Irwanda; Jovi Pardomuan Siagian; Angga Dominius
Current medical education in Indonesia now implements a competence-based curriculum, replacing the content-based curriculum that many assess is now outdated to the advance and development of technology. This new curriculum demands a higher level of cognitive ability from students with a rather more effective method to stimulate an independency and continuity in the learning process, both aspects correspond to self-learning and long-life learning traits that doctors need to have.
The curriculum is often integrated with a problem-based learning method, abbreviated as PBL. Maastricht University in Maastricht, the Netherlands is credited to be the impetus of PBL in 1969, which only had one faculty back then. PBL is a learning system with an approach to authentic problems in order for students to construct their own knowledge, develop their skills and improve their overall competence. PBL’s approach is based on the SPICES principle (student-centered, problem based, integrated, community-based, elective, and systematic planning). PBL itself has various methods of implementation, three among them are full PBL, semi-PBL and hybrid PBL. However, the implementation of the system across Indonesian medical faculties has not been in an equal level throughout. For example, one university uses full PBL system while another carries out a semi-PBL system. This inequality creates a difference of perception among students and, with these three methods of PBL implementation being widely spread across universities in Indonesia, will force an imbalance in medical education in Indonesia.
Based on its implementation so far in Indonesia, PBL appears to be an approach that is easily said than done because of its high standard of requirements such as motivation, curiosity, responsibility, facilities and infrastructures. From those aforementioned requirements, some of them are often not met by the academic’s components, like insufficient interest from the students or lack of facilities from the university’s part. To work around that, several universities invoke a semi-PBL system instead or even the teacher-centered, conventional approach. This is rather unfortunate as it has been a common knowledge that there is a large gap between PBL and conventional system. In the future, an equal learning method is to be expected across all medical faculties in Indonesia.
Most notable difference between PBL and conventional system is their teaching method. Conventional system is, as mentioned before, teacher-centered. This might cause the students to be more passive and hamper their creativity in solving problems. PBL, a student-centered approach on the other hand, emphasizes the students to be independent, critical and actively communicating. On this basis, doctors produced under this system are expected to be skilled in solving even the most complex problems and act based on the standard competencies of Indonesian doctors. The standard competencies are as follows:
1. Noble professionalism
2. Self-introspecting and self-developing
3. Effective communication
4. Information management
5. Scientific medical knowledge
6. Clinical skill
7. Management of health problems
As a doctor, problems are going to be a constant part of the job. Most of these problems’ solutions are not taught in conventional lectures. Medical study keeps on developing, and that development requires the professionals working on that field of work (a doctor, for example) to be developing as well. PBL gives students problems, which is then analyzed by the students. This learning system familiarizes future doctors to learn new things even the ones they have not heard of. As a matter of fact, this is one of the system’s main objectives, to make the students become long-life learners. If PBL is fully implemented, changes for the better are to be expected among future doctors. These changes, or rather ‘improvements’, will be substantial especially on the seven standard competencies mentioned before.
Based on the elaboration above, PBL and the standard competencies produce a harmony as professionalism, independency, communication, management, and medical science all make up for a learning method based on problems. In this system, students are not limited in exploring and elaborating the knowledge which makes it suitable to be implemented in current medical education.
Thus, PBL is very appropriate as a learning method in order to produce doctors that follow the standard competencies. PBL is expected to have an equal implementation throughout all medical faculties across the nation, and at the same time universities must improve on various aspects to facilitate the system for best results, such as availability of infrastructure and facilities, competent human resources and the willingness from the students themselves.
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