PRECEPTORSHIP MODEL

Moh. Afandi, SKep.,Ns.,MAN.,HNC

081908134304
mohafandi2003@yahoo.com

PRECEPTORSHIP
MENTORSHIP
Clinical Supervision

Planned, regular periods of time that student and

supervisor spend together discussing the students
work in the placement and reviewing the learning
process (Ford and Jones, 1987)
An exchange between practising professional to
enable the development of professional skills
Butterworth 1992

A formal process of professional support and

learning which enables individual practitioners to
develop knowledge and competence, assume
responsibility for their own practice and enhance
consumer protection and safety of care in complex
situations. It is central to the process of learning and
to the scope of the expansion of practice and should
be seen as a means of encouraging selfassessment and analytical and reflective skills
(DoH, Vision for the future 1993).

areas for supervisory:

theoretical orientation
assessment techniques
skills competence
intervention
treatment goals and plans
professional ethics
client conceptualization
individual differences
interpersonal assessment

Novice
Advanced beginner
Competent
Proficient
Expert

Experience

Action
plan

Reflection

Conceptualization

The experiential learning cycle (Kolb, 1975)

Two central purposes of supervision:

1. To foster the supervisees professional
development
The supervisor and supervisee should have a set of
precise and concrete goals to accomplish during their
time together.
2. To ensure client welfare
As a supervisor, it is crucial to monitor client care as
an essential supervision goal. Although the supervisor
is an ally of the supervisee, action must be taken in
situations involving potential harm to the client.

Functions of supervision
Monitoring/evaluating
Instructing/advising
Modeling
Consulting
Supporting/sharing

Models
So many
Some are:
(1) developmental model
(2) integrated model
(3) orientation-specific model

Developmental

Continuum of Supervision
Stage

Evaluationfeedback

Style

Direct/active

Supervisor

Transitional stage

Collaborative

Supervisee

Self-supervision

Consultative

Peer

Integrative task maturity model

Kemandirian
mahasiswa

Petunjuk spesifik
dari pembimbing
klinik tidak
mengubah
ketidakmampuan
penguasaan suatu
skill

M1
Tingkat
kematangan

Tidak kompeten
Tidak percaya diri
Tidak ada
kemauan

Model
S1
supervisi Telling

Siswa membutuhkan
petunjuk spesifik /
demonstrasi dari
pembimbing klinik
untuk menunjukkan
penguasaan

Siswa membutuhkan
petunjuk umum dari
pembimbing klinik
untuk melakukan
tindakan lebih efektif

Siswa menunjukkan
performance yang
efektif dengan
ditunjukkan adanya
inisiatif dan membuat
perubahan bilamana
perlu

M2

M3

M4

Tidak kompeten
Percaya diri
Punya kemauan

Kompeten
Tidak percaya diri
Punya kemauan

Kompeten
Percaya diri
Punya kemauan

S2

S3

S4

Selling

Participating

Delegating

CCT/RS TMG/M.AFANDI/PSIK FK UMY

12/08/10

15

Learning vector model

Clinical instruction

Independent

Dependent

Mature

Novice
Professional development

Developmental Stages
Level One - The beginning of the Journey

Level Two -Trial and Tribulations

Level Three - Challenges and Growth

Level One - The beginning of the

Journey

dependent on supervisor
imitative
lacking self-awareness
categorical thinking, with limited experience

Level One - The beginning of the

Journey

high motivation to do well

high anxiety channeled to hard work
focused on skill acquisition
highly dependent on supervision

Level One - The beginning of the

Journey

Supervision Environment
1. provide structure to keep anxiety low,
2. provide positive feedback regarding
3. focus on data rather than on supervisee

Level Two -Trial and Tribulation

fluctuating motivation
striving for independence
becoming more self-assertive and less imitative
dependency/autonomy conflict
confusion stage

Level Two -Trial and Tribulation

Supervisees skills, strengths and

weaknesses are becoming evident
Beginning awareness that this is not a job for
the faint of heart

Level Two -Trial and Tribulation

Realization that there is more issues related to

health care
Not all cases respond as hoped for, even with
good skill level usage
Professional Ethics relates

Level Two -Trial and Tribulation

Autonomy is increased

Supervisee may not seek opinions or advise of

supervisor
May even resist discussion of cases

Level Two -Trial and Tribulation

Supervision Environment:
Highly autonomous, little structure
Blend of client types is important
Consultative

Level Two -Trial and Tribulation

Focus on theory and application
Alternative views of clients
Broadening repertoire of theory and technique
Confrontation and interface issues are more a
part of supervision now.

Level Two -Trial and Tribulation

Supervision Environment:
Less inclined to take the supervisors word
without critically evaluating suggestions as
applied to clients
Supervisory relationship is less hierarchical, and
this should be supported

Level Three - Challenge and Growth

Self-confidence.
Motivation more stable
Autonomy is not threatened
Self- and other awareness is heightened.

Level Three - Challenge and

Growth
Generally aware of their own strengths and
weaknesses.

Can think of individual differences of clients.

Understand ethics and professional perspective

Level Three - Challenge and

Growth
Supervision Environment:
1. dependency and strengths need to be
acknowledged and supported (sometimes
even encouraged),
2. case accountability needs to be provided
within this context

Level Three - Challenge and

Growth
Supervision Environment:
Supervisee may be beyond formal,
regular supervision but may seek help with
specific cases.
There is a need for supervision to advance past
a single theoretical framework, broadening the
supervisees repertoire. Focus should be on
integration of all aspects of health care

Gaya Supervisi

Transaksi

Superviso
r

Supervisee

Supervisor: kompetensi pengetahuan

Supervisee: insight tentang dirinya

Situational leadership
(Blanchard, 1985)

Terutama digunakan untuk membantu

mengembangkan tim
Prinsip dasar
Anggota mengalami tahap-tahap
belajar/perkembangan

Tahap perkembangan ini perlu disesuaikan

dengan gaya leadership yang sesuai

Tahap perkembangan

Komponen: Kompetensi dan Komitmen

D1: Pemula yang antusias

D2: Kurang mampu dan tidak bermotivasi
D3: Mampu tetapi khawatir gagal
D4: Mandiri dan bermotivasi

Gaya leadership

Komponen: pengarahan dan dukungan

S1: directing
S2: coaching
S3: supporting
S4: delegating

D1: Pemula yang antusias

Komitmen tinggi: Saya ingin sekali bisa

mengemudi
Kompetensi rendah: Saya tidak bisa
mengemudi, tetapi saya siap untuk belajar

D1 perlu S1

Bersifat arahan, bahasa

lugas thd tugas

Tujuan yg jelas: Hari ini kita akan belajar

cara parkir
Standard: mobil ada di dalam garis
Praktek
Feedback yg sering: Bagus, tetapi jangan
terlalu cepat
Memuji antusiasme

D2: kurang mampu dan tidak

bermotivasi

Komitmen rendah: Belajar mengemudi itu

sulit, saya benar-benar menyerah

Kompetensi rendah atau cukup: Saya bisa

mengemudi tetapi saya belum pandai
memarkir. Mengemudi tidak semudah yang
saya duga (too hard syndrome)

Bersifat mitra tergantung, bahasa

percakapan

D2 perlu S2

Perspektif dan penjelasan ttg alasan: Kalau hujan harus

lebih perlahan karena
Feedback ttg hasil yg sering: Bagus, sekarang kamu sudah
bisa parkir lebih lurus
Boleh berbuat salah: Tidak masalah kalau menabrak tanda

Libatkan dalam pengambilan keputusan: Mau berlatih cara

memarkir lagi..
Dorongan dan pujian atas kemajuan: Hari ini lebih baik

D3: mampu tetapi takut gagal

Komitmen bervariasi: Saya bisa mengemudi

dengan baik, hanya saya tidak suka bila
mengemudi saat hujan
Kompetensi sedang hingga tinggi: Saya
merasa cukup mampu mengemudi, tetapi tidak
percaya diri kalau di jalan yang padat

Bersifat mendukung,
bahasa percakapan

D3 perlu S3

Mentor/coach: Ada lagi yang ingin dilatih untuk hari

ini?
Kesempatan untuk mengekspresikan kekhawatiran
Dorongan untuk mengembangkan keterampilan
pemecahan masalah
Penilaian secara objektif sehingga memupuk percaya
diri
Dorongan dan pujian atas penampilan yang baik

D4: mandiri dan bermotivasi

Komitmen tinggi: Saya senang mengemudi

Kompetensi tinggi: Saya pengemudi yang
baik dan tanpa catatan kecelakaan.

Bersifat otonomi, men-dorong

tanggung jawab

D4 perlu S4

Variasi dan tantangan: Kelihatannya kamu

perlu kursus mengemudi tingkat mahir
Kepercayaan: Kamu pengemudi yang baik,
bisa mengajari saudaramu?
Mentor dan kolega; Hubungi saya kalau
perlu bantuan
Penghargaan pada kontribusinya

A clinical supervisor attributes

Expertise
Through skill, experience, status and training
Experience
The supervisor will be recognised as having both a breadth and
depth of experience in their field. Ongoing current or recent clinical
practice is highly desirable
Acceptability
The clinical supervisor needs to be acceptable to those that they
supervise
Training
It is desirable that clinical supervisors receive training in clinical
supervision at the outset of their supervisory experience.
Refresher training is central to the maintenance of such skills.

Behaviours most favoured in supervisors

Confidence in the practitioner

Empathy
Encouragement
Positive reinforcement
Promotion of patient care
Role modelling

Characteristics of healthy supervisory

relationships

Bidirectional trust, respect and facilitation,

A commitment to enthusiasm and energy for the relationship,
An adequate amount of time committed to supervision,
Sensitivity to supervisees developmental needs,
Encouragement of autonomy,
Sense of humor,
Comfort in disclosing and discussing perceived errors,
Clarity of expectations, and regular feedback,
A non defensive supervisory style, and
A clear understanding of the rights and responsibilities of both
the supervisee and supervisor.

Characteristics of Effective Clinical Teachers

A Self-Checklist
A = Always F = Frequently O = Occasionally N = Never
To what extent...
A F O N 1. do I have the ability to handle - even to thrive in - the "messy" world of clinical teaching?
A F O N 2. do I enjoy and respect people?
A F O N 3. am I interested in and committed to being helpful to patients, students, and residents?
A F O N 4. do I have the capacity to work collaboratively with others?
A F O N 5. am I sensitive to the subtleties of human functioning involved in patient care and
teaching?
A F O N 6. am I enthusiastic about my subject?
A F O N 7. am I enthusiastic about teaching?
A F O N 8. do I enjoy - and am good at - learning?
A F O N 9. am I able to convey my enthusiasm for teaching, learning, and my subject?
A F O N 10. am I reflective about what I do as a clinician and teacher?
A F O N 11. am I willing to admit my limitations?
A F O N 12. am I open to challenges to the way I do things?
A F O N 13. am I adaptable?
A F O N 14. am I willing to make needed changes?
A F O N 15. am I able to deal constructively with ambiguity and uncertainty?
A F O N 16. is what I say congruent with what I do (do I practice what I preach)?

The last
We cannot hold a torch to light
anothers path without brightening
our own.
Ben Sweetland

Terimakasih
Semoga Bermanfaat