LEVEL OF RELATED LEARNING EXPERIENCE OF LEVEL III ANDLEVEL IV NURSING STUDENTS BASED ON TEACHING PERFORMANCE OF CLINICAL INSTRUCTOR

A Thesis Presented to the Faculty of College of Nursing of Pamantasan ng Cabuyao

In Partial Fulfillment of the Requirement for the Degree of Bachelor of Science in Nursing

Angeles, Monica A. Desingao, Rachel P. Mercado, Amberly S. Refrea, Cyrene L. Trasmonte, Monica Monette R.

S.Y. 2011-2012

CHAPTER I

THE PROBLEM AND ITS BACKGROUND

INTRODUCTION: Nursing is Caring. This description already epitomizes the ideals of a profession that is holistic in approach and grounded in unwavering service to mankind. This nursing profession is a lifelong commitment to quality service and excellence, a calling and not just as a means to make ends meet. (TFN Joy Bautista, 2008) Nurses, being a heath care provider, must provide a quality and holistic care to their patient. Student nurses who are in nursing profession should have the skills, knowledge, and attitude not just in academic area but most especially in applying these in their related learning experience as they were exposed in different clinical areas for their development. Florence Nightingale (1820 - 1910) known as the mother of a modern nursing, serves as a role-model in nursing. Her theory contributed a lot in caring the patient. In Nightingales theory, she view nursing is having the responsibility for some one elses health a characteristic shared by women, especially mothers. As a future nurses they should capable enough and knowledgeable enough to meet and satisfy the human needs and also to bring man to the optimum level of health. The reason why researchers choose this study is for the researchers to know and to assess the Skills and Performance of the Level IV Nursing Students. To evaluate if the Level IV nursing students are ready to do their responsibilities. To assess if they are knowledgeable and skilled enough to perform such intervention in their own.

THEORETICAL FRAMEWORK This investigate study is specialty anchored on the theory of Patricia Benner, From Novice to Expert: the nursing expertise model, where in the novice are the person who lacks background, experience of the situation he/she involved in. simple rules and objectives contributes should be given to the novices in order to guide their performance because the novices are usually have difficult differentiating relevant and irrelevant aspects of a ritualism. As such, novices have no Life Experience in the application of rules. Advanced Beginner are these already started coping with enough real situation and has allowed him or her to demonstrate minimally acceptable performance within a given situation. The advanced beginner already has enough experience to grasp aspects of a situation but not within the content of the situation. They should be guided by rules and are oriented by the completion of task. Competent are characterized by considerable, conscious and can deliberate planning which determines the important aspect of present and future situations. It is a must that the competent nurse exhibits a sense of mastery, increased level of efficiency, consistency, predictability and time management. The competent person does not yet have enough experience to recognize situation in term of an overall picture or in terms of which aspects are most salient and most important. The proficient nurse already has a holistic view of particular situations. Performance is guided by a maxim which is a mysterious description of skilled performance. It a course certain level of experience to recognize the implications of the instructors. The nurse can already show an intuitive grasp of the situation based on background understanding. She now can view changing relevance in a given situations including recognition and implementation of skilled responses to the situation as it evolves.

Expert Performer does not rely anymore on the analytical principles of the situation to an appropriate action. The expert already operates a deep understanding of the clinical situations. He/she characterized a clinical grasp of features and rules. His /her performances become highly skilled and competitive. As person progresses though their level, they also developed and demonstrate an improvement in Cognitive, Psychomotor and Affective Domain acquisition. Just like Benners model, it is important for nursing students and to start being a novice that learning needs begin at the early stages of clinical knowledge whos relying on principles or theory. Learning skill involves caring though practical experience and helps to gain mastery of a given skill. As they practice their skills in clinical areas, they also need to learn and practice to improve their values and attitudes in communicating with their patients for them to build rapport. And being a professional, you should be full of knowledge and skills for you to perform your responsibilities as a health care provider. Aside from that, you should know how to treat the patients in a right way as in a good manner. In assessing the Level of Clinical Performance of Level IV Nursing Students based on Methods of Teaching of Clinical Instructors they must pass through levels of Cognitive, Psychomotor and Affective Domain acquisition. The researches made a research paradigm in this study for better understanding and to make this research more organized based on the theory conducted by Patricia Benner, which focused students nurses acquired nursing knowledge, skills and attitudes in actual clinical situation and their excellence in clinical care.

Research Paradigm Independent Variables 1. Demographic Profile. 1.1 Age 1.2 Gender Through Output/ Process 1. Level of Clinical Performance of Level III and IV Nursing Students based on Methods of Teaching of Clinical Instructors 2. Request of their RLE grades in Nursing Care Management 102 and 104. 3. Survey through questionnaires based on self evaluation in terms of: 3.1 Cognitive Domain 3.2 Psychomotor Domain 3.3 Affective Domain Dependent Variables 1. Improvement of learning abilities and Clinical Performance of Level III and IV Nursing Students
2. Ways to improve the level of Clinical performance of Level III and IV Nursing students

FEEDBACK Figure 1. Level of Clinical Performance of Level III and IV Nursing Students based on Methods of Teaching of Clinical Instructors.

Conceptual Framework To determine and understand how we conduct this study, the conceptual paradigm was made. It comprises three boxes. In the first box which is the independent variables it includes the demographic data that we gathered from our respondents. In through output/ the process comprises the procedure used by the researchers. These are the ways how we collected. These are the Level of Clinical Performance of Level III and IV Nursing Students based on Methods of Teaching of clinical Instructors, requesting of their RLE grades in NCM 102 and 104, and survey through questionnaires based on evaluation in terms of Cognitive Domain, Psychomotor Domain and Affective Domain. And in the dependent variables shows the results of the surveys conducted by the researchers to evaluate the level of performance of level III and IV nursing students.

General Objective: 1. To determine the Level of Performance of Level III and IV Nursing Students based on Methods of Teaching of Clinical Instructors. 2. To evaluate the Cognitive Domain, Psychomotor Domain and the Affective Domain of the Level III and IV Nursing Students. 3. To determine ways to improve the Level of Clinical Performance of Level III and IV Nursing Students.

Statement of the Problem: The studies specifically aimed determine the Level of Clinical Performance of Level III and IV Nursing Students based on Methods of Teaching Strategies of Clinical Instructors. 1. What is the demographic profile of the respondents in terms of: 1.1 Age 1.2 Gender

2. What is the Level of Clinical Performance of Level III and IV Nursing Students in terms of grades in NCM 102 and 104?

3. What methods of teaching of the Clinical Instructors is most efficient in the Level of Performance of Level III and IV Nursing Students in terms of: 3.1 Cognitive Domain 3.2 Psychomotor Domain 3.3 Affective Domain

4. Is there a significant relationship between the Level of Clinical Performance of Level

III and IV Nursing Students in terms of:

4.1 Age 4.2 Gender

5. Is there a significant relationship between the Level of Clinical Performance of Level

III and IV Nursing Students and the Methods of Teaching of Clinical Instructors?

HYPOTHESIS

H0. There is no significant relationship between the Level of Clinical Performance of Level III and IV Nursing Students and the Methods of Teaching of Clinical Instructors.

H1. There is a significant relationship between the Level of Clinical Performance of Level III and IV Nursing Students and the Methods of Teaching of Clinical Instructors.

CHAPTER II RELATED LITERATURE

What brings about effective learning in nursing students? Is it insight on the part of the student on a powerful clinical experience? Perhaps, it is the dynamic, creative manner in which nurse educator presents information or structures the learning experience.

According to Bradshaw, learning is cyclical, with new learning coming from new experiences. Consequently, learning occurs in a comprehensive means, beginning with performance and ending with educational growth. The learning environment and personal factors such as motivation and goals can lead the learner through a stream of experiences that, once connected, bring about meaningful learning.

Effective learning is more than merely the results of good teaching. It is enhanced by a learning environment that includes active interactions among faculty, students and students peers. Effective learning is achieved through the use of creative strategies designed not to entertain but to inform and stimulate.

We approach learning individually, based largely on awareness of and taking in of relevant information and preferred approaches to learning or learning style. To understand ones own learning styles is to help understand ones thinking, to be aware of a fit between style and strategies for learning, and thus to select most effective and efficient means to go about learning. Actually, some students are aware of their style and preference, some gain insights into these patterns as they become sophisticated learner and some students have been guided to determine

how they learn best. Many student find learning to be more powerful when they experience something new or significant in a clinical experience.

A knowledgeable and insightful educator is the key to effective learning in many situations. He/she can also guide the student in enhancing predominant styles or in beginning to cultivate additional dimensions of thinking and responding. Consequently, the educator should call upon a knowledge base in learning and teaching as well as an extensive repertoire of useful strategies to reach learning goals. In nursing education, knowing the extent of learning of the student is important in order for nurse educators to gain insight if there is an acquisition of knowledge. In addition, this is use to determine how far and how deep he/she can facilitate, orient and guide his/her student with knowledge, ideas, abilities, skills and attitudes that he/she wishes to build up in order to achieve his/her teaching abilities and to make his/her students responsive to the changing needs of the society, especially in the practice of their profession.(Paler, Calmorin 2004)

Faculty in health profession education are challenged to be directive in their teaching, addressing measurable learning outcomes that are directly linked to professional standards. Students in health profession are career oriented and need to see practical value in their educational endeavours. Furthermore, taking charge of ones own learning is empowering. Students who gain a sense of self responsibility can feel empowered in other areas of their lives, such as professional practice. Faculty in turn, have responsibility to cultivate empowerment and to feel affect learning outcomes. The effective instructor should be the facilitator of learning in the students. In professional education, motivation is gained when the relationship to the well being of the client is pointed out. The value of the faculty experience is evident when the nurse-

teacher shares from his/her own professional experiences and uses these anecdotes as example for client outcomes. Students in professional education programs do respond positively to opportunities to choose or structure some learning experiences (Rose, 2003). This approach should be used frequently by the teacher, to not only promote active learning but to instill in student a sense of empowerment, which is an important attribute for the clinical setting.
Learners can easily identify their "best" and "worst" teachers.We have been students, or atleast informal learners for years. We have learned to identify the differences between effective and ineffective teachings. We may even be able to distinguish some of the factors that make up those differences. Different skills are required for subjectively evaluating a teacher than for being a good teacher, just as different skills are needed to be a theater critic than to be a good actor. Teaching is an intentional action designed to have an impact on a learner or group of learners. It is an interpersonal effort to help learners acquires knowledge, develop skills and realize their potential. It involves more than just an interaction between a teacher and students. There are lots of factors to be considered inorder for a person to be an effective teacher. It takes time to become an effective teacher. Effective teacher does not become so just by imitating former good teachers, although following a good role model can be helpful. It's not enough that a teacher knows his/her lectures to be given to his/her students, but she/he must have the knowledge about the process of teaching which involves a knowledge of educational theory and research, a willingness to learn new roles and teaching methods and the ability to reflect on one's own performance. To accomplish this goals, teacher should explain, demonstrate, listen, guide,support, assess, offer feedback, and otherwise, structure a learning oppurtunity to help learners advance from a state of having less knowledge, skill and potential to a state of enhanced knowledge, skill and potential. In addition to this,according to Zandra Young, teachers who aims at excellence develops a thorough knowledge of subject matter and polishes skills throughout his/her career. He/she maintains and expands his/her knowledge through reading, research, clinical practice and continuing education. According to Torff (2003) teaching experience alone does not make an expert teacher. He decided to compare three groups of teachers; novices, experienced teachers who were not considered experts and

experienced teachers who were experts. Klein and Hoffman (1993) stated that it is not enough simply to teach prospective teachers the skills, knowledge,and abilities of expert teachers. They believe that various experience are necessary including personal experience in the area of expertise being developed, supervised experience with a mentor or advisor, role-playing experiences and vicarious experiences in which one envisions what one would do in certain situations. Most beginning teachers are all too conscious of their lack of expertise. Their novice status is just one of the things that makes the first year of teaching challenging. Most of the time, beginning teachers become experts by advancing through the following phases (Kegan, 1992); 1. Decrease focus on self-as-teacher; increased focus on the needs of learners. 2. Enhanced knowledge about learners. 3. Automation of classroom routines and procedures. 4. Growth in problem-solving skills. In addition to this, Berlinear (1986), states that, novice teachers often possess an oversimplified picture of what constitutes classroom practice. Expert on the otherhand, have acquired a wealth of classroom experience and professional reflection that allows them to autonomate classroom routines and procedure.

According to Enriquez (1977), on the Filipino learning style..The Filipino seems to be most effective when he is exposed to a material as a meaningful whole. While he appreciates parts, he tackles them simultaneously or sequentially. He does this not according to an inflexible and pre- concerned plan but according to the most efficient combination or interaction between the exigencies of the situation and the changing demands of the active self, the Filipino would rather control his schedule than to allow himself to become a compulsive victim of an imposed structure.

But Diokno (1977), emphasizing learning as consisting of both theory and practice. For the Filipino, learning for the sake of knowledge and which is not used is not learning at all. He argued that there are no equivalence in any Philippine language of the terms theory and practice. This is shown by the

fact that the Filipino who knows a lot (labis na dunong) but who lacks action (kulang sa gawa) is not appreciated. These statements suggest that, indeed, there are indigenous concepts relevant to learning among Filipinos even if these have not been systematically organized to constitute a theory or theories of learning.

On the otherhand, Galloways (1976) The Association or Behavior Theories and the Cognitive or Gestalt theories. Learning occurs when a connection or bond between stimulus and response has been established a stimulus is directly connected with a particular response. It is called associationist theories or S-R theorist. While cognitivist or gestaltists is do not focus on the stimulus and the response both on mental processes.

------ Sprinthal (1974), Readiness to learn refers to a temporary neurophysiological state which referred maturation is more lasting. The teacher could help to prepare the learner to be ready to learn instead of simply waiting for him to be ready to learn. Motivation is on way of preparing the learner.

------According to Burrhus F. Skinner, he formulated his learning theory called operant conditioning. To some, his theory is more of a theory of behavior rather than of learning. For him, learning occurs when a response is reinforced. As a theory of behavior, behavior is managed by its environment.

CHAPTER III RESEARCH METHODOLOGY This portion of study presents the Research Design, Respondents of the Study, locale of the Study, Data Gathering Instruments, data Gathering procedures and Statistical Treatment.

RESEARCH DESIGN

The researchers use quantitative method. Calderon (2000) states that descriptive research is purposive process of gathering and analyzing. Tabulating and classifying the data about the conditions beliefs, practices, trends, processes, and cost-effects relationships and then making adequate interpretation about such views of statistical method. It is a descriptive method. It analyzes and interprets the present nature of composition, which are the most effective teaching strategies since the main concern deals with the effectiveness of the strategies used by the clinical instructors of Pamantasan ng Cabuyao,that will help student learners to be competitive in the near future.

RESPONDENTS OF THE STUDY

The total respondents for this study are the 32 Level III and 45 Level IV Nursing of Pamantasan ng Cabuyao year 2011-2012.

RESEARCH LOCALE

The study is conducted at Pamantasan ng Cabuyao, Cabuyao, Laguna for school year 2011-2012. Pamantasan ng Cabuyao is tertiary Institution offering courses for the citizens of Cabuyao as well as its neighboring towns. Pamantasan ng Cabuyao (PNC) is the first locally founded University established by municipal government in the entire province of Laguna. It was established by virtue of municipal ordinance no. 2003-059.

The institution first started with a modern four-storey with ample facilities comparable to other colleges and universities in Metro Manila. It was constructed and completed in time for the opening classes for the school year 2003-2004. It was formally inaugurated on July 31, 2003. It stands on a 1 hectare lot in Katapatan Homes, Banay-banay, Cabuyao, Laguna. This is donated to the municipal government of Cabuyao.

An additional four storey building, the "Mayor Etok Aguillo Building" was inaugurated last 2004 to further accommodate the increasing population of the intuition. It quarters the nursing and midwifery offices and laboratories and the University Library and increasing collection of textbooks, reference materials, professional magazines and journals.

RESEARCH INSTRUMENTS

The researchers will be using a survey questionnaire in gathering data. It includes the part 1: about the demographic profile which includes the age and gender. Part II will cover the questionnaire, it will show the methods of teaching and finally, the Part III will be the level of satisfaction of the level III and IV nursing students.

DATA GATHERING PROCEDURE

At the outset, permission will be secured from the Dean, college of Nursing to conduct the study among the students. Letter of recommendations obtain will be use for conducting survey to level III and IV Nursing students of College of Nursing of Pamantasan ng Cabuyao year 2011-2012. Through survey, questionnaires will personally distributed by the researchers to the respondents of the study. All collected data will assure us confidentiality. It will be analyzed by counting and presented in tabular form and will give interpretation.