IS PATIENT SAFETY AT THE HEART OF MEDICAL EDUCATION IN INDONESIA? REFLECTION ON THE IMPACT OF THE NATIONAL EXAMINATION

https://doi.org/10.22146/jpki.48759

Rachmadya Nur Hidayah(1*)

(1) Department of Medical Education and Bioethics Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada
(*) Corresponding Author

Abstract


ABSTRACT

 Background: National examinations in Indonesia (UKMPPD) has been implemented since 2007 as a quality assurance method for medical graduates and medical schools. The impact of UKMPPD has been studied since then, where one of the consequences were related to how it affected medical education and curricula. This study explored the consequences of UKMPPD, focusing on how the students, teachers, and medical schools’ leaders relate the examination with patient care. This study aimed to explore the impact of UKMPPD on medical education, which focusing on the issue of patient safety.

 Methods: This study was part of a doctoral project, using a qualitative method with a modified grounded theory approach. The perspectives of multiple stakeholders on the impact of the UKMPPD were explored using interview and focus groups. Interviews were conducted with medical schools’ representatives (vice deans/ programme directors), while focus groups were conducted with teachers and students. A sampling framework was used by considering the characteristics of Indonesian medical schools based on region, accreditation status, and ownership (public/ private). Data was analysed using open coding and thematic framework as part of the iterative process.

 Results: The UKMPPD affected how the stakeholders viewed this high-stakes examination and the education delivered in their medical schools. One of the consequences revealed how stakeholders viewed the UKMPPD and its impact on patient care. Participants viewed the UKMPPD as a method of preparation for graduates’ real clinical practice. The lack of reference for patient safety as the impact of the UKMPPD in this study showed that there were missing links in how stakeholders perceived the examination as part of quality assurance in health care.

 Conclusion: The UKMPPD as a high-stakes examination has a powerful impact in changing educational policy and programmes in Indonesia. However, in Indonesia, the examination brought in the reflection on how the “patient” element was lacking from medical education. This research offers an insight on the concept of patient safety in Indonesia and how the stakeholders could approach the issue.

 Keywords: UKMPPD, national licensing examination, impact, competence, patient safety, curriculum

 


Keywords


UKMPPD, national licensing examination, impact, competence, patient safety, curriculum

Full Text:

PDF


References

  1. Firmansyah M, Widyandana W, Rahayu GR. Studi Kualitatif Dampak Uji Kompetensi Dokter Indonesia terhadap Pembelajaran pada Mahasiswa Kedokteran. Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education. 2015;4(3):129-39.
  2. Hauer KE, Teherani A, Kerr KM, O’Sullivan PS, Irby DM. Impact of the United States Medical Licensing Examination Step 2 Clinical Skills exam on medical school clinical skills assessment. Academic Medicine. 2006 Oct 1;81(10):S13-6.
  3. Gilliland WR, Rochelle JL, Hawkins R, Dillon GF, Mechaber AJ, Dyrbye L, Papp KK, Durning SJ. Changes in clinical skills education resulting from the introduction of the USMLE™ step 2 clinical skills (CS) examination. Medical teacher. 2008 Jan 1;30(3):325-7.
  4. Lin CW, Tsai TC, Sun CK, Chen DF, Liu KM. Power of the policy: how the announcement of high-stakes clinical examination altered OSCE implementation at institutional level. BMC medical education. 2013 Dec;13(1):8.
  5. Park HK. The impact of introducing the Korean Medical Licensing Examination clinical skills assessment on medical education. Journal of the Korean Medical Association/Taehan Uisa Hyophoe Chi. 2012 Feb 1;55(2).
  6. Corbin J, Strauss A, Strauss AL. Basics of qualitative research. Sage; 2015.
  7. Cohen L, Manion L, Morrison K. Research methods in education. Routledge; 2018.
  8. Archer J, Lynn N, Coombes L, Roberts M, Gale T, Price T, de Bere SR. The impact of large scale licensing examinations in highly developed countries: a systematic review. BMC medical education. 2016 Dec;16(1):212.
  9. Archer J, Lynn N, Coombes L, Roberts M, Gale T, Regan de Bere S. The medical licensing examination debate. Regulation & Governance. 2017 Sep;11(3):315-22.
  10. Harden RM. Five myths and the case against a European or national licensing examination. Medical Teacher. 2009 Jan 1;31(3):217-20.
  11. Tamblyn R, Abrahamowicz M, Dauphinee D, Wenghofer E, Jacques A, Klass D, Smee S, Blackmore D, Winslade N, Girard N, Du Berger R. Physician scores on a national clinical skills examination as predictors of complaints to medical regulatory authorities. Jama. 2007 Sep 5;298(9):993-1001.
  12. Norcini JJ, Boulet JR, Opalek A, Dauphinee WD. The relationship between licensing examination performance and the outcomes of care by international medical school graduates. Academic Medicine. 2014 Aug 1;89(8):1157-62.
  13. Tamblyn R, Abrahamowicz M, Dauphinee WD, Hanley JA, Norcini J, Girard N, Grand’Maison P, Brailovsky C. Association between licensure examination scores and practice in primary care. Jama. 2002 Dec 18;288(23):3019-26.
  14. Wenghofer E, Klass D, Abrahamowicz M, Dauphinee D, Jacques A, Smee S, Blackmore D, Winslade N, Reidel K, Bartman I, Tamblyn R. Doctor scores on national qualifying examinations predict quality of care in future practice. Medical education. 2009 Dec;43(12):1166-73.
  15. Swanson DB, Roberts TE. Trends in national licensing examinations in medicine. Medical education. 2016 Jan;50(1):101-14
  16. Hidayah RN. Impact of the national medical licensing examination in Indonesia: perspectives from students, teachers, and medical schools (Doctoral dissertation, University of Leeds). 2018.
  17. Nie Y, Li L, Duan Y, Chen P, Barraclough BH, Zhang M, Li J. Patient safety education for undergraduate medical students: a systematic review. BMC medical education. 2011 Dec;11(1):33.
  18. Walton M, Woodward H, Van Staalduinen S, Lemer C, Greaves F, Noble D, Ellis B, Donaldson L, Barraclough B. The WHO patient safety curriculum guide for medical schools. BMJ Quality & Safety. 2010 Dec 1;19(6):542-6
  19. Sandars J, Bax N, Mayer D, Wass VA, Vickers R. Educating undergraduate medical students about patient safety: priority areas for curriculum development. Medical teacher. 2007 Jan 1;29(1):60-1.
  20. Patey R, Flin R, Cuthbertson BH, MacDonald L, Mearns K, Cleland J, Williams D. Patient safety: helping medical students understand error in healthcare. BMJ Quality & Safety. 2007 Aug 1;16(4):256-9.
  21. de Feijter JM, de Grave WS, Dornan T, Koopmans RP, Scherpbier AJ. Students’ perceptions of patient safety during the transition from undergraduate to postgraduate training: an activity theory analysis. Advances in health sciences education. 2011 Aug 1;16(3):347-58.
  22. Tregunno D, Ginsburg L, Clarke B, Norton P. Integrating patient safety into health professionals’ curricula: a qualitative study of medical, nursing and pharmacy faculty perspectives. BMJ Qual Saf. 2014 Mar 1;23(3):257-64.
  23. Kyrkjebø JM, Brattebø G, Smith-Strøm H. Improving patient safety by using interprofessional simulation training in health professional education. Journal of interprofessional care. 2006 Jan 1;20(5):507-16.
  24. Seiden SC, Galvan C, Lamm R. Role of medical students in preventing patient harm and enhancing patient safety. BMJ Quality & Safety. 2006 Aug 1;15(4):272-6.
  25. Thompson DA, Cowan J, Holzmueller C, Wu AW, Bass E, Pronovost P. Planning and implementing a systems-based patient safety curriculum in medical education. American Journal of Medical Quality. 2008 Jul;23(4):271-8.
  26. Myung SJ, Shin JS, Kim JH, Roh H, Kim Y, Kim J, Lee SI, Lee JH, Kim SW. The patient safety curriculum for undergraduate medical students as a first step toward improving patient safety. Journal of surgical education. 2012 Sep 1;69(5):659-64.



DOI: https://doi.org/10.22146/jpki.48759

Article Metrics

Abstract views : 1157 | views : 1178

Refbacks

  • There are currently no refbacks.


Copyright (c) 2019 Rachmadya Nur Hidayah

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Jurnal Pendidikan Kedokteran Indonesia (The Indonesian Journal of Medical Education) indexed by:

 

JPKI Stats