Purpose: The development of students’ clinical reasoning skills should be a consideration in the design of instruction and evaluation in medical education. In response to the coronavirus disease 2019 (COVID-19) pandemic, several changes in the medical curriculum have been implemented in promoting clinical reasoning. This study aims to explore medical students’ perceptions and experiences with the clinical reasoning curriculum during the COVID-19 pandemic and determine their skills development.Methods: The study used a mixed-method design with a concurrent approach. A cross-sectional study was conducted to compare and examine the relationship between the outcomes of the structured oral examination (SOE) and the Diagnostic Thinking Inventory (DTI). Then, the qualitative method was used. A focus group discussion using a semi-structured interview guide with open-ended questions was conducted, then the verbatim transcript was subjected to thematic analysis.Results: There is an increase in SOE and DTI scores between second-year to fourth-year students. The diagnostic thinking domains and SOE are significantly correlated (r=0.302, 0.313, and 0.241 with p<0.05). The three primary themes from the qualitative analysis are perceptions regarding clinical reasoning, clinical reasoning activities, and the learning component.Conclusion: Even if students are still studying throughout the COVID-19 pandemic, their clinical reasoning skills can improve. The clinical reasoning and diagnostic thinking skills of medical students increase as the length of the school year increases. Online case-based learning and assessment support the development of clinical reasoning skills. The skills are supported in their development by positive attitudes toward faculty, peers, case type, and prior knowledge.
<p class="AbstractNormal"><strong>Introduction:</strong> Metabolic syndrome is an accumulation of several disorders, one of which is hyperglycemia. <em>Clitoria ternatea</em> is a plant that contains lots of flavonoids and is known to reduce blood glucose levels in metabolic syndrome. This study aimed to determine the effect of butterfly pea extract (<em>Clitoria ternatea</em>) on blood glucose levels in white rats with metabolic syndrome models.</p><p class="AbstractNormal"><strong>Methods: </strong>This research is an experimental study using animal models with pre and post-test control group design method. The number of samples was 30 male white rats which were divided into 5 groups: group 1–negative control group; group 2–positive control group; group 3, group 4, and group 5 were the metabolic syndrome group which was given <em>Clitoria ternatea</em> extract with doses of 100, 200, and 400 mg/kgBW, respectively for 28 days. Measurement of blood glucose levels for all groups was carried out on the 36<sup>th</sup> day as the pre-test and the 64<sup>th</sup> day as the post-test. Blood glucose levels were obtained through retroorbital venous blood which was analyzed with the Easy Touch blood glucose stick meter. One-way ANOVA was used to analyze data, followed by post-hoc LSD test, and paired T-test.</p><p class="AbstractNormal"><strong>Results: </strong>The average post-test random blood glucose levels decreased by 135.16 mg/dl, 163.18 mg/dl, and 168.35 mg/dl. There was a significant difference (p<0.05) between the pre-test and post-test blood glucose levels along with the average blood glucose level amongst groups.</p><p class="AbstractNormal"><strong>Conclusion: </strong>Butterfly pea (<em>Clitoria ternatea</em>) could decrease blood glucose levels and cause further decrease with higher doses.</p>
<p><strong><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">ABSTRAK</span></span></strong></p><p><strong><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">Pendahuluan</span></span></strong><span style="vertical-align: inherit;"><span style="vertical-align: inherit;"> : Awal tahun ini, dunia menghadapi pandemi Covid-19. </span><span style="vertical-align: inherit;">Berawal dari Wuhan China, dan sampai di Indonesia. </span><span style="vertical-align: inherit;">Dampak Covid-19 adalah kasus dan kematian yang parah. </span><span style="vertical-align: inherit;">Di Indonesia, ada 57.000 kasus yang dikonfirmasi dan 2.934 meninggal. </span><span style="vertical-align: inherit;">Lebih dari 82% kasus orang lanjut usia. </span><span style="vertical-align: inherit;">Dalam hal komorbiditas, sebagian besar kasus kematian memiliki hipertensi, diabetes melitus, gagal jantung dan gagal ginjal. </span><span style="vertical-align: inherit;">Kemudian bagaimana Indonesia penduduk rentan ini. </span><span style="vertical-align: inherit;">Penelitian ini bertujuan untuk menilai respon untuk melawan Covid-19 melalui pengawasan masyarakat, terutama bagi penduduk yang rentan.</span></span></p><p><strong><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">Metode</span></span></strong><span style="vertical-align: inherit;"><span style="vertical-align: inherit;"> : Metode yang digunakan adalah responden yang diwawancarai secara online di antara 25 pemimpin rumah tangga sebagai data kuantitatif. </span><span style="vertical-align: inherit;">Metode pengukuran adalah kualitatif online di kalangan masyarakat, tokoh masyarakat, pimpinan rumah tangga, kader, dan pemerintah desa.</span></span></p><p><strong><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">Hasil dan diskusi</span></span></strong><span style="vertical-align: inherit;"><span style="vertical-align: inherit;"> : Hanya ada 80% setuju bahwa infeksi COVID-19 melalui tetesan. </span><span style="vertical-align: inherit;">Ada 84% pemimpin rumah tangga yang memahami gejala. </span><span style="vertical-align: inherit;">Mereka memiliki pengetahuan yang baik tentang cuci tangan, masker, jarak sosial, dan isolasi. </span><span style="vertical-align: inherit;">Pengetahuan tentang pencegahan sangat rendah. </span><span style="vertical-align: inherit;">Hanya 32% yang tahu bahwa lansia memiliki risiko mati pada COVID-19. </span><span style="vertical-align: inherit;">Itu termasuk hipertensi dan diabetes melitus. </span><span style="vertical-align: inherit;">Terkait hasil kualitatif, hanya 2 informasi dari 15 informasi yang memahami jumlah penduduk rentan di daerahnya. </span><span style="vertical-align: inherit;">Tidak ada kebijakan yang jelas terkait dengan penduduk yang rentan terutama di kabupaten dan di bawah pada perlindungan yang rentan. </span><span style="vertical-align: inherit;">Tidak ada pengawasan masyarakat di antara penduduk yang rentan.</span></span></p><p><strong><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">Kesimpulan</span></span></strong><span style="vertical-align: inherit;"><span style="vertical-align: inherit;"> : Pengawasan masyarakat terkait COVID-19 kesesuaian, tetapi penduduk rentan masih khawatir. </span><span style="vertical-align: inherit;">Rekomendasinya yaitu mengembangkan model pengawasan masyarakat tentang perlindungan populasi yang rentan terhadap COVID-19.</span></span></p><p><strong><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">Kata Kunci: </span></span></strong><em><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">Community Surveillance</span></span></em><span style="vertical-align: inherit;"><span style="vertical-align: inherit;"> , Covid-19, Era Pandemi</span></span><strong></strong></p>
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