CHAPTER 1 Action Research

8/6/2019 CHAPTER 1 Action Research

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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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Documents

CHAPTER 1 Action Research