RESULTS AND DISCUSSION Data analysis technique The analytical method used in this study is

RELATIONSHIP BETWEEN INDEPENDENCE LEARNING AND THERAPEUTIC COMMUNICATION SKILL WITH CLINICAL COMPETENCE LEARNING IN PROGRAM STUDI DIII KEPERAWATAN STIKES KARYA HUSADA KEDIRI Sutiyah Heni, Ambar Mudigdo, Nunuk Suryani Diploma of Nursing STIKES Karya Husada Kediri Family Medicine Studies Program, Graduate School, Sebelas Maret University Email: sutiyah.henigmail.com ABSTRACT Based on the Indonesia Law Number 23 in 1992 about Health. It is decided that Health Program means to develop the Healthy Life Ability for everyone in order to reach The Optimal Health Phase. One of effort in Health Implementation is Family Health Effort. That is Nurse. Nurse‟s Graduation Quality is influenced by The Result of competition when they do their education. The Objective of Observation is to analyze the correlation between Independence Learning and Therapeutic Communication Skill with Clinical Competence Learning in Program Studi DIII Keperawatan STIKES Karya Husada. The Design of Observation is Cross Sectional. The Source of Observation is the students of Nursing Academy Diploma III of Third Semester. The Sample of Observation is 50 Students on Census .The Data take in closed questionnaire and Analyzed by The Type of Double Linier Regression. The Result of Observation shows that it has any significant correlation between Independence Learning and Competence r=0,068, p= 0,545, p0,05 and between Therapeutic Communication Skill and Clinical Competence Learning r=0,139,p=0,010,p0,05 and F=11,088, p=0,000,R=0,566,Adj R=0,292 . The Independence Learning and High Therapeutic Communication Skill with Clinical Competence Learning can make The Optimal Competence. It is important to inform to all Clinic Lecturer and Others Lecturer. They must develop Clinic Quality Learning in Practicing during training and create The Independence Learning and High Therapeutic Communication Skill with Clinical Competence Learning. We hope that all students can get optimal competence. They become professional Nurse in the future and can develop The Indonesia Health Program Key Word : Independence Learning, Therapeutic Communication Skill, Clinical Competence Learning 965 INTRODUCTION Health development is essentially directed towards the achievement of awareness, willingness and ability to live a healthy life for everyone, involving physical, mental, and social, cultural and economic. To achieve optimal health degree carried out various efforts to comprehensive health services, directed and continuous. Kepmenkes, 2007 Communication skills are the driving force and steering actions learned. Driving in the sense enabler that allows the act of learning is executed. Steering in the sense of giving guidance to the act of learning towards the goals set. The purpose of learning the mastery of new competencies to deal mater. Teratasinya problems mean inevitability of learners from undesirable circumstances Mudjiman, 2008 The nurse is a person who has completed a primary education and care is vested with the government as well qualified to provide quality nursing care and full responsibility Poniman in diknakes bina magazine, 1999 Nursing Diploma III study program STIKES Karya Husada Kediri as one of the universities in the health sector have a vision of creating a professional nurse and master of science and technology, is also cautious against God Almighty. Based on preliminary studies conducted by researchers in the 20122013 academic year clinical study data obtained that as much as 20 of students do not complete the clinical study reports appropriate predetermined time, nearly 20 of students have the competence index in According Muhaibin shah 2005: 92, Learning is a phase change in the behavior of individuals all over the relatively settled as a result of experience and interactive with the environment that involve cognitive processes. Meanwhile, according to Oemar Hamalik 2003: 21 says, Learning is a form of growth or change in a person who is expressed in the ways of behavior thanks to the experience and training. In the study there is a change in habits, abilities skills or get this aspect of knowledge cognitive, attitudes affektif and skills psychomotor obtained as a deliberate and not due to the physiological process of growth or maturity. According to Rousseau, as quoted Sukmadinata 2003: 168 states that, the child has a potential that is still hidden, through a childs learning should be given a chance to develop or actualize these potentials. Children have the power to seek its own, try, discover and develop themselves. According Sukmadinata 2003: 165-166, some of the principles of learning as follows: Learning is part of the development, lifelong learning, learning takes place in every place and time, learning can take place either with the teacher and without a teacher, learning due to the demands of motivation According to Umar Tirtadiharja and La Sulo 2005: 50 the concept of independence in learning rests on the principle that individuals who learn only be until the acquisition of learning outcomes ranging skills, development of reasoning, the formation of attitudes to the clinical learning under graduation self-discovery when he experienced standards, and as much as 15 of the students at the end of the learning process has not yet reached the target attainment of physical examination of the patient. Primary Data STIKES Karya Husada, 2013 Independence is indispensable man, the lack of independence would arise confidence, its own capabilities, the ability to control themselves, so satisfied with what is done or made. 966 himself in the process of obtaining results The study According Mudjiman 2011 indicator independent learning are: 1 Continuous persistance Learning activities undertaken an activity that lasts longer, continuous, not serning stop 2 Consistent Consistence Activities steady, disciplined, not lazing 3 Systematic Systemic Activities always planned as oriented to the mastery of competencies 4 Focus Goal orientedness Learning activities focus, with continuing evaluation to measure the achievement of objectives 5 Innovative Innovative Always trying to find a way out when faced with problems, including a new exit that had not been done 6 Follow-up clear Follow-up clarity Follow-up of activities are always clear. This related to the consistence above characteristics. 7 Learning throughout life Learning for Life Learning activities carried out at any time of life, to survive or develop life. Communication is a reciprocal process and an experience in which the sender and the recipient participate simultaneously Lu Verne Wolff, Marlene HW, Elinor VF, 1984. Communication can be defined as between a personal process in sending and receiving the symbols that are meaningful to their interests John R.Schemerhom, in AWWijaya, 2000 interaction phase, orientation phase, working phase and termination phase. In order for therapeutic communication between the nurse and the client can run as expected, a strategy is needed to be done by nurses at the time of therapeutic communication with clients. According to As Homby 1974, quoted by Nurjannah, I 2001 says that the therapeutic is an adjective that relates to the art of healing. This illustrates that in undergoing the process of therapeutic communication, a nurse doing activities ranging from assessments, in accordance with the nursing actions that have been planned until the evaluation of all that can be achieved with a maximum in the event of an effective communication process and intensive. Roger Carl concept developed by Mundakir 2006 identifies three basic factors indicators in therapeutic communication to develop a relationship of mutual help helping relationship, namely sincerity genuineness, empathy empathy, and warmth warmth The structure of the therapeutic communication, according Stuart.GW Duldt-Bettey quoted Suryani 2006 1998, consists of four phases, namely: defines communication as a process of adjustment and adaptation of the dynamic between two people or more in a face to face interaction and an exchange of ideas, meanings, feelings, and concerns. Communication skills is a critical skill that must be possessed by impersonating a nurse and an integral part of nursing care. Communication in nursing called therapeutic communication, which is a communication made by a nurse at the time of nursing interventions so as to provide therapeutic efficacy for the healing process of patients. Therapeutic communication is a structured communication which consists of four stages: pre-interaction phase, orientation phase, working phase and termination phase. Therapeutic communication that occurs between the nurse and the client must go through four stages of the pre- 967 1. Phase Preinteraksi This phase is a preparatory period before the start of dealing with clients . Duties of nurses in this phase are: a. Explore the feelings , hopes and anxieties b . Analyzing strengths and weaknesses , with a self-analysis he will be trained to maximize the therapeutic him so valuable to the client , if you feel ready then need to relearn , discussion groups of friends . c . Collect data on the client , as the basis for a plan of interaction d . Make a plan in writing meetings , which will be implemented when meeting with clients 2. Phase Introduction orientation This phase begins when the first met with the client . The main tasks of nurses at this stage is to provide environmentally sensitive situation and indicate acceptance , as well as assist clients in expressing feelings and thoughts . The tasks of nurses at this stage , among others : a. Build a trusting relationship, indicate acceptance and open communication. b. Formulate contact with the client. The contract, which must be agreed with the client, namely: place, time, topic of the meeting. c. Digging feelings and thoughts as well as to identify the clients problem. To encourage clients to express their feelings, the technique used is an open question d. Formulate goals with the client. Objectives formulated after the clients problem is identified. Things to note in this phase include: For through this phase successfully and valuable therapeutic, nurses use the concept of loss. Termination is the end of the meeting of nurses, which is divided into two, namely: 1. Termination Meanwhile, there is still further meeting 2. Termination end, occurs when nurses have the nursing process as a whole. Duties of nurses in this phase, namely: a. Evaluating the achievement of the goals of interaction that has been done, this evaluation is called an objective evaluation. b. Perform subjective evaluation, carried out by asking the clients feelings after interacting after performing certain actions a. Greets therapeutic accompanied reached c. Agree on the follow-up of the handshake b. Introduce yourself nurses c. Agreeing contracts. The agreement relates to the willingness of clients to communicate, topic, place and duration of meetings d. Completing the contract. At the first meeting of nurses need to complete explanation of the identity and purpose of the interaction so that the client believes to nurses. e. Evaluation and validation. Assessment contains the main complaint, the reason or event that makes the client to ask for help. f. Agree on the issue. By focusing techniques nurse with the client to identify the problems and needs of the client. 3. Work Phase This stage is the core of the whole process of therapeutic communication. The nurse and the client explore the stressor and encourage the development of self- awareness by linking perceptions, feelings and behavior of the client. 4. Phase Termination This phase is a phase that is difficult and important, because a relationship of trust already established and at the optimum level. The nurse and the client jointly review the nursing process that has been passed and the achievement of objectives 968 interactions that have been made. Follow- up given should be relevant to the new interaction performed or to be performed at the next meeting. d. Making a contract for the next meeting, a contract needs to be agreed is the topic, time and place of the meeting. Competence is a set of intelligent action full responsibility of a person as a condition to be considered capable by the public in carrying out tasks in certain occupations Kepmendiknas 045 U 2002 Reilly and Oermqnn in Pusdiknakes 2007 states that the learning experience clinical hospital, community and health care units etc. is an important part of the health education program, because it provides a rich experience for learners in applying the knowledge gained into the real situation , The research objective is to analyze the relationships between independent learning and therapeutic communication skills with competency in clinical learning in Nursing Diploma Program STIKES Karya Husada Kediri The hypothesis in this study There is a relationship between learning independence with competence in clinical learning in the Diploma Program Nursing STIKES Karya Husada Kediri. There is a