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 PastKnowledge

What is Competence?

Knowledge

SkillThe Past

What is Competence?The Present

KnowledgeSkillAttitude/

Behaviour

= Competence

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

PERFORMANCEneeds

COMPETENCEneeds

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 Six Characteristics of CompetenciesCompetencies

• 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

ATTITUDESKNOWLEDGE SKILLS

COMPONENTCLINICALABILITIES

COMPOSITECLINICALPERFOMANCE

COMPETENTCLINICALPRACTICE

PREREQUISITES

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. Technical effectiveness in using knowledge and skills.2. Positive effects on the disease process, seen in outcomes of care.3. Positive effects of the doctor’s behaviour on the patient.4. Efficiency in using finite resources.

Dokter yang ingin kita hasilkan

Dokter y

ang kompete

n

Kompeten di bidang apa?

• Di bidang komunikasi efektif, dst

(7 area, 8 area, dst)

Area ofCompetence

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

CoreCompetence

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

CompetenceComponents

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

LearningOutcome

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