FACTORS THAT AFFECTING STUDENT'S LEARNING READINESS IN CLINICAL PRACTICE

Quality education process will support the implementation of quality health services, anesthesia nursing education is education in which clinical learning is one of the learning processes. Student readiness is needed to undergo clinical practice so that competence can be achieved. Student readiness is influenced by several factors that can affect the clinical learning process. The general objective of this study was to identify emotional, psychological and knowledge factors related to the clinical practice readiness of anesthesiology nursing students at UNISA Yogyakarta. This research is a descriptive analytic study that will be conducted at the University of 'Aisyiyah Yogyakarta. The sample technique is purposive sampling technique during August 2020 - October 2020. The analysis test that will be used is Kruskal-Wallis Test. The results showed that emotional factors (P = 0.011), psychological factors (P = 0.03) and knowledge (P = 0.04) were factors that influenced students' clinical practice readiness. The conclusion this research is the factors that influence the readiness of students' clinical practice are emotional factors, psychological factors and knowledge factors.


Introduction
Quality health education will support the delivery of quality health services. Anesthetist administrators are one of the health professionals required for the management of patients in operating rooms. As a profession, anesthetist is required to have intellectual, interpersonal, and technical abilities. Competence and ability as an anesthetic administrator requires a learning process both in educational institutions and clinical learning in hospitals (Kruglansk, 2014).
Clinical environment can exacerbate stress for students, they will be nervous when they are unable to answer questions, they may accidentally hurt patients and are unable to work quickly and efficiently. Anxiety is also often experienced by practical students who have never previously been exposed to the hospital environment (Nelwati et al, 2013).
Anesthetic nursing students must be prepared to enter the practice environment and be prepared to care for patients (Casey et al., 2011). Anesthesia nursing education is an applied undergraduate education where graduates are expected to have skills in patient management practices. Education includes education that is professional academic in nature, namely education that has sufficient academic and professional foundation. The attitudes and professional abilities of graduates are cultivated and nurtured throughout the educational process through various forms of learning experiences, including through practical learning experiences (Kruglansk, 2014).
Readiness and motivation of students in facing clinical practice was in the poor category so that intervention needed, one of which was using the OSCE method to increase student motivation and readiness (Zulfikar, 2017).
The factors that influence students' readiness to learn in clinical practice must be identified in order to prepare students to practice clinical practice well. The readiness of good clinical practice will affect the learning process of students which will affect the achievement of predetermined competencies.

Method
This research was conducted at 'Aisyiyah University Yogyakarta and students of the nursing anesthesiology study program became research respondents. The number of respondents in the study was 99 respondents with the sampling technique using purposive sample.
The inclusion criteria for this research sample are students in semester 3 and 5 who will undergo clinical practice learning at the hospital and are willing to become respondents. This study uses two research instruments according to the variables contained in this study. The instruments used in this research are emotional factors, psychological and knowledge factors and student learning readiness instruments taken from the instruments used for research by Zulfikar in 2017 which were used to measure students' readiness to face clinical practice in nursing students STIKES Kepanjen. . This instrument has been tested for its validity and reliability before and has been declared valid and reliable. The data collection method in this research is to use google form. . Before starting the research, make a google form which includes an explanation of the research objectives and informed consent. If students are willing to be involved in this research, students are asked to fill in the informed consent points and fill out a questionnaire that has been distributed by google form. Researchers will use the kruskal Whalis data analysis, which previously conducted a normality test with Kolmogorov Smirnov with the results of the data not being normally distributed. .

Results and Discussion
The results of the analysis of the characteristics of the respondents included age, gender, and semester  Table 1 shows that the age of the most respondents is 18 years and the distribution of sexes is mostly female, the majority of respondents are third semester students.
Most of the respondents in this study were 18 years old so that it could affect students' learning readiness in following clinical practice. This is in line with the principles of readiness, which includes physical and spiritual maturity. One of the principles of readiness is physical and spiritual maturity, in this case the respondent's age is a young adult who is considered an individual who has physical maturity (Slameto, 2013).
Experience is also one of the elements that makes students ready to undergo clinical practice.
The experiences gained also have an effect on students' readiness to study, in this study the fifth semester students have had previous experiences that have been obtained, namely the experience of following clinical practice in the previous semester, but for third semester students do not have experience following previous clinical practice. so that this can affect the readiness of students. The readiness of student clinical practice can be seen in the table 2. Table 2 shows that the level of readiness of students in following clinical practice is mostly good, namely 57.5%. The readiness of students to take part in clinical practice is one of the students' readiness to learn when participating in a series of learning processes. The data in the study showed that the readiness of students in following clinical practice was at a high level of 57.5%. Readiness is a person's overall condition that makes him ready to respond in a certain way to a situation. In this study, students' learning readiness was specifically related to the readiness of students in participating in clinical practice learning at the hospital. Learning readiness is a self-condition that has been prepared for clinical practice learning. Learning readiness is influenced by several factors that influence it, physical and psychological factors are factors that affect learning readiness (Dlamini, 2014).
Students' learning readiness is influenced by several factors, including physical readiness, psychological readiness and material readiness (Djamarah, 2017). Physical readiness means that students have the ability physically to take part in clinical learning. Physical readiness includes a body that is healthy, has no health problems, and a lethargic body condition.
Students' physical preparation is needed to be able to participate in learning in the hospital properly. During the current COVID 19 pandemic, students are required to have immunity and good health to be able to follow clinical practices that will be undertaken.
Psychic readiness is also an indicator of student readiness to follow clinical practice. Psychological readiness means that students have the psychological ability to receive learning in clinical practice. This psychological readiness includes the desire to learn, to be able to concentrate and awareness in learning as well as the motivation of students in participating in the learning process in the hospital.
Copyright ©2021, Jurnal Keperawatan Respati Yogyakarta, p-ISSN: 2088-8872; e-ISSN: 2541-2728 Material readiness is an indicator of readiness in undergoing clinical practice. Material readiness is readiness where students have material abilities in learning. Material readiness includes material to be studied or guidance in the implementation of clinical practice. It is hoped that the readiness of students when participating in clinical practice can increase the understanding and competence that should be obtained when participating in the learning process at the hospital.The factors that influence the readiness of clinical practice can be seen in the table 3. Table 3 shows students who have good emotional factors have high learning readiness with a percentage of 40.3%, respondents who have sufficient psychological factors have high learning readiness with a percentage of 35.4%, and students with sufficient knowledge factors have a sufficient readiness percentage with a percentage of 28.3%. Moderate 6 (6,1) 28 (28,3) 14 (14,1) Low 2 (2,0) 6 (6,1) 1 (1,0) Based on the results of statistical tests, it was found that the emotional factor (X1) had PX1 = 0.011, the psychological factor (X2) had a significance PX2 = 0.03 and the knowledge factor (X3) had a significance P = 0.04. From these results it is known that psychological, emotional and knowledge factors have a significant influence on students' readiness to undergo clinical practice.

a. Emotional Factors
According to the results of the study, it was found that emotional factors had a significant influence on students' learning readiness in following clinical practice. The ability to manage emotions shows that students are ready to take part in the learning process at the hospital. The ability to manage emotions indicates that students are physically and psychologically ready to accept a series of learning processes at the hospital.
Enthusiasm and perseverance as well as motivation to learn are important factors that encourage a person to achieve learning readiness.
Emotional intelligence has an important role to play in the learning process in the hospital. There are five emotional components, namely being able to recognize one's own feelings, being able to manage feelings, being able to empathize with others, being able to establish social relationships with others. This emotional condition has a relationship with motives (intensive, value, reward) and has an influence on student learning readiness. This is an effect of emotional intelligence on student learning readiness (Fatmawati, 2015).
Emotion affects the quantity and quality of learning. Positive emotions help the learning process run smoothly so that it achieves better results, while negative emotions can inhibit and even stop learning (Khodijah, 2014). The existence of the ability to regulate emotions in oneself and others significantly affects to avoid feelings of frustration. Students who are able to manage emotions will be able to keep themselves trying to achieve the planned learning goals. In addition, emotional intelligence will provide an adaptive mechanism for students to be able to handle stressful clinical practice learning (Indah, 2020). This will help students to have stable emotions, which helps reduce the negative impact of negative emotions on cognitive function during the learning process.
There is a significant relationship between emotional intelligence and study readiness of medical students (Indah, 2020). Emotional intelligence is a person's ability to assess, express themselves, and regulate emotions to solve a problem. Emotional intelligence, which includes the ability to manage emotions, affects the learning process and will ultimately affect student achievement and competency attainment in the practical field.

b. Psychological Factors
According to the results of the study, it was found that psychological factors have a significant relationship to student learning readiness. Psychological factors include the desire to learn, interests, talents and motivation and awareness in following the learning process. Student motivation to learn is one of the psychological factors that can influence students' learning readiness in following clinical practice.
This psychological factor is an internal factor within students that can influence the learning process when attending clinical practice. One of the psychological factors is motivation which will encourage students to follow clinical practice well. Students who have high motivation tend to be able to follow the learning process well (Dale, et al, 2013).
The psychological state of students can influence the thinking process of students during the learning process in the practical field. The Copyright ©2021, Jurnal Keperawatan Respati Yogyakarta, p-ISSN: 2088-8872; e-ISSN: 2541-2728 encouragement of individuals or students to take part in the clinical practice learning process is one of the important components in the success of clinical practice and competency achievement.
Motivation is a psychological factor that influences the readiness of students to practice clinical practice. Students who have high motivation and interest in following a series of learning processes can carry out their duties and roles as students during clinical practice. Student motivation is an important part of a learning process. Intrinsic motivation or from within students must be improved so that the learning process can achieve its goals (Bolkan, 2015).

c. The knowledge factor
Knowledge is the result of "knowing" and occurs after a person senses a certain object (Notoatmodjo, 2010). The results showed that the knowledge factor had a significant relationship to the readiness of students in following clinical practices. Good student knowledge tends to be influenced by the existence of a lot of information about learning and is obtained from the student's process when getting material in lectures. Knowledge is also obtained by students from independent learning or seeking additional information related to learning materials.
Students' knowledge of learning materials is also influenced by exposure to information and reference sources from books, journals and scientific articles. These media and learning resources can be a source of reference to increase students' knowledge of learning materials in preparation for clinical practice.
Someone who has more information will have broader knowledge. Information obtained from various sources can increase a person's knowledge (Dale et al, 2013).
The clinical practice that students will participate in has requirements, among others, that students are considered capable of attending clinical practice by completing courses that are prerequisite for following clinical practice, so that in this study it is possible for students to think that they already have sufficient knowledge and are worthy to follow clinical practice. .
Students who have good knowledge are expected to have the ability or skills of students to care for patients. Students are said to be ready to practice if students have basic knowledge and specific practical skills, provide safe patient care, prepare for current and future possible realities, and have a balance between skills, knowledge and critical thinking (Wolff et al, 2010).

Conclusions and suggestions
The conclusion in this study is that psychological factors, emotional factors and knowledge factors affect the readiness of students in undergoing clinical practice learning at the hospital. It is hoped that educational institutions and hospitals will collaborate to provide provision and preparation so that students are ready and able to undergo learning in the hospital well.