection & prompt
treatment
PROMOTIVE
PREVENTIVE
PROMOTIVE
Disability Th/ & Rehabilitation
CURATIVE
REHABILITATIVE
PREVENTIVE
CURATIVE
REHABILITATIVE
Aspek
personal
Genogram
Pasien
Family Map
Aspek klinis
Aspek risiko
internal
Aspek risiko
eksternal
Anamnesis – patient
centered anamnesis
Dinamika
Keluarga
Family
APGAR
Family
SCREEM
Pemeriksaan fisik
Pemeriksaan
penunjang
Family life
cycle
Rumah
Lingkungan
Pekerjaan
Diagnosis
Medis
Diagnosis HOLISTIK
Diagnosis
Psikososial
Intervensi
Medis
Penatalasanaan
KOMPREHENSIF
Intervensi
psikososial
BMP: Preclinical phase
- Molecular
- Cellular
- Tissue
Normal Structures
Normal Functions
- Organ
- System Organ
Congenital
Infection/
Inflammation
Principles of
diagnostic
Abnormality
Neoplasm
Trauma
Others
Pathogenesis
Principles of
management
Patophysiology
Complication
Signs-Symptoms
S-S
S-S
Family Medicine approach
Normal Functions
Normal Structures
Neoplasm
Trauma
Congenital
Infection/
Inflammation
Principles of
diagnostic
Abnormality
Others
Family
Medicine
approach
Pathogenesis
Patophysiology
Complication
Signs-Symptoms
S-S
S-S
APPLIED
PRINCIPLE
Scenario
Problems
(1st page/s)
generate
Hypotheses
(un-implemented theory –week
theme – diseases or psychosocial
problems).
Mechanism
direction to meet with
embedded-Learning
Issues of Fam Med
Concept mapping
Implementation of the concept
BMP
•
•
•
•
•
Bioscience
Pathogenesis
Pathophysiology
Clinical aspect
Management
FM
•
•
•
•
•
Review Clinical aspect
Risk factor
Family as a unit of care
Biopsychosocial approach
Health care maintenance for individual
and family
• Screening
• Counseling
• Immunization
• Chemoprophylaxis
• Curative and rehabilitative
Stroke
BMP
•
•
•
•
•
Describe the cause
Describe the pathogenesis
Explain risk stratification
Describe PE
Explain the principles of clinical and
laboratory assessment
• Give basic treatment (non and
pharmacology)
• Describe MOA
Kedokteran keluarga
• Review the diagnosis of stroke
• Describe the impact of illness to the
family
• Describe the monitoring for patient
• Describe the care for caregiver
• Describe the concept for home care
• Describe health care maintenance for
elderly (screening, counselling,
immunization and chemoprophylaxis)
Week-theme
Lifecycle
Newly
married
Theme
and Preventive care
Topic
1
Infancy, childhood
Pre-conception
care
and
management
and
Family planning
Preventive care
2
Failure to thrive
Adolescence/ teenagers Preventive care
3
Weight
nutrition
Adult
Biopsychosocial approach
4
Behavioral problems in
teenager
Biopsychosocial approach
5
Insomnia
Week-theme
Lifecycle
Adult
Elderly
Theme
Topic
Chronic Diseases
6
Hypertension
Chronic Diseases
7
Cataract
Elderly care
8
Stroke
Elderly care
9
Osteoporosis
Palliative
care
and
domiciliary 10
Cervical cancer
The activities
Tutorial
Pre-conception care and
Family planning
Failure to thrive
Weight management
and nutrition
Refraction error
Behavioral problems in
teenager
Somatic disorder
Hypertension
Mini
lecture
-Overview of the
system
-Good parenting
-The right to sight
-Overview of
behavioral problems
-Complementary and
alternative medicine
Osteoporosis
-Management of
physical activity for
various diseases
Cervical cancer
-Rational prescribing
Stroke
Tuberculosis
Hearing Loss
The activities
Skills’
lab
Breast care for
pregnant women,
post delivery
Lab
activity
Create a genogram
Meal planning and
food replacement
General physical
examination
Writing referral
letter
Direct
ophthalmoscope
examination
Health care
maintenance
Detection for mental
health problems
Create physical
activity
Counseling skill
Medical audit
Bed turning and bed
positioning
Prescribing
Breaking bad news
Develop medical
record

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