family medicine system
DESCRIPTION
FAMILY MEDICINE SYSTEM. UNDERGRADUATE MEDICAL DEGREE PROGRAM FACULTY OF MEDICINE UNIVERSITAS PADJADJARAN 2012. Rasionalisasi. Kurikulum berbasis kompetensi. Kurikulum Berbasis Kompetensi. Standar Kompetensi dokter yang disusun mengacu pada gambaran dokter yang dibutuhkan. - PowerPoint PPT PresentationTRANSCRIPT
FAMILY MEDICINE SYSTEM
UNDERGRADUATE MEDICAL DEGREE PROGRAM
FACULTY OF MEDICINEUNIVERSITAS 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. Keterampilan komunikasi efektif2. Keterampilan klinik dasar3. Keterampilan penerapan dasar-dasar ilmu biomedik, klinik,
perilaku & epidemiologi dalam praktek kedokteran keluarga4. Keterampilan pengelolaan masalah kesehatan individu, keluarga
ataupun masyarakat dengan cara yang komprehensif, holistik, bersinambung, terkoordinir & bekerja sama dalam konteks pelayanan kesehatan primer
5. Keterampilan pemanfaatan, penilaian secara kritis dan pengelolaan informasi
6. Mawas diri dan pengembangan diri/belajar sepanjang hayat7. 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 skills3. to apply principles of basic biomedical,
clinical, behavioral sciences and epidemiology in the practice of medical profession
4. to manage professionally and ethically common health problems at individual, family and community level in a comprehensive, holistic, and continuous manner
5. to access, critically appraise and manage medical and health information to improve his/her quality professional task leading to be a lifelong learner
6. to be self-aware, self-care and self-developed professional.
Educational Objectives of Medical Doctor Program (at Unpad) (cont’d)
Curriculum Structure 2008
I II III IV V VI VIIFBS I (4) RPS (10) EMS
(7)DMS
(8)CVS (8)
GUS (7)
TM (7)
FBS II (4) NBS (10)
HIS (8) RS (7) GIS (7) FM
(7)FBS III (4) CSP I (2) CSP II
(2)CSP III
(2)CSP IV
(2)CSP V
(2)CSP VI
(2)FBS IV
(4)PHOP I
(1)PHOP II
(2)PHOP III
(1)PHOP IV
(1)PHOP V
(1)PHOP VI
(2)PHOP VII
(1)
CRP I (1) CRP II (2) CRP III (1)
CRP IV (1) CRP V (1) CRP VI (2) CRP VII (2)
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
FAMILY MEDICINE APPROACH TO MANAGE THE CASES
Personal
Primary
Continuing
Comprehensive
A care delivered with a close rapport b/w patient and the doctor
First contact care
Care of chronic medical problem, care of complications
Preventive, promotive, curative and rehabilitative
The Principles
FAMILY PHYSICIAN
DEDICATED TO THE PERSON
UNDERSTAND THE CONTEXT OF ILLNESS
ALL CONTACT WITH PATIENTS AN OPPORTUNITY FOR PREVENTION & HEALTH
EDUCATION
THE PRACTICE AS A POPULATION AT RISK
DOES COMMUNITY NETWORKING
LIVE IN COMMUNITY/ A PART OF THE COMPLEX OF FAMILY
RELATIONSHIP
HOME VISITS (SEES PATIENTS AT HOME)
SUBJECTIVE ASPECTS OF MEDICINE (SENSITIVITY TO FEELINGS, EMOTIONAL ETC)
MANAGER OF RESOURCES
BIO – PSYCHO –SOCIAL ECONOMY MODEL OF ILLNESS
THE HEALTH OF THE FAMILY AS AN UNIT
INDIVIDU IS A PART OF THE FAMILY, AND FAMILY AS A PART OF THE COMMUNITY
FAMILY DOCTORLIFE CYCLE CARE
Personalbehavior
Psycho-socio-Economic
Environment
Human biology
Physicalenvironment
The Mandala of HealthA model of human ecosystem
Culture
Community
lifestyle
workSickcaresystem
Human-Made Environment
Biosphere
spirit
body mind
Pre-pathogenesis Pathogenesis
Before man is involved The course of the disease in man
Interrelation of the various: - AGENT - HOST - ENVIRONMENT factors
(known & unknown) which
bring AGENT & HOSTtogether, orproduce a disease-provokingSTIMULUS
in the human HOSTEarly pathogenesis Discernable early
lesionsAdvanceddisease Convalescence
Interaction ofHOST & STIMULUS
HOST reaction
STIMULUS & AGENT becomesestablished & increases bymultiplication or increment
Tissue & physiologicchanges
Signs & symptoms
IllnessDisability
DefectChronic state
DEATH
RECOVERY
Immunity & resistance
Health promotion & Spesific protection
Early detection & prompt treatment
Disability Th/ & Rehabilitation
PROMOTIVE
PREVENTIVE
CURATIVE REHABILITATIVE
PROMOTIVEPREVENTIVE CURATIVE
REHABILITATIVE
The health enhancement continuum
Pasien
Anamnesis – patient centered anamnesis
Pemeriksaan fisik
Pemeriksaan penunjang
Diagnosis HOLISTIK
Penatalasanaan KOMPREHENSIF
Aspek personal
Aspek klinis
Aspek risiko internal
Aspek risiko eksternal
Dinamika Keluarga
Lingkungan
Genogram
Family Map
Family life cycle
Family APGAR
Family SCREEM
Rumah
PekerjaanDiagnosis
MedisDiagnosis Psikososial
Intervensi Medis
Intervensi psikososial
DOUBLE DIAGNOSIS
BMP: Preclinical phase
Normal Structures Normal Functions
- Molecular- Cellular- Tissue- Organ- System Organ
Pathogenesis
Abnormality
CongenitalInfection/ Inflammation
NeoplasmTrauma
Others
Patophysiology
Principles of diagnostic
Principles of management
Signs-Symptoms S-S S-S
Complication
Family Medicine approachNormal Structures Normal Functions
Pathogenesis
Abnormality
Congenital
Infection/ Inflammation
NeoplasmTrauma
Others
Patophysiology
Principles of diagnostic
Family Medicine approach
Signs-Symptoms S-S S-S
Complication
APPLIEDPRINCIPLE
Scenario
Hypotheses (un-implemented theory –week theme – diseases or psychosocial problems).
Problems (1st page/s)
Mechanismdirection to meet with embedded-Learning Issues of Fam Med generate
Concept mapping
Implementation of the concept
BMP FM
• Bioscience• Pathogenesis• Pathophysiology• Clinical aspect• Management
• 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 Kedokteran keluarga
• 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
• 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 Theme Topic
Newly married and
Infancy, childhood
Preventive care 1 Pre-conception care and
Family planning
Preventive care 2 Failure to thrive
Adolescence/ teenagers Preventive care 3 Weight management and
nutrition
Adult Biopsychosocial approach 4 Behavioral problems in teenager
Biopsychosocial approach 5 Insomnia
Week-theme
Lifecycle Theme Topic
Adult Chronic Diseases 6 Hypertension
Chronic Diseases 7 Cataract
Elderly care 8 Stroke
Elderly Elderly care 9 Osteoporosis
Palliative and domiciliary
care
10 Cervical cancer
The activities
Pre-conception care and Family planning Failure to thrive Weight management and nutritionRefraction errorBehavioral problems in teenager Somatic disorderHypertension StrokeOsteoporosis Cervical cancer TuberculosisHearing Loss
Tutorial-Overview of the system-Good parenting-The right to sight-Overview of behavioral problems-Complementary and alternative medicine-Management of physical activity for various diseases-Rational prescribing
Mini lecture
The activities
Breast care for pregnant women, post deliveryGeneral physical examinationDirect ophthalmoscope examinationDetection for mental health problemsCounseling skillBed turning and bed positioningBreaking bad news
Skills’ lab Create a genogram
Meal planning and food replacementWriting referral letterHealth care maintenanceCreate physical activityMedical auditPrescribingDevelop medical record
Lab activity