Tesis

Evaluasi Hasil Pelatihan Dengan Model Blended Distance Training (BDT) IVA DoIVA TeleDoIVA sebagai Metode Skrining Kanker Serviks pada Dokter Umum dan Bidan = Evaluation of Training Outcomes Using the Blended Distance Training (BDT) Model for VIA–DoVIA–TeleDoVIA as a Cervical Cancer Screening Method Among General Practitioners and Midwives.

Latar belakang: Kanker serviks masih menjadi salah satu penyebab utama morbiditas dan mortalitas pada perempuan, terutama di negara berkembang termasuk Indonesia. Metode skrining Inspeksi Visual dengan Asam Asetat (IVA) merupakan pendekatan yang mampu laksana secara luas, namun memiliki keterbatasan berupa subjektivitas dan variasi interpretasi antar pemeriksa. Pengembangan Dokumentasi IVA (DoIVA) dan Telemedisin DoIVA (TeleDoIVA) diharapkan dapat meningkatkan kualitas interpretasi IVA melalui dokumentasi visual dan konsultasi jarak jauh. Untuk mendukung implementasi metode ini, diperlukan pelatihan yang efektif dan berkelanjutan bagi dokter umum dan bidan. Model Blended Distance Training (BDT) memungkinkan SpOG melatih dan mensupervisi tenaga layanan primer, memperkuat kapasitas skrining sesuai kebijakan co-testing nasional (HPV DNA dan VIA) serta mendukung praktik terstandar. Tujuan: Penelitian ini bertujuan untuk mengevaluasi hasil pelatihan dengan model Blended Distance Training (BDT) IVA–DoIVA–TeleDoIVA sebagai metode skrining kanker serviks pada dokter umum dan bidan. Metode: Penelitian ini menggunakan desain studi evaluatif dengan pendekatan pre-test dan posttest. Subjek penelitian adalah dokter umum dan bidan yang mengikuti pelatihan BDT IVA– DoIVA–TeleDoIVA. Evaluasi meliputi peningkatan pengetahuan sebelum dan sesudah pelatihan, kemampuan pembuatan dokumentasi DoIVA, ketepatan interpretasi hasil IVA dibandingkan konsultan peneliti, waktu respons konsultasi melalui TeleDoIVA, serta tingkat kepuasan peserta terhadap sistem TeleDoIVA. Analisis data dilakukan secara deskriptif dan analitik sesuai dengan jenis variabel yang diteliti. Hasil: Hasil penelitian menunjukkan adanya peningkatan bermakna pengetahuan peserta setelah mengikuti pelatihan BDT. Mayoritas peserta mampu menghasilkan dokumentasi DoIVA dengan kualitas baik dan cukup. Ketepatan interpretasi hasil IVA oleh dokter umum dan bidan menunjukkan kesesuaian yang baik dengan interpretasi konsultan peneliti. Waktu respons TeleDoIVA tergolong cepat dan memenuhi kebutuhan pelayanan klinis. Tingkat kepuasan peserta terhadap pelaksanaan TeleDoIVA berada pada kategori tinggi. Kesimpulan: Pelatihan dengan model Blended Distance Training IVA–DoIVA–TeleDoIVA terbukti efektif dalam meningkatkan pengetahuan, keterampilan dokumentasi, dan ketepatan interpretasi IVA pada dokter umum dan bidan. Implementasi DoIVA dan TeleDoIVA berpotensi menjadi strategi yang berkelanjutan untuk meningkatkan kualitas dan cakupan skrining kanker serviks di Indonesia, khususnya di daerah dengan keterbatasan sumber daya.
Kata kunci: Kanker serviks, skrining, IVA, DoIVA, TeleDoIVA, Blended Distance Training


Background: Cervical cancer remains a major cause of morbidity and mortality among women, particularly in developing countries including Indonesia. Visual Inspection with Acetic Acid (VIA) is a widely implemented and feasible cervical cancer screening method; however, it is limited by subjectivity and inter-observer variability in interpretation. The development of VIA Documentation (DoVIA) and Telemedicine-based DoVIA (TeleDoVIA) is expected to improve diagnostic accuracy through visual documentation and remote expert consultation. Effective and sustainable training is essential to support the implementation of these methods among general practitioners and midwives. Blended Distance Training (BDT) model is particularly relevant which enables obstetrician–gynecologists to train and supervise primary care providers, strengthening frontline screening capacity in line with Indonesia’s national co-testing (HPV DNA and VIA) and promoting standardized practice. Objective: This study aimed to evaluate the outcomes of a Blended Distance Training (BDT) program on VIA–DoVIA–TeleDoVIA as a cervical cancer screening method for general practitioners and midwives. Methods: This study employed an evaluative design using a pre-test and post-test approach. The study participants were general practitioners and midwives who attended the BDT VIA–DoVIA– TeleDoVIA training program. Evaluations included changes in knowledge before and after training, participants’ ability to produce DoVIA documentation, accuracy of VIA interpretation compared with expert consultants, response time of TeleDoVIA consultations, and participants’ satisfaction with the TeleDoVIA system. Data were analyzed descriptively and analytically according to the characteristics of the variables. Results: The results demonstrated a significant improvement in participants’ knowledge following the BDT program. Most participants were able to produce DoVIA images of good to adequate quality. The accuracy of VIA interpretation by general practitioners and midwives showed good concordance with expert consultants. TeleDoVIA response times were rapid and clinically acceptable. Overall participant satisfaction with the TeleDoVIA platform was high. Conclusion: The Blended Distance Training model for VIA–DoVIA–TeleDoVIA is effective in improving knowledge, documentation skills, and interpretation accuracy among general practitioners and midwives. The implementation of DoVIA and TeleDoVIA has strong potential as a sustainable strategy to enhance the quality and coverage of cervical cancer screening in Indonesia, particularly in resource-limited settings.
Keywords: Cervical cancer, screening, VIA, DoVIA, TeleDoVIA, Blended Distance Training