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Isnindiah Koerniati
Rosfita Rasyid
Zelly Dia Rofinda
Malinda Meinapuri




After completing this module, the students can :

Family life cycle Explain the definition of family life cycle
Explain the concept of the family life cycle
Explain the components of the family life
Unattached young adult
The newly married couple
Families with young children
Families with adolescents
Launching family
Family in later life
Understand how to apply family life cycle
concepts and components to solve family
Family wellness plan Explain the definition of family wellness plan
Explain the dimensions of family wellness
Do Periodic Health Examination using Family
Wellness Plan
Have holistic understanding of current issues
that affect on family health problems
Apply EBM approach in doing family health problems analysis


1. PBL tutorial

During tutorial sessions, students will:

Come prepared to discuss the case and learning issues researched since
the last
Actively participate in group discussions and contribute to the learning
process in a manner that allows for the balanced participation of everyone
in the group.
Develop learning issues at each session, phrase them as full-sentence
questions, write them on the board, and post them on the course web page.
Consider biological, population, behavior/mental health
issues/explanations and questions of professional attitudes, values, and
ethics related to the patients problem(s) described in the case.
Go to the board to diagram, outline, draw, etc. in explanation of
mechanisms related to hypotheses.
Debate evidence related to the case and avoid personal attacks on others.
Comply with ground rules with regard to how the group will function
and how its members treat one another.
Participate in end-of-session reflection and assessment by giving and
receiving constructive criticism regarding self, tutor, student, and group

2. Expert Concultation
This activity is the basicly needs. The group have responsibility to control and
plan an expert concultation by make a contact with the expert directly

3. Introductory Lectures By Expert

4. Skills Lab:
Role play: educate and inform patient, verbal communication with other
healthcare professionals
Write effective referral letter
Conduct effective oral presentation

Field work: family attachment

5. Laboratory Practice
This activity is a way to make students more undertand the goals of lecture

6. Self Direct Study

Between tutorial sessions, students will:

Research key learning issues using a variety of resources.

Critically evaluate the credibility of sources and the validity of the
information they have obtained in their research.
Integrate what they have learned through research, lectures, labs,
clinical skills, Perspectives in Medicine (PIM), etc. into what is discussed
in tutorials
Synthesize what they have learned and be prepared to discuss it without
reading directly from their materials, as much as possible, and apply it
to the case at the next tutorial session

7. Plenary Discussion
The goals of this activity is to make same perception and to compare the tutorial
activity in other groups


End-Session Mid Unit End Unit Formal Reporting

Oral tutor and student Written student self- Written student self- On-line completion
self-assessment; oral assessment with assessment with and submission of
assessment by all of learning prescription learning prescription pass or fail for each
how well individuals for last half of unit; for next unit; oral student and
and group are oral assessment by all assessment by all of narrative evaluation
functioning of how well how individuals and of each students
individuals and group group have grown performance;
are functioning and and progressed and Student Evaluation
plans for development how students can of the Tutor on-line
continue to develop (by students)
in the next unit
At the end of each At a time specifically At a time specifically At conclusion unit
tutorial session (approx scheduled for this scheduled for this
15 minutes) purpose toward the purpose at the end of
middle of the unit the unit

In the tutorial room In the tutorial room or In the tutorial room

at some other location or at some other
such as someones location such as
house someones house
Observation of Observation of Observation of Tutor observation/
performance in relation performance in performance in documentation of
to Tutorial relation to Tutorial relation to Tutorial student performance
Performance Criteria Performance Criteria Performance Criteria and progress over
(individual and group); (individual and (individual and the course of the
new and previously group); new and group); growth and unit in relation to
identified opportunities previously identified development over Tutorial
for development opportunities for unit; progress Performance
development implementing Competencies and
learning prescription learning
student observation
of tutor performance
Formative reinforce Formative reinforce Formative reinforce Summative certify
effective performance effective performance Effective that student has
and improvement, and improvement, performance and passed or failed
identify individual and identify individual and improvement and tutorial; provide
group performance group performance identify ways student written
opportunities for opportunities for can continue to documentation
development, develop development, develop improve in next unit of student
plan for improving plan for improving Summative though performance that
the oral feedback is goes in student file
not officially and is used in

recorded, it serves as writing Deans
the basis for formal Letter; provide
pass/fail and written
narrative evaluation documentation of
tutor performance
that goes to tutor,
Block Chair, and
Department Chair;
satisfy institutional


Carter, B., McGoldrick, M. (2004). The Expanded Family Life Cycle : Individual,
Family, and Social Perspectives, 3rd edition, New York: Pearson Allyn
& Bacon.
Greenhalgh, T (2010). How to Read a Paper: The Basics of Evidence-Based
Medicine, London: BMJ Books.
Hernandez, J (2013). Family Wellness Skills: Quick Assessment and Practical
Interventions for the Mental Health Professional, New York: W. W.
Norton & Company.
McGoldrick, M., Carter, B., Garcia-Preto, N. (2010). The Expanded Family Life
Cycle: Individual, Family, and Social Perspectives, 4th Edition, London:
Miettinen, O. S. (2011). Up from Clinical Epidemiology & EBM Paperback, New
York: Springer.
Sackett, D. L., Straus, S. E., Richardson, W. E., Rosenberg, W., Haynes, R. B.
(2000). Evidence-Based Medicine: How to Practice and Teach EBM,
2Ed, New York:Churchill Livingstone.


In a metropolis city, there is a family who live in a high class cluster residential
area peacefully, namely, the Nicos family.

Mr.Nico has 3 children, the oldest one is boy, named Obie 15 years old, 3 grade
junior high school student. He has weight of about 72 kg and height of 158 cm.

The second one is a girl named Fety, and she is 10 years old, 5th grade elementary
school student. She has weight of about 60 kg and height of 140 cm. The 3rd is a
boy, Gemie, 5 years old, kindergarden student. He has weight about 40 kg and
height of 110 cm. Mr.Nicos wife is Bety, 37 years old.

Mr Nico works as a successful property developer in his city.Meanwhile his wife

works as a manager in the biggest private bank. Mr Nico and his wife work from
07.00 am to 17.00 pm everyday.

Almost all house works, including cooking, washing, and cleaning the house in
MrNicos family are done by a servant. Unfortunately Mr.Nicos children dont
like the food which are prepared by the servant. So, the children always buy from
nearby fast food store. Although Mrs Bety is relatively young, she was
hospitalized because of stroke 1 year ago. Mrs Betys father died from heart
attack and her mother died of diabetes mellitus and Stroke 3 months ago.

Fety often doesnt want to go to school because she is always bullied by her
friends due to her weight.

Obie has never been bullied by his friends. However, he cant follow all of his
friends activities, for example: when his friends are playing basketball, Obie just
watch and sit because he feels breathless early.

Gemie has problem with his socialization, he just spends almost all of his day
with computer games.

How do you explain Nicos Family Problem from the perspectives of the Family
Life Cycle and Family Wellness Plan? Please do the analisys using EBM


This case describes the presentation and clinical course of a metropolis
family with many problems in health issues in every stage of family members
life. The father is a smoker, the mother has strong history of stroke, Diabetes
Mellitus and all of their children are obese. It is possible to describe stage that
occur throughout the life of family unit. Although the stage of family
development are less distinct and more variable than that of individual
development, such a conceptualization can help the worker assess a familys
functioning in a broader context, and better understand the familys strengths and

This family is in the stage of family with adolescents. In this stage, the
family has transition of emotional process in increasing flexibility of family
boundaries to include childrens independence and grandparents frailties. Also,
the family has significant changes in development process, namely shifting of
parent-child relationships to permit adolescent to move in and out of system,
refocus on midlife marital and career issues, and beginning shift toward joint for
older generation.

The key to successful goal setting is planning. Establishing fitness and

eating goals and habits for family can provide long term benefits that help prevent
illness. Families that set and accomplish goals collectively, receive the support
and motivation needed to achieve them. A well-designed family wellness plan can
create life-long healthy habits, and better mental and physical health overall. The
time spent designing the plan is well worth the effort.

Family wellness covers the lifespan from infancy to old age and all the
places we spend time our homes, daycares, schools, recreation centres,
workplaces, and public spaces. It includes physical, emotional, intellectual,
spiritual, occupational and social wellness. No single plan can do it all, or at least
not well. We need to begin by carving off a piece of work that is manageable,
realistic, and will move us closer to a healthier future for all. We know that health
is influenced by many factors. We cant tackle them all at once but we can focus
our efforts on promoting well-being, and preventing illness and injury.

Family Wellness Plan of Nico Family

Family Lifestyle Screening Immuni Chemoprop
member modification Zation hilaxis
Mr.Nico S a
40 y.o Smoking Annual BMI High intake
Smoker R antioxidant
regular physical Daily BP
act a
Annual CXR r
Regular D
sleeping RE
schedule T
Total cholesterol w
Well balanced y
diet Early dental
exam i
Mrs. Bety R a
37.y.o Regular Annual BMI Aspirin
strong physical act D
history Daily BP r Calcium
stroke Regular E
DM sleeping Every 3 month
schedule blood glucose
check up w
Well balanced B
diet Breast self exam
s p
Stress work Paps smear
i t
Injury Total cholesterol
Obie l a
15 y.o Low fat diet Annual BMI nnual flu
Obese vaccination
w y
Weight Early dental
reduced exam etanus
toxoidr C
Regular CXR
exercise S
Smoking/alcohol d
Diet test
Junk food

Fety Psychological a
10 y.o Annual BMI Annual
Obese vaccination y
early dental
exam Tetanus
toxoid C
Gemie peer group a
5 y.o socialization Annual BMI IPV
Obese y
early dental MMR
Vision screening