PENERAPAN 'SUPERVISI INTENSIF' PADA KEGIATAN COMMUNITY-BASED EDUCATION TOPIK PELAYANAN KESEHATAN LANSIA: MENGEVALUASI MOTIVASI BELAJAR, KESIAPAN BELAJAR MANDIRI, DAN PEMAHAMAN MAHASISWA MENGENAI PRIMARY HEALTH CARE

AKING SANDI PRIBADI, Prof. dr. Mora Claramita, MHPE, Ph.D; dr. Widyandana, MHPE, Sp.M(K)

2021 | Tesis | MAGISTER ILMU PENDIDIKAN KEDOKTERAN DAN KESEHATAN

Latar Belakang: Minimnya pengawasan dari instruktur dan belum adanya panduan spesifik cara memfasilitasi sesi umpan balik di kegiatan community-based education (CBE) mempengaruhi motivasi belajar mahasiswa yang cenderung lebih ekstrinsik. Pertanyaan umpan balik reflektif dari instruktur pada kelompok kecil mahasiswa diduga dapat menstimulasi motivasi belajar, kesiapan belajar mandiri, dan pemahaman mahasiswa yang lebih baik selama mengikuti kegiatan CBE. Penelitian ini bertujuan: (1) menerapkan kerangka konsep baru fasilitasi pemberian umpan balik reflektif yang disebut Supervisi Intensif pada kegiatan CBE dengan topik Pelayanan Kesehatan Lansia, (2) mengukur perubahan tingkat motivasi belajar, kesiapan belajar mandiri, dan perubahan pemahaman mahasiswa, serta (3) mengekplorasi faktor-faktor dalam Supervisi Intensif yang kemungkinan turut memberikan pengaruh pada perubahan tersebut. Metode: Penelitian ini menggunakan rancangan eksperimen-kuasi, jenis one-group pretest -posttest design yang dilakukan dua tahap (sequencing) mengkombinasikan pendekatan kuantitatif dan kualitatif, melibatkan 48 mahasiswa tahun keempat di Fakultas Kedokteran Univeristas Surabaya (UBAYA). Pre-test dan pos-test dilakukan pada tahap kuantitatif dengan menggunakan instrumen Motivated Strategies for Learning Questionnaire (MSLQ), Self-directed learning readiness scale (SDLRS), dan soal Multiple Choice Question (MCQ) yang sudah tervalidasi untuk mengukur tingkat perubahan skor yang terjadi antara sebelum dan setelah mengikuti kegiatan CBE yang dipadu dengan sesi Supervisi Intensif. Tahap kualitatif dilakukan melalui in-depth interview untuk mengekplorasi faktor-faktor pada sesi Supervisi Intensif yang kemungkinan turut memberikan pengaruh pada perubahan skor tersebut. Angket pendapat mahasiswa mengenai Supervisi Intensif digunakan sebagai probing ekplorasi. Data kuantitatif dianalisa dengan menggunakan SPSS ver.25. Data kualitatif dianalisa dengan teknik analisis konten (content analysis). Hasil: Terdapat peningkatan skor motivasi tujuan instrinsik [pre-test: 24.04 (SD + 3.03), post-test: 25.17 (SD + 2.32), p = 0.002], skor kemaknaan tugas [pre-test: 36.69 (SD + 4.65), post-test: 38.04 (SD + 3.69), p = 0.006], skor efikasi diri [pre-test: 45.27 (SD + 5.98), post-test: 48.33 (SD + 4.67), p = 0.000], skor menejemen diri [pre-test: 49.88 (SD + 6.36), post-test: 52.21 (SD + 5.56), p = 0.000], dan skor pemahaman topik [pre-test: 55.31 (SD +10.44), post-test: 68.02 (SD + 11.57), p = 0.000] setelah mengikuti kegiatan CBE yang dipadu dengan sesi Supervisi Intensif. Hasil kualitatif menunjukkan faktor-faktor dalam sesi Supervisi Intensif yang kemungkinan turut berperan dalam peningkatan skor tersebut, yaitu: (1) adanya kesempatan berbagi pengalaman antar teman dalam kelompok yang difasilitasi oleh pembimbing, menstimulasi peningkatan motivasi belajar intrinsik; (2) adanya fasilitasi diskusi artikel dan kaitannya dengan tugas-tugas yang dilakukan selama CBE, mempengaruhi kemaknaan tugas-tugas yang diberikan dan membantu pemahaman topik CBE; (3) adanya umpan balik dari pembimbing, umpan balik dari teman sekelompok, dan kesempatan melakukan role-play menstimulasi keyakinan diri melakukan tugas CBE yang diberikan; (4) adanya persepsi bahwa teman sekelompok menyenangkan diajak belajar, menstimulasi menajemen diri untuk belajar secara lebih kolaboratif. Kesimpulan: Penerapan sesi Supervisi Intensif dalam kegiatan CBE turut memberikan pengaruh pada perubahan tingkat motivasi belajar, kesiapan belajar mandiri, dan pemahaman mahasiswa selama mengikuti kegiatan CBE.

Background: The lack of supervision from the instructors and the absence of specific guidelines to facilitate reflective feedback sessions in community-based education (CBE) activities may affect student learning motivation which tends to be more extrinsic. Reflective feedback questions from the instructors to a small group of students were presumed could stimulate their motivation to learn, self-directed learning readiness, and a better understanding of the CBE topic. This study aims to: (1) apply a new conceptual framework of facilitating reflective feedback session named 'Intensive Supervision' in CBE which focus on Elderly Health Services; (2) measure the changes of learning motivation score, self-directed learning readiness score, and student understanding on the CBE topic score; and (3) explore factors in 'Intensive Supervision' which may have contributed to those scores change. Methods: This study used a quasi-experimental one-group pretest-posttest design which was conducted in two sequencing stages combining quantitative and qualitative approaches, and involving 48 fourth-year students at the Faculty of Medicine, at the University of Surabaya (UBAYA). The pre and post-test were conducted at the quantitative stage using validated Motivated Strategies for Learning Questionnaire (MSLQ) instrument, Self-directed Learning Readiness Scale (SDLRS), and Multiple-Choice Question (MCQ) questions to measure the level of change of the scores before and after participating in CBE activities combined with an 'Intensive Supervision' session. The qualitative stage was carried out by in-depth interviews to explore the factors in 'Intensive Supervision' which may have contributed to those scores change. A set of the self-reported questionnaire about the "Intensive Supervision" was also used as a probing exploration. Quantitative data were analyzed using SPSS ver.25. Qualitative data were analyzed using content analysis techniques. Results: There were significant increasing scores in the intrinsic goal motivation score [pre-test: 24.04 (SD + 3.03), post-test: 25.17 (SD + 2.32), p = 0.002], task value score [pre-test: 36.69 (SD + 4.65), post-test: 38.04 (SD + 3.69), p = 0.006], self-efficacy score [pre-test: 45.27 (SD + 5.98), post-test: 48.33 (SD + 4.67), p = 0.000], self-management score [pre-test: 49.88 (SD + 6.36), post-test: 52.21 (SD + 5.56), p = 0.000], and understanding on the CBE topic score [pre-test: 55.31 (SD +10.44), post-test: 68.02 (SD + 11.57), p = 0.000] after the students involved in CBE which was combined with a series of 'Intensive Supervision'. The qualitative stage revealed the factors in the 'Intensive Supervision' session that may have contributed to the increasing score, namely: (1) the opportunity to share experiences between friends in the group facilitated by the supervisor, stimulating increased intrinsic motivation to learn; (2) facilitating discussion of articles and their correlation to the tasks performed during CBE, influenced the meaning of the assignments given and helping to understand the topic of CBE; (3) the existence of feedback from the supervisor, feedback from a group of friends, and the opportunity to do a role-play stimulated self-confidence in carrying out the assigned CBE task; (4) the perception that a group of friends was fun to study with, stimulated self-management to learn more collaboratively. Conclusion: The implementation of 'Intensive Supervision' sessions in CBE might affected the changes to learning motivation, self-directed learning, and students understanding of the CBE topic.

Kata Kunci : Community-based education (CBE), 'Supervisi Intensif', Motivasi Belajar, Kesiapan Belajar Mandiri, Pemahaman Mahasiswa.