Learn How to Learn and Think How to Think

1. Learn How to Learnand Think How to Think dr. Isti Ilmiati Fujiati, MSc.CM-FM, MPD.Ked. Medical Education Unit – FK USU

2. AGENDA • Generic skills • Critical thinking • Cognitive Level - Taxonomy Bloom • Metacognitive Skills

3. KIPDI – III Generic Skills • Area kompetensi 1: Keterampilan komunikasi efektif (Effective communication Skill) • Kompetensi inti: Mampu menggali dan bertukar informasi secara verbal dan non verbal dengan pasien pada semua usia, anggota keluarga, masyarakat, kolega dan profesi lain MODUL KOMUNIKASI – SEMESTER 1

4. KIPDI – III • Area kompetensi 6: Mawas diri dan pengembangan diri • Kompetensi inti: belajar sepanjang hayat

5. Lulusan dokter mampu: Generic Skills • Menunjukkan sikap skeptis dan kritis terhadap bukti-bukti lmiah dalam praktik kedokteran berbasis bukti • Menanggapi secara kritis literatur kedokteran dan relevansinya terhadap pasiennya. • Mengidentifikasi masalah-masalah klinis dan kesehatan • Mendapatkan informasi secara efisien untuk menjawab permasalahan klinis dan kesehatan • Mengevaluasi kualitas informasi dan evidence. • Mengambil keputusan apakah akan memanfaatkan informasi atau evidence untuk penanganan pasien dan justifikasi alasan keputusan yang diambil. MODUL STUDY SKILLS: SEM.1 BLOK CRP 4 & 5: SEM. 4 DAN 5

6. DEFINING GENERIC SKILLS • What are generic skills? In 1992 the Mayer Committee (Mayer 1992) identified seven key competency strands: (1) collecting, analyzing and organizing ideas and information (2) expressing ideas and information (3) planning and organizing activities (4) working with others and in teams (5) using mathematical ideas and techniques (6) solving problems, and (7) using technology.

7. Innovation Summit Implementation Group 2000 • Interpersonal/relationship soft skills: • interpersonal, inter-group and cross-cultural communication skills • team building and teamwork skills • time management • customer focus • thinking and creativity • reflective skills • Generic core/basic hard skills: • literacy • numeracy • problem-solving skills • information technology skills • systems thinking

8. Philosophy of Knowledge Knowledge exist only in minds that have comprehended and justified it through thought. Knowledge is something that we must think our way to, not something we can simply be given. Knowledge is produced by thought, organized by thought, evaluated, refined, maintained, and transformed by thought. Knowledge can be acquired only through thought. The educational philosophy underlying educational goals, standards, and objectives should be based on an accurate and full conception of the dependence of knowledge on thought.

9. CRITICAL THINKING • Critical thinking is the intellectually discipline process of actively and skillfully conceptualizing, applying, synthesizing, and/or evaluating, information gathered from, or generated by, observation, experience, reflection, reasoning, or communication as a guide to belief and action.

10. EXAMPLE: • The 11 November 1998 issue of the Journal of the American Medical Association reported that a Chinese remedy used on pregnant women improves the position of the fetus for an easier birth. The treatment reduces the risk of breech (rump-first) births. • The treatment involved heating an acupuncture point upon the smallest toe ("moxibustion"). Two hundred and sixty women with poorly positioned fetuses were studied. Half of the women were randomly selected to receive moxibustion. The other women ["controls"] received no treatment. The investigators found that the untreated women had significantly more breech births. The authors stated that previously no randomized controlled trial [like this one] had ever been conducted.

11. Following this five criteria: • Outcome measure: Was the promised treatment outcome actually measured to determine if it occurred? • Control: Was the outcome of the treatment group compared to the outcome of an otherwise similar untreated group? • Replication: Was the treatment replicated, that is tested on an adequate number of subjects to rule out coincidence? • Randomization: Were subjects assigned to the treatment or control in an unbiased manner? • Reproducibility: Has other research produced similar evidence?

12. Outcome measure: Was the claimed treatment outcome actually measured? In this case the answer is yes. The claimed outcome pertains to the risk of breech births, and that is the outcome that was measured -- the number of breech births. In some cases fraudulent claims are pseudojustified by measuring irrelevant variables or by citing speculative assertions by "authorities" (argumentum ad verecundiam).

13. Control: Was the treatment outcome compared to that of an otherwise similar untreated group? In this case the outcome of treated women was compared to that of a control group of 130 untreated women that should have been otherwise similar. However, this control group was not otherwise similar. Treated women knew that they were being treated and untreated women knew that they were different -- they were not being treated. Differing expectations between the two groups may have affected the motility of the fetuses. For example, the treated women may have been less worried about birthing because they knew that they were being treated and therefore had different levels of stress hormones. A better investigative design would blind the women to their treatment status. The control women would receive a sham treatment such as heating of a non-acupuncture point.

14. Replication: Was the treatment replicated? • The answer is yes. One hundred and thirty pairs of women were used in the investigation. If only one pair of women was studied (no replication) there would be little confidence that a difference in outcome between them was other than happenstance. Adequate replication establishes a statistical benchmark against which to judge the treatment, that is the likelihood of breech births among untreated women.

15. Randomization: Was the treatment allocated randomly? • The answer is yes. The women were randomly assigned to either the treatment group or the control group. This is important because it guards against bias. For example, if all women of slim physique were assigned to the treatment group, unique results in that group might be credited to the treatment when in fact perhaps physique was the cause.

16. Reproducibility: Has other research produced similar evidence? • The answer is no. The report stated that until now no randomized controlled trial had been conducted. A claim tested by only a single experiment, as in this case, is tenuous until the results have been reproduced by a number of high quality trials conducted by independent investigators. Results must be reproducible.

17. Conclusion • The claim that moxibustion is helpful in positioning of the fetus is not well justified. The major flaw in the evidence is the lack of proper controls. A better test of this claim would involve double-blinding, that is giving a sham treatment to the control group, thus isolating the independent variable.

18. Level Kognitif dalam Taxonomy Bloom • Knowledge – recall of specific facts • Comprehension– understanding what is communicated • Application – generalization and use of abstract information in concrete situation • Analysis – breakdown of a problem into subparts and detection of relationships among the parts • Synthesis– putting together all parts to form a whole • Evaluation – using criteria to make judgments

19. Mari kita lihat contoh di bawah ini: Wanted: thinking students Are you tired of being frustrated? Do you refuse to settle as second best? Do you want to succeed? Do you know how to analyze a problem? Do you know how begin to attack a problem? If your answer to these questions indicate that you are unhappy with your present level of thinking skills, meet me in Room 211 at 3 pm

20. Mari kita coba tentukan level kognitif pertanyaan di bawah ini: • Imagine that you saw this notice taped to the classroom bulletin board. How would you reply? • Who wrote this notice? • Do you this is an appealing notice? • How would you rewrite it to make it more attractive? • What type of students do you think would response to this notice? • What type of problem do you see in using this questions in the notice? • When the interested students report to Room 211, what will they be told?

21. Synthesis – putting together parts to form a whole/ create something by data you are given • Knowledge – recall • Evaluation – make judgment • Comprehension • Comprehension • Analysis – breakdown of problem into subparts and detection of relationships among the parts • Application – generalization and use abstract information in concrete situation Understanding

22. CONTOH LAIN: • Listsix drugs used in the management of hypertension • Classify drugs used in treatment of hypertension • Manage a specific patient with simple, uncomplicated hypertension • Identifythe indications for the use of different categories of drugs in the management of hypertension, eg. Ca. channel blockers • Design a management plan for a specific patient with complicated hypertension • Compare the use of beta blockers with ACE inhibitors in the management of a young hypertensive. Justify your answer with evidence from the literature

23. BUILDING THE SKILLS OF LEARNING Metacognitive Skills

24. Concepts of metacognition • The knowledge of our own cognitive functions and the thinking about our own thinking process • Knowledge and regulation about the process • Our acquired knowledge about own cognitive ability and how such ability can be applied to the cognitive process • Metacognition is the skill of learning

25. THE SKILL OF LEARNING IS AN IMPORTANT ELEMENT OF LEARNER CENTERED LEARNING…

26. DEVELOP METACOGNITIVE SKILLS • Identifying the needs • Developing and implementing a plan of learning • Monitoring and evaluating the progress

27. a. Identifying the needs • What do I already know about the topic? • What do I not know about the topic? • What is the knowledge gap • What the most important topic that I need to adress?

28. b. Developing and implementing a plan of learning: • What learning strategy is most likely help me achieve the target? • What alternative do I have? • Is it the best strategy? • What are the resources I need? • Do I have prior success with this strategy? • What is the type of monitoring and evaluation most suitable for this particular strategy?

29. c. Monitoring and evaluating the progress • What is the progress so far? • Is the time frame realistic? • Do I need to change the learning strategy? • What is the most important determinant of my success or failure? • What have I learned from the process that would help me in the future?

30. ANY QUESTIONS?