What is Competence? Titi Savitri Prihatiningsih Department of Medical Education Gadjah Mada Medical School
Tugas 1
Topics • What is competence? • What are characteristics of competence? • How to formulate competence?
What is Competence?
What is Competence? The Past Knowledge
What is Competence? Skill
The Past Knowledge
What is Competence? The Present Attitude/ Behaviour
= Competence
Knowledge
Skill
What is Competence? Ability to apply Knowledge, Skills and Attitude/Behaviour
Capability of doing a task/job
What is Competence? what professionals can do in controlled environment it is a representation of professional practice, performing at the maximum of their ability
Definition of Competencies • Professional competence is the habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values, and reflection in daily practice to improve the health of the individual patient and community: – What you know – How you use what you know – How you add to what you know Epstein and Hundert, 2002, JAMA
What is Competency? • seperangkat tindakan cerdas dan penuh tanggungjawab • dimiliki seseorang sebagai syarat • untuk dianggap mampu oleh masyarakat • dalam melaksanakan tugas-tugas di bidang pekerjaan tertentu (SK Mendiknas No. 045/U/2002)
What is Performance? What he or she does in day-to-day practice What professionals actually do in their professional practice
Tugas 2
PERFORMANCE needs COMPETENCE needs KNOWLEDGE, SKILLS, ATTITUDES
Characteristics of Competence • • • • • •
Specific Comprehensive Durable Trainable Measurable Relevant
Features of a Competency Statement • Focuses on outcome performance • Integrates a broad range of related knowledge and skills objectives • Contextualized – related to a practical task in the field • Drawn from multiple domains, including affective and moral dimensions • Include professional behaviours relevant to the task • Indicates a level of expected ability
Elemen Kompetensi (SK Mendiknas No.045/U/2002) • • • •
a. Landasan Kepribadian b. Penguasaan ilmu dan ketrampilan c. Kemampuan berkarya d. Sikap dan perilaku berkarya menurut tingkat keahlian berdasarkan ilmu dan ketrampilan yang dikuasai • e. Pemahaman kaidah kehidupan bermasyarakat sesuai dengan pilihan keahlian dalam berkarya
Six Characteristics of Competencies • 1) competencies are context-bound; • 2) they are indivisible (knowledge, skills and attitudes are integrated); • 3) they are subject to change; • 4) they are connected to activities and tasks; • 5) learning and development processes are conditional for competencies
LEVELS OF CLINICAL COMPETENCE PREREQUISITES
KNOWLEDGE
SKILLS
ATTITUDES
Element CLINICAL ABILITIES
COMPOSITE CLINICAL PERFOMANCE (komponen) COMPETENT CLINICAL PRACTICE (area)
Ken Cox & R Bandaranyake, 1991
LEVELS OF CLINICAL COMPETENCE 1. Pre-requisites - PRIOR CONDITIONS
• Anatomical, Physiological, Pathological knowledge. • Skills of Communication, Observation, Measurement. • Respect, Honesty Persistence. 2. Partial Tasks - COMPONENT ABILITIES
• Skills of history taking, physical examination. • Generating diagnostic explanations. • Planning investigations. • Establishing rapport and trust.
LEVELS OF CLINICAL COMPETENCE 3. Patient/Problem - COMPOSITE ABILITY
• Selective search, studying whole patient and problem, leading to diagnosis and management plan. 4. Performance in Practice - COMPETENCE
• Habitual behaviour in managing a succession of patients. • Relations with colleagues. • Records, efficiency, communication.
CRITERIA OF CLINICAL COMPETENCE
1. 2. 3.
4.
Technical effectiveness in using knowledge and skills. Positive effects on the disease process, seen in outcomes of care. Positive effects of the doctor’s behaviour on the patient. Efficiency in using finite resources.
Dokter yang ingin kita hasilkan
Kompeten di bidang apa? • Di bidang komunikasi efektif, dst (7 area, 8 area, dst) Area of Competence
Kompeten di bidang komunikasi efektif, maksudnya bagaimana? Mampu menggali dan bertukar informasi (verbal) dan non verbal ) dengan pasien/ pada semua usia, anggota keluarga, masyarakat, kolega dan profesi lain
Core Competence
Untuk bisa kompeten di bidang ‘komunikasi efektif ‘ butuh kemampuan apa? 1. Kemampuan berkomunikasi dengan pasien serta anggota keluarganya menggunakan prinsip-prinsip komunikasi yang sesuai
2. Kemampuan berkomunikasi dengan sejawat 3. dst
Competence Components
Agar disebut mampu berkomunikasi dengan pasien dan keluarganya menggunakan prinsip-prinsip komunikasi yang sesuai, maka apa yang harus dikuasai oleh mahasiswa?
Menunjukkan perhatian dan penghargaan pada pasien Membangun sikap empati dan dapat dipercaya Menggali keluhan dan keinginan dari pasien Mempersiapkan perasaan pasien untuk menghindari rasa takut sebelum melakukan pemeriksaan fisik Mendengarkan dengan penuh perhatian dan memberi waktu yang cukup pada pasien untuk menyampaikan keluhannya Memberikan peluang untuk mengeksplorasi keyakinan pasien, hal-hal yang perlu diperhatikan dan harapan tentang asal penyakit, proses penyakit, pengelolaan penyakit dan prognosis penyakit
Learning Outcome
Fungsi standar kompetensi • Sebagai kerangka pengembangan kurikulum di setiap institusi pendidikan kedokteran • Sebagai materi ujian kompetensi dalam rangka sertifikasi kompetensi • Sebagai penapis bagi lulusan luar negeri
Perumusan Kompetensi • 1. Mengacu pada peran dan fungsi lulusan dokter, sesuai dengan kebijakan pembangunan kesehatan • 2. Mengacu pada realitas empiris • 3. Konsensus stakeholder
Perumusan masalah dan daftar penyakit • Mengacu pada priority-health problems untuk dokter • B = M (F+QD+CB) • M = magnitude of the problem (morbidity and mortality) • F = Case fatality rate • Q = Degree of deviation from normal health (disability, distress, discomfort, dissatisfaction, cost)
Perumusan masalah dan daftar penyakit • D = duration of the deviation from health • CB = effects to other individuals and community
The Past
