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"Time is gold" Name: Bernadette Angela P. JavonitallaLuna Name: Ednel Jyn V. J.

Mandapat Name: Risha Joie ame: Beanne Joie B. Lozano Name: P. Llamas Malaki M. E. Abutog Name: Kevin Leanne L. Corazon Garcia Name:Name: Desiree Anne Name: Katrina B. Lozano Cristybelle Joie Age: 19 Name: Mary Ann G. Cinense Age: 1919 Age: ge: 20 Age: 2020 20 19 Age: Age: 20 Age: Age: Address:Age: 38 #30 Welfareville1 door 5 Lt. Gen. PMAAA Complex, Blk. 18 Address: JOQ Compound St. Bambang Taguig City Address: 22-B Kentucky ddress: Blk. 191 Lt. 18 Hudyat St.Address:SierraBrgy.DeHudyatMandaluyong Mandaluyong City Address: Address: 19 Dama 18St. Dreamland Subd. City City Address: # 95 Makati Madre St. Mandaluyong City Address: Blk. St. Saturn Noche St. Taytay Rizal 39 Arayat 191 City Mauway St. Pembo Makati Pembo 602 Lt. Mandaluyong CityBlk. Date of birth: June 22,San Andres Cainta, Rizal Address: Fort Bonifacio, Taguig City 3 Cup St. Lakas Bisig 1992 ate of birth: Jan. 11, 1991 Date birth: July 19, 1991 11,1992 Date of of birth: Jan.Jan. 11,8, 1991 Date of birth: 25, 1991 Date of birth: Feb. 1991 Date of birth: Jan. 1 Date of birth: Aug. 23, Oct.Status:Apr. 17, 1992 Date of birth:Civil 14, 1992 Date of birth: Single 1992 vil Status: Single Civil Status: SingleSingle Civil Status: SingleSingle Civil Status: Civil Status: Single Civil Status: Civil Status: Single Civil Status: Single Catholic Civil Status: Single Religion: Roman eligion: Roman Catholic Religion: Religion: roman Catholic Religion: Roman Catholic Religion: Roman Catholic Religion: Roman Catholic Christian Religion:Religion: Roman Catholic ni ashireioj@yahoo.com Chapter 1: Christian Religion: Address: Cristo E-mail Iglesia mail Address: bhey_tazmanian09@yahoo.com lhea_chubby@yahoo.com E-mailE-mail Address: E-mailE-mail Address: desiree.anne.m.garcia@yahoo.com Address: Address: katrina11-hale@yahoo.com E-mail kevin_llamas@yahoo.com Address: kembe_larz@yahoo.com E-mail Address:Address: ememqoe_o23@yahoo.com/ maryannsalamanes@yahoo.com E-mail angelajavonitalla@yahoo.com E-mail Address: eurxoxo_angel@yahoo.com Educational Background ducational Background Educational Background Educational Background Educational Background Educational Background Educational Background Educational Background Educational Background Educational Background Tertiary: Our Lady of Guadalupe Colleges Tertiary: Our Lady of Guadalupe Tertiary: Ourof Problem Guadalupe Colleges Tertiary: Our LadyOurGuadalupe Colleges Tertiary: Our Lady of GuadalupeIts Background Colleges The Lady Guadalupe Colleges Tertiary: Our Lady of and Colleges Tertiary: Lady of of Guadalupe Tertiary: Tertiary: OurGuadalupe Colleges Colleges Our Lady of Lady of GuadalupeGuadalupe Tertiary: Our Lady of Secondary: Maranatha Christian Academy Secondary: Pateros Catholic SchoolSecondary:De San JuanNeriLetran Secondary: Colegio Juan Felipe de Hilongos SchoolCollege Secondary: St. Teresa'sSumulong Memorial Junior Secondary: Pateros Catholic School Secondary: San School of Parochial Secondary: Bonifacio Javier NationalBonifacio High School Secondary:Secondary: Fort Nat'l High School Dominican High High School Dasmarinas School Primary: Pateros Catholic School Primary: PaterosAna Elem. School Primary: Primary: Sta.Francis of Assissi School Primary: GuadalupeBaptist College International Nuevo Elem. School Primary: Catholic School Introduction San School for theSt. High City Primary: Primary: P. Javier Elementary SchoolSchool Filemon Fabian Elementary School Taguig Science Iloilo Arts, If the world gives you thousandsdontTaguig Elem. School everyones in you unceasing reasons to smile "Life goes by fast. Primary: San Juan Elementary School If Primary:reasons to cry, then God could give a while, you might miss it." you of stop and look arond, The best and the most beautiful thingsisofto fail ratherwithout music. of Stevie Wonder" "See the "God provides" for a reason"the eyes even heard, but must be felt with the heart." "Everything happens "It's better this world cannot be give up" "Life in the world through seen or vision meaningless than to Name: Aldrin Licayan "Dont deprive yourself in the pleasures of life" its own unique body of knowledge As Inspired by Love, guided involved in identifying a profession, nursing is by Faith Age: 19 Address: 95 Caldozo St. P6-B Lower Bicutan, essential to nursing practice which can be learned by the student nurses from lectures and return Taguig City Date of birth: Aug. 12, 1992 demonstrations in school. Nursing education is a continuous process. It begins upon the decision to Civil Status: Single Religion: Christian E-mail Address: aldrinlicayan@yahoo.com not end, because the formal education of a nurse is a crucial become a nurse. After that, it does Educational Background Tertiary: Our Lady of Guadalupe period. Everything they have High School Secondary: Ma. Asuncion Tinga to know about nursing is being programmed in the four years of their Primary: CP Sta. Teresa Elementary School "If you have courage to begin, you have courage to succeed."

study. A big chunk of their education is devoted to the Related Learning Experience (RLE) wherein the student is exposed to the different areas of nursing. Most of the students time is spent in wards and special areas of the hospitals. There, they experience what it is like to be a professional nurse.

Hence, nursing has always emphasized the importance of correct application of the gained knowledge from school to the clinical area to provide a quality health care to the patients. There are different factors that could affect the way that student nurses render quality health care to patients in different aspects. Defining quality health care is difficult. The expense of quality is an interactive process, just like between a customer and provider. The customer does not receive anything tangible, mostly only a piece of paper with a promise for a better future. The standards of education and practice for the profession are determined by the members of the profession, rather than by the outsiders. The education of the professional involves a complete socialization process, more far reaching in its social and attitudinal aspects and its technical features than is usually required in other kinds of occupation. (Kozier, 2008) Performance is simply defined as the ability to perform or to execute an action. In nursing, level of performance is based on Benners Stages of Nursing Expertise, from Stage 1 (Novice,

2 performance is limited) to Stage 5 (Expert, performance is fluid, flexible and highly proficient). (Clarke & Aiken, 2003). According to ANA (American Nurses Association), Nursing care is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities and population. It is the provision of high quality care to individually sick people until their full recovery or death. This study aims to help investigate factors that may affect the way that student nurses render nursing care. It will also aid in giving effective nursing care through helping in redefining these factors.
Statement of the Problem

The study aimed to determine the factors that affect the level of performance of student nurses of Our Lady of Guadalupe Colleges in rendering nursing care to the patients of Victor R. Potenciano Medical Center. Specifically, it shed to answer the following questions: 1. Profile of the Student Nurses in terms of: Age Sex Clinical area of duty

2. What are the factors that affect the level of performance of student nurses of Our Lady of Guadalupe Colleges in rendering nursing care in Victor R. Potenciano Medical Center in terms of: Clinical learning environment Clinical Instructors Personal Factors

3 3. How do these factors affect the level of performance of student nurses of Our Lady of Guadalupe Colleges in rendering nursing care in Victor R. Potenciano Medical Center in terms of: Knowledge Skills Attitude

4. Is there a significant difference among the factors affecting the level of performance of student nurses of Our Lady of Guadalupe Colleges in rendering health care in Victor R. Potenciano Medical Center? 5. Is there a significant relationship between factors and level of performance of student nurses of Our Lady of Guadalupe Colleges in rendering health care in Victor R. Potenciano Medical Center? Theoretical/Conceptual Framework Among student nurses, the clinical learning experience is perceived as the most influential context for gaining nursing skills and knowledge (Chan, 2001). Benner's (1982) theory outlined the process of a nurses' development from a new graduate or novice to an expert nurse. Benner described the sequence in which nurses attain their skills and knowledge in the clinical environment. The different stages of Benner's (1982) theory are novice, advanced beginner, competent, proficient, or expert nurse. Three common themes further define nurses' development. First, clinical knowledge does not rely on the principles of theory alone but is intertwined with patient interaction and responses to care. The second theme describes the development of perceptual awareness, the ability to separate relevant information from the irrelevant within a clinical problem (O'Connor, 2001). Perceptual awareness stems from the nurse's intuition about the clinical problem. Individual nursing intuition develops with knowledge and experiences gained from previous clinical problems. O'Connor (2001) stated, "... intuition is not guessing or feeling; it is a deep knowing, and a necessary

4 element of expert practice". The third theme represents a quality of the expert nurse that cannot be taught in a classroom, but through the interaction of nurse-patient practice. An expert nurse not only knows what is important within a clinical problem, but also what needs to be done. This conveys confidence and assurance to patients and their families. Benner's (1982) novice-to-expert theory explained how nurses' intuition develops when it comes to knowledge and experiences from clinical practice. Nursing students begin their education as novices. O'Connor (2001) indicated the novice stage describes the initial stage of development for nursing students. "The novice's focus is on rule-based activities and the application of theoretical knowledge". Upon graduation, nursing students are advanced beginners. "Task completion rather than patient management is the goal of the advanced beginner" (O'Connor, 2001). Competent nurses show greater awareness in distinguishing what is important from what is not important. Clinical experiences have contributed to the development of this awareness. Proficient nurses demonstrate expanded personal awareness and intuition above that of competent nurses. O'Connor noted expert nurses are able to respond intuitively to a patient situation because they understand what is needed and why. O'Connor suggested expert nurses have developed from a state of critical thinking to thinking like a nurse. Benner's theory differentiated the levels of nursing expertise and supported the clinical setting as an essential aspect of nursing education. This study also anchored on the theory of Sister Callista Roys Role of Adaptation Model which states that, all the conditions, circumstances and influences surround and affect the development and behavior of persons on groups, the input into the person as an adaptive system involve both internal and external factors. Furthermore, Roy defined the adaptation as the process & outcome whereby the thinking and feeling person uses conscious awareness and choice to create human and environmental integration. She emphasized that the complexity of person and

5 environment self-organization, and on the relationship between and among persons, universe and spiritual relationship with God. On these theories, the course of the study is set. The basic understanding of oneself is the theoretical basis of this research which reflects on different factors, whether internal or external, that may affect an individual. In this study, the students socio-cultural profile and the expertise they acquire for a certain level are being assessed. With Roys Role Adaptation Model, students are influenced by internal and external factors whereby affecting ones development and behavior. With Benners Level of Expertise, an individual is classified according to their development. It stated there that student nurses are classified as novice, an initial stage of development for them. Hypotheses The study was guided by the following hypothesis: 1. There is no significant difference among the factors affecting the level of performance of

student nurses of Our Lady of Guadalupe Colleges in rendering nursing care in Victor R. Potenciano Medical Center, when group according to: 2. Clinical Learning Environment Clinical Instructors Personal Factors

There is no significant relationship between the factors and the level of performance of

student nurses of Our Lady of Guadalupe Colleges in rendering nursing care in Victor R. Potenciano Medical Center. Assumptions 1. Students are influenced by internal and external factors whereby affecting ones development

and behavior.

6 2. Student nurse learning within a clinical environment is an essential component of Bachelor

of Nursing curricula. Significance of the Study The following people will benefit in the study: Student Nurses: This study aims to help student nurses identify the factors affecting the level of performance of student nurses in rendering health care in VRPMC and aid in redefining these factors. This study also aims to improve the learning experience of the students in VRPMC. VRPMC Administration: This study aims to identify factors affecting the level of performance of student nurses in rendering health care in VRPMC which may be the basis of improvement of nursing service of the institution. Clinical Instructors: This study aims to identify factors affecting the level of performance of student nurses in rendering health care which may help the clinical instructors to identify ways on how to improve the learning experience of student nurses. Researchers: This can aid them in determining the factors and proving the significance of the proposed problems. This may help them in future related studies. Future Researchers: This study may also serve as their basis or reference for future research. Scope and Limitations of the Study The study focused on the factors affecting the level of performance of student nurses of Our Lady of Guadalupe Colleges in rendering nursing care in Victor R. Potenciano Medical Center during the calendar year 2011-2012. The factors included clinical learning environment, clinical instructors and personal factors. The respondents of the study were the student nurses of Our Lady of Guadalupe Colleges who had their clinical learning experience at Victor R. Potenciano Medical Center.

7 Definition of Terms Attitude. A complex mental state involving beliefs, feelings, values, dispositions toward a specified target. Clinical Area of Duty. Area where student nurses practice related learning experience, render nursing care and do student nurses tasks. Clinical Instructor. They are the ones providing insight on methods and practices for use in the healthcare, health services and academic work environments. They may be staff nurses of the hospital or clinical instructor of the college. Clinical Learning Environment (CLE). A place where student nurses have their clinical experience and where they continue education as aspiring nurses. Factor. One of the element contributing to a particular result or situation. Health Care. The preservation of health by preventing or treating illness through services offered by health practitioners. This includes health promotion, disease prevention and rehabilitation. Knowledge. The familiarity with something which includes information, facts, or descriptions that can be acquired through experience or education. Level of performance. A stage or achievement of ones displayed skill, knowledge and attitude. Nursing Care. A special care given to patient by a nurse or a student nurse. Personal Factors. Factors that include personal issues and concerns of an individual such as physical, emotional, mental and even socio-economic status, Skills. The ability to do something well coming from ones own knowledge, practice, or aptitude.

8 Chapter 2: Review of Related Literature and Studies This chapter presents the literature and studies read and reviewed by the researchers. Foreign Literature According to Koontz, Mallory, Burns & Chapman (2010), One of the most valuable components of a nursing program is the clinical learning environment (CLE). This setting provides students with unique learning opportunities in which classroom theory and skills are put to the test with real life situations. Clinical learning environments include hospitals, doctors' offices, health departments, hospice units, and other health care settings utilized for student learning. The CLE differs from the classroom or lab setting in many ways. Typically, the classroom and labs are controlled by instructors. This includes lectures, labs, tests, dress codes, student conduct, break times, attitudes, and the learning environment atmosphere. The CLE is a different story. Clinical learning cannot be separated from the context in which it occurs, for which reason studies exploring the clinical learning environment for student nurses were included in the review. The clinical learning environment has been defined as "the interactive network of forces within the clinical setting that influence the students' clinical learning outcomes" (Dunn & Burnett, 2006). Findings from the literature indicate that the quality of the learning environment hinges on many factors including nature, type and perceived relevance of the clinical or hospital setting, opportunities for learning, and relationships with other participants in the practice area (Chan, 2001; Dunn 2000). Based on the study made by Vallant & Neville (2006), Student nurse learning within a clinical environment is an essential component of Bachelor of Nursing. During clinical experiences, student nurses rely on nurse clinicians for day-to-day facilitation of their learning. The purpose of this descriptive interpretive study was to explore relationships between student nurses and nurse

9 clinicians. Eleven student nurses at the end of a three year Bachelor of Nursing program in one institution participated in focus group interviews. Data gathered from the three focus groups were analyzed using an inductive approach. Findings indicated that when students experienced relationships with clinicians as not being positive, this inhibited learning. Conversely, when students saw the clinician as participating actively and positively in the student/clinician relationship then student learning was enhanced. This evidence forms the basis for recommending further complementary research into the clinician's attitudes and perceptions related to their teaching role. While there are many factors influencing the clinical learning environment and student nurse perceptions of this environment, it was attitudes of clinical staff and student nurses themselves that appeared to be the recurring themes in the studies reviewed. In particular, the nurse clinician was seen to have a critical influence on student nurse experiences in the clinical learning environment (Labelle, & Miller, 2008). It appears that nurse clinicians influence the ward learning environment through their attitudes and interpersonal style. Studies have identified interpersonal characteristics inherent in nurse clinicians that enhance student nurse learning. These include role modeling skills, patience, respect, consistency, genuineness, understanding, sympathy, being approachable and having memory of being a student themselves (Cahill; Chan; Savage). Current knowledge and experience, effective management skills, and a willingness to teach are other characteristics of nurse clinicians identified as enhancing student learning (Dunn & Hansford, 2000). It would appear from the literature that both negative attitudes of staff and a negative atmosphere created in the clinical learning environment cause feelings of vulnerability and inadequacy in student nurses (Campbell & Windsor). Not only do student nurses frequently report negative experiences and dissatisfaction in the practice setting (Chan, 2001), but it seems they anticipate hostility from staff in practice, and difficulty in communicating with them, including nurse clinicians. Given the importance of clinical learning for student nurses and evidence that interactions

10 between student nurses and nurse clinicians have a critical influence on student learning, it seemed important to find out the types of relationships that exist between students and nurse clinicians. Therefore the aim of the present research was to gain an understanding of the nature of the interaction between student nurses and the nurse clinicians in the clinical setting in which they work. Based on a book by Marguerite Paetznik R.N, M.A.N. (A Guide for staffing a Hospital Nursing Services) A successful educational program for student nurses depends on the quality of nursing care that is practiced in the hospital. A strong well planned, nursing education program can; however, assist in improving the quality of nursing care if the student assignments are integrated into the nursing practices. The importance of coordination and integration of the nursing education and nursing service programs is emphasized and recommended. The student nurse, as a learner, should be present on the ward to gain experience appropriate to her education. In so doing, she contributes the nursing care of the patients. A successful meth for the use of student nurses in the planning for the staffing of the hospital has been reported and outlined in detail. Local Studies Based on a study conducted by the Institute for Christian Teaching Education Department of Seventh-day Adventists on 2010 , change in the health care system and population demographics; shift in the chronological age of nurse educators, nursing students and working nurses; and emergence of culturally diverse populations have profound implications on nursing education and practice. Among these are reduced mentorship availability, and a decreased number of teachers, students and nurses. These changes call for a restructuring in nursing curricula that will continue to promote quality education and skilled nursing care delivery in spite of the challenges facing the nursing profession. How can a teacher prepare students of the 21st century, to be diverse, genuinely

11 motivated, effective critical thinkers with efficient problem solving abilities and, at the same time, "inspire [them] with principles of truth, obedience, honor, integrity, and purity" (White)

12 Chapter 3: Research Methodology This chapter presents the research design, the sample size, type, sampling technique, research instrument, data gathering procedure and statistical treatment of data. Research Design The researchers used the descriptive-survey and correlational survey, types of decriptive research, because this study focuses at the present condition. This research design is appropriate wherever the objects of any class vary among themselves and one is interested in knowing the extent to which different conditions obtain among these objects. The word survey signifies the gathering of data regarding present conditions. A survey is useful in providing the value of facts and focusing attention on the most important things to be reported. Aquino describes this type of research as follows: Descriptive research is a fact finding with adequate interpretation. The descriptive method is something more and beyond just data gathering the letters is not reflective thinking nor research. The true meaning of the data collected should be reputed from the point of view of the objectives and the basic assumption of the project underway, this follows logically after careful classification of data. Facts obtained may be accurate expression of central tendency, deviation or correlation, but the report is not research unless discussion of those data is not carried up to the level of adequate interpretation. Data must be subjected to thinking process in terms of reasoning. Best and Kahn also described descriptive research as one concerned with condition or relationship that exist, option that are held processes that are going on, effects that are evidences and trends that are developing. It is primarily concerned with the present, although it often consider past events and influences as they relate to current condition.

13 The Sample Size, Type, and Sampling Technique The sample size is 161 which is the population of the level IV student nurses of Our Lady of Guadalupe Colleges without the number of researchers and those who participated the pretest. The sample size represented the total number of population of student nurses who had their clinical learning experience in Victor R. Potenciano Medical Center. The researchers made use of purposive sampling technique. The purposive sampling is based on the assumption that a researchers knowledge about the population can be used to hand pick the cases to be included in the same. The researcher might decide purposely to select the widest possible variety of respondents or might choose subjects who are judged to be typical of the population in question or particularly knowledgeable about the issues under study (Polit, Beck and Hungler). Distribution of Respondents Year Level Level IV Block Number 1 2 3 4 Total Research Instrument This study made use of questionnaires as a research instrument to gather data. The researchers formulated a set of questions for the respondents that helped them understand and provide the necessary data for the success of this study. The contents of these questionnaires assessed demographic profile, the factors that affects the level of performance in rendering health care in VRPMC and how do these factors affect the level of performance of the respondents. The questionnaire includes: Part I. This part of the questionnaire consists of the demographical data of the respondents in terms of: Number of Respondents 36 45 46 34 161

14 Age Sex Area of duty

Part II. This part of the questionnaire consists of the factors affecting the level of performance of student nurses of Our Lady of Guadalupe Colleges in rendering nursing care in Victor R. Potenciano in terms of: Clinical Learning Environment Clinical Instructors Personal Factors

Part III. This part of the questionnaire answers how the factors affect the level of performance of student nurses of Our Lady of Guadalupe Colleges in rendering nursing care in Victor R. Potenciano in terms of: Skills Knowledge Attitude Data Gathering Procedure Researchers asked for the permission of the Dean of College of Nursing of Our Lady Guadalupe Colleges to allow the researchers to distribute questionnaires to the student nurses involved in the study. While waiting for the permission, a preliminary test or pretest was done to acquire comments on what to change on the questionnaire. Upon approval of request, the researchers started to conduct the distribution of questionnaires. This gave them the chance to explain the mechanics of answering and the actual purpose of the study. Researchers gave them ample time to answer the questionnaire to have reliable

15 information. After distribution and collection of all the questionnaires, it was tallied, computed, interpreted and analyzed by the researchers. Statistical Treatment of Data The researchers processed the raw data into quantitative and qualitative forms. Data processing involves input, throughput, and output mechanisms. Input involves the responses to the measuring instrument of the subjects of the study.; throughput includes the statistical procedures and techniques; and output, the results of the study which are presented in data matrix form. This study used univariate type of data matrix which involves only one variable. In processing of data, the weighted arithmetic mean, not percentage, is the right statistical tool to use. But, this study also used percentage in summarizing the processed data. The Percentage formula is as follows: % = Where: % F N = = = Percentage Frequency Number of cases F N x 100

The weighted mean formula is as follows:

Where: x = Weighted Arithmetic Mean

16 fx = Sum of all products of f and x; where f is the frequency of each option and x is the weight of each option. n = total number of subjects

The formula for population standard deviation is as follows:

Where: 2 f x n = = = = = Population variance Frequency Class mark Population mean Number of observations

This study used Chi-square test to compare the differences of two or more variables with data that can be readily transformed into frequencies.(Guilford and Fruchter) To determine if the foregoing data differ significantly, the following formula was considered:

Where: X2 Oi Ei = = = Chi-square Observed frequencies Expected frequencies

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To process the foregoing data into quantitative and

qualitative forms and to get the correlation of the foregoing data of X and Y, Pearson ProductMoment Correlation Coefficient was used. The following formula of r was considered:

Where: r = Pearson r; correlation Sum of Test X Sum of Test Y Sum of the product of X and Y Number of cases Sum of squared X score Sum of squared Y score

X = Y = XY = N =

X2 = Y2 =

Note that the results of r should be interpreted only after its value has been found to be significant, as shown below.

18 R 0.00 to 0.20 0.21 to 0.40 0.41 to 0.60 0.61 to 0.80 0.81 to 1.00 Descriptive Interpretation Slight correlation Low correlation Moderate correlation High correlation Very high correlation

19 Chapter 4: Analysis, Presentation and Interpretation of Data

This chapter presents the results, analysis and interpretation of the data obtained through surveys using questionnaires. It looked into some personal profile characteristics of the student nurses respondents in terms of age, sex and area of assignment. Likewise it looked into the factors affecting the level of performance of student nurses in rendering nursing care as perceived by the student nurses themselves; how the factors affect the level of performance of student nurses in rendering nursing care; the significant difference among the factors affecting the level of performance of student nurses of Our Lady of Guadalupe Colleges in rendering nursing care in Victor R. Potenciano Medical Center, and the significant relationship between the factors and level of performance of student nurses of Our Lady of Guadalupe Colleges in rendering nursing care in Victor R. Potenciano Medical Center.

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Table 1 Age Group Distribution of the Student Nurses

Age 18-19 20-21 22-23 24-25 26-27 28-29 30-31 TOTAL Range Mean Standard Deviation Coefficient of Variation (%)

Frequency (N=161) 73 76 10 1 0 0 1 18-31 19.80 1.52 7.68%

Percent 45.34 47.21 6.21 0.62 0 0 0.62 100

Table 1 reveals that majority of the respondents belonged to the age bracket of 20 to 21 years with a frequency of 76 or 47.21 percent, while 73 or 45.34 percent belonged to the age bracket of 18 to 19 years, 10 or 6.21 percent belonged to the age bracket of 22 to 23 years, 1 or 0.62 percent belonged to the age bracket of 24 to 25 years and 30 to 31 years, and no respondents belonged to the age bracket of 26 to 27 years and 28 to 29. The age range of all respondents was from 18 to 31 years with an average of 19.80 years and a standard deviation of 1.52 years. This meant that the ages of the student nurse respondents belonged to the young adulthood age group and the distribution of their ages were heterogeneous (CV=7.68%).

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Table 2 Sex Distribution of the Student Nurses

Sex Female Male

Frequency (N=161) 119 42

Percent 73.91 26.09

Table 2 shows that majority of the student nurse respondents were females with a frequency of 119 or 73.91 percent, while 42 or 26.09 percent were males. This result revealed that there were more female student nurses than male. This result disclosed that the student nurses were dominated by the female group.

Table 3 Area of Assignment of the Student Nurses

Age Delivery Room Operating Room Recovery Room Emergency Room Intensive Care Unit Nursery Room

Frequency (N=161) 28 76 11 11 29 6

Percent 17.39 47.20 6.83 6.83 18.02 3.73

Table 3 shows the area of assignment of respondents. Student nurse respondents who were assigned at Operating Room obtained a frequency of 76 or 47.20 percent, while 28 or 17.39 percent were assigned at Delivery Room, 29 or 18.02 percent at Intensive Care Unit, 11 or 6.83 percent at Emergency Room and Recovery Room, and 6 or 3.73 at Nursery Room. This result revealed that majority of the student nurses had their duty at Operating Room, and the minority of student nurses was assigned at Nursery Room.

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Table 4 Factors Affecting the Level of Performance of Student Nurses in Rendering Nursing Care

Factors Clinical Learning Environment Clinical Instructor Personal factors Overall Mean Descriptive Interpretation Legend: Weighted Mean 3.26 4.00 2.51 3.25 1.76 2.50 1.00 1.75

Mean (x) 3.30 3.51 3.06 3.29 Always

Descriptive Interpretation Always Always Often

Descriptive Interpretation Always Often Seldom Never

Table 4 shows the factors affecting the level of performance of student nurses in rendering nursing care as perceived by the student nurses themselves. The following items such as Clinical learning environment and Clinical Instructor obtained weighted mean evaluating scores of 3.30, 3.51, respectively, and had a descriptive interpretation of Always. While the item Personal factors obtained weighted mean evaluating score of 3.06 and had a descriptive interpretation of Often. This meant that factors such as Clinical Learning Environment and Clinical Instructors always affect the level of performance of student nurses in rendering care, while the Personal Factors often affects the level of performance of student nurses in rendering nursing care.

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Table 5 Summary of Factors Affecting the Level of Performance of Student Nurses in Rendering Nursing Care

CLE F Scale Ratings Always 3.26-4.00 Often 2.51-3.25 Sometimes 1.76-2.50 Never 1.00-1.75 Weighted Mean Descriptive Interpretation Legend: Weighted Mean 3.26 4.00 2.51 3.25 1.76 2.50 1.00 1.75 72 65 24 0 % 44.72 40.37 14.91 0 3.30 Always

Clinical Instructors F % 87 69 5 0 54.03 42.86 3.11 0 3.51 Always

Personal Factors F % 50 74 34 3 3.06 Often 31.06 45.96 21.12 1.86

Descriptive Interpretation Always Often Seldom Never

Table 5 presents the summary of the factors affecting the level of performance of student nurses in rendering nursing care using the frequency distribution, percentage distribution, and weighted mean. The table shows that majority of respondents indicated that the clinical learning environment always affects their level of performance with a frequency of 72 or 44.72 percent, while 65 or 40.37 percent indicated that their level of performance is often affected, and 24 or 14.91 percent indicated that it is seldom affected. The overall weighted mean evaluation score as computed is 3.30 and has a descriptive interpretation of always. The same table also shows that majority of respondents indicated that the clinical instructors always affect their level of performance with a frequency of 87 or 54.03 percent, while 69 or 42.86 percent indicated that their level of performance is often affected, and 5 or 3.11 percent indicated that it is seldom affected. The overall weighted mean evaluation score as computed is 3.51 and has a descriptive interpretation of always.

24 The same table also shows that majority of respondents indicated that personal factors always affect their level of performance with a frequency of 50 or 31.06 percent, while 74 or 45.96 percent indicated that their level of performance is often affected, 34 or 21.12 percent indicated that their level of performance is seldom affected and 3 or 1.86 percent indicated that it is never affected. The overall weighted mean evaluation score as computed is 3.06 and has a descriptive interpretation of often.

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Table 6 How the Clinical Learning Environment Affects the Level of Performance of Student Nurses in Rendering Nursing Care

Clinical Learning Experience Skills Knowledge Attitude Overall Mean Descriptive Interpretation Legend: Weighted Mean 2.34 3.00 1.67 2.33 1.00 1.66

Mean (x) 2.63 2.60 2.47

Descriptive Interpretation Strongly Affected Strongly Affected Strongly Affected 2.59 Strongly Affected

Descriptive Interpretation Strongly Affected Affected Not Affected

Table 6 shows how the Clinical Learning Environment affects the level of performance of student nurses in rendering nursing care as perceived by the student nurses themselves. The following item such as Skills, Knowledge and Attitude obtained weighted mean evaluating scores of 2.63, 2.60, 2.47, respectively, and all had a descriptive interpretation of Strongly affected. This meant that Skills, Knowledge and Attitude of the student nurses are all strongly affected by the Clinical Learning Environment.

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Table 7 Summary of How the Clinical Learning Environment Affects the Level of Performance of Student Nurses in Rendering Nursing Care

Scale

Ratings

Skills F 103 56 2 % 63.98 34.78 1.24

Strongly Affected 2.34-3.00 Affecter 1.67-2.33 Not affected 1.00-1.66 Weighted Mean Descriptive Interpretation Legend: Weighted Mean 2.34 3.00 1.67 2.33 1.00 1.66

2.63 Strongly Affected

Knowledge F % 101 62.73 55 34.16 5 3.11 2.60 Strongly Affected

Attitude F % 81 50.31 74 45.96 6 3.73 2.47 Strongly Affected

Descriptive Interpretation Strongly Affected Affected Not Affected

Table 7 presents the summary of how the clinical learning environment affects the level of performance of student nurses in rendering nursing care in terms of skills, knowledge, and attitude using the frequency distribution, percentage distribution, and weighted mean. The table shows that majority of the respondents Skills are strongly affected by the Clinical Learning Environment with a frequency of 103 or 63.98 percent, while 56 or 34.78 percent indicated that their skills are affected, and 2 or 1.24 indicated that it is not affected. The overall weighted mean evaluation score as computed is 2.58 and has a descriptive interpretation of strongly affected. The same table shows that majority of the respondents Knowledge is strongly affected by the Clinical Learning Environment with a frequency of 101 or 62.73 percent, while 55 or 34.16 percent indicated that their knowledge is affected, and 5 or 3.11 percent indicated that it is not affected. The overall weighted mean evaluation score as computed is 2.59 and has a descriptive interpretation of strongly affected.

27
The same table also shows that majority of the respondents Attitude is strongly affected by the Clinical Learning Environment with a frequency of 81 or 50.31 percent, while 74 or 45.96 percent indicated that their attitude is affected, and 6 or 3.73 indicated that it is not affected. The overall weighted mean evaluation score as computed is 2.47 and has a descriptive interpretation of strongly affected. Table 8 How the Clinical Instructor Affects the Level of Performance of the Student Nurses in Rendering Nursing Care

Clinical Instructor Skills Knowledge Attitude Overall mean Descriptive Interpretation Legend: Weighted Mean 2.34 3.00 1.67 2.33 1.00 1.66

Mean (x) 2.71 2.70 2.58

Descriptive Interpretation Strongly Affected Strongly Affected Strongly Affected 2.66 Strongly Affected

Descriptive Interpretation strongly affected Affected not affected

Table 8 shows how the Clinical Instructor affects the level of performance of student nurses in rendering nursing care as perceived by the student nurses themselves. The following item such as Skills, Knowledge and Attitude obtained weighted mean evaluating scores of 2.71, 2.70, 2.58, respectively, and all had a descriptive interpretation of Strongly affected. This meant that Skills, Knowledge and Attitude of student nurses are all strongly affected by the Clinical instructor.
Table 9 Summary of How the Clinical Instructor Affects the Level of Performance of Student Nurses in Rendering Nursing Care

Scale

Ratings

Strongly Affected 2.34-3.00 Affected 1.67-2.33 Not affected 1.00-1.66 Weighted Mean Descriptive Interpretation
Legend:

Skills F % 116 72.05 43 26.71 2 1.24 2.71 Strongly Affected

Knowledge F % 113 70.19 47 29.19 1 0.62 2.70 Strongly Affected

Attitude F % 96 59.63 63 39.13 2 1.24 2.58 Strongly Affected

Weighted Mean 2.34 3.00

Descriptive Interpretation Strongly Affected

28 1.67 2.33 1.00 1.66 Affected Not Affected

Table 9 presents the summary of clinical instructor that affects the level of performance of student nurses in rendering nursing care in terms of skills, knowledge, and attitude using the frequency distribution, percentage distribution and weighted mean. The table shows that majority of respondents indicated that their skills in rendering health care is strongly affected by the clinical instructor with a frequency of 116 or 72.05 percent, while 43 or 26.71 percent indicated that their skills are affected, and 2 or 1.24 percent indicated that it is not affected. The overall weighted mean evaluation score as computed is 2.70 and has a descriptive interpretation of strongly affected. The same table shows that knowledge is strongly affected by the clinical instructor having the frequency of 113 or 70.90 percent, 47 or 29.19 percent indicated that their knowledge is affected, and 1 or 0.62 percent indicated that it is not affected. The overall weighted mean evaluation score as computed is 6.69 with a descriptive interpretation of strongly affected. It also shows that majority of respondents indicated that their attitude is strongly affected by the clinical instructor with a frequency of 96 or 59.63 percent, while 63 or 39.13 percent indicated that their attitude is affected, and 2 or 1.24 percent indicated that it is not affected. The overall weighted mean evaluation score as computed is 2.58 and has a descriptive interpretation of strongly affected.

29
Table 10 How the Personal Factors affect the Level of Performance of Student Nurses in Rendering Nursing Care

Personal Factors Skills Knowledge Attitude Overall mean Descriptive Analysis Legend: Weighted Mean 2.34 3.00 1.67 2.33 1.00 1.66

Mean (x) 2.53 2.48 2.39

Descriptive Interpretation Strongly Affected Strongly Affected Strongly Affected 2.46 Strongly Affected

Descriptive Interpretation strongly affected Affected not affected

Table 10 shows how the Personal Factors affect the level of performance of student nurses in rendering nursing care as perceived by the student nurses themselves. The following item such as Skills, Knowledge and Attitude obtained weighted mean evaluating scores of 2.5, 2.5, 2.4, respectively, and all had a descriptive interpretation of Strongly affected. This meant that Skills, Knowledge and Attitude of the student nurses are all strongly affected by the Personal Factors.

30
Table 11 Summary of How the Personal Factors Affect the Level of Performance of Student Nurses in Rendering Nursing Care

Scale

Ratings

Skills F 90 66 5 % 55.90 40.99 3.11

Strongly Affected 2.34-3.00 Affected 1.67-2.33 Not affected 1.00-1.66 Weighted Mean Descriptive Interpretation Legend: Weighted Mean 2.34 3.00 1.67 2.33 1.00 1.66

2.53 Strongly Affected

Knowledge F % 84 52.17 70 43.48 7 4.35 2.48 Strongly Affected

Attitude F 74 77 10 % 45.96 47.83 6.21

2.39 Strongly Affected

Descriptive Interpretation Strongly Affected Affected Not Affected

Table 11 presents the summary of how the Personal Factors affect the level of performance of student nurses in rendering nursing care in terms of skills, knowledge, and attitude using the frequency distribution, percentage distribution, and weighted mean. The table shows that majority of the respondents indicated that their Skills in rendering health care is strongly affected by the Personal Factors with a frequency of 90 or 55.90 percent, while 66 or 40.99 percent indicated that their skills are affected, and 5 or 3.4 percent indicated that it is not affected. The overall weighted mean evaluation score as computed is 2.53 and has a descriptive interpretation of strongly affected. The same table shows that majority of the respondents indicated that their Knowledge is strongly affected by the Personal Factors with a frequency of 84 or 52.17 percent, while 70 or 43.48 percent indicated that their knowledge is affected, and 7 or 4.35 percent indicated that it is not affected. The overall weighted mean evaluation score as computed is 2.48 and has a descriptive interpretation of strongly affected. The same table also shows that majority of the respondents indicated that their Attitude is affected by the Personal Factors with a frequency of 77 or 47.83 percent, while 74 or 45.96 percent

31 indicated that their attitude is strongly affected, and 10 or 6.21 percent indicated that it is not affected. The overall weighted mean evaluation score as computed is 2.96 and has a descriptive interpretation of strongly affected.

32
Table 12 Significant Difference among the Factors Affecting the Level of Performance of Student Nurses in Rendering Health Care

Survey Results Clinical Instructor Clinical Learning Environment Clinical Instructor Personal Factors x2 df Tabular value

Always 72 87 50

Often 65 69 74

Seldom 24 5 34 37.20 6 16.68

Never 0 0 3

The table 12 shows the significant difference among the factors affecting the level of performance of student nurses in rendering nursing care in terms of clinical learning environment, clinical instructors and personal factors. The significant differences were tested at 1% level of significance. The table reveals that the computed value of Chi-square which is 37.20 is greater than the tabular value, 16.68. This meant that there is a significant difference among factors that affect the level of performance of student nurses in rendering nursing care.

33
Table 13 Significant Relationship between Factors and Level of Performance of Student Nurses in Rendering Nursing Care

Survey Results x y 161 474 161 470 158 466 TOTAL=480 1,410 r Verbal interpretation df Tabular Value

xy 76,314 75,670 73,628 225,612

x2 25,921 25,921 24,964 76,806 0.87 very high correlation 12 .532

y2 224,676 220,900 217,156 662,732

The table 13 shows the significant relationship between factors and level of performance of student nurses in rendering nursing care. The statistical tool used in measuring the relationship between two random variables was Pearson Product-Moment Correlation Coefficient at 5 percent level of significance. The table reveals that the computed value, 0.87, is greater than the tabular value, 0.53. This meant that there is a significant relationship between factors and level of performance of student nurses in rendering nursing care. The verbal interpretation of r shows that there is very high correlation between two variables.

34 Chapter 5: Summary of Findings, Conclusions, and Recommendations Summary of Findings This study aimed to determine the factors that affect the level of performance of student nurses of Our Lady of Guadalupe Colleges (OLGC) in rendering nursing care to the patients of Victor R. Potenciano Medical Center (VRPMC). Specifically, it shed to answer the following questions, (1) Profile of the Student Nurses in terms of (a) age, (b) sex, and (c) clinical area of duty; (2) What are the factors that affect the level of performance of student nurses of Our Lady of Guadalupe Colleges in rendering nursing care in Victor R. Potenciano Medical Center in terms of (a) clinical learning environment, (b) clinical instructors, and (c) personal factors;

(3) How do these factors affect the level of performance of student nurses of Our Lady of Guadalupe Colleges in rendering nursing care in Victor R. Potenciano Medical Center, in terms of (a) skills, (b) knowledge, and (c) attitude; (4) Is there a significant difference among the factors affecting the level of performance of student nurses of Our Lady of Guadalupe Colleges in rendering health care in Victor R. Potenciano Medical Center?, and (5) Is there a significant relationship between factors and level of performance of student nurses of Our Lady of Guadalupe Colleges in rendering health care in Victor R. Potenciano Medical Center? The study was guided by the following hypotheses; (1) There is no significant difference among the factors affecting the level of performance of student nurses of Our Lady of Guadalupe Colleges in rendering nursing care in Victor R. Potenciano Medical Center, and (2) There is no significant relationship between the factors and the level of performance of student nurses of Our Lady of Guadalupe Colleges in rendering nursing care in Victor R. Potenciano Medical Center. The descriptive-survey and correlational survey, types of descriptive research were used in the study to determine the factors affecting the level of performance of student nurses of Our Lady of Guadalupe Colleges in rendering nursing care in Victor R. Potenciano Medical Center. Survey

35 questionnaire was used as a tool in gathering data from the respondents. A total of 161 student nurses who had their clinical learning experience at Victor R. Potenciano Medical Center were the respondents of the study. The collected data were interpreted, analyzed and measured using the following statistical treatments and methods: percentage formula, measure of central tendency such as weighted mean, measure of dispersion such as standard deviation, Pearson product-moment correlation coefficient to measure the correlation of two variables, and Chi-square test for the independence between two variables. Majority of the student nurse respondents ages were in the 20 to 21 years old category with an average age of 19.80, females, and had their duty at Operating room. The factors affecting the level of performance of student nurses in rendering health care such as Clinical Learning Environment and Clinical Instructors were verbally interpreted as always with overall weighted mean scores of 3.30 and 3.51, respectively, while Personal factor obtained an overall weighted mean, 3.06, which was verbally interpreted as often. All the Skills, Knowledge and Attitude were all verbally interpreted as strongly affected by the Clinical Learning Environment, Clinical Instructors and Personal Factors which obtained overall weighted mean scores of 2.59, 2.66 and 2.46, respectively. Correlation analysis revealed that there is a significant difference among factors such as clinical learning environment, clinical instructors and personal factors; and are significantly related to the level of performance of student nurses in terms of skills, knowledge, and attitude.

Conclusions Based on foregoing findings these following conclusions:

36 1. Majority of the student nurses belong to the young adulthood age group and the distribution of their ages were heterogeneous (CV=6.16%). 2. Majority of the student nurses are females that denote the greater population of female student nurses in Our Lady of Guadalupe Colleges (OLGC). 3. Majority of the student nurses had their duty in the Operating room than in other clinical areas. 4. Factors such as Clinical Learning Environment and Clinical Instructors always affect the level of performance of student nurses in rendering care, while the Personal Factors often affects the level of performance of student nurses in rendering nursing care 5. Skills, Knowledge and Attitude of the student nurses are all strongly affected by the factors identified. 6. There is a significant difference factors affecting the level of performance of student nurses of Our Lady of Guadalupe Colleges in rendering nursing care in Victor R. Potenciano Medical Center; the hypothesis that there is no significant difference among factors was rejected. 7. There is a significant relationship between factors and level of performance of student nurses. The study revealed r as 0.81 with the verbal interpretation of very high correlation; the hypothesis that there is no significant relationship between factors and level of performance of student nurses was rejected.

Recommendations 1. It is recommended to the clinical learning environment to create a welcoming learning environment and develop strategies in order to have a good collaboration between staff nurses and student nurses.

37 2. A clinical learning environment should establish an easy access to electronic teaching and learning facilities that will help the student nurses to improve their skills, knowledge and attitude in rendering health care. 3. It is recommended to have a full and active participation of the student nurses rather than passive observation to enhance and improve clinical skills. 4. Clinical Instructors must develop core behaviors evidencing mutual respect with those she/he teaches through interpersonal sensitivity and humanistic caring by which respect for human dignity and uniqueness of the student nurses are preserved in the clinical instructional setting. 5. Establishing a relaxed, collegial environment for learning decreases student anxiety and frees energy and attention for learning. 6. A positive tone empowers the student to engage in collaborative problem solving, to take risks and challenge themselves to higher levels of achievement. 7. Hospital administration should have a continuous evaluation of the hospital settings & protocols, hospital personnel and other institutions affiliating in Victor A. Potenciano Medical Center. 8. It is highly recommended to future researchers to have further studies that may help to improve nursing service of the institution and to improve the learning experience of the students.

38 References

Parreo, E., & Jimenez, O.,(2006).Basic Statistics: A worktext. Quezon City, C & E Publishing, Inc. Paler-Calmorin, L., & Calmorin, M., (1995). Methods of Research & Thesis Writing. Manila, Rex Book Store Inc. Kuzma, J., & Bohnenblus, S., (2005). Basic Statistics for the health Sciences 5th Edition. New York City, McGraw Hill. Polit, D., Beck, C.T. & Hungler, B.,(2001).Essentials of nursing Research; Methods, Appraisal & Utitlization. Philadelphia, Lippincott Williams & Wilkins. Berman, A., Snydeer S., Kozier, B., & Erb, G.L., (2007). Fundamentals of Nursing: Concepts, Process and Practice. Jurong, Singapore. Pearson Education South Asia Pte. Ltd. Vallant, S., Neville, S. (2006). The relationship between student nurse and nurse clinician: impact on student learning. Business Library, http://findarticles.com/p/articles/mi_m5PXL/is_3_22/ai_n25002075/ Koontz, A., Mallory, J., Burns, J., & Chapman, S. (2010). Staff nurses and students: the good, the bad, and the ugly. Business Library, http://findarticles.com/p/articles/mi_m0FSS/is_4_19/ai_n55187816/?tag=mantle_skin;content Paetznick, M. (2000). A guide for staffing a hospital nursing service. World Health Organization. http://whqlibdoc.who.int/php/WHO_PHP_31.pdf

39 APPENDIX A: Thesis Approval Request Letter


September 21, 2011 Ms. Myraflor C. Lava, RN, MAN Dean, College of Nursing Our Lady of Guadalupe Colleges Dear Madam: As partial fulfilment in Nursing Research, we the Level IV Block 1 Group III will conduct a study on Factors Affecting the Level of Performance of Student Nurses in Rendering Health Care 2011. This is for the College of Nursing of Our Lady of Guadalupe Colleges and for the Nursing Service of the Victor R. Potenciano Medical Center in improving the learning experience of students. At this juncture, we would like to ask your permission to allow us to undertake this study. Your favorable consideration to this request will surely make the undertaking possible which is a requirement in our course. We hope that this request will merit your favorable response and preferential attention. Thank you very much. Respectfully yours, _____________________ Katrina Corazon Abutog _____________________ Mary Ann Cinense _____________________ Desiree Anne Garcia _____________________ Marjorie Guilamo _____________________ Bernadette Javonitalla _____________________ Aldrin Licayan _____________________ Kevin Llamas _____________________ Beanne Joie Lozano _____________________ Leanne Joie Lozano _____________________ Ednel Jyn Luna _____________________ Cristybelle Malaki _____________________ Risha Joie Mandapat

Recommending Approval: Approved: ____________________________ Rosenda N. Jaramillo, RN, MAN Level IV Coordinator ____________________________

40 Myraflor C. Lava, RN, MAN College Dean

41 APPENDIX B: Questionnaire Cover Letter September 19, 2011

Dear Respondent, We, group three (3)-level IV nursing students of Our Lady of Guadalupe Colleges (OLGC), are currently conducting a study on factors affecting the level of performance of OLGC student nurses in rendering health care in Victor R. Potenciano Medical Center (VRPMC). Data gathered will serve as pertinent information for the college of nursing and for the nursing service of the said hospital in improving the learning experience of students. Enclosed with this letter is a brief questionnaire that asks questions about the said study. The questionnaire is very brief and will take about three minutes to fill out. Instructions for completing the questionnaire can be found on the form itself. We would appreciate if you would complete the questionnaire and return to the researchers. You need not to identify yourself in your response. We assure you of strict confidentiality and we will greatly appreciate your reply. Thank you for your cooperation.

Sincerely yours, _____________________ Katrina Corazon Abutog _____________________ Mary Ann Cinense _____________________ Desiree Anne Garcia _____________________ Marjorie Guilamo

_____________________ Bernadette Javonitalla _____________________ Aldrin Licayan _____________________ Kevin Llamas _____________________ Beanne Joie Lozano

_____________________ Leanne Joie Lozano _____________________ Ednel Jyn Luna _____________________ Cristybelle Malaki _____________________

42 Risha Joie Mandapat

APPENDIX C: Thesis Questionnaire Part I. Demographic Profile Name: (Optional) __________________________________ Age: ________ Sex: ________ Area of assignment (e.g. ER 1st floor): _________________ Part II. Identify factors that affect your level of performance in rendering health care in VRPMC. Factors affecting the level of performance of nursing students in rendering health care Clinical Learning Environment Clinical Instructor Personal Factors Part III. Indicate how the factors affect your level of performance in rendering health care. How the factors affect the Strongl Affected Not level of performance of y affected nursing students in rendering affecte health care d Clinical Learning Environment Skills Knowledge Attitude Clinical Instructors Skills Knowledge Attitude Personal Factors Skills Knowledge Attitude
Thank you!

Always

Often

Seldo m

Never

44 Curriculum Vitae

46

48