Evaluasi Penugasan Clinical Reasoning dan Refleksi Mahasiswa di SKills Lab FK UGM


Widyandana Widyandana(1*)

(1) Bagian Pendidikan Kedokteran, Universitas Gadjah Mada Yogyakarta
(*) Corresponding Author


Background: Teaching clinical reasoning and reflection skills in skills laboratory are usually neglected, therefore Skills Lab of FM UGM initiate to teach those skills for undergraduate students. This study aimed to evaluate student’s assignment of clinical reasoning and reflection skills and explore how to improve it.

Method: An experimental study by giving student assignments to make an essay about particular disease based on SKDI level 4 that written on a medical record and reflection form format. All 4th-year medical students of FM GMU (n=186) and skills lab instructors (n=5) were involved. Assignments were assessed (by the instructors) using instrument by Driessen (2008), and analyzed by correlating those scores with students’ OSCE score and GPA using Pearson Correlation test. Qualitative data collected by deep interview with assessors and analyzed using Inductive Content Analysis by 2 coders.

Results: There were no significant correlation between assignment score with OSCE score and GPA. However, there were significant correlations (p<0.05) between score of clinical reasoning with reflection skills, and OSCE score with GPA. Assessors conclude that assignment has been good enough to stimulate clinical reasoning and reflection skills, but still had weaknesses e.g. incompatibility of assignment’s format to assessment’s checklist, unclear instructions, and no assignment’s sample that made students submitted in various format.

Conclusion: The assignment has been successfully conducted in Skills Lab FM UGM, however it needs some improvement, such as giving detail instructions, examples, and matching it with assessment instrument.


Clinical reasoning, reflection, OSCE, GPA

Full Text:



  1. Liddell MJ, Davidson SK, Taub H, Whitecross LE. Evaluation on procedural skills training in an undergraduate curriculum. Med Educ. 2002; 36:1035-41.
  2. Nielsen DG, Moercke AM, Hansen GW, Eika B. Skills training in laboratory and clerkship: connections, similarities, and differences. Med Educ Online [Internet]. 2003 [cited 2009 Apr 10];8:12. Available from http://www.med-ed-online.org.
  3. Van Dalen J, Flippo-Berger JF. Skills lab: centre for training of skills. Maastricht: Maastricht University Press; 1999.
  4. Smith B. From simulation to reality - breaking down the barriers. Clin Teach. 2006; 3:112-7.
  5. Lynagh M, Burton R, Fisher RS. A systematic review of medical skills laboratory training: where to from here? Med Educ. 2007; 41:879-87.
  6. Leddingham IM, Harden RM. Twelve tips for setting up clinical skills training facility. Med Teach. 1998; 20(6): 503-7.
  7. Norman G. Research in clinical reasoning: past history and current trends. Med Educ. 2005; 39: 418-27.
  8. Windish DM. Teaching medical students clinical reasoning skills. Acad Med. 2000; 75(1):90.
  9. Custers EJFM, Regehr G, Mcculloch W, Peniston C, Reznick R. The effects of modelling on learning a simple surgical procedure: see one, do one or see many, do one? Adv Health Sci Educ. 1999; 4:123-43.
  10. Dornan T, Littlewood S, Margolis SA, Scherpbier A, Spencer J, Ypinazar V. A BEME systematic review: how can experience in clinical and community settings contribute to early medical education? Med Teach. 2006; 28(1):3-18.
  11. General Medical Council. Tomorrow’s Doctors: recommendations on undergraduate medical education. London: General Medical Council; 2003.
  12. Remmen R, Scherpbier A, van der Vleuten C, Denekens J, Derese A, Hermann I, et al. Effectivenes of basic clinical skills training programes: a crosssectional comparison of four medical schools. Med Educ. 2001; 35:121-8.
  13. Claramita M, Widyandana. The skills laboratory. Yogyakarta: Fakultas Kedokteran Universitas Gadjah Mada Press; 2008.
  14. Prince KJAH, Boshuizen HPA, van der Vleuten C, Scherpbier AJJA. Students opinions about their preparation for clinical practice. Med Educ. 2005; 39:704-12. 15.
  15. Widyandana D, Majoor GD, Scherpbier AJJA. Transfer of undergraduates’ clinical skills from laboratory to the clinic: students’ challenges and their suggestions for improvements. Educ Health (Abingdon), 2010; 23(3):339.
  16. Sarikaya O, Civaner M, Kalaca S. The anxieties of medical students related to clinical training. Int J Clin Pract, 2006; 60(11):1414-8.
  17. Yuwono A, Widyandana, Hadianto T. Hubungan antara tingkat kesiapan mahasiswa memasuki pendidikan profesi dengan nilai objective structured clinical examination dan indeks prestasi kumulatif. JPKI, 2009; 3(4):152-65.
  18. Fraenkel JR, Wallen NE. How to design and evaluate research in education. 8th ed. New York: McGraw-Hill; 2009.
  19. Driessen E. The self critical doctor: a portofolio to stimulate and assess reflective skills [dissertation]. Maastricth: Maastricth University Press; 2008.
  20. Bryman A, Cramer D. Qualitative data analysis with SPSS release 10 for windows, also suitable for SPSS realease 11, a guide for social scientist. New York: Routledge; 2001.
  21. Elo ES, Kyngäs H. The qualitative content analysis process. Adv Nurs J. 2008; 62:107-15.
  22. Higgs J, Jones M, Loftus S, Christensen S. Clinical reasoning in the health professions. 3rd ed. Amsterdam: Elsevier (Butterworth Heinemann); 2008.
  23. Freidson E. Professionalism reborn: theory, prophecy and policy. Chicago: University of Chicago Press; 1994.
  24. Fish D, Coles C. Developing professional judgement in health care: learning through the critical appreciation of practice. Oxford: Butterworth- Heinemann; 1998.
  25. Higgs J, Burn A, Jones M. Integrating clinical reasoning and evidence-based practice. AACN Clin Issues. 2001;12(4):482-90.
  26. RyleG. The concept of themind. Chicago:University of Chicago Press; 1949.
  27. Sandars J. The use of reflection inmedical education: AMEE guide no 44. Med Teach. 2009; 31(8):685-95.
  28. Jones R, Jenkins F. Managing and leading in allied health professions. Abingdon: Radcliffe Publishing; 2006.
  29. Rycroft-Malone J, Seers K, Titchen A, Harvey G, Kitson A, McCormack B. What counts as evidence in evidence-based practise. J Adv Nurs. 2004; 47:81–90.
  30. Higgs J, Titchen A. Practice knowledge&expertise in the health professions. Oxford: Butterworth-Heinemann; 2001.

DOI: https://doi.org/10.22146/jpki.25190

Article Metrics

Abstract views : 1838 | views : 1969


  • There are currently no refbacks.

Copyright (c) 2017 Widyandana Widyandana

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: