Beruflich Dokumente
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STUDENT WORKBOOK
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(NAME:____________________________________)
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(SRN )
: ____________________________
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MEDICAL COMMUNICATION 2014
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How to use this workbook?
This book will be used to document your activity during the block. You should report all your
task including student projects and basic clinical skills on the worksheet given. Each task will
refer to a specific worksheet. Several worksheet will also be your guidance in role playing or
presentation as it provides the checklist of specific skills trained.
The worksheet should be signed by the facilitator. Student should asked for signature after
accomplishing student projects or skills training. This process ensure us that the learning
process will give enough learning opportunity to the student.
Your facilitator and or your friend will give score on certain worksheet. In Basic clinical skill
you are allowed to asked for repetition and be assessed by your best perfomance, but try to
keep with the time limit. For several items there be also a note coloumn, you should make a
note on your own perfomance in that space. The score given will be used as formative
assessment and also summative assessment. Student workbook and all attached material
subjected to student projects should be collected by the head of the group to secretary of
Medical Communication by theend of this block.
Your answer :
1. Calgary-Cambridge Observation Guide adalah buku yang mengulas tentang gambaran umum mengenai
kurikulum yang berhubungan dengan kemampuan berkomunikasi dan bagaimana menggunakan
kemampuan tersebut untuk meraih informas dari pasien secara runtut dan lengkap. Ada 4 hal penting yang
berpengaruh dalam kemampuan ini yaitu:
a. Structure : Cara mengatur agar komunikasi tersebut tertata dengan baik dan efisien
b. Skills : Untuk memahami kemampuan yang harus kita kuasai
c. Validity : Realitas dan kepastian data yang didapatkan oleh dokter haruslah sepaham dengan
pasien agar tidak terjadi salah penafsiran
d. Breadth : Mengetahui jangkauan dari komunikasi tersebut
Adapun manfaat dari Calgary-Cambridge Observation Guide adalah dapat memberikan tuntunan serta
dasar dasar dalam meraih informasi secara runtut, tepat, luas dan jelas yang dapat menciptakan kondisi
kondusif antara dokter-pasien
2. Calgary-Cambridge Observation Guide merujuk kepada 4 hal yang berpengaruh dalam keterampilan
berkomunikasi sebagai seorang dokter yaitu:
Structure : Bagaiana cara mengatur agar komunikasi tersebut tertata dan mampu membantu untuk meraih
informasi?
Skills : Apa saja kemampuan yang harus ditingkatkan dan dikembangkan ?
Validity : Apa bukti bahwa kemampuan ini dapat memberikan perbedaan dalam komunikasi antar dokter
dan pasien?
Breadth : Seberapa luas cakupan dari data tersebut diraih?
3. Terdiri atas 5 runtutan kegiatan dasar dari Calgary-Cambridge Observation Guide yang tersetruktur yaitu:
a. Initiating the session
b. Gathering information
c. Building the relationship
d. Explanation and planning
e. Closing the session
Dan alasan dari mengapa struktur ini dibentuk adalah agar hubungan dokter dengan pasien dapat terjalin
lebih erat sehingga mampu menimbulkan dampak positif dari pemeriksaan agar mampu saling bekerja sama.
Adapun sering kali di kenyataan kita melihat bahwa hubungan dokter pasien hanya sekedar saja dan kurang
bersinergi, maka dari itu keterikatan baik antara dokter pasien dirasa perlu dan Calgary-Cambridge
Observation Guide dapat membantu dalam memudahkan mempelajari dan menerapkan struktur struktur
komunikasi dasar tersebut
4. Initiating the session
- Membangun hubungan awal
- Mencaritahu alasan berkonsultasi
Gathering information
- Menggali lebih dalam masalahnya
- Menemukan kesepahaman dengan pasien perihal masalahnya
- Melakukan komunikasi secaa tersrtuktur
Building the relationship
- Mengembangkan hubungan dengan pasien
You may write on another paper if the box does not accomodate your answer
Date Completed :
Facilitator Sign.:
Complaint/disease:
Anemia sel sabit adalah penyakit turunan berupa kelainan hemoglobin(hemoglobinopati), yaitu
terbentuknya hemoglobin S yang fungsinya terganggu sehingga sel darah merah berbentuk bulan sabit. Anemia
sel sabit merupakan kelainan genetik terkait gen resesif. Anemia sel sabit adalah gangguan resesif autosomal
yang disebabkan pewarisan dua salinan gen hemoglobin defektif, masing-masing satu dari orang tua.
Hemoglobin yang cacat tersebut, yang disebut hemoglobin S (HbS), menjadi tidak elastis dan berbentuk seperti
bulan sabit. Sel darah merah pada anemia sel sabit ini kehilangan kemampuan untuk bergerak dengan mudah
melewati pembuluh yang sempit dan tersangkut dalam pembuluh darah. Hal ini menyebabkan penyumbatan
aliran darah ke jaringan berikutnya. Meskipun bentuk sel sabit ini bersifat reversible atau dapat kembali ke
bentuk semula jika saturasi hemoglobin kembali normal, sel sabit sangat rapuh dan banyak yang sudah hancur di
dalam pembuluh yang sangat kecil, sehingga menyebabkan anemia. Dalam keadaan normal, sel darah merah
mempunyai waktu hidup 120 hari. Jika menjadi tua, sel pemakan dalam sumsum tulang, limpa dan hati dapat
mengetahuinya dan akan merusaknya. Jika suatu penyakit menghancurkan sel darah merah sebelum waktunya
(hemolisis), sumsum tulang berusaha menggantinya dengan mempercepat pembentukan sel darah merah yang
baru, sampai 10 kali kecepatan normal. Jika waktu penghancuran sel darah merah melebihi waktu
pembentukannya, maka akan terjadianemia hemolitik.
Complaint/disease:
A. Informasi Awal
Tanggal Pemeriksa : 4 Januari 2014
Identitas Pasien
Nama : I Ketut Andreas
Jenis Kelamin : Laki-laki
Umur : 16 tahun
Alamat : Jl. Salak no. 217, Denpasar, Bali
Pekerjaan : Pelajar
Agama : Hindu
Status : Belum menikah
Sumber Data : Pasien sendiri
Reliabilitas : Pasien dalam kondisi sadar, tidak mabuk dan memorinya baik
B. Keluhan Utama : Mudah lelah, letih dan lesu
C. Penyakit Sekarang
1. Lokasi : Seluruh tubuh
2. Kualitas : Badan menjadi cepat lelah dan wajah terlihat lesu
3. Kuantitas : Bisa ringan yaitu hanya mengalami kelelahan, namun bisa juga parah yang
akan mengakibatkan pingsan atau badan tidak seimbang
4. Onset : Kondisi fisik yang mudah lemah semenjak lahir
5. Durasi : Terjadi secara episodik sementara atau episodik permanen dalam kurun
waktu yang tidak menentu, bisa lama atau cepat
6. Frequensi : Dalam sehari sering kali mengalami kelelahan meskipun tidak bekerja
begitu berat
7. Setting : Dalam periode tertentu penderita akan merasakan kondisi tubuhnya lelah,
letih, dan lesu. Kondisi ini terjadi secara teratur dan dapat menghilang serta datang kembali
8. Faktor pemberat : Dehidrasi, kurang konsumsi zat besi, terlalu banyak beraktifitas, beban
pikiran dan stress, konsumsi minuman alkohol
Faktor peringan : Makanan dengan zat besi tinggi, kandungan cairan cukup, istirahat yang
cukup dan olahraga secara teratur
9. Gejala yang menyertai : Rasa sakit secara episodik yang dapat hilang dan datang, pembengkakan
ekstremitas, sering kali terjadi infeksi, keterlambatan pertumbuhan pada masa kanak kanak dan
gangguan pengelihatan
Obat yang dikonsumsi saat ini : obat obat yang mengurangi kemampuan metabolisme tubuh
terhadap zat besi seperti halnya antasida, aspirin dan anti-inflamasi
D. Riwayat Penyakit
1. Riwayat penyakit kecil :
a. Orang tua karier atau penderita anemia bulan sabit
b. Kekurangan konsumsi zat besi yang memperparah keadaan tubuh
You may write on another paper if the box does not accomodate your answer
Date Completed :
Facilitator Sign.:
Score Comment
No Skills
0 1 2
Initiating the session
EvaluatorSign. :
Score Comment
No Skills
0 1 2
Initiating the session
1. GREET patient and obtain patient’s name
2. INTRODUCE SELF and clarifies role
1 3. DEMONSTRATES interest and RESPECT, attend to physical comfort
4. IDENTIFIES AND CONFIRMS PATIENT’S PROBLEM LIST OR ISSUES
5. NEGOTIATES AGENDA taking both patient’s and doctor’s perspective into account
Gathering Information
6. ENCOURAGE PATIENT TO TELL STORY of problems from when first started to the
present in own words (clarifies reason for presenting now)
EvaluatorSign. :
Date Completed :
Score = total score x 100 Score :
44 Comment :
EvaluatorSign. :
Score Comment
No Skills
0 1 2
Initiating the Session
1. GREET patient and obtain patient’s name
2. INTRODUCE SELF and clarifies role
1 3. DEMONSTRATES interest and RESPECT, attend to physical comfort
4. IDENTIFIES AND CONFIRMS PATIENT’S PROBLEM LIST OR ISSUES
5. NEGOTIATES AGENDA taking both patient’s and doctor’s perspective into account
Gathering Information
6. ENCOURAGE PATIENT TO TELL STORY of problems from when first started to the
present in own words (clarifies reason for presenting now)
Evaluator Sign. :
Score Comment
No Skills
0 1 2
Preparation
1. SET UP APPOINTMENT, uninterrupted time
2. PRIVATE and comfortable place
1
3. INVITE accompanying person as appropriate
4. SELF PREPARATION emotionally and factually, resume all clinical information to
share and prepared of patient’s background
Initiating the session
5. GREET patient
2 6. SUMMARIZE where things have reach to date
7. FOLLOW UP what happened since the last time
8. NEGOTIATES AGENDA
Building relationship
9. DEMONSTRATES APPROPRIATE NON-VERBAL BEHAVIOUR, e.g. eye contact,
posture and position, movement, facial expression, use of voice, do not be afraid to
show emotion or distress.
3
10. DEVELOPING RAPPORT (deals sensitively, read non verbalcues, allow for shut
down, encourage expression of feelings, accepts legitimacy of patient’s view and
feeling, is not judgmental, uses empathy, provide support by expressing concerns,
understanding, willingness to help,andpartnership)
Explanation and planning
11. PROVIDING THE CORRECT TIME, AMOUNT AND TYPE OF INFORMATION
(give warning shot, basic information first, chunks and checks, assess patient’s
starting point, gauge how much patient wish to know)
12. AIDING ACCURATE RECALL AND UNDERSTANDING (organize explanation,
uses explicit categorisation or sign posting, uses repetition and summarizing, use
language carefully, checks patient’s understanding)
4
13. ACHIEVING A SHARED UNDERSTANDING: INCORPORATING THE
PATIENT’S PERSPECTIVE (relate’s explanation to patient’s illness framework,
provide opportunities e.g. keep pausing and encourage patient, elicit patient’s
beliefs, reactions and feelings re informationgiving)
14. PLANNING: SHARED DECISION MAKING (give hoped tempered with realism, ,
identify plan, negotiate plan, checks if accepts plans or concern has been addressed,
copartnership)
Closing the session
15. FORWARD PLANNING (contracting for further appointment, do no trush to treatment,
5 safety nets, identify support system, offer to see spouse or others)
16. ENSURING APPROPRIATE POINT OF CLOSURE (summarises, final checks)
References:
Kurtz SM, Silverman JD, Draper J (1998) Teaching and Learning Communication
Skills in Medicine. Radcliffe Medical Press (Oxford)
Silverman JD, Kurtz SM, Draper J (1998) Skills for Communicating with Patients.
Radcliffe Medical Press (Oxford)
Date Completed :
Score = total score x 100 Score :
Comment :
32
Facilitator Sign. :
Score Comment
No Skills
0 1 2
Initiating the session
1. GREET patient and obtain patient’s name
2. INTRODUCE SELF and clarifies role
1 3. DEMONSTRATES interest and RESPECT, attend to physical comfort
4. IDENTIFIES AND CONFIRMS PATIENT’S PROBLEM LIST OR ISSUES
5. NEGOTIATES AGENDA taking both patient’s and doctor’s perspective into account
Gathering Information
6. ENCOURAGE PATIENT TO TELL STORY of problems from when first started to the
present in own words (clarifies reason for presenting now)
7. ENCOURAGE PATIENT TO TELL STORY of problems from when first started to the
present in own words (clarifies reason for presenting now)
8. LISTEN ATTENTIVELY, allows patient to complete statement without interruption
and leaves space for patient to think before answering or go on after pausing
9. FACILITATES PATIENT’S RESPONSES VERBALLY AND NON VERBALLY (use
encouragement, silence, repetition, paraphrasing, interpretation)
10. USE concise, EASILY UNDERSTOOD QUESTIONS AND COMMENTS, avoids
jargon
11. CLARIFIES PATIENT’S STATEMENT which are vague or need amplification
12. DETERMINES AND ACKNOWLEDGES PATIENT’S IDEAS
2
13. EXPLORES CONCERNS (including worries, effects on lifestyle) regarding each
problem
14. DETERMINE PATIENT’S EXPECTATIONS regarding each problem
15. ENCOURAGES EXPRESSION OF FEELING AND THOUGHT
16. PICK UP VERBAL AND NONVERBAL CLUES i.e. body language, speech, facial
expression, affect, CHECKS OUT and acknowledges as appropriate
17. SUMMARIZES AT THE END OF A SPECIFIC LINE OF INQUIRY to verify own
interpretation of what patient has said, to ensure no important data were omitted
18. PROGRESSES, USING TRANSLATON STATEMENTS; includes rationale for next
session
19. STRUCTURE interview in LOGICAL SEQUENCE
20. ATTEND TO TIMING and keeping interview on task.
Building relationship
21. DEMONSTRATES APPROPRIATE NON-VERBAL BEHAVIOUR, e.g. eye contact,
posture and position, movement, facial expression, use of voice, if read or write does
with appropriate manner.
3 22. DEVELOPING RAPPORT (accepts legitimacy of patient’s view and feeling, is not
judgmental, uses empathy, acknowledge patient’s view and feeling, provide support by
expressing concerns, understanding, willingness to help, partnership and deals
sensitively)
23. INVOLVING THE PATIENT (shares thinking, explain rationale of question,
examination, procedure, explain process and ask permission during examination)
Explanation and planning
24. PROVIDING THE CORRECT TIME, AMOUNT AND TYPE OF INFORMATION
(give at appropriate time, chunks and checks, assess patient’s starting point, ask other
information needed)
4 25. AIDING ACCURATE RECALL AND UNDERSTANDING (organize explanation,
uses explicit categorisation or sign posting, uses repetition and summarizing, uses
concise easily understood language, uses visual methods, checks patient’s
understanding)
26. ACHIEVING A SHARED UNDERSTANDING: INCORPORATING THE
PATIENT’S PERSPECTIVE (relate’s explanation to patient’s illness framework,
Facilitator Sign. :
Faculty of Medicine
Udayana University
Jalan P.B. Sudirman
Denpasar – Bali
Indonesia
5 January 2015
Endocrinology Department
British Unity Hospital
England
This man has an enlargement of pancreas which caused by tumor. Relevant Magnetic Resonance Imaging (MRI),
blood and urine tests have been done in Denpasar and with this letter, the test results are attached.
Yours sincerely,
You may write on another paper if the box does not accomodate your answer
Date Completed :
Facilitator Sign.:
Faculty of Medicine
Udayana University
Jalan P. B. Sudirman
Denpasar – Bali
Indonesia
5 January 2015
Radiologist
Jalan Sudirman no. 12
Denpasar
Yours sincerely,
You may write on another paper if the box does not accomodate your answer
Date Completed :
Facilitator Sign.:
This is to certify that I have been today examnied Mr. Riyanto, 43 year old. Home address: Jalan Kartika
no. 3, Denpasar and I have found him to be unfit on duty due to being ill (with headache, weaken of body and
easily get tired) from 15 up to 18 December 2014. Date to ressume day: 20 November 2013.
You may write on another paper if the box does not accomodate your answer
Date Completed :
Facilitator Sign.:
Curicullum Vitae
You may write on another paper if the box does not accomodate your answer
Date Completed :
Facilitator Sign.:
CHECK LIST
PRESENTATION SKILL
Presenter:..............................................................
Presentation topic:.................................................
Comments
Good Ok Need work
Item (include spesific
(2) (1) (0)
problems)
STRUCTURE
Opening
(opening remark, introduction,
objectives)
Preview
(topic outline)
View
(interesting and appropriate
content, define terms and concepts,
sign posting, relate each part)
Review
(summarize important point)
Closing
(thanking the audience)
Organization
(appropriate organization strategy)
AUDIO VISUAL AID
Large and clear
Properly labeled
Unnecessary writing eliminated
Citation included
PERFOMANCE
Enthusiasm and confidence
Pace
Clarity
Gesture
Interaction with the audience
Competency
Facilitator Sign.: