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Are patient-centered care values as reflected in teaching scenarios really being taught when implemented by teaching faculty? A discourse analysis on an Indonesian medical school's curriculum

DOI: 10.1186/1447-056x-10-4

Keywords: Patient-centered care, Comprehensive care, Continuous care, Discourse analysis

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Abstract:

Discourse analysis was done by 3 general practitioners of scenarios and learning objectives of an Indonesian undergraduate medical curriculum. The coders categorized those sentences into two groups: met or unmet the educational goal of patient-centered care.Text analysis showed gaps in patient-centered care training between the scenarios and the learning objectives which were developed by both curriculum committee and the block planning groups and the way in which the material was taught. Most sentences in the scenarios were more relevant to patient-centered care while most sentences in the learning objectives were more inclined towards disease-perspectives.There is currently a discrepancy between expected patient-centered care values in the scenario and instructional materials that are being used.The "Health for All" goals as stated in the 1978 Alma Ata declaration described the need to acknowledge the patient as a person [1]. It is essential that patient-centered care be recognized by health professionals who work in any domain of medicine. Patient-centered care is at the core of care provided by family practitioners [2-7]. Caring for patients, while recognizing their personal and environmental background helps to define the specialty of family practice. This is in contrast to other specialties that often view patients based on particular specific diseases.In 2006, the Indonesian Medical Council, adopted a competence-based education as the basis for undergraduate medical curriculum and clearly stated the orientation of the curriculum should be towards family medicine [8-10]. The idea was that all undergraduates would learn 7 competencies: effective communication, clinical skills, medical knowledge, patient-management, information-management, life-long learning and ethics-professionalism [8]. Looking at general scope of the 7 competences, patient-centered care values should have already been included.There is often a discrepancy between "curriculum on paper" and "c

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