Case Management of Musculoskeletal System Disorders

CASE MANAGEMENT OF MUSCULOSKELETAL SYSTEM DISORDERS CASE SCENARIOS Bro. Y (19 years old) was hospitalized due to a traffic accident, the patient complained of pain in his legs, dizziness, the patient screamed because he was in pain. From the examination, it was found that there were bruises on his legs, and lacerations on his back, elbow and left thigh, swelling on his right leg, bones were visible protruding, bleeding was flowing from the wound. History of illness; has no history of allergies, hereditary diseases. Hb lab examination results: 8 mg%, Al 15,000 ml/dl. VS : BP : 90/70 mmHg, S : 37°C, RR : 18 X/min, N : 80 X/min. Results of RO fracture of the complete cris of 1/3 of the distal dextra open. In the emergency room, the patient received a heating situation. The patient was put on a splint, had an RL infusion installed, and received a 30 mg ketorolac injection, a 1 mg Ceftriaxon inj. and ATS inj. INSTRUCTIONS FOR STUDENTS III.1. Students discuss the cases given using the seven jumps method accompanied by a tutor.Seven Jump stages: (1) Clarify unfamiliar terms: a. This stage aims to understand the scenario and equalize perceptions b. Process: students identify terms/concepts that are not yet understood by using prior knowledge/opening a dictionary. c. Reason: Unusual terms will hinder understanding d.Results: list of terms that are not understood (2) Define the problem a. Aims to make students aware that there are problems that need to be discussed b. Process: students are motivated to contribute their opinions about the problem in the scenario c. Reason: allows each member to have a different view to broaden their horizons d. Result: the formation of topics that need explanation in the form of questions e. If these questions are not understood, they can be raised as learning outcomes that will be discussed at the next meeting. (3) Brainstorm possible hypothesis/explanation: a. This stage aims to activate the prior knowledge of each group member b. Process: students try to formulate, test and compare the advantages of each hypothesis c. Reason: encouraging the use of prior knowledge from each individual d. Results: a list of hypotheses or a brief explanation of the answers to the second step e. In the form of short answers (4) Arrange experience into a tentative solution: a. At this stage the problem is discussed in detail and compared to the hypothesis to see the possibility and need for further explanation b.All hypotheses are connected to each other schematically c. Reason: so that students can see the relationship between one concept and another concept, so that students understand and don't memorize. d.Results: in the form of a systematic explanation of the problem by the group in the form of a scheme/chart (5) Define LO (Learning Objective): a. At this stage the group determines what must be learned to be able to understand and solve unanswered problems. Tutors encourage students not to make problems too general or superficial b. Reason: the formulation of appropriate learning objectives is obtained from discussions between tutors and students c. Results: preparation of learning objectives/LO (learning objectives) d. LO is discussed at the next meeting (6) Info on gatherings and private studies: a. Carried out between the first and second discussions b. Process: students must look for all unanswered questions. c. Students can use different sources to get information (text books, journals, asking directly to experts, public lectures) d. Reason: students understand that they have to do it themselves and gather new information to fulfill learning goals e.Results: students summarize all the results obtained (7) Share the results of information gathering and private study; a. The process begins by looking at the LO, then identifying sources of information, sharing information that has been obtained and helping each other to understand b. Review the information that has been obtained and discuss whether all the problems in the scenario have been answered c. Reason: so that the group produces a complete problem analysis, combines learning results and identifies unknown problems for advanced learning. d.Results: summary of the information obtained e. If all the LOs are answered, then the discussion is finished, but if the LOs have not been achieved then the tutor gives assignments to group members. f. Unanswered LOs can be discussed at the Plenary meeting by presenting experts g. Presentations are made orally, writing charts on the board or presenting using power point h. The tutor provides feedback at the end of the second meeting Tutorial Implementation Techniques (i) Preparation for implementing the tutorial -Organization and group dynamics e. Prayer before carrying out activities f. Introduction to tutorial activities g. Introduction to all participants and tutors h. Election of Group Chair and Secretary Role of Group Leader g. Lead and moderate the course of the tutorial h. Encourage each participant to play an active role i. Balancing the participation of tutorial participants j. Ensure that the discussion does not stray from the agreed topic k. Maintain effective discussions and time in every step l. Directing the discussion to reach a conclusion. Role of the Group Secretary f. Listen and note down the main ideas and concepts that emerge g. Organize notes according to categories of ideas and concepts h. Submit notes to the group to ensure all ideas and concepts have been documented i. Actively participate in expressing opinions without forgetting the task of taking notes j. Underline important ideas and concepts Participant Roles e. Actively participate in the discussion process f. Explore problems based on scenarios g. Discuss problems to find answers h. Collaborate with other members to dig up information from necessary sources Tutor Role e. As a facilitator f. As a listener g. As a professional h. As an evaluator (ii)Tutorial Implementation - Read the scenario - Problem analysis and clarification of terms Defining and structuring problems can be in the form of questions or statement sentences - Formulate a hypothesis (temporary answer) from the problem or statement above -Identify and seek knowledge necessary to support a hypothesis -Organize and describe the required knowledge -Divide members to collect information from existing learning sources (analysis results/journal/textbook summaries submitted to tutors) - Synthesizing the problem, namely discussing existing information to find out whether there are errors and/or something is incomplete (iii) Closing of Tutorial Activities -Read back (notulations) the results of the discussion - Each student makes a summary of the discussion in the guidebook and the report is initialed by the lecturer tutor - Evaluation of discussions by tutors and students - Closing pray