NCMA110 - FINALS
ROZZANO C. LOCSIN
“Competency with technology is the skilled
demonstration of intentional, deliberate, and
authentic activities by experienced nurses who
practice in environments requiring technological
expertise.”
~ He is able to relate competency in technology and
nursing care.
~ Is a professor of nursing at Florida Atlantic
University’s Christine E. Lynn College of Nursing in
Boca Raton FL, she holds a master’s degree from
Silliman University of the Philippines. He was a
Fullbright Scholar to Uganda in 2000 and is a
recipient of the 2004-2006 Fullbright Alumni Initiative
Award.
~ Rozzano Locsin is a Professor of Nursing at
Tokushima University (Japan), a Professor Emeritus
of Florida Atlantic University (United States), and a
Visiting Professor at universities in Thailand, Uganda,
and the Philippines.
~ He has authored a book entitled Technological
Competency as Caring in Nursing: A Model for
Practice, edited and co-authored three more books,
including one entitled A Contemporary Nursing
Practice: The (Un)Bearable Weight of Knowing in
Nursing.
EARLY LIFE
● Locsin was born in 1954. He is a registered
nurse, a native of Dumaguete City, Philippines
who resides and practices his nursing profession
at Tokushima University, Tokushima, Japan as a
Professor of Nursing. He is a Professor emeritus
of Florida Atlantic University in Boca Raton,
Florida, USA. Dr. Rozzano Locsin earned his
PhD in Nursing from the University of the
Philippines in 1988, and his MA in Nursing and
Bachelor of Science in Nursing from Silliman
University in 1978 and 1976 respectively in the
Philippines
ACADEMIC CAREER
● In 1991, Locsin joined Florida Atlantic University,
Christine E. Lynn College of Nursing, where he
was a tenured Professor of Nursing, and now a
Professor Emeritus
● Locsin's middle range nursing theory [2] is an
interesting discussion of the correlation between
hands-on patient care and the use of technology.
Technology is defined as anything that makes
things efficient – from basic diagnostic
technologies to therapeutic practices familiar to
all nurses. Specifically, he discusses the
importance of understanding the need for
knowing “high-tech” instruments, e.g. monitors,
implants, and devices, that are a part of patient
care, as these will provide opportunities for the
nurse to know the patient fully as a person.
● Nurses use and encounter technology in nearly
every aspect of their profession. What does it
mean to be technologically competent? What
does it mean to be a caring nurse? How does
technology support nursing work? How does it
hinder nursing work? How can nurses care for
their patients as technological advancements
are introduced nearly every day? Technological
Competency as Caring in Nursing: A Model for
Practice provides insight and answers into how
nurses can express their nursing by being
technologically competent. As such, Locsin
sustains the understanding that being
technological competent is being caring.
● Locsin's work is obviously guided by the
question asked by thoughtful nurses
everywhere: How can I satisfactorily reconcile
the idea of competent use of technology with the
idea of caring in nursing? His theory significantly
describes a practical understanding of the
solution, enriching the practice value of all of the
general theories of nursing which are grounded
in caring. Technological competency as caring in
nursing informs nursing as a critical process of
knowing persons’ wholeness. Locsin's theory
book explores, clarifies, and advances the
conception of technological competency as
caring in nursing. His theory is essential to
modeling a practice of nursing from the
perspective of caring. It is a practical illumination
of excellent nursing in a technological world
NCMA110 - FINALS
Technological Competency as Caring in
Nursing
○ Technological competency as caring in nursing
is the harmonious coexistence between
technologies and caring in nursing.
○ The harmonization of these concepts places the
practice of nursing within the context of modern
healthcare and acknowledges that these
concepts can co-exist.
○ Technology brings the patient closer to the
nurse. Conversely, technology can also increase
the gap between the nurse and nursed.
○ When technology is used to know persons
continuously in the moment, the process of
nursing is lived
I. Conceptualization of Technological
Competency, Caring and Nursing
● Rozzano Locsin believes that if a nurse is
technologically competent, he/she will be able to
provide adequate and proper nursing care.
● Rozzano Locsin believes that a nurse should be
able to learn how to manipulate machines in
order to provide appropriate, effective, and
efficient nursing care. Because if a nurse is not
competent in terms of manipulating different
devices or apparatus, it will be a challenge for
the nurse to provide good nursing care.
II. Understanding Technological Competence
Through Philosophy of Technology and
Nursing
● Philosophy of technology has been identified as
an important developing area for nursing and a
complex interpretation of technology has been
outlined that emphasizes technology and its
relations to the context of modern nursing and
health care.
● According to Rozzano Locsin, since we are
already evolving, a nurse should also evolve and
develop as the technological advancements go.
(dapat nakakasabay ang nurses sa pag develop
and advance ng technology).
● There are many issues related to technology
that need to be addressed by nurses, and there
are a number of key areas that need attention in
relation to philosophy of technology and nursing.
According to Rozzano Locsin’s Technological
Competency as Caring in Nursing
➧ Nurses need to interpret technology from a
range of non-essentialist perspectives.
➧ Nurses need specific and refined analyses of
technology that rely less on common place
generalization about, for example,
dehumanization or uncritical celebration of
unsubstantiated advantages of technology, than
on considered critical reflection on discrete
interventions and technologies.
➔ According to Locsin, it is imperative or very
important that nurses should be able to
adapt to these technological advancements.
➔ We should not see technology as something
that is disrespectful to human society
because technology is really helpful.
➧ Philosophy of technology encourages us to
reflect on technology from perspectives that are
wider than the relation between technology and
instrumental action.
✓ Technology has something to do with caring
and if you are well-versed with technology,
you can provide good nursing care.
ASSUMPTIONS
➧ Technological Competency as Caring in
Nursing is a middle range theory grounded in
Nursing as Caring (Boykin & Schoenhofer),
2001). It is illustrated in the practice of nursing
grounded in the harmonious coexistence
between technology and caring in nursing. The
assumptions of the theory are:
✓ Persons are caring by virtue of their
humanness (Boykin & Schoenhofer, 2001).
NCMA110 - FINALS

✓ Persons are whole or complete in the continuous knowing, implementation and

moment (Boykin & Schoenhofer, 2001). participation is reflective of the cyclical process
✓ Knowing persons is a process of nursing that of knowing persons.
allows for continuous appreciation of persons
moment to moment (Locsin, 2005).
VERIFYING KNOWLEDGE
✓ Technology is used to know wholeness of
persons moment to moment (Locsin, 2004). ● The continuous, circular process demonstrates
✓ Nursing is a discipline and a professional the ever-changing, dynamic nature of knowing in
practice (Boykin & Schoenhofer, 2001). nursing. Knowledge about the person that is
derived from knowing, designing, and
implementing further informs the nurse and the
DIMENSIONS OF TECHNOLOGICAL VALUE one nursed.
IN THE THEORY
➧ Technology as completing human beings to
re-formulate the ideal human being such as in
replacement parts, both mechanical
(prostheses) or organic (transplantation of
organs.)
➧ Technology as machine technologies, e.g.
computers and gadgets enhancing nursing
activities to provide quality patient care such as
Penelope or Da Vinci in the Operating Theatres;
➧ Technologies that mimic human beings and
human activities to meet the demands of
nursing care practices, e.g. cyborgs (cybernetic
organisms) or anthropomorphic machines and
robots such as ‘nursebots’ (Locsin & Barnard,
2007).

THE PROCESS OF NURSING

KNOWING
● The process of knowing a person is guided by
technological knowledge in which persons are
appreciated as participants in their care rather
than as objects of care. The nurse enters the
world of the other. In this process, technology is
used to magnify the aspect of the person that
requires revealing - a representation of the real
person. The person’s state changes moment to
moment - a person is dynamic, living, and can
not be predicted.

DESIGNING
● Both the nurse and the one nursed (patient) plan
a mutual care process from which the nurse can
organize a rewarding nursing practice that is
responsive to the patient’s desire for care.

PARTICIPATION IN APPRECIATION
● The simultaneous practice of conjoined activities
which are crucial to knowing persons. In this
stage of the process is the alternating rhythm of
implementation and evaluation. The evidence of
NCMA110 - FINALS
SR. CAROLINA AGRAVANTE
~ She is famous for being the first Filipina theorist for
writing the CASAGRA Transformative Leadership
Model. The title of the theory was derived from her
name, CArolina S. AGRAvante.
~ She finished her secondary education at St. Paul
University - Manila (formerly St. Paul College -
Manila) as class salutatorian.
~ In 1964, she earned her BS Nursing degree in the
same school as magna cum laude. In the same year,
she passed the nurse licensure examinations as the
board topnotcher.
~ From 1967 to 1969, she studied for a Master's
Degree in Nursing Education at Catholic University of
America as a full-fledged scholar.
~ In 2002, she earned her Doctoral Degree in
Philosophy at University of the Philippines Manila -
the same year her theory was published.
~ She served as the president of St. Paul University -
Iloilo, where she taught research subjects among
senior students.
~ She was a former president of the Association of
Deans of the Philippines Colleges of Nursing
(ADPCN) as she became the representative in the
International Nursing Congress that was held in
Brunei in 1996. A year after, she was a part of a
delegation that participated in the International
Council of Nursing in Vancouver, Canada.
~ Received a Service Award from the Philippine
Accreditation Association of Schools, Colleges and
Universities (PAASCU) for being one of the
accreditors.
~ One of the founding members of the Integrated
Registered Nurses of the Philippines (IRNP).
~ Currently, she is the President of St. Paul College -
Ilocos Sur while performing the duties of the
Vice-President for Academics. Moreover, she also
functions as the program chair of the school's
Department of Nursing.
The CASAGRA Transformative Leadership
Model: Servant-leader Formula and the Nursing
Faculty’s Transformative Leadership
Behavior
● The theory “CASAGRA Transformative
Leadership” is a psycho-spiritual model. It is
coined after the name of the investigator: Sr.
CArolina S. AGRAvante
● The model is a Three-Fold Transformation
Leadership Concept rolled into one, comprising
of the following elements:
✓ Servant-Leader Spirituality
✓ Self-Mastery
✓ Special Expertise
● These elements rolled into one make-up the
personality of the modern professional nurse
who will challenge the demands of these crucial
times in society today.
The CASAGRA Transformative Leadership Theory is
classified as a Practice Theory basing on the
characteristics of a Practice Theory stated by
McEwen (2007), which are the following:
a. Complexity / Abstractness, Scope - Focuses
on a narrow view of reality, simple and
straightforward;
b. Generalizability /Specificity - Linked to a
special populations or an identified field of
practice;
c. Characteristic of Scope – Single, concrete
concept that is operationalized;
d. Characteristic of Proposition – Propositions
defined;
e. Testability – Goals or outcomes defined and
testable;
f. Source of Development – Derived from
practice or deduced from middle range theory or
grand theory.
PURPOSE
● The present day demands in the nursing
profession challenge nursing educators to revisit
their basic responsibility of educating
professional nurses who are responsive to
technological, educational and social changes
happening in the Philippines society today. The
reopening of the doors of foreign market to
Filipino nurses, migration made easy, attractive
salaries and benefits way beyond what hospitals
can afford to give.
● Nursing education is faced with a new concern
that is globalization of nursing services for the
international market. Therefore a need to
NCMA110 - FINALS
develop globalization of care with focus on
developing caring nurses.
● The formation of new nursing leaders is urgently
needed; leaders with new vision who will venture
new traits and who have gone through new
formation in order to serve the society as
professional nurses.
● Nurses need competent leaders with a dream of
what nursing can be, whose basic stand is
caring and service who are competent in
nursing, assertive of their own rights with the
help profession.
MAIN PROPOSITIONS
● CASAGRA Transformative Leadership is a
psycho-spiritual model, and was an effective
means for faculty to become better teachers and
servant-leaders.
● Care complex is a structure in the personality of
the caregiver that is significantly related to
leadership behavior.
● The CASAGRA servant-leadership formula is an
effective modality in enhancing the nursing
faculty’s servant-leadership behavior.
● Vitality of Care Complex of the nursing faculty is
directly related to leadership behavior.
KEY CONCEPTS
● The CASAGRA Transformative Leadership
Model has concepts of leadership from a
psycho-spiritual point of view, designed to lead
to radical change from apathy or indifference to
a spiritual person.
● Servant-leader formula is the enrichment
package prepared as intervention for the study
which has three parts that parallel the three
concepts of the CASAGRA transformative
leadership model, namely: the care complex
primer, a retreat-workshop on
Servant-leadership, and a seminar-workshop on
Transformative Teaching for nursing faculty.
● Special expertise is the level of competence in
the particular nursing area that the professional
nurse is engaged in workshop is the spiritual
exercise organized in an ambience of prayer
where the main theme is the contemplation of
Jesus Christ as a Servant-leader.
● Servant-leadership behavior refers to the
perceived behavior of nursing faculty manifested
through the ability to model the servant
leadership qualities to students, ability to bring
out the best in students, competence in nursing
skills, commitment to the nursing profession,
and sense of collegiality with the school, other
health professionals, and local community.
● Nursing leadership is the force within the nursing
profession that sets the vision for its
practitioners, lays down the roles and functions,
and influences the direction toward which the
profession should go.
● Transformative teaching may also be termed
Reflective teaching, an umbrella term covering
ideas, such as thoughtful instruction, teacher
research, teacher narrative, and teacher
empowerment.
● Care complex is the nucleus of care experiences
in the personality of a nurse formed by a
combination of maternal care experiences,
culture based-care practices indigenous to a
race and people, and the professional training
on care acquired in a formal course of nursing.
The CASAGRA Transformative
Leadership Model
● The CASAGRA Transformative Leadership
Model: Servant – Leader Formula & the Nursing
Faculty’s Transformative Leadership Behavior
CArolina S. AGRAvante= CASAGRA
- According to Sr. Carolina, nurse leaders and
nurse educators have a huge impact in
transforming the nursing profession in the
Philippines.
- The nursing educators, the faculty members,
together with the nurse leaders, provide an
important role in transforming the nursing
profession in our country.
● The present day demands in the nursing
profession challenge nursing educators to revisit
their basic responsibility of educating
professional nurses who are responsive to
technological, educational and social changes
happening in the Philippines society today. The
reopening of the doors of foreign market to
Filipino nurses, migration made easy, attractive
salaries and benefits way beyond what hospitals
can afford to give
- We have different changes, and educators in
nursing and nursing leaders should be able to
adapt to those changes so that they can
transform the nursing profession in the
Philippines.
- It is a challenge for nursing educators or
nursing leaders to provide or give a globally
competitive nurses for the global market,
GOALS / CONCEPTS
➧ Globalization of nursing services
- Nowadays, Filipino nurses are very much in
demand abroad, and it is a responsibility for
NCMA110 - FINALS
nursing leaders and educators to develop
globally competitive nurses.
➧ The formation of new nursing leaders is urgently
needed; leaders with new vision who will venture
new traits and who have gone through new
formation in order to serve the society as
professional nurses.
- Nowadays, nursing leaders are becoming
younger and younger because that is the
trend with leadership. Leaders, managers
nowadays are becoming more youthful as
compared to before because according to Sr.
Carolina, formation of nursing leaders is
crucial in providing and transforming the
nursing profession. If we do not have leaders
with good vision, leaders that can easily
adapt to changes and leaders who are more
open to changes then it will be a challenge to
transform the nursing profession in the
Philippines.
➧ In Agravante's Theory of Transformative
Leadership Model, she initially mentioned the
concept of servant-leadership spirituality. For
nurse educators, they can apply this concept by
being passionate about their craft. They can also
show willingness to impart their acquired
knowledge to their students and colleagues in a
selfless way. These educators contemplate first
by attending a variety of workshops regarding
new trends in nursing, applying evidenced-
based practices through patient simulation, and
cascading it to the target learning group.
Sister Carolina Agravante’s CASAGRA
Transformative Leadership Theory Focuses
on the Three-fold Transformative
Leadership Concept namely:
1) Servant-Leader Spirituality, wherein a
leader, through spiritual exercise, realizes
that his model in caring for individual is Jesus
○ Is prescribed to run parallel to the generic
elements of the transformative leadership
model.
○ This formula consists of a spiritual exercise, the
determination of the vitality of the care complex
in the personality of an individual and finally a
seminar workshop on transformative teaching.
○ The servant-leader formula prescription includes
a spiritual retreat that goes through the process
of awareness, contemplation, story telling,
reflection, and finally commitment to become
servant-leaders in the footsteps of Jesus.
2) Self-Mastery, which involves an individual's
self-awareness through formal education in
nursing, a continuous education, seminars
attended and his involvement in
organizations; and lastly.
- Nurse educators and nurse leaders should
have self-mastery.
What do you mean by that?
- When we graduated from the BSN program,
we had our clinical experiences and all of
your clinical instructors and professors in the
College of Nursing have more than three
years of clinical experiences in each field.
○ Consists of a vibrant care complex possessed to
a certain degree by all who have been through
formal studies in a caregiving profession such as
nursing.
3) Special Expertise, which draws emphasis in
the nurse faculty’s involvement in the
formation of his students.
○ Shown in a creative, caring, critical,
contemplative and collegial teaching of the
nurse faculty who is directly involved with the
formation of the nursing.
✓ Indeed, Sr. Carolina’s CASAGRA
Transformative Leadership Theory is timely in
this ever fast-paced world. Nursing as a
profession is inevitably changing and the
demand to be at par with technology made it
more competitive. Nursing students need
nursing teachers to look up to. Embodied with
these three concepts, it is timely to put this
theory into practice
✓ Moving forward, Agravante introduced her
second concept which is "The Self- Mastery."
In spite of our world's empirical culture
wherein newly accepted norms that focus on
the external rather the internal or mental
thought process, people tend to have a direct
reaction and an emotional response. This
theory aims to promote self- discovery by
knowing strengths and weaknesses as well
as to practice controlling internal thought
processes that will eventually influence
emotions, ideas and behaviors. In the
academe, knowing one's strengths and weak
points can help in becoming a better
individual and professional resulting in
effective teaching on students and staff.
✓ Lastly, Agravante introduced the concept of
The Special Expertise which states that it is
the level of competence of a professional
nurse in the particular nursing area is
engaged in. In other words, professionals
should be aware of what area they are expert
at. In nursing education, the preceptorship
program is essential for learning of novice
NCMA110 - FINALS

nurses in the unit. The preceptors must

educate newly hired nurses through hands
-on experience, and evidence-based practice
as well as the demonstration of personal
values and character needed in the specific
unit. In addition, expectations and other
activities are subsequently done in the said
unit.

★ This theory focuses on the development of

leadership in the nursing profession because
without the leaders, we will have chaos in the
profession. And the nursing students today
are the future leaders of the nursing
profession.
NCMA110 - FINALS
CARMELITA DIVINAGARCIA
~ Master in Nursing in 1975
~ Doctoral Degree holder in 2001
~ Specialty in Cardiology
~ Advanced Nurse Practitioner
~ Dean College of Nursing - University of the East
Ramon Magsaysay Memorial Medical Center
The Lived Experiences of Nursing
Service Personnel and Nursing
Educators on Collaboration
○ The significance or the goal of her research talks
about the study will eventually rebound to better
strategies and better models of collaboration
that is culture bound which can produce
beneficial effects to training of the students and
patient care.
What is the idea of her research?
- She would like to know what is the effect of
good collaboration between the nursing
service personnel and the nurse educators or
the clinical instructors. Because new nursing
students will go on clinical rotations,
according to carmelita Divinagracia, there
should be a collaboration between the
nursing service personnel (the staff nurses in
the hospital, chief nurses) and the clinical
instructors and the leaders of the university
because without the collaboration of these
two, we won’t be able to provide good
experiences and exposure to students.
THREE MAIN THEMES AND SUB THEMES
WERE IDENTIFIED:
COORDINATION
○ According to Divinagracia, nursing service
personnel and the nursing educators or the
clinical instructors should have proper and good
coordination. And the sub teams are:
➧ Intra Organizational Coordination
- Within the university
- Harmonious relationship of students, of
students and teachers or the clinical
instructors.
➧ Unified Concept and implementation
- Within the university, all of the teachers or
instructors teaching Theoretical Foundations
in Nursing will have the same syllabus that
they follow. They have the same concepts,
same ideas, same topics that they are
teaching the students.
➧ Inter Organizational Coordination
- Outside of the university
- Relationship of the university with the hospital
affiliate.
- Collegial Relationship, Consultative
Relationship, Balance and synergy between
theory and practice
- When you say Inter Organizational
Coordination, there should be good collegial
relationship (there should be a professional
and harmonious relationship between the
clinical instructors and the nursing personnel
or nursing staff), there should be balance an
synergy between the theory and practice
(whatever teachers have thought students,
when students go into the hospital, students
should be able to apply the theories).
➧ Reciprocal Interdependence
- Talks about the leadership capabilities
- The interdependence between the leaders of
the universities and the hospitals
COMMUNICATION
○ Communication is key
○ Communication is another main theme of the
research and the two sub teams are:
➧ Environmental Factors
- This is the status relationship between
nursing education and nursing services.
- Do they have a harmonious relationship?
Because if they do not have a harmonious
relationship (the nursing personnel and the
clinical instructor) there would be an impact
towards the nursing students
➧ Personal Factors
INTERPERSONAL RELATIONSHIP
○ These are the character that everyone should
have (the nurses in the hospital and the nurse
educator)
➧ Engagement
- Nurses and nurse educators should be
engaged with the students and the patient.
➧ Esprit (Morale)
- Nurses in the hospital and nurse educators
should have high morality or high morals.
➧ Concern
➧ Support
- Both should have concern and support with
each other.
NCMA110 - FINALS

COMPOSURE Behaviors (Composure

Theory)
● Are sets of behaviors or nursing measures that
the nurse demonstrates to selected patients.
● COMPOSURE is an acronym which stands for
COMpetence, Presence and Prayer,
Open-mindedness, Stimulation, Understanding,
Respect and Relaxation, Empathy.
○ According to Divinagracia, this composure
behavior should be present to all nurses for us
to r=provide effective and efficient nursing care.

○ If the nurse is showing competence, if the nurse

is present in all situations, if the nurse is praying
with the patient, if the nurse is open-minded to
all kinds of situations, if the nurses can use
appropriate stimulation or touch, if a nurse is
understanding and provides respect and gives
relaxation to the patient and if the nurse is
empathetic to the patient, it will have a
significant impact towards the improvement of
the patient.
○ According to Divinagracia, these are the
common or the usual behaviors or attitudes
that a nurse should have in order to provide
efficient and effective nursing care.

CONCLUSION
○ Coordination, communication and interpersonal
relationships have been identified as major
components of collaboration based in the lived
experiences of the respondents
○ Quality patient care and training of students can
be at best only if nursing service and education
can truly operationalize the meaning of
collaboration and put into real action
○ The connectedness of nursing service and
education calls for a new wave of visionary
leadership, empowerment and an environment
or cf trust and openness
○ Nursing as a profession can really draw a power
base if only a unification model can be crafted
which is culture based, practical, relevant and
acceptable to the concerned nursing
professionals
○ Recommend “Unification model for
collaboration”