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Introduction Self-regulated learning is one of the influencing factors in successful learning. There is a need to understand the factors influencing self-regulated learning in undergraduate medical students in implementing a student-centred learning curriculum. This scoping review aims to systematically identify and map undergraduate medical students’ self-regulated learning during student-centred learning implementation and to learn the tools used to measure it.Methods and analysis The scoping review will use Arksey and O’Malley’s proposed five-stage framework guideline. A search for published literature between 2012 and 2022 in the five electronic databases of EBSCOHost, Science Direct, Scopus, ProQuest and PubMed will be conducted using keywords to identify relevant studies. Articles will be limited to the English language. Mendeley software will eliminate duplicates, and results will be exported into abstracts for two stages of the screening process: title and abstract reviews and full-text reviews. The selection process of eligible literature will be reported using the Preferred Reporting Items of Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist recommendations. Studies using qualitative and quantitative data from all world regions will be considered. To be included, studies should examine medical students’ self-regulated learning in a student-centred learning approach curriculum. A data chart will capture relevant information from all the included studies. As a scoping review, no assessment of the studies’ quality and risk of bias will be made. Results will be presented in tabular form and a narrative report.Ethics and dissemination No Ethics Committee or Institutional Board approval is required. The findings of this study will be disseminated through peer-reviewed publications, conference presentations and professional networks.

In the field of delivery of medical education, assessment plays a pivotal role in measuring attainment of the student learning outcome. However, we must acknowledge that more often than not, assessment methods have been employed to predominantly measure short-term outcomes. Nevertheless, with the passage of time, medical educators have realized that we must also aim to assess the long-term impact of educational strategies, including assessment methods, in facilitating long-term learning and skill development among medical students. Evaluating the long-term impact of assessment methods has gradually gained importance owing to multiple reasons, such as we can measure the impact of assessment methods in contributing toward the acquisition and retention of knowledge and skills over an extended period of time. In conclusion, the process of evaluating the long-term impact of assessment methods is extremely crucial to gain an understanding of their effectiveness in promoting lasting learning and skill development. In fact, the evaluation findings are expected to provide valuable information in the domains of knowledge retention, skill application, critical thinking, and continuous learning and thereby provide adequate evidence for policymakers to bring about timely and appropriate modifications in the curriculum to ensure the attainment of learning outcomes.

Abstract Background Indonesia has applied a national competency exit-examination for medical graduates since 2014, called The Indonesia Medical Doctor National Competency Examination (IMDNCE). This examination is administered to ensure the competence of medical graduates from at present 83 medical schools in Indonesia. Although many studies reported their evaluation on medical licensing examinations, there are not many studies performed to evaluate the correlation of a national licensing examination to the graduates’ clinical practice. Aims This research aimed to evaluate the performance of new medical doctors in Indonesia in their internship period after the IMDNCE completion, and whether it might become a predictive indicator for the new medical doctors’ clinical performance. Methods An observational cross-sectional study was performed in November–December 2017 on 209 doctors who were new medical graduates. Thirty-one senior doctors from a range of regions in Indonesia who were recruited and trained previously participated in the observation. The Clinical Performance Instrument (CPI) tool was developed as an evaluation tool of the new doctors’ clinical competence to be observed for three weeks. The obtained data were analysed using descriptive statistics and correlated to the IMDNCE scores. Results The mean (95% CI) of the CPI for all participants was 83.0 (80.8–85.2), with no correlation of CPI score with IMDNCE results in domains of communication, professionalism and patient safety (p > 0.05). However, the mean total of the CPI observation scores from doctors who graduated from public medical schools was higher than those graduating from private medical schools. Also, there were differences in scores related to the institution’s accreditation grade (p

Background: A medical teacher as a healthy role-model has a critical role in supporting health promotion effectiveness in medical school. However, an instrument to measure the characteristics of the medical teacher as a healthy role-models is unavailable. This study aimed to develop and validate a questionnaire to evaluate these characteristics by analyzing a model from previous grounded theory. Methods: A total of 442 medical teachers at the Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, were invited to participate. We used hierarchical component models (HCMs) to develop our path model. A partial least squares structural equation modeling (PLS-SEM) were then used to analyze this model. Results: Twenty-six items from seven constructs supports our model. The construct of socially healthy (SH) has the most substantial effect on constructing healthy people's characteristics (H). The constructs of healthy role-models (HRM) in medical schools are mainly influenced by healthy people characteristic (H). Conclusion: A questionnaire with 26 items grouped in these seven constructs showed good reliability and validity. Seven constructs have relevance to the characteristics of a healthy role-model in the medical school model.

Background: Rational prescribing is an important skill for medical doctors. Many graduates still feel insufficiently prepared to make rational prescribing and fail to demonstrate the related clinical reasoning after graduation. For these reasons, it is important to improve the medical student teaching of rational prescribing. The aim of this study is proving the effectiveness of experiential learning methods to improve rational prescribing skills of medical students. Methods: This study used a one-group pretest-posttest design. Rational prescribing courses use experiential learning methods for 6 year medical students. Every student provided evaluation of rational prescribing and clinical reasoning through pretest and posttest, and we analyzed the results by paired t test. Results: The change in the rational prescribing skill of the students is significant between pretest and posttest. However, in the hypertension case the scores are not significant between pretest and posttest. Also, the scores of clinical reasoning based on drug interaction and evidence based methods are not significant in the hypertension and otitis media cases. Conclusions: Experiential learning methods can enhance rational prescribing skill in medical students but the students were still not able to choose appropriate medications based on drug interaction and evidence based approach.

Background: Medical students in Indonesia are required to pass a national licensing examination (e.g., UKMPPD) as a requirement of graduation and to obtain their certificate of competence. Medical schools prepared their students based on their needs and capacity. The preparation might use different teaching approaches. Undergraduate medicine program in Universitas Gadjah Mada conducts a national licensing examination preparation program facilitated by both faculty members and peer tutors. The peer tutors are newly graduated medical doctors who were recruited and trained. The use of trained peer tutors in a structured program to prepare high-stake examination such as a national examination is considered novel. This paper aims to describe a peer-assisted learning (PAL) approach used to prepare medical students in facing a national licensing examination. Case Discussion: A preparation program using faculty and peer tutors was deployed to prepare final-year medical students for facing the Indonesian national licensing examination. The ratio of sessions facilitated by faculty to peer tutors was 1:2. The preparation included CBT and OSCE training. Sessions with faculty used a medium to large class approach while sessions with peer tutors used a small to medium group approach. Through February 2020, 147 students have participated in the program. A questionnaire was developed to measure agreement that the program was successful and if the tutees were satisfied with various aspects of the program. The tutees responded with high rates of satisfaction to most items on the questionnaire (responses for all but one item ranged between 72.1% and 90.5% in favorable agreement or satisfaction). The one exception was CBT preparation where the level of satisfaction was lower (54.4% rated CBT favorably). Participants highly valued the involvement and the performance of peer tutors. Conclusion: The use of near-peer assisted learning for national licensing examination preparation has strong potential. Further study is required to investigate the impact of the peer-assisted national licensing examination preparation program on students’ achievement and clinical practice.

Background: Medical students who experience failure in the final exam are around 10%. In Indonesia, there are students who failed to pass the competency test for medical profession program students (UKMPPD) until 14 times. The impact of this failure is the occurence of mental health disorder. Students need support more than guidance on clinical knowledge and skills. This study aimed to identify the motivation and support needed by the UKMPPD retaker students in the effort to achieve graduation Methods: This research is a qualitative research with phenomenological approach, the data was obtained by in-depth interview and focus group discussion (FGD). This research was followed by 16 respondents. The data analysis was conducted by thematic analysis method. Results: Identified intrinsic motivation predictor originated from learning independence, relation, and low competence. The extrinsic motivation predictors are originated from external regulation, that is UKMPPD regulation. The motivation predictor is originated from anxiety and study period limit. The support needed by the respondents from medical schools are in the form of psychological approach, absolving the retaker students from selection tests, providing form of selection tests that compatible with the blueprint and rules of UKMPPD multiple choice question, also giving the opportunity to pass with other exam methods. Conditions of motivation can change with the factors that influence it. Changes in motivational conditions that may occur are an increase in motivational conditions, decreased motivational conditions, or persistent motivational conditions. Conclusion: The motivation condition of retaker students is amotivated and motivated (external and internal motivation). Support from medical school that can increase motivation is given to students to keep their motivation level.

Background: It is very important to develop professional identity among medical students, as it will affect how they work in the future. Factors affecting professional identity in medical education context need to be explored. This study aimed to develop a model of professional identity in medical students which examine the role of motivation, self-efficacy, personal reflection, social interaction, curriculum in action perceived by students and participation in determining professional identity. Methods: A cross-sectional survey was conducted among medical students in Mataram University. A total of 303 pre-clinical (year 1 to 4) and clinical students (year 5 to 6) filled out the questionnaires. Partial least square - structural equation model analysis was performed. Results: The modification model had a good model fit (GoF 0.404). The average path coefficient was 0.303 (p

Background: Role modeling is known as one of the most effective methods in learning professionalism, especially in the workplace. Each role model shows a different substantial values of professionalism, therefore the 'positive' or 'negative' role model criterion are difficult to set. This study aims to understand how students identify 'professional behavior’ (positive role model) and ‘unprofessional behavior’ (negative role model). Method: The design was a qualitative with case study approach. The sample was 20 students of undergraduate medical school at one university in Indonesia, selected by purposive sampling using maximum variation strategy. Gender, GPA, origin, and clinical rotation are used as key dimensions. Data collection used two methods, written narrative and focus group discussion. While the steps of qualitative analysis refers to Miles and Huberman. Results: This study found four themes as ‘behavioral identification’, namely: 'self-principle', 'self-standard of professionalism', 'normative standard of professionalism' and 'subjectivity'. Conclusion: Differences in identification are a reflection of students’ cognitive maturity. The outcome of learning professionalism can be improved from ‘valuing’ to ‘organizing’ and ‘internalizing’ through role model exposure and facilitation that provides the opportunity to explore and to reflect on professional values, before the student chooses them independently. This is part of the development of internal belief systems that are closely related on how students build their professional identity.

Background: Learning environment is an important factor in learning process and can affect students' competence and work-readiness. Learning environment is not only about physical facilities but also social and psychological condition. The complexity of clinical learning environments pose challenges and problems that may affect students learning process so it is necessary to monitoring and evaluating students learning environments. This study aims to assess students' perception of their learning environment and the effect of primary, secondary and tertiary health care services utilization as clinical learning environments. Method: This study was conducted with a cross sectional study design. The subjects were 36 students of obstetrics and gynecology department. Data obtained from learning environment questionnaires in tertiary, secondary and primary health care services. A non-parametric test was applied to compared learning environment score in each health care level. Results: Students perception of their learning environment between tertiary and secondary as well as tertiary and primary health care services were significantly different. Students stated advantages and disadvantages of each learning environment that can affect their competence level. Conclusion: Students have a good perception of the their learning environment. There was significant difference between tertiary and two other health care services.

Background: Interprofessional Education (IPE) is a process occurs when students from two or more professions learn about and from each other to enable effective collaboration and improve health outcomes. Faculty initiated the IPE program called Community and Family Health Care - interprofessional Education (CFHC-IPE) that began in 2013 with the aim to build the capacity of community, family medicine and interprofesional. This study aims to evaluate the effect of context, input and process towards the achievement of interprofessional competences. Method: This study was a qualitative research design using a case study evaluation Context-Input-Process-Product (CIPP). Respondents of this study are five-IPE CFHC managers, three heads of study program, 10 lecturers and 35 students from PSPD, PSIK and PSGK. Data collected through FGD, in-depth interviews and document analysis. FGD and in-depth interviews conducted using an interview guide while document analysis carried out on the grand design CFHC-IPE. Results: Context evaluation shows that the needs assessment has not been carried out. Input evaluation shows that the preparation of the grand design CFHC-IPE is not align and debriefing facilitators need to be added. There were gaps in the implementation of learning activities and assessment and program monitoring was inadequate. IPE competencies in the first year on the student of 2014 were not achieved. Conclusion: Inter-professional communication and teamwork competence on student of class 2014 at CFHC-IPE program in the first year was not achieved and influenced by the weaknesses in the content, inputs and processes aspects.

Background: The physician who reflects critically will interpret the experience, aware of its limitations, and will become life long learner. When implementing reflection learning in medical education, it is necessary to assess the ability of learners to help improve the ability of reflection. The objective of the research is to know the students 'reflection ability by giving feedback and different of reflection ability between intervention group and control group. Method: Research using pre and post control group design. The subjects of the study were 62 students medical students of Faculty of Medicine UGM year II who had collected narrative reflection to Gamel (n = 176 students) and willing to participate, divided into 2 groups with simple random sampling. Intervention of treatment group are giving feedback based on the result of narrative reflection from Gamel followed by narrative reflection assignment. The subjects' narrative reflection was assessed using the REFLECT rubric, and analyzed by Wilcoxon and Mann-Whitney tests. Results: The results showed that students' pre and post test reflection ability is in the reflection stage. Giving feedback once does not increase the ability from reflection stage to the critical reflection stage. This result may be due to several things: critical reflection does not occur without significant / dramatic experience that shifts perspective resulting in transformative learning, feedback is given regularly, lack of trustworhty to instructors who are not university lecturers. Another result of a decrease in the ability of reflection in general after 6 months indicates the need to do reflection activity / assignment in each semester to maintain and improve the ability of reflection. Conclusion: Increased reflection ability from reflection stage to critical reflection stage does not occur with single feedback. If reflection is not done regularly, it can cause a decrease in reflection ability.

Background: Derogation of professional behavior (PB) increased in education, even in medical education revealed cheating during in educational process as best predictor when the students at work placed in the future. The aim of this study is to know the students’ perspective on cheating, altruism and plagiarism. Method: This study was conducted using a qualitative approach. Sampling technique was purposeful sampling with criterion reference. Fifty-two year-one students of medical school of faculty of medicine and health sciences (FMHS) divided into 5 groups, each group consists of 10 to 11 students. The students received teaching learning of PB (three times tutorial with trigger film, reflection and expert panel). Qualitative data from students’ reflection analized using constant comparative method. Results: The results of this study indicated the presence of 6 final themes (i.e., learning value, learning approach, student preparedness, examination strategy, learning spiritual, study plan. Students who had the ability to understand various learning events would have a good study plan, and then could choose appropriate examination strategy to reach success and could avoid blamable event such as cheating. The students who had good learning spiritual and learning value to dilemmatic event, they would be motivated and their heart would be touched, so in their future plan they would try to be altruistic and professional doctor in all situation. There would be influence on positive study plan, make more effort and pried to God, also respect others work, so plagiarism could be avoided. Conclusion: There were 6 final themes of students’ reflection on cheating, altruism and plagiarism after they exposure by teaching learning of PB. They were learning value, learning approach, student preparedness, examination strategy, learning spiritual and study plan.

Background: Change seems to be a constant in education. The shifting paradigm from teacher-centered to student-centered impact on demands of medical and health professions education institution to undertake curricullum reform. The development of PBL requires the provision of resources needed for its implementation. The emergence of newly developed method, TBL, garnered interest because of its potential to promote active learning without requiring large numbers of resources. The integration of these two methods can complement each deficiencies with their advantages, so it can optimize student learning. This study is aimed to determine the impact of the integration of PBL and TBL (PiTBL) on student engagement and to evaluate the perceptions of students in terms of accountability, preferences and their satisfaction with this method. Method: This study was a pre-experimental with one group pre and post test design. Subjects consisted of 103 nursing students who enrolled Fluid, Electrolyte an Elimination course. The collection of data before and after the intervention were held to determine the difference in student engagement, using “Classroom Engagement Survey” instrument from Baylor University. Students perceptions in terms of accountability, preference and satisfaction were measured with PiTBL-Student Assessment Instrument (PiTBL-SAI). Results: PiTBL had a positive impact on student engagement, but its results were lower then PBL. The difference was not significant for participation sub-scale, and significant in several weeks of course for enjoyment sub-scale and total value of student engagement. Students perceptions in terms of accountability, preference and their satisfaction with PiTBL all showed positive results. Conclusions: PiTBL had a positive impact on student engagement, although lower than PBL. Students perceptions in terms of their accountability, preference and satisfatction with this method is also positive. We concluded that this method can be used as an alternative in implementing an effective and eficient active learning method.

Background: Clinical Skills is a fundamental ability that must be mastered by the newly graduated nurses. Therefore, assessment of clinical competence is essential to be considered by educators and education managers. It needs a valid assessment instrument, which is reliable and impactful on learning the process by giving a structured feedback so that qualified graduates can be produced. Some assessment instruments in the clinical nursing education have less evidence of validity and reliability and less feasible, so it requires a development of clinical assessment instruments. This study aims to develop a clinical assessment instrument in the nursing clinic and to test the content validity. Method: This study used a qualitative research design that includes drafting through literature review and expert review by the expert panel. Results: The process of drafting and reviewing produces a rubric named Nursing Clinical Exercise (NCEx) made of six domains consisting the assessment of subjective data, physical examination, diagnosis formulation, treatment planning formulation, communication and interpersonal relationships, and professionalism. The value of content validity is good (CVR of the entire domain = 1) Conclusion: The NCEx Rubric consists of six domains and has good content validity.

Background: Anatomy is one of basic science in medicine. As doctors are obligated to assure their service is safe and efficient, they need to master anatomy science to support their work on comprehend the patient condition. In another condition, there is a shifting on medical curricula that impacted on decrease of anatomy instructional hours. This condition result in lower of anatomy academic achievement among medical students. The third of ten question Harden in curriculum development, that is what content should be included? need to be resolved so that the limited time available can be utilized as well as possible. This study aims to achieve national scope consensus among anatomical expert about anatomical material course that must be delivered to medical students. Method: This study was design in qualitative approach with specified method of two round Delphi Technique. Using purposive sampling method, the subject of study involved was 20 experts of anatomical science in Indonesia. The questionnaire as instrument in this study arranged based on anatomy text book. The first Delphi purpose to select the anatomical course material and additional course material. The second Delphi round intent to provide level range from 1-4. The consensus level established by the researcher at 80% point. Results: The first Delphi round result in 760 anatomy topics consist of 636 original material arranged by researcher and 124 additional material added by the Delphi panel. Additional materials are osteomyology and sesnsory system. The second Delphi round agree 64% material of first Delphi round (489). Conclusion: Indonesian anatomical experts agree in which not all of anatomy material need to be learned by medical student. Their consensus is about 64% of all the material that must be learned.

Background: Medical education research has been flourished in the past two decades in Indonesia. It is highly important to study results of medical education researches in Indonesia to provide future direction for medical education. Six published literature in medical education from Asian context was used as the basis of this study. Method: We used the narrative review in which quantitative data were interpreted qualitatively. All national and international publication and the unpublished research in medical education from Indonesia between 2000 - 2013 were collected with multiple methods based on 8 criteria of inclusion/ exclusion. We also grouped the articles into quantitative and qualitative groups based on each method in each study. Results: Total articles interpreted was 151 and grouped into 17 areas of interest and level of evidences from ‘very rarely’ to ‘very frequently’ studied. Studies in the area of understanding problem–based learning (PBL) are still dominating the area of interest including the student-assessment within PBL program. Other areas are still rarely done, especially research in health professions education other than medical doctors. Conclusion: Research in medical education in Indonesia should be more stimulated; in terms of numbers and quality, more importantly to strive for future agent of culture, socio-economic and political changes based on the actual community problems in the universal coverage era toward solid interprofessional team work to accomplish patient safety.

Background: The skill of breaking bad news is listed in the 2012 Indonesia’s Doctor Competency Standards so that this becomes one of the skills that must be mastered by all doctors in Indonesia. The curriculum of breaking bad news is much developed in western cultural background. The curriculum may not necessarily be well developed in Indonesia because the communication process is strongly influenced by culture. Therefore, the exploration of the problems faced by the practitioner in delivering bad news in the context of local cultural needs to be done as a first step to develop the right educational curriculum and training. Objective: This study aimed to identify problems of the practicing doctors in delivering bad news to patients or their families in the context of local culture (Banyumas). Methods: This study was a qualitative research with a phenomenological approach. The method used was in-depth interviews to the practicing doctors with experience in delivering bad news selected from various educational backgrounds, sex, and age. Results: This study indicated that the doctors had difficulty in breaking bad news. It was known from the attitude of the doctors who tended to avoid by giving the task to others, to cover the actual condition of the patient or just delivering the bad news to the family. The causes identified were the lack of knowledge and skills, the lack of ability to control emotions, the lack of confidence, the anxiety on the patient’s response, the knowledge gap between doctors and patients, and the limitations of space and time. Conclusion: The main problem of the practicing doctors in delivering bad news was the lack of knowledge and skills. Therefore, it is necessary to develop a training curriculum on breaking bad news adequately for basic and advanced medical education.

Background: In the teaching process at medical faculty, there are many measuring devices have been used to evaluate the clinical reasoning ability. Each measuring device has the advantage and disadvantage. MCQ and SCT are the clinical reasoning measuring device. In the previous study, both methods have been validated. SCT is a more recent method to measure clinical reasoning compared to MCQ. This study aims to evaluate the concurrent validity between MCQ and SCT. Method: Forty-three students who had already passed the Paediatric clinical rotation were asked to complete 100 items of MCQ. The next day, they did 100 items of SCT. The concurrent validity is measured using correlation analysis. Results: Concurrent validity between MCQ and SCT did not show strong correlation (coefficient of rank spearman correlation= 0.291 with the probability = 0.058). Conclusion: Concurrent validity between MCQ and SCT do not have strong correlation in evaluating the clinical reasoning. SCT is used as complement to evaluation of clinical reasoning in order to be more specific and close to real setting.

Background: Self-directed learning is a form of independent learning where in the process it is advisable that students create a study planner so that the learning process is more focus and effective. A study planner can be used as a reference that will assist students in evaluating and reflecting the learning process. This study aimed to find out how the application of study planner can support the process of self-directed learning, this will be based on a literature study. Method: This research was in the form of a literature study which covered the application of study planner and its relation to self-directed learning. The literature searches were conducted with two databases (e-sources national library and ERIC), by using 11 keywords, in order to obtain more amounts of readings available, that were in relation to the utilization of study planner in order to support self-directed learning. Based on five inclusion and exclusion criteria were used to select 22 journals that obtained from the results of database searches, two journals that can be used to answer research questions were found. Data were extracted systematically by segmenting and coding. Followed by determining patterns to find broader category. Results: Based on segmenting and coding process and determining important patterns, two broad categories were found, that are (1) The benefit of study planner in self-directed learning; and (2) Factors that affect study planner and self-directed learning. Conclusion: Study planner can assist students in developing their self-directed learning skills, that will be handy to support their lifelong learning skills. Study planner can also give motivations to students in performing self-directed learning

Background: Feedback constitutes one of the important components in student Since feedback is not solely limited to student assignments, it can also be given during student learning, including tutorials. Therefore, the institution should pay particular attention to the process of feedback provision one of which is through evaluations on the process of providing feedback in tutorials. This study aimed to evaluate the process of providing feedback on the Problem-Based Learning tutorials in the Faculty of Medicine, Universitas Islam Sumatera Utara. Method: This study used mixed methods with a quantitative method performed first, followed by a qualitative method with a phenomenology approach. The subjects were the undergraduate medical students of the class of 2012 and tutors of the Problem-Based Learning tutorials. The quantitative data analysis was done by the descriptive analysis while the qualitative data analysis was done through verbatim analysis, coding, categorization and conclusion. Results: The students had received feedback but not routinely. Both the students and the tutors had perceived that feedback was important and gave them many benefits. In practice, feedback was given on the basis of tutors’ direct observation results. Action ;plan was often given but rarely involved discussion. Self-assessment/reflection was also not a matter of routine and the tutors did not know that it was part of the feedback. The contents of feedback were more often in the form of general comments. Feedback was often communicated in one direction. The students’ response to feedback varied. In giving and receiving feedback, the students, the tutors, the tutorial activities and the content of the feedback itself could influence one another. The students had preferences so feedback can be more easily accepted and they focused on the structural aspects of feedback (the frequency of giving feedback, the detail and spesific feedback, two way communication in giving feedback and the feedback target). Tutors expected more trainings in giving feedback provided by institution to tutors and students. Conclusion: Despite its valuable benefits, tutorial feedback in the Faculty of Medicine, Universitas Islam Sumatera Utara,is still not in accordance with the principle of providing feedback and many factors have affected this condition.

Background: Problem Based Learning (PBL), a form of active learning model that is constructive, independent, collaborative and contextual, implemented in the learning process in the form of tutorial discussions. The quality of tutorial discussion need to be improved. One way to improve the quality of the tutorial is to revise or to select the appropriate assessment methods of tutorial discussion. Aside from tutor perception as a user, student perception about the benefits of the assessment process in PBL as subjects assessed need to be considered as a consideration in determining the appropriate model of assessment. One of tutorial discussion PBL method is using a seven jumps. This tutorial process is assessed and the result becomes a component of summative assessment. Therefore, the quality of these assessments must be guaranteed in terms of validity, reliability, impact of learning and in terms of ease of implementation. Method: This study used a qualitative method through a case study approach that use focus group discussions and in-depth interviews. This research carried out in the faculty of medicine of Islamic University of Indonesia. The study population was representative students of the years 2011-2014, the representative of tutors, and the leadership of the study program and faculty. Results: there were eight categories of perception in the tutorial discussion assessment. The perceptions included the perception of tutor and student knowledge about the assessment tutorials, the conformity tutorial discussion assessment with the concept of PBL, the technical assessment, the deviation judgment, the assessment objectivity, the assessment impact of the tutorial process, the learning/educational impact of tutorials assessment, and the recommendation of tutorial assessment Conclusion: Based on eight categories of perception in the tutorial discussion assessment, this study recommended three things, recommendation to keep doing the assessment of tutorial, to improve the objectivity of ratings tutorial by improving various components related to the assessment of tutorials, and to prevent the occurrence of irregularities in tutorial assessment.

Background: The study explores the factors that affecting the readiness to (self-directed learning readiness) in the context of PBL is still rare, especially when in fact unprepared students in the initiative and the desire for self-learning, a lack of understanding of students on independent learning and interpretation mischaracterized the self-learning (self directed learning) is still frequently encountered. This study aimed to measure simultaneously identify factors that influence student SDLR in the first, second and third at the Medical Faculty of Hasanuddin University. Method: through two stages (sequencing), which combines two research approaches, namely qualitative as the main approach (dominant) and quantitative approaches as facilitators (less dominant). data collection with questionnaires and focus group discussions. The number of subjects quantitative 399 people (143 people from the first year, 152 the second year and 104 people from the third year), while for FGD about 18 people who set out with purposive sampling. Distributing questionnaires carried out in advance to obtain SDLR categories of high, medium and low, followed by FGD each batch by category SDLRnya. The analysis starts with the transcription process then the coding process. Results: This study shows that the average score lowest SDLR owned by First-year students FK UNHAS while the highest SDLR owned by Second year students. Not found SDLR category lower because students have had plenty of experience of active and independent learning that develops steadily. There are several factors that affect SDLR construct the desire to learn, self-control and self-management. Conclusion: Factors that affect SDLR the first year students, second and third in the FK Unhas divided into two, namely: (1) internal factors which consist of physical health, the availability of leisure time, hobby or avocation, self maturity, and intelligence; (2) external factors which consists of the support of family and friends, faculty facilities, problems, relationships between peers, and the influence of parents and friends

Background: There are two important characteristics that need to be considered by the institution of medical education today, the first is about the importance of using assessment as a measuring instrument and the role of curriculum in producing good quality graduates. UKDI is only one exit to be a doctor that will certainly have varied impact on students from the expected and unexpected. The purpose of this study was to determine the impact on student learning UKDI on which will follow UKDI related to the allocation of time for study, the number of hours of study, the distribution of learning, the selection of learning resources and learning materials selection. Method: The research method is qualitative study that use Focus Group Discussion to get the data. The number of participants is 61 people devided into 6 groups. That group of students at the Faculty of Medicine with the accreditation of A, B and C respectively - each of the public and private colleges. Results: The results of the qualitative analysis portrait that UKDI has an impact on the student learning. The impact of learning that occurs associated with two things, the first is related to the quality of student learning and the second related to student metacognitive regulation. The general quality of the student learning that occurs in the face of UKDI is still low quality, learn by rote. For metacognitive regulation is related to the allocation, the number and distribution of learning, the selection of learning materials, the selection of learning resources, the selection of a place of learning, learning strategies, learning to maintain consistency, and monitor the process of learning and improvement. Conclusion: UKDI have an impact on the learning of medical students, both in the quality of learning and metacognitive regulation.

Background: In the process of becoming a doctor, a medical student experiencing the development of professional identity. In this process, students need a broad picture of medical profession. They need to orient themselves in the medical profession to determine the future professional identity as a doctor. Source of the picture of medical profession needs to be explored further. This study aims to explore the ways students get picture of the medical profession. Method: Qualitative research by conducting in-depth interviews to 17 preclinical and clinical medical students. Determinants and emergent coding performed to analyze the results of the interview. Results: Source of imagination can be derived from the curriculum and outside the curriculum. Students get two important things, first was overview of the work environment and how the physician work and second was physician professional values. Characters of role models identified primarily from student interaction with faculties. The characters include faculty’s role as teacher, as doctor, their personal atributes and how they interact with students. Conclusion: Formal curriculum plays important roles in providing and facilitating students to get overview about the work environment and how the doctors work in the health service. Although the transfer of professional value to students is determined by the hidden curriculum, but the formal curriculum can facilitate by providing activities that allows the interaction between generations or conduct review on fiction and non-fiction medical stories and histories that is obtained from media.

Background: Multiple choice question (MCQ) has been used widely as a method to assess the achievement of learning outcomes. MCQ as an assessment instrument may give both expected and unexpected impact. The research’s objective is to identify the impacts of MCQs in term of the structure, content, information and regulation on the learning process of student at Medical Faculty Hasanuddin University Method: The study was a descriptive survey involving 505 medical students from Hasanuddin University who were still in the academic phase, class of 2010, 2011 and 2012. Preliminary study was carried out to explore learning impacts caused by MCQs. Based on the result of preliminary study a questionnaire using rating scale was developed, consisting 92 items of possible learning impacts. Open ended questions were added to get free response from the students. The answers were classified into expected and unexpected learning impacts. Results: The structure, content, information and regulation of the MCQ method gave expected impacts such as learning from many sources (74.4%), group studying (96.2%), mind mapping (37.9%) and re-discussing the exam materials (96.2%). It also gave unexpected impacts such as guessing the answer (44.8%), only studying previous exams (93.5%), cheating (33.7%) and taking pictures of the exam papers (38.2%). Conclusion: Unexpected impacts may occur from the MCQ method, which structurally consists of item flaws, such as only assessing memorizing skills rather than the application of knowledge and incomplete information in the stem. The regulation, in the form of summative exam, will encourage students to prepare themselves more seriously if compared to the formative exam.

Background: OSCE is one of the assessments used in the Faculty of Medicine of Universitas Gadjah Mada, Yogyakarta since 1993. The uses of the OSCE as assessment tool have been widely proven. However, it also had limitations such as the presence of anxiety of the students and the high complexity of resources. This study aimed at finding out the impact of the OSCE on learning and its catalytic effects on the first, second and third year students of the Faculty of Medicine of Universitas Gadjah Mada. Method: In a qualitative method, data was collected using focus group discussion. There were 25 participants assigned to 3 groups, which were the group of the first year students, that of the second year students and that of the third year students. Samples were drawn using purposive sampling technique. The data was collected once the students have followed the OSCE. Analysis was made using Atlasti verion 6 and intercoding was conducted along with medical and health education experts. Results: The impacts of the OSCE were the learning strategy of the students more focused on clinical skills and their learning motivation increase. The OSCE caused anxiety of the students and they needed constructive feedback. The catalytic effects of the OSCE in the study were: It made the students more aware of the necessity to more diligently learn, to actively look for learning sources, to more creatively learn, to learn in a more integrated and comprehensive manner. Conclusion: The impact of the OSCE on learning was influenced by its organization and students’ characteristics. The positive catalytic effect of the OSCE on the students was that they needed standard OSCE. The study must be continued using other methods for example survey, cross-sectional or mixed methods.

Background: Shifting method from teaching to learning approaches require students to take the initiative to learn more, while academic staff only acts as a facilitator and requires them to be able to manage learning activities well. Thus it is necessary for them to know several methods of essential student centered learning so they can select the most suitable type of learning method to achieve the learning competencies from a single subject. The objective of this study is to evaluate academic staff knowledge, students of Nutrition Department, Faculty of Public Health class of 2008 and 2009 and supporting staff’s knowledge about student learning centered method. Method: This research was conducted with the mixed method (embedded design, qualitative research as part of the quantitative research) with a primary emphasis on quantitative research involving all students of class 2008 and 2009, who are still in the academic phase, academic staff of nutritional department and supporting staff of Faculty of Public Health, Hasanuddin University. Results: There are 3 methods most answer correctly by 54,5% of respondents that the advantages of using small group discussion, advantages of cooperative learning and problem based learning weaknesses. While the least correct answer is the advantage of problem-based learning method that is 4,5% respondents. For open questions, the most preferred methods are small group of, 18,2%; case studies of 18,2% and PBL of 13,6%. While the least preferred methods are cooperative learning and discovery learning 13,6%, respectively. This question is actually an open question so there were 27,3% of the respondents that did not answer; the preferred method or not. Conclusion: Respondents generally knew and heard the term SCL through correspondence, newspaper and faculty meetings. Respondents define SCL as learning with computers, in small rooms or some sort of FGD. In terms of the benefits of SCL respondents define it variously; to develop the potential and motivation of students, students more actively seek and accept; provide opportunities for students to obtain more sources, students find it easier to find lecture material”; student is more serious in his courses”; students more active in the lecture”; students are more self-sufficient“. Efforts made for the implementation of the SCL, according to in formant sare facilitating room equipments, props and LCD; expedite the administrative process; monitoring, inserting topics, and being ontime in the implementation of lecturers and improvementals of academic staff.

Background: Caring in nursing is a very basic component, as the heart of profession, Which means that caring is a fundamental component, and central and unique focus of nursing. Caring, which is a core of nursing practice, must grow from self and deepest heart to help other people since being a nursing student so that caring in nursing education, must be placed as main competency in nursing education. The aim of this research to evaluation the efficacy of caring training in improving understand cognitive, affective and psychomotor competencies of caring, among students during clinical period Method: This research used quasi experiment non-randomized control group pretest-posttest design. Respondents of research were nursing students of Poltekes Palangka Raya, Semester V, regular class, X-A period, with total of 37 respondents as intervention group and regular class of X-B period with total of 35 respondents as control group. Results: Data were analyzed using descriptive and inferential statistical analyses. Results of research indicated that cognitive, affective and psychomotor competencies of caring in nursing students with caring training did not show significant effect (cognitive: p-value = 0,21, affective: p-value = 0.58, psychomotor: p-value = 0.07); however, the average scores were higher among student received caring training The caring behavior showed no difference between male and female students. Conclusion: There is insignificant difference between students with caring training and students without caring training. The training should be modified as suggested in the paper.

Background: Problem-based Learning (PBL) is a new strategy on a learning system. There are four basic theories regarding PBL such as constructive, self-directed, collaborative, and contextual learning. The success of the implementation of PBL in one institution can be measured by the implementation of its four basic theories. Faculty of Medicine UGM (FM UGM) has been implementing PBL as their curriculum since 2002, however there have not been any conducted research that measure the implementation of PBL in FM UGM towards its 4 (four) basic theories. The objectives of this study are to validate instrumen developed by Romauli et al8 that can measure the implementation level of PBL towards its 4 basic theories, to measure the implementation level of PBL in FM UGM towards its 4 basic theories, and to compare the implementation level of PBL based on students’ academic level and regular/international program. Method: This research used quantitative non-experimental research with cross-sectional design. 321 students from 2nd (2008) and 3rd (2007) students’batch regular and international program filled the questionnaire developed by Romauli et al (2009) which had been reliable (Alpha Cronbach) and validated (Pearson Moment Product) twice previously. The data were analyzed using mean analysis to measure the implementation level of PBL towards its four basic theories. This research also compared the implementation level of PBL based on students’ academic level and regular/international by using Independent Sample t-test. Results: Instrument developed by Romauli et al8 had high validity and reliability level (á=0,01 and r=0,931). The implementation level of PBL in FM UGM towards constructive, self-directed, collaborative, and contextual learning were in moderate level (1,72±0,28;min 0 & max 3). There were not any significant differences of the implementation level of PBL among 2007 & 2008 batch (p>0,05). There were any significant differences of the implementation level of PBL among regular & international students regarding constructive & contextual learning (p0,05). Conclusion: Instrument developed by Romauli et al (2009) had high validity and reliability. The implementation level of PBL were in moderate level. There were not any significant differences of the implementation level of PBL among two different students’ batch. There were any significant differences of the implementation level of PBL among reg

Background: Tutorial in Problem-based Learning is a learning method where faculty prepares a scenario to trigger students learning through small group discussion. In the first meeting of tutorial, a group of students analyze the scenario given by raising and answering questions to explore phenomenon described in the scenario. Unresolved questions then become students’ learning issues which are a starting point for their independent learning. Answers gathered during individual learning then being reported and synthesized on the second meeting. The aim of this study is to investigate student learning experience regarding the role of scenario in tutorial. Method: Reflective writings of 36 medical students about learning experience using PBL collected at the end of first year were analyzed qualitatively through within-case analysis and cross-case analysis. Methods chosen to increase credibility are peer review and verbatim. Results: Students found that some scenarios stimulated their learning since it increase students’ curiosity. Scenarios discussing the latest news in medicine also attract to students to learn more. However, majority students admitted that some scenarios not providing enough clues to guide student determining learning objectives. Student preferred to discuss and formulate learning objectives by listing the title/topic of lecture scheduled on the same week as related tutorial session. Scenario that found identical to scenario given on the previous academic year also demotivates students to learn deeply. Students admitted learning from their senior notes in preference to learning from other valid resources. In addition, this study found that scenarios that lead students to discuss topic beyond their first-year competencies also disencourage students learning. Conclusion: Scenario plays an important role in student learning. Therefore, scenario have to be carefully designed by determining students’ prior knowledge, the length of independent learning session needed and learning resources available for students. It is also necessary to always renew the scenario for every academic year and improve its quality, for example by adding visual trigger along with written text.

Background: Besides knowledge and clinical skills, nursing students should have professional behavior as an essential component of competences as a side of knowledge and clinical skills. One aspect of professionalism is academic integrity. Lecturer should know about students’ perception of academic integrity and behavior, to make a good way to detect and prevent the deviant behavior. The objective of this study is to describe nursing students’ perception and behavior on academic integrity. Method: Survey was conducted in a nursing school in Yogyakarta. The subject were 230 nursing students who were taken by proportionate stratified random sampling. The data were analyzed with descriptive analysis. Results: There were many deviant or unacceptable behaviors which were not considered as an academic misconduct (by 5.2%-61.3% students). Peer students’ percentage who had done an academic misconduct with 10 of the highest percentage was 50%-82.2% and the behavior ever done by students was 28.7%-68.7%. The intention to do the behavior in the future was 3-38.7%. Conclusion: Perceptions of nursing students on academic integrity varied widely. Many of the actual behaviors were not considered as academic misconduct. Nursing students had different opinions about the behavior that violated academic integrity. Students’ perceptions about the behavior and the behavior of a peer friend were in accordance with the students’ own behavior. Therefore, there is a need for a shared perception between institutions and students about behaviors that violate academic integrity.

Background: For two years implementation of PBL in Faculty of Medicine Islamic University of Sumatera Utara several phenomenon should be evaluated such as various performance of tutor in facilitating PBL and student’s self study not much. This research aimed to evaluate the relationship between tutor performance and student’s self study and reporting process in PBL. Method: This was observational analytical research, cross sectional study with population of all students of Faculty of Medicine Islamic University of Sumatera Utara. Primary data was collected from June to August 2009. Instrument used were tutor performance evaluation questionnaire, self learning activity evaluation questionnaire and student’s self study and reporting process in PBL questionnaire with Likert scale. Kruskall Wallis test was used to assess the relationship between tutor and student performance. Results: Average score of tutor performance on first year was higher compared to the second year students (p=00,32). There is significant difference in student’s self study and report process in PBL between high and moderate tutor performance’s group (p=0,000; p=0,000), high and low tutor performance’s group (p=0.007, p=0,008), but not significant difference between moderate and low tutor performance’s group (p=0,111, 0,280). Conclusion: Tutor performance is related to higher level of student’s self study and report process in PBL.

Background: Early Clinical Experiences (ECEs) is a learning strategy that helps students integrate their knowledge through clinical learning in classes easily from their initial semester of study. Advantages have been earned by both students and lecturers; nevertheless, obstacles in the implementation have frequently emerged. Ideally, lecturers and students should know their own perception on ECEs for the sake of creating good communication and expected learning results in order to improve preclinical education. The purpose of this study is to find out different perceptions between students and lecturers on ECEs in nursing undergraduate program. Method: This was a descriptive study using quantitative and qualitative approaches (mix method). Subjects comprised students in the year of 2007 and 2008 as many as 71 nursing students and 21 lecturers, consisting of 11 academic advisors and 10 clinical advisors. Qualitative method was done with Focus Group Discussion for students groups and in-depth interview to academic advisors and clinical advisors. Quantitative analysis used descriptive analysis and comparative analysis used One Way Anova analysis. Qualitative analysis used content analysis that included identification, coding, categorization, and synthesis. In the end, the result of quantitative analysis was integrated with the result of qualitative analysis. Results: Mean score of students’ perception on ECEs was 3.11 (SD 0.24) which was lower than that of academic advisors (3.27 (SD 0.28)) and of clinical advisors (3.30 (SD 0.25)), (F score of 3.18 and p