Model Identitas Profesional Mahasiswa Kedokteran

YOGA PAMUNGKAS SUSANI, Prof. dr. Harsono, Sp.S(K); dr. Rossi Sanusi, M.PA., Ph.D., dr. Gandes Retno Rahayu, M.Med.Ed., Ph.D.; Dra. Yayi Suryo Prabandari, M.Si., Ph.D.

2015 | Disertasi | S3 Ilmu Kedokteran

Latar belakang: Identitas profesional menentukan cara seseorang menjalankan profesinya. Pembentukan identitas profesional terjadi selama masa pendidikan. Peran kurikulum dan interaksi sosial dalam lingkungan pendidikan serta efikasi diri, motivasi dan kemampuan refleksi mahasiswa dalam pembentukan identitas profesional belum banyak dieksplorasi. Tujuan: mengembangkan model identitas profesional kedokteran. Metode: Pengembangan model terutama didasarkan pada konsep identitas dan partisipasi dari Wenger (1998). Penelitian kualitatif dilakukan untuk mengembangkan instrumen yang diperlukan dalam pengujian model dan mendapatkan penjelasan lebih luas tentang identitas profesional. Wawancara mendalam semi-terstruktur dilakukan pada 17 orang mahasiswa pra-klinik dan klinik. Elaborasi pustaka dan hasil kualitatif dijadikan dasar pembuatan butir-butir instrumen. Penentuan tujuan, cetak biru, format yang sesuai dengan tujuan dan kajian dari ahli memperkuat validitas isi. Uji keterbacaan kepada mahasiswa memperkuat validitas muka. Selanjutnya, 303 dari total 347 mahasiswa pra-klinik dan klinik mengisi kuesioner tentang identitas profesional, partisipasi, efikasi diri, motivasi, refleksi personal, persepsi terhadap interaksi sosial dan persepsi terhadap kurikulum aksi. Analisis faktor, analisis per tahun dan uji model kemudian dilakukan. Hasil: Ada 4 instrumen yang dihasilkan dari penelitian ini dengan validitas dan reliabilitas yang cukup baik, yaitu instrumen yang menilai identitas profesional, partisipasi, persepsi terhadap interaksi sosial dan persepsi terhadap kurikulum aksi yang digunakan dalam pengujian model. Model identitas yang dihasilkan memiliki ukuran kecocokan yang baik (GoF 0.404, APC 0.303, P < 0.001, dan AARS sedang, 0.321, P < 0.001). Identitas profesional mampu dijelaskan sebesar 40% oleh motivasi (β 0.51, P < .01, f2 0.281) dan partisipasi (β 0.32, P < .01, f2 0.118). Efikasi diri (β 0.32, P < .01, f2 0.130) berpengaruh pada partisipasi lebih besar dibandingkan persepsi terhadap interaksi sosial (β 0.18, P 0.009, f2 0.062) dan persepsi terhadap kurikulum aksi (β 0.14, P 0.05). Namun, ketiganya hanya mampu menjelaskan 25% varians partisipasi. Kesimpulan: Model identitas profesional mengindikasikan bahwa identitas profesional dipengaruhi oleh motivasi dan partisipasi mahasiswa, sedangkan partisipasi dipengaruhi oleh efikasi diri, interaksi sosial dan persepsi mahasiswa terhadap kurikulum aksi. Efikasi diri memiliki pengaruh terbesar terhadap partisipasi. Model ini masih harus dibuktikan dengan penelitian eksperimental. Diharapkan proses pendidikan dapat dilakukan dengan terus meningkatkan motivasi dan efikasi diri yang baik dalam diri mahasiswa untuk belajar. Fakultas juga perlu memfasilitasi mahasiswa untuk melakukan partisipasi dalam komunitas profesi dokter.

Background: Medical student’s professional identity is very important to be developed as it will affect how they work in the future. Factors affecting professional identity in medical education context still need to be explored. The role of motivation, self-efficacy, personal reflection, social interaction, curriculum in action perceived by students, and participation in explaining professional identity has not been explored. Aims: To develop a model of professional identity in medical students which indicate motivation, self-efficacy, personal reflection, social interaction, curriculum in action perceived by students, and participation towards professional identity. Methods: The model proposed was a synthesis from literature. The identity concept in communities of practice theory mainly influenced the model. Mixed method study was conducted. Qualitative research was held to explore identity and participation among students, and how social interaction and curriculum support participation. Semi-structured interview to eight clinical students and nine pre-clinical students was conducted. The results of analysis was used to develop instruments. Elaboration of literature and the results of qualitative research were used as the basis of developing the items of instruments. The instrument development process always considering the content validity. Readability test strengthen the face validity. Survey was then conducted. From 347 total of pre-clinical (year 1 to 4) and clinical students (year 5 to 6), 303 students filled out the questionnaires. Structural equation model analysis then was performed. The main outcomes were goodness of model fit and effects of variables towards professional identity. Results: There are four new instruments with good validity and reliability. Outer model evaluation were adequate. Professional identity model had good model fit (GoF 0.404), the average path coefficient was 0.303 (P < 0.001) and the adjusted average R square was 0.321 (P < 0.001) which was in moderate criteria. Professional identity could be explained 40% by motivation (β 0.51, P < 0.001, f2 0.281) and participation (β 0.32, P < 00.01, f2 0.118). Participation could be explained 26% by self-efficacy (β 0.32, P < 0.001, f2 0.130), social interaction (β 0.18, P 0.009, f2 0.062) and curriculum in action perceived by students (β 0.14, P 0.05). Conclusion: The model indicated that professional identity was affected by motivation and student’s participation, while participation was affected by self-efficacy, social interaction and curriculum in action perceived by students. Self-efficacy had the greatest influence. To get more evidence, this model still need to be evaluated by doing experimental research. Based on model, motivation and self-efficacy were very important and worthwhile to be maintained and fostered within medical education process. Faculty also need to facilitate participation of medical students.

Kata Kunci : identitas profesional, partisipasi, motivasi, efikasi diri, refleksi personal, interaksi sosial, kurikulum aksi/ identity, professional identity, participation, motivation, self-efficacy, personal reflection, social interaction, curriculum in action