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THE PROBLEM AND ITS SETTING
The growing demand for Filipino nurses abroad has given the country’s administrators a responsibility of ensuring the quality of care rendered and the competency of Filipino nurses. It has to be made sure that they get the best education and that they render effective quality care to clients. Nurses are required to have the necessary skills to be able to achieve this. According to Valanis (2000), nurses need additional competencies in order to function effectively, a term which refers to their skills, knowledge and attitude. The Joint Commission on Accreditation of Health Organizations also said that nurses need to develop competencies to perform well in their job function. The competencies stated refer to skills, knowledge and behaviors, as well as personal characteristics.
The Nursing Aptitude Test (NAT) was first used as a criterion for retention in the college of nursing, to determine a student’s learning preferences and talents. However, on March 10, 2009, Dr. Rizalina
2 Mitra-Pangan approved the recommendation to temporarily adopt the NAT in the BSN program for diagnostic purposes rather than qualifying criteria (Malimbag, 2009). On a study made by del Rosario, et al., the outcome of major nursing subjects and the entrance exam were perceived to be in the position to determine cut-offs which are predictors for passing the Philippine Licensure Examination (Malimbag, 2009).
Many studies that have been done on nursing quality focused on a single factor such as putting emphasis on nursing care while neglecting other characteristics and components (Mamaoag and Magno, 2005). The study involved four culturally relevant characteristics of Filipino nurses: caring, compassion, commitment and connectedness. As stated, these factors of nursing quality are directed towards the others where caring means providing comfort, compassion is sympathetic consciousness of others, commitment is responsibility to others and the profession, and connectedness is the nurse-patient bond.
A growing concern now exists on the decline in the quality of care given by nurses and their ability to render effective care. This has been the reason why the Commission on Higher Education has identified several ways of upholding nursing quality. Schools with
3 passing rates below the national standards have been given warnings by the Commission on Higher Education making it a must for school administrators to know firsthand possible ways of determining the performance of their students in the said examination in order for them to identify their course of action. The researchers of this study aim to discover and understand the relationship that students’ performance in the Nursing Aptitude Test may possibly have to their performance and ability to pass the Philippine Nursing Licensure Examination, determine whether the Nursing Aptitude Test can be used as a predictor for passing the Philippine Nursing Licensure Examination.
The proponents prompted this research study due to the low passing rate of our institution. For the past years, the average passing rate of the Notre Dame of Midsayap College – College of Nursing has been above the national passing rate. However, with the school’s aim for academic excellence, this is still not enough. This study may be helpful by providing a basis for improvement and selecting measures to not only ensure that the students receive quality nursing education, but also to know who among the students are ready to take the Philippine Nursing Licensure Examination and what steps to take in order to have a high passing rate.
Statement of the Problem
The main purpose of this study is to determine if a relationship exists between the result of the students’ NAT examination and their performance in the Nursing Licensure Examination, and to refine our understanding on how preferences and skills in learning, which are assessed through the Nursing Aptitude Test, affect the performance of nursing students in the Philippine Nursing Licensure Examination. This study aims to answer the following questions:
1. What are the scores of the students in the Nursing Aptitude Test and the Philippine Nursing Licensure Examination? 2. Is there a significant relationship between the students’ performance in the Nursing Aptitude Test and the Nursing Licensure Examination?
Scope and Limitation
The study is limited only to the analysis of the scores of the students in the Nursing Aptitude Test and the Nursing Licensure Examination and determining whether their performance in the Nursing Aptitude Test can be used as a criterion for determining the students’ performance in the Licensure Examination. This also includes assessment of the strengths and weaknesses of the students in the
5 Philippine Nursing Licensure Examination and analysis of the correlation of the performance of the students in the Nursing Aptitude Test and the different subjects of the Philippine Nursing Licensure Examination.
Although this study includes students’ performance in the NLE and the NAT examination, it excludes other factors like time for review, values, beliefs, and others. As stated by Mamaoag and Magno (2005) based on the model on nursing quality by Valanis (2000), nurse competencies entail aspects of abilities more than affective qualities. Valanis contended a more crucial need for nurses to possess competencies rather than focus on the separate etymological concepts.
Significance of the Study
This study may help in the evaluation of the effectiveness of the implementation of utilizing the Nursing Aptitude Test for ensuring excellent nursing education for students. It may serve as a preliminary investigation on Nursing Aptitude Test (NAT) as a predictor for passing the Philippine Nursing Licensure Examination (PNLE) and as basis for making changes, policies and teaching strategies to ensure quality of education. The NAT, being a test for evaluation of students’ readiness
6 for the course, may be a probable criterion for evaluating students’ ability to pass the Nursing Licensure Examination. And because the test evaluates a student’s skills and learning preferences, it can be used to study the effect of their skills and learning preferences on their performance in the Board Exam and their performance as future nurses. Knowledge on this topic would be helpful to administrators in selecting actions to be taken to improve performance and quality of education the students receive and ensure a high passing rate in the Philippine Nursing Licensure Examination.
This could be helpful to the College of Nursing by providing the department an insight on several factors affecting the performance and competence that the students have. A refined understanding on the relationships between NLE performance, competence, and learning preferences as well as readiness may be helpful in providing a basis for improvement and selecting measures to not only to ensure that the students receive quality nursing education but also know who among them are ready for the Philippine Nursing Licensure Examination and ways of ensuring a high passing rate.
Definition of Terms
7 For clarity of terms used in the study, the following operational definitions are given:
Affective Qualities . refers to qualities related to a person’s attitude and behavior rather than competence or performance Community Health Nursing. refers to a nursing subject which is part of the Bachelor of Science in Nursing Curriculum and the subject 3 of the Philippine Nursing Licensure Examination focused on concepts and principles in the provision of basic care in terms of health promotion, disease prevention and health maintenance of the individual, family, community and special population groups. It also includes the study of the Philippine Health Care Delivery System and the general context of public health. It describes public health in the context of the Philippine Health Care Delivery System. Competence. refers skills, knowledge, personal characteristics and ability to render effective client care. Fundamentals in Nursing. refers to a nursing subject part of the Bachelor of Science in Nursing Curriculum and subject 1 of the Philippine Nursing Licensure Examination that is about standard operating procedures, basic principles in nursing, normal values and the nursing process.
8 Learning. refers to a change in a person’s behavior, perception, skills and attitude that occurs through teaching, practice and experience. Learning Preferences. refers to the type of learning or teaching strategy that a student(s) find most comfortable and easily understandable. Medical – Surgical Nursing. refers to a nursing subject part of the Bachelor of Science in Nursing Curriculum and subject 4 of the Philippine Nursing Licensure Examination that is about techniques and principles in nursing management of sick clients across the lifespan in any setting. Nursing. refers to the protection and promotion of optimal health and prevention of injuries, alleviation of suffering through diagnosis and treatment of human responses, focusing not only on the individual but also includes the family and the community. Nursing Aptitude Test (NAT). refers to a diagnostic test given to nursing students giving an insight on the profile of a student on four areas: verbal reasoning, numerical facility, science and health and spatial aptitude. Philippine Nursing Licensure examination (PNLE). refers a test given to nursing graduates to determine whether they are qualified for the nursing profession.
9 Psychiatric Nursing. refers to a nursing subject part of the Bachelor of Science in Nursing Curriculum and subject 5 of the Philippine Nursing Licensure Examination that is about techniques and principles in nursing management of sick clients across the lifespan with maladaptive behaviors and alterations in cognition in any setting. Quality Care. refers to effective care rendered by nurses and other health care professionals to their clients/patients. Related Learning Experience. refers to a component of the Bachelor of Science in Nursing Curriculum which is the clinical application of the principles taught in the classroom.
REVIEW OF RELATED LITERATURE, STUDIES AND CONCEPTUAL FRAMEWORK
This section presents related topics regarding the types of tests, NAT Examination, The Nursing Licensure Examination and Nurse Competence.
Nursing Achievement and Aptitude Majority of studies in nursing shows that nursing achievement is moderately perceived as important. This concerns a great concern to improve the abilities of nurses such as their aptitude and academic
11 achievement. The common measure of nursing achievement in published studies on nursing education can be found in the results of licensure examinations such as the NCLEX (National Council Licensure Examination). In the Philippine setting, the Philippine Regulation Commission also uses a test for the licensure of nurses, although there are no published studies using the said instrument.
Three studies are published in reviews using the NCLEX as a measure of nursing achievement. The study by Lamm and McCaniel (2000) used the State Board Test Pool Examination (SBTPE), Grade Point Average (GPA), parental education level, and age as predictors of the NCLEX. The purpose of the study was to identify which variables accurately predict the success of practical nursing students on the NCLEX-PN. The results indicate that among all predictors, the General Mental Ability (GMA-subscale of SBTPE) was the only significant predictor of the NCLEX-PN. A recent study by Waterhouse and Beeman (2003) was able to identify more significant predictors of the NCLEX such as scores in the Risk Appraisal Instrument (RAI), grades in the different nursing courses, and the nursing achievement test. In a more recent study, Giddens and Gloekner (2005) investigated the relationship between critical thinking and the performance scores on the NCLEX. Their study showed that both measures of critical thinking (California Critical Thinking Test and California Critical Thinking
12 Disposition Inventory) did not significantly predict the NCLEX scores. The study recognized the need to explore other dispositional variables in explaining nursing achievement scores. The studies on nursing achievement usually correlated other cognitive measures such as critical thinking, mental ability, grades, with demographic factors such as age, gender, and parents’ educational level. Previous studies did not explore other dispositional factors such as nursing quality traits in predicting nursing achievement levels because these concurrent studies were driven by the factors explained by other previous studies. This poses a need to explore and use other kinds of disposition such as quality traits in explaining nursing achievement and aptitude (Mamaoag and Magno, 2005).
Education/Licensure Students of nursing bring abilities and attitudes to their nursing courses. Within the course the knowledge and skills of nursing are presented. Together the educators and students attempt to integrate knowledge with caring, abilities with skills, skills with knowledge and so on. Not all students of nursing in formal courses are beginners. Many possess valuable skills and knowledge that are relevant to nursing. The Recognition of Prior Learning (RPL) of skills, experience and qualifications can be expedited by the use of Competencies. If a
13 student or nurse believes they already possess the integrated attributes required in some aspect of nursing, they could be assessed against the Competency and gain RPL. Savings in costs of education and time for the learner can be achieved in this way. However to date, this aspect of the use of Competencies in nursing has not been widely used. Another definition of Competency is the ability to perform the activities within an occupation or function to the standard expected in employment.' (Heywood, Gonczi & Hager, 1992). One of the central themes of the use of Competencies in education is the change of focus from what a student is taught and the knowledge they learn, to outcomes, or demonstration of what the learner can actually do. Many nurses have difficulty in understanding the competency movement because nursing has traditionally prepared its students in settings and in a manner that closely resembles this description. Hospital-based schools of nursing presented theory and skills for learning that were highly relevant and functional to the standard expected in the hospital ward. Since the move of nursing education to tertiary settings, the workplace nature of much of the learning and application of that learning has altered. However, nursing courses for Enrolled and Registered nurses remain based upon the knowledge, skills and attitudes nurses are expected to demonstrate in
14 employment in a wide variety of contexts and settings. More emphasis is placed on ensuring every participant gains and is able to apply the required competencies in the course of their occupation or profession. Competency-based Education and Training have been introduced to many occupational and trade vocational preparation programs as well as to some professional programs and courses such as nursing. Another distinct feature of Competency-based education or training is the emphasis on assessment in real-life settings and situations. The demonstration of knowledge is frequently assessed by judging its application in the work situation rather than by undertaking written exams. Although students of nursing may no longer be employees of the hospital where they gain clinical experience, much of the assessment of their suitability to qualify as a nurse, or their competency in nursing, takes place in the real-life setting. This may be in the context of planning the care of a patient upon admission to the surgical ward of a hospital, providing care at the bedside of a patient in the nursing home, caring for a child in the operating room, assessing a client in a community clinic or their home or teaching the patient and their family about medications. Using descriptions of the performance competencies required of RNs or ENs throughout Australia (for example, the standards of a nurse
15 who undertook basic preparation in Western Australia can be compared with one who graduated in Queensland), the equivalence of professional performance can be determined. A nurse from Argentina or Thailand or Great Britain can also be assessed for suitability for recognition in any state, by assessing each individual's nursing performance and knowledge using the Australian nursing competencies(Hird, 1995). Do Nursing Quality Traits affect Ability Measures? Nursing quality traits do not affect ability measures, but aptitude affects achievement in nursing. These findings support previous models of using cognitive factors to predict cognitive criterion as well. Current literature describes nursing licensure exams like NCLEX as a measure of nursing achievement. Most often, studies indicate factors such as general mental abilities, Grade Point Average (GPA), parental education level and age as best predictors of success in passing board examinations. None ever described yet that empirically, personality or personal attributes can also predict success in the nursing profession.
The findings indicate that affective measures such as traits are not good predictors of ability measures such as achievement and aptitude. The nursing traits having no effect on both aptitude and achievement further indicate that nursing quality is distinct with the
16 two ability measures. The distinction is indicated by the nature of the constructs itself – where the nursing traits are non-cognitive and the ability measures as cognitive. The traits were self-reported that may be subject to social desirability in the measurement, while the ability measures are tests of one’s achievement and aptitude that are assumed objective. Previous studies that used affective predictors also did not yield significant effects for ability measures like the risk appraisal assessment (Waterhouse & Beeman, 2003).
Apparently there is a need to explore and use other measures of disposition aside from quality traits in explaining nursing aptitude and achievement. However, the belief that human functioning includes behaviors, person variables, and the environment that are interacting with and shaping with one another (Bandura, 1986) has been further strengthened as indicated in the resulting model tested in this study. Further studies can include other disposition measures such as interest, motivation, and self-efficacy in exploring the predictability of successful careers in nursing. A further analysis using a larger sample needs to be undertaken to increase the power of the statistics (Magno and Mamauag, 2007).
17 Is the Integration of Nursing Quality with Ability Measures a Good Model? Integrating nursing quality with both aptitude and achievement shows a considerable good fit for the proposed model and more so with the constrained model as indicated in the noncentrality fit indices and single sample fit indices. The good fit of the resulting model may be attributed to the three distinct measures of the NQS, Aptitude, and Achievement tests. Considering that these all belong in a single test battery, the participants of the study most likely saw the parallelism in the measures used. It also indicates that the structure of the three variables fit together because all the items were calibrated with person ability by using the same one parameter Rasch model in a binary response type of scaling (“0” and “1”). The technique of calibrating the infit and outfit characteristics of items for all the factors in a model increases its fit indices.
Unlike earlier studies that generated multivariate procedures, the SEM takes a confirmatory rather than exploratory approach to data analysis as illustrated in this study. While most of the multivariate techniques from previous studies provides regression and predictive models of nursing achievement, the present study showed that the factors of nursing quality, achievement, and aptitude fits together in a structural model. As depicted in this study, the constructs of nursing
18 quality, aptitude, and achievement in nursing were shown to be independent measures of both non-cognitive and cognitive abilities. The integration of the nursing quality with ability measures was apparently good as a model but the model also showed that affective qualities are independent of cognitive abilities.
Aside from citing statistical considerations and benefits of using the SEM and Rasch model applications as shown in this study, nurses in the academic setting are expected to possess all the necessary competencies, skills, attributes to be effective in their profession (Valanis, 2000).
Standardized Tests A standardized test is one that is administered under standardized or controlled conditions that specify where, when, how, and for how long children may respond to the questions or "prompts." Standardized tests should meet acceptable standards for technical qualities in construction, administration, and use. Goodwin and Driscoll (1980, pp. 59-60) note that standardized tests have the following qualities: 1. They provide a "systematic procedure for describing behaviors, whether in terms of numbers or categories."
19 2. They include specified procedures for administration and scoring. 3. The test items are derived from experience, either by experiment or observation, rather than theory. 4. They have an established format and set of materials. 5. They present the same tasks and require the same response modes from all test takers. 6. They provide tables of norms (see standards for technical qualities) to which the scores of test takers can be compared in order to ascertain their relative standing. The great majority of standardized tests are marketed by commercial test publishers, who have prepared them for use in a broad array of educational institutions in many different settings. This means that they are based on educational objectives common to such diverse schools, and "rarely will these common objectives coincide exactly with the specific objectives of the individual classroom teacher or project director" (Goodwin & Driscoll, 1980, p. 60). Individually administered standardized tests can serve important purposes when they are selected wisely and used as intended by the test developers, and their results are not overgeneralized or misinterpreted. Hills (1992) notes:
20 "The primary strengths of standardized tests, if they are properly designed and properly used, are that they can eliminate biases in assessment of individual children and that they provide data that can be aggregated, permitting comparisons of groups to a standard." (p. 49) School personnel must not, however, limit assessment to such tests or allow the tests to dominate assessment of the test takers.
Can readiness be considered as an important aspect of learning? Readiness may be included in the factors that affect education and learning. As stated by Nunnery (2005), readiness is an important concept in learning, regardless of the learner’s chronological age. For teaching to be effective and learning to take place, the readiness of the learner must be a prime consideration. How Learning, Readiness, Cognitive Aspects and Understand are Related Learning is the perception of and assimilation of the information presented in a variety of ways. Learning has the following aspects:
21 1. perception of new information 2. initial reaction to the information 3. ability to recall or repeat the information (simple knowledge level) 4. rejection or acceptance of the information (understanding) 5. use of the information in a similar situation (application) 6. critical analysis of the information 7. incorporation of the information in the values system (evaluation) 8. use of the information in various situations and combinations 9creation) an increasing complexity emerges here as the learner moves from receiving and recalling information through: 1. understanding 2. application 3. analysis 4. evaluation of the knowledge acquired and creation of new applications Learning can also be enhanced with specific strategies or approaches: individual styles vary, motivation strengthens learning, arousal influences attention, application in varied context broadens
22 generalization, personal history shapes the perception of the experience (Nunnery, 2005). In terms of learning and cognitive aspects, what has to be remembered is that to achieve a lasting change in observed behavior (which is the goal of learning), the value of that change (affective domain of learning) and the intellectual capacity (cognitive domain) must first be present (Nunnery, 2005).
Main Areas of the Nursing Aptitude Test Nursing career is getting attention all around the world. However, unlike mechanical and technical professions you need some qualities of heart for nursing jobs. The best in the nursing services have been generous, loving and compassionate. Still nursing career is not considered personal because it involves a lot of team work. You will have to take care of physically or mentally ill people. You have to perform in different roles such as a disciplined care giver, a counselor, a manager, a teacher etc. Your every action shall focus upon benevolence of the patients. Furthermore, you need not only to be responsible and dependable but also capable to accept truths of death and life.
23 Most of the nursing jobs screen you through nursing aptitude tests. The psychologists build them around the following main areas: A. Applied Sciences 1. Physics - The multiple choice questionnaire tries to measure your comprehensions for mechanics, measurements, laws of thermodynamics, acceleration, momentum etc. 2. Organic and Inorganic Chemistry - You have to take care of the patients with certain medicines and chemicals. You are expected to know basics of solvents, electrons, titration, periodic table etc. 3. Daly Life Science - You need to learn basics of TCA cycle, ATP, cardiac control, human nervous system, endocrine glands, ECG basics, cardiovascular system, lungs and respiratory effects, thyroid hormones, etc. You are expected to hear and use these basic things about the human medical science for your life long nursing career. 4. Vocabulary Skills - The nursing career requires you to have correct knowledge of different words. Sometimes, your wrong perception of words can put lives of the patients in severe danger. That’s why vocabulary skills are tested with nursing aptitude test. 5. Mathematics Skills - Though the nursing aptitude tests include only a portion of math to test your mathematical reasoning but it is still a
24 important to know about real numbers, fractions, trigonometry, area calculations, logarithmic scale etc. 6. Reading Comprehension - In your nursing career you will have often to read the instructions issued by the doctors during their visits. When you fail to comprehend the simple instructions, you can’t help the patients in any way. So your reading comprehension is also tested before you qualify for entry level nursing jobs. 7. Analytical Reasoning - Analytical reasoning helps you to make quick decisions during emergency. Most of the nursing aptitude tests include this portion before you are selected for a nursing career.
Independent Variable Variable
25 Nursing Aptitude Test 1. Judgment in Nursing Situations 2. Visual Memory 3. Memory for Content 4. Information 5. Scientific Vocabulary 6. Ability to Understand and Follow Instructions Philippine Nursing Licensure Examination Fundamentals of Nursing Community Health Nursing, Maternal and Child Health Nursing Medical-Surgical Nursing Part I Medical-Surgical Nursing Part II Psychiatric Nursing
Figure 1.1 shows the conceptual framework of the study demonstrating how the student’s abilities, which are assessed through the Nursing Aptitude Test (NAT) which include all important skills that nurses require such as judgment in nursing situations, visual memory, memory for content, information, scientific vocabulary and ability to understand and follow instructions, affect their performance in the Philippine Nursing Licensure Examination. CHAPTER III
This chapter presents a brief description of the method used in the research including the research design, study subject, method of sampling used, research instrument, data gathering procedure and methods of data processing.
The researchers used the descriptive correlational design. It does not infer cause-and-effect but describes the relationships between two variables namely the students’ performance in the Nursing Aptitude Test and their performance in the Philippine Nursing Licensure Examination.
Respondents and Locale of the Study
The population of this study is defined as the 4th year nursing students of Notre Dame of Midsayap College during the school years 2006-2007 and 2007-2008 who have taken the Nursing Aptitude Test, graduated, complied with the requirements and have taken the Philippine Nursling Licensure Examination regardless of whether they passed or not.
The researchers utilized complete enumeration to select the respondents for the study. This is due to the small number of students
27 in the nursing department of Notre Dame of Midsayap College and to ensure higher reliability of the results of the statistical treatment.
The research instrument in the study mainly composes of official records of the outcomes of their Nursing Aptitude Test of the respondents from the Notre Dame of Midsayap College Guidance Office and records of their scores during the Philippine Nursing Licensure Examination with permission from the dean of the College of Nursing, Psychometrician and Guidance Counselor.
Data Gathering Procedure
The data needed for the study are official records of the results of the Philippine Nursing Licensure Examination and the records of the results of the Nursing Aptitude Test in the Guidance Office of Notre Dame of Midsayap College.
Data gathering began by obtaining the approval of the dean of the College of Nursing to conduct this study and gather the data, permission and approval of the Guidance Office of Notre Dame of Midsayap College to have access to the grades and scores of the
28 respondents included in the study. Reviewing these materials ad securing our own copy of these materials were the most crucial parts of this process.
The statistical treatment used to analyze the data and determine the degree of association and closeness of relationship between the two variables is the Pearson r or the Pearson Product-Moment Correlational Coefficient.
The correlational coefficient in this method is measured on a scale that varies from positive one through zero to negative one. When one variable increases as the other does, then the correlation is positive; when one decreases as the other does, the correlation is negative. Complete absence of correlation between two variables would mean an r-value of zero (Basilio et al, 2003). CHAPTER IV
PRESENTATION, ANALYSIS AND INTERPRETATION OF DATA
This chapter contains a presentation and analysis of all the data collected as part of the research. These data include scores of the
29 respondents in the Nursing Aptitude Test and the Philippine Nursing Licensure Examination which is also comprised of different subjects namely: Fundamentals of Nursing (Subject 1), Community Health Nursing (Subject 2), Psychiatric Nursing (Subject 3), Medical-Surgical Nursing (Subject 4), and (Subject 5).
The demographic profiles of the respondents have not been included since the only factors that have been considered were the Nursing Aptitude Test and the Philippine Nursing Licensure Examination results.
The results of the Nursing Aptitude Test have been correlated to every subject of the Philippine Nursing Licensure Examination.
Scores of the Respondents in the Nursing Aptitude Test and the Philippine Nursing Licensure Examination
The Nursing Aptitude Test which is given to nursing students before they proceed to Level 2 may have a significant relationship to their performance in the Philippine Nursing Licensure Examination. The 5 areas of the Nursing Aptitude Test namely: Judgment in Nursing
30 Situations, Visual Memory, Memory for Content, Information, Scientific Vocabulary, and the Ability to Understand and Follow Directions are all necessary characteristics that nursing students and nurses alike should possess. Therefore, the performance of nursing students in the Philippine Nursing Licensure Examination may be affected by their skills in these areas.
On these grounds, the following discussions present the scores of the respondents in the Nursing Aptitude Test and the Philippine Nursing Licensure Examination including both the general average and their scores in 5 different subject areas of the Philippine Nursing Licensure Examination, and the correlation between these scores. Data regarding these are presented in the following tables.
Table 1.1 Table 1.1 presents the respondents’ scores in the Nursing Aptitude Test.
Number of Respondent 1 2 3 4 5 6 7 Nursing Aptitude Test 70 77 74 77 75 77 82 8 9 10 11 12 13 14 15 16 79 75 83 78 78 78 75 75 81
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 72 73 73 80 72 76 74 85 77 85 81 79 76 86 79 79 82 82 82 90 71 80 78 77 85 73 85 76 79 76 77 71 82 76 75 72 75 87 81 78 79 77 83 72 85 78 74 80 82 80 67 68 69 70 71 74 85 80 73 74
Table 1.2 Table 1.2 presents the ranks, range of scores, frequency and percentage of scores in the Nursing Aptitude Test.
RANK Low Average Average High Average Above Average Superior Excellent RANGE OF SCORE 17-30 31-68 69-86 87-96 97-98 99-100 FREQUENCY 0 0 69 2 0 0 PERCENTAGE 0% 0% 97.18% 2.9% 0% 0%
Based on the data presented above, 69 or 97.18 percent of the respondents ranked high average (R=69-86) while 2 or 2.9 percent ranked above average (R=87-96). These findings indicate that majority of the respondents ranked high average in the Nursing Aptitude Test while only a few of them have ranked Above Average. This reflects the effectiveness of the methods that the College of Nursing uses in screening students. Students that are accepted are required not only to have satisfactory grades but also good performance and aptitude. This is the reason why the use of the Nursing Aptitude Test to measure these things is considered as an important part of ensuring that the Notre Dame of Midsayap College – College of Nursing is not only able to produce very capable graduates but also maintain a high passing rate in the Philippine Nursing Licensure Examination. Scores in the Philippine Nursing Licensure Examination
The Philippine Nursing Licensure Examination has 5 areas namely the Nursing Practice I (Fundamentals of Nursing), Nursing Practice II (Maternal and Child Health Nursing, Community Health Nursing), Nursing Practice III (Medical-Surgical Nursing part 1), Nursing Practice IV (Medical-Surgical Nursing part 2), and Nursing Practice 5 (Neurological Medical-Surgical Nursing, Psychiatric Nursing). These are all key areas in the nursing profession. The examination also assesses the skills of a nurse in different key areas of competency which mainly revolve on responsibilities of nurses and how to give quality care to patients in different stages of life.
Learning preferences and skills are very important not only for a graduate who takes or is about to take the Philippine Nursing Licensure Examination but also for professional nurses because learning does not stop when one becomes a registered nurse. Judgment in nursing situations, visual memory, and memory for content, information, scientific vocabulary and ability to understand and follow instructions are skills that all nurses must possess. Experiences in the clinical setting prove that nurses are regularly faced with situations wherein they are required to make decisions when they care for their patients. Making the right decision in these situations is crucial because nurses are held responsible for the lives and welfare of patients. The knowledge they have can become basis for the decisions they make
and their vocabulary and ability to understand and follow instructions are all important when it comes to carrying-out doctors’ orders.
On these grounds, the following discussions present the mean of scores of students in the Philippine Nursing Licensure Examination per subject area and as a whole, the passing rates in the different areas, standard deviation of their scores and the value of r which shows the correlation of the variables.
Table 1.3 presents the mean of the scores of the respondents in the Philippine Nursing Licensure as a whole and per subject area, the passing rates in these areas, the standard deviation of the scores and the value of r. SCORE General Average in PNLE Subject I Subject II Subject III Subject IV Subject V
MEAN OF SCORES PASSING RATE STANDARD DEVIATION
VALUE OF R 0.51 0.53 0.35 0.25 0.41 0.46
73.06 77.73 73.58 74.32 66.59 72.86
52.11 98.59 90.14 91.55 56.34 81.69
5.66 5.72 6.67 6.37 9.4 7.85
Based on the data presented above, subject I (Fundamentals of Nursing) has the highest mean (77.73). It is followed by subject III with a mean of 74.32, subject II with 73.58, subject V with 72.86 and finally subject IV with a mean of 66.59.
When analyzed by passing rates, subject I (Fundamentals of Nursing) has the highest passing rate (98.59%) suggesting that students have been able to receive good foundation on this subject. Subject IV (Medical-Surgical Nursing part 2) on the other hand, has the lowest passing rate (56.34%) although the passing rate of students in subject III which is part 1 of Medical-Surgical Nursing is quite high. This shows that Medical-Surgical Nursing is indeed a broad subject. A low passing rate in subject IV means that not all concepts in this subject
area (Medical-Surgical Nursing) have been discussed. Since it involves all concepts regarding care of patients in all stages of life with illnesses in different systems or organs, all medications, medical managements, nursing responsibilities and even assessments, students need more time to familiarize themselves with these different concepts. Since the time they have for review is limited, it is crucial that they be given a background of these concepts as early as possible in the school setting. The very high standard deviation of the respondents’ scores in this subject (9.4) shows the inconsistency in their performance. As presented above, subject I (Fundamentals of Nursing) has the lowest standard deviation suggesting that the scores of the respondents has the least difference in this area.
When analyzed by their correlation to the independent variable, subject I (Fundamentals of Nursing has the highest correlation (r=0.53) which is even higher than the correlation of the Nursing Aptitude Test to the general average of the respondents in the Philippine Nursing Licensure Examination (r=0.51). These show a very high positive correlation to the Nursing Aptitude Test suggesting that the performance of students in the Nursing Aptitude Test can determine their performance in subject I (Fundamentals of Nursing) and the Philippine Nursing Licensure Examination as a whole. Performance in subjects II, IV and V have moderate positive correlation to their
performance in the Nursing Aptitude Test which means that the Nursing Aptitude Test can also determine performance of students in these areas. As presented above, there is a moderately small positive correlation between the performance in the Nursing Aptitude Test and subject III or Medical-Surgical Nursing part 1 (r=0.25). Although there is a positive correlation between the two, it is the least. The low correlation in this area suggests that performance in subject III is not affected so much by a person’s skills (those assessed in the Nursing Aptitude Test). This may be where factors such as teaching strategies, time for learning, and review come in. This shows how important quality education is. The high mean of the scores and passing rate in this subject area suggests that the College of Nursing has been able to give the students this kind of education.
SUMMARY OF FINDINGS, CONCLUSIONS AND RECOMMENDATIONS
Restatement of the Problem The main purpose of this study is to determine the relationship between the result of the students’ NAT examination and their performance in the Nursing Licensure Examination. Another is to refine our understanding on how preferences and skills in learning which are assessed through the Nursing Aptitude Test affect the performance of nursing students in the Philippine Nursing Licensure Examination. This study aims to answer the following questions:
1) What are the scores of the students in the: Nursing Aptitude Test and Philippine Nursing Licensure Examination? 2) Is there a significant relationship between the students’ performance in the Nursing Aptitude Test and the Nursing Licensure Examination?
Summary of Findings
Based on the presentation, analyses and interpretation of data, the following are the major findings of the study:
1. Analysis of the scores of the respondents in the Philippine Nursing Licensure Examination revealed that the highest scores are Subject 1 (Fundamentals of Nursing) with a passing rate of 98.59 percent and a mean of 77.72. This is followed by Subject 3 (Medical-Surgical Nursing part 1) with a passing rate of 91.55 percent and a mean of 74.32. Subject 2 (Maternal and Child Health Nursing, Community Health Nursing) follows with a passing rate of 90.14 and a mean of 73.58 then Subject 5 (Neurologic Medical-Surgical Nursing, Psychiatric Nursing) with a passing rate of 81.69 percent and a mean of 72.86. The lowest scores that the respondents had during the Philippine Nursing Licensure Examination were in Subject 4 (Medical-Surgical Nursing part 2) where only 56.34 percent passed the subject and the mean is only 66.59. 2. With the scores of the students we can say that they have a good foundation in the Fundamentals of Nursing, Maternal and Child Health Nursing, Community Health Nursing, Psychiatric Nursing and Medical-Surgical Nursing part 1. As of their performance in Subject 4 (Medical – Surgical Nursing), it
demonstrates a weak point in their education and a need for strengthening their foundations in this subject (Medical – Surgical Nursing). The high passing rate in the first part of this subject suggests that the result of the low passing rate in the second part would be that the students were not able to encounter the concepts included in the second part of Medical-Surgical Nursing. This may be a result of the lack of time allotted for the subject.
Analysis of the correlation of the scores of the
respondents in the Nursing Aptitude Test and the Philippine Nursing Licensure Examination as a whole and by subject showed that there is a strong relationship between the variables. Correlating the scores in the Nursing Aptitude Test and the general average of the respondents in the Philippine Nursing Licensure Examination showed that there is a high correlation between the two variables (r=0.5125). Upon correlation of the scores in the Nursing Aptitude Test and the scores in the 5 different subjects in the Philippine Nursing Licensure Examination, researchers have identified that the subject with the greatest correlation to the Nursing Aptitude Test is the Subject 1 or the Fundamentals of Nursing (r=0.53), followed by Subject 5 or Psychiatric Nursing (r=0.46), Subject 4 or Medical Surgical Nursing part 2 (r=0.41), Subject 2 or Maternal and Child
Health Nursing, and Community Health Nursing (r=0.35), and Subject 3 or Medical-Surgical Nursing part 1 with the least correlation (r=0.25).
Based on the findings of the study, the researchers have formulated the following conclusions:
1. The College of Nursing especially the Clinical Instructors have been able to give the students a good foundation on these subjects: a. Fundamentals of Nursing b. Maternal and Child Health Nursing c. Community Health Nursing d. Psychiatric Nursing This is demonstrated by a high passing rate and high average score of students in these subjects. 2. Nursing education given to students should focus on strengthening their foundations 3. More time must be given to Medical-Surgical Nursing to be able to cover all the important concepts and further strengthen the foundation and understanding of students in this subject.
4. The Nursing Aptitude Test can be used as a predictor for the performance of students in the Philippine Nursing Licensure Examination and may also be used to determine how well they perform in the different subjects of the Philippine Nursing Licensure Examination particularly on Subjects 1, 4 and 5 which have the moderate and high correlation to the scores in the Nursing Aptitude Test.
In the light of the findings of the study, the researchers have made the following recommendations:
A. Possible Course of Action 1. Clinical Instructors assigned on these subjects should have a good background on the subject for him to be able to impart knowledge to students and be able to properly discuss the topics so students would be able to completely understand the subject. 2. Clinical Instructors should always be updated about current issues related to nursing for them to be able to share this to students.
3. Clinical Instructors should monitor the performance of students. Clinical instructors should then take the necessary steps to improve their performance in areas where it is not satisfactory. 4. The Nursing Skills Laboratory should have better equipment and facilities where students can practice and simulate clinical skills. 5. There should be more books and other updated sources of information on Medical – Surgical Nursing in the library which are accessible to nursing students. 6. In terms of Related Learning Experience, ward classes should be practiced to reinforce the knowledge that students receive in the classroom and also help them understand cases that they encounter in the area. 7. Students need to have more review sessions on Medical – Surgical Nursing. And the review center must be well-chosen to ensure that the students receive the best lectures and instructions. 8. Nursing students should do their best to expand their knowledge and understanding of topics related to Medical – Surgical Nursing. 9. Administrators should monitor the performance of the students and instructors.
B. Further Studies In the light of the findings of the study, the researchers recommend the following for further studies: 1. Further studies should include the academic performance of students as a predictor for their performance in the Philippine Nursing Licensure Examination. 2. Further studies should also utilize other statistical tools or treatment to determine the correlation of the variables (e.g. regression).
A) BOOKS 1. Divinagracia, C. (2008). Bachelor of Science in Nursing Curriculum. Manila, Philippines: ADPCN Inc. 2. Mamauag, M. & mango, C. (2005). Nursing Quality Scale: Test Development. Unpublished manuscript. Asian Psychological Services and Assessment, Inc. 3. Subong, P. (2005). Statistics for Research. Quezon City: Rex Printing Company Inc., 2005 4. Theodore, C. A. (1982). Managerial Statistics. Belmont, California: Kent Publishing Company, 1982 5. Valanis, B. (2000). Professional Nurisng Pracices in an HMO: the future is now. Journal of Nursing Education. 39, 13-26. 6. Polit, D. and Beck, C. (2005). Nursing Research. Philadelphia: Lipincott Williams and Wilkins
B) INTERNET 1. Roman, M. (2005). Assessing Nursing Competency. Available at: http://www.docstoc.com
2. How to Find the Correlation Coefficient When Doing Statistics. Available at: http://www.ehow.com 3. Main Areas of Nursing Aptitude Tests. Available at:http://www.wikipedia.com 4. Hird, V. Nursing Competencies. Available at: http://www.medcenter.com
Scores of the respondents in the Nursing Aptitude Test
Number of Respondent 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 Nursing Aptitude Test 70 77 74 77 75 77 82 79 75 83 78 78 78 75 75 81 72 73 73 80 72 76 74 85 77 85 81 79 76 86 79 79 82 82 82 90 71 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 80 78 77 85 73 85 76 79 76 77 71 82 76 75 72 75 87 81 78 79 77 83 72 85 78 74 80 82 80 74 85 80 73 74
Scores of the Respondents in the Philippine Nursing Licensure Examination.
Number of Respondent 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 PHILIPPINE NURSING LICENSURE EXAMINATION Subject Subject Subject Subject Subject Gen. 1 2 3 4 5 Ave. 80 72 80 57 63 70.4 81 67 82 73 72 75 79 78 77 76 77 77.4 70 75 75 52 61 66.6 85 67 83 77 78 78 86 69 80 76 77 77.6 80 74 80 70 72 75.2 67 60 74 56 65 64.4 75 77 76 77 70 75 61 61 76 56 62 63.2 75 72 72 59 61 67.8 75 70 74 76 67 72.4 86 76 83 76 76 79.4 78 76 77 63 52 69.2 76 69 77 77 76 75 82 69 82 70 79 76.4 77 76 79 76 70 75.6 76 66 72 71 75 72 77 71 75 57 54 66.8 74 59 65 48 65 62.2 74 69 72 56 60 66.2 88 81 85 79 79 82.4 82 73 78 71 71 75 75 78 79 65 80 75.4 77 67 67 60 63 66.8 82 82 79 75 79 79.4 76 67 77 65 70 71 72 70 69 59 71 68.2 86 71 82 76 72 77.4 77 74 79 63 69 72.4 82 78 85 64 80 77.8 75 63 77 57 69 68.2 66 62 75 56 61 64 83 84 84 80 83 82.8 72 65 76 67 66 69.2 80 80 70 65 77 75 61 72 79 56 56 64.8 72 78 71 68 77 73.2 81 79 76 75 80 78.2 77 77 61 59 77 70.2 77 59 65 60 64 66
42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71
79 79 79 88 65 76 83 76 85 80 76 78 72 79 85 87 80 80 77 80 71 83 74 82 78 74 84 82 75 77
75 77 79 87 76 62 82 65 79 79 69 77 65 75 85 81 79 78 77 79 68 81 77 80 77 68 81 79 78 76
61 76 77 79 69 75 71 62 80 76 72 71 61 71 83 78 78 71 71 76 58 72 66 72 77 59 76 71 66 77
60 69 74 79 63 46 77 53 74 63 50 69 57 57 85 82 77 75 60 77 56 76 59 68 72 57 74 63 59 78
78 81 80 80 75 64 78 68 83 79 66 80 75 75 83 83 79 80 72 82 71 81 81 72 79 72 80 81 59 80
71 76.4 77.8 82.6 69.6 64.6 78.2 64.8 80.2 75.4 66.6 75 66 71.4 84.2 82.2 78.6 76.8 71.4 78.8 64.8 78.6 71.4 76.2 76.6 66 79 75.2 67.4 77.6
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