FINAL REPORT:

DEVELOPMENT OF
CLINICAL LEARNING PRACTICE
STANDARD
FOR NURSING STUDENTS

FACULTY OF NURSING UNIVERSITAS INDONESIA

AND
WORLD HEALTH ORGANIZATION
JAKARTA
2009

FINAL REPORT
DEVELOPMENT OF STANDARD ON CLINICAL LEARNING
PRACTICE
FOR NURSING STUDENTS

MAIN TEAM:
Chairperson : Lestari Sukmarini, SKp., MN
Secretary

Treasure

: Hayuni Rahmah, SKP., MNS

Coordinator :
1. Amelia K, SKp., MN
2.

Elfi Syahreni, SKp., PgDipl

3. Herni Susanti, SKp., MN

4. Ns. Dwi Nurviyandari, Skep, MN
5. Eryanto Hidayat, SE

FACULTY OF NURSING UNIVERSITAS INDONESIA

AND
WORLD HEALTH ORGANIZATION
JAKARTA
2009

LIST OF WORKING GROUP MEMBER

1. Design Core Competency of Clinical Learning

a. PIC

:....

b. Secretary

c. Members

2. Develop Clinical Practice Evaluation

a. PIC

:....

b. Secretary

c. Members

3. Develop Assessor or Clinical Instructor Guidelines

a. PIC

:....

b. Secretary

c. Members

4. Create Grand Design of Nursing Laboratory

a. PIC

:....

b. Secretary

c. Members

INTRODUCTION
The increase in demand of nurses in many health services cannot be fullfilled
with the high number of good performance of nurses staffs. Many health
institutions stated a low performance of nurses staffs in their units. It is realized
that a quality nurse ability might be related to education process before entering
the real work situation. Preparing the clinical competency is followed through
clinical learing in acedemic term.
Clinical learning in nursing education is proposed to develop students skills to be
a professional based on nursing science and technology. Clinical learning is a
process for students to enhance their ability in providing direct care to clients.
During this clinical experience students attempt to integrate theory and concept
from classroom into realm situation. They have to face many problems related to
the implementation of nursing care. Thus, they are expected having competency
to deal with the complex problems in field practice. Therefore, clinical practice of
nursing students acquire effective and intensive guidance from clinical
instructors
Faculty of nursing , Universitas Indonesia has implemented the clinical teaching
and learning process since 1985. However, there are still many obstcales faced
by clinical instructors who also works as academic staffs. In addition, the clinical
instructors realized that many clinical competencies of nurses students have
not achieved yet. Beside that, they have identified disparitites of curriculum
and clinical competencies in every nursing schools. The phenomena have been
occuring in any clinical fields in Indonesia. Nurses graduated from diploma (DIII)
and bachelor degree seem to have the same performances qualities. Many
graduates from both levels have a low quality in their clinical performances.
Another problem identified is lack of nursing laboratory facilities that can support
the students clinical learning in education institutions. Recognizing all situation
mentioned above, nursing educations have to pay attention to overcome all
osbtacles in order to produce an excelent clinical performance of nursing
graduates.
An excelent performance of nursing graduates would be expected by every
nursing education institution. Each institutions has developed facilities and
many support systems to improve the clinical performance of nursing graduates
because they have responsible to provide a better nursing care for community
or public services. Therefore, initiatives to improve clinical learning experience
for nursing students could contribute to increase value and quality of nurses,
nursing care, and clients health outcome as well. To enhance effectiveness of
clinical learning experiences of nursing students, there are some strategic
frameworks available. These strategies can coordinate improvement activities
between nursing education institutions and nurses organizations that have
aimed to improve the quality of nurses competency

GOAL AND PURPOSES

Goal:
To develop initiatives in order to improve clinical learning for nursing students.

Purposes:
1. Design core competencies of clinical learning for diploma nursing students
and university/bachelor nursing students.
2. Develop clinical practice evaluation tools.
3. Develop assessor/clinical instructor guidelines with minimal standards of
clinical practice instruction for nursing schools.
4. Create a guideline to utilize nursing laboratory that support students
performance in clinical practice areas.

STRATEGIES
1. Search some documents from Ministry of Education-Republic of
Indonesia, PUSDIKNAKES, AIPNI, and PPNI
At the beginning of activities, main team has searched any
documents related to curriculum of nursing education from
Ministry of Education , PUSDIKNAKES, AIPNI, and PPNI. The team
has learned and discussed all documents found in main group.
From this activity, main team can identify some trends and issues
of any level nursing education (S1 and DIII) that is very usefull
for developing national standard of nursing clinical learning
2. Conduct literature searching
Besides searching important documents, main team also
conducted literature study. Main team member learned any lesson
regarding the competency development for nursing students.
Group member designed strategies and approaches used for
designing core competencies of clinical learning for diploma
nursing students and university/bachelor nursing students,
clinical practice evaluation tools, assessor/clinical instructor
guidelines, and a guideline utilized in nursing laboratory.
3. Conduct group disscussion
Group disscussion was conducted to explore information
associated trends and issues in nursing education especially in
clinical learning for nursing students.

IMPLEMENTATION
First step, team worked together exploring many documents related to clinical
competency for nurses in Indonesia which referenced from National Education,
Indonesia Nurses Association, and document from Indonesia Nurse Institution
Association. The team surveyed three documents and analyzed them in order to
build many considerations to develop a draft of clinical nurse student
competencies.
According to develop a draft of clinical competency, the core team conduct
preparation meeting to arrange fixed activities as scheduled.
a. Pre-workshop 1
General Objective: to explore clinical competency S1 nursing students based
on any different clinical setting.
Time and place
The meeting was held on 28-29 July 2009, took place in Faculty of Nursing
Universitas of Indonesia, Depok.
Participants:
The participants were core team consisted of 14 academic staffs of FON-UI
who represented relevant clinical nursing experts (medical surgical nursing,
psychiatric nursing, community nursing, basic nursing, maternity, paediatric
nursing).
Evaluation:
The team made a resume of the clinical competency for S1 nursing student
which it would be compared with competency of DIII nursing student on
further meeting.

b. Pre-workshop 2
General Objective: to build one perception related to clinical competencies for
nursing students.
Time and place
The meeting was held on 4th August 2009, took place in Faculty of Nursing
Universitas of Indonesia, Depok.
Participants:
The participants were core team, representative of INNA/PPNI, representative
of nursing Diploma Institution from POLTEKES1 and POLTEKES 3 Jakarta.

c.

Pre-workshop 3
General Objective: to make arrangement about clinical competencies for
nursing students S1 and DIII.
Time and place

The meeting was held on 12-13th August 2009, took place in Wisma Makara UI,
Depok.
Participants:
The participants were core team, representative of INNA/PPNI, representative
of Ministry of Health, representative of DIII Institution from POLTEKES1 and
POLTEKES 3 Jakarta.
Activities:

Representative of PPNI (INNA) presented the standard of competency of

Nurses in Indonesia. This standard became a guideline for team in
developing clinical competency for nursing student S1 and DIII.
All participants divided in some small group based on their expertise trying
to identify clinical competency of S1 nursing student and DIII student.
Afterward, they made leveling the competency based on PPNI standard.
The team and other participants formulated the form of students clinical
competencies founded on the profile and formulated profile of care
provider rooted in Hendersons theory: 14 basic needs.

Evaluation:

d.

The curriculum of DIII which developed by PUSDIKNAKES had similarity with

S1 curriculum related to credit and competency as well. Therefore, the DIII
staffs felt unsure to make changes in clinical competency of DIII students.
They suggested to invite PUSDIKNAKES in further meeting.
The small team identified clinical competency in level: DIII and S1.
Workshop

General Objective: to make agreement of clinical competencies and the

leveling for nursing students S1 and DIII.
Time and place
The meeting was held on 4-5 September 2009, took place in Pusbindilkat LIPI,
Bogor.

Participants:

The participants were core team, representative of INNA/PPNI, representative

of Ministry of Health, PUSDIKNAKES, representative of S1 institution:
University of Gadjah Mada, University of Airlangga-Surabaya, University of
Padjajaran-Bandung), DIII Institution (POLTEKES1 and POLTEKES 3 Jakarta,
POLTEKES Bandung).
Activities:

Presentation from resource persons:

- Representative of PPNI (INNA) presented the standard of
competency of Nurses in Indonesia.
- Representative of Ministry of Health shared the development of
standard on hospital university as a clinical practice for nursing
students.
- PUSDIKNAKES presented about curriculum DIII.
- AIPNI presented about the formulation of graduate S1
Nursing.
Discussion session
Group work : developing clinical competency of nursing
student S1 and DIII
Evaluation of the process:

The event was ..

e. Finalization of workshop result

The core team made conclusion and revised the draft based on final
agreement on workshop. The team met and worked intensively due to
wrap up the draft.

f.

Workshop development of clinical competency standard and clinical

evaluation.

Objective:
Wrap up the draft of clinical competency and formulate the clinical
evaluation.

Participants:
The core team

Activities:

Representative of PPNI (INNA) presented the standard of competency of

Nurses in Indonesia. This standard became a guideline for team in
developing clinical competency for nursing student S1 and DIII.
All participants divided in some small group based on their expertise trying
to identify clinical competency of S1 nursing student and DIII student.
Afterward, they made leveling the competency based on PPNI standard.
The team and other participants formulated the form of students clinical
competencies founded on the profile and formulated profile of care
provider rooted in Hendersons theory: 14 basic needs.

Evaluation:

BENEFITS
1. For nursing education institutions
The standard of core competencies for nursing students in clinical practice
will
2. For nursing students
Nursing students will get standardize clinical learning based on competencybased curriculum which is
3. For nurse educators
This results help nurse educator in implementing

SUPPORTS AND CONSTRAINS

Supports for this initiatives were obtained from
The main constrain was relating to

RECOMMENDATION