Abstract

Transforming Ki Hajar Dewantara's proverb in leadership strategy as a challenge

agent in improving HIM professional competencies
Gemala Hatta

The globalization in health information professionals education as declared by Global Health

Workforce Council (GHWC) is an eminent and big steps programs towards global academic
curricula competencies. Since June 2015, Health Information Management (HIM) - Health
Informatics (HI) - Health Information and Communication Techonogies (HICT) are 3 professions
globally embedded under health information professions. Countries who run the curricula are
facing implementation cosiderations, especially toward infrastructure readiness plus culture
implication. Indonesia with present 44 medical record and health information programs has to
challenge 29 GHWC's HIM curricula competencies versus Indonesia's 7 HIM competencies. How
do we do ?
Indonesia will be a good example model in implementing the robust program above by
adjusting global curricula implementation into Ki Hajar Dewantara's (KHD) local wisdom (1920)
i.e by transforming that famous proverb in leadership education to 3 actions tool for improving
and implementing HIM education. The 7 Indonesian competencies compared to 29 global HIM
competencies will be rechecked and analyzed on its similar correlation of competencies.
Grouping the result into 3 sections will allow educators/practitioners (EP) of each competency
sharing, work closely and patronage each other in the 3 sections with the guidance of KHD's
action plan and linkage to Bloom's taxonomy to earn or mastering more knowledge to fulfill
each competency.
This strategy approach of transforming Indonesian immortalize education local wisdom proverb
into GHWC HIM action as a road map will accummulate power and condense mutual support of
each EP plus awareness amongst HIM EPs of all 3 level actions. This KHD leadership action is
our challenge agent in improving HIM Professional Competencies and be an international
lesson learned, as well.
==================
Key words: Ki Hajar Dewantara Leadership Strategy - Global Health Workforce Council (GHWC) - Health
Information Management Competency 6 Bloom's Taxonomy

INTRODUCTION
Global Health Workforce Council (GHWC) is an eminent and big steps programs towards global
academic curricula competencies. Since 30th of June 2015, Health Information Management
(HIM) - Health Informatics (HI) - Health Information and Communication Techonogies (HICT)
are 3 professions globally embedded under health information professions.
Indonesia is a country with a growing medical record and health information programs.
Initiated from the first runner school of ARM or Admnistrasi Rekam Medis ( = medical record
administration) program in Jakarta, 1989 and now substantiately growing into 44 schools under
the name of Medical Record and Health Information (MRHI). These 44 schools are categorized
into 3 parts. (a) Starting from the end of 90's many new D3 schools gradually scaling up into
present 39 schools of Diploma a 3 (D3) or an associate degree (3 years course) use the new
name as above; (b) four schools of Diploma 4 (D4) or Bachelor's degree program, called Sarjana
Sains Terapan which is a 4 years course. Upon graduates be called Sarjana Sains Terapan in
Manajemen Informasi Kesehatan (MIK) or (Health Information Management). D4 is a more
skillful and ready to the work or "siap kerja". (c) Lastly, there is one Bachelor Degree program
which is an undergraduate program, called Sarjana (S1) (4 years course, applied science, ready
to use or "siap pakai").
As noted by Higher Education for Health Information Management Association (IHE-HIMA or
aptiRMIK (abbreviated in Indonesian language) until November 2015, the 44 schools have
produced 14.906 D3 graduates and around 240 graduates of D4 and S1. Their standard of
competency mostly came from the 7 items of Health Ministry Decree no. 377 in the year of
2007. These are (1) Classification and Codefication of Disease and Health Related Problems and
Procedures, (2) Law Aspect and Professional Ethics, (3) Medical Record Management and
Health Information, (4) Medical Record Quality, (5) Health Statistics, (6) Management of
Medical Record Department and (7) Professional Interrelated.
Meanwhile, from PORMIKI's VIII congress in Makassar in 2014 the discussion between PORMIKI
and aptiRmik have formulated a new concept on HIM Competency. PORMIKI is an abbreviation
of the Indonesian Professionals on Medical Record and Health Information Organization (since
1989). These are another 7 items principles standard in competency which are (1) Professional
nobelity (2) Introspective and self development, (3) Health data management, (4) Health
statistics, biomedical research and quality management, (5) Health care provider and
organization, (6) System and information technology, (7) Organization and management.
With the new GHWC's 29 competencies, we would like to adjust the principles of the 2
Indonesian versions of Competencies Standards above to the famous 3 actions proverb in
education by Ki Hajar Dewantara (1922) and linkage also with the use of revised six levels of
2

Bloom taxonomy for Global Curricula Mapping which are 1) remembering, 2) understanding, 3)
applying, 4) analsisng, 5) evaluating and 6) creating.
METHODOLOGY
How do we do ?
Ki Hajar Dewantara was born in Javanese aristocracy but he was a person who against Dutch
colonialization and being exiled to the Netherlands. Very fortunate, he used his time there to
further learning education. Later, his is immortalized proverb based on Javanese culture always
being known by the Indonesian educators. He has coined a famous proverb on describing his
ideals for education. Rendered in Javanese language, the maxim reads: 1) Ing ngarso sung
tulodo, 2) ing madyo mangun karso, 3) tut wuri handayani. Which translates: 1) "(for those) in
front should set an example, 2) (for those) in the middle should raise the spirit, and 3) (for
those) behind should give encouragement". The proverb is used as the principle of Taman
Siswa, the school he created in Yogyakarta (1922) and still exist until now while the branches
are presently in some places in Indonesia. Today, part of this maxim, Tut Wuri Handayani is
used as the motto of Indonesian Ministry of Education. It was meant to describe an ideal
teacher, after transmitting knowledge to their students, the teacher would stand behind their
students and give them encouragements in their quest for knowledge.
From the 3 actions in his proverb above, each of them will be set as an action
1.
"in font" or ing ngarso sung tulodo that means, HIM competency subjects who have
been known long and mastered by most educators will be a set an exampel. It does not mean
that the subjects have
been fulfilled with complete manuals or handouts but
educators/practitioners have known most of these competencies and the subjects being taught
are regarded as the "mother of the HIM science". This no. 1 serves as a set an example, this will
be followed by the two behinds (no. 2,3). From time to time, updating the knowledge of those
subjects should be accomplished and a compulsory matter.
2.
Those in the "middle" or ing madyo mangun karso should raise the spirit. Thus,the spirit
of implementing the competencies should also by checking and review the compilation of
subjects. Some competencies might be not yet fully understood by the educators/practitioners
or similar comptencies might be seen as over lapping or even not yet seen in the table of
Indonesian standard. Might be they are under the sub heading of the standards. Thus, the no.
1 "in front" of KHD will recommend to those involve in the middle part to check the available
learning objects and giving the required consultation.
3.
Those in the "back" or tut wuri handayani: Tut Wuri = following from the back,
Handayani = cheerleading (penyemangat). Thus, someone must be able to give impetus
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moral or become of encouragement for those who are around him. Thus, competency subjects
which are regarded difficult should not be over looked or regarded as a barrier by the HIM
educators or practitioners. In this stage, those in "behind" or tut wuri handayani should give
encouragement to the middle part. While the no.1 and no. 2 should also communicate to no. 3
in order rowing the encouragement processes from all levels.So, everybody in the system will
work closely to each other and giving impetus moral in order to achieve the succesful program.
Each educator should also develop learning ovjecties and assessment based upon an
appropriate cognite level of Bloom's taxonomy.
The action motto of KHDs should be loudly spoken to those involve in the system so they are
not be self centered or feeling great on certain achievement. Each of them should understand
that knowledge always evolve and the cycle might change to certain condition and level of
understanding. Also, one HIM education institution might be strong in certain subjects on
competencies while other places are weak. So, even inter province may help others.
In order to understand the required GHWC's comptentecies standards, we can see from the
below table and compared with the two of 7 items listed by the MoH decree and PORMIKI aptiRMIK.
Table 1. List of GHWC 2015 GHWC standard competencies - Ministry of Heatlh decree and
PORMIKI 8th Congres in 2014
GHWC June 2015
1, Analysis and Statistics

Indonesian Ministry of
Health decree no. 377 2007

PORMIKI aptiRMIK
Mksr 2014

1.Professional
nobelity

4.0 Clinical Documentation Improvement (CDI)

1. Classification and
Codefication of Disease, and
Health Related Problems and
Procedures
2.
Law
Aspect
and
Professional Ethics.
3.
Medical
Record
Management and Health
Information
4. Medical Record Quality,

5.0 Data Management and Information

Governance:

5. Health Statistics
GHWC : 1

6.0 Data Quality and Information Integrity:

6. Manajemen of Medical
Record Department

5.
Health
provider
organization,
6.
System
information
technology

2.0 Change Management

3.0 Classification of Disease, Coding Diagnoses
and Procedures:

2. Introspective and
self development,
3.
Health
data
management
4. Health statistics,
biomedical research
and
quality
management
care
and
and

GHWC June 2015

7.0 Ethics:

Indonesian Ministry of
Health decree no. 377 2007
7. Professional Interrelated.

8.0 Financial Management:

9.0 Health Information Access, Disclosure,
and Exchange tics and Statistics
10.0 Health Information Systems and
Application
Design and Planning:
11.0 Health Information Systems and
Application
Development and Deployment:
12.0 Health Information Systems and
Application
Support
13 Health Law, Regulation, Accreditation,
and/or Certification
14.0 Health Record Content & Documentation
15.0 Human Resource Management:
16.0 Information and Information Systems
Governance:
17.0 Information Protection - Data Privacy,
Confidentiaity and Security:
18.0 Information Security Stregy and
Management
19.0 Organisational Management and
Leadership:
20.0 Project Management:
21.0 Purchasing and Contracting:
22.0 Quality Management:
23. Research Design and Methods:
24. Risk Management
25.0 Standards for Data Content, Health
Information Exchange and Interoperability
26.0 Strategic Planning
27.0 Training and Development
28.0 Work Design and Process Improvement
29.0 Health Care Delivery Systems

If the competency block being correlated, it might turns into :

PORMIKI aptiRMIK
Mksr 2014

7. Organization and
management.

Tabe 2. The Correlation between GHWC standard competencies vs MOH 377/3007 and PORMIKI 2014

GHWC June 2015

1.0 Analysis and Statistics

2.0 Change Management

3.0 Classification of Disease, Coding Diagnoses

and Procedures:

4.0 Clinical Documentation Improvement (CDI)

Indonesian Ministry of
Health decree no. 377 2007
1. Classification and
Codefication of Disease, and
Health Related Problems
and Procedures
GHWC : 3
2.
Law
Aspect
and
Professional Ethics.
GHWC : 7,13
3.
Medical
Record
Management and Health
Information
GHWC : 2, 10, 11, 12, 16, 17,
18
4. Medical Record Quality
GHWC : 4, 6, 14, 25

5.0 Data Management and Information

Governance:

5. Health Statistics
GHWC : 5, 23

6.0 Data Quality and Information Integrity:

6. Medical Record
Department Management
GHWC : 8, 15, 19, 20, 22,24,
26, 27, 28

7.0 Ethics:

7. Professional Interrelated
GHWC : 9, 21, 24, 29

8.0 Financial Management:

9.0 Health Information Access, Disclosure,
and Exchange tics and Statistics
10.0 Health Information Systems and Application
Design and Planning:
11.0 Health Information Systems and Application
Development and Deployment:
12.0 Health Information Systems and Application
Support
6

PORMIKI aptiRMIK
Mksr 2014

1. Professional
nobelity
GHWC : 7

2. Introspective and
self development
GHWC : 27
3. Health data
management
GHWC : 1, 14, 25

4. Health statistics,
biomedical research
and quality
management
GHWC : 1, 4,5,6,23,
24
5. Health care
provider and
organization
GHWC : 21, 29
6. System and
informa -tion
technology
GHWC : 3, 9, 10, 11,
12, 16, 17
7. Organization and
management.
GHWC : 2, 8, 13, 14,
15,16, 18, 19, 20, 22,
24, 26, 28

GHWC June 2015

Indonesian Ministry of
Health decree no. 377 2007

PORMIKI aptiRMIK
Mksr 2014

13 Health Law, Regulation, Accreditation,

and/or Certification
14.0 Health Record Content & Documentation
15.0 Human Resource Management:
16.0 Information and Information Systems
Governance:
17.0 Information Protection - Data Privacy,
Confidentiaity and Security:
18.0 Information Security Stregy and
Management
19.0 Organisational Management and
Leadership:
20.0 Project Management:
21.0 Purchasing and Contracting:
22.0 Quality Management:
23. Research Design and Methods:
24. Risk Management
25.0 Standards for Data Content, Health
Information Exchange and Interoperability
26.0 Strategic Planning
27.0 Training and Development
28.0 Work Design and Process Improvement
29.0 Health Care Delivery Systems

By looking to the spreading patterns of GHWC to be adjusted to the Indonesian version, it shows many
subjects that still have to be formulated in order to be impelemented. There are some GHWC
competency subjects which are correlated to more that one numbers under Indonesian version. These
have to be formulated more by PORMIKI and aptRMIK version.
Once, the final decision has been reached, it is a compulsory that the guidance of Ki Hajar Dewantara
being implemented and linked into 3 boxes. Thus, to subjects such as medical terminology should be
analyzed and which one is more understood by educators. Meanwhile, the 6 Bloom's taxonomy
approach should be used by the educators to develop learning objectives and assessment based upon
an appropriate cognitive level.

Table 3. Formulated Competencies Combined with 6 Bloom's taxonomy and KHD action proverb

Indonesian Version to GHWC's Formulated

Competencies Combined with 6 Bloom's
taxonomy

KHD action proverb

1. "in font" or ing ngarso sung tulodo

As a set ann example

Subjects of
Competency
Level I KHD

2. the "middle" or ing madyo mangun karso Spirit ever lasting

Subjects of Competency
Level II KHD

3. the "back" or tut wuri

encouragmenet to the front rows

Subjects of Competency
Level 3 KHD

handayani

The next step :

Competencies and educators/practitoners in the 3 KHD's action have to follow the rules as described on
each KHD rules as explained above.
The "in front" : hold comptency subjects and lead other subjects from level no 2 and no.3
The "middle" : consist of competency subjects that should be evaluated and guided by the "in front"
The "back" : educators/practitioners with less understood competency subjects have to get involved
with those in the middle. The "back" spirit encourage the middle part while the other uper levels also
helping the below level. This means, when ever there are some barriers in implementing the
competency subjects, these will be discussed and helped by others ( 1,2)
CONCLUSION
The result of implementing GHWC's 29 competency subjects will depend on the quick action from
PORMIKI aptiRMIK side. Each country, include Indonesia will adjust their planning program. To
Indonesia it is the time to lift up the local wisdom in order Transforming Ki Hajar Dewantara's Proverb in
Leadership Strategy as a challenge agent in Improving HIM Professional Competencies.

References
AHIMA, 2015 Global Health Workforce Council.Global Academic Curridula Competencies for
Health Information Professionals.
aptiRMIK, 2014. Standar of Competencies of two versions (MOH vs Congress 2014 results)
Internet search on Ki Hajar Dewantara.
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