Study Guide Medical

Communication 2020

~ CONTENT OF THE STUDY GUIDE ~

1. Introduction
2. Curriculum
3. A Guide to A Successful Study
4. Planners Team and Lecturer
5. Facilitators
6. Time Table
7. Time Table Supplement
8. Meeting of Student Representatives and Facilitators
9. Assessment Method
10. Learning Programs
a. Abstract
b. Learning task
c. Student Project
d. E – learning Programs
11. References

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~ INTRODUCTION ~
Good communication skills are essential in the medical profession because doctors are
dealing with humans, autonomous and social individuals. Today’s doctors are facing more
and more demanding patients in their need to maintain health. Doctors need to be able to
communicate effectively and sensitively with their patients and with their colleagues. There
is no doubt that the ability to communicate is by far the most precious skill that a doctor can
learn. Even in present-day complex and sophisticated world of medicine, the skills to
communicate effectively remain to be of prime importance for developing a successful and
gratifying medical profession and practice.

The Block Medical Communication (MC) has been designed to provide the medical
students with enough opportunity to learn communication skills needed in medical
profession. The first part of the Block curriculum deals with basic concepts of
communication skills required to build effective interaction between doctor and
patient/relative such as basic concepts in medical communication, taking history, reviewing
the system, and approaching to specific patients such as different cultural background,
paediatric, psychiatric and obstetric patients. There are also time allocation for student to
rehearse their skill in communication through role play in basic clinical skill, comprising the
skills in opening the session, gathering information, building relationship, giving explanation
and planning, closing the session, and imparting bad news. In the later part of the
curriculum, the programs concern with other aspects of communication skills such as writing
medical notes and letters, techniques of paper presentation and discussion, communication
in health promotion and education, and scientific writing. The forms of the teaching -
learning activities include reading assignments, lectures, small group discussions, and
exercises on self-assessment items to test students’ understanding on the main contents of
lectures and reading material.

On having completed the Block’s programs at the first semester, we hope that the
students will be reasonably proficient in the skills of effective communication that they can
use throughout all stages of their medical training – especially the later clinical stages, as
well as throughout their future medical career after qualification.

This small Study Guide manual has been written to aid students to get through the
various teaching-learning activities without too much difficulty. As it contains all the
necessary information such as time-table of learning activities, subjects/topics and tasks or
assignments, the students will know in advance what to learn, when and how to do it and
what to expect from them. In short, with this manual at hand, the students should be able to
prepare themselves properly before participating in each teaching-learning activity.

We hope that this manual is useful not only for the students, but also for the lecturers
and facilitators.

Team of Planners
Block Medical Communication

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 Study Guide Medical
Communication 2020

~ CURRICULUM ~

Aims:
To introduce to the students the basic principles and skills of communication essential in
medical profession: taking patient’s history, approaching patient with specific clinical
situation or entity, and communicating with professional associates.

Learning Outcomes:
1. Understand and apply the basic principles of effective communication with patient
and family
2. Understand and apply communication strategy for health promotion and education to
lay community
3. Communicate effectively with professional associates in scientific meeting
4. Write professional letters, notes and curriculum vitae
5. Apply basic principles of scientific writing in professional communication
6. Apply specific approach or communication strategy to patient with specific clinical
condition or entity

Curriculum contents:
1. Principles of communication between doctor and patient/family
2. Concepts of history taking and review of the body systems
3. Skills in communicating with patients in general
4. Approaching patient with specific situation or entity:
a. Delivering bad news to patient and family
b. Communicating with patients from different cultural backgrounds
c. Communication approach in consultation regarding sensitive subject
(personal/sexual related problem)
d. Communicating with pediatric patients and their parents
e. Communicating with patients with specific emotional condition or
psychological problem and disorder
5. Concepts and skills of paper presentation and discussion
6. Concepts and skills of communication in health promotion and education
7. Concepts and skills of communicating to media in health profession
8. Writing medical letters, notes and curriculum vitae (CV)

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9. Concepts and skills of scientific writing.

A Guide to Successful Study

Studying medicine is very hard and therefore severely demands that you have a strong
determination to study, attend lectures and discussions as scheduled, read learning
materials diligently and critically, and execute your assignments properly and on time.
Although studying manner differs from one individual student to the other, there are things
that have much in common to achieve success.
Here are some general “tips” for you to comply in order to reach success in your studies
at this Faculty, including the Block Medical Communication.
1. Keep your enthusiasm high for your tasks
Your high scores you were able to obtain at High School that enabled you to enrol to
this Faculty of Medicine tell that basically you have the basic potential to reach
success in your present studies. Different from the school study, however, at
university you are faced with more complex work, more wide and critical reading,
and you must focus on issues in a more detailed and searching way. This means
you should be able to manage yourself and your time wisely. Being a last
minute crammer for lectures and assignments is a serious disadvantage and reflects
poor self-motivation.
2. Increase your proficiency in reading, writing and speaking
You are given a great deal of reading material, so you have to be selective with
which to read in-depth or superficially, know which is important and which is not, see
beyond the details to the underlying principles, pay attention to similarities and
differences, to note exceptions to general rules, to understand cause and effect
relationships, tie in what you are reading with what you already know, etc. Similarly,
you have to keep-up your writing and speaking ability to such a level required for
university studies (in Bahasa Indonesia and/or in English). It is for all these purposes
that this Faculty includes Academic Reading, Critical Thinking, Speaking in
Conferences, and Scientific Writing courses in this Block and in a few other blocks.
There are also both General English and Medical English courses offered by this
Faculty. You must remember that reading, writing and speaking are three main
elements of communication skills of great importance in almost all
professions, including medicine in particular. So why not make the best out of
these courses!
3. Have flexibility in thinking and learning
As a medical student, you are dealing with large bodies of information with which
you gradually have to become familiar. In our medical school curriculum system, the
first seven semesters are devoted to integrated learning of basic biomedical and
clinical sciences, while the later five semesters are concentrated more on clinical
studies with real patients. Generally, the teaching-learning activities of the early
seven semesters consist of lectures, discussions on specific learning tasks or
problems, and in some topics simulations/role-plays. Since early in your studies, you
are introduced to the relation of biomedical knowledge to their clinical implications. In
some of the learning tasks or model cases in the earlier semesters, you may not yet
familiar with certain terms regarding diseases or other clinical disorders mentioned in
the tasks/simulated cases. Each lecture takes only one hour for a topic, in which the
lecturer explains more about concepts and principles rather than on details of factual
information. In consequence, therefore, it is your responsibility to find out explanation
to unknown terms or diseases and you have to read more extensively to get more

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information from your reading resources. In fact, unlimited amount of information is
in existence in the library and on the internet about almost anything. Therefore, the
question lies not on where to find the information, but on whether or not you
are willing to find it. So, make the best use of the library and Internet available in
this School.
4. Ability to work by yourself
The present teaching and learning feature of this Faculty of Medicine is more
“student-centered” than the old “teacher-centered” one. Thus, your success will be
dependent greatly on how well or hard you drive yourself to studying. No teaching
staff is assigned to checking on you or spying on your progress. Lecturers do not
“teach” about details of information, but instead emphasize more about concepts
and principles. The task of the tutors/facilitators is not to give you the answers
to the learning tasks of the discussion sessions, nor to “teach” or “lecture”
you about the topic of discussion. Their task is, by working together with you --
students, to assure that you delve yourself into the discussion deeply and seriously.
In fact, it should be relatively easy for you to make your day-to-day study plans,
because you already have a somewhat well- structured learning time-line, as in this
Study Guide for Block Medical Communication. If you always read your references
before each lecture and discussion day, it means you get yourself ready for the block
final examination. If you are building up a habit of delaying reading the references to
the last minute, then take into account the heaving workload of the examinations,
because you must take them very shortly after the end of each block. With careful
planning, it is most likely that you will succeed in your study and, as a result, enjoy
your life as a student.

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~ PLANNERS TEAM ~

No Name Department Phone

1 dr. P. Siadi Purniti, Sp.A Pediatrics 08123812106
2 dr. IGA Ratnayanti, M.Biomed Histology 085104550344
3 dr. Yuliana, M.Biomed Anatomy 085792652363
4 Prof. Dr. dr. Gd Raka Widiana, Sp.PD (KGH) Internal Medicine 0816297956
5 Dr. Adiartha Griadi, M.For. Fisiologi 03617811372

~ LECTURERS ~

NO NAME DEPT PHONE

1 Prof. Dr. dr. IB Tjakra Wibawa M, Sp.B.Onk Oncology Surgery 0811393779
2 Dr. dr. Ratna Saraswati, Sp.PD Internal Medicine 08123814688
3 Prof. Dr. dr. Gd Raka Widiana, Sp.PD (KGH) Internal Medicine 0816297956
4 dr. I Gusti Ayu Dewi Ratnayanti, M.Biomed Histology 085104550344
5 Prof. Dr. dr. I Putu Gede Adiatmika, M.Erg. Fisiologi 08123811019
6 dr. P. Siadi Purniti, Sp.A Pediatrics 08123812106
Obstetric and
7 Dr. dr. I N Hariyasa Sanjaya,Sp.OG, MARS 081558314827
Gynecology
8 dr. Yuliana, M.Biomed. Anatomy 08579252363
9 Dr. dr. Lely Setiawati, Sp.KJ Psychiatry 08174709797
10 Prof. Dr. dr. Mangku Karmaya, M.Repro Anatomy 0811387105
11 Dr. dr. Adiartha Griadhi, M.For. Physiology 03617811372
12 dr. Desak Putu Yuli Kurniawati, M.KM Public Health 081290802144
13 Dr. dr. Dyah Pradnya Paramita D Public Health 0818357777
14 Dr. dr. Ida Ayu Ika Wahyuniari, M.Kes Histology 08123614856
15 dr. N G A A Manik Y Wetan, Sp.B (Onk) Oncology Surgery 08123214075

~ FACILITATORS ~

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Regular Class
Venue
No Name Group Department Phone
(2rd floor)
Dr.dr. Desak Ketut Indrasari 2rd floor
1 A1 Neurology 082136942928
Utami, Sp.S(K) 2.09
Dr. dr. Luh Putu Ratna 2rd floor
2 A2 Physiology 081933070077
Sundari, M.Biomed 2.10
dr. Ni Nengah Dwi 2rd floor
3 A3 Microbiology 087862200814
Fatmawati, Sp.MK(K), Ph.D 2.11
Dr. dr. I Made Muliarta, M. 2rd floor
4 A4 Physiology 081338505350
Kes 2.12
dr. I G A Dewi Ratnayanti, 2rd floor
5 A5 Histology 085104550344
M.Biomed 2.13
dr. I Made Agus 2rd floor
6 A6 Microbiology 08123921590
Hendrayana, M.Ked. 2.14
Dr.dr. Ni Putu Ayu Asri 2rd floor
7 A7 Parasitology 082237396899
Damayanti, M.Kes 2.15
dr. Wayan Citra Wulan 2rd floor
8 A8 Public Health 087761838141
Sucipta Putri, MPH 2.16
dr. A.A Gde Yuda Asmara, Orthopaedi & 2rd floor
9 A9 081337870347
Sp.OT (K) Traumatology 2.20
Dr. dr. Cok. Bagus Jaya 2rd floor
10 A10 Psychiatry 0816295779
Lesmana, Sp.KJ (K) 2.21

English Class
Venue
No Name Group Department Phone (2rd floor)
dr. Ida Ayu Dewi Wiryanthini, 2rd floor
1 B1 Biochemistry 081239990399
M.Biomed 2.09
dr. Pontisomaya Parami, 2rd floor
2 B2 Anesthesiology 08123661312
Sp.An.MARS 2.10
2rd floor
3 Dr. dr. Ika Wahyuniari, M.Kes B3 Histology 08123614856
2.11
Dr.dr. I Gusti Ayu Eka 2rd floor
4 B4 Pediatric 08123920750
Pratiwi, M.Kes, Sp.A 2.12
dr. Agung Nova Mahendra, 2rd floor
5 B5 Pharmacology 087861030195
M.Sc 2.13
Dr.dr.Dewi Sutriani Mahalini, 2rd floor
6 B6 Pediatric 08123641466
Sp.A 2.14
dr. I Putu Yuda Prabawa, Clinical 2rd floor
7 B7 081337051550
S.Ked Pathology 2.15
dr. Kunthi Yulianti, Sp.KF 2rd floor
8 B8 Forensic 081338472005
2.16
Dr.dr. Sianny Herawati, Clinical 2rd floor
9 B9 081236172840
Sp.PK Pathology 2.20
dr. IGA Sri Darmayani, 2rd floor
10 B10 DME 081338644411
Sp.OG, M.Pd.Ked 2.21

~ TIME TABLE ~

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Day/
Time Class A and B Conveyer
Date
08.00 – 08.50 Introductory Lecture 1: Block Introduction dr. Ratnayanti
09.00 – 09.50 Introductory Lecture 2: Basic concepts of Prof Tjakra
communication with patient and family
1 10.00 – 10.50 Independent learning
Tues 11.00 – 11.50 Break
7 April 12.00 – 12.50 Introductory Lecture 3: Basic concepts of Dr. Ratna
2020 history taking review of the system Saraswati
13.00 – 13.50 Introductory Lecture 4: Review of the system Dr. Ratna
14.00 – 14.50 Independent learning Saraswati
15.00 – 15.50 Student Project
08.00 – 08.50 Introductory Lecture 5: Writing letters, notes dr. Yuliana
and CV
09.00 – 09.50 Independent Learning
2 10.00 – 10.50 SGD Facilitator
Wed 11.00 – 11.50 SGD Facilitator
8 April 12.00 – 12.50 Plenary session Lecture
2020 13.00 – 13.50 Plenary session Lecture
14.00 – 14.50 Break
15.00 – 15.50 Student Project
08.00 – 08.50 Introductory Lecture 6: Communication with Dr. Mita Duarsa
patient from different cultural backgrounds 1
09.00 – 09.50 Introductory Lecture 7: Communication with
patient from different cultural backgrounds 2
3 10.00 – 10.50 Independent learning
Thurs 11.00 – 11.50 Break
9 April 12.00 – 12.50 Introductory Lecture 8: Communication in dr. Yuli
2020 Health Promotion and Education 1
13.00 – 13.50 Introductory Lecture 9: Communication in
Health Promotion and Education 2
14.00 – 14.50 Independent learning
15.00 – 15.50 Student Project
08.00 – 08.50 Introductory Lecture 10: Presentation and Prof. Adiatmika
Discussion in Scientific Meeting
09.00 – 09.50 Independent Learning
4 10.00 – 10.50 SGD Facilitator
Mon 11.00 – 11.50 SGD Facilitator
13 April 12.00 – 12.50 Plenary session Lecture
2020 13.00 – 13.50 Plenary session Lecture
14.00 – 14.50 Break
15.00 – 15.50 Student Project
08.00 – 08.50 Introductory Lecture 11: Communication Dr. Lely
approach in special emotional
condition/psychiatric disorder 1
09.00 – 09.50 Introductory Lecture 12: Communication
approach in special emotional
condition/psychiatric disorder 2
5 10.00 – 10.50 Independent learning
Tues 11.00 – 11.50 Break
14 April 12.00 – 12.50 Introductory Lecture 13: Communication Dr. Hariyasa
2020 approach in consultation regarding sensitive
subject (personal/sexual related problem) 1
13.00 – 13.50 Introductory Lecture 14: Communication
approach in consultation regarding sensitive
subject (personal/sexual related problem) 2
14.00 – 14.50 Independent learning
15.00 – 15.50 Student Project
6 08.00 – 08.50 Introductory Lecture 15: Medical Media dr. IB Alit

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Communication
09.00 – 09.50 Independent Learning
10.00 – 10.50 SGD Facilitator
Wed 11.00 – 11.50 SGD Facilitator
15 April 12.00 – 12.50 Plenary session Lecture
2020 13.00 – 13.50 Plenary session Lecture
14.00 – 14.50 Break
15.00 – 15.50 Student Project
08.00 – 08.50 Introductory Lecture 16: Communication with Dr. Siadi Purniti
pediatric patient and parent 1
09.00 – 09.50 Introductory Lecture 17: Communication with
pediatric patient and parent 2
10.00 – 10.50 Independent learning
7 11.00 – 11.50 Break
Thurs 12.00 – 12.50 Introductory Lecture 18: Basic concepts of Prof. Raka
16 April scientific writing 1 Widiana
2020 13.00 – 13.50 Introductory Lecture 19: Basic concepts of Dr. Ika
scientific writing 2 Wahyuniari
14.00 – 14.50 Independent learning
15.00 – 15.50 Student Project
08.00 – 08.50 Introductory Lecture 20: Online Seminar Prof. Adiatmika
Simulation
09.00 – 09.50 Independent Learning
8 10.00 – 10.50 SGD Facilitator
Fri 11.00 – 11.50 SGD Facilitator
17 April 12.00 – 12.50 Plenary session Lecture
2020 13.00 – 13.50 Plenary session Lecture
14.00 – 14.50 Break
15.00 – 15.50 Student Project
08.00 – 08.50 Student Project Presentation Fasilitator &
09.00 – 09.50 Student Project Presentation Evaluator
9 10.00 – 10.50 Break
Mon 11.00 – 11.50 Student Project Presentation Fasilitator &
20 April 12.00 – 12.50 Student Project Presentation Evaluator
2020 13.00 – 13.50 Break
14.00 – 14.50 Student Project Presentation Fasilitator &
15.00 – 15.50 Student Project Presentation Evaluator
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April 10.00 – 12.00 EXAMINATION Team
2020

Student Project Evaluator

Student Project Evaluator

SP 2 1. dr. Ratnayanti
(Doctor Patient Communication Scenario) 2. dr. Adiartha Griadhi
SP 3 (Health Campaign/COVID-19) 1. dr. Yuli Kurniawati
SP 4 (Medical Letters) 2. dr. Yuliana

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~ ASSESSMENT METHOD ~

Cognitive assessment will be carried out on Thursday, April 27th 2020. The test will consist
of 100 questions with 100 minutes provided for working. The assessment will be held at the
same time for both Regular Class and English Class. SGD’s, role playing’s and student
projects’s mark will be included in the final score as describe below. The overall passing
score requirement is ≥ 65. More detailed information or any changes that may be needed
will be acknowledged before the assessment.
SGD will be reviewed everyday by facilitator with a standard SGD assessment and it
contributes 10 % to the final score. Student projects, as a sumative assessment account for
25% of the final score.

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~ LEARNING PROGRAMS ~

Abstracts of Lectures

Prof. Dr. dr. Tjakra W. Manuaba

The lecture will begin with explanation of the definition, methods, and purposes of
communication, especially as related to the field of medicine. By having a good
communication with the patient, a doctor is more likely to: (1) make an accurate,
comprehensive diagnosis of the patient’s problem (2) detect the patient’s emotional distress
(3) have the patient more satisfied with the medical care and less anxious about his/her
problem (4) have the patient agree and follow the advice given. Some studies have shown
that patients preferred doctors who: (1) were warm and sympathetic (2) were easy to talk to
(3) introduced themselves (4) were self-confident (5) listened to the patient and responded
to their verbal cues (6) asked questions that are easily understood and were precise (7) did
not repeat themselves. These basic communication skills of a doctor can be learned and
retained, hence this topic of lecture.
The outcome of the doctor-patient communication is influenced by several factors,
namely factors related to the patient, factors related to the doctor, and factors related to the
environment. Factors related to the patient include physical symptoms, psychological
conditions, and previous and current experiences of medical care. Factors related to the
doctor include past training in communication skills, self-confidence in ability to
communicate, personality, and physical and psychological conditions. The interview
setting/environment requirements include privacy, comfortable surroundings and
appropriate seating arrangement. General guidelines for conducting an interview with a
patient are explained in detail, which include the beginning, main part, and end of the
interview. The most basic skills of communication, which include the skill of questioning,
listening, and facilitating the patient to tell more significant information, are explained. It is
important to use open questions in most parts of the doctor-patient communication to obtain
sufficient, clear and accurate information from the patient. Closed questions are used in
certain specific situations such as in an emergency.

Dr Ratna Saraswati

Determining the scope of assessment

When performing the history taking to the patient, at the first time we have to determine
scope of the assessment, should it be comprehensive or focused. For patient who is coming
at the first time in the office or hospital, usually we will choose to conduct the
comprehensive assessment including all the element of health history. However in many
situation, a more flexible focused or problem-oriented assessment is appropriate,

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particularly for patient you know well who are returning for routine office follow up care or
patient with specific urgent care concern like chest pain or knee pain.

The history taking: comprehensive of focused?

Comprehensive Focused
Is appropriate for new patients in the office of Is appropriate for established patients,
hospital especially during routine or urgent care visits
Provides fundamental and personalized Addresses focused concerns or symptoms
knowledge about the patient Assesses symptoms restricted to a specific
Strengthens the clinician-patient relationship body system
Helps identify or rule out physical causes
related to patient concerns
Provide baselines for future assessments
Creates platform for health promotion
through education and counseling
Table adapted from: Bickley LS, Szilagyi PG, 2009. Bates’ Guide to Physical Examination and History Taking, 10th edition.
Lippincot William and Wilkins, Philadelphia.

Most patients have specific worries or symptoms. The comprehensive examination

including history taking will provide a more complete basis for assessing patient concerns
and answering patient question. For the focused examination, the patient’s symptoms will
lead us to a more specific history taking, and next will help us to be more focused during
physical examination.

Components of the comprehensive adult health history

There are seven component of the comprehensive adult history taking:
● Identifying data and source of the history
● Chief complaint (s)
● Present illness
● Past history
● Family history
● Personal and social history
● Review of the system

The review of the system may uncover problems that the patient has overlooked,
particularly in area unrelated to the present illness. Some clinicians do the review of the
system during the physical examination, for example: asking about ear as they examine
them. If the patient has only few symptoms, this combination may be efficient, however in
multiple problem, the flow of history taking and the examination may be disrupted.
Standard series of review of system question including the organ and system below:
● general
● skin
● head, eyes, ears, nose, throat (HEENT)
● neck
● breast
● respiratory
● cardiovascular
● gastrointestinal
● peripheral vascular
● urinary
● genital
● muskuloskeletal

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● psychiatric
● neurologic
● hematologic
● endocrine
As you gain experience, the yes and no question at the end of the interview will take only several
minutes.

Dr. Yuliana

Physicians almost often deal with writing notes and letters. There are two kinds of
letters: formal/business and private letters. In the medical profession/practice there are
several kinds of formal letters, for example: referral letter, accompanying or covering letter,
letter of introduction, notes on one’s being fit for employment and notes on one’s being unfit
for duty or requiring hospitalization. In letter writing there is basic rules/formats that should
be considered although they are not very strict rules. There may be differences between
British and American practice and traditional and modern practice of letter writing.
Generally, the guidelines for letter writing relate to writing name of the sender and
addressee, address on the envelope and letter; date, greeting, main content and letter
ending. Although there are many styles, the main principle of writing business letter is to
write clearly, simply, and briefly. The principle of writing Curriculum Vitae or “resume”, which
is a summary or outline of educational and professional background and personal
information, will also be taught to students. It should contain the essential details such as
name, address (personal and work), telephone number, date of birth, professional interests,
current position/employment, educational background, professional experience, publication
in journals, bulletins etc and papers delivered at conferences. The layout of curriculum vitae
is not strict but there may be certain personal information needed when applying for a post.

Dr. dr. Diah Pradnya Paramita Duarsa

It is important to allow the patient to explain their cultural backgrounds, values, beliefs and
expectations when these may be relevant to the consultation. Heightened awareness of the
cultural issues can help you make a more accurate assessment of the patient's behavior,
improve your professional relationship with the patient, and decide proper treatment.
The doctor needs to accept other people's cultural and racial ideas as different, but
equally important. Important issues can be overlooked if either the doctor or the patient fear
misunderstanding and rejection of cultural values.
The patients may be part of a particular culture, but they will have adopted some
aspects of it and rejected others. The doctor must carefully assess each patient's individual
and cultural needs before deciding on an appropriate treatment.
Matching patient and doctor according to race or culture is not always helpful.

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dr. D P Yuli Kurniawati

According to World Health Organization (WHO), doctor who fits the Five Star Doctor
criteria (care provider, decision maker, community leader, manager and communicator) will
be successful doctor in the future. Among those five, the main skill doctor is to able
communicate about health soundly and effectively. Communicating in the field of health and
medicine is not only happen in practice room, but also in community in form of Health
Promotion.
Health promotion is defined as the process of enabling people to increase control over
their health and its determinants, and thereby improve their health (World Health
Organization). One of the most used approaches to health promotion is based on education
and communication media. Health campaigns and education-entertainment approaches
(entertainment advocacy) are been used by scholars in health communication to prevent
very different diseases and to improve quality of life. Health communication is a
transdisciplinary field whose intended outcomes are increasing audience knowledge and
awareness of a health issue, influencing behaviors and attitudes towards a health issue and
implementing and evaluating health interventions disseminated using media in very different
ways (from advertising and social marketing campaigns to television fiction).
In health promotioncommunication is a planned process. The effectiveness of this
planned process comes to fruition when theaudience has achieved, acted on or responded
to a message.Models in health promotion usually seek to include key elements importantto
behavior and decision-making processes. In health promotion and healtheducation, models
are often borrowed from areas of social psychology or healthcommunication and applied to
health contexts.

Prof. Dr. dr. Adiatmika

By the end of this course, the students are expected to be able to make a good paper
presentation in a scientific meeting. They are expected to be able to collect necessary
information and references to organize the paper. They should also be able to develop the
appropriate audio visual aids to support the presentation and know the necessary steps of a
good presentation. These steps include opening remarks, entering the main section,
summarizing, closing and thanking the audience. They should also be familiar with
statements or expressions commonly used in an informal conversation following the
presentation.

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Dr. Lely Setyawati

To be an effective clinician in any field, a physician must understand both the science
and the art of medicine. With all of the technological advances in medicine, successful care
giving still relies on the very basic, and deceptively simple, relationship between doctor and
patient. Such relationship cannot be achieved without good communication between
practitioner and patient and may not matter how sophisticated the available treatments are.
In one survey of 700 patients, patients substantially agreed that many physicians do not
have the time or inclination to listen and consider their feelings, that physicians do not have
enough knowledge of the emotional problems and socioeconomic background of their
families, and that physicians increase their fear by giving explanations in technical
language.
The quality of patient doctor or patient therapist relationship is crucial to the practice of
medicine. The capacity to develop an effective relationship requires a solid appreciation of
the complexities of human behavior and a rigorous education in the techniques of talking
and listening to people. To diagnose, manage, and treat an ill person, doctors and
therapists must learn to listen. They need the skills of active listening, which means listening
both to what they and the patient are saying and to the undercurrents of the unspoken
feelings between them.
An effective relationship is characterized by good rapport. Rapport is the
spontaneous, conscious feeling of harmonious responsiveness that promotes the
development of a constructive therapeutic alliance. It implies an understanding and trust
between the doctor and the patient. Frequently, the doctor is the only person to whom the
patients can talk about things that they cannot tell anyone else. Most patients trust their
doctors to keep secrets, and this confidence must not be betrayed. Patients who feel that
someone knows them, understands them, and accepts them find that a source of strength.
In his essay, Caring for the Patient, Francis Peabody, M.D. (1881-1927), a talented teacher
and clinician, wrote: The good physician knows his patients through and through, and his
knowledge is bought dearly. Time, sympathy, and understanding must be lavishly
dispensed, but the reward is to be found in that personal bond which forms the greatest
satisfaction of the practice of medicine. One of the essential qualities of the clinician is
interest in humanity, for the secret of the care of the patient is in caring for the patient.
Different patient types and special situations are discussed in this topic, for example
how we communicate and show empathy to a sad or weeping patients, silent, quite, angry,
aggression, and dispute each others.

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dr. Hariyasa Sanjaya

           
Effective communication is the key to successful provision of health services to
patients. Communication involved verbal communication, physical contact as well as
emotion presentation and impression. Good communication will result in trust of the patients
and this will make it easier for the doctors to explore the patients’ history, do physical
examination etc to reach appropriate diagnosis. In many instances, patients go to the doctor
to discuss sexual problem or suffered from a sexual-related disease. Discussing about
sexual problem is not easy to some patient. Special skills are required for soliciting a sexual
history from a patient. Basically and ethically, no discrimination should be made in health
services provision, but in to some extent exception is given to female patients. Obstetric and
gynecologic patients are women, and thus should be treated differently. Women are unique
in the sense that they have special characteristics and behaviors needing special
approaches when dealing with them. Commonly all patients will expect respect, courtesy
and privacy assurance from the doctors.
The following are conditions in female patients that should be considered by doctors
before taking history, doing physical examination and giving treatment. In the eastern
culture, women are more shy, more closed and tend to have sensitive feeling
♦ There are common assumptions and misconceptions about sexuality.
♦ In the eastern culture women are more shy, more closed and tend to have sensitive
feeling
♦ Most women do not tolerate harsh or rude approach, so these should be avoided in
obstetrics and gynecology, in which examination is focused on the genital organ that is
most sensitive for women
♦ Pelvic examination tends to often cause hurt or pain sensation
♦ In examining pregnant woman, it should be taken into account that there is also a fetus
as the second patient
♦ In certain condition, the complaints of the female patients may be expressed by body
language and therefore the doctor should be able to “catch” the signals.
♦ The examination room should be organized to fulfill the standard requirements for
examining women (closed or semi-closed to maintain privacy).

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Dr. Ida Bagus Alit, Sp.F.

Opening medical information to the media becomes increasingly unavoidable in

nowadays information openness era. This situation is especially come to pass in law-related
medical cases. Guidance to this skill is important to understand by the medical
professionals due to it’s potential implication to patient or doctor or community in general.
The goal of transparency or openness of the medical information to the Media is to build
the good and accountable management of information (good Governance). The principles of
information management to the public and media include: accountability, transparency, Law
supremacy and society participation. All information must be correct, adequate and
adherent to Medical ethics principles. Transparency or openness is related to showing all of
information that is needed by society with confidential reasoning. In Law supremacy not all
information can be informed to the media. The information should be considered to have no
influence to the criminal case management. The confidentiality in criminal case is based on
principles i.e. not to talk too soon, not to talk too much and not to talk to the wrong person.

Dr. Siadi Purniti

The therapeutic relationship is achieved in a large measure during the doctor-patient

interview. Rapport building, engaging with the patient, eliciting psychosocial and personal
aspects of the patient’s experiences, supporting the parents in their roles as the child’s
guardians, and involving the child, grandparent(s) and other significant individuals are the
most important parts of the approach in dealing with the child patient. All of these are
essential to establish a therapeutic relationship.
There are some basic factors that virtually can always strengthen the therapeutic
relationship: greeting, introducing one’s self and set the agenda jointly with the parent,
listening, facilitating the interview, using common courtesy, talking with the child, dealing
with acute illnesses appropriately, redirecting the interview, counseling and reassurance,
and closure.
Even the most intentioned and highly skilled clinicians may experience
communication barriers with children because of limitations in children’s abilities to
understand information and the clinician’s difficulty in communicating information at the
approach of developmental level. The primary goal of open communication in the pediatric
visit is to establish therapeutic alliance both with children and parents. The benefits of such
therapeutic alliance have been well documented.

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Prof. Dr. dr. Raka Widiana/ Dr. dr. Ika Wahyuniari

Until recently, scientific writing especially aiming for publication has been a much–
neglected subject in Indonesian medical education and studies have shown that such high-
level intellectual skills cannot be achieved overnight or in a fixed time period and the
instruction should go deeper than mere instruction in English as a foreign language. Our
new curriculum has taken a new initiative to overcome at least the ‘cognitive burden’ of
scientific writing, a common problem for novice.
The course of scientific writing is divided into 2 parts: foundational or general
consolidation English and essentials of writing biomedical papers. The foundational English
will deal with highlighting the problems of accumulating a working vocabulary, common
errors in English and word choice in academic writing. The second part of the course will
focus on problems related to plagiarism, expressions to avoid, constructing effective
sentences, deductive paragraphs, the basic principles of writing a biomedical research
papers aiming to achieve a clear and coherent biomedical communication and the general
anatomy of biomedical research paper.
Learning activities designed to strengthen the acquisition of the general knowledge
and skills of scientific writing include 2 lectures, independent learning and exercises,
facilitated small group learning, plenary sessions and feedbacks, self assessments and
student project report. Summative assessment based on the defined learning outcomes will
be conducted at the end of the curriculum block on medical communication scheduled for
November 8, 2010.

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LEARNING TASKS

Basic Concepts of Communication With Patient And Family

Prof. Dr. dr. Tjakra W Manuaba

Case:
Dr Made is a 54-year-old experienced orthopedic surgeon. He is regarded by his colleagues
as having excellent technical skills. For most of his 20-year career, he has been rewarded
for his successful surgical outcomes and high productivity. Surprisingly, his patients’
satisfaction score is not as highly as he has assumed so far. More recently, he has been
told to improve his patient satisfaction scores and too many of his patients complained and
said that he is too much in a rush, businesslike, and doesn’t listen to his patients.

Learning Task:

1. In your opinion, what has caused the low patients’ satisfaction regardless of dr. Made’s
excellent expertise?
2. What are the purposes of communicating in general? How do you relate them with the
context of doctor-patient interview?
3. In your opinion, is it necessary or not necessary to study communication skills in your
medical education? Explain your answer clearly!
4. What is the most suitable seating arrangement for a doctor-patient interview? Explain
why.
5. It is said that to have a good beginning of the interview with patient will give a profound
effect on the good outcome of the interview. How do you make such a good beginning of
the interview?
6. Why do you use open questions in most part, especially at the beginning, of the
interview with the patient? Give examples of open questions!
7. Discuss about all the key elements of listening skills and give examples of various ways
to prove that you are listening attentatively to your patient!
8. Explain about the most important things to do at the beginning, main part, and end of
the interview with the patent!
9. How can family of the patient help in the diagnosis and care of the patient’s problem?

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Basic Concepts Of History Taking And Review Of The System

Dr Ratna Saraswati
History Taking
1. When performing history taking of your patient, how would you determine the scope
of your question?
2. What kind of relevant personal data that you need to identify your patient at the first
time?
3. Give examples of chief complaint (try to have different one for each student)
4. Identify the information that you need to ask from your patient, regarding:
a. the present illness
b. the patient past history
c. the family history
d. the personal and social history

Review of The System

1. List some problem that you need to ask while reviewing of each system below:
a. general
b. skin
c. head, eyes, ears, nose, throat (HEENT)
d. neck
e. breast
f. respiratory
g. cardiovascular
h. gastrointestinal
i. peripheral vascular
j. urinary
k. genital
l. muskuloskeletal
m. psychiatric
n. neurologic
o. hematologic
p. endocrine

2. Formulate some question asking the listed above problem.

Writing Letters, Notes, and CV

Dr. Yuliana

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1. Differentiate the formal/business letter and private letter.

2. Give one example of formal/business letter and private letter
3. What the letter-ending if you begin the letter with Dear Sir / Madam?

Communication With Patient From Different Cultural Backgrounds

Dr. dr. Diah Pradnya Paramita D

Case 1
So you are Mr. — ? Did I pronounce that properly?
How do you prefer to be addressed?
Question: How do you prepare yourself to address the issue in those questions?

Case 2
I need to ask you some questions about your health. I'll go through them, and I would like
you to answer 'Yes' or 'No' to the questions. Afterwards, we can discuss how you are doing
with the treatment and if you have any worries or questions.
Question: Do you think this type of interview is appropriate for common patients from Asian
society? Explain your answer!

Case 3
During the fasting month of Ramadhan, a diabetic moslem patient has been on medication
with oral anti-diabetic (morning and afternoon doses). The patient follows the daily fasting
and asks if the medication can be postponed until the fasting time has ended.
Question: As a doctor who takes this religious practice into account, how do you respond to
the patient’s request? Explain your arguments!

Case 4
In an emergency situation, a patient from a strict religious sect refused to receive blood
transfusion.
Question: As the doctor in charge of the Emergency Room, how do you respond to this
patient’s attitude? Explain your reasons!
Case 5
Doctor: I'm sorry that your daughter has to be examined by a man, but I'm afraid I am the
only doctor on duty tonight. I think she needs to be seen straight away since she is in bad

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pain, so I shall have to examine her myself. I really think we have no choice at this stage. If
possible, we can try to arrange for a female doctor to follow-up, if that is necessary.
Question: What seems to be the doctor’s concern related to the cultural aspects of this
patient that made the doctor uses the above expressions? Explain your answer!

Case 6
In a particular case, you may need an interpreter because your patient has little knowledge
of English, and it can be a relief for the patient to speak in their native language. Moreover,
an interpreter from the patient's own culture can identify the crucial issues and give comfort
and support.

Question: What problems may arise in using interpreters? Please explain.

Communication In Health Promotion And Education

Dr Yuli Kurniawati

Learning Taks
1. A doctor upload an educational video to YouTube channel, promoting the superiority of
apple stem cell to delay aging and mangosteen rind herbal juice that can cure HIV
patient. He invited several patients to give testimony of the successful treatment.
Please explain the mistakes of communication in this case!
2. Delivering a message to lay community using acronym or easily remembered term is
very good. The successful example is “4 Sehat 5 Sempurna” for healthy and nutritious
food, and “3M” for dengue fever mosquitoes eradication. Mention three other and
explain each meaning!
3. In a health promotion of STD and HIV prevention to teenager in a quite remote village,
a primary care centre doctor plan to socialize ABCDE prevention concept. Please help
the doctor to prepare the best and effective concept!

Presentation & Discussion in Scientific Meeting

Prof Dr Adiatmika

1. To discuss about necessary steps for preparing a good paper presentation

2. To discuss about the anatomy of scientific presentation
3. To discuss about the basic concepts of developing and using good audio visual aids
4. To discuss about expressions, language and phrases commonly used during paper
presentation, discussion and informal communication following a presentation by
completing the sample expressions or phrases as written in the reference with relevant
subject matter
5. Each student must speak (clearly and loudly) expressions mentioned in point 4 above.

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Communication Approach In Special Emotional Condition/Psychiatric

Disorder

Dr. Lely Setyawati

1. Describe the communication approach to interview a weeping patient?

2. Describe the communication strategy in interviewing a silent / quite patient?
3. How can we establish a good rapport while interviewing an angry patient?
4. How can we communicate and establish a good rapport with an aggressive patient?
5. How can we manage a dispute patient in front of you in your room?

Communication Approach In Consultation Regarding Sensitive Subject

(Personal/Sexual Related Problem)

Dr Hariyasa Sanjaya

The students should discuss on how to deal with the patient in each of following
situations:

Situation 1:
A woman with nine months old pregnancy with complaint of having pains since the last four
hours and already discharging a “bloody show” (blood and mucus from her vagina). In brief,
the mother is in the process of giving birth to a baby.
Task:
What should be your communication approach in situation above?

Situation 2:
A fourteen-year-old-girl complains of having been raped by her senior fellow students in the
school’s rest room. She is suffered from pain because of some chafed and bruised thigh,
the sign of past violence.
Task:
How is your communication approach (examination scenario) in situation above?

Situation 3:

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A female student is suspected to have benign ovary tumor. She is extremely worried about
the possibility of having cancer.
Task:
How should be your examination scenario and approach in situation above?

Situation 4:
A sixty-year-old woman apparently having prolapsed uterus.
Task:
How should you deal or approach in situation above?

Situation 5:
A fifteen-year-old girl admitting never had sexual intercourse but obviuosly found to be three
months pregnant.
Task:
How should be your communication approach?

Situation 6:
A female patient with complaints suggestive of sexual transmitted disease.
Task:
How should be your communication approach in above situation?

Situation 7:
A girl presenting with hematome of her labia majora because of falling in a motor bike
accident.
Task:
How should be your approach in above situation?

Situation 8:
A man was depressed since he complained chronic sexual impotence.
Task:
How should your communication approach in above situation?

Medical Media Communication

dr. Ida Bagus Alit

Learning Task
Vignette
In criminal case, the media request the doctor to give information about the case. The
information is an evidence and confidential. In the other hand, society (through media) has
rights of information. The principles of good governance information are accountability,
transparency and society participation. How the doctor should give information to the
media?
1. What is the regulation that regulates Public information?
2. What are the principles of Public information? Give explanation!
3. What are the confidentiality principles in giving criminal case information? Give
explanation!

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Communication With Pediatric Patient And Parent

Dr Siadi Purniti

Task 1: Talking With Parent (s)

A mother from a village, not having finished Elementary School, brings her 6-month-old
baby to the Pediatric Outpatient Clinic of Sanglah Hospital, with a referral letter from a
Puskesmas (Public Health Center) doctor. The mother does not understand why the baby is
being referred to Sanglah Hospital. The doctor of the Puskesmas only stated that the baby
is suffering from Congenital Heart Disease.
The students’ task
Please discuss in the small group how the doctor in the Puskesmas should ideally have
explained to the patient’s mother about the disease and the reasons to refer the patient to
Sanglah Hospital.

Task 2: Talking With Children

A mother brings her 15 year-old daughter to the Pediatrics Outpatient Clinic in Sanglah
Hospital, with the main complaint of her daughter’s never getting menstruation. The mother
is worried because most of her daughter’s friends of the same age have already got
menstruation.
Please discuss in the small group how should the doctor take history from the patient
above.

Basic Concepts of Scientific Writing 1

Prof Dr Raka Widiana

I. Exercise in Word Choice

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Principles of word choice: Words used in academic or scientific writing should be
precise, simple, and necessary.
Instruction: Improve the word choice in following examples; it is not necessary to
change the sentence structure. If you are not sure of how to improve the word choice,
guess.
i. Renal blood flow was drastically compromised when the aorta was obstructed.
ii. With inhalation of amyl nitrate, lung compliance decreased
iii. The salicylates are rapidly absorbed with a peak plasma concentration within 2
hours.
iv. In isolated, perfused dog lungs, infusion of serotonin was associated with an
increase in microvascular pressure.
v. Blood samples were drawn from the 5 female and 3 male children at Yi, 1, 2, 3,
and 4 hours following the initiation of dialysis.
vi. Prostaglandins are known to enhance nociceptive responses and accordingly
indomethacin and aspirin have been shown to reduce pain.
vii. After 4 hours of hemodialysis, we abruptly ended the hemodialysis procedure.
viii. Oxygen uptake in response to drugs was examined and found to vary
considerably.
ix. Maximal coronary vasodilatation with carbochromen had other effects.
x. The cells were exposed to lipoprotein-deficient serum for 48 hours.

II. Words carelessly interchanged: Choose one of the words, within the parentheses to
make the best sense in the sentence, and indicate your choice by underlining it.
i. The response was blocked by phentolamine but was not (affected, effected) by
propranolol.
ii. The digoxin (amount, concentration, content, level) was increased from 0.5 to 2.5
mg/ml.
iii. Preganglionic stimulation (enhances, increases) norepinephrine release from
terminals within the superior cervical ganglion.
iv. Increased knowledge of cardiac muscle function has greatly (enhanced,
improved) our ability to detect and quantify disorders of myocardial contraction.
v. Treatment with methylprednisolone after the lesion is established significantly
(enhances, speeds) recovery.
vi. At frequent (intervals, periods) we measured pH, PO2, and PCO2 in arterial
blood, and during each (interval, period) of study we measured pulmonary blood
flow two or three times.
vii. We studied the responses of the following (parameters, variables): heart rate,
cardiac output, oxygen consumption, and systemic vascular resistance.
viii. Seventy-five percent nitrous oxide (represents, is) a sub-anesthetic
concentration in the dog.

III. Change the structure of the following sentences, so that the core message
becomes more explicit or direct.
i. A progressive decrease in the death rate occurred.
ii. Evaporation of the ethanol from the mixture takes place rapidly.
iii. Measurements of blood pH were made with a Radiometer capillary electrode.
iv. Prolongation of life for uremic patients has been made possible by improved
conservative treatment and hemodialysis.
v. An abrupt increase in minute ventilation and respiratory frequency occurred in all
dogs as exercise began.
vi. The mutation causes an embryonic lethality.

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vii. These agents exert their action by inhibition of synthesis of cholesterol by the
liver.
viii. This net difference in osmolarity causes a flux of water into the cerebrospinal
fluid, causing increased pressure.
ix. We made at least two analyses on each specimen.

IV. For the following 4 pairs of sentences, indicate your choice by putting a cross
(X) either on (A) or (B).
(A) These results are similar to the results of previous studies.
(B) These results are similar to previous studies.

(A) Pulse rate decreased by 40 beats/min, systolic blood pressure declined by 50

mmHg, and cardiac out fell by 18.
(B) Pulse rate decreased by 40 beats/min, systolic blood pressure by 50 mmHg, and
cardiac output by 18.

(A) Losses at 34 minutes were greater than those at 4 minutes.

(B) Loses were greater at 34 minutes than at 4 minutes.

(A) Activation-controlled relaxation in these membrane-deprived cells resembled that

in intact myocardium from frogs.
(B) Activation-controlled relaxation in these membrane-deprived cells resembled
intact myocardium from frogs.

V. Read the following paragraph carefully, and then do the following:

• Identify the topic sentence (main idea or message) and all of the supporting
sentences.
• States explicitly but very briefly the message in the topic sentence and in the
supporting sentences, by using the space available below.
• Identify the type or structure of the paragraph (Is it an inductive or a deductive one?)

There are three different theories put forward for the very slow relaxation of catch
muscles of molluscs. One theory holds that catch is due to some unusual property of
myosin in these muscles that produces a slow rate of detachment. In this theory,
paramyosin would have no special role beyond that of providing the long scaffolding
on which the myosin is positioned as well as the mechanical strength for the large
tensions developed. The second theory holds that tension is developed by actin-
myosin interaction but is maintained by paramyosin interactions. Because the thick
filaments are of limited length, interaction would have to occur through fusion of thick
filaments. A third theory to which I subscribe, pictures a structural change in the
paramyosin core affecting the rate of breaking of myosin-actin links at the filament
surface.

Brief message of
Topic sentence: .............................................................................................................
Supporting sentence 1:...................................................................................................
Supporting sentence 2:...................................................................................................
Supporting sentence 3:...................................................................................................
This is a ................ paragraph. (Starting with ................................ followed by.............)

VI. Avoiding plagiarism

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Plagiarism can be defined as the attempt to pass off the work of another as one's own.
The rules for avoiding plagiarism are: (1) cite all quoted materials and all summarized
and paraphrased material and (2) make sure that both the wording and the sentence
structure of your summaries and paraphrases are substantially your own.
"The different scientific disciplines are designed for explaining different types of
phenomena. To explain why rubber doesn't conduct electricity is a task for physics. To
explain why turtles have such long lives is a task for biology. To explain why higher
interest rates reduce inflation is a task for economic, and so on. In short, there is a
division of labor between the different sciences: each specializes in explaining its own
particular set of phenomena. This explains why the sciences are not usually in
competition with one another - why biologists, for example, do not worry that
physicists and economists might encroach on their turf. " (Samir Okasha, Philosophy
of science, Oxford, Oxford University Press, 2002, p 55)
Question: If you are now asked to make a citation and a summary of the above
passage (viz. paragraph), and to avoid plagiarism, what would be your best choice
among the following options.
(A) "Different disciplines of sciences are devoted to explaining different types of
phenomena. For examples, physics, biology, and economics are designed to
explain such phenomena as why rubber doesn't conduct electricity, why turtles
have such long lives, and why higher interest rates reduce inflation respectively.
This provide the explanation why the sciences usually are not competing with
each other- and physicists, for example, do not worry that the influence of
biologists and economists might spread and become stronger, and slowly
dominate the field of study of biologists (Okasha, 2002). "
(B) "There seems to be a kind of convention among the scientists of different
disciplines to be chiefly involved in their respective fields of study, thus avoiding
intrusion into the domain of other disciplines (Okasha, 2002)"
(C) "The specific sciences are concerned chiefly with their respective fields of study,
therefore there is little possibility that they would compete with each other and
worry about being dominated by scientists of another discipline (Okasha, 2002)."
(D) "According to S. Okasha, scientists usually do not compete with their fellow
scientists of other discipline, or even worry about being dominated by them, for
the simple reason they are usually committed to their respective defined field of
study"

Basic Concepts of Scientific Writing

Dr. dr. Ika Wahyuniari

Vignette 1
There is an example of background and result of abstract “Obat X Menurunkan
Pertumbuhan Sel Kanker Payudara”.
Latar Belakang/Background
Kanker payudara merupakan kanker yang paling banyak terjadi pada wanita di seluruh
dunia. Efek samping pengobatan kanker payudara sangat banyak, seperti mual muntah,
kerontokan rambut, dll. Di samping itu resistensi pengobatan kanker payudara saat ini juga
masih tinggi. Oleh karena itu perlu dilakukan pengembangan obat antikanker.
(Breast cancer is the most common cancer in women around the world. There are
numerous side effects of breast cancer treatment, such as nausea, vomiting, hair loss, etc.

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In addition, resistance to breast cancer treatment is still high. Therefore, it is urgently to
develop new anticancer drugs.)
Hasil/Result
Terdapat perbedaan bermakna pertumbuhan sel kanker payudara kelompok yang diberi
perlakuan obat X dibandingkan dengan kelompok yang tidak diberi perlakuan obat X
(P<0.05).
(There was a significant difference in the growth of breast cancer cells in the group treated
with drug X compared to the group that was not treated with drug X (P<0.05).

Learning Task
1. Give your opinion of the abstract above! If the background and result are not correct,
please revise it into a good abstract!
2. What is the function of abstract in scientific writing and its section?
3. What should are not contain in an abstract?

Vignette 2
There is a table about “JumlahCovid-19 positifdi Indonesia”.
Tabel 1

Provinsi Jumlah Covid-19 positif (orang)

(Province) Number of Covid-19 positive (persons)
A 796
B 254
C 120
D 99
E 25
F 10
G 8

Learning Task
1. Give your opinion about structure of table above! If necessary, please revise it!
2. Describe the data presentation in research!
3. Improve the structure of the following sentences!
a. Rambut rontok, mual, muntah, kulit kering merupakan efek samping
penggunaan kemoterapi pada pengobatan kanker.
b. Seorang ilmuwan melalui eksperimen molekular telah menemukan vaksin
corona.
c. Penyebaran corona sangatcepat di seluruhdunia, termasuk Indonesia.
Sehingga kita hendaknya mengisolasi diri di rumah untuk mengurangi
penyebarannya.
d. Kanker yang paling sering terjadi di seluruh dunia adalah kanker payudara,
dimana kanker ini merupakan penyebab kematian tertinggi pada wanita.
e. BUMN merupakan perusahaan yang dimiliki baik sepenuhnya, sebagian
besar, maupun sebagian kecil oleh pemerintah.
f. Kita hendaknya menghindari kebiasaan merokok. Hal ini disebabkan karena
merokok dapat membahayakan kesehatan.
g. Hampir 1.000.000 orang mengalami positif Covid-19 di seluruh dunia.

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Online Seminar Simulation

Prof. Dr. dr Adiatmika

Online Seminar Simulation

Students of class A and B should arrange a joint online seminar simulation on the pointed
date in the study schedule. This will be done through Webex. The seminar may not be
about a certain topic, but should be health-related issues. Class A and B should appoint,
well in advance before the session, 2 volunteers each. One student must prepare a topic
of medicine-related issue to present in the seminar simulation and another student will be
the Master of Ceremony/Moderator. The rest of the students will be acting as the
participants; and should prepare with at least one question to ask to each presenter.
Seminar simulation for Class B should be performed in English and for Class A in Bahasa.
Each presenter will be given 15 minutes for presentation and 5 minutes of discussion.
Following final discussion your lecture will give you feedback on your performances.

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STUDENT PROJECTS

All student projects, except health video campaign, should be worked on your
student workbook and sent to your facilitator and evaluator according to the
schedule in time table.
The scored student workbook and health campaign video of each group should be
sent to the block coordinator by the end of this block.

Students have been given material about basic concepts of history taking and review of the
systems. The task for student project is to make brief summary using the frame work in
history taking and review of the systems. The summary should contain important related
informations that need to be elicited from a patient with certain complaint/disease. Each
group should make all summaries of symptoms/diseases listed below. These summaries will
be helpfull during role playing in Basic Clinical Skill, not as your interview guideline but as
internal thinking process to reveal the health problem of your patient. The summary should
also describe in brief related knowledge needed for explanation and planning with the
patient. All summaries should be written on your workbook and will be evaluated by
facilitator and evaluator. The Result of Student Project will also be evaluated by the lecture
in the student project presentation as appointed in the schedule.

Example:
Dengue Fever
What/Main complaint: fever
When/Onset: more than 5 days if not treated
How/Chronologic: body temperature suddenly rising up………..
Etc....
List of symptoms/diseases:
1. Dengue Hemorraghic Fever
2. Hypertension
3. Lung Tuberculosis
4. Anemia
5. Chest pain
6. HIV/AIDS
7. Diabetes
8. Depression
9. Vaginal discharge

You may look for the information through the internet from a valid resources. You could
refer to reliable sites to obtain information regarding the symptoms/diseases above.
Due date: refer to time table

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Students have already been taught about patient oriented model of medical interview which
consists of five basic steps in Basic Clinical Skills. Individual skills for each step, initiating
the session, gathering information, building relationship, explain to the patient, and closing
the session, should be explicitly expressed in the the scenario.
Instructions:
1) In group you should make a scenario about an ideal medical interview between
doctor and patient. The scenario should comprise all processess from initiating the
session until closing the session. Your group may freely decide which case or
symptom will be chosen, but it is preferable to use Bahasa Indonesia in the script.
2) The scenario should contain sentences from each individual skills needed.
Example:
a. Greeting: “Selamat pagi, Bu Amat!”
b. Introduce your role : “Saya dokter muda Amin, saya ditugaskan untuk
melakukan wawancara dengan ibu”
3) The nonverbal gesture should also be detailed in the scenario as appropriate.
4) You may decide how many personal characters will be included in the scenario. You
may add the family from the patient, or mother from a child patient or other related
roles.
5) The scenario should be collected to and discussed with your facilitator and evaluator
at the given time.
Due date: refer to time table

Health Campaign Presentation

This student project is aimed to give the student a real experience on planning and
executing a health campaign model as part of their professional responsibility as a medical
doctor in the future. Each group should plan and conduct a health campaign to the
community. The medicine-related topic and the target community will be discussed further
with the lecture. The health campaign should be recorded and each recording must not
exceed 8 minutes. Each group will send the health campaign video to Block’s coordinator
that will upload it to Medical Communication You Tube Channel. Facilitator and evaluator
then will assess the video. The presentation schedule is provided in the time table.

Due date: refer to time table

Each group should write letters/notes and CV (Curriculum Vitae) based on the cases
provided. In writing letters/notes and CV, you may look at the samples in the reading
resources but you must use your imagination about information that you think are necessary
to mention, according to your purpose of writing them. Remember that business letter to a
colleague, a company, a hotel etc. are normally brief, clear and using simple words; but
should mention enough important information needed.

1. Write a referral letter to Dr. Steven Chow, senior Urologist at Mount Elizabeth Hospital,
Singapore to request for further investigation and treatment to a male patient, aged 64
years, with history of chronic kidney failure due to stones in both kidneys. Relevant

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ultrasonography, blood and urine tests have been done in Denpasar and you want to
send the tests results with your referral letter.
2. Write a letter to Dr Amman (Radiologist), Jalan Sudirman no.12, Denpasar. Your
request is for a general abdominal ultrasonography including the kidneys, for a male
patient, aged 55 years, living on Jalan Buton no. 18, Denpasar 80223, with a history of
acute colicky abdominal and flank pain.
3. A male patient, born in 1964, living on Jalan Sumatra 34 Denpasar, sees you for a
medical consultation. Now you have examined him and found him suffering from a
disease with fever, cough and shortness of breath. Due to his illness, you think this
patient needs a rest for three days. Please write a note regarding his being ill and
needing a rest as mentioned above.
4. Suppose you were a graduate medical doctor from Udayana University Faculty of
Medicine five years ago with experience working in two hotel clinics. Now you want to
get a new and better job in the Emergency Department of International Hospital in
Denpasar. To support your application, you need to write your CV. Please write your CV
appropriately by including as much information as you can imagine that you think are
relevant to your purpose.

Due date: refer to the time table

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E – LEARNING PROGRAMS
All material of this block, including study guide, student project, student’s/group’s workbook
of this block can be also accessed from elearning website of udayana university. Example
of communication and health campaign video is available in Medical Communication
YouTube channel. The link will be shared during lecture.
Student’s/group’s workbook consists of worksheet and checklist. Worksheet is used to
record group student project assignment.
All lectures, plenaries, SGDs and student project presentations will be done through cisco
webex app and or any other programs available to support the teaching learning program in
this block.

~ SELF ASSESSMENTS ~

Basic concepts of communication with patient and family

1. Describe about the doctor-related factors that can influence the result of doctor-patient
interview.
2. Describe the patient related factors that can influence the interview outcome.
3. Explain about the importance of appropriate setting or requirements for an interview
with the patient.
4. Why is it important to use open questions to most part of the interview with the
patient? When do you use closed questions?
5. What are the steps to make a good beginning of the interview?
6. What are the factors to consider in the main part of the interview?
7. How do you best end the interview?
8. What is meant by empathy? How do you show your empathy to the patient in an
interview?
9. Explain about all the key elements of listening skills!
10. Explain about the various ways to prove that you are listening attentatively to your
patient!
11. What are the advantages if the doctor listens to the patient’s complaints attentatively?

Basic Concepts of History Taking & Review of the Systems

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1. List the identifying data of patient that relevant to medical problem.
2. List the seven attributes of a symptom.
3. Mention the common individual problem as listed in the appendix of ‘Standar
Kompetensi Dokter Indonesia’ (SKDI).
4. Try to put each problem into organ or system related.

Communication with Pediatric Patient and Parent

1. How do you show the parent(s) that you are listening to the main complaint?
2. How do you facilitate the interview with the parents?
3. What are the basic factors that can strengthen therapeutic relationship?
4. Describe about the sacred seven for taking history of the main complaint?
5. Describe about the fundamental (basic) four?
6. What is the method used for enhancing communication with pediatric patients and
their parents? Explain.
7. When you take a history from a-8-year-old boy, how do you establish T (trust) in the
child? Explain.

Communication Approach in Psychiatry

1. Some patients experience and describe emotional distress in terms of physical
symptoms. Why the somatizing patients pose a number for the consulting and
treating the physician?
2. A 20-year-old woman describes an almost unremitting headache, stomach ache,
and another complain. She is asking the physician’s permission for absence from
her office. What must be done?
3. Listening to the patient is a critical skill, but listening is more than just hearing what
the patient is saying. How can you describe the emphatic listener?
4. Differences in race, nationality, religion and other significant cultural differences
between patient and interviewer can impair communication and can lead to
misunderstandings. How can you do to minimize the problem?
5. Seductive behavior during an examination must be handled somewhat differently.
Seductiveness can be manifested in a patient dress, behavior and speech. Please
describe your opinion to manage the seductive patients.

Specific Communication Approach to Obstetric Patient

1. What are the reasons of students and doctors having difficulty talking about sex to
the patient?
2. What are the differences between a male and a female patient in nature, which
make the doctor treat them differently? 
3. Mention thw specific factors in a woman status that should be considered to adjust to
an appropriate approach!
4. If possible, what conditions should be made for ideal gynecologic examining room?
What are the ideal criteria for examining room for female patients?

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5. Explain the appropriate attitudes that should be performed by a doctor or paramedic
in examining a female patient.
6. What precautions should be considered before doing examination on a female
patient’s pelvic organ?
7. When should we talk about sex to the patient?
8. What are the myths and misconceptions about sexuality?
9. Why should a nurse be present and assist the doctor in the examining room when
examining the obstetric patient?

Communicating With Patients from Different Cultural Backgrounds

1. Please give specific practices that could be relevant in a medical practice in: naming,
food and diet, religion, hygiene and grooming, dress, and significant others.
2. What attention should be paid in dealing with cross-cultural communication with
patients?
3. What should be the do's and don’ts in cross-cultural communication?
4. Explain in brief the importance of cross-cultural and racial issues
5. If you want to explore individual views of the illness, care and treatment, what
questions may be asked?
6. Please give reasons why it is difficult for doctors to raise cross-cultural issues!

Writing Letters, Notes, and CV

4. What are the differences between formal/business letter and private letter?
5. How do you write the address of an unmarried women Lindsay Brown, 25 years,
home address 14 Orchard Road, Wakefield WF2 9DG, West Yorkshire, United
Kingdom (on the envelope).
6. What should be the letter-ending if you begin the letter with Dear Sir / Madam?
7. What kind of letters/information do you have to send if you applying for a post?
8. What you mean by testimonials or references and referees?

Basic Concept of Scientific Writing

1. Revise this article title:
Beberapa Faktor-faktor RisikoTerjadinya Penyakit Kardiovaskular Di Indonesia.
2. What should be considered in creating the article title?
3. What should are not contain in an abstract?
4. How to present research data?
5. If quantitative information to be conveyed consists of one or two numbers, it is more
appropriate to use …… in order to data presentation.
6. We use ……………… between different references in-text citation of Harvard format.

Presentation & Discussion In Scientific Meeting

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1. What should you do to prepare a scientific presentation?
2. Describe necessary steps in presenting a scientific paper!
3. Describe necessary points in developing a good power point to support the
presentation!

4. Give at least three examples of statements or expressions commonly use during the
following steps of presentation:
a. Greeting and opening remarks
b. The plan of the paper
c. Opening the main section
d. Moving to a new point
e. Elaborating a point
f. Postponing
g. Referring back
h. Highlighting
i. Indicators
j. Summarizing
k. Thanking the audience
5. Describe what is meant by “ice breaking conversation”!

Communication in Health Promotion and Education

1. What is the deference between Health Education and Health Promotion? How
both perpetuate behavior changes?
2. The increase of health status of the community is very much depending upon the
success of Health Education and Health Promotion in the Community! Give your
opinion about this statement using aspects affecting health status!
3. Describe basic principles ofThe health belief model adapted from Rosenstock,
The transtheoretical model adapted from Prochaska &Diclemente and Lawrence
Green Theory!
4. What are the problems need to be anticipated during delivering health
information to the community?
5. Describe some aspects need to be considered during developing media
communication such as billboard, banner and leaflet to support the delivery of
health information.

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~ REFERENCES ~
1. Desmond J, Copeland LR; Communicating with Today’s Patients; Jossey-Bass; 2000
2. Llyod M, Bor R; Communication Skills for Medicine; Churchill Livingstone; 1996
3. Maher JC; International Medical Communication in English; The University of Michigan
Press; 2004
4. Parkinson J; A Manual of English for the Overseas Doctor. 5 th Edition, Churchill
Livingstone; 1999
5. Bickley LS, Szilagyi PG, Bates’ Guide to Physical Examination and History Taking, 10 th
edition. Lippincot William and Wilkins, Philadelphia; 2009.
6. Ganiovor L, Porter RE; Communication Between Cultures; Wadsworth Publishing
Company; 1995
7. Eleftheriadou Z; Transcultural Counselling; London: Central Book Publishing; 1994
8. Kleinman A; Patients and Healers in the Context Of Culture; Berkeley: University of
California Press; 1980
9. Brislin RW, Yoshida T, eds; Improving Intrecultural Interactions: Modules for Cross
Cultural Training Program; London: Sage; 1994
10. Silverman J, Kurtz S, Draper J; Skills in Communicating with Patients; The University of
Michigan Press; 2000
11. Behrens L, Rosen LJ, Beedles B; A Sequence for Academic Writing. New York:
Longman, 2002
12. Zeiger M; Essentials of Writing Biomedical Research Papers, 2 nd ed. New York:
McGraw-Hill, 2000
13. Goodmann N W, Edwards M B; Medical Writing: a Prescription for Clarity; 2 nd ed.
Cambridge University Press.
14. Korsch B; Talking with Parents (Resource Unknown)
15. Bernzweig J, Pantell R, Lewis CC; Talking with Children (Resource Unknown)
16. Soetjiningsih; Teknik Berkomunikasi dengan Orangtua Pasien (Unpublished)
17. Soetjiningsih; Teknik Berkomunikasi dengan Anak (Unpublished)
18. DeCherney AH, Nathan L; Current Obstetric and Gynecologic Diagnostic and
Treatment, 9th ed. Boston: McGrawHill; 2003
19. Berek J S; Novak’s Gynecology, 13th ed. Los Angeles: Lippincott Williams & Wilkins;
2002
20. Sadock B J and Sadock V A; Kaplan and Sadocks’s Synopsis of Psychiatry 10 th ed.
Lippincott Williams & Wilkins, Philadelphia, 2007
21. Naidoo J, Wills J; Health Promotion, 2nd ed.; Edinburgh: Bailliѐre Tindall
22. UU No, 14 tahun 2008 tentang Keterbukaan Informasi Publik

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CURRICULUM

Program or curriculum blocks

10 Senior Clerkship
9 Senior Clerkship
8 Senior Clerkship
Health System- Community-based Evidence-based Special topics : Elective Study IV Compre Clinic 18
7 based Practice practice Medical Practice Health Ergonomy & (evaluation) Orientation
(3 weeks) Health Environment (Clerkship)
(4 weeks) (2 weeks) (2 weeks) + medical
BCS (1 weeks) (2 weeks) ethic
(4 weeks)

The Cardiovascular Medical Emergency The Urinary The Reproductive Elective Study III 19
6 System and (3 weeks) System and System and Disorders
Disorders Disorders (3 weeks) (3 weeks)
(3 weeks) BCS (1 weeks) (3 weeks)
BCS (1 weeks) BCS (1 weeks) BCS (1 weeks)

Neuroscience and The Respiratory The skin & Special Topic : Forensic Medicine Elective Study 18
5 neurological System and hearing system - Palliative med and Medicolegal II
disorders Disorders & disorders - Complemnt & (2 weeks) (2 weeks)
(3 weeks) (3 weeks) (3 weeks) Alternative Med.

BCS (1 weeks) BCS (1 weeks) BCS (1 weeks) (2 weeks)

Musculoskeletal Alimentary The Endocrine Clinical Nutrition and The Visual 18
4 system & & hepatobiliary System, Disorders system &
connective tissue systems & disorders Metabolism and (2 weeks) disorders
disorders (3 Weeks) Disorders (2 weeks)
(3 weeks) BCS (1 weeks) (3 weeks)
BCS (1 weeks) BCS (1 weeks) BCS (1 weeks) BCS (1weeks)
Behavior Change Basic Infection Immune system Hematologic Special Topic 19
3 and disorders & infectious & system & disorder & - Andro & aging
(3 weeks) diseases disorders clinical oncology - Geriatri
(3 weeks) (2 weeks) (3 weeks) -Travel medicine
BCS (1 weeks) BCS (1 weeks) BCS (1 weeks) BCS (1 weeks) (4 weeks)
BIOMEDIK III Growth Medical Medical Basic Elective Study 17
2 (4 weeks) & communication Professionalism Pharmaceutical I
development (2 weeks) (2 weeks) medicine & drug (2 weeks)
(2 weeks) etics
BCS: (1 weeks) BCS (1 weeks) BCS (1 weeks) (2 weeks)
Studium BIOMEDIK I The cell BIOMEDIK II 19
1 Generale and (8 weeks) as biochemical (6 weeks)
Humaniora machinery
(2 weeks) (2 weeks)
BCS(1 weeks)

Pendidikan Pancasila & Kewarganegaraan ( 3 weeks )

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