CHAPTER I

THE PROBLEM

Background of the Study

Education at all levels has become uncertain due to the closure of schools,

colleges and universities and has changed dramatically during the crisis of COVID-19

pandemic. Moreover, due to the ongoing chaos at the teaching hospitals; medical

education has been affected probably more than other academic programs. After half year

COVID-19 crisis, it is likely that life won’t revive back to previous status. The changed

status has been labeled as ‘New normal’ in various walks of life. In this context, this

article is an attempt to explore the situation in medical education.

The World Health Organization (WHO) led the severe acute respiratory syndrome

coronavirus 2 (SARS-CoV-2) to its definition as a pandemic due to its fast propagation

on March 13, 2020 as it met the epidemiological criteria and had infected more than

100,000 people in 100 countries (Remuzzi, 2020). The main public health

recommendation was to remain at home and stay safe within it (Jackson, 2020). The

world, in a globalized manner, is facing an extraordinary public health emergency in

which the nurses are, as always, on the front line. Challenges are even greater in this

period of pandemic and nurses have the knowledge and aptitudes for providing the care

necessary in the different clinical scenarios that are emerging (Tsai, et.al, 2020).

Part of nursing's most essential foundation in nursing care is hand skills (Nelmes

2011, 11). Research has proven that learning is achieved most effectively through

practically working with your hands thereby gaining experience. Methods of teaching

have advanced immensely in recent years; one significant improvement is the use of the
modernized skills laboratory rooms that have state of the art machinery. This has made it

possible for students practice as many times as they wish. It has resulted in perfection of

hand skills generally increasing performance of clinical nursing skills among nursing

students. (Godson, Wilson & Goodman 2007, 943.)

Nursing skills competence is the use of evidence-based procedures is aimed at

promoting patient’s health by use of applicable procedure(s). It is made up of various

methods and procedures performed at skills laboratories, where skills are improved with

each training. Critical thinking is important in performing most of the skills. (Standing

2007, 260.) The effectiveness of skill laboratory is attained by fostering a good

foundation throughout nursing school. Nursing students trained early in their studies

ensures growth and experience over the studying period as one masters the technique and

becomes confident erasing uncertainty and fear of making mistakes, thereby, boldly

seeking to learn more skills while retaining those already learnt. (Raurell-Torredà, Olivet-

Pujol, Romero-Collado, Malagon-Aguilera, Patiño-Masó & Baltasar-Bagué 2015, 36;

Felton & Royal 2015, 41.)

These phenomenon leads in today’s era of the fourth industrial revolution where

human and technology are connected has had impact on all sectors, including the health

system and higher education (WEF & Schwab, 2017). Regarding higher education, the

current era is also known as Higher Education 4.0 (HE 4.0). The HE 4.0 requires

changing skills in the industry which demands a learning system alteration in the

universities (Jhingan, 2017). Universities should provide comprehensive resources based

on technology that supports the students’ development related to problem solving and
decision-making skills in order to follow along with the globalization of education

(Muawiyah, Yamtinah, & Indriyanti, 2018).

The researcher’s main objective is to discover the effects of the new normal to the

nursing students’ clinical skills. This will also provide awareness from student’s end on

how the teachers motivate them in order to face the challenges in the new normal.

Conceptual Framework

The relationship among the independent variables: Factors affecting nursing

student’s clinical skills in terms of (a) Standard health protocol and Blended learning

modalities to the dependent variables which is the Student’s Level of Clinical Skills in

the new normal as depicted in Figure 1.

As shown in the schema, the study will treat two variables, namely, factors

affecting the nursing students and their level of clinical skills in the new normal. The two

variables were seen to manifest a cause-and-effect correlation.

The effects of the new normal to the nursing students as variables are seen to

influence or cause their self-effectiveness during clinical exposure; therefore, it is

considered as the independent variable.

Student’s level of clinical skills, being the result or the outcome variable; is the

dependent variable.
 Independent Variables Dependent Variables

FACTORS AFFECTING
THE NURSING
STUDENTS IN THE NEW
NORMAL:
STUDENT’S LEVEL OF

1.1 Standard Health CLINICAL SKILLS

Protocol
1.2 Blended Learning
Modalities

Figure 1. Schematic Diagram of the Study

Statement of the Problem

This study will evaluate the effects of the new normal as perceived by the nursing

students of Blancia College Foundation Incorporated for the school year 2020-2021.
 Specifically, it sought answers to the following questions:

1. What are the affecting factors of the new normal to the nursing students in terms

of the following indicators:

1.1. Standard Health Protocols; and

1.2. Blended Learning modalities

2. What are the levels of nursing student’s clinical skills as assessed by them?

3. Is there a significant correlation between the factors affecting nursing students on

their level of clinical skills?

Hypothesis

H01. The effects of the new normal do not correlate to the nursing student’s level

of clinical skills.

Significance of the Study

The result of this study is beneficial to the following persons in many ways.

Guidance Counselors. The results to be generated by this study may guide this

group in the assessment of how the nursing students adapt in the new normal on their

self-effectiveness especially in the clinical environment and in the designing of guidance

program that would maximize academic achievements of students through their

effectiveness.

Nursing Students. Through improved motivational styles of teachers, students

would be able to generate and maintain interests in the learning process, establish and

promote the importance of learning process, establish and promote the importance of

learning skills, promote satisfaction in their accomplishment, and be motivated to

continue the exploration of knowledge in the new normal.

 School Administrators. This study may give school officials the basis in

improving school programs aimed at developing the self-effectiveness of the students

especially in doing clinical works with the assurance that the school would produce only

quality graduates especially in this time of pandemic.

Teachers. The findings of this study could be great help to teachers in their work

with the students could make their subjects interesting through the improved application

of the different motivational styles and strategies in the learning process of their students

especially using F2F and blended learning. They could also take advantage of the

intrinsic motivation that the learners possess, like self-efficacy and confidence, self-

determination, and interest during the new normal.

Future Researchers. The study’s finding must provide awareness to the nursing

students on how they should adapt in the new normal especially during clinical exposures

and may guide them on how to conduct similar studies in another setting.

Scope and Limitation of the Study

This study merely focused on affecting factors of the new normal and the

student’s level of clinical skills as assessed by them; and the possible correlation between

the two variables. This will also help the teachers and the school administration to

formulate new motivational style approach to the students in the new normal.

The respondents were limited to the send year and third year nursing students of

Blancia College Foundation Inc. for the academic year 2020-2021.

Definition of Terms

The following terms are used in this study and should be construed according to

their definitions given in this section.

 New Normal. A new normal is a state to which an economy, society, etc. settles

following a crisis, when this differs from the situation that prevailed prior to the start of

the crisis.

Clinical Skills. It is any discrete and observable act within the overall process of

patient care. Included are all those skills required during patient-doctor interactions and

in addition communication skills required during interactions with other health

professionals as part of patient care.

Self-Assessment. Assessment or evaluation of oneself or one's actions and

attitudes, in particular, of one's performance at a job or learning task considered in

relation to an objective standard.

Learning environment. This component of teacher’s motivational technique

involves the provision of a friendly and active virtual learning environment by the teacher

so that students may pay attention to class activities and eventually learn especially the

new learning schemes in the new normal.

Student’s self-effectiveness. This is the student’s belief that they have control over

things and events that happen in their lives through proper choice of activities and

environment, effort and persistence, thinking and decision making and emotional

reactions during the new normal.

Standard Health Protocol. , It is a set of instructions which describe a process to

be followed to investigate a particular set of findings in a patient, or the method which

should be followed to control a certain disease.

Blended Learning Modalities. It is a system where students receive instruction

from a teacher in a physical classroom and via online courses.

 Teachers. Refers to all people engaged in teaching at Blancia College Foundation

Inc., teaching nursing students; whether on full time or part time basis.

COVID-19. It is a disease caused by a new strain of coronavirus. 'CO' stands for

corona, 'VI' for virus, and 'D' for disease. Formerly, this disease was referred to as '2019

novel coronavirus' or '2019-nCoV.

CHAPTER II

REVIEW OF RELATED LITERATURE

The literature review relevant to this study embraced the following themes which

emerged from the research questions of the study.

Related Studies

Several studies find that strong educator presence along with quality course

content is essential elements in courses that successfully facilitate online student

engagement and learning (Moore, 2014; Swan and Shih, 2014). Establishing educator

presence in online courses can be achieved in a number of ways, such as through regular

communication with students, consistent feedback and critical discourse modeled by the

educator (Gray and DiLoreto, 2016). Online students need to feel connected to the

educator, to other students in the course and to the course content (Southard, Meddaugh

and France-Harris, 2015; Martín-Rodríguez, Fernández-Molina, Montero-Alonso and

González-Gómez, 2015. Research indicates that online learning communities can help to

create a feeling of connectedness to fellow learners and can help to establish trust in other

students as a resource for knowledge construction and knowledge growth (Cho and

Tobias, 2016). However, it is also clear that such engagement does not occur

automatically; developing a learning community takes time and is only accomplished

with conscientious effort (Beth, Jordan, Schallert, Reed and Kim, 2015).

Moreover, participants need to feel that they are engaging in human-to-human

interactions that will allow them to cultivate their professional as well as personal

relations, and the presence of an educator can be a key factor in student engagement (Cho

and Tobias 2016). A number of researchers find that the educator plays a crucial role in

scaffolding students to successfully participate in asynchronous online discussions by

providing clear guidelines for how to initiate and take part in online discussions that

facilitate learning (Beth, Jordan, Schallert, Reed and Kim, 2015; Cho and Tobias, 2016).
 In a study on how responsibility and generativity were enacted in asynchronous

online discussions in a hybrid course, Beth et al. (2015) conclude that educators can

successfully scaffold students’ online discussions in terms of both quantity (e.g., online

discussion were scheduled at regular intervals and students were required to post a

minimum number of posts) and quality (e.g., students were instructed to use a

conversationally inviting tone, to provide contextual information and to address academic

questions and comments to their peers). Others have found that in blended courses

involving few F2F classes, synchronous online classroom sessions involving interaction

and discussion can contribute positively to students’ feelings of connectedness to their

educator and fellow peers (Sidebotham, Jomeen and Gamble, 2014).

Literature and previous research has shown that student nurses have difficulty

dealing with patients who has serious illnesses and will feel anxiety and stress when

caring for patients. One study showed that after end of life education, nurses’ anxiety

diminished (Jafari et al., 2015). Another study showed that education in a specialized area

such as end of life care can adequately prepare the nurse for the challenge of caring for a

dying patient or patients who have serious illnesses (Noome, Dijkstra, Leeuwen, & Vloet,

2016). There is a need for improved quality end of life care education for students in

nursing programs in colleges and universities (Wallace et al., 2009). Many patients will

receive care in a hospice facility in the United States (Martin, 2011); and over 5,000

hospice facilities are currently licensed to provide care for patients in the United States.

These data show that caring for critical patients is in high demand and experienced

providers are needed. Because new nurses often feel overwhelmed and inadequate when

caring for critical or dying patients (Barrere et al., 2014), it is crucial that comprehensive
education on end of life nursing care is provided to all nurses and particularly to those

who work in hospice settings. With education, this inadequacy may be overcome, and

nurses may look at care of patients with a different perspective. End of life nursing care

can be an emotional challenge, but the nurse must be acclimated to such a challenging

endeavor. Nurses’ perceptions and attitudes about end of life care are formulated most

often during the first few weeks of nursing school (Jafari et al., 2015).

The American Association of Colleges of Nursing (AACN) has recently

recommended that the amount of time/course content on healthcare be reassessed in

nursing school curricula to better prepare nurses prior to graduation. The AACN also

suggested that the nursing education be offered in an online format (Rooster, 2016).

However, this is a future goal, online nursing education content is currently lacking in

nursing school curricula (Jafari et al., 2015). Enhanced healthcare can create positive

social change for both the patient and the family of the patient especially those who are in

a critical condition. The patient and family can feel overwhelmed with the terminal

outcome of death and may need added care and support (Barrere et al., 2014). It is

imperative that nurses become adequately prepared before caring for this type of patient

(Barrere et al., 2014). Enhanced education in nursing school curricula can aid nurses in

becoming familiar with the special care that a dying patient may need, as well as steps on

how to support the grieving family (Jafari et al., 2015). Specialized education in end of

life care may create a powerful social change, in that nurses will no longer feel

inadequate in caring for dying patients.

Nurses spend more time with patients than members of any other discipline in the

hospital setting (Barrere et al., 2014). Most nurses will provide care for a dying patient at
some point in their career. Nurses tend to feel uncomfortable in the end of life care

setting (Barrere et al., 2014). Research has shown that there is a lack of education for

nurses who care for dying patients (Wilson, Avalos, & Dowling, 2016). One researcher

noted that this lack of education and knowledge can affect nurses’ attitudes and

perceptions about caring for dying patients or patients with serious ailments (Wilson, et.

al., 2016). These findings were supported by Robinson and Epps (2017), who showed

that anxiety affected the attitudes and perceptions nurses have while caring for dying

patients. After receiving specific education on end of life care, nurses’ anxiety levels

decreased, and they demonstrated a caring for dying patients. Care for a dying patient can

be challenging for any nurse but is especially challenging for the new nurse. By

addressing the learning needs of student nurses, nurse educators may help them build

confidence to care for the dying patient (Bassah, Cox, & Seymour, 2016). In this study, I

show that there is a need for more education in end of life care. While most nursing

school curricula address basic concepts from a systems approach, few address the needs

of the dying patient (Schlairet, 2009). The implications for social change lie in ensuring

that end of life needs is met to ensure a peaceful end of life.

Technology and social networking with the arriving of the personal computer and

internet, ODL has led to a revolution to further support the distance education by all

disciplines (Watts & Waraker, 2008). Legg, Adelman and Levitt (2007) suggested that

the flexibility of online distance learning is particularly appealing to registered nurses, to

obtain a higher degree without having to leave their full-time position. Brown et al.

(2015) study showed students reported that in terms of digital literacy, it had shown that

it reasonably comfortable using the online learning environment. The use mobile devices,
particularly by young people, offer new and exciting possibilities for learning. Learning

with mobile devices or m-Learning has attracted researcher that focused on specific

pedagogical applications the potential of the devices (Kukulska-Hulme, 2007). Fahad

(2008) showed that mobile devices were used extensively by students to meet a learning

objective using mobile technologies. Online interaction is a tool for a successful ODL

mode in teaching and learning (Davies et al., 2015). The high degree of flexibility,

without making trips to class for face-to-face gives students opportunity to cope with the

competing priorities of housework, home, and school (Brown et al., 2015). The

flexibility, make it more convenience that encouraged active participation in online

learning environment. However, the flexibility in using the technology for interaction

varies according to the socio-demographic background of the learners, namely

professional careers, personality, age and cognitive learning style.

Interactional online support Moore (1989) outlined three types of interactions ODL

framework. There are learner-content interaction, learner-instructor interaction, and

learner-learner interaction. Recent studies in various fields such as education, business

and nursing supported Moore’s finding (Melrose & Bergeron, 2007; Munich, 2014).

Melrose and Bergeron (2007) mentioned about attributes of educators that contribute to

nursing students’ online learning, such as the ability to develop relationships, prompt

feedback, engage with students during online interaction and facilitate networking. A

study had looked at how the educator positively influences the students’ experience with

the teacher (Melrose & Bergeron, 2007). The students were more likely to stay in a

course if they have effective relationships with the educators (Atack, 2003); educators

provide a caring environment and detailed feedback on assignments (Mann, 2014);

educators were consistently online, answered students’ questions promptly, encouraged

networking, and supported students to resolve group work conflict (Melrose & Bergeron,

2007).

Related Literature

Corona Virus (COVID 19)

The current coronavirus pandemic (COVID 19) is caused by Severe acute

respiratory syndrome coronavirus 2 (SARS CoV 2), a positive-sense single-stranded

RNA virus. The initial disease outbreak started in China as a cluster of pneumonia due to

unclear etiology. The disease was linked to contact with the seafood and wet animal

market in Wuhan city of Hubei province of China. Eventually, the virus was identified as

a novel coronavirus and named as SARS-CoV-2 by the World Health Organization

(WHO). The virus spread exponentially over the next few weeks to several countries, and

WHO declared it as a pandemic on 11 March 2020. Since then, more than 1 827 284

patients have been diagnosed with a confirmed infection in 185 countries, with 113 031

deaths as per Johns Hopkins University (Zhao, S, Lin, Q, Ran, J, et al, 2020).

The virus causes animal and human diseases affecting respiratory and

gastrointestinal systems. The disease can be transmitted to when humans come in contact

with secretions and body fluids of infected animals either through droplets or

consumption of infected meat. Once the virus comes in contact with human respiratory

and gastrointestinal mucosa, it uses entry receptors angiotensin-converting enzyme 2

(ACE2) to enter the human cells (Kopel, et. Al, 2020). Transmission of disease between

humans happens through secretions, droplets, and fecal-oral contamination. The virus has

been detected in sputum, nasopharyngeal secretions, respiratory droplets, blood, stool,

and urine samples (Wang, 2020). At this time, there is no evidence to suggest vertical

transmission to the fetus during pregnancy. Experience in treating pregnant women with

COVID 19 lacks to make a clear determination at this time. The estimated incubation

period for the SARS-CoV-2 virus is around 14 days, with a median of 4-5 days. Common

symptoms of COVID-19 include fever, cough, shortness of breath reported in more than

70% of patients. Other symptoms include headache, and myalgia. Gastrointestinal

symptoms such as nausea, vomiting, abdominal pain, diarrhea, dysgeusia, anosmia, and

liver involvement have also been observed (Chen, H, Guo, J, Wang, C, et al, 2020)

CLINICAL SKILLS

Clinical skills laboratories are educational facilities that have the potential benefit

for undergraduate and postgraduate medical students and medical staff. They provide a

safe and protected environment in which the learner can practice clinical skills before

using them in real clinical settings. These skills laboratories help to ensure that all

students acquire the necessary techniques and are properly assessed before practising on

real patients. In addition, they support the acquisition, maintenance and enhancement of

the clinical skills of students in the healthcare profession. The term ‘clinical skills’

involves history-taking, physical examination, clinical investigations, using diagnostic

reasoning, procedural perfection, effective communication, team work and

professionalism (Bradley, 2003).

Medical schools and postgraduate centers have gone to considerable lengths to

create educational facilities dedicated to the teaching of clinical skills. The first CSL was

established in Maastrich, The Netherlands Limburg University 1976 (Al-Yousuf NH,

2003). Since then, many medical schools and educational institutions have integrated
CSLs into their curricula. Currently, CSLs are established in several innovative medical

schools including the University of Leeds, Dundee, Dublin, Southampton, Liverpool, and

the Imperial College. In the Arab world, the United Arab Emirates University was the

first to establish CSL in 1988 (Remmen, et.al, 2001). At present, there are many

universities in the region using CSLs as a teaching tool.

Most CSLs have core clinical skills that can be taught and learned. These include

history taking with communication skills, physical examination and some technical and

practical procedures. In general, the exact nature of the skill taught is usually determined

by the local logistical and educational requirements. With advances in technology and the

changes in teaching methodology, the list of skills that can be taught and learned in the

CSLs has grown longer. Because of the variety of these skills, it is important to define

them and determine the level of competence required at each institution. For that reason,

many CSLs involve curriculum development committees, undergraduate and

postgraduate faculty members in the planning process (Bradley, 2003). 

CHAPTER III

RESEARCH METHODOLOGY

Research Design
 In order to carry out the study, the researchers choose the descriptive research

design. This provides answers to the questions of who, what, when, where, and how

associated with a particular research problem; a descriptive study cannot conclusively

ascertain answers to why it is used to obtain information concerning the current status of

the phenomena and to describe what exists with respect to variables or conditions in a

situation.

Research Setting

The study was conducted at Blancia College Foundation Inc. situated in Brgy.

Sudlon, Mabini St., Molave, Zamboanga del Sur. The school can be reached through a

two to three-minutes motorcycle ride from the heart of Molave. It has also been

considered as a, “Child-Friendly School” by the versatile and committed school

administrator, Nida Grace P. Arcayos, R.N., M.N., MAED.

Research Respondents

There were 42 students-respondents from Blancia College Foundation Inc. 28 of

them were second year level and 14 in the third year level for the academic year 2020-

2021.

Research Instrument

In order to gather the necessary data of the study, students were given a two-part

survey questionnaire. The first part is the affecting factors of the new normal to the
nursing students, and the second part is the students’ level of clinical skills as assessed by

them.

Below are the quantitative values used for the affecting factors to weigh the data:

Numerical Scale Continuum Adjectival Equivalent

4 3.50 – 4.00 Strongly Agree
3 2.50 – 3.49 Agree
2 1.50 – 2.49 Disagree
1 1.00 – 1.49 Strongly Disagree

Rating Scale below used for quantitative values in the Clinical Skills checklist.
Numerical Scale Continuum Interpretation
5 4.50 – 5.00 Unsatisfactory (74 and below) (U)
4 3.50 – 4.49 Minimal Satisfactory (75-80) (MS)
3 2.50 – 3.49 Moderately Satisfactory (81-82) (MDS)
2 1.50 – 2.49 Very Satisfactory (83-84) (VS)
1 1.00 – 1.49 Outstanding (85) (O)

Validation of Instrument

The instrument used in the study were an adapted-modified questionnaire-

checklist and have been checked and validated by the expert research professor before

utilizing and distributing those to the samples. The researchers used random sampling in

selecting samples in which decisions concerning the individuals to be included in the

sample are taken by the researcher, based on the capacity and willingness of the target

respondents to participate in the research. Some of the respondents were also reached

through online access by conversing them through social networking sites/messengers.

 To determine the sample size from the population, Sloven’s formula was used.

N
1 + Ne2
n=

Where: n = sample size

N = population size

e = desired marginal error

Data Gathering Procedure

The researchers have gathered information through a survey questionnaire

checklist vis google form. The survey was framed using suitable questions for ease of

understanding. In the questionnaire, the respondents were asked to check the column of

the corresponding response.

After the approval of the letter (Appendix A) requesting permission to conduct the

study, questionnaires were then disseminated via offline and online. A series of directions

were also provided by the researchers for guidance on how to set off about each of the

items. Further guidelines were also given orally to ensure clarity of instructions for the

respondents to fully understand the given questions/ statements.

Statistical Treatment

To determine the effects of the new normal as assessed by the nursing students

and their level of clinical skills weighted average mean was used:
M=ΣFX/N

Where:

M = Weighted Mean

Σ = Sum

F = Frequency

X = Assigned Weights

N = Total number of respondents

To test the hypothesis between the affecting factors and the level of level of

clinical skills, Pearson product moment correlation (r) and t-test were used.

Hypothesis of the study was tested at 0.05 level of significance.

To test the significant correlation between the two variables, t-test was used.

r
r=
∑ ( x−x́ )( y− ý ) and
t=
1−r 2
√ ∑ ( x−x́ )2 ∑ ( y− ý )2 √ n−2

Where:t = t-test

r = Pearson r moment of correlation

n = sample size

x & y = variable

x & y = mean
 CHAPTER IV

PRESENTATION, ANALYSIS, AND INTERPRETATION OF DATA

This chapter presents, analyzes, and interpret the data gathered from the study

which are arranged according to the following:

Affecting factors;

Level of Clinical Skills; and

Significant correlation between two factors

Table 1.1 Standard Health Protocols

Table 1.1 shows the standard health protocols affecting factors as affecting factors

in determining the performance of nursing students. Statement 1 “The use of PPE when

taking patient to bed or transferring to another place.” got the highest WAM of 3.21 with

an Adjectival Equivalent of “Agree” interpreted as “Affected”. Statement 7 “The use of

PPE during intervention in emergency service” has a WAM of 3.19 with an Adjectival

Equivalent “Agree” interpreted as “Affected”. Statement 2 “The use of PPE or face

mask/face shield during taking patient history” has a WAM of 3.14 with an Adjectival

Equivalent “Agree” interpreted as “Affected”. And statement 8 “The use of PPE while

communicating with co-nursing staff and physician” has a WAM of 2.88 with an

Adjective Equivalent “Agree” interpreted as “Affected”. The overall mean of 3.03 with

Adjectival Equivalent “Agree” interpreted as “Affected”. This means that most of the

nursing students agree that the implementation of the standard health protocols affects the

performance of the nursing students.

Table 1.1 Standard Health Protocols

A. Standard health Protocols WAM AE I

1. The use of PPE when taking patient to bed or transferring A
3.21 A
to another place.
2. The use of PPE or face mask/face shield during taking A
3.14 A
patient history
3. The use of PPE in delivering laboratories samples (blood, A
3.00 A
urine, tools) of patient.
4. The use of PPE in tracking patients' vital signs. 3.05 A A
5. The use of PPE in preparing drugs for treatment 2.93 A A
6. The use of PPE in giving regular care to patient. 3.00 A A
7. The use of PPE during intervention in emergency service 3.19 A A
8. The use of PPE or face mask/face shield during taking A
2.98 A
patient history
 9. The use of PPE while communication with patients. 2.93 A A
10. The use of PPE while communicating with co-nursing A
2.88 A
staff and physician
Overall Mean 3.03 A A
Legend for Tables 1.1 and 1.2:

Numerical Scale Continuum Adjectival Equivalent

4 3.50 – 4.00 Strongly Agree
3 2.50 – 3.49 Agree
2 1.50 – 2.49 Disagree
1 1.00 – 1.49 Strongly Disagree
Table 1.2 displays the teaching and learning modalities used by nursing students.

Statement 5 “Ability development to self-learning” got the highest WAM of 3.38 with an

Adjectival Equivalent of “Agree” interpreted as “Affected”. And statement 4 “Increased

interpretation of knowledge.” got the lowest WAM of 3.12 with an Adjectival Equivalent

of “Agree” interpreted as “Affected”.

Table 1.2 Teaching and learning Modalities

WA
B. Teaching and learning Modalities AE I
M
1. Effective participation 3.26 A A
2. Deep understanding of difficult concepts. 3.17 A A
3. Ability development in acquiring knowledge. 3.33 A A
4. Increased interpretation of knowledge. 3.12 A A
5. Ability development to self-learning. 3.38 A A
Overall Mean 3.25 A A

Table 2.1 Clinical Knowledge

Table 2.1 shows the level of efficiency in determining the performance of nursing

student’s clinical knowledge. Statement 1 “Gathers data appropriately and completely,

then validating it focusing function needing assistance support” got the highest WAM of

4.24 interpreted as Minimal Satisfactory”. Statement 6 “Knows the rationale behind

every intervention given for the care of the patient.” and statement 7 “Have knowledge in

giving proper instruction for medicine; classified as nursing responsibility; drugs and

solution” with a WAM of 4.19 interpreted as “Minimal Satisfactory”. Statement 4 “Gives

attention and synthesize the significant laboratory findings” got the lowest WAM of 3.24

interpreted as “Moderately Satisfactory”. The overall mean of 3.75 interpreted as

“Minimal Satisfactory”. This means that most of the nursing students assessed

themselves that they only have minimal clinical knowledge.

Table 2.1 Clinical Knowledge

WA
Statements I
M
1. Gathers data appropriately and completely, then validating it
4.24 MS
focusing function needing assistance support
2. Analyze and interpret collected data 3.64 MS
3. Knows the correct way of doing physical assessment. 3.31 MDS
4. Gives attention and synthesize the significant laboratory findings 3.24 MDS
5. Knowledge in identifying nursing problems and categorizing it
3.79 MS
according to the patients need.
6. Knows the rationale behind every intervention given for the care of
4.19 MS
the patient.
7. Have knowledge in giving proper instruction for medicine:
a. classification
4.19 MS
b. nursing responsibility
c. drugs and solution
8. Explain or discuss the report clearly and able to answer question
3.48 MDS
correctly.
9. Knowledge in preparation of patient for any diagnostic procedure 3.45 MDS
10. Knows how to formulate an accurate nursing care plan for
3.93 MS
particular cases.
 Overall Mean 3.75 MS

Legend:
Numerical Scale Continuum
5 4.50 – 5.00
4 3.50 – 4.49
3 2.50 – 3.49
2 1.50 – 2.49
1 1.00 – 1.49
Table 2.2 Clinical Skills
Interpretation
Unsatisfactory (74 and below) (U)
Minimal Satisfactory (75-80) (MS)
Moderately Satisfactory (81-82) (MDS)
Very Satisfactory (83-84) (VS)
Outstanding (85) (O)

Table 2.2 shows Table 2.1 shows the level of efficiency in determining the

performance of nursing student’s clinical skills. Statement 3 “Able to provide or assist

patient in performance of activities of daily living whenever needed.” got the highest

WAM of 4.05 interpreted as “Minimal Satisfactory”. Statement 5 “Able to give health

teachings clearly to the patient.” with a WAM of 3.95 interpreted as “Minimal

Satisfactory”. Statement 2 “Perform procedure properly such as doing physical

assessment, taking VS, and giving medication as ordered.” with a WAM of 3.88

interpreted as “Minimal Satisfactory”. Statement 9 “Reassesses patient to determine

whether a remodification of care plan is necessary.” got the lowest WAM of 2.76 with

interpreted as “Moderately Satisfactory”. The overall mean of 3.47 interpreted as

“Moderately Satisfactory”. This means that most of the nursing students assessed

themselves as moderately satisfactory in their clinical skills.

Table 2.1 Level of Clinical Skills

Statements WAM I
1.Ability to give and respond to the care needed by the patient 3.43 MDS
2.Perform procedure properly such as doing physical assessment,
3.88 MS
taking VS, and giving medication as ordered.
3.Able to provide or assist patient in performance of activities of
4.05 MS
daily living whenever needed.
4.Always guided in precautionary and preventive measure in 3.33 MDS
 providing care to the patient.
5.Able to give health teachings clearly to the patient. 3.95 MS
6.Communicate effectively in identifying the needs of the patient. 3.40 MDS
7.Properly handling an instance of emergency situation. 3.24 MDS
8.Implement Nursing care plan appropriately 3.17 MDS
9.Reassesses patient to determine whether a remodification of care
2.76 MDS
plan is necessary.
10. Able to conduct discharged planning with the patient, his family
3.48 MDS
and significant others.
Overall Mean 3.47 MDS

Table 3. Significant Correlation between the Affecting Factors and the Student’s Level of

Clinical Skills

t value
Variable ∑(Data) ∑(Data)2 r coefficient
t critical t computed
Affecting
12 1317.6
factors (x)
0.56842 3.030 4.369
Clinical Skills
48 2412.0
(y)

Table 3 displays the Pearson r moment of correlation and t value. The value of r is

0.56842 which implies a strong positive correlation. At 0.05 level of significance with 40

as degree of freedom, the computed t value of 4.369 is greater than the critical t value of

3.030, therefore Ho is rejected. This means that there is a significant correlation between

the affecting factors and the level of clinical skills.

 CHAPTER V

SUMMARY OF FINDINGS, CONCLUSIONS AND RECOMMENDATIONS

Findings

The study sought to determine whether there is a significant correlation between

the affecting factors of the new normal to the nursing student’s clinical skills as assessed

by them. The respondents were the selected 28 second year and 14 third year nursing

students of Blancia College Foundation A.Y. 2020-2021.

The following findings were visible in the study:

1. Data showed how the standard health protocols affect the nursing students’

performances. The use PPE when taking patient to bed or transferring to

another place.” got the highest WAM of 3.21 with an adjectival equivalent of

“agree” interpreted as affected while the use of PPE while communicating with

co-nursing staff and physician got the lowest WAM of 2.88 with an adjectival

equivalent of “agree” interpreted as affected. This implies that the nursing

students are having a hard time in the movements of patients in the hospital,

but the use of face masks/shields does not really affect to them while

interacting with their co-nurse and physicians.

 2. On the second affecting factor which is the blended learning modality; data

showed that Statement 5 “Ability development to self-learning” got the

highest WAM of 3.38 with an Adjectival Equivalent of “Agree” interpreted as

“Affected”, while statement 4 “Increased interpretation of knowledge.” got

the lowest WAM of 2.12 with an Adjectival Equivalent of “Disagree”

interpreted as “Less Affected.

3. On the Level of clinical skills of students based on knowledge; statement 1

“Gathers data appropriately and completely, then validating it focusing

function needing assistance support” got the highest WAM of 4.24 interpreted

as Minimal Satisfactory while statement 4 “Gives attention and synthesize the

significant laboratory findings“ got the lowest WAM of 3.24 interpreted as

Moderately Satisfactory. On the other hand, based on the student’s skills;

statement 3 “Able to provide or assist patient in performance of activities of

daily living whenever needed” got the highest WAM of 4.05 interpreted as

Minimal Satisfactory; while statement 8 “Implement Nursing care plan

appropriately” got the lowest in rank with a WAM of 3.17 interpreted as

Moderately Satisfactory.

4. Data revealed that the computed value of value of r is 0.56842 which implies a

strong positive correlation. At 0.05 level of significance with 40 as degree of

freedom, the computed t value of 4.369 is greater than the critical t value of

3.030, therefore Ho is rejected. This means that there is a significant

correlation between the affecting factors and the level of clinical skills.

Conclusions
 The following can be concluded from the study:

1. The selected nursing students were having a hard time in performing clinical

tasks especially in transferring patients from another place while using PPE’s

and usually not careful in doing the same while talking with their co-nurse

and/or physicians. The blended learning modality also affects in their

performance because based on findings they had an increased of ability of self-

learning and increased their interpretation of knowledge.

2. Majority of the nursing students have minimal knowledge in gathering data

appropriately and completely, then validating it focusing function needing

assistance support. They also have minimal skills in providing or assisting

patient in performance of activities of daily living whenever needed.

3. The implementation of Standard health protocol in the clinical instructions and

the use of Blended learning modality in teaching the students affects the

clinical skills of the nursing students of Blancia College Foundation based on

their knowledge and skills.

Recommendations

Several important implications emerged from this research on student’s clinical

skills of Blancia College Foundation. The researchers recommend the following:

1. For the nursing students, they must be able to generate and maintain interests in

the learning process, establish and promote the importance of learning process, establish

and promote the importance of learning skills, promote satisfaction in their

accomplishment, and must be motivated to continue the exploration of knowledge even

in the new normal situation.

 2. For teachers, they should make their subjects interesting through the improved

application of the different modalities in the learning process of their students. Since most

of them were not closely monitor due to no face-to-face classes, the teachers must know

student’s weaknesses in getting appropriate instructions especially they were dealing

patient’s life in the future.

3. For school administrators, they must utilize to improve school programs aimed

in developing the self-effectiveness of the nursing students with the assurance that the

school would produce only quality graduates adapting the new normal situation.

4. For future researchers, they must conduct similar studies in a wider scope or in

another setting to conduct further study in order to determine what other factors that may

affect the nursing student’s clinical knowledge and skills.

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