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THE CLINICAL PERFORMANCE OF CLINICAL INSTRUCTORS ANDNURSING STUDENTS
OF LORMA COLLEGES BASED ON THE NURSING PROCESS
A RESEARCH PROPOSAL PRESENTED TO
THE FACULTY OF LORMA COLLEGES
CITY OF SAN FERNANDO, LA UNION
IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR
Action Research
Lorma Colleges, College Of Nursing
CITY OF SAN FERNANDO, LA UNION
BY:
EDITHA PULIDO RIVERA
JEFF HEXTON OTERO
MARITES GALLARDO
GILBERT LAPPAY
AURELIO MAEGO
March 2010
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CHAPTER 1
INTRODUCTION
Background of the Study
Since nursing is an art, student nurses must work systematically in
accordance with the nursing theories together with their clinical experiences
that helps widen their scope of knowledge. Clinical performance of the students
must not be limited to pure skills, fixed mental associations and information.
Ideals and appreciation must be instilled as well and developed as an
outgrowth of all students experiences.
Schwe calls it cupicle that provides students with the opportunity to
translate basic theoretical knowledge into learning of variety of intellectual and
psychomotor skills media to provide patient centered quality nursing care.
Clinical teaching prepares students to integrate previously acquired basic
science information with performance oriented skills and competencies
associated with the diagnosis, treatment and care of patient and to acquire the
kind of professional and personal skills, attitudes and behaviors essential for
the health delivery system and embarking continuing form of education. The
teaching in nursing involves acquisition of knowledge, enabling one to form
concepts, see relationship and derived generalizations as basis for taking action
in a given situation, but the most important is to enhance clinical teaching is
that of skills because generally in nursing we deal with lives.
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Benner points out that theres another important dimension in clinical
teaching that is richness of the practice we want to teach. Clinical teaching is
the relationship between theory and practice. Practice can assist students not
to apply theory but also to search the way that nursing theory can emerge from
the rich texture of clinical practice. Since nursing is an art, student nurses
must work systematically in accordance with the nursing theories together
with their clinical experiences that help widen their scope of knowledge.
Clinical performance of the students must not be limited to pure skills, fixed
mental associations and information. Ideals and appreciations must be
instilled as well and developed as an outgrowth of all the students experiences.
Many medical educators think that the only role of the teacher/ clinical
instructor is to be a reservoir of knowledge and skills that occasionally, and
unpredictably, spills over its dam, letting information flow randomly down a
canyon of learning. Knowledge and expertise are necessary, but not sufficient,
conditions to guarantee good teaching.Medical education suffers terribly under
the weight of unrelated and often relatively useless facts. As medical knowledge
expands, so does the density of the medical education process, often to the
detriment of the problem-solving and clinical reasoning skills of future nurses.
Clinical teachers, by emphasizing use, rather than mere retention, of facts will
not contribute to what is already recognized as a major problem by national
authorities.
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Medical educators offer numerous opportunities for making decisions
about competence, promotion or advancement, called summative evaluation.
However, clinical instructors have a critical role to play in making comments,
particularly negative ones, that will help the learner change a professional
behavior, make a better decision or perform a skill more precisely.
Constructive critics molds student nurses in improving their performance
govern with the right attitude that could be beneficial to their future profession
as nurses.
Some clinical instructors believe that showing concern for an interest in
students lead to lack of discipline, which makes students take more advantage
of their relationship with teachers. All are desirable personal characteristics of
teachers such as personal magnetism, enthusiasm, cheerfulness, self-control,
patience, flexibility, a sense of humor, a good speaking voice, well confidence,
willingness to admit errors and a caring attitude.
In educating and training the nursing students, the clinical instructor
who is creative and stimulating can excite students interest in nursing, or
could demonstrate clinical skills with expertise. There are two basic domains
which the nursing students need. The first one is in the formal classroom
where students acquire knowledge and information, while on the other hand is
in the clinical setting or clinical area where the students are trained to apply
learning into practice. Transferring knowledge to clinical practice situations in
training nursing students is a challenge for many clinical instructors and
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requires an understanding of the difference between the teachings and
practicing arena As clinical instructors, they must explain, and acknowledge
variances in the clinical study. This offers the students to have a more
complete experience.
Now, more and more nursing schools are established in the Philippines which
play a vital role on national development. However, in the increasing number of
nursing students who have flocked in nursing schools, the quality of education
and training seems to be inadequate. Clinical instructors utilize different
methods of teaching yet are not a guarantee to help students improve their
RLE clinical performance. Clinical instructors find difficulty in giving full
attention to a lot of students in their clinical training which lead to poor
performance of students in the clinical area. Nursing students often report in
their clinical duties with limited background in both knowledge and clinical
skills.
Quality education is the fruit of quality teaching. If the clinical
instructors are poor, the students will be poor. Moreover, there is no way of
improving an education unless we improve our clinical instructors. Better
teaching should always bring about learning and better learning should always
show better teaching.
Gregorio certainly states, The quality of learning attained by the
learner is related to the quality of teaching done by the teacher/clinical
instructor.
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Involving audience or students after the lecture then questions, clarity and
challenge in lecture discussion on the other hand, the time may limit
discussion period and the quality and discussion.
In the article written by Carol Maasiw, clinical teaching methods
among nursing students in the clinical area and efforts on student learning
have been reported. Substantial use of clinical teaching methods among
students has been reported, but there is limited description of outcome and no
reports of the use of theoretical framework. The purpose of the study was to
investigate the effects of clinical teaching methods: a) achieve significantly
higher improvement scores than students taught with other methods, and b)
rate their preference for clinical teaching methods equal to or higher than the
instructor teaching.
In nursing, clinical practice becomes an integral part of every clinical
exposure. Some of its main concerns are character formation, independence
and confidence as she or he deals with the challenges in the clinical area that
includes good working relationship with the staff and the patients. Expertise in
nursing is the result of theoretical knowledge and clinical practice. The
expertise required interpreting clinical situations, making complex decisions
and the theoretical knowledge needed. Clinical expertise is the basis for the
advancement of nursing practice and the development of nursing science.
Knowledge and expertise are gained overtime through a continued process.
Nursing is more than just performing skills. The nursing process should be a
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part to any nursing skills. Nursing skills are most valuable when the rights of
the patients, the framework of the nursing process and the value of technical
competence are kept in mind.
The nursing process skill characterized nursing from the beginning of
the profession and should be introduced in the first nursing care. The nursing
process is composed of five phases namely: assessment, diagnosis, planning,
implementation and evaluation. Performing different nursing activities are
based from the phases of nursing process. An effective student performance in
their RLE reflects back on the appropriate use of the nursing process.
The different variables influencing the RLE clinical performance of the
nursing student include the following factors affecting the RLE clinical
performance of students.
Study habits. Study habits are important part of learning because your
achievement in school depends greatly on how you study. You dont expect to
learn everything you need to know from your clinical instructors. Good study
habits are good asset to learners because these habits assist students to attain
mastery in areas of specialization and consequent excellent performance.
Interest is accompanied with a degree of tension which facilitates
behavior. This conflicting interest affects their RLE clinical performance.
Bruners theory states that one learns bets when he is into something he cares
about and can get pleasure from being engaged in. Ones drive to study is in
proportion to the nature of ones motives or goals.The learner must be
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motivated to learn and this is the basic principle in teaching and learning
process.
Nursing students find difficulty in understanding, analyzing, recalling
and memorizing what they read. Problems arose when the work given by the
clinical instructors which were not related to their course, compounded by the
limited, insufficient and obsolete facilities and equipments. These imply that
the institution or the hospital should be updated in all concerned areas in
order to achieve quality nursing service and education.
The Clinical Instructor related Factors include the following. One is
Academic Qualifications. The more the teacher knows about the subject
matter, the more he or shes able to present the subject in all stimulating way
to perceive when he or she is confusing and discouraging his students and to
know what remedial actions he or he has to tell. Only teachers with a good
subject matter can organize effectively of what is taught.
Human resources involved in the higher education must be qualified to
impart knowledge, teach skills and develop positive values and attitudes. They
must be the models for their students. Their academic achievement,
professional experience, work experience and personality must be satisfactory
to suit the needs of the students.
Teaching and Professional Experiences. The most important factor in students
teaching in the competency of the teacher, the more competent the teacher, the
more successful the students. Clinical instructors with frequent in service
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trainings had significantly better teaching processes and procedures.
Professional competence of the clinical instructors is the effect of the various
factors such as educational attainment, length of teaching service and
condition of work.
Teaching methodologies. One of the most important methods of teaching
is mastery learning because it accommodates the natural diversity of ability
within any group of student. Demonstration method of teaching involves the
teacher showing students the proper nursing procedures. Involving students in
demonstration allow this method to be less passive. As a whole, the clinical
instructor should have a repertoire of capacities which enable them to
structure instruction, methods to be used, order content adequately, ask
questions, administer tests, and give feedback to their students.
Environment related Factors. According to the nursing students, in order
for them to have good concentration in their studies they must have a room
that is free from noise and a definite schedule for studying.
Personal issues. One of the most important issues in our daily lives is
financial matters. Financial problems often precipitate personal stress and
marital crisis. It has also implication on a persons life function such as the
family and work.
More recently, cash identified financial problems as the source of stress
that may also affect the RLE clinical performance of the nursing students.
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Environment condition. As we have observed, environmental condition
such as noise may cause stress on the work and these factors can have similar
effects on the public at large. In fact surveys have shown that Americans
regard noise as one of the foremost irritants in their lives. Constant exposure to
unpleasant and loud noise can lead to hearing loss and can interfere with
learning.
Environment related factors include the scarcity of resources and the
participation of the patients. Of course for the students to provide nursing
care, resources should be available, and as for the patient to achieve a good
nursing care, participation and cooperation is needed for further treatment and
medication.
The nursing process is essential for the clinical application of knowledge
and theory in nursing practice. Concepts related to nursing process continue to
evolve. The RLE are highly chosen to develop competencies of the nursing
students in utilizing the nursing process in rendering the nursing care and
services well in the care of the individual, families and community by assessing
the clients health status, planning without client and other significant others
the nursing action based on identified needs and problem, implementing
appropriate interventions, modify interventions and evaluate the results of
nursing care according to the criteria established.
There are five phases of the nursing process: assessment, diagnosis,
planning, implementation and evaluation.
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Assessment is the systematic method of collecting subjective and
objective data with the goal of making a clinical nursing judgment about a
client and identifying actual and potential problems. The nurse is providing a
database for the clients total situation by considering the physical,
psychological, emotional, socio culture and spiritual factors that may affect
his overall health status during this phase of assessment. Data gathering
occurs with every nurse-client interaction. It is an ongoing process of the
nursing skills used in the collection of the data which consist of observation,
interviewing, physical examination, and intuition. Use of observation lays the
groundwork for collecting other kinds of assessment data. It includes looking,
watching, hearing, scrutinizing, surveying, scanning and appraising. The
nursing interview allows for the systematic assessment of functional health,
including the clients perception and interpretation of problems.
During interviewing process, the good therapeutic communication needs
to be utilized and a rapport between the nurse and the client is being
established. Physical examination is a systematic data collection method that
uses inspection, palpation, percussion and auscultation in order to expand and
verify the information already gathered. Institution has just recently been
acknowledged as a legitimate part of nursing practice. The nurse in analyses
cues to make clinical decisions define it as the use of insight, instinct and
clinical experiences.
The second phase of nursing process is diagnosing the clients need for
nursing care based on actual or potential health problem. The NANDA
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identifies nursing diagnosis as the clinical judgment about individual, family
or community responses to actual or potential health problems life processes.
Nursing diagnosis provides the basis for selection of nursing interventions to
achieve outcomes for which the nurse is accountable. Nursing diagnosis is
derived from the actions the nurse care perform and carry out independently
without doctors order , such as prevention, education, corrective and
encouragement. They also refer using judgment with a directive or order from
the doctor, such as when to administer pain medication and observing for side
effects.
After determining nursing diagnosis, establishing priorities and writing
expected outcomes, the planning phase begins. The planning phase involves
preparing a Nursing Care Plan (NCP); this NCP is a written summary of specific
care to direct the action of the nursing staff. The purpose of the plan is to
reduce he identified client problems. Writing the plan of care on the client
record formally recognizes what the nurse planned and accomplished to assist
the client and it becomes a permanent part of the health care team will be
called in to assist in meeting the clients need. Constant evaluation of the plan
allows the nurse to change her focus as the needs of the client changes.
Implementation is the action phase of the nursing process. It is the
actual carrying out of the specific, individualizes plan and recording of nursing
actions and clients response of the actions. Nursing action are goal directed
and should be based on specific principles and rationale, not intuition,
emphasis is on enabling the client to reach maximum functional healthy
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implementation requires expertise and professional use of intellectual,
interpersonal and technical skills.
In the evaluation phase, it is determined if the nursing plan of care was a
success or a failure. The nurse determines the clients reaction to nursing
interventions and judges whether the goals of the plan of care have been
achieved. Determining goal achievements is a joint decision between the client
and the nurse. Although the evaluation is a separate phase, it is also on
ongoing and continues process performed throughout all phases of the nursing
process. From an effective evaluating process, emerge constant reassessment,
re-diagnosing and re-planning.
Students are prone to changes and they can be easily affected by the
different factors that arise in their ways as they go on to their journey of life.
The following factors are: studentrelated factor; teacher related factor; and
environment related factor, these factors may lead to become a successful
individual in the future if not to become a problem maker in the society.
The findings of Carol Maasiw reported that, in analyzing the data, it
became evident that two major factors influenced the students learning in the
clinical setting: the first one is the clinical instructor, and the second one is the
peer support. Clinical instructors who are organized, encouraging, outgoing
and who had good relationships with students, patients and nursing staff are
seen as good role model. When clinical instructors are unable to establish
rapport on a unit, negative feedback from nursing staff could be detrimental to
student learning. Peer support encompassed three dimensions: facilitating
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learning, providing emotional support, and assisting with physical tasks.
Therefore, in educating the students there is a need for a positive interaction of
both the peer group and the learners together with the clinical instructors, so
that a positive feedback from the nursing students will occur.
According to Smith, the students future competence as practitioner of
nursing depends upon the quality of instruction provided during clinical
practice periods. It is then that the students can apply and refined concepts
presented in class and develop the skills and judgment which can be required
of them as practicing nurses. It is during the clinical practice in the hospital
that student nurse gains actual experience in performing nursing skills. We all
go through many challenging years of being a student; we are nurtured and
guided by our mentors to achieve the best of our abilities.
Nightingale clearly stated that effective nursing practice requires a liberal
education, intellectual and reasoning powers, and support systems. The
clinical instructors stand as a support systems that provide through assisting
in the developing and implementing different methods of teaching and
coordinating clinical experiences in accordance with clinical education. The
clinical performance of nursing students is then evaluated through their grades
that determine the degree of effectiveness of the clinical enhancement trainings
among the clinical instructors.
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Theoretical Framework
Sister Callista Roy stated that the function of nursing education is the
development and storing of knowledge concerning the theories about the
phenomena of nursing, knowledge and skills related to theories of the practice
of nursing. Theories are indispensable factors in the growth of nursing
practice. In relation to my study, the nursing concepts are being applied in the
RLE clinical setting or clinical area wherein nursing process gives a vital role in
rendering care to our patients. This theory is being taught and is being
practiced in the clinical area. It contributes to the development of quality and
productivity of nursing practice which depends so much if imparted to the RLE
clinical duties to enhance quality RLE clinical performance of nursing students
in the clinical setting.
Nightingale clearly stated that effective nursing practice requires a liberal
education, intellectual and reasoning powers, and support systems. The
clinical instructors stand as a support systems that provide through assisting
in the developing and implementing different methods of teaching and
coordinating clinical experiences in accordance with clinical education. The
clinical performance of nursing students is then evaluated through their grades
that determine the degree of effectiveness of the clinical enhancement trainings
among the clinical instructors.
Beans Theory influential theory, Bean developed a model explaining
university persistence as well. His model focuses not on factors external to the
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institution such as non school responsibilities. The variables that the students
influence vs. the variables that influence students are: 1) personal which
are factors within the individual, including students attitudes; 2)
Environmental which are aspect outside the institution; 3) Organizational
which are variables within the institution, including how well a university fits a
students needs.
Overall, Bean argues that the above mentioned personal, environmental
and organizational factors are crucial in the understanding and helping
students cope with the transition. In relation to my study these factors such as
personal, environmental and organizational would really influence the RLE
clinical performance of a nursing student in terms of nursing process. And this
will be a great challenge for each student to be better in doing or applying the
nursing process during their exposure on their RLE clinical duty.
Another theory is about Social Learning theory by Albert Bandera.
There are several components of this theory. First, people learn as they are in
constant interaction with their environment. Most learning occurs as result of
observing other peoples behavior and its consequences. He called this
modeling. Second, intentional processes determine which model behavior will
be learned. People perceived and attend to only a certain modeled behavior.
Characteristic of the individual, the modeled activities themselves and the
social interactions in which the learner engages determine which behavior in
permanent theory. For retention to occur people must retain modeled behavior
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(picturing a skill to be carried out) or a verbal symbol, what is easily recalled
(remembering a numbered list of activities in a skill). Bandera further
emphasizes that although observation starts the learning process, expertise is
develop through practice with external and internal feedback. In relation to my
study, learning is best achieved by experience and observations. Learning is
easily remembered when it is applied. Likewise, in the clinical area, student
nurses become experts in doing the nursing process when they always apply
and practice it during patients encounter in rendering a quality nursing care in
the clinical area.
Kolbs theory of experimental learning similar to Banderas theory
supports four stage cycle of learning beginning with an immediate concrete
experience during the persons observation and reflections. Then the person
develops an abstract theory from which he or she develops ideas on how to
proceed. Finally, the person actively experiments with actions to test them out.
Kolb then hypothesized that learners need four abilities in order to be effective.
This learning is achieved by actual experience, learning by observing others,
creating theories to explain what is seen and using theories to solve problems.
In relation to my study, exploring in the clinical area is one way of learning
wherein we can apply our knowledge and theories learned in the school and at
the same time developing our skill in doing the nursing process.
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Conceptual Framework
Experience is the best teacher, this is one of the most common
proverbs that we hear. This is applicable to our profession because we are
catering lives of individual. In relation to my study, factors influencing the level
of RLE clinical performance of Lorma nursing students, nursing process can be
best carried out through experience. Effectiveness cant be measured by
specific tool but by experience, knowledge, and preparedness.
The nursing process is the foundation in which the nurse should be well
versed. The nursing process composed of the different phases namely:
assessment, diagnosis, planning, implementation, and evaluation. This will
evaluate students performance in applying concepts learned in the classroom
to their related learning experiences. Practicing nursing and performing
nursing activities are based from the phases of nursing process. An effective
performance of nursing students in their RLE reflects back on the appropriate
use of the nursing process which will be implemented by the students during
their RLE clinical exposure or clinical duties.
Expertise in nursing is the result of theoretical knowledge and clinical
practice. Clinical expertise is the basis for the advancement of nursing practice
and the development of nursing science. Knowledge and expertise are gained
overtime through a continued process.
In nursing, clinical practice becomes an integral part of every clinical
exposure. Some of its main concerns are character formation, independence
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and confidence as he or she deals with the challenges of the clinical area that
includes good working relationship with the staff and the patient.
Students are given the chance to be exposed on the different clinical
areas and these would give them the opportunities to become better and more
effective in rendering nursing care, communication skills, observation skills,
analytical thinking and planning nursing care are some of the things developed
when employed in the hospital.
From the theories posted, this study is conceptualized. The paradigm of
the study, shared the concept on which it is based. The diagram showed the
involvement of the independent, dependent and the moderator variables in
undertaking the study.
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Statement of the Problem
The study aims to determine the clinical performance of clinical
instructors and nursing students based on the nursing process. Specifically, it
seeks to answer the following questions:
1. What is the level of clinical performance of Clinical instructors along the
different phases of nursing process:
a. Assessment
b. Diagnosis
c. Planning
d. Implementation
e. Evaluation?
2. What is the level of clinical performance of the nursing students along the
following phases of the nursing process:
a. Assessment
b. Diagnosis
c. Planning
d. Implementation
e. Evaluation?
3. Is there a significant relationship between the level of clinical performance of
clinical instructors and nursing students along the phases of nursing process?
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4. What action plan can be formulated to address the level of clinical
performance of clinical instructors and nursing students?
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Chapter II
Research Design and Methodology
This chapter presents the research design, locale, and population of
study of data gathering tools, procedures and treatment of data.
Research Design
The study will make use of descriptive research design. Specifically, a
correlational survey method will be utilized for the collection of data among
clinical instructors and nursing students. In this study, well also determine
the causal and relational factors among variables.
Population and Locale of the Study
The study will be conducted at Lorma Colleges, San Fernando City, La Union.
The respondents will be taken from a population of Lorma clinical instructors
and Lorma first year, second year and third year nursing students which will
be selected using the simple random sampling. The Lynch Formula will be
employed to determine the sample size.
Lynch Formula: n= (Nz
)(P(1-P)/(Nd
)+(Z
)(P(1-P)
Wherein: n= sample size
N=Population
d=Sampling error
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P=largest possible population
N= (300) (1.96)
(0.50) (1-0.50)/ (300) (0.05)
+ (1.96)
(0.50) (1-0.50)
= (300)(1.96)
(0.25)/0.75+ (1.96)
(0.25) =288.12/1.7104
= 168.45 or =168 Students
N= (122) (1.96)
(0.50) (1-0.50)/ (122) (0.05)
+ (1.96)
(0.50) (1-0.50)
= (122)(1.96)
(0.25)/0.305+ (1.96)
(0.25) =117.17/1.2654
= 92.6 or =93 Clinical Instructors
Data Gathering Tool
The instrument that will be used in gathering data will be questionnaire. Likert
scale will be employed in a five point scale with numerical value of: 1=Poor;
2=fair; 3=satisfactory; 4=Very satisfactory and 5= Outstanding. It will be used
to measure the level of performance in the five phases of the Nursing Process.
The scale is as follows:
Scale Score Interpretation Description
5 4.2-5 Outstanding Performs the competencies excellently
with optimum initiative
4 3.4-4.19 Very
Satisfactory
Performs the competencies with
maximum initiative
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3 2.6- 3.39 Satisfactory Performs the competencies with
moderate initiative
2 1.8-2.59 Fair Performs the competencies with
minimum initiative
1 1-1.79 Poor Performs the competencies with very
little or no initiative
The questionnaire has a cover letter that includes the following: introduction of
the researcher and title of the study, the purpose of the study, the importance
of the respondents participation the assurance of confidentiality of the
responses and the expression of gratitude after the retrieval of questionnaires,
and analysis of the data will be done.
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Chapter III
Results and Discussions
The following are the salient findings derived from the study:
Table 1.a.
Level of performance of Nursing Students in the five phases of the Nursing
Process
Score Frequency Percentage Interpretation
4.2-5 0
3.4-4.19 91 54.17%Very
Satisfactory
2.6- 3.39 57 33.93% Satisfactory
1.8-2.59 13 7.74% Fair
1-1.79 7 4.17% Poor
Total 168
Table 1.a. shows that 54.17% of Nursing Students of Lorma College posted
a 3.4-4.19% score with a frequency count of 91. Close at second is the
group posting 2.6-3.39% with a 33.93% presence and a frequency count
of 57. This is a graphic representation that the majority of Nursing
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Students rate as very satisfactory in competency in the five phases of the
nursing process.
Generally the data shows that there is a very satisfactory result in the clinical
performance amongst the nursing students. This is probably due to the
appropriateness and teaching style applied by the clinical instructors during
the demonstration of nursing procedures.
Table 2.a.
Level of performance of Clinical Instructors in the five phases of the
Nursing Process
Score Frequency Percentage Interpretation
4.2-5 8 8.6% Outstanding
3.4-4.19 58 62.37%Very
Satisfactory
2.6- 3.39 27 29.03% Satisfactory
1.8-2.59 0 Fair
1-1.79 0 Poor
Total 93
Table 1.a. shows that 8.6% of Clinical Instructors of Lorma College posted a
4.2-5% score with a frequency count of 8. Bringing up the second rung is
the group posting 3.4-4.19% with a 62.37% presence and a frequency
count of 58. This is a clear indication that the majority of Clinical
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Instructors are rated as very satisfactory in competency in the five
phases of the nursing process.
Table 5. The Relationship Between the Extent of Influence of the ClinicalInstructor to the Level of Performance of Nursing Students
Factors r degree of relationship interpretation
Clinical
Instructor
related
factors 0.5326 positive moderate correlation significant
Conclusions & Recommendations
This study aimed to know if the extent of effectiveness of the
clinical instructors skills enhancement trainings highly contributed to the level
of RLE clinical performance of the Lorma nursing students.
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Conclusions
Our findings lead us to the following conclusions:
1.The clinical enhancement trainings of clinical instructors do have anobvious palpable impact on the Lorma Nursing Students clinicalperformance.
2.The confidence of the nursing student brought about by theirpreparation plus the guidance of an adept clinical instructor enhancesthe performance of tasks and results in efficient and effective delivery ofinterventions.
3. Errors are minimized and the overall clinical exposure experience ismuch more meaningful when the student reflects a composure thatmeans self-confidence and adequate capacity to do the required tasks atthe clinical area.
4. Patients are more receptive to interventions and interaction when thestudent nurse is knowledgeable and carries an air of comport reflective ofself-assurance.
5.The clinical performance of the students is not be limited to pure skills,fixed mental associations and information and that ideals and
appreciation if instilled as well as developed will lead to the increased
quality of all students experiences.
Recommendations
We the researchers are genuinely happy to note that the Lorma Colleges
nursing students are skillful and possess a mindset that will boost their efforts
to become future nurses. Our study has provided unequivocal insight into the
various stumbling blocks that have to be overcome to produce capable and well
prepared graduates. It is therefore with stout hearts that we stipulate
requisites to have clinical instructors who will nourish the minds of our
students in more ways than one. In the pursuit of this goal we recommend
therefore:
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1. Clinical Instructors must avail of every opportunity to develop their skillsand knowledge.a.The Lorma Colleges must provide training sessions, seminars or
enhancement exercises.b. Allow instructors to enroll or travel to the venues where advancement
of their skillsets and cognitive prowess is found.2. While we acknowledge the need to instill discipline and adhesion to
authority, a democratic exchange of insights must be given free reign ifonly to present an atmosphere of mutual growth of instructor andstudents.
3.The clinical duty shift is task intensive and involving but there areperiods in between when a trough in activity is observed. If the studentswish for these pockets of time utilized through reading and contemplativeintramurals then this must be encouraged.
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