PENYUSUNAN MODUL

PELATIHAN KETERAMPILAN
UNTUK PENDIDIKAN TENAGA
KESEHATAN
ARDI FINDYARTINI
Department of Medical Education
Faculty of Medicine Universitas Indonesia
• Kompetensi dan proses pencapaian kemampuan keterampilan
• Kurikulum, modul/mata kuliah dan prinsip asesmen
• Pengembangan staf pengajar untuk memenuhi kebutuhan kurikulum
Kemampuan keterampilan klinis apakah yang selama ini paling sulit
dilatihkan di program studi Bapak Ibu?
System-based medical & health professions
education

Frenk, Julio, Lincoln Chen, Zulfiqar A. Bhutta, Jordan Cohen, Nigel Crisp, Timothy Evans, Harvey Fineberg, et al. 2010. Health professionals for a new century:
transforming education to strengthen health systems in an interdependent world. The Lancet 376(9756): 1923-1958.
Pencapaian keterampilan klinis profesi kesehatan
Konsep capaian
pembelajaran/kompetensi
Doing the
right thing

Doing the
thing right
The right
person doing
it

(Harden RM, 2000)

Domain Kognitif

https://cft.vanderbilt.edu/guides-sub-pages/blooms-taxonomy/
Domain Psikomotor (Harrow’s)

Use effective body language, such as gestures and facial

Non-discursive communication expressions

Skilled movements Advanced learner movements as one would find in

sports or acting

Stamina that must be developed for further

Physical abilities (fitness) development such as strength and agility

Perceptual abilities Response to stimuli such as visual and auditory

Fundamental movements Basic movements such as walking or grasping

Reactions that are not learned, such as an involuntary

Reflex movements reaction
Domain Afektif (Bloom’s)

Acts consistently due to an internal belief, can articulate

a philosophy or world-view, can break down complex
Characterizing situations and respond accordingly based on values,
develops and lives by a code of personal behavior

Values become systematic, can compare and contrast

Organizing values and choices, begins to order and prioritize values,
chooses to commit to certain values and behaviors
Motivated to invest. Chooses to behave in a certain way
Valuing frequently. Begins to identify with a behavior and
commit to it

Responding Willingly participating, obedient, volunteers, finds

satisfaction in participating, ready to respond

Willing to be aware of the setting/situation, gives

Receiving/attending attention by choice, open to the experience
 P
R
O
S
E
D
U
R

Mc Leod, Steinert, Trudel & Gotettesman. Seven Principles for Teaching Procedural and Procedural Skills. Academic Medicine. 2011
 Prinsip pengajaran prosedur klinis
Konsep umum

Demonstrasi oleh instruktur/tutor

Narasi prosedur oleh instruktur

Narasi prosedur oleh peserta ddidik

Latihan keterampilan

Prasetyono TOH, Nusanti S. Prinsip Pengajaran Keterrampilan Prosedural. Dalam: Findyantini A, Jusuf A, Menaldi Sri LSW(eds)
Panduan Praktis Bagi Pengajar Klinis. Sagung Seto: Jakarta. 2017
Pendidikan profesi kesehatan

Pembelajaran
tahap
Pembelajaran profesi/latihan
tahap praktik
https://jabsom.hawaii.edu/center-for-clinical-skills/

akademik
Does
Tahapan pencapaian
Shows how kemampuan
Knows how keterampilan klinis
Knows https://kingsbridgetrainingacademy.com/arlo/events/5-clinical-skills-for-healthcare-assistants/
Kurikulum, modul dan asesmen
 Didokumentasikan,
• Rangkaian rencana dilaksanakan &
dievaluasi

Rangkaian pengalaman Untuk peserta didik dan

belajar staf pengajar

Untuk mencapai capaian

Kurikulum pembelajaran/
kompetensi yang
diharapkan (Harden RM, 2013, Coles C, 2011)
Grant J, 2010)
Langkah pengembangan kurikulum berbasis
kompetensi

1. Mengidentifikasi profil lulusan (“akan menjadi apa sajakah lulusan

program studi ini?”)

2. Merumuskan secara eksplisit kompetensi/capaian pembelajaran

yang diharapkan dan komponen kompetensinya (“kemampuan
apa sajakah yang harus dimiliki?”)

3. Penetapan bahan kajian/substansi keilmuan

4. Merumuskan milestones atau tahapan pencapaian kompetensi,

Entrustable Professional Activities (EPA)/kewenangan klinis, dan
tingkat supervisi
Frank JR, et al (2010). Competency-based medical education: theory to practice. Medical Teacher 32: 638-645.
Kementerian Pendidikan dan Kebudayaan (2012). Direktorat Jenderal Pendidikan Tinggi Direktorat Pembelajaran dan Kemahasiswaan. Buku KPT – DITJEN DIKTI.
Pengembangan dan penyusunan kurikulum pendidikan tinggi.
Langkah pengembangan kurikulum berbasis
kompetensi
5. Pembentukan mata kuliah atau modul

6. Memilih dan menetapkan aktivitas pembelajaran dan

metode instruksional

7. Memilih dan menetapkan metode evaluasi hasil

pembelajaran untuk memonitor pencapaian kompetensi secara
bertahap

8.Merumuskan dan melaksanakan evaluasi outcome program

Frank JR, et al (2010). Competency-based medical education: theory to practice. Medical Teacher 32: 638-645.
Kementerian Pendidikan dan Kebudayaan (2012). Direktorat Jenderal Pendidikan Tinggi Direktorat Pembelajaran dan Kemahasiswaan. Buku KPT – DITJEN DIKTI. Pengembangan dan penyusunan
kurikulum pendidikan tinggi.
LANGKAH PERUMUSAN KURIKULUM BERBASIS
LUARAN/KOMPETENSI
Menetapkan tahapan
Merumuskan pencapaian capaian
Identifikasi kemampuan
kompetensi/capaian
yang dibutuhkan lulusan pembelajaran/
pembelajaran
milestones

Memilih pengalaman
Memilih metode
Merencanakan evaluasi belajar dan metode
evaluasi hasil
program/kurikulum instruksional yang
pembelaran yang sesuai
sesuai

Frank JR, et al. (2010). Competency-based medical education: theory to practice. Medical Teacher 32: 638-645.
Matriks Pengalaman Belajar
Capaian Pengalaman Belajar Bahan Kajian Media dan Mata Indikator Asese
Pembelajaran (Ruang Teknologi Kuliah men
(Kompetensi) Lingkup
Materi )
sub aktivitas, Substansi:
kompetensi metode pokok
pembelajaran bahasan dan
sub pokok
bahasan

Sumber: Paulina Pannen, Presentasi KKNI

Desember 2012
 Tingkat kurikulum

Standar/Kurikulum di
tingkat nasional

Kurikulum tingkat program Contoh: Kurikulum Program

studi (makro) Pendidikan Dokter

Contoh: Buku Rancangan

Kurikulum tingkat
modul/mata kuliah (meso) Pengajaran (BRP) Modul
Keterampilan Klinis Dasar

Contoh: Lesson plan/SAP untuk sesi

Kurikulum tingkat kelas
(microteaching) (mikro) tutorial keterampilan klinis
pemeriksaan EKG
 Goals,
topics,
general
purposes Learner
Evaluation characte
ristics

Rancangan
Support pengajaran Learning
services outcome

Teaching
learning Subject
activities, content
resources
Pre-
assess
ment
(Kemp JE, 1998)
 Prinsip asesmen
• cognitive
dalam pendidikan Learning
• affective
domains
kedokteran & • psychomotor

profesi kesehatan
Purpose of • summative
assessment • formative

• written examination
• clinical - practical
Assessment
instruments examination
• workplace based
assessment

Standard • norm-referenced
setting • criterion-referenced
 Work-based assessment,
eg. Portfolio, logbook, MSF,
Mini-CEX, DOPS, CBD

Clinical and practical assessment,

eg. OSCE, long case, OSLER

Written assessment, eg.

MCQ, EMI

Written
assessment

(Miller, 1991)
Aspek psikometrik instrumen asesmen

Validitas
• Derajat sebuah tes menguji apa yang seharusnya diujikan/dievaluasi

Konsistensi (reliabilitas)
• Derajat sebuah tes mengukur apapun yang diukur secara konsisten

Feasibility
• Cost
• Practicability
Educational impact
• Efek evaluasi hasil belajar terhadap mahasiswa
 Reliability (konsistensi) dan validitas; konsistensi adalah salah satu syarat validitas

Miller D, Linn RL, Gronlund NE. 2009. Measurement and assessment in teaching. New Jersey: Pearson. pp 72
 OVERVIEW
(Portfolio for PLANNING AND MONITORING)

‘Smart’ assessment
Portfolio for personal
and professional
development

Driessen E, Heeneman S, Van Der Vleuten CPM (2013). Portfolio assessment.

Using portfolio: continuous guidance, In: Dent JA, Harden RM (eds). A Practical Guide for Medical Teachers. 4th
edition. Churchill Livingstone Elsevier.
feedback, monitoring
Portfolio for learning
Portfolio for
assessment
Supported by technology
ASSESSMENT COACHING
(Portfolio as EVIDENCE) (Portfolio for REFLECTION)

More formative assessment

More narrative (qualitative) assessment

and feedback

Put focus on the development of future

work skills

Portfolio mapping for undergraduate

medical students – courtesy of
Medical Education Unit FKUI
Pengembangan kurikulum =
pengembangan staf pengajar
Pengembangan staf pengajar
Well-prepared and future-
oriented medical and health
professionals
teachers/faculty

System-based medical
and health professions
education

Future medical doctors and

health professionals
Pengembangan staf
pengajar Assessor &
Curriculum
developer &
diagnostician
evaluator
Facilitator & Manager &
mentor change agent

Role model as
Scholar &
teacher &
researcher
practitioner

Health Professional
Information
& enquirer
provider & Professional into own
guide Teacher competence

Harden RM, Lilley P (2018). The eight roles of the medical teacher. 1st edition. Elsevier
 Entrustable professional
activities (EPA)

A unit of professional practice that

Level of supervision can be fully entrusted to a trainee,
as soon as he or she has
5 Level 5: Resident may provide supervision to junior trainees
demonstrated the necessary
Level 4: Resident may act under distant supervision not directly
4 available (“unsupervised”) competence to execute this activity
Competence threshold
unsupervised.
Competence threshold reached; formal entrustment decision, “STAR” (Statement of Awarded Responsibility) is
documented in portfolio and in institutional registers, after confirmation by three staff members

Level 3: Resident may act with proactive indirect supervision, not

3 present, quickly available if needed
Level 2: Resident may act under direct, pro-active, ongoing full supervision
2 present in the room
Level 1: Resident has some knowledge and skills but not allowed to perform entrustable
1 professional activities independently
ten Cate O, Scheele F (2007). Competency-based postgraduate
ten Cate O,
ten Cate O, T. J. O., Snell, L., & Carraccio, C (2010). T. J. O., Snell,
Medical L., & Carraccio,
competence: TheC (2010). Medical
interplay competence:
between
The interplay between individual ability and the health care training: Can we bridge the gap between theory and clinical practice?
individual ability and the health care environment. Medical Teacher, 32(8),
environment. Medical Teacher, 32(8), 669-675. 669-675. Acad Med 82(6):542–547.
 Supervisi di tatanan klinis

Pemberian umpan Keterampilan Pengajaran

balik konstruktif interpersonal (e.g penalaran klinis)

Belajar dari
pengalaman
SUPERVISORY DIMENSIONS

Clinical supervision Formal

Management supervision (primary task) Debriefing after critical incident
Caseload
Contoh: laporansupervision
jaga, tutorial, Contoh: sesi debriefing setelah ada
Giving feedback on student
Performance review
presentasi kasus kasus tertentu, bedside teaching
performance
Clinical audit mentoring
Mentoring/preceptorship
Mentoring/preceptorship

Planned Ad-hoc
(agreed in (A response to
advance) an event)

Peer review
Contoh: saat mahasiswa didampingi Impromptu teaching opportunity
Team briefings Contoh: saat mahasiswa di IGD, atau di
oleh seniornya, saat pertukaran jaga, Immediate advice/support
Team conference Informal poliklinik dan mendapat umpan balik
saat mahasiswa didampingi oleh General advice on skill or
Shift handover (service DPJP, mentoring
perawat senior saat memasang infus performance
Professional forum delivery
continues)

(Driscoll D, O’Sullivan J (2007). The place of clinical supervision in modern health care. In Driscoll J (ed). Practising clinical supervision. 2nd edition. Baillieere Tindall
Elsevier)
Supervision and entrustment

Previous
Characteristics
experience in
of the
regards to
student/resident
supervision

Past assessment Current situation

& evidence of (patient, case
current complexity,
competencies circumstances)

Cianciolo, A. T., & Kegg, J. A. (2013). Behavioral Specification of the Entrustment Process. Journal of Graduate Medical Education, 5(1), 10–12.
Take home message
• Pencapaian kemampuan keterampilan
secara bertahap dan terkait dengan
aspek pengetahuan dan perilaku
• Penyusunan kurikulum untuk
pencapaian keterampilan klinis perlu
dilengkapi rumusan komponen yang
jelas.
• Evaluasi hasil pembelajaran perlu
diterapkan dengan sistematis
• Peran staf pengajar sangat penting
dalam implementasi kurikulum
berbasis kompetensi
Terima kasih
ardi.findyartini@ui.ac.id
findyartini@yahoo.com
findyartini
findyartini