MAJELIS PENDIDIKAN TINGGI PENELITIAN DAN PENGEMBANGAN

PIMPINAN PUSAT MUHAMMADIYAH PALEMBANG

COUNCIL OF HIGHER EDUCATION, RESEARCH, AND DEVELOPMENT
CENTRAL BOARD OF MUHAMMADIYAH

SEKOLAH TINGGI ILMU KESEHATAN

MUHAMMADIYAH PALEMBANG
SCHOOL OF HEALTH SCIENCES OF MUHAMMADIYAH PALEMBANG

SURAT KEPUTUSAN PENDIRIAN NOMOR : 214/D/0/2006

DECREE OF UNIVERSITY ESTABLISHMENT NUMBER : 214/D/0/2006

TERAKREDITASI B SK NO: 332/SK/BAN-PT/Akred/PT/VIlI/2014

DECREE OF ACCREDITATION NUMBER : 332/SK/BAN-PT/Akred/PT/VIII/2014

ACCREDITED B
PROGRAM DIII FISIOTERAPI
DIPLOMA DEGREE OF PHYSIOTHERAPY

SURAT KETERANGAN PENDAMPING IJAZAH

DIPLOMA SUPPLEMENT

NOMOR/NUMBER: /03/16/SKPI/2019

Surat Keterangan Pendamping Ijazah (SKPI) ini mengacu pada Kerangka Kualifikasi Nasional Indonesia (KKNI) dan Konvensi UNESCO tentang
pengakuan studi, ijazah dan gelar pendidikan tinggi. Tujuan penerbitan SKPI ini adalah menjadi dokumen yang menyatakan kemampuan kerja,
penguasaan pengetahuan, dan sikap/moral pemegangnya.

This Diploma Supplement refers to the Indonesian Qualification Framework and UNESCOConvention on the Recognition of Studies, Diplomas and
Degrees in Higher Education. Thepurpose of the supplement is to provide a description of the nature, level, context and status ofthe studies that were
pursued and successfully completed by the individual named on the originalqualification to which this supplement is appended.

1. IDENTITAS DIRI
PERSONAL INFORMATION

1.1 Nama Lengkap

Sulfi Sulastri
Full Name

1.2 Tempat & Tanggal Lahir Kamal, 07 Juli 1998

Place and Date of Birth Kamal, july 07 1998

1.3 Nomor Induk Mahasiswa

30016067
Student Identification Number

1.4 Tahun Masuk

2016
Admission Year
1.5 Tanggal Kelulusan 19 Juli 2019
Date of Graduation July 19, 2019

1.6 Nomor Ijazah

058/03/16/ISM/2019
Number of Certificate

1.7 Gelar Ahli Madya Fisioterapi (A.Md. FT)

Title Associate Degree of Physiotherapy

1.8 Lama Studi 3 Tahun

Regular Length of Study 3 Years

1.9. Sistem Kredit Semester 114 SKS

Credits 114 Credits

1.10 Indeks Prestasi Kumulatif

3,34
Grade Point Average
2. IDENTITAS PROGRAM STUDI
IDENTITY OF STUDY PROGRAM

2.1 Program Studi Major

Fisioterapi Physiotherapy
Kelas : Reguler Class : Regular
Program : DIII Fisioterapi Program : Diploma of Physiotherapy

2.2 Jenis&Jenjang Pendidikan Type & Level of Education

Vokasi& Diploma 3 Vocational& Diploma Degree

2.3 Jenjang Kualifikasi Sesuai KKNI Level of Qualification in the National Qualification Framework
Level 5 Level 5

2.4 Persyaratan Penerimaan Entry Requirements

Lulus SLTA/Sederajat & Lulus Seleksi Mahasiswa Baru Graduate from High School or Similar Level of Education& Passed the
Student Admission Selection

2.5 Bahasa Pengantar Kuliah Instruction Languages

Bahasa Indonesia Indonesian Language

2.6 Gradasi Penilaian Grading System

Skala: 1- 4; A=4, B=3, C=2, D=1 Scale: 1- 4; A=4, B=3, C=2, D=1

2.7 Lama Studi Reguler Reguler Length of Study

6 Semester 6 Semesters

2.8 Pendidikan Lanjut Further Study

Sarjana Fisioterapi / Kesehatan Bachelor Degree of Physiotherapy / Health Science

2.9 Status Profesi (Bila Ada) Professional Status (If Applicable)

- -

3. KUALIFIKASI DAN HASIL YANG DICAPAI

3.THE QUALIFICATION AND OUTCOMES OBTAINED

A. CAPAIAN PEMBELAJARAN A. LEARNING OUTCOMES

(KKNI Level 5) (KKNI Level 5)

SIKAP ATTITUDES
1 Bertakwa kepada Tuhan Yang Maha Esa dan mampu Being faithful to God Almighty and be able to show religious attitudes;
menunjukkan sikap religius;
2 Menjunjung tinggi nilai kemanusiaan dalam menjalankan tugas Upholding humanity values while performing duties based on religious,
berdasarkan agama,moral, dan etika; moral and ethical values
3 Berkontribusi dalam peningkatan mutu kehidupan bermasyarakat, Contributing in improving the quality of life in the community, nation, state
berbangsa, bernegara, dan kemajuan peradaban berdasarkan and progress of civilization based on Pancasila;
pancasila;
4 Berperan sebagai warga negara yang bangga dan cinta tanah air, Taking part as a citizen who is proud and loves the country, has
memiliki nasionalisme serta rasa tanggungjawab pada negara dan nationalism and a sense of responsibility in the country and nation;
bangsa;
5 Menghargai keanekaragaman budaya, pandangan, agama, dan Appreciating diversity of cultures, views, religions, and beliefs, as well as
kepercayaan, serta pendapat atau temuan orisinal orang lain; the opinions or original findings of others;
6 Bekerja sama dan memiliki kepekaan sosial serta kepedulian Demonstrating collaboration and have social sensitivity and concern for
terhadap masyarakat dan lingkungan secara profesional dan society and the environment in a professional and Islamic manner;
islami;
7 Taat hukum dan disiplin dalam kehidupan bermasyarakat dan Being lawful and discipline in the life of society and the state in a
bernegara secara profesional dan islami; professional and Islamic manner;
8 Menginternalisasi nilai, norma, dan etika akademik; Internalizing academic values, norms and ethics;
9 Menunjukkan sikap bertanggungjawab atas pekerjaan di bidang Demonstrating an attitude of responsibility for work in his area of
keahliannya secara mandiri; expertise independently;
10 Menginternalisasi semangat kemandirian, kejuangan, dan Internalizing the spirit of independence, struggle and entrepreneurship;
kewirausahaan;
11 Mampu bersikap etis dan peka budaya dalam memberikan Being able to behave ethically and be culturally sensitive in providing
pelayanan fisioterapi physiotherapy services;
12 Memiliki sikap menghormati hak privasi, nilai budaya yang dianut Having the attitude of respecting the right to privacy, the cultural values
dan martabat klien, menghormati hak klien untuk memilih dan adhered to and the dignity of the client, respecting the right of the client to
menentukan sendiri pelayanan kesehatan khususnya pelayanan choose and determine his own health services, especially the
fisioterapi yang diberikan, serta bertanggung jawab atas physiotherapy services provided, and being responsible for the
kerahasiaan dan keamanan informasi tertulis, verbal dan confidentiality and security of written, verbal and electronic information
elektronik yang diperoleh dalam kapasitas sesuai dengan lingkup obtained in the capacity in accordance with the scope his responsibility;
tanggung jawabnya;
13 Mampu mengintegrasikan dan mengaplikasikan nilai-nilai Al Islam Being able to integrate and apply the values of Al Islam
Kemuhammadiyahan (Penciri Prodi DIII Fisioterapi STIKes-MP). Kemuhammadiyahan

KETERAMPILAN UMUM GENERAL COMPETENCE

1 Mampu menyelesaikan pekerjaan berlingkup luas dan Able to complete extensive work and analyze data with various methods
menganalisis data dengan beragam metode yang sesuai, baik that are appropriate, both those that have not been and those that are
yang belum maupun yang sudah baku; already standard;
2 Mampu menunjukkan kinerja bermutu dan kuantitas yang terukur; Able to show quality performance and measurable quantity;
3 Mampu memecahkan masalah pekerjaan dengan sifat dan Able to solve work problems with the nature and context in accordance
konteks yang sesuai dengan bidang keahlian terapannya with the applied field of expertise based on logical thinking, innovative,
didasarkan pada pemikiran logis, inovatif, dan bertanggung jawab and responsible for the results independently;
atas hasilnya secara mandiri;
4 Mampu menyusun laporan hasil dan proses kerja secara akurat Able to compile reports on results and work processes accurately and
dan sahih serta mengomunikasikannya secara efektif kepada validly and communicate them effectively to other parties in need;
pihak lain yang membutuhkan;
5 Bertanggungjawab atas pencapaian hasil kerja kelompok; Responsible for achieving group work results;
6 Mampu melakukan supervisi dan evaluasi terhadap penyelesaian Able to supervise and evaluate the completion of work assigned to
pekerjaan yang ditugaskan kepada pekerja yang berada di bawah workers who are under their responsibility;
tanggungjawabnya;
7 Mampu melakukan proses evaluasi diri terhadap kelompok kerja Mampu melakukan proses evaluasi diri terhadap kelompok kerja yang
yang berada dibawah tanggung jawabnya, dan mengelola berada dibawah tanggung jawabnya, dan mengelola pengembangan
pengembangan kompetensi kerja secara mandiri; dan kompetensi kerja secara mandiri; and
8 Mampu mendokumentasikan, menyimpan, mengamankan, dan Able to document, store, secure and rediscover data to ensure validity
menemukan kembali data untukmenjamin kesahihan dan and prevent plagiarism.
mencegah plagiasi.

KETERAMPILAN KHUSUS SPECIFIC COMPETENCE

1 Mampu melakukan tindakan teknis fisioterapi pada lingkup Able to perform physiotherapy technical actions in a certain scope
tertentu (sederhana) terkait dengan problem/ gangguan gerak dan (simple) related to motion problems / disorders and functions by
fungsi dengan melakukan analisis data (mulai dari asesmen, conducting data analysis (starting from assessment, physiotherapy
diagnosis fisioterapi, membuat pemilihan metode (perencanaan & diagnosis, making selection methods (planning & intervention) and
intervensi) dan evaluasi dengan mengacu pada prosedur evaluating with reference to standard operational procedures (SOP);
operasional baku (POB);
2 Mampu memecahkan masalah problem gerak dan fungsi dengan Able to solve the problem of motion problems and functions with the
kontek pelayanan kesehatan primer dengan prinsip logis , context of primary health services with a logical principle, responsible for
bertanggungjawab atas hasilnya secara hirarkhis vertical; the results in a hierarchical vertical;
3 Mampu menunjukan kinerja dengan mutu dan kuantitas yang Able to show performance with quality and quantity measured according
terukur sesuai legal termasuk keterbatasan kemampuan dan to legal conditions including limited ability and professional ethics;
etika profesi;
4 Mampu melaksanakan prosedur bantuan hidup dasar (basic life Able to carry out basic life support procedures (basic life support / bls) in
support/bls) pada situasi gawat darurat/bencana dengan memilih emergency / disaster situations by selecting and applying the right
dan menerapkan metode yang tepat, sesuai standar dan method, according to their standards and authority;
kewenangannya;
5 Mampu mengumpulkan, menyusun, mendokumentasikan, dan Able to collect, compile, document, and present physiotherapy service
menyajikan informasi layanan fisioterapi yang meliputi information which includes the ability to collect and compile client health
kemampuan dalam mengumpulkan dan mengkompilasi data data as a reference basis for physiotherapists in determining the actions
kesehatan klien sebagai dasar rujukan bagi fisioterapis (Ftr) of advanced physiotherapy / referral;
dalam menetapkan tindakan fisioterapi lanjutan / rujukan;
6 Mengidentifikasi dan melaporkan situasi perubahan yang Identify and report change situations that aggravate the patient's condition
memperburuk kondisi pasien kepada fisioterapis (Ftr) secara to a physiotherapist hierarchically vertically;
hirarkis vertical;
7 Mampu mendokumentasikan secara hirarki vertikal aspek Able to document hierarchically vertically aspects of handling
penanganan fisioterapi secara akurat sesuai dengan kewenangan physiotherapy accurately according to their authority and responsibilities;
dan tanggung jawabnya;
8 Mampu melaksanakan komunikasi terapeutik dengan klien dan Able to carry out therapeutic communication with clients and provide
memberikan informasi yang akurat kepada klien atau keluarga accurate information to clients or families about physiotherapy
tentang rencana intervensi fisioterapi yang menjadi tanggung intervention plans that are their responsibility;
jawabnya;
9 Mampu melaksanakan pencegahan penularan infeksi sesuai Able to carry out prevention of infection transmission in accordance with
dengan SOP (standard operating procedure); SOP (standard operating procedure);
10 Mampu melaksanakan kegiatan promosi dan preventif kesehatan Able to carry out health promotion and preventive activities related to
berkaitan dengan masalah gerak dan fungsi; motion and function problems;
11 Mampu bekerja dan berkomunikasi efektif dalam tim; Able to work and communicate effectively in teams;
12 Mampu bertanggung jawab atas kerja sendiri dan kelompok di Able to be responsible for their own work and groups in the field of
bidang pelayanan fisioterapi serta memiliki komunikasi physiotherapy services and have interpersonal communication, empathy
interpersonal , empati dan sikap etis sesuai dengan kode etik and ethical attitudes in accordance with the code of ethics of
fisioterapi; physiotherapy;
13 Mampu mengelola pengembangan kompetensi kerja secara Able to manage the development of work competencies independently
mandiri dan mengikuti perkembangan fisioterapi dengan belajar and follow the development of physiotherapy with sustainable learning
berkelanjutan (Continues Profesional Development =CPD); dan (Continues Professional Development = CPD); and
14 Mampu melakukan pelayanan fisioterapi pada kondisi Able to perform physiotherapy services in musculoskeletal conditions
musculoskeletal (Penciri Prodi DIII Fisioterapi STIKes MP). (Identifier of STIKes MP in Physiotherapy DIII Study Program).

PENGETAHUAN KNOWLEDGE
1 Menguasai pengetahuan tentang konsep dasar, prinsip, bidan Mastering knowledge of basic concepts, principles, scientific midwives
keilmuan fisioterapi dasar (fundasi), ilmu gerak manusia, basic physiotherapy (foundation), human motion, physiotherapy related to
fisioterapi yang berkaitan dengan kesehatan manusia secara human health in general which is related to motion and function and able
umum yang berkaitan dengan gerak dan fungsi serta mampu to formulate the resolution of standard procedural problems;
memformulasikan penyelesaian masalah prosedural baku;
2 Mempunyai pengetahuan konsep dasar tentang sistim pelayanan Having knowledge of the basic concepts of the national health service
kesehatan nasional dan pengetahuan faktual tentang legislasi system and factual knowledge about physiotherapy legislation and limits
fisioterapi serta batasan wewenang fisioterapi; on physiotherapy authority;
3 Menguasai prinsip, teknis dan prosedur pelaksanaan praktik Mastering the principles, technical and procedures for implementing core
fisioterapi inti (core physiotherapy), yaitu fisioterapi physiotherapy practices, namely musculoskeletal physiotherapy,
muskuloskeletal, fisioterapi neuromuskuler, fisioterapi neuromuscular physiotherapy, pulmonary cardiovascular physiotherapy
kardiovaskuler pulmonal dan ilmu gerak sepanjang rentang and life span motion using physiotherapeutic and movement science
kehidupan menggunakan teknik fisioterapeutik dan ilmu gerak techniques carried out independently and in groups;
manusia (movement science) yang dilakukan secara mandiri dan
kelompok;
4 Mempunyai pengetahuan tentang konsep ,prinsip, dan teknik Having knowledge of the concepts, principles and techniques of health
penyuluhan kesehatan berkaitan dengan promotif dan preventif education related to promotion and prevention related to movement
yang berkaitan dengan gangguan gerak dan fungsi; disorders and functions;
5 Menguasai pengetahuan faktual tentang sistem informasi Mastering factual knowledge about health care information systems and
pelayanan kesehatan dan fisioterapi; physiotherapy;
6 Menguasai prinsip-prinsip K3, hak dan perlindungan kerja Mastering OSH principles, rights and protection of physiotherapy work;
fisioterapi;
7 Mempunyai pengetahuan konsep dan prinsip tentang pencegahan Having knowledge of concepts and principles about prevention in
pada kondisi yang berhubungan dengan musculoskeletal (Penciri musculoskeletal conditions (Identifier of STIKes MP in Physiotherapy DIII
 Prodi DIII Fisioterapi STIKes-MP); dan Study Program); and
8 Mempunyai pengetahuan tentang konsep Al Islam Having knowledge of the concept of Al Islam Kemuhammadiyahan and
Kemuhammadiyahan dan mengkorelasikannya dengan ilmu correlating it with science (Identifier of STIKes MP in Physiotherapy DIII
pengetahuan (Penciri Prodi DIII Fisioterapi DIII Fisioterapi STIKes- Study Program).
MP).

B. AKTIVITAS, PRESTASI, DAN PENGHARGAAN B. ACTIVITIES, ACHIEVEMENTS, AND AWARDS

B.1. Pengalaman Praktik & Sertifikasi Kompetensi B.1. Practice Experiences & Certification of Competency
Pemegang Surat Keterangan PendampingIjazah ini memiliki sertifikat The holder of this supplement has the following professional certifications:
professional:
1 Praktek Klinik Komprehensif I Comprehensive Clinical Practice I
2 Praktek Klinik Komprehensif II Comprehensive Clinical Practice II
3 Praktek Kerja Lapangan Apprentice Practical
4 Pelatihan Basic Neuromuscular Taping (NMT) Basic Neuromuscular Taping (NMT) Training
5 English Course In Community English CEC English Course In Community English CEC

B.2. Pengembangan Keterampilan, Sikap, dan Tanggung Jawab B.2. Development of Attitude, Skills, and Responsibilities
Pemegang SKPI ini memiliki kemampuanpengembangan sikap dan Holders of SKPI have undertaken trainings on attitude development and
tanggung jawab dengan mengikuti kegiatan sebagai berikut: responsibility which include the following:
1 Baca Tulis Al-Qur’an Reading and Writing Al-Qur’an
2 Seminar Internasional Stroke Fast Track International Seminar Stroke Fast Track
3 Seminar Kesehatan Introducing Neuromuscular Tapping Health Training Introducing Neuromuscular Tapping
4 Program Pembentukan Kepribadian dan Kepemimpinan (P2KK) Personality and Leadership Development Program

B.3. Prestasi dan Penghargaan B.3. Achievements and Awards

1 Juara II Badminton Ganda BEM EXPO Ke-VII Badminton Champion in The 7th BEM EXPO

B.4.Pengalaman Organisasi B.4. Organizatinal Experience

1 Peserta Masa Ta’aruf Akbar Ikatan Mahasiswa Muhammadiyah Participants Of The Ta’aruf Akbar Muhammadiyah Student Associaton
2 Sekretaris Umum PC IMM Kota Palembang PC IMM General Secretary in Palembang
3 Anggota Dapertemen Karya HMPS Fisioterapi MemberOf The Scientific Work Departement of Physioterapy’s Study
Program Student Assoociation Period 2017-2018
4. INFORMASI TENTANG SISTEM PENDIDIKAN TINGGI DAN KERANGKA KUALIFIKASI NASIONAL INDONESIA
4. INFORMATION ON THE INDONESIAN HIGHER EDUCATION SYSTEM AND THE INDONESIAN NATIONAL QUALIFICATIONS FRAMEWORK
Informasi tentang sistem pendidikan tinggi dan Kerangka Kualifikasi Nasional Indonesia (KKNI) dapat dilihat di https://stikesmp.ac.id/kkni/
The Information on the Indonesian Higher Education System and the Indonesian National Qualifications Frameworkcan be accessed in
https://stikesmp.ac.id/kkni/

PENDIDIKAN (Education) :
GELAR AKADEMIS (Title)

SM SM PR
D1 D2 D3 S1 S2 S3
P A O
9
U 8
MD 7
M 6
PROFESI OTODIDAK
5 (autodidact) :
(Profession) :
SERTIFIKAT PROFESI 4 PENGALAMAN
(Professional KEAHLIAN
Certificate) 3 KHUSUS (Experience
And Skill)
2
1
OPERATOR ANALIS
AHLI (Expert)
(Operator) (Analyse)

INDUSTRI (Industry):
FUNGSI JABATAN KERJA (Job Function)

S3 S3T SPESIALIS 2
9
S2 S2T SPESIALIS 1 AHLI AHLI
8
PROFESI
7
S1 DIV/ S1T
6 TEKNISI/ TEKNISI/
DIII ANALIS ANALIS
5
DII
4
DI
3
OPERATOR OPERATOR
SMU SMK
2
PROGRAM
PROFESI 1
Kerangka Kualifikasi Nasional Indonesia (KKNI)adalah kerangka The Indonesian National Qualification Framework is a framework
penjenjangan kualifikasi dankompetensi tenaga kerja Indonesia denoting levels of Indonesian workforce qualifications and competence,
yangmenyandingkan, menyetarakan, danmengintegrasikan sektor that compares, equalizes, and integrates the education and training
pendidikann dengansektor pelatihan dan pengalaman kerja dalamsuatu sectors and work experience in a scheme recognizing work competence
skema pengakuan kemampuan kerja yangdisesuaikan dengan struktur di based on the structures of various work sectors. The Framework is the
berbagai sektorpekerjaan. KKNI merupakan perwujudan mutudan jati diri manifestation of the quality and identity of the Indonesian people in
Bangsa Indonesia terkait dengansistem pendidikan nasional, sistem relations to the national education system, national workforce training
pelatihankerja nasional serta sistem penilaian kesetaraancapaian system and national learning outcomes equality evaluation system that
pembelajaran (learning outcomes)nasional, yang dimiliki Indonesia Indonesia has in order to produce qualified and productive
untukmenghasilkan sumberdaya manusia yangbermutu dan produktif. humanresource.

KKNI merupakan sistem yang berdiri sendiri danmerupakan jembatan KKNI is a stand-alone system and is a bridge between the education and
antara sektor pendidikan dan pelatihan untuk membentuk SDM training sector to form qualified and certified national human resources
nasionalberkualitas dan bersertifikat melalui skemapendidikan formal, non through a scheme of formal, non-formal, formal education, job training or
formal, in formal,pelatihan kerja atau pengalaman kerja. Jenjang work experience. The qualification level is the level of learning
kualifikasi adalah tingkat capaian pembelajaranyang disepakati secara achievement agreed nationally, arranged based on the results of
nasional, disusunberdasarkan ukuran hasil pendidikan dan/ataupelatihan education and / or training obtained through formal, non-formal, informal,
yang diperoleh melalui pendidikanformal, nonformal, informal, atau or work experience education as shown above. KKNI consists of 9 (nine)
pengalaman kerja seperti yang ditunjukkan pada di atas.KKNI terdiridari 9 qualification levels, starting from qualification 1 as the lowest
(sembilan) jenjang kualifikasi,dimulai dari kualifiaksi 1 sebagai qualification to qualification 9 as the highest qualification.
kualifiaksiterendah hingga kualifikasi 9 sebagai kualifikasitertinggi.

5. PENGESAHAN SKPI
5. SKPI LEGALIZATION

Palembang, 19 Juli 2019

Palembang, July 19, 2019
Ketua,
Chairperson,

Heri Shatriadi C. P, M.Kes.

NIDN: 884664/0209097901