Model Development Of Clinical Learning With Outcome Present Test Method (Opt)-Peer Learning And Its Application In Medical Surgical Nursing

MODEL DEVELOPMENT OF CLINICAL LEARNING WITH OUTCOME PRESENT TEST METHOD (OPT)-PEER LEARNING AND ITS APPLICATION IN MEDICAL SURGICAL NURSING STASE FOR THE STUDENT OF NURSE PROFESSION IN STIKES MANDALA WALUYA KENDARI Asbath Said, Dwi Wulandari Ningtias STIKES Mandala Waluya Kendari Southeast Sulawesi, Indonesia Nursing clinical education is an instrument in improving the clinical reasoning skills of students. One of learning models of clinical reasoning that is used to improve clinical reasoning skills in nursing education is the Outcome-Present Test Model (OPT). OPT is a nursing process model that is designed to develop the skills of learners’ clinical reasoning and the focus of the model are the results (outcomes) and thinking behind (backward) to change the client from his health status at this time (the present state) to the desired state (outcome ). In other words, a very simple model that consists of only 1 (one) page makes the learning improving clinical reasoning skills more easily and reduce the element of copy and paste in the documentation. While peer learning is an effective strategy to address the problem in which the students will be divided into several groups of 2- 3 students. To obtain the result, this learning model uses research development method with the respondents 10 clinics and institutions preceptor and 30 students who practice in medical surgical nursing stase. The research results shows the level of student satisfaction after using OutcomePresent Test (OPT)-peer learning for 4 weeks, it affected with the value of α: 0,001. By using this model, not just a clinical reasoning that they get but they also will understand about how to use the diagnosis of NANDA, NIC and NOC. The next suggestion, this model can be a format in clinical learning in other departments Keywords: Clinical Learning ,Outcome-Present Test (OPT), peer learning I. BACKGROUND Learning in the profession nurses are learning at this stage of clinical education is learning that focuses on direct engagement with patients and a wide variety of problems. In this environment, students learn to be a real nurse. A wide variety of skills like history taking, physical examination, communication with the patient, and very precise professionalism studied and trained at this educational stage. Knowledge of nursing science can be applied directly to provide care to patients so that students are motivated to teach (Habiba et al., 2010). The fact the hospital, clinic guidance does not match the expectations of students due to some problems in the implementation of such guidance clinic, clinical instructor has double duty in addition to conducting clinical guidance. Coaching clinics do not have enough time to implement the guidance, not provided an adequate tool to implement nursing actions, lack of information on the academic part, do not understand the purpose of learning the clinic, do not have a special room for counseling or discussion, tend to use the old style in guiding curriculum instructor training clinics give less equipped to undertake coaching clinics, lack of interest in becoming a clinical instructor. While some of the problems faced by the students is the lack of motivation to learn and the high stress in a program of professional nurses, especially in medical-surgical nursing stases for SKS greater burden. Student of profession nurses Stikes Mandala Waluya sometimes complain of clinical learning models that they get in each field of practice, especially if they are doing clinical practice in hospitals in Southeast Sulawesi. Although some of the clinical instructor has conducted training preceptor but they have not been able to implement and even puzzled to implement. So that the expected results of the academic that nursing students have the ability to provide nursing care in the short term and the long term is not achieved with the maximum. This can be corrected through some effort, which is to improve the learning process of the clinic, the hospital environment, improve clinical instructor and increase student involvement in clinical learning. Repairs to all the components is a big job and give a long time , so in this study was limited to efforts to improve clinical learning process , such as the development of clinical teaching model to achieve competence in hospital nursing care in medical-surgical course. a. The Specific Objective The specific objectives of this research are: 1. Knowing picture learning model hospital clinics used in clinical learning process especially medical-surgical nursing course at this time. 2. Finding the clinical learning development model that is used in the process of learning a special clinic medical-surgical nursing courses. 3. Testing the quality of clinical teaching model in hospitals result of the development, especially in the subject of medical-surgical nursing. b. Urgency Research Selection of research problems is done by two considerations. The first development of clinical teaching model of choice because it is considered necessary to the development of clinical learning models that can improve the quality of clinical learning in accordance with the real situation in the hospital that performed at the time of the survey. The second output is expected that the nurse is able to take decisions effectively, quickly and precisely in treating patients. So that it can train students' critical thinking skills when facing cases experienced by the patient under management during clinical practice. Clinical Reasoning is an essential component in nursing practice. In the face of the needs of the service system is complex and dynamic, requires nursing practice nurses who are able to think and make decisions effectively. Hopefully with OPT-peer learning methods can be overcome faced by nurses and professional program participants the program manager for this study. II. STUDY LIBRARY Clinical learning as a behaviorist learning, the learning means behavioral development. The process of behavioral development is affected by two aspects namely cognitive and environmental aspects. In the process of behavior formation occurs observational learning from what is seen and observed, resulting in attention, retention, production and motivation to do a new behavior. Model behavior that students are found in the order of the clinic will be adopted and adapted, so behavior in providing nursing care services in the future later. Which should be a clinical learning is a hospital that can provide exemplary in providing nursing care so that the behavior model that is adopted provide quality nursing care. Level achievement of clinical competence is divided into four levels, namely knows, knows how, shows how and does (miller 1990). At the level knows, such as the ability to recall facts, principles and theories. The level knows how is the form of the ability to solve problems and describe the procedure. The level shows how typically have involved a patient simulation, a computer simulation which has been able to do a demonstration of skills in standardized situations. The level does have observations on actual patients, who have been able to perform the protocol, to apply the principles in familiar situations, adapting the principles to new situations and new links between knowledge and principles that have been studied previously. Paul, Lisa, and Vanessa (2006) in Sukmadinata stated that peer learning is one method of learning in which students will be assisted by teacher or friend who has the same level of learning a concept or the capabilities (skills). As disclosed in some of the results showed that the peer learning provides significant influence on student learning outcomes. This is in line with the theory of Slavin (1991) that the peer learning is a form of cooperative learning that can be used to improve student learning outcomes. It can be caused due to the application of peer learning on learning allows each student gets more attention than Preceptor and have plenty of time in talking or listening. This gives students the opportunity to participate actively in building knowledge. This approach usually focused on solving the problem and this is very