Kusman Ibrahim, PhD., RN

Faculty of Nursing, Universitas Padjadjaran

Bandung, Indonesia k.ibrahim@unpad.ac.id

TRANSFORMATIVE NURSING EDUCATION

AND ITS CONTRIBUTION FOR HEALTHY

INDONESIA 2025

Health Professional Education

Transformative Learning

OUTLINE OF PRESENTATION

Implementation of TL

Future Development

Indonesia Health Development

DIRECTION OF HEALTH DEVELOPMENT

RPJMN I

2005 -2009

Health efforts are directed from curative, rehabilitative to promotive, preventive

in line with the need and condition of population

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

VISION:

HEALTHY PEOPLE,

SELF-RELIANCE,

AND FAIRNESS

RPJMN II

2010-2014

RPJMN III

2015 -2019

RPJMN IV

2020 -2025

CURATIVE-

REHABILITATIVE

PROMOTIVE - PREVENTIVE

NATIONAL MIDDLE

TERM PLAN FOR

HEALTH

DEVELOPMENT

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

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)

HEALTHY INDONESIA PROGRAM

Application of

continuum of care

approach

Health Risk based

Intervention

4

EMERGING CHALLENGES TO HEALTH SYSTEMS (Frenk et al, 2010)

Health system

Technological innovation

Professional differentiation

Population demands

Epidemiological & demographic

transitions

Sustainable development

Transformation and stronger

global partnership

UHC

(Post MDGs)

Epidemiologic Transition

Industrialization and

Urbanization

Economic, social, environmental

changes

Public sanitation Housing

healthcare

Nutrition technology for

healthcare

Mortality Infant mortality Life expectancy

Fertility

Increasing and aging population

Persons at risk of developing

NCDs

NCDs Infectious

disease

Per capita income Wealth

Level of RF: fat, calories, tobacco,

sedentary habits

Health transition: demographic transitions and epidemiologic transitions

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

REFLECTION ON CURRENT HEALTH PROFESSION EDUCATION

Informative Formative Transformative

Experts Professionals Enlightened Change agents

Acquiring

knowledge

& skills

Socializing

values &

norms

Developing

leaderships

attributes

TRANSFORMING LEARNING

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 Communicative learning

TRANSFORMATIVE EDUCATION

focuses on learning through task –

oriented problem solving and

determination of cause and effect

relationships

involved with how others communicate their feelings, need and

desires with another person. It helps the learners to become

critical, autonomous and responsible thinkers

Disorienting dilemma

Self examination Critical

assessment Shared

discontent

New roles, relationships, and actions

Planning action Knowledge/skill

acquisition Role

experimentation

Role competency Reintegration

Mezirow’s Ten Phases of Transformative Learning

Identified common profile of graduates

across study programs

Identified common area of competencies /learning outcomes

Identified learning materials

Formulating integrated subject and lesson plan

Socialization and dissemination to

lecturers and assistants

Organizing schedule (rooster), faculties, equipment, rooms

Implementation

Student assessment

Evaluation and feed back

THE IMPLEMENTATION OF TRANSFORMATIVE LEARNING AND

INTERPROFESSIONAL EDUCATION IN UNPAD

THE IMPLEMENTATION OF TRANSFORMATIVE LEARNING AND

INTERPROFESSIONAL EDUCATION IN UNPAD

Three integrated subjects:

General Education (TPB,

integrate from Bahasa,

Pancasila, Civic, Religion, English)

Student Study Service (KKN) integrated with Faculty’s community

service

Sport, Health and Art (OKK)

Phase of Learning Together (TPB)

Diversity Transition Bridging

gap Foundation

Students are ready to study and increase

their prestation in year I

Development personal

competences

Development social

competences

Healthy life style

Development academic

competences

Learning (Curricular)

Sport and Arts

(Extra Curricular)

Character Building Unpad’s

values (Co- Curricular)

Facilitation

Conceptual Framework of General Education (TPB)

Design

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

Padjadjaran Academic Health System

Research

Basic Sciences

Community & Public Health

Sciences

Clinical Sciences

Health Care

Service

Tertiary Level

Secondary Level

Primary Level

Education & Training

Academic

Profession

Further Development:

Health System Approach in Health Profession Education

IPE TPE