GAMBARAN UMUM PELATIHAN ULTRASONOGRAFI DASAR OBSTETRI GINEKOLOGI

(1)

GAMBARAN UMUM

PELATIHAN

ULTRASONOGRAFI

DASAR OBSTETRI

GINEKOLOGI

BiranAfandi

(2)

Key Features of Mastery

Learning

•

Adult learning

•

Behavior modeling

•

Competency-based

•

Humanistic training

techniques

(3)

Adult Learning

Means that learning is

participatory,

relevant

&

practical

. It builds

on what the participant

already knows or has

(4)

•

Skill acquisition

•

Skill Competency

•

Skill Profciency

Knows the steps and their

sequence (if necessary) to

perform the required skill or

activity but

need assistance

sequence (if necessary) &

can

perform

the required skill or

activity

sequence (if necessary)

&

efficiently performs

the

required skill or activity

Behavior Modeling

(5)

What is competency

based education?

Competencybased

education focuses on

learner performance

(learning outcomes) in

reaching specifc

objectives (goals and

objectives of the

(6)

Competency - Based

Training

1. Competency-based training

(CBT) is learning by doing. It

focuses on the specifc

knowledge, skills and attitudes

needed to carry out a procedure

or activity.

2. How the participant performs

(I.e., a combination of

knowledge, attitudes and most

important, skills) is emphasized

rather than just what

information the participant has

learned. Competency in the new

skill or activity is assessed

objectively by evaluating overall

performance

.

(7)

3.To successfully accomplish

CBT, the clinical skill or

activity to be taught must be

broken down into its essential

steps. Each step is then

analyzed to determine the

most efficient and safe way to

perform and learn it. The

process is called

standardization

.

Once a procedure, such Caesarian

section, has been standardization,

competency-based learning

guides and evaluation checklists

can be developed to make

learning the necessary steps or

tasks easier and evaluating the

participant’s performance more

objective.

(8)

LEMBAR PENILAIAN

MEMIMPIN PENGAWASAN PUERPERIUM

NORMAL

Berinilaiuntuksetiaplangkahklinikdengank

etentuansebagaiberikut:

0 :Lalai: Langkahkliniktidakdilakukan

V:Baik:

Langkahklinikdilakukandenganbenardanb

aik,

sesuaidenganurutannyadanwaktu

yang dipergunakancukupefektif

X:

Kurang:

(9)

LEMBAR PENILAIAN

NORMAL

PROSEDUR/LANGKAH KLINIK KASUS

2. PEMERIKSAAN IBU Anamnesis: 2.1. Menanyakankeluhanpasiendankeluhanmengenaibayi nya 2.2. Menyanyakan: • _{Apakahdapatistirahat/tidurcukup} • _{Apakahmakanandanminuman yang}

disediakanselaludapatdihabiskanataumasihteras akurang

• _{Apakahobat yang diberikandiminum} • _{Apakahadamasalahmobilisasi}

• _{Apakahbuang air kecillancar} • _{Apakahsudahbuang air besar}

(10)

LEMBAR PENILAIAN

NORMAL

Pemeriksaanfsik:

2.3. Memperhatikan keadaan umum

pasien, kesadaran, penampilannya

2.4. Memeriksa tekanan darah, suhu,

nadi dan frekuensi pernafasan

(11)

LEMBAR PENILAIAN

NORMAL

2.6. Meminta pasien membuka

pakaiannya di daerah yang

akandiperiksa.

2.7. Memeriksa payudara

2.8. Memberi nasihat mengenai

perawatan payudara

2.9 Memeriksa abdomen dan

memeriksa tingginya fundus uteri

serta kontraksinya

(12)

2.11. Pasien dalam keadaan tidur

miring, diperiksa:

•

Luka jahitan episiotomi

•

Kebersihan daerah perineum

•

Lokhia yang keluar

•

Adakah perdarahan dan pada

anus apakah ada hemorrhoid

2.12. Mengembalikan posisi pasien

dan

bantu merapikan kembali

pakaiannya

LEMBAR PENILAIAN

NORMAL

(13)

3. PEMERIKSAAN BAYI & PROSES

MENYUSUI

3.1. Cuci tangan dalam air mengalir

3.2. Perhatikan:

•

Keadaan umum bayi

•

Refleksnya

•

Keadaan tali pusat

•

Apakah apa penurunan berat badan

LEMBAR PENILAIAN

NORMAL

(14)

3. PEMERIKSAAN BAYI & PROSES

MENYUSUI

3.3. Perhatikan apakah ibu dapat menyusui

dalam posisi yang baik dan benar

3.4. Perhatikan apakah bayi menyusu

dalam posisi yang benar

3.5. Perhatikan cara ibu memegang bayi

dan memegang payudara

3.6. Perhatikan cara bayi mengisap dan

cakupan mulut bayi pada areola

mammae

LEMBAR PENILAIAN

NORMAL

(15)

The use of more humane (humanistic)

techniques also contributes to better clinical

training.

A major component of humanistic training is the

use of anatomic models, which closely simulate

the human body, and other learning aids.

Working with models initially allows participants

to learn and practice new skills in a simulated

setting rather than with clients.

This reduces stress for the learner as well as

risk of injury and discomfort to the client.

Thus, the effective use of models (humanistic

approach) is an important factor in improving

the quality of clinical training and, ultimately,

service provision

.

Humanistic Training Techniques

(16)

•

The clinical trainer should demonstrate the

required skills and client interactions several

times using an anatomic model and

appropriate training videotape.

•

Under the guidance of the clinical trainer, the

participant should practice the required skills

and client interactions using the model and

actual instruments in a setting that is as

similar as possible to the real situation.

Before a participant performs a clinical

procedure with a client, two learning

activities should occur:

Only when

skillcompetency

and some degree

ofskillproficiency

have been demonstrated

should participants have their first contact with a

client.

(17)

Comparison of the Traditional

Years-in-training Approach to Residency Education

with Competency-based Training,

Years-in-training

approach

• Requires specifed number of years in training, geared to attainment of specifc skills

• Resident evaluated by certifying opinion of the program director that the trainee is ready to

practice; evaluation may be supplemented by required examinations during training

• Board certifcation

• No specifc measures for training in each specialty; no specifc

standardized measures for ensuring that competency has been achieved in the time allotted

• Concern by some trainees that they may not be competent to perform required procedural or manage particular patients.

Competency-based

training

• Time taken to acquire

knowledge and skills based on the abilities of individual

trainees rather than on the number of years in training • Provision of an algorithm of

the training experience as a blueprint for trainees

• No limit on numbers of years in training (except defnition of minimal and maximal

times)

• Training in each specialty by recognized experts

• Competency judged by the program director

supplemented by newly

developed, standardized set of requirements

Long MD. CBT…Acad. Med.

(18)

Long MD. CBT…Acad. Med. 2000;75:1178–

(19)

Modul Judul Modul

1 Ketrampilan klinik dasar

2 Pengajaran, telaah dan penilaian

3 Teknologi informasi, peraturan klinis dan penelitian 4 Isu etik dan legal

5 Ketrampilan bedah inti (pra-operatif) 6 Penanganan pasca operasi (post-operatif) 7 Prosedur pembedahan (intra-operatif) 8 Asuhan antenatal

9 Kedokteran maternal 10 Penanganan persalinan 11 Asuhan kelahiran

12 Masalah pasca persalinan dan neonatus 13 Masalah-masalah ginekologi

14 Subfertilitas

15 Kesehatan reproduksi dan seksual 16 Asuhan kehamilan awal

17 Ginekologi onkologi 18 Uroginekologi

19 Pengembangan profesionalisme

(20)

Bas

ic

T1

T2

T3

T4

Basic skill and knowledge Basic surgical skill 1 Basic surgical skill 2 Basic ultra-sound (Obs) Gynecolog y surgical skill Obstetric surgical skill Basic CTG Vaginal surgery 2 Induksi obstetri Induksi ginekologi Clinical training skills Vaginal surgery 1 Perioperati ve medicine Basic ultra-sound (Gyn) T1 A T1 B T2 A T2 B T3 A T3 B Emergenc y Team App

APN, PONED, APK, CTU, RN,

Manajemen laktasi, PI, IVA, CMBM, EBM

W O R K S H O P Family fnancial management Induksi chief Clinical governance Ethico-medico-legal Clinical and medical audit 12 roles of

medical teacher CEEBM Leader in emergency team Obstetri -Safe Motherho od 1 Obstetri -Safe Motherho od 2 Ginekolog i Pengemba ngan Profesi

Materi MRCOG 1

(21)

JADWAL ACARA PELATIHAN USG DASAR KOLEGIUM OBSTETRI DAN GINEKOLOGI

HARI PERTAMA

07.00-07.15 Registrasi Panitia

07.15-07.30 Pembukaan Direktur Pelatihan 07.30-08.00 Perkenalan, Harapan dan Kekhawatiran

08.00-08.30 Gambaran Umum Pelatihan (P) Direktur Pelatihan 08.30-09.00 Kuesioner Awal

09.00-09.30 Rehat Kopi Panitia

09.30-10.00 Introduksi USG (Diskusi dan Tanya Jawab)

+ Fisika Dasar USG

10.00-10.30 Peralatan, Ruang Periksa, dan Persiapan Pemeriksaan

10.30-11.30 Teknik Dasar, Etika, Medikolegal, dan Profesionalisme

11.30-12.30 ISHOMA

12.30-13.00 Live Demo dan hands on Ginekologi Normal

13.00-13.30 Live Demo USG Normal trimester I (Hamil 10-12 minggu)

13.30-14.15 Panduan USG Dasar Ginekologi

14.15-14.45 Dasar-dasar pemeriksaan Doppler Obgin (knowledge)

14.45-15.00 Rehat Kopi

15.00-15.30 Penilaian Cairan Amnion dan Plasenta

15.30-16.00 Meet the experts Semua Pelatih

16.00-16.15 Rangkuman Hari Pertama

(22)

HARI KEDUA

07.15-07.30 Agenda dan Pemanasan

07.30-08.30 Diagnosis kelainan uterus dan adnexa yang sering ditemukan (mioma, adenomiosis, kista ovarium simpleks, endometrioma)

08.30-09.00 Diagnosis kehamilan ganda 09.00-09.15 Rehat kopi

09.15-10.00 Diagnosis kelainan pada trimester I (KE, BO, Missed abortion, dan mola hidatidosa

10.00-10.30 Konsep Dasar Pemantauan Kesejahteraan Janin 10.30-11.30 Dasar-dasar KTG

11.30-12.30 ISHOMA

12.30-13.00 Live Demo USG Normal TM II (hamil 20-22 minggu)

13.00-13.30 Live Demo USG TM III (hamil 30-32 minggu) 13.30-14.15 Penerapan klinis CTG dan Profl Biofsik

14.15-14.45 Disfungsi Susunan Saraf Pusat

14.45-15.00 Pembuatan Dokumentasi, Laporan USG dan KTG serta komunikasi

15.00-15.15 Rehat Kopi

15.15-15.45 Latihan Interpretasi KTG (1 Normal, kategori 2 atau 3)

15.45-16.15 Meet the experts Semua Pelatih 16.15-16.30 Rangkuman Hari Kedua

(23)

JADWAL ACARA PELATIHAN USG DASAR

KOLEGIUM OBSTETRI DAN GINEKOLOGI

HARI KETIGA

07.30-08.00 Agenda dan Pemanasan 08.00–

09.00 Hands-on : ginekologi normal

Semua Pelatih

09.00–

10.00 Hands-on : trimester 1 normal

Semua Pelatih

10.00–

10.15 Rehat kopi 10.15–

11.15 Hands-on : trimester 1 patologi

Semua Pelatih

11.15– 12.00

Hands-on : trimester 2 dan 3 normal

Semua Pelatih

12.00–

13.00 ISHOMA 13.00–

13.30 Uji akhir : 30 soal MCQ

Semua Pelatih

13.30– 15.30

Hands-on : trimester 2 dan 3 normal

Semua Pelatih

15.30–

16.00 Rehat Kopi

Panitia

16.00–

16.30 Feed Back

Tim

(24)

(25)

(26)

DASAR OBSTETRI TRIMESTER 2 DAN 3

•

IX PEMERIKSAAN USG INTRA DAN

POSPARTUM

•

X DASAR-DASAR PEMERIKSAAN

(28)

CONTENTS

•

XI PEMERIKSAAN USG

DASARGINEKOLOGI (GAMBARAN

NORMAL TERMASUK IDENTIFIKASI VU

DAN REKTUM)

•

XIIPATOLOGI JINAK GINEKOLOGI,

KEHAMILAN EKTOPIK DAN MOLA

•

XIII PEMBUATAN LAPORAN USG

OBSTETRI GINEKOLOGI

(29)

Editor Ketua

Prof. Dr. dr. BiranAfandi, SpOG(K)

Editor

dr. BambangKarsono, SpOG(K)

dr. Herman Kristanto, MS, SpOG(K)

dr. Judi JanuadiEndjun, SpOG

dr. AndiDarma Putra, SpOG(K)

dr. AzenSalim, SpOG(K)

(30)

KONTRIBUTOR

1. Prof. Dr. dr. SoegihartoSoebijanto,

SpOG(K)-Dep.Obgin FK-UI

2. Prof. Dr. dr. BiranAfandi, SpOG(K)-Dep.Obgin

FK-UI

3. Prof. dr. HidayatWijayanegara,

SpOG(K)-Dep.Obgin FK-UNPAD

4. dr. George Adriaansz, SpOG(K) -Dep.Obgin

FK-UNSRI

5. dr. Herman Kristanto, MS,

SpOG(K)-Dep.Obgin FK-UNDIP

6. dr. BambangKarsono, SpOG(K) -Dep.Obgin

FK-UI

7. dr. AzenSalim, SpOG(K) -Dep.Obgin FK-UI

8. dr. Judi JanuadiEndjun, SpOG -Dep.Obgin

RSPAD-GS

(31)

MITRA BESTARI

• _{Dr. dr. M. Fidel GanisSiregar, M.Ked(OG),}

SpOG(K)-Dep.Obgin FK-USU

• _{dr. EdyArdiansyah, M.Ked(OG), SpOG-Dep.Obgin FK-USU}

• _{dr. JohnyMarpaung, M.Ked(OG), SpOG-Dep.Obgin FK-USU}

• _{dr. DudyAldiansyah, M.Ked(OG), SpOG-Dep.Obgin FK-USU}

• _{dr. Mohd. Andalas, SpOG-Dep.Obgin FK-UNSYIAH}

• _{dr. Rajuddin, SpOG(K)-Dep.Obgin FK-UNSYIAH}

• _{dr. TgkPuspaDewi, SpOG-Dep.Obgin FK-UNSYIAH}

• _{dr. Cut MeurahYeni, SpOG(K)-Dep.Obgin FK-UNSYIAH}

• _{dr. Af Angelia Ratnasari, SpOG, MKes-Dep.Obgin FK-UNS}

• _{dr. AsihAnggraeni, SpOG-Dep.Obgin FK-UNS}

• _{dr. M. AdrianesBachnas, SpOG-Dep.Obgin FK-UNS}

• _{dr. WisnuPrabowo, SpOG-Dep.Obgin FK-UNS}

• _{dr. Daniel Henri Usmany, SpOG-Dep.Obgin FK-UNCEN}

• _{dr. David RandelChristanto, SpOG, MKes-Dep.Obgin}

FK-UNCEN

(32)

MITRA BESTARI

• _{dr. ApterPatay, SpOG-Dep.Obgin FK-UNCEN}

• _{dr. NugrahantiPrasetyorini, SpOG(K)-Dep.Obgin}

FK-UNIBRAW

• _{dr. Sutrisno, SpOG(K)-Dep.Obgin FK-UNIBRAW}

• _{dr. TjokGdeAgungSuwardewa, SpOG(K)-Dep.Obgin}

FK-UNUD

• _{dr. A.A.N. Anantasika, SpOG(K)-Dep.Obgin FK-UNUD}

• _{dr. I NyomanBayuMahendra, SpOG-Dep.Obgin FK-UNUD}

• _{dr. I Gede Mega Putra, SpOG(K)-Dep.Obgin FK-UNUD}

• _{dr. Jon Madi, SpOG(K)-Dep.Obgin FK-UNRI}

• _{dr. Ruza P. Rustam, SpOG-Dep.Obgin FK-UNRI}

• _{dr. Yanuarman, SpOG-Dep.Obgin FK-UNRI}

• _{Dr. dr. JoserizalSerudji, SpOG(K)-Dep.Obgin FK-UNAND}

• _{dr. Yusrawati, SpOG(K)-Dep.Obgin FK-UNAND}

• _{dr. Putri Sri Lasmini, SpOG(K)-Dep.Obgin FK-UNAND}

• _{dr. Bobby IndraUtama, SpOG(K)-Dep.Obgin FK-UNAND}

(33)

MITRA BESTARI

• _{Dr. dr. DwianaOcviyanti, SpOG(K)-Dep.Obgin FK-UI}

• _{dr. Aria Wibawa, SpOG(K)-Dep.Obgin FK-UI}

• _{dr. KanadiSumapradja, SpOG(K), MSc-Dep.Obgin FK-UI}

• _{dr. FitriyadiKusuma, SpOG(K)-Dep.Obgin FK-UI}

• _{dr. FernandiMoegni, SpOG(K)-Dep.Obgin FK-UI}

• _{dr. RukmonoSiswishanto, M.Kes, SpOG(K)-Dep.Obgin}

FK-UGM

• _{dr. DiahRumektiHadiati, MSc, SpOG(K)-Dep.Obgin}

FK-UGM

• _{dr. Irwan T. Rachman, SpOG(K)-Dep.Obgin FK-UGM}

• _{dr. AhsanuddinAttamimi, SpOG(K)-Dep.Obgin FK-UGM}

• _{dr. Detty S. Nurdiati, MPH, PhD, SpOG(K)-Dep.Obgin}

FK-UGM

• _{Dr. dr. Freddy W. Wagey, SpOG(K)-Dep.Obgin}

FK-UNSRAT

• _{dr. John J. E. Wantania, SpOG, IBCLC-Dep.Obgin}

FK-UNSRAT

• _{dr. Juneke J. Kaeng, SpOG(K)-Dep.Obgin FK-UNSRAT}

• _{dr. Erna Suparman, SpOG-Dep.Obgin FK-UNSRAT}

• _{dr. M. BesariAdiPramono, MSi.Med.,}

(34)

MITRA BESTARI

• _{dr. Julian Dewantiningrum, MSi.Med, SpOG-Dep.Obgin}

FK-UNDIP

• _{dr. EdiwibowoAmbari, SpOG(K)-Dep.Obgin FK-UNDIP}

• _{dr. InuMulyantoro, SpOG(K)-Dep.Obgin FK-UNDIP}

• _{dr. IrawanSastradinata, SpOG(K)-Dep.Obgin FK-UNSRI}

• _{dr. FirmansyahBasir, SpOG(K)-Dep.Obgin FK-UNSRI}

• _{dr. NuswilBernolian, SpOG(K)-Dep.Obgin FK-UNSRI}

• _{Dr. dr. K. Yusuf Efendi, SpOG(K)-Dep.Obgin FK-UNSRI}

• _{dr. AndiRinaldi, SpOG-Dep.Obgin FK-UNPAD}

• _{dr. Mulya Nusa A. Ritonga, SpOG, MKes-Dep.Obgin}

FK-UNPAD

• _{dr. AmaliaSiddiq, SpOG, MSi-Dep.Obgin FK-UNPAD}

• _{Dr. dr. AdjarWibowo, SpOG(K)-Dep.Obgin FK-UNLAM}

• _{dr. Samuel Tobing, SpOG(K)-Dep.Obgin FK-UNLAM}

• _{dr. BambangAbimanyu, SpOG(K)-Dep.Obgin FK-UNLAM}

• _{dr. RennyAditya, M.Kes, SpOG-Dep.Obgin FK-UNLAM}

(35)

MITRA BESTARI

• _{dr. Sanny Santana, SpOG-Dep.Obgin RSPAD-GS}

• _{dr. Novi Resistantie, SpOG(K)-Dep.Obgin RSPAD-GS}

• _{dr. FebriansyahDarus, SpOG-Dep.Obgin RSPAD-GS}

• _{dr. BintariPuspasari, SpOG-Dep.Obgin RSPAD-GS}

• _{dr. GunawanDwi P., SpOG(K)-Dep.Obgin RSPAD-GS}

• _{dr. Budi Santoso, SpOG-Dep.Obgin RSPAD-GS}

• _{Dr. dr. DevianaSorayaRiu, SpOG-Dep.Obgin FK-UNHAS}

• _{Dr. dr. Maisuri T Chalid, SpOG(K)-Dep.Obgin FK-UNHAS}

• _{Dr. dr. Nusratuddin Abdullah, SpOG(K),}

MARS-Dep.Obgin FK-UNHAS

• _{Dr. dr. IsharyahSunarno, SpOG(K)-Dep.Obgin FK-UNHAS}

• _{dr. Budi Wicaksono, SpOG-Dep.Obgin FK-UNAIR}

• _{dr. Ernawati, SpOG-Dep.Obgin FK-UNAIR}

• _{dr. Sri Pudyastuti, SpOG(K)-RS Persahabatan}

(36)

MITRA BESTARI

• _{dr. AmaliaSiddiq, SpOG, MSi-Dep.Obgin FK-UNPAD}

• _{Dr. dr. AdjarWibowo, SpOG(K)-Dep.Obgin FK-UNLAM}

• _{dr. Samuel Tobing, SpOG(K)-Dep.Obgin FK-UNLAM}

• _{dr. FeryArmanza, SpOG(K)-Dep.Obgin FK-UNLAM}

• _{dr. BambangAbimanyu, SpOG(K)-Dep.Obgin FK-UNLAM}

• _{dr. St. Finekri A. Abidin, SpOG(K)-Dep.Obgin RSPAD-GS}

• _{dr. Sanny Santana, SpOG-Dep.Obgin RSPAD-GS}

• _{dr. Novi Resistantie, SpOG(K)-Dep.Obgin RSPAD-GS}

• _{dr. FebriansyahDarus, SpOG-Dep.Obgin RSPAD-GS}

(37)

(38)

(39)

(40)

(41)

(42)

(43)

(44)

(45)