TRANSFORMATIVE NURSING EDUCATION AND ITS CONTRIBUTION FOR HEALTHY INDONESIA 2025 Kusman Ibrahim, PhD., RN Faculty of Nursing, Universitas Padjadjaran Bandung, Indonesia k.ibrahim@unpad.ac.id
OUTLINE OF PRESENTATION Indonesia Health Development Health Professional Education Transformative Learning Implementation of TL Future Development
DIRECTION OF HEALTH DEVELOPMENT RPJMN I 2005-2009 RPJMN II 2010-2014 RPJMN III 2015-2019 RPJMN IV 2020-2025 NATIONAL MIDDLE TERM PLAN FOR HEALTH DEVELOPMENT Directed to increase access and quality of health care Access to quality health care service more develop and improved Access to quality health care service has more stable Awareness to quality of health care, equally distributed CURATIVE- REHABILITATIVE PROMOTIVE - PREVENTIVE VISION: HEALTHY PEOPLE, SELF-RELIANCE, AND FAIRNESS Health efforts are directed from curative, rehabilitative to promotive, preventive in line with the need and condition of population
HEALTHY INDONESIA PROGRAM Health Paradigm Programs Health as Development Mainstream Promotion and Prevention as main pillar of Health Efforts Community Empowerment Health Facilities Strengthening Programs Access Growth on First Contact Health Facilities Referral System Optimization Quality Improvement Application of continuum of care approach Health Risk based Intervention Universal Coverage Programs Benefit Financial System: Insurance Principles of Mutual Sid Quality and Cost Control Target: beneficiaries and non beneficiaries Membership Healthy Indonesia Card (KIS) 4
EMERGING CHALLENGES TO HEALTH SYSTEMS (Frenk et al, 2010) Sustainable development Epidemiological & demographic transitions (Post MDGs) Technological innovation Health system Professional differentiation UHC Population demands Transformation and stronger global partnership
Epidemiologic Transition Industrialization and Urbanization Economic, social, environmental changes Public sanitation Housing healthcare Nutrition technology for healthcare Per capita income Wealth Mortality Infant mortality Life expectancy Fertility Level of RF: fat, calories, tobacco, sedentary habits NCDs Infectious disease Persons at risk of developing NCDs Increasing and aging population Health transition: demographic transitions and epidemiologic transitions
REFLECTION ON CURRENT HEALTH PROFESSION EDUCATION The problem of higher education is not yet completely ready to face the challenges due to: Fragmented & outdated education Static Curriculum = Mismatch of competencies to population needs = Poor teamwork = More technical focus than broader contextual understanding = Episodic encounter rather than continuous care = Predominant hospital orientation rather than community based Re-examine & redesign of professional health education is necessary Any changes in health care programs should be integrated with the changes in health professional program and curriculum Health Professional Education need to become more outcome oriented Require a series of instructional & institutional reform : Transformative learning & Interdependence education
TRANSFORMING LEARNING Informative Formative Transformative Acquiring knowledge & skills Socializing values & norms Developing leaderships attributes Experts Professionals Enlightened Change agents
TRANSFORMATIVE EDUCATION Transformative Learning is The process of using a prior interpretation to construe a new or revised interpretation of the meaning of one s experience in order to guide future action" (Mezirow, 1996: 162). Idealized model of adult learning Learners who are actively engaged vs. learners as receptacles Critical reflection, discourse, and relationships New perspectives guide actions
TRANSFORMATIVE EDUCATION Instrumental learning focuses on learning through task oriented problem solving and determination of cause and effect relationships Communicative learning involved with how others communicate their feelings, need and desires with another person. It helps the learners to become critical, autonomous and responsible thinkers
Mezirow s Ten Phases of Transformative Learning Disorienting dilemma Self examination Critical assessment Shared discontent Role experimentation Knowledge/skill acquisition Planning action New roles, relationships, and actions Role competency Reintegration
THE IMPLEMENTATION OF TRANSFORMATIVE LEARNING AND INTERPROFESSIONAL EDUCATION IN UNPAD Identified common profile of graduates across study programs Organizing schedule (rooster), faculties, equipment, rooms Implementation Identified common area of competencies /learning outcomes Socialization and dissemination to lecturers and assistants Student assessment Identified learning materials Formulating integrated subject and lesson plan Evaluation and feed back
THE IMPLEMENTATION OF TRANSFORMATIVE LEARNING AND INTERPROFESSIONAL EDUCATION IN UNPAD Three integrated subjects: Sport, Health and Art (OKK) General Education (TPB, integrate from Bahasa, Pancasila, Civic, Religion, English) Student Study Service (KKN) integrated with Faculty s community service
Phase of Learning Together (TPB)
Conceptual Framework of General Education (TPB) Diversity Transition Bridging gap Foundation Facilitation Learning (Curricular) Development personal competences Design Sport and Arts (Extra Curricular) Development academic competences Students are ready to study and increase their prestation in year I Development social competences Character Building Unpad s values (Co- Curricular) Healthy life style
General Education (TPB) Integration from Bahasa, English, Civics, Pancasila, Religion Class composed of students from various study programs available in Unpad (Law, Medicine, Economics, Nursing, Dentistry, Pharmacy, Psychology, Agriculture, Engineering, etc) Learning issues drawn from 17 Goals of SGDs, discussed from various perspectives Learning methods: Interactive lecture, PjBL, SGD, Role Play, active learning, etc Student assessment: paper assignment, quiz, class presentation
Sport, Health, and Art (TPB) Students divided into several groups across study programs A group was facilitated by a faculty. They went to community to learn from people, develop projects related to sport, health, and arts Students reflected and made report (written report or short documentation video)
Student Study Service (KKN) integrated with Faculty s Community Service Program (PKM)
Students were actively participated in World AIDS Day; learning from and sharing with people
Further Development: Health System Approach in Health Profession Education Basic Sciences Tertiary Level Clinical Sciences Research Community & Public Health Sciences IPE TPE Primary Level Health Care Service Secondary Level Academic Education & Training Profession Padjadjaran Academic Health System