PENGAMBILAN DATA DALAM RANGKA TRAINING NEED

ASSESSMENT (TNA) BAPELKES PROVINSI SUMATERA SELATAN

PALEMBANG – 2019

Nama :
Asal Daerah :
Asal Instansi :

Tanda Tangan :
Petunjuk
Mohon dijawab dengan jelas dan ringkas pertanyaan. Apabila jawaban dari
bapak/ibu atas pernyataan/pertanyaan tersebut adalah negatif, mohon dijawab
kata/kalimat negatifnya dan uraikan alasannya.

Pertanyaan :

No. Uraian

1. Sebutkan masalah yang ibu/bapak rasakan/hadapi dalam melaksanakan tugas di tempat

bekerja saat ini, sehingga mengganggu/menghalangi pencapaian tugas secara baik/optimal.
a. ...................................................................................................................................
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b. ....................................................................................................................................
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c. .....................................................................................................................................
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d. ....................................................................................................................................
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e. ....................................................................................................................................
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f. ....................................................................................................................................
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2. Sebutkan apa yang menjadi penyebab munculnya masalah tersebut di atas terjadi.
a. ..................................................................................................................................
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b. ..................................................................................................................................
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c. ..................................................................................................................................
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d. ..................................................................................................................................
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e. ..................................................................................................................................
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f. .................................................................................................................................
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Prioritas Pelatihan yang dibutuhkan guna mendukung tugas : .......................
Mohon dituliskan berdasarkan nomor urut dan selanjutnya berikan skore sesuai
dengan prioritas kebutuhan bapak/ibuk pada judul pelatihan tersebut disamping kanan
pada formulir ini.
NO NAMA PELATIHAN SKORE KETERANGAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
PENAWARAN STRATEGI PEMBELAJARAN DIKLAT :
Pernyataan :

No. Uraian

1. Diklat dapat dilaksanakan dengan strategi pembelajaran tanpa mengganggu jam kerja
bapak/ibu selama bapak/ibu bekerja.
 On The Job Training merupakan diklat yang dilaksanakan dengan bimbingan ahli
dibidangnya.
 Contoh : Diklat OJT : Diklat Pelayanan Perkesmas di Puskesmas, dsbnya

2. Tuliskan Strategi Pembelajaran Pelatihan yang saudara usulkan/harapkan tanpa

mengganggu jam kerja bapak/ibuk selamat melaksanakan tugas.
.
a. ..................................................................................................................................
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b. ..................................................................................................................................
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c. ..................................................................................................................................
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d. ..................................................................................................................................
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e. ..................................................................................................................................
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f. .................................................................................................................................
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