KONSEP KOLEGIUM

DALAM PROFESI

Editing by jhs[99]
Terbentuknya profesi
dan
profesionalisme
Terbentuknya profesi
Sebuah profesi lahir bila suatu kelompok
“okupasi” mentransformasikan diri melalui
pengembangan kualifikasi formal melalui
pendidikan dan ujian, serta munculnya badan
regulasi (konsil) dengan kewenangan untuk
memberi ijin dan mendisiplinkan anggotanya,
dan monopoli kewenangan tertentu.
Regulasi (suatu profesi)
 Regulasi ditegakkan dengan Undang-undang yang
membedakannya dengan okupasi lain
 Dibanyak negara, profesi memiliki badan regulasi atau
professional bodies (konsil)
- define
- promote
- oversee
- support
-regulate the affairs of its members
PERKEMBANGAN PROFESI
Suatu perbandingan
Profession
 An occupation whose core element is work, based on the
mastery of the complex body of knowledge and skills
 It is a vocation in which knowledge of some department of
science or learning, or the practice of an art founded on it, is
used in the service of others
 Its members profess a commitment to competence, integrity,
morality, altruism, and the promotion of the public good
within their domain
 This commitment form the basis of a social contract between a
profession and society, which in return grants the profession
autonomy in practice and the privilege of self-regulation
 Professions and their members are accountable to those serve
and to society
Characteristics of Profesionalism
1. Practitioners apply a specialized skill enabling them to offer a spesialiced
service
2. The skill has been acquired by intellectual and practical training in a well
defined area of study
3. The service calls for a high degree of detachment and integrity on the part of
the practitioner in exercising his personal judgment on behalf of his client
4. The service involves direct, personal and fiduciary relations with the client
5. The practitioners collectively have a particular sense of responsibility for
maintaining the competence and integrity of the occupation as a whole
6. The practitioners tend or are required to avoid certain methods o attracting
business
7. The practitioners are organised in bodies which, eith or without State
intervention, are concerned to provide machinery for testing competence
and regulating standards of competence and conduct
Sejarah GUILD
Isu otonomi profesi saat ini dan
pengendaliannya merupakan produk
lingkungan masyarakat urban pada akhir
abad pertengahan
The Guild Doctors adalah salah satu
diantara duapuluh “korporasi ahli” yang
dikukuhkan oleh peraturan (the Ordinances
of Justice) 1293 di Italia
GUILD
A guild is an association of
craftspeople in a particular trade
Craftspeople : skilled manual worker
who uses tools in a particular craft
 Characteristics of Guilds
 The cohessiveness of the guild`s membership
underpinned solidarity and brotherhood
-when members of the guild experienced hard times, they
were eligible for material aid from the guild
- their funerals were attended by representatives of the guild
 They were prohibited from bad mouthing one
another in various circumstances
 They also had penalties imposed for treating
another`s patient before the first had been paid in
full
 Obligations to consult their colleagues when
attending a patient with a life-threatening
condition, and when a physician was making a
forensic judgment concerning the cause of death
PERKEMBANGAN GUILD
 In Florence the guild had existed long before 1296 and in
Pisa the College of Physicians had been established
between 1286 and 1318
 In Northern and Central Italy the regulation of the
medical profession was originally in the hands of the
local guilds
 Three hundred years later, Thomas Linacre brought the
idea of the College of Physicians to England in the early
sixteenth century
SEJARAH
 The conditions of medical practice were shaped by the
multiple functions of the Guild of Doctors, which was
reflected in its statues
 The statutes elucidated not only the licensing
mechanism and regulation of medical practice, but also
governed the relationship amongst its members
- resulting in a cohesion which bound them together and
- gave them a group identity
 Socially, the guild responded appropriately when society
was suffering the plague epidemic by amending its
statutes after 1348
PROTEKSI PUBLIK
 Protecting the public from incompetent practitioners
was underpinned by the profession
 It also stipulated that the applicant should be examined
by a panel consisting of six consuls the Guild and four
friars (“Collegio Medico”)
 This credentialing mechanism became an early model of
a registration body that protects the public
 The Authority of Florence confirmed that anybody in this
jurisdiction was prohibited from practising medicine or
surgery unless he had been examined by the Collegio
Medico
 SOCIAL
PROFESSIONALS - COMMUNITY
CONTRACT

Clinical priviliage
Self credentialing
Self licensing

Moral responsibility
High stndard of competence

Market control PROFESIONALISM

Working condition
DUA KOMPONEN UTAMA
PROFESIONALISME
CONDUCT / PERILAKU
- Empathy
- Duty of Care
KOMPETENSI / KECAKAPAN
- Kognitif dan keterampilan
- Fisik
HAKEKAT PROFESIONALISME
PROSES MEMBAYAR HUTANG

 Kelompok profesi membayar kembali “clinical privilage”

yang diterima melalui peraturan
dengan cara :
 Menjaga kompetensi
 Menjaga moralitas

FOKUS PADA KLIEN,

BUKAN PADA KEPENTINGAN DIRI SENDIRI
X

Council

Clinical privilages

Registered practitioners

Masyarakat / Pasien
SEJARAH COLLEGES
 In the mid of sixteenth century, the “Collegio Medico”
developed and became a College of Physicians as a
separate institution from the guild
- It consisted of twelve physician who were appointed for life
- to ascertain that new physicians and surgeons had sufficient
medical competence and
- to issue licenses for practice
 The College of Physicians is assumed to be the successor
of the old guild which broadened its power by
- Acquiring regulating and controlling functions , and
- Becoming the sole adviser for the goverment
SEJARAH COLLEGES
 Colleges (Latin : collegium) is a term most often used
today to denote an educational institution
 It meant a group of persons living together under a
common set of rules
- (con- = “together” + leg- = “law” or lego = “l choose”)
 Colleges call their members “fellows”
- These colleges enjoy a special status whereby they can confer recognised
post-nominal titels comparable to degrees, eg FRCOG (Fellow of Royal
College of Obstetric and Gynaecolgy)
- They are granted statutory licensing, regulatory and disiplinary power
over their own members
COLLEGES VS ASSOCIATION
 Currently, registration boards and learned colleges have
taken over the old guild`s functions on regulating and
controlling medical practice
- Medical practitioners have established professional
(medical) associations to address their interests
- They have similar characteristics as trade unions, which are
concerned with protecting members` interests
 It follows that the medical associations are resistant to
any diminishing of professional autonomy, although,
unlike the trade unions, they are concerned with the
standards and qualifications of their members
MAGANG (APPRENTICESHIP)
Is a system of training a new generation of
practitioners of a skill
The system of apprenticeship first developed in
the later Middle Ages
It came to be supervised by crafts guilds and
governments
KOLEGIUM
 Kelompok Mitra Bestari (Peer-Group)
 Mengampu profesi / “pekerjaan” (aspek kognitif-
psikomotor-afektif)
- Membuat standar-standar (pendidikan – performance)
 Bukan sekedar kumpulan orang-orang dengan minat
(ilmu) yang sama
 Memberikan pengakuan (recognition) pada orang yang
memenuhi syarat sebagai anggota kelompok (profesi)
 Bukan memperjuangkan kepentingan anggotanya, tapi
mempertahankan kemuliaan/martabat kelompok
profesi
BAGAIMANA DI
INDONESIA…. ?
FAKTOR KOLONIAL BELANDA
 Belanda enggan “memprofesionalkan” kaum bumi
putera
- Pendidikan dokter akibat wabah cacar, pendidikan
hukum akibat BB butuh “tukang” untuk membuat
undang-undang
- Inggris memprofesionalkan wilayah koloninya dalam
ikatan “commonwealth”
 Walaupun dikenal profesi dokter, namun konsep
kolegium tidak diperkenalkan
 Organisasi “profesi” lahir dari latar belakang politik
 PENGATURAN PROFESI
KEPERAWATAN

KEPMENKES …………………….
SEJARAH KEPERAWATAN DI
INDONESIA
 PROLONGED-ARM DOCTRINE
- Diintroduksikan oleh penguasa Hindia Belanda ke
nusantara dengan konsep Eropa Kontinental
(verlengde arm van de arts doctrine)
- Perawat adalah kepanjangan tangan dokter (fungsi
kolaborasi)
- Berbeda dengan konsep Anglo-Saxon (Florence
Nightingale)
 Merambah ke arah pengobatan
- To cure, bukan to care
- Praktek Pak Mantri
BIROKRATISASI PERAWAT
 KEBANYAKAN PERAWAT ADALAH PEGAWAI
NEGERI
 Kendali oleh Birokrat
- Birokrat menetapkan standar
- Birokrat memberikan standar
PERAWAT SPESIALIS
 TIDAK BOLEH ADA “KASTA” DALAM PROFESI
- Bandingkan konsep dr. Umum vs Dr. Spesialis
- Perbedaan kompetensi harus bersifat horizontal-
sederajat (berbeda bidang) - spesialisasi
 SPESIALIS BIDANG TERTENTU
- Harus ada kolegium yang mengampu ilmunya
- Pengakuan dan “kendali” dari profesi selama
menjalankan profesi tersebut
Deprofessionalization and
Proletarianization Process

Profesionalized Proletarianized

Bureaucratic Erosion Consumerism Corporate Erosion

Deprofessionalization Process

Professionalized Proletarianized
BAGAIMANA KE
DEPAN……?
MEKANISME PROTEKSI
MASYARAKAT
PENDIDIKAN PRAKTIK
KEPERAWATAN KEPERAWATAN
(AKADEMIS/PROFESI)
- Pengendalian (mutu) - Pengendalian (mutu)
institusi pendidikan praktik bidan
- Akreditasi – pengakuan - Perijinan – disiplin
- Fakultas - Kolegium
 AUTHORITY
NEGAR Ijin kerja Ijin masuk NEGARA
IMMIGRATION
A wilayah

Kolegium Keperawatan

KONSIL
KEPERAWATAN
Credentialing
MTDK

e ss i onal
of
Clinical Privilege Unpr nduct
Co

Registered Fit Unfit

Practitioners Praktik bidan Re-credentialing
 Herkutanto, 2009

NURSES ASS. ACADEMY

EDUCATIONAL LAW &

(PPNI - COLLEGES (AKPER – FIK)
HEALTH LAW &
REGULATIONS

SERTIFIKASI IJAZAH

REGULATION
KOMPETENSI PERAWAT

NURSING REGISTRATION
COUNCIL (DE-
(Disiplinary Board) REGISTRATION)

MUNICIPAL LICENSING & DE-

GOVERNMENT LICENSING
KESIMPULAN
 Profesi terkait dengan isu monopoli pekerjaan
 Tanpa melakukan proteksi terhadap publik, suatu
kelompok tidak layak disebut profesi
- Kelompok yang hanya memproteksi anggotanya
adalah suatu “kartel / sindikat”
 Proteksi terhadap kompetensi dilakukan melalui
kolegium
 Proteksi terhadap perilaku dilakukan melalui konsil