THE PITFALL OF STUDENT PERFORMANCE IN THE FINAL YEAR OSCE FOR UNDERGRADUATE MEDICINE PROGRAM FACULTY OF MEDICINE, PUBLIC HEALTH AND NURSING UNIVERSITAS GADJAH MADA IN 2018

HELEN NATALIA, dr. Ide Pustaka Setiawan, M.Sc., Sp.OG, dr. Rachmadya Nur Hidayah,M.Sc., Ph.D.

2021 | Skripsi | S1 KEDOKTERAN

Latar Belakang. OSCE tingkat akhir merupakan instrumen standar yang digunakan oleh Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan Universitas Gadjah Mada untuk menilai kemampuan klinis mahasiswa kedokteran sebagai calon dokter sebelum memasuki rotasi klinik. Instrumen ini terdiri dari pemeriksaan beberapa stase dengan pengaturan simulasi tertentu untuk melakukan keterampilan klinis tertentu. Evaluasi internal menunjukan hanya sekitar 57,2% dari peserta OSCE tingkat akhir yang lulus ujian. Studi lebih lanjut diperlukan untuk memahami kesalahan performa keterampilan mahasiswa kedokteran selama mengikuti OSCE tingkat akhir dikarenakan belum terdapat studi yang dilakukan terkait masalah ini. Tujuan. Untuk mengetahui kesalahan-kesalahan performa keterampilan mahasiswa kedokteran pada OSCE tingkat akhir di Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan Universitas Gadjah Mada pada tahun 2018. Metode. Penelitian ini bersifat deskriptif analitik dengan menggunakan data yang diperoleh dari data sekunder hasil OSCE tingkat akhir pada tahun 2018. Subjek penelitian ini adalah seluruh mahasiswa kedokteran yang mengikuti OSCE tingkat akhir pada tahun 2018. Hasil. Penelitian ini menunjukan stase dengan jumlah subjek yang tidak lulus terbanyak secara berurutan adalah Stase 5 (13,61%), Stase 1 (12,84%), Stase 8 (12,45%), Stase 3 (11,28%), Stase 9 (10,89%), Stase 6 (7,41%), Stase 2 (7%), Stase 7 (7%), dan Stase 4 (5,06%). Kasus dengan jumlah subjek terbanyak yang tidak lulus adalah Dermatologi dan Venereology (17,09%), ET & Injeksi Intramuskular (16,78%), Kegawatdaruratan-Dewasa (13,07%), Neurologi (13,04%), IPM (12,84%), dan Operasi Minor (10,89%). Hasil rerata persentase kesalahan dari tiap kompetensi adalah sebagai berikut: Perilaku Profesional (45,31%), Anamnesis (48,17%), Komunikasi dan Edukasi Pasien (48,88%), Diagnosis dan Diagnosis Banding (60,6%), Terapi Non Farmakologi (62,26%), Pemeriksaan Fisik (62,26%), Terapi Farmakologi (64,23%), dan Interpretasi Data (68,57%). Kesimpulan. Kesalahan-kesalahan performa keterampilan mahasiswa kedokteran pada OSCE tingkat akhir adalah interpretasi data yakni keterampilan untuk memahami data untuk menentukan diagnosis (68,57%), terapi farmakologi yakni keterampilan dalam menentukan terapi yang tepat serta menuliskan resep (64,23%), terapi non farmakologi yakni keterampilan melakukan prosedur (62,26%), dan pemeriksaan fisik yakni keterampilan dalam menentukan dan melakukan pemeriksaan fisik yang relevan (62,26%).

Background. The final year Objective Structured Clinical Examination (OSCE) is a standardized instrument used in Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada to assess the clinical skills of the medical students as a future medical doctor before entering the clinical rotation. It is a test consisting of a multi-station examination with a simulated setting to perform specific clinical tasks. The Internal evaluation showed approximately only 57,2% of Final year OSCE first-takers passed the examination. A need for further study to understand the pitfalls of medical students during the final year OSCE is needed since there aren't any studies conducted regarding this matter. Objectives. The purpose of this study is to understand medical students' common pitfalls during the final year Objective Structured Clinical Examination (OSCE) at Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada in 2018. Methods. This is descriptive-analytic study using data obtained from the secondary records of the final year OSCE's result in 2018. The subjects are all medical students who took the final year OSCE in the year 2018 at Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada. Results. This study shows the highest number of subjects who failed the station were from Station 5 (13,61%), Station 1 (12,84%), Station 8 (12,45%), Station 3 (11,28%), Station 9 (10,89%), Station 6 (7,41%), Station 2 (7%), Station 7 (7%), and Station 4 (5,06%) consecutively. The most number of subjects with score 1 on Global Rating Scale for each respective case were Dermatology and Venereology (17,09%), ET & Intramuscular Injection (16,78%), IPM Emergency-Adults (13,07%), Neurology (13,04%), IPM (12,84%), and Minor Surgery (10,89%). The Mean percentages of each competence with pitfalls are as follows: Professional Behavior (45,31%), History Taking (48,17%), Communication and Patient Education (48,88%), Differential Diagnosis (60,6%), Non Pharmacological Therapy (62,26%), Physical Examination (62,26%), Pharmacological Therapy (64,23%), and Data Interpretation (68,57%). Conclusion. Medical students' common pitfalls during the final year Objective Structured Clinical Examination (OSCE) at Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada in 2018 are Test/Clinical Procedure or Interpretation of Data to Support Diagnosis/ Differential Diagnosis competence in which students are required to understand data to determine diagnosis (68,57%), Pharmacological therapy in which students are required to determine the treatment plan and prescribe (64,23%), Non Pharmacological Therapy in which students are required to perform procedural skills (62,26%), and Physical Examination competencies in which students are required to provide relevant examination (62,26%).

Kata Kunci : Pitfalls, OSCE, Clinical Skills, Medical Students, Final Year, Competency