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All Journal Sriwijaya Journal of Forensic and Medicolegal Enigma in Education
Ahmad Erza
Department of Criminal Law, Enigma Institute, Palembang, Indonesia
Humanities Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Mathematics Medicine & Pharmacology Other

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The Power Imbalance Personified: A Mixed-Methods Analysis of Senior-to-Junior Bullying in Indonesia's Medical Residency Programs Alex Putra Pratama; Henry Clifford; Ahmad Erza; Ericca Dominique Perez; Fakhrul Setiobudi; Dedi Affandi; Lestini Wulansari; Fachrudin Sani; Vita Amanda; Zahra Amir
Enigma in Education Vol. 3 No. 1 (2025): Enigma in Education
Publisher : Enigma Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61996/edu.v3i1.92

Abstract

Bullying within medical residency is a pervasive global issue with severe consequences for residents' mental health and patient safety. In Indonesia, where hierarchical structures in medicine are deeply entrenched, senior-to-junior bullying is a significant yet under-investigated problem. This study aimed to analyse the prevalence, forms, and lived experiences of bullying perpetrated by senior residents against their junior counterparts in Indonesian medical residency programs. A sequential explanatory mixed-methods design was employed. In the quantitative phase, an anonymous online survey was distributed to 584 junior medical residents across five major teaching hospitals in Indonesia. The survey included the validated Negative Acts Questionnaire-Revised (NAQ-R) and questions on demographics and specialty. In the qualitative phase, 25 junior residents who reported high levels of bullying were purposively selected for in-depth, semi-structured interviews to explore their experiences. Quantitative data were analysed using descriptive and inferential statistics, while qualitative data were subjected to reflexive thematic analysis. Quantitatively, 81.3% (n=475) of junior residents reported experiencing at least one bullying behaviour weekly. The most common forms were work-related, such as excessive workloads and meaningless tasks, and personal humiliation. Year of residency was significantly associated with bullying exposure. Qualitatively, four major themes emerged: (1) ‘The Hierarchy as an Unassailable Mandate for Abuse’; (2) ‘The Pedagogy of Fear: Bullying as a Misguided Educational Tool’; (3) ‘Silent Suffering and the Armour of Complicity’; and (4) ‘The Perpetuating Cycle: Victims on a Trajectory to Becoming Perpetrators’. The qualitative findings revealed that bullying was often rationalised by seniors as a necessary part of medical training. In conclusion, senior-to-junior bullying is alarmingly prevalent and deeply embedded in the culture of Indonesian medical residency programs. It is personified through a profound power imbalance, rationalised as an educational necessity, and sustained by a culture of silence. Urgent, multi-level interventions focusing on systemic change, faculty training, and robust confidential reporting systems are imperative to dismantle this destructive cycle.
Reading the Epigenetic Clock: A Comparative Analysis of DNA Methylation Markers for Age Estimation in Semen, Saliva, and Touch DNA Febria Suryani; Bryan Helsey; Leonardo Simanjuntak; Karina Chandra; Mustafa Mahmud; Lisha Sandrina; Ahmad Erza
Sriwijaya Journal of Forensic and Medicolegal Vol. 3 No. 1 (2025): Sriwijaya Journal of Forensic and Medicolegal
Publisher : Phlox Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjfm.v3i1.233

Abstract

Background. Predicting an individual's age from biological evidence is a significant advance in forensic intelligence. DNA methylation, a stable epigenetic mark, provides the molecular basis for epigenetic clocks, but their operational reliability requires validation across diverse sample types and populations, particularly for low-template touch DNA. Objective. To develop and validate body-fluid-specific age prediction models from a curated five-CpG panel in semen, saliva and touch DNA, and to compare their accuracy in an Indonesian population. Methods. Following approval from the Ethical Committee of CMHC Indonesia (No. 128/EC/CMHC/2023), 150 healthy Indonesian male volunteers aged 18–65 provided semen, saliva and high-yield standardized touch DNA. Methylation at five CpG sites (ELOVL2, FHL2, TRIM59, KCNQ1DN, C1orf132) was quantified by controlled pyrosequencing after bisulfite conversion with efficiency controls. Body-fluid-specific models were built by multiple linear regression and validated by 10-fold cross-validation. Results. The semen and saliva models were highly accurate, with mean absolute deviations of 3.19 years (R²=0.94) and 3.55 years (R²=0.92). The touch DNA model was less precise but still informative (MAD 5.49 years, R²=0.85). All models satisfied the assumptions of linear regression, with variance inflation factors below 2.5, and 95% prediction intervals were narrowest for semen. Conclusion. The panel is validated for age prediction in a Southeast Asian population. The semen and saliva models are accurate enough for consideration in casework, while the touch DNA model, interpreted cautiously, can generate investigative leads from trace evidence. The findings underline the importance of tissue-specific modeling and provide a methodological blueprint for responsible forensic age estimation.
Co-Authors Alex Putra Pratama Bryan Helsey Dedi Affandi Ericca Dominique Perez Fachrudin Sani Fakhrul Setiobudi Febria Suryani Henry Clifford Karina Chandra Leonardo Simanjuntak Lestini Wulansari Lisha Sandrina Mustafa Mahmud Paula Guelle Vita Amanda Zahra Amir