Redesigning a faculty development program for clinical teachers in Indonesia: a before-and-after study.

PURPOSE: Faculty development (FD) is important to support teaching, including for clinical teachers. Faculty of Medicine Universitas Indonesia (FMUI) has conducted a clinical teacher training program developed by the medical education department since 2008, both for FMUI teachers and for those at other centers in Indonesia. However, participation is often challenging due to clinical, administrative, and research obligations. The COVID-19 pandemic amplified the urge to transform this program. This study aimed to redesign and evaluate an FD program for clinical teachers that focuses on their needs and current situation. METHODS: A five-step design thinking framework (empathizing, defining, ideating, prototyping, and testing) was used with a pre/post-test design. Design thinking made it possible to develop a participant-focused program, while the pre/post-test design enabled an assessment of the program's effectiveness. RESULTS: Seven medical educationalists and four senior and four junior clinical teachers participated in a group discussion in the empathize phase of design thinking. The research team formed a prototype of a 3-day blended learning course, with an asynchronous component using the Moodle learning management system and a synchronous component using the Zoom platform. Pre-post-testing was done in two rounds, with 107 and 330 participants, respectively. Evaluations of the first round provided feedback for improving the prototype for the second round. CONCLUSION: Design thinking enabled an innovative-creative process of redesigning FD that emphasized participants' needs. The pre/post-testing showed that the program was effective. Combining asynchronous and synchronous learning expands access and increases flexibility. This approach could also apply to other FD programs.

Cultivating patient-centered care competence through a telemedicine-based course: An explorative study of undergraduate medical students' self-reflective writing.

Background: The COVID-19 pandemic has encouraged adaptations of learning methods in clinical clerkship. There have been limited reports on the merits of involving medical students in telemedicine. This study, therefore, aims to investigate students' reflection on what they learned and identify the challenges and benefits of doctor-patient interaction through their experience in a telemedicine-based course. Methods: A 4 week telemedicine-based course for medical students to participate in telemonitoring of COVID-19 patients undergoing self-isolation was conducted. This is a qualitative study using an interpretive phenomenology design to investigate students' self-reflection on their experiences in monitoring COVID-19 patients. Students were asked to reflect on their experience upon completion of the course through 750-1,000 words essays. A thematic analysis which considers units of meaning based on students' experiences was completed. Results: Our study identified four main themes gathered from students' experiences related to the telemedicine-based course: communication and education, professionalism and professional identity formation, system-based practice, and patient-centered care. Conclusion: The course was part of an integrative effort involving multiple parties to tackle the burden on the nation's healthcare system during the pandemic. Telemedicine is part of future medical practice which supports the medical curriculum adaptability along with attempts to develop future-proof medical doctors through various clinical learning experiences.

Burnout and coping strategies among resident physicians at an Indonesian tertiary referral hospital during COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has increased the burden on resident physicians. They may use different coping strategies to manage those burdens, which partly determine their mental health outcomes, including burnout syndrome. This study explores the relationship between coping strategies and burnout among resident physicians during the COVID-19 pandemic in an Indonesian tertiary referral hospital. METHODS: This online cross-sectional study was conducted from June to August 2020, involving nine residency programs in the Faculty of Medicine Universitas Indonesia-Cipto Mangunkusumo Hospital. Burnout syndrome was assessed using Maslach Burnout Inventory, while Brief COPE measured coping strategies. RESULTS: A total of 388 residents participated in this study. High emotional exhaustion (EE), depersonalization (DP), and low personal accomplishment (PA) were found in 15.5%, 5.2%, and 39.2%, respectively. Residents more often use adaptive than maladaptive coping strategies. Higher PA was correlated to residents using problem-focused (r = 0.299; p < 0.001) and emotion-focused (r = 0.397; p < 0.001). Meanwhile, dysfunctional coping strategies are moderately correlated with EE (r = 0,518; p <0,001) and DP (r = 0,507; p<0,001). CONCLUSION: The use of dysfunctional coping strategies is linked to higher emotional exhaustion and depersonalization aspect of burnout. However, a higher sense of personal accomplishment is linked to problem-focused and emotion-focused strategies. Appropriate identification and intervention of residents with dysfunctional coping strategies may be beneficial in reducing burnout risk.

A COVID-19 self-isolation monitoring module for FMUI undergraduate medical students: Linking learning and service needs during the pandemic surge in Indonesia.

To ensure that students continued receiving adequate yet safe clinical exposure during the COVID-19 pandemic, the Faculty of Medicine at Universitas Indonesia (FMUI) created the Module of COVID-19 Self-Isolation Monitoring which aims to equip students with the knowledge and skill to monitor confirmed and close contact cases of COVID-19. Module development, divided into four phases: preparation, orientation, implementation, and evaluation phase, started as soon as the delta wave of COVID-19 cases forced medical students to halt their offline clinical rotations. A quantitative secondary data were obtained from student and patient satisfaction questionnaires and on students' performance and reflection. We analyzed the distribution of module evaluation, the student's discussion score during the module, the students' interest in participating as Covid-19 volunteers before and after the module's deployment, and the correlation between learning outcomes and satisfaction. A total of 372 patients were monitored by 208 students during the 4-week module. The response rates were above 80%, with the majority agreeing that students found this module well-organized and fulfilled their expectations. There was a significant increase in discussion scores from weeks 1 to 4, a significant difference in the proportion of students interested in COVID-19 volunteering before and after the module completion as well as a significant low correlation between the patient's monitoring score sheet and the reflection essay towards the patient's satisfaction. We should still improve tutors' time management, tutors' provision of triggering questions for critical thinking skills, and tutors' feedback for students. The module met patient expectations and is expected to assist tutors in providing feedback and examples of doctor-patient communication, thus accelerating students' competence in patient interaction. Further evaluation is needed regarding knowledge transfer, the impact on community health, and the faculty development program, especially regarding how tutors fulfill their roles as medical educators.