THE IMPLEMENTATION OF PRECEPTORSHIP MODEL IMPROVE COMPETENCY ACHIEVEMENT OF NURSING CLINICAL STUDENTS (Implementasi Model Preceptorship Meningkatkan Pencapaian Kompetensi Mahasiswa

Introduction: Nursing clinical study as purpose to create a nurse graduate who has competency include cognitive, skills and good manner, be able to give nursing and health services with apply the nursing principles and rules in the health system services. The achievement of student’s competency is obtained by selection of appropriate of learning models. Preceptor ship is one of the learning models in a clinical study. The research aims to analyze the implementation of preceptor ship model toward competency achievement of clinical nursing students. Method: This fi rst year is a quantitative observational study. Samples were taken by consecutive sampling to 38 precepts and 38 preceptors. The data was taken by checklist instrument. The data processing used univariate and bivariate within chi-square. Result: The results showed that 20 (52.6%) preceptors were good in preceptor ship implementations and 18 (47.6%) preceptors were less good. While that the competency of student’s achievement results showed that amount 21 (53.3%) were achieved and amount 17 (44.7%) were half achieved. Chi-square result showed that p-value 0.010 (<0.05) which means there was a correlation between implementation of preceptorship model toward competency achievement of clinical nursing students. Discussion: This research recommended preceptor ship model into clinical learning towards enhancing the competency achievement of students.


INTRODUCTION
The higher of community demands toward quality of nursing services require a nurse to deliver the quality of nursing care.This is certainly supported by the quality of graduates from nursing education institutions.For these, various methods of learning in the clinic have been developed.One of the methods is preceptor ship.
Students nurses in the clinical study required to have various competencies in spite of hard skill and soft skill.For these competencies achievement used preceptor ship model approach which this model is a series of clinical learning process occurs short term relationship between preceptor with a preceptor in the form of direction and guidance.
The development of this model has been studied by experts.Among them, Hill & Melander in 2009-2011 has obtained results that preceptor ship models are very important and could be applied in a clinical study, where this model can enhance critical thinking skills preceptee when facing the real cases in the clinical field.The learning model is also supported by clinical research conducted by Lawal et al. (2015) with the result that the learning model preceptor ship students are able to obtain a better experience through the guidance, direction and good interpersonal relationship of the preceptor.Meanwhile, in a qualitative study conducted by Brathwaite and Lamonde (2011) model of clinical preceptor ship on perceived student learning is very helpful in preparing students to achieve the expected competencies.
Based on the above, the study of science nursing program (PSIK) STIKes Hang Tuah Pekanbaru have applied this learning model preceptorship.So, it is important to do an evaluation of the implementation of preceptor ship model towards the competencies achievement of nurse profession students.The purpose of the implementation of this study was to analyze the implementation of preceptorship model towards the competencies achievement of nurse profession students in STIKes Hang Tuah Pekanbaru.

Competency of nurses professional education
Nurses professional education learning based of KKNI is a complete description of nurses professional graduation with regard to competencies which have to be owned by the students after graduation.The learning gains obtained through the internalization of knowledge, attitudes, skills and special general (AIPNI, 2014).So it can be interpreted that the competence of graduate nurses is the achievement of all the internalization of knowledge, attitudes, general and specific skills a nurse who is ready to provide medical and nursing services to their clients.Achievement of competency in professional education nurses refers to the competence of graduates and graduates competence unit described in the book Ners education curriculum (AIPNI, 2010).

Preceptor ship
Some literature discusses that preceptor ship learning model is one the clinical learning methods which is a short-term relationship between students (preceptor) as a new comer and a nurse experienced professionals as mentors (preceptor).Preceptor provides direction and guidance in accordance with the individual learning needs preceptee, provide feedback on the performance of preceptee.Nabolsi et.all in 2012 on the research suggests that the model preceptor ship a clinical learning process to enable students to integrate theoretical learning, skills in dealing with patients, critical thinking, intervene creatively and professionally.Moran (2011) in his book explains that the model preceptor ship can facilitate the sharing of knowledge between preceptee and preceptor and improve the ability of the student clinical skill.This is supported by Hilli & Melender (2015) suggested that the model preceptor ship the priorities in the nursing clinical learning and education is recognized in the clinic.Preceptor ship learning model has many benefits related to the achievement of competence of students (Carlson, 2015;Brathwaite, 2011), such as: -Ability to increase self-confi dence, selfesteem, and self-awareness of learners (Huriani & Malini, 2011) -Able to increase the motivation of students in the achievement of learning objectives clinic -Enhance students' critical thinking skills -Ability to improve the skills to intervene creatively and professionally (Nabolsi et.all, 2012) -Enhance professionalism precept (Carlson, 2015) But to achieve these benefits need to be considered the readiness of the preceptor, and preceptee (et.all Donley, 2015).These preparations include: a. preceptor: -Have a minimum educational background equivalent to preceptee -Following the training.This is related to raising the bar in the guidance and understanding of preceptor ship -Have eff ective communication skills that support during the process guidance to preceptee -Has the attitude of a good educator -Have skills in decision-making in the clinic -Have an interest in clinical learning process -Have the ability to determine appropriate learning techniques on preceptee -Have expertise in their area which will be guided (Botma, et.all, 2012) -Have the ability to provide feedback to preceptee -Have the ability to understand the character of preceptee -Have a high commitment according to the concept preseptor ship (Matua et.allThis study uses a mix of techniques, which is a sequential explanatory strategy.Where the fi rst phase of this strategy is to collect data and analyze quantitative data is then followed by collecting and analyzing that builds on the initial results of qualitative (Cresswell, 2013).In this year's study, the data gained in the fi rst year followed the analytic, quantitative research design correlation.This study aims to determine the extent of implementation of the model preceptorship to the achievement of student competence, so that will produce a solution or good implementation of preceptor ship model toward increase student competency achievement.Collecting data on the qualitative stage is through participant observation, focus group discussion (FGD), as well as documentation.For FGD conducted on two groups.Each group consists of 6-8 people preseptee or precept.Data collected by the tools records, video recorder, and a tape recorder and then will be mix method study the processing and analysis of data at the stage of transcribing the data and then aggregating them in a matrix form in accordance with the themes that appear in any of the variables.(Cresswell, 2013).

Research implementation
At this first phase which is a quantitative study with the retrospective design.This study is to describe the relationship between independent variables and the dependent variable.Where the independent variable in this study is the implementation model of preceptorship, and the dependent variable

RESULTS
The design used in this study is consecutive sampling.The number of samples in this study was 38 students and 38 professional nurses preceptor.The instrument of this research is on the checklist sheet preceptor ship model implementation and achievement of student competence nurses.Checklist sheet made by researchers based on theoretical concepts from a variety of sources.Analysis of the data used in this research is the analysis of univariate and bivariate.
Based on Table 1 above it can be seen that the characteristics preceptor, preceptor most are in the category of a middle-aged adult, female, having work experience> 10 years experience of being a clinical instructor> 2 years and have been coaching preceptor ship.Meanwhile, the independent variable model implementation preceptor ship was good, and the dependent variable is declared student competency achievement was achieved.
In Table 2 above shows that the chisquare test results showed that p-value 0.010 (<0.05), which means that there is a relationship between implementation models with the attainment of student preceptorship nurses.

Figure 3 .
Figure 3. scheme of research