Salah satu tujauan uji kompetensi adalah mewujudkan Sumber daya manusia kesehatan  yang unggul, kompetitif serta mampu berdaya saing. Dinas Kesehatan Provinsi DKI Jakarta berkomitmen agar Pelaksanaan uji Kompetensi teknis jabatan fungsional dilaksanakan dengan konsisten dan berkelanjutan selaras dengan kebijakan yang sudah diamanatkan oleh Undang-Undang. Penelitian ini bertujuan untuk menganalisis implementasi kebijakan pelaksanaan Uji Komptensi teknis jabatan fungsional kesehatan di Dinas Kesehatan Provinsi DKI Jakarta serta keselarasannya dengan kebijakan pemangku kepentingan. Penelitian ini merupakan penelitian kualitatif dengan desain penelitian menggunakan Model implementasi kebijakan George C. Edward III dengan menggunakan 4 variabel yang digunakan yaitu komunikasi, Sumberdaya, Disposisi dan Srtuktur Birokrasi. Pengambilan data dilakukan melalui wawancara mendalam  kepada informan dan menggunakan telaah dokumen.  Informan penelitian adalah Kementerian Kesehatan, Dinas Kesehatan Provinsi Jakarta dan para tim Penguji Uji Kompetensi dari berbagai rumpun jabatan Funsgional. Penelitian dilakukan bulan April hingga Mei-Juni 2022. Hasil penelitian menunjukkan bahwa implementasi kebijakan pelaksanaan uji kompetensi teknis jabatan fungsional kesehatan sudah berjalan namun pada pelaksanaan kebijakan ditemukan beberapa ketidaksesuaian yaitu belum semua jenis jabatan fungsional kesehatan yang sudah melaksanakan uji kompetensi. Pada variabel Komunikasi khususnya pada sub variabel transmisi terlihat bahwa proses sosialisasi masih kurang sehingga berdampak pada kurangnya antusiasme dan pemahaman para pemangku jabatan fungsional terhadap pelaksanaan uji kompetensi. Pada variabel Sumber Daya yaitu pada sub variabel Sumber daya manusia dan fasilitas ditemukan bahwa masih sedikitnya jumlah para tim penguji uji kompetensi yang memiliki sertifikat uji komptensi dan dari segi fasilitas juga masih ditemukan kekurangan terkait tempat dilaksanakannya uji kompetensi dan sarana prasarana yang tersedia. Hasil penelitian ini menunjukkan bahwa pelaksanaan kebijakan uji kompetensi belum selaras dengan amanah Undang-Undang yaitu belum semua tenaga kesehatan melaksanakan uji kompetensi. Kata kunci: implementasi kebijakan, Uji kompetensi, Tenaga Kesehatan

One of the objectives of the competency test is to create superior, competitive and competitive health human resources. The DKI Jakarta Provincial Health Office is committed that the implementation of the technical competency test for functional positions is carried out consistently and sustainably in line with the policies mandated by law. This study aims to analyze the implementation of the policy implementation of the technical competency test for health functional positions at the DKI Jakarta Provincial Health Office and its alignment with stakeholder policies. This research is a qualitative research with research design using George C. Edward III's policy implementation model using 4 variables, namely communication, resources, disposition and bureaucratic structure. Data collection was carried out through in-depth interviews with informants and using document analysis. Research informants are the Ministry of Health, the Jakarta Provincial Health Office and the Competency Test Examiners team from various functional positions. The study was conducted from April to May-June 2022. The results showed that the implementation of the policy for implementing the technical competency test for health functional positions had been running, but in the implementation of the policy several discrepancies were found, namely not all types of health functional positions had carried out the competency test. In the Communication variable, especially in the transmission subvariable, it can be seen that the socialization process is still lacking so that it has an impact on the lack of enthusiasm and understanding of functional office holders for the implementation of the competency test. In the Resources variable, namely in the Human Resources and facilities sub-variable, it was found that there were still a small number of competency test examiners who had competency test certificates and in terms of facilities, deficiencies were also found regarding the place where the competency test was carried out and the available infrastructure. The results of this study indicate that the implementation of the competency test policy has not been in line with the mandate of the Act, namely not all health workers have carried out the competency test Keywords: policy implementation, competency test, health workers

Peningkatan kapabilitas Aparat Pengawasan Intern Pemerintah (APIP) merupakan pilar strategis dalam mengawal tata kelola pemerintahan. Pemberlakuan Peraturan BPKP Nomor 6 Tahun 2025 membawa pergeseran paradigma dari pemenuhan administratif menuju kualitas hasil pengawasan yang berorientasi pada nilai tambah. Transformasi ini memicu fase transisi yang berdampak pada penurunan sementara capaian kapabilitas APIP di Inspektorat Jenderal Kementerian Kesehatan (dari Level 4 menjadi Level 2). Penelitian ini bertujuan untuk menganalisis implementasi kebijakan peningkatan kapabilitas APIP menuju peran yang efektif di Inspektorat Jenderal Kementerian Kesehatan. Pendekatan kualitatif dengan desain studi kasus digunakan dalam penelitian ini, di mana data dikumpulkan melalui wawancara mendalam terhadap pimpinan, auditor, dan pembina BPKP, serta didukung oleh telaah dokumen strategis. Analisis dilakukan menggunakan teori implementasi kebijakan George C. Edwards III yang mencakup variabel komunikasi, sumber daya, disposisi, dan struktur birokrasi. Hasil penelitian mengungkap terjadinya kesenjangan antara tingginya mandat wewenang regulasi dengan kapasitas operasional di lapangan. Pada aspek komunikasi, efektivitas terdegradasi oleh ambiguitas instruksional dari pihak regulator dan tertahannya transmisi informasi di level pimpinan. Pada aspek sumber daya, penambahan auditor baru belum mampu menutup defisit keahlian analisis akar masalah (root-cause analysis), sementara metode remote audit justru mendegradasi daya paksa APIP terhadap entitas binaan. Pada aspek disposisi, kuatnya komitmen pimpinan puncak berhasil menjadi penahan disfungsi birokrasi, namun auditor pelaksana mengalami kelelahan adaptif akibat praktik beban kerja ganda (role overload) tanpa diimbangi insentif finansial yang proporsional. Pada aspek struktur birokrasi, koordinasi informal pimpinan efektif meredam tumpang tindih tugas, namun inefisiensi pencarian data masih terjadi akibat ketiadaan Standar Operasional Prosedur (SOP) masa transisi dan tingginya fragmentasi data digital. Penelitian ini menyimpulkan bahwa implementasi berada pada fase adaptasi yang rentan terhadap inefisiensi. Organisasi direkomendasikan untuk segera menerbitkan Buku Saku Transisi Pengawasan, memberlakukan aturan kepatuhan penyediaan data digital bagi auditee, merasionalisasi beban kerja dengan usulan insentif berbasis risiko, mengesahkan SOP transisi internal, serta membangun pangkalan data pengawasan yang terintegrasi.

Enhancing the capability of the Internal Government Supervisory Apparatus (APIP) is a strategic pillar in safeguarding government governance. The enactment of BPKP Regulation Number 6 of 2025 shifted the paradigm from administrative compliance to value-added supervision quality. This transformation triggered a transition phase that resulted in a temporary decline in the APIP capability achievement at the Inspectorate General of the Ministry of Health (from Level 4 to Level 2). This study aimed to analyze the implementation of the APIP capability enhancement policy towards an effective role at the Inspectorate General of the Ministry of Health. A qualitative approach with a case study design was employed, where data were collected through in-depth interviews with leaders, auditors, and BPKP supervisors, supported by strategic document reviews. The analysis utilized George C. Edwards III's policy implementation theory, encompassing communication, resources, disposition, and bureaucratic structure variables. The findings revealed a gap between high regulatory mandates and operational capacity in the field. Regarding communication, effectiveness was degraded by instructional ambiguity from the regulator and stagnant information transmission at the leadership level. In terms of resources, the addition of new auditors had not resolved the skill deficit in root-cause analysis, while the remote audit method degraded APIP's enforcement power over the auditees. Concerning disposition, strong top leadership commitment successfully buffered bureaucratic dysfunction, but implementing auditors experienced adaptive fatigue due to role overload practices without proportional financial incentives. In the bureaucratic structure aspect, informal leadership coordination effectively reduced overlapping tasks, yet data retrieval inefficiency persisted due to the absence of transition Standard Operating Procedures (SOPs) and high digital data fragmentation. This study concludes that the implementation is in an adaptation phase vulnerable to inefficiency. The organization is recommended to immediately publish a Supervision Transition Pocketbook, enforce digital data compliance rules for auditees, rationalize workloads alongside proposing risk-based incentives, legalize internal transition SOPs, and build an integrated supervision data warehouse.

Perundungan terhadap peserta didik Program Pendidikan Dokter Spesialis (PPDS) merupakan permasalahan sistemik dalam pendidikan kedokteran di Indonesia yang berdampak pada kesehatan mental peserta didik, kualitas pendidikan klinis, keselamatan pasien, dan mutu pelayanan kesehatan. Sebagai respons terhadap berbagai kasus yang terjadi, Kementerian Kesehatan menerbitkan Instruksi Menteri Kesehatan Nomor 589 Tahun 2025 tentang Pencegahan dan Penanganan Perundungan terhadap Peserta Didik pada Rumah Sakit Pendidikan di Lingkungan Kementerian Kesehatan. Penelitian ini bertujuan menganalisis implementasi kebijakan tersebut pada Rumah Sakit Pendidikan di lingkungan Kementerian Kesehatan. Penelitian ini menggunakan pendekatan kualitatif dengan desain studi kasus. Data diperoleh melalui wawancara mendalam terhadap pembuat kebijakan, pimpinan Rumah Sakit Pendidikan, pengelola Program Pendidikan Dokter Spesialis, dan peserta didik PPDS, serta didukung telaah dokumen kebijakan. Analisis dilakukan menggunakan model implementasi kebijakan Van Meter dan Van Horn yang meliputi standar dan sasaran kebijakan, sumber daya, komunikasi dan aktivitas penegakan, karakteristik agen pelaksana, kondisi ekonomi, sosial, dan politik, serta disposisi pelaksana. Hasil penelitian menunjukkan bahwa implementasi Instruksi Menteri Kesehatan Nomor 589 Tahun 2025 telah berjalan melalui pembentukan Tim Pencegahan dan Penanganan Perundungan, penyusunan regulasi internal, serta mekanisme pelaporan dan penanganan kasus, namun implementasinya belum optimal. Standar kebijakan dinilai telah memberikan definisi dan mekanisme yang jelas, tetapi masih menyisakan area abu-abu dalam membedakan pembinaan klinis dengan perundungan. Sasaran kebijakan dipahami tidak hanya untuk melindungi peserta didik, tetapi juga mendukung keselamatan pasien, meskipun target zero bullying dinilai belum realistis. Implementasi juga dipengaruhi oleh keterbatasan sumber daya, belum optimalnya komunikasi dan koordinasi lintas institusi, kompleksitas hubungan antar pelaksana, budaya hierarkis, hidden curriculum, fear of retaliation, serta budaya pendidikan kedokteran. Penelitian ini menyimpulkan bahwa implementasi Instruksi Menteri Kesehatan Nomor 589 Tahun 2025 telah memperkuat sistem pencegahan dan penanganan perundungan di Rumah Sakit Pendidikan, namun belum sepenuhnya efektif dalam mengatasi faktor-faktor struktural yang melatarbelakangi perundungan. Penguatan implementasi memerlukan harmonisasi kebijakan lintas sektor, penguatan kelembagaan dan sistem pelaporan, penyusunan pedoman operasional yang lebih spesifik, peningkatan kapasitas pelaksana, penguatan perlindungan peserta didik, serta pengembangan mekanisme deteksi dini dan integrasi indikator budaya anti-perundungan ke dalam sistem monitoring dan akreditasi Rumah Sakit Pendidikan.

Bullying among residents in Specialist Medical Education Programs (Program Pendidikan Dokter Spesialis/PPDS) has become a systemic issue in medical education in Indonesia, adversely affecting residents' mental health, the quality of clinical education, patient safety, and healthcare service quality. In response to a series of reported cases, the Ministry of Health issued Minister of Health Instruction Number 589 of 2025 concerning the Prevention and Management of Bullying against Medical Trainees in Teaching Hospitals under the Ministry of Health. This study aimed to analyze the implementation of this policy in teaching hospitals under the Ministry of Health. This study employed a qualitative approach with a case study design. Data were collected through in-depth interviews with policymakers, teaching hospital leaders, residency program administrators, and medical residents, complemented by a review of relevant policy documents. Data were analyzed using the Van Meter and Van Horn model for policy implementation, which comprises policy standards and objectives, resources, communication and enforcement activities, characteristics of implementing agencies, economic, social, and political conditions, and implementers' disposition. The findings indicate that the implementation of the Minister of Health Instruction Number 589 of 2025 has progressed through the establishment of Bullying Prevention and Management Teams, the development of institutional regulations, and the implementation of reporting and case management mechanisms. However, implementation has not yet been fully optimal. Although policy standards provide clear definitions and procedures, ambiguities remain in distinguishing legitimate clinical supervision from bullying. Policy objectives are widely understood as extending beyond the protection of residents to include patient safety, although achieving zero bullying is considered unrealistic in the short term. Policy implementation is further constrained by limited resources, suboptimal communication and inter-institutional coordination, complex relationships among implementing actors, hierarchical culture, the hidden curriculum, fear of retaliation, and resistance to cultural change within medical education. This study concludes that the implementation of Ministry of Health instruction No. 589 of 2025 has strengthened the system for preventing and managing bullying in teaching hospitals. However, its implementation has not yet been fully effective in addressing the structural factors underlying bullying. Strengthening policy implementation requires cross-sectoral policy harmonization, institutional strengthening, and improvements to the reporting system; the development of more specific operational guidelines; capacity building for implementers; enhanced protection for medical residents; as well as the development of early detection mechanisms and the integration of anti-bullying culture indicators into the monitoring and accreditation systems of teaching hospitals.