Hasil Pencarian  ::  Simpan CSV :: Kembali

"Bertumbuhnya rumah sakit di Indonesia menjadikan iklim persaingan yang semakin ketat dan pengembangan pelayanan di dunia kesehatan menjadi semakin dinamis. Saat ini terjadi perubahan dalam bisnis rumah sakit di Indonesia semenjak diluncurkannya Jaminan Kesehatan Nasional JKN pada 1 Januari 2014 yang pengelolaannya dilakukan oleh Badan Pengelola Jaminan Kesehatan BPJS dalam peta jalan menuju Universal Health Coverage 2012-2019. RSIA Pratiwi adalah RS khusus kelas C yang terus mengalami penurunan pasien kebidanan dan belum bekerjasama dengan BPJS Kesehatan hingga akhir 2016. Penelitian ini untuk melakukan analisis pasar layanan kebidanan RSIA Pratiwi pada tahun 2017 di awal kerjasama RSIA dengan BPJS Kesehatan KCU Tangerang. Lokasi penelitian di RSIA Pratiwi Tangerang, Banten. Waktu penelitian adalah bulan Mei-Juni 2017. Metode yang digunakan dengan wawancara mendalam kepada informan yang terdiri dari pasienkebidanan dan karyawan struktural RSIA serta telaah dokumen. Hasil yang ada kemudian dilakukan triangulasi data dan didiskusikan oleh tim Consesus Decission Making Group CDMG. Hasil didapatkan potensi pasar yang besar di wilayah kota Tangerang dengan target pasar wanita usia produktif, tingkat pendidikan menengah atas atau setara, pendapatan rumah tangga 3 - 5 juta perbulan dan memiliki pengetahuan serta minat yang tinggi terhadap pemanfaatan jaminan BPJS. Hal ini menunjukan bahwa era JKN memiliki pengaruh besar terhadap sistem pemasaran dan karakteristik pasien kebidanan Rumah Sakit Ibu Anak Pratiwi tahun 2017.

---

The growth of hospitals in Indonesia makes the increasingly fierce competition climate and the development of services in the health world become more dynamic. The need for strategy, commitment and creativity to innovate in managing and developing the hospital business along with continuous improvement of service quality quality for the hospital stay in the globalization era. Currently, there is achange in the hospital business in Indonesia since the launching of the National Health Insurance JKN on January 1, 2014 which is managed by the Health Insurance Management Board BPJS in the roadmap to Universal Health Coverage 2012 2019. Pratiwi Mother Child Hospital is a C class hospital that continues todecline and has not cooperated with BPJS Health until the end of 2016.

This research is to analyze the market of midwifery service in 2017 at the beginning of Pratiwi mother Child Hospital cooperation with BPJS Health. Research location at Pratiwi mother Child Hospital Tangerang, Banten. The study period was from May to June 2017.

The method used was in depth interviews with informants consisting ofobstetric patients and structural employees of and document review. The results arethen triangulated data and discussed by the Consesus Decision Making Group CDMG team.

The results obtained a large market potential in the city of Tangerang with a target market of women of reproductive age, upper secondary education, household income 3 5 million per month and have knowledge and a high interest in the utilization of BPJS guarantees. That is JKN era has effect influence on marketing system and midwifery patient characteristic in 2017."

"Salah satu upaya yang ditempuh oleh pemerintah untuk mempercepat penurunan AKI (Angka Kematian Ibu) dan AKB (Angka Kematian Bayi) di Indonesia adalah dengan mendekatkan pelayanan kepada masyarakat yaitu menempatkan Bidan di Desa (BDD). Studi ini merupakan studi kuantitatif dengan rancangan potong lintang (Cross Sectional) yang bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan perilaku tinggalnya Bidan di Desa di Kabupaten Banjar Provinsi Kalimantan Selatan. Pengumpulan data dilakukan pada Bulan Juni 2012 dengan populasi penelitian adalah seluruh Bidan di Desa yang bertugas di Kabupaten Banjar pada bulan tersebut. Data dikumpulkan melalui kuesioner. Dari total 252 orang Bidan Desa terkumpul data sebanyak 80 orang. Angka ini di dapat dengan rumus penentuan sampel uji beda dua proporsi. Dari 16 variabel di temukan 6 variabel yang bermakna. Ditemukan bahwa variabel keamanan, ketersediaan tempat tinggal, kelengkapan fasilitas tempat tinggal, kelengkapan fasilitas pelayanan, supervisi puskesmas dan supervisi Dinas Kesehatan Kabupaten behubungan secara signifikan dengan perilaku tinggalnya bidan di desa. Faktor-faktor tersebut harus mendapatkan intervensi yang optimal demi mempertahankan keberadaan Bidan di Desa.

---

One of the efforts made by the government to accelerate the decline in MMR (Maternal Mortality Rate) and IMR (Infant Mortality Rate) in Indonesia was to bring services to the people that placed Midwife in the Village (BDD). This study was a quantitative study with a cross-sectional design (Cross Sectional) which aims to determine the factors related to with behavior in the village midwife lived in Banjar district South Kalimantan Province.

The data was collected in June 2012 with the entire study population was a midwife in the village of Banjar district duty at the month. Data were collected through a questionnaire. Of the total 252 village midwives collected the data as much as 80 people. Numbers is obtained by the formula determining the proportion of two different test samples. Of the 16 variables found 6 significant variables.

It was found that the variable safety, housing availability, completeness, residential facilities, the completeness of facilities, supervising public health centers and District Health Office supervision relate significantly to the behavior of lived in the village midwife. Those factors have to get the optimal intervention to defend the existence of the village midwife."

"Akademi Kebidanan Depkes Karawang diresmikan oleh pemerintah melalui Keputusan Menteri Kesehatan Republik Indonesia Nomor : HK.00.06.1.3.2784, tanggal 9 Juni 1998 yang bertempat di SPK Depkes Karawang yang terletak di Jalan Kertabumi No. 74 Kabupaten DT.II Karawang, dimu[ai tahun ajaran 1998/1999. Dalam proses perencanaan dan penyelenggaraan program pendidikan D 111 Kebidanan Karawang ditemukan masalah penelitian yaitu belum adanya perencanaan strategik penyelenggaraan program pendidikan D III Kebidanan Karawang periode tahun 2000-2004. Adapun yang menjadi tujuan penelitian ini adalah dirumuskannya perencanaan strategik untuk penyelenggaraan program pendidikan D III Kebidanan Karawang tahun 2000-2004. Penelitian ini adalah penelitian operasional dengan analisis data kuantitatif dan analisis data kualitatif melalui metode wawancara mendalam. Proses penelitian meliputi pengumpulan data eksternal dan internal, pengolahan data, analisis data dan kemudian dilanjutkan dengan penetapan tujuan jangka panjang dan penetapan strategi. Data eksternal bersumber dari data sekunder dari berbagai instansi dan data primer bersumber dari hasil wawancara mendalam. Hasil penelitian menunjukkan faktor-faktor eksternal pads EFE matrix adalah 3,29 terletak pada posisi diatas rata-rata. Faktor-faktor internal dalam matrix 1EE adalah sebesar 3,54, termasuk niiai tinggi. Berdasarkan matrix IE AKBID Depkes Karawang terletak pada sel III, strategi yang dianjurkan pada organisasi yang terletak pads sel ini adalah Hold and Maintain dengan strategi market penetration dan product development, Dari hasil analisis SWOT didapat 4 strategi yang sesuai untuk dijalankan pada strategi market development dan 6 strategi yang sesuai untuk strategi product development. Dari perhitungan QSPM, didapat nilai TAS untuk market development 5,07 dan untuk product development 5,33, sehingga product development mendapat prioritas pertama. Berdasarkan perhitungan TAS, dari 6 strategi product development ditetapkan bahwa prioritas utama strategi product development adalah membuatlmemasukkan kursus "English Conversation" ke dalam kurikulum lokal. Saran yang dapat penuiis berikan mengacu pada konsep Hagel & Sanger, yaitu tingkatkan pemasaran, tingkatkan kemampuan organisaasi dan manajemen Akbid Berta tingkatkan infra struktur yang mendukung pendidikan.

---

Strategic Planning Academy Of Midwifery Karawang 2000 - 2004 YearsThe Academy of Midwifery Health Departemen Karawang legitimed by the goverment through decision Minister of Health Republic Indonesia No. HK. 0006132784 at june 9, 1998, located at Nursing School of Health Departement , Kertabumi 74 street Karawang. It has been start at 1998-1999 years period. In the process of planning and made D III Midwifery Education programe in Karawang, has a problem in research. The problem is No Strategic Planning for D [II of Midwifery Education program 2000-2004 years period. The Objective of this research is made a strategic planning for D III of midwifery Education program in Karawang 2000-2004 years. This Research is the operational research with the quantitative analysis date and qualitative analysis date though deep interview methode. The process of research consist of gathering external date and internal date, preparing date, analysis date, and follow with the objective long periode and made strategy. The resourch of external date is from secondary date at any institution and primary date from the deep interview. The product of research, showing external factor at the matrix EFE is 3,29 at the upper rate position. Internal factor at matrix IFE is 3.54, include high value. Based on matrixs IE the academy of midwifery Health Departement Karawang has a III Cell. The strategy for organization should be at this cell is hold and maintain with the market penetration and product development strategy. From the SWOT analysis, there is four strategy that appropriate from market development strategy and six strategy that appropriate for product development strategy. From the calculation QSPM which can get the value of TAS for market development 5,07 and for product development 5,33 so the product development has the first priority. Based on the calculation TAS from six product development strategy decision is made that the first priority of product development strategy is make English Conversation Course as local curriculum. Researcher give the suggestion based on the Hagel and Sanger concept is increase promotion, increase ability of organizing and management the academy of midwifery and increase the infra structure that support the education."

"ABSTRAKRumah Sakit Muhammadiya yang mempunyai unggulan dibidang kebidanan ingin tetap mempertahankan posisi tersebut dengan mengupayakan peningkatan pemasaran rawat inap kebidanannya yang ditinjau dari segi dokternya, karena hingga saatini dokter masih merupakan perantara pemasaran di rumah sakit.Untuk membatasi bervariasinya keinginan dari para dokter tersebut, maka penulis hanya melihat dari kebijakan manajemen terutama pada tarif, potongan jasa medis dan Cara pembayarannya. Dari kebijakan personil yaitu medic, paramedis dan petugas rumah sakit serta kebijakan fasilitas yaitu pada mutu dan kelengkapan peralatan poli dan VK, ruang praktek, ruang bersalin, kamar operasi, kamar perawatan, jarak dan kemudahan serta parkir.Sedangkan lingkup penelitian meliputi direktur Rumah Sakit Muhammadiyah, sebagai koordinator pemasaran di Rumah Sakit Muhammadiyah serta dokter-dokter kebidanan part timer, dokter kebidanan luar yang terdiri dari dokter-dokter tamu dan dokter kebidanan yang peraktek disekitar Rumah Sakit Muhammadiyah serta berpotensi untuk mengirimkan pasiennya ke Rumah Sakit Muhammadiyah.Metode penelitian yang dipakai adalah disain studi kasus dan datanya dianalisa dengan metode kwalitatif, dan Cara pengumpulan data dengan wawancara mendalam dan pengkajian dokumen.Hasil penelitian ini akan mendapatkan analisa kekuatan dan kelemahan dari Rumah Sakit Muhammadiyah, dokter kebidanan part timer, dokter luar serta kekuatan dan kelemahan secara keseluruhan terhadap variabel-variabel diatas.Sehingga akan didapatkan upaya-paya yang dapat dilakukan untuk meningkatkan pemasaran rawat inap kebidanan Rumah Sakit Muhammadiyah dalarn bentuk saran-saran untuk kebijakan dan saran-saran operasionalnya.

---

ABSTRACT

The Hospital of Muhammadiyah which has superiority in midwifery field continually wants to maintain that position by seeking improvement of its midwifery staying treatment, viewed from its obstetrician due to at the present doctors are still as marketing mediators in the Hospital.

To limit the varieties of willingness among those obstetricians, so that the - writer just views it from management policy chiefly on tariffs, reduction on medical service and its payment procedure. From personnel policy namely medics, paramedics and hospital attendants and also facility policy on quality and the completeness of policlinic instruments and VK and practice room, giving birth room, operation room, treatment room, space distance, simplification and parking lot.

Meanwhile, the scope of research covers director of the Hospital of Muhammadiyah and part timer obstetricians, outside obstetricians who practice in the Hospital of Muhammadiyah.

Method of research that is used is design of study case and its data are analyzed with qualitative method and method of collecting data by serious interview and analyzing documents.

Result of this research will aim at finding advantages and disadvantages of the Hospital of Muhammadiyah, part timer obstetricians, outside doctors and all strong points and weaknesses as a whole of the above mentioned variables.

So that at the end it will be found efforts that can be done in order to increase the marketing of midwifery staying treatment at the Hospital of Muhammadiyah in form of suggestions for marking policy and operational advice."

"Background: There are many challenges women face to be able to give birth in health facilities in many parts ofIndonesia. This study explores the roles and observations of close-to-community maternal health providers and othercommunity members on potential barriers faced by women to deliver in health facilities in two districts within TheArchipelago. Methods: Employing an explorative qualitative approach, 110 semi-structured interviews and 7 focusgroup discussions were conducted in 8 villages in Southwest Sumba, in the East Nusa Tenggara province, and in 8 villagesin Cianjur, in the West Java province. The participants included village midwives, Posyandu volunteer (village healthvolunteers), traditional birth attendants (TBAs), mothers, men, village heads and district health officials. Results: Themain findings were mostly similar in the two study areas. However, there were some key differences. Preference forTBA care, traditional beliefs, a lack of responsiveness of health providers to local traditions, distance, cost of travel andindirect costs of accompanying family members were all barriers to patients attending health facilities for the birth oftheir child. TBAs were the preferred health providers in most cases due to their close proximity at the time of childbirthand their adherence to traditional practices during pregnancy and delivery. Conclusions: Improving collaborationsbetween midwives and TBAs, and responsiveness to traditional practices within health facilities and effective healthpromotion campaigns about the benefits of giving birth in health facilities may increase the use of health facilities inboth study areas."

"There are many challenges women face to be able to give birth in health facilities in many parts ofIndonesia. This study explores the roles and observations of close-to-community maternal health providers and othercommunity members on potential barriers faced by women to deliver in health facilities in two districts within TheArchipelago. Methods: Employing an explorative qualitative approach, 110 semi-structured interviews and 7 focusgroup discussions were conducted in 8 villages in Southwest Sumba, in the East Nusa Tenggara province, and in 8 villagesin Cianjur, in the West Java province. The participants included village midwives, Posyandu volunteer (village healthvolunteers), traditional birth attendants (TBAs), mothers, men, village heads and district health officials. Results: Themain findings were mostly similar in the two study areas. However, there were some key differences. Preference forTBA care, traditional beliefs, a lack of responsiveness of health providers to local traditions, distance, cost of travel andindirect costs of accompanying family members were all barriers to patients attending health facilities for the birth oftheir child. TBAs were the preferred health providers in most cases due to their close proximity at the time of childbirthand their adherence to traditional practices during pregnancy and delivery. Conclusions: Improving collaborationsbetween midwives and TBAs, and responsiveness to traditional practices within health facilities and effective healthpromotion campaigns about the benefits of giving birth in health facilities may increase the use of health facilities inboth study areas."

"Dalam upaya meningkatkan kemampuan tenaga kesehatan yang handal dan profesional, maka keberadaan dosen yang profesional di institusi pendidikan sangatlah penting. Dosen mempunyai tugas dan tanggung jawab sangat besar dalam menentukan kualitas pendidikan. Oleh karena itu sudah selayaknya bagi institusi untuk memperhatikan kepuasan kerja dosen yang bekerja pada institusinya, karena kepuasan kerja seorang pegawai sering dianggap menggambarkan efektifitas organisasi dalam mencapai tujuan (Siagian, 1997).Setiap individu akan memiliki kepuasan yang berbeda-beda sesuai dengan kebutuhan yang ada pada dirinya, karena pada dasarnya kepuasan bersifat individual (Robbins,1998). Sebagai seorang individu yang unik, dosen mempunyai karakteristik yang berbeda antara yang satu dengan yang lain. Karakterisatik tersebut diantaranya: umur, jenis kelamin, pendidikan, masa kerja, pangkat/golongan, dan jumlah tanggungan.Kehadiran dosen dalam bekerja merupakan salah satu indikator kedisiplinannya dalam bekerja. Pegawai yang memiliki kepuasan kerja rendah, cenderung memiliki tingkat kehadiran rendah, demikian sebaliknya (Davis, 1996).Penelitian ini bertujuan untuk mendapatkan informasi mengenai gambaran karakteristik individu, kehadiran dan kepuasan kerja dosen, selain itu melihat hubungan antara karakteritik individu dengan kepuasan kerja, kehadiran dengan kepuasan, dan karakteristik individu dengan kehadiran. Penelitian ini dilaksanakan dengan menggunakan desain Cross Sectional. Lokasi penelitian di jurusan keperawatan dan kebidanan Poltekkes Bandung. Jumlah responden sebanyak 113 orang. Analisa data terdiri dari analisa univariat, bivariat dan multivariat.Hasil peneltian ini menunjukkan sebagian dosen berumur <40 tahun (53,1%), jenis kelamin paling banyak perempuan (60,2%), tingkat pendidikan paling banyak adalah D4/S1 (62%), masa kerja setengahnya (56,9%) <17 tahun, sebagian besar adalah pangkat/golongan III (80,5%), setengahnya (51,3%) mempunyai tanggungan <4 orang, separuh lagi jumlah tanggungan >4 orang. Kehadiran dosen dalam bekerja berada di bawah rata-rata kehadiran (III jam) atau memenuhi 86% dan jam seharusnya. Karakteristik dosen yang mempunyai hubungan bermakna dengan kepuasan kerja adalah variabel umur (p=0,006) dan jumlah tanggungan (p=-0,040). Variabel yang berhubungan dengan kehadiran yaitu umur (p=0,000), jenis kelamin (p=0,025) dan masa kerja (p-0,015), hubungan kehadiran dengan kepuasan bermakna (p=0,413). Hasil uji multivariat variabel yang paling dominan terhadap kepuasan kerja adalah umur dan jumlah tanggungan.Disarankan institusi keperawatan dan kebidanan untuk memberikan perhatian kepada dosen yang berumur <40 tahun guna mendapatkan kepuasan dalam bekerja, misalnya pemberian tugas dan tanggung jawab sesuai bidang keahliannya, diberikan kebebasan dalam mengembangkan diri sesuai kemampuan yang dimiliki. Dilakukan pengawasan jam kehadiran dosen setiap hari, perlu aturan untuk mernberikan sanksi bagi dosen yang tidak memenuhi jam kerjanya.Daftar Pustaka: 34 (1994-2002).

---

Relationship between Individual Characteristics and Attendance with Job Satisfactory of Lecturers in Nursery and Midwifery Department of Bandung Polytechnic of Midwifery in 2003In order to increase ability of health worker, and make them skillful and professional, it is very important the existence of professional lectures in educational institution. Lecturer has great responsibility on education quality. Because of it, it is worthwhile for institution to pay attention on job satisfactory of lecturer, because job satisfactory of a staff often considered as a description of organization effectiveness in achieving the goals (Siagian, 1997).

Every individual has different satisfaction level, as each one needs, because satisfactory is individually (Robbins, 1998). As a unique individual, lecturer has different characteristics such as; age, sex, education, working experience, rank, and number of burdens.

Lecturer's attendance in their jobs is one of indicators of working disciplinary. Employee who has low level in job satisfactory tend to have low in attendance, also in contrast (Davis,1996).

The objective of this study is to gain information about description of individual characteristics, attendance, and job satisfactory of lecturer, in addition to view relationship between individual characteristics with job satisfactory, attendance with satisfactory and individual characteristics with attendance. This study carried out in Nursery and Midwifery Department of Poltekkes Bandung and use cross-sectional design. Respondents are 113 lecturers. Data analysis use univariate, bivariate, and multivariate analysis.

Result of this study showed that some of lecturer with age ? 40 years old (53,1%), most of them are women (60,2%), most education level is D41SI (62%), half of them have ? 17 year work experience, most of them at rank III (80,5), half of them have burdens ? 4 people (51,3%). Lecture attendance below average attendance (111 jam) or conform 86% of their working hours, Lecturer's characteristics that have significant relationship to satisfactory are age (p=0,006) and number of burdens (p=0,040). Variable which related to attendance are age (p=0,000), sex (p=0,025), and working experience (p=0,015), relationship attendance with satisfactory is significant (p=0,x13). The result of multivariate analysis is the most dominant factors on job satisfactory are age and number of burdens.

It is recommended to midwifery and nursery institution to pay more attention to lecturer at age below 40 to satisfy their job, such as; giving their job assignment and responsibility as their specialties, give more flexibility to them to develop their self in their field. To conduct daily attendance monitoring of lecturer, and regulating sanction to those who has not fulfilled their working hours.

References: 34 (1994-2002)"

"Untuk mewujudkan tujuan pembangunan kesehatan diselenggarakan berbagai upaya kesehatan yang didukung oleh sumberdaya manusia kesehatan yang memadai. Salah satu sumber daya manusia yang berperan adalah tenaga bidan yang dapat menerapkan peran fungsinya di pelayanan kesehatan. Tujuan penelitian ini adalah diperolehnya informasi tentang mutu lulusan D III Kebidanan Cipto Mangunkusuko Poltekes Depkes Jakarta III Tahun 2004. Penelitian dilakukan di Prodi Kebidanan Cipto Mangunkusumo karena Prodi ini merupakan institusi yang pertama kali menyelenggarakan D III Kebidanan. Metode yang digunakan dengan pendekatan kualitatif dan data diperoleh dari hasil wawancara mendalam (indepth interview) serta Diskusi Kelompok Terarah. Dengan informan dalam penelitian ini sebanyak 24 orang yang terdiri dari 14 orang lulusan yang sudah bekerja, 5 orang lulusan yang tidak bekerja, 2 orang dari institusi pendidikan dan 2 orang dari provider.Dari hasil penelitian untuk komponen masukan didapatkan peserta didik sesuai ketentuan yang berlaku, SDM dari segi kuantitas dan kualitas dirasakan masih kurang, kurikulum sudah mengacu kepada kurikulum nasional, fasilitas sudah memadai, biaya sudah sesuai dengan ketentuan dan kebutuhan; dari komponen proses terlihat belum semua dosen membuat perencanaan pengajaran khususnya SAP, pelaksanaan pembelajaran sudah cukup baik, evaluasi yang dilaksanakan meliputi UTS, UAS dan UAP sesuai dengan ketentuan; komponen luaran didapatkan hampir seluruh lulusan terserap/bekerja, yang tidak bekerja karena melanjutkan pendidikan, dalam menjalankan tugas dan fungsinya terutama yang bekerja di puskesmas dan rumah bersalin swasta sedangkan yang di rumah sakit kurang kontribusinya.Kesimpulan yang dapat diambil: mutu lulusan DIII Kebidanan Cipto Mangunkusumo cukup baik, dimana banyak diserap di layanan kesehatan dan dapat menerapkan peran dan fungsinya secara maksimal khususnya di puskesmas dan rumah bersalin swasta. Untuk lebih meningkatkan mutu lulusan, maka perlu meningkatkan secara kualitas SDM (pengajar) baik institusi maupun Clinical instructure (CI) dengan mengikutkan pendidikan lebih tinggi dan menambah jumlah serta mengikutsertakan pelatihan.

---

In order to achieve health development objectives, a varied activities and efforts are conducted supported by adequate human resources in health sector. One of the important human resources in health is midwife who can apply her function in health appropriately. The objective of this study was to obtain information on quality of graduates from diploma on midwifery produced by Cipto Mangunkusumo Midwifery Study Program, Jakarta Health Polytechnics III year 2004. This study was conducted in Cipto Mangunkusumo Study Program since this institution was the first institution that provided midwifery diploma. Qualitative approach was employed and data were collected through in-depth interview and FGD with 24 informants consisted of 14 working graduates, 5 non-working graduates, 2 from the institution, and 2 from health provider.The study result on input show proper students in accordance to the rule, quantity and quality of human resources were felt as lacking, curricula was already referred to national curricula, facility was felt adequate, cost was in accordance to regulation and needs; result on process shows that not all of lecturers prepared teaching plan, particularly SAP, implementation of teaching was good, evaluation (mid-exam, final exam, and practical exam) was in accordance to the regulation; result on output shows that almost all graduates were absorbed in workplace, those who were not absorbed were continuing their study, regarding duty and function, the graduates who work in public health centers and private maternity clinics contributed better than those who worked in hospitals.The study concludes that quality of graduates were considerably good reflected by the high absorption in work place and could apply their role and function in an optimal way particularly among those who worked in public health centers and private maternity clinics. To improve more the graduates quality, there is a need to improve human resources quality (lecturers) both academic and clinical instructors by attending higher level of education and adding the number of lecturers as well as increasing attendance of training."