THE CHALLENGES THAT STUDENT NURSES ENCOUNTER WHEN LEARNING IN THE

CLINICAL SETTING OF OUR LADY OF FATIMA ANTIPOLO SKILLS LAB: EXPLORING THE
DISPARITY IN THE ACTUAL PERFORMANCE OF STUDENT NURSES IN PRACTICE.

Review of Related Literature

Nursing's most important foundation in practice is skills. (Nelmes, 2011). According to research,
learning occurs most effectively when you successfully work with your hands and thus gain
experience. Teaching methods have advanced tremendously in recent years. One notable
advancement throughout the years has been the employment of upgraded talents. laboratory rooms
outfitted with cutting-edge technology. It is possible for students to practice as many times as they
like. This has resulted in the improvement of hand skills and overall clinical performance. nursing
students' nursing abilities. (Godson, Wilson, and Goodman, 943.) A skill laboratory's efficacy is
achieved through developing a strong foundation throughout nursing school. Nursing students who
receive training early in their studies benefit from increased growth and experience as they master
the technique and gain confidence, erasing uncertainty and fear of making mistakes, and boldly
seeking to learn new skills while retaining those already learned (Raurell-Torredà, Olivet-Pujol,
Romero-Collado, Malagon-Aguilera, Patio-Masó, and Baltasar-Bagué (2015)36; Felton & Royal
2015).

Foreign Literatures

Bringing education and practice together

Nursing education has a substantial impact on the knowledge and competencies of all healthcare
workers, including nurses. Nurses with Bachelor of Knowledge in Nursing (BSN) degrees may fulfill
a wide range of patient needs, serve as leaders, and promote science that improves patients' and
health professional's ability to provide safe, high-quality patient care (Institute of Medicine, 2011).

The healthcare system is getting increasingly complex; future nurses will face a demanding
healthcare practice environment. Because the healthcare system is diverse and uncontrolled, with
inadequate funding, the twentieth century has been defined by many healthcare system reforms (El-
Jardali et al., 2014).
Relationship between student nurses and their Clinical instructors

Nurses have an important role in nursing students' learning. The job of training nursing
professionals in nursing education is becoming increasingly important. Working with a
knowledgeable and education-oriented nurse can assist nursing students to minimize their stress
levels in the clinical learning environment. Nursing students' learning experiences may be stressful
due to a lack of nursing professionals for education. In general, a setting in which staff members are
pleasant and friendly, have a good attitude and are willing to teach and mentor students has a
favorable impact on students' learning.

According to the findings of a 2003 study by Grindel et al, more experienced nurses committed
more time to teach nursing students, whereas less experienced nurses led students to carry out
other obligations and devote less time to them. Jones retrieved the factors of friendship, closeness
to students, availability, and readiness of nursing staff in a study done in Canada, and in terms of
students participating in the study, nurses' closeness to students was ranked first, while
preparedness for education was ranked last. In a systematic review study conducted by Rebeiro et
al in 2015, the main cause of nursing students' unsatisfactory interaction with nurses was a lack of
time and knowledge.

In an Iranian qualitative study, Mamaghani et al discovered that educational, communication, and

psychological aspects all have a role in students' interactions with nurses. As reported, the most
important factor in establishing such communication was self-confidence. In another study
conducted in Malaysia, nurses and students reported a better outlook toward clinical education to
improve learning. In a study that conducted in Iran, nurses stated that while nurses have the clinical
skills to teach nursing students, they can negatively affect students' professionalism.

Clinical Instructors and Teaching Strategies

Teachers and teaching approaches have always been an essential part of students' learning
processes. This is especially true in the Clinical Learning Environment, where students may become
increasingly passive and rely partially or fully on their instructors. Students were so used to teacher-
centered instructional approaches that their independence in the learning environment was low.
Nursing educators served as a bridge to help connect their students with CLE-related topics while
they performed in clinical settings. The mentor was a deciding factor in providing students with the
opportunity to study in demanding clinical situations (Harrison-White & Owens, 2018)
As a result, clinical lecturers' roles, as well as the selection of appropriate teaching approaches, are
critical in a student's academic performance. Recent research, on the other hand, has highlighted
clinical lectures as one of the elements influencing nursing students in the Clinical Learning
Environment. Clinical educators must tackle the challenging problem of sparking academic learning
interest as well as generating a passion for the nursing profession. When students are exposed to a
complex and diverse context in the Clinical Learning Environment, they may become confused and
distracted by negative emotions. Difficulties or problems that students may encounter in the Clinical
Learning Environment may cause them to become discouraged and lose their learning objectives.

Technological Obstacles in Nursing Education

Technology has a large impact on our lives, practice, education, management, and research.
Outcome-oriented education is currently being emphasized in nursing education rather than
process-based education, for example, through skill-based techniques; evidence-based techniques
in education; providing students with a rich learning journey, as opposed to previous models of
formal lecturing; and incorporating evolved learning technologies in many programs.
Inadequate Practical Skills

Inadequate Practical Skills

The clinical setting is an ideal setting for developing the skills required to care for patients. Some of
these, however, are regarded as core healthcare abilities, and any deficiencies in them have an
impact on the quality of service. Due to a lack of basic abilities, pupils had difficulty performing
procedures in several scenarios. According to one of the participants. Many clinical students were
concerned about their lack of actual abilities in caring for patients. As stated by one of the
participants of the Nahid Jamshidi, Zahra Molazem, Farkhondeh Sharif, Camellia Torabizadeh,
Majid Najafi Kalyani, "The Challenges of Nursing Students in the Clinical Learning Environment: A
Qualitative Study", The Scientific World Journal, vol. 2016,
"... The first time I used the blood pressure machine to take a patient's blood pressure, I had the
blood pressure cuff upside down around his elbow...it was entirely my fault, and I was ashamed in
front of him."
 Local Literature

Old Vs New Nursing Curriculum

In a research made at the University of the Immaculate Conception, Davao City, Philippines they
showed a significant relationship between the level of knowledge and clinical experience among
UIC nursing students. It revealed that nursing students from the old curriculum were highly
knowledgeable compared to students in the new curriculum. However, students in old and new
curriculums were shown to have highly satisfactory clinical experience in an actual clinical setting.
The theory-practice gap was evident, as supported by weak correlations of the level of knowledge
and clinical experience of old and new curriculums. Hence, curriculum change in nursing programs
satisfied the minimum requirements essential to student nurses’ clinical experience. The theory-
practice gap is a widely used term in nursing literature that refers to the gap between theoretical
understanding and actual performance of nursing students in practice (Carson & Carnwell, 2007).
Nursing education has undergone significant changes in several countries in recent years as a
result of integration with institutions. Nurse educators are working hard to adapt to educational
changes; nonetheless, the link between theoretical inputs provided in the classroom and what is
performed or experienced on the wards remains a challenge (Ashworth & Longmate 1993;
Ferguson & Jinks, 1994).

The results of the study conducted at the University of the Immaculate Conception in Davao City,
Philippines, demonstrated that nursing students enrolled in the old curriculum were more
knowledgeable than those enrolled in the new curriculum. Students in both the old and new
curricula, however, were proven to have highly satisfactory clinical experience in the actual clinical
situation. The theory-gap practice was also visible, as evidenced by the weak correlations between
the old and new curriculum's degree of knowledge and clinical experience. It was also discovered
that the nursing program's curriculum adjustment provided an appropriate expansion of student
nurses' knowledge and clinical experience.
MODERNIZED CARE: EXAMINING THE ROLE OF TELEMEDICINE IN THE EVOLUTION
OF HEALTH CARE FOR PATIENTS IN FAR-FLUNG COMMUNITIES OF ANTIPOLO
CITY

As the world evolves, so does the health-care system. As evidence, new methods of

delivering medical care to those in need have been discovered, regardless of where you

are. Telehealth, also known as telemedicine, is one way to enhance the country's health

service. It is a method of seeking professional medical assistance through the use of

technologies and devices such as smartphones to obtain information about one's health

status digitally (Cabatbat, 2021). For its convenience, many individuals are becoming

appreciative of telehealth. However, the question that remains at hand is its effectiveness.

Will telemedicine be effective when used in a far-flung community? Is telemedicine equal to

the traditional patient- doctor check-up?

REVIEW OF RELATED LITERATURES

This chapter shows a retrospective presentation of previously written material: research
literature and conceptual that has relevance and significance to the research under
considered.
Foreign Literatures
There are numerous ways physicians provide care. In this modern world, where

90.04 % of people around the world owns a cellphone, providing medical care becomes a

lot easier by means of telemedicine (Turner, 2023). Telehealth includes a broad array of

services that facilitate delivery of medical consultation, patient education, health information

services, and other related services via use of digital technologies. Technologies utilized in

telehealth include but are not limited to video conferencing, health apps, mobile health, and

other methods that promote patient monitoring from remote locations if needed. It is

important to note that telehealth enables patients in rural areas to access medical providers

at larger facilities. These services can be used to address physician shortages and access

to specialty care in rural and remote areas ( Catalyst, 2018).

 In addition to that, according to Watsons (2020) using technology to deliver health

care has several benefits, including cost savings, convenience, and the ability to provide

care to people with mobility issues or those living in rural areas who do not have access to

a local doctor or clinic.

Another major benefit of telehealth, according to the Centers for Disease Control and

Prevention is maintaining continuity of care while avoiding the negative consequences of

delayed preventive, chronic, or routine care. It has been reported that people living in rural

areas are more likely to die prematurely from chronic illness, stroke, and unintentional

injury. Telehealth can be an effective method of providing care, particularly when medical

professionals can monitor a patient's condition, such as lung disease, from a distance. This

can result in fewer hospital admissions and, in some cases, even deaths.

Due to these factors, the use of telehealth has increased significantly over the last

decade. Currently, 76 percent of hospitals in the United States use telehealth to connect

doctors and patients remotely, up from 35 percent a decade ago (Watsons, 2020). That is

also why, unsurprisingly, a recent study suggests that , 95% of patients who received

medical consultation via telehealth were remarkably satisfied with the quality of care, ease

of access, timeliness, and ability to incorporate technology into their care plan.

On the other hand, although telehealth is a convenient and cost-effective way to see

your doctor without leaving your house, it still has a few drawbacks. Every type of visit

cannot be performed remotely. You must still visit the office for imaging tests and blood

work, as well as diagnoses that require a more hands-on approach. Also, concerns have

been raised about the security of personal health data transmitted electronically. Many rural

healthcare providers still struggle with interoperability, which includes the exchange of

electronic health information. Some rural telehealth programs may struggle to ensure

secure and effective methods for providers from various systems to share information and
access electronic health records.. Furthermore, during the COVID-19 pandemic, insurance

companies are increasingly covering the cost of telehealth visits; however, some services

may not be fully covered, resulting in out-of-pocket costs ( Watsons, 2020).

Other things to consider in applying telehealth are the barriers to its effective

implementation. A few of them are, lack of access to high internet speed, interoperability

and mistrust of technology and health care.

The Health Information Technology in Rural Healthcare topic guide examines a

number of factors that may impact rural programs' ability to maintain and expand access to

telehealth in rural areas. According to the 2018 Broadband Deployment Report, only 69.3%

of rural areas and 64.6% of tribal areas had access to high-speed broadband internet that

met the Federal Communications Commission's minimum benchmark (FCC). Patients'

ability to participate in video consultations, transmit health information, and monitor their

health at home is affected by broadband availability (RHIhub,2019).

Local Literatures

In the Philippines, the growth in teleconsultations came about after an organization

collaborated with the Philippines Department of Health and the National Privacy

Commission in providing free telemedicine services, which aided in reducing health center

occupancy and preventing the spread of COVID-19. Since the partnership’s inception,

almost 70,000 virtual session services had been provided to patients throughout the

country.

The local telehealth platform enables users to bypass health facility lines and video-

call a registered healthcare practitioner in 5 minutes, with medication being administered

the following day. Metro Manila offers completely free medication delivery. The app stores

medical history, health reports, and other documents for easy access. The platform also

allows trained counsellors and therapists to provide mental health counseling.

 Telemedicine is practically the future of the country's healthcare sector, and the

Philippines government must consider it as a critical component of universal health

coverage. Because there aren't enough doctors in the country, using technology to

distribute medicine is critical to improving the country's healthcare sector. As telehealth

advances, people may soon hear "the robot will see you now" in the not-too-distant future

(Hani, 2021).

REFERENCES:
Barriers to Telehealth in Rural Areas - RHIhub Toolkit. (n.d.).

https://www.ruralhealthinfo.org/toolkits/telehealth/1/barriers

Cabatbat KPM. Telemedicine: keeping patients safe during pandemic. J Publ

Health. 2021. doi: 10.1093/pubmed/fdab273 [PubMed] [CrossRef] [Google Scholar]
Hani, A. (2021, September 28). Rapid Development of Telehealth Services in the

Philippines - OpenGov Asia. OpenGov Asia -. https://opengovasia.com/rapid-development-

of-telehealth-services-in-the-philippines/

Polinski J.M., Barker T., Gagliano N., Sussman A., Brennan T.A., Shrank W.H. Patients’
Satisfaction with and Preference for Telehealth Visits. J. Gen. Intern. Med. 2016;31:269–
275. doi: 10.1007/s11606-015-3489-x. [PMC free article] [PubMed] [CrossRef] [Google
Scholar]
Telehealth in Rural Communities. [(accessed on 14 February 2023]; Available
online: https://www.cdc.gov/chronicdisease/resources/publications/.factsheets/telehealth-in-
rural-communities.htm

Turner, A. (2023, February 7). How Many People Have Smartphones Worldwide (Feb

2023). BankMyCell. https://www.bankmycell.com/blog/how-many-phones-are-in-the-world

Watson, S. (2020, October 12). Telehealth: The advantages and disadvantages. Harvard

Health. https://www.health.harvard.edu/staying-healthy/telehealth-the-advantages-and-

disadvantages

What Is Telehealth? [(accessed on 14 February 2023)]; Available

online: https://catalyst.nejm.org/doi/full/10.1056/CAT.18.0268
 ADVERSE HEALTH EVENTS RELATED TO SELF-MEDICATION ADHERENCE AMONG
ELDERLY IN ANTIPOLO

REVIEW RELATED LITERATURE

FOREIGN LITERATURE
Older adults often resort to self-medication to relieve symptoms of their current illnesses;
however, the risks of this practice are multiplied in old age. The aim of the study was to obtain an
overview of the adverse health events related to self-medication among subjects aged 60 years and
over through a systematic review of the literature. According to Locquet M., Honvo G., Rabenda V.,
(2017), studies on self-medication in the elderly and its adverse health effects are clearly lacking.
There is a need to perform prospective studies on this topic to gain a clear understanding of the
extent of this problem and to enhance the awareness of health professionals to better inform
seniors.

Self-medication is defined as the selection and use of medicines by individuals (or a member
of the individuals’ family) to treat self-recognized or self0diagnosed conditions or symptoms. Several
benefits have been linked to appropriate self-medication, among them: increased access to
medication and relief for the patient, the active role of the patient in his or her own health care,
better use of physicians and pharmacists skills and reduced (or at least optimized) burden of
governments due to health expenditure linked to the treatment of minor health conditions However,
self-medication is far from being a completely safe practice, in particular in the case of non-
responsible self-medication. Potential risks of self-medication practices include: incorrect self-
diagnosis, delays in seeking medical advice when needed, infrequent but severe adverse reactions,
dangerous drug interactions, incorrect manner of administration, incorrect dosage, incorrect choice
of therapy, masking of a severe disease and risk of dependence and abuse. In this short review the
author analyzes recent literature on some of the most important dangers related to self-medication
practices, particularly: polypharmacy and drug interactions, medications abuse or dependence,
misdiagnosis and incorrect choice of treatment. The author also proposes measures that could be
adopted in order to solve or improve these issues. (Ruiz, Maria E., 2010)

Self-medication is one of the problems in the treatment cycle of patients. Aging is associated with
increased drug use and adverse effects. The purpose of this study was to assess the factors
influencing self-medication among the elderly referring to urban health centers in Khorramabad,
Iran, based on the Health Belief Model (HBM) in 2016-2017. According to Katayon Bakhtiar,
Fatemeh Bastami, Naser Sharafkhani, Mohammad Almasian (2017) The result indicated that
perceived severity and barriers play a more crucial role in the development of self-care behaviors
regarding self-medication among the elderly.

LOCAL LITERATURE
Self-medication is rampant in the Philippines, with a prevalence of 31-66%. Self-medication
provides some semblance of health care, especially for low-income households that avoid economic
and opportunity costs (ie, productive work hours compromised by long clinic wait times) of medical
consultation and diagnostics. Self-medication is also common among higher-income earners, who
have easier access to health information, and have the financial and social means to acquire
medicine. Non-medical professionals commonly prescribes antimicrobials, and antibiotics sharing
remains a common practice among Filipino families and communities. Such as practices reflect poor
regulation of dispensaries in the country. Culture also substantially impacts health behaviour, and
many Filipino people in rural areas still seek first-line from traditional healers. These healers provide
unknown herbal treatments – with some containing suboptimal levels of antibiotics, which might
later enhance pathogen resistance-and perform outdated practices, such as crushing antibiotics to
apply to skin injuries. (J. Robredo, M. Eala, J. Paguio, M. Salamat, L. Celi, 2022)
As the number of elderlies in the Philippines continues to increase, attention has been focused on
efforts to promote their well-being and address their health needs. In recent years, the role of the
elderlies has shifted from that of being recepients of care to active participants of their own care.
Self-care means that activities are performed by the aged on their own behalf, particularly, in health
promotion, prevention and in disease detection and treatment. Self-care emphasized a person’s
control over health care and health actions through knowledge and the development of skills (Orem,
1980).
This study aimed to determine the self-care practices of elderlies who were members of the
Federation of Senior Citizens’ Association of the Philippines (FSCAP) in five selected barangays in
the disctrict of Jaro, Iloilo City. The study further aimed to determine the relationship between the
elderlies’ self-care practices and selected factors, namely, age, gender, work status, income and
educational attainment.
The concept of self-care emphasizes the need for individuals to perform activities of daily
living without assistance. The person makes the decision to attain the desired outcome and
determines which risk to contend with or avoid (Orem, 1996). A person’s response to self-care,
however, may vary depending on certain situations/factors which facilitate or hinder a desired
behavior, such as age, sex, educational attainment, occupation, marital status, individual beliefs and
expectations and attitudes may affect their needs and perceptions. In this study, it was assumed
that these factors (independent variables) may have some important bearing on the elderlies’
promotive, preventive, and curative self-care practices (dependent variables). (Sofia Cosette P.
Monteblanco, M.A.N, 1999)

References:

Factors associated with self-care practices of the elderly FSCAP ... (n.d.). Retrieved February 14,
2023, from
https://repository.cpu.edu.ph/bitstream/handle/20.500.12852/2028/04_CPURJ_MonteblancoS
CP_1999.pdf?sequence=1

Locquet, M., Honvo, G., Rabenda, V., Van Hees, T., Petermans, J., Reginster, J.-Y., & Bruyère, O.
(2017, February 28). Adverse health events related to self-medication practices among
elderly: A systematic review - drugs & aging. SpringerLink. Retrieved February 14, 2023, from
https://link.springer.com/article/10.1007/s40266-017-0445-y
LEVEL OF PREPAREDNESS AND CONFIDENCE OF GRADUATING NURSING STUDENTS OF
OUR LADY OF FATIMA UNIVERSITY IN PASSING PHILIPPINE NURSING LICENSURE
EXAMINATION.

Review of Related Literature

Local Literature

The main goal of this research is to assess the level of preparedness of graduating students in
taking the board examinations in three different learning domains namely - cognitive, affective, and
psycho-motor. However, this research will include the collection and collation of data from academic
institutions in Central Luzon, the Philippines with engineering courses. This study used the non-
experimental quantitative design, particularly the descriptive survey. Respondents are graduating
engineering students officially enrolled in different State Universities and Colleges during the 2nd
semester of the school year 2021- 2022. Demographic profiles of respondents were presented.
Results showed that the three learning domains greatly affect the student's preparedness and
confidence in taking the board examinations. The research conducted depicted a number of points
that needs to be addressed to improve the level of preparedness and confidence in taking the
licensure exam.

Students’ high performance, if not 100% passing rate, in taking the Licensure Examination
for Teachers (LET) is the ultimate goal of every Teacher Education Institutions (TEI). Hence, it
requires all the necessary preparations not only for what the school can provide but also with the
examinees’ personal accountability. This paper investigated the respondents’ personal
preparedness in taking the licensure examination along with self-motivation, study skills and habits,
and time management. There were 40 (22 Bachelor of Elementary Education and 18 Bachelor of
Secondary Education practicum students) of the University of Nueva Caceres College of Education,
Naga City, Philippines, who were used as the respondents of this study. These students were also
preparing for their LET Examination through once a week assessment classes for the entire
duration of their practicum. The survey revealed that respondents were exceptionally high in their
personal drive along self-motivation but their commitment/goal setting needs to be defined. The use
of resources was noted to be very highly used along study skills but health habits were the least
given attention. It was further revealed that time management skills of the respondents were very
high along deciding and starting their study routine but are struggling with difficult tasks that are not
of their interest but might be highly relevant to their professional examination.
 The passing rate in the Nurse Licensure Examination (NLE) is considered a key indicator of
the quality of the nursing program. While a plethora of studies has identified the factors affecting
NLE success, no study has tried to explore the role of an institutional standardized competency
examination on NLE. The purpose of this study was to determine the relationship of institutional
terminal competency assessment (TCA) and other factors on the NLE performance of nursing
graduates. This study used a descriptive-correlational research design using data sets of nursing
graduates of West Visayas State University from 2015 to 2017 (N=354). Pearson’s r set at .05 alpha
level was used in the inferential analysis. Results indicated that TCA was significantly related to
NLE performance. Other factors such as High School Grade General Average, College Grade
General Weighted Average and scores in College Admission Test, Nursing Aptitude Test, and Pre-
board Examination were significantly correlated with NLE rating. Aside from the known factors in the
literature, nursing schools may also benefit from developing and conducting an institutional
standardized competency assessment administered at the end of the nursing program to aid in
assessing students’ likelihood of success in the NLE.

Foreign Literature

The purpose of this study was to explore the perception of preparedness in nursing students
who transitioned to online and virtual learning platforms brought about by Coronavirus disease 2019
(COVID-19). Design: Descriptive, correlational, nonexperimental research design. Method: Data
collection was attained through Facebook groups using the Casey-Fink Readiness for Practice
Survey and questions about comfort in nursing skills and multiple patient assignments. The sample
size of 103 included nursing students and those with less than two years of experience. Results: As
school support during the transition increased, comfort in performing nursing skills improved. As the
number of patients within a nurse's assignment increased, comfort decreased. Participants
expressed a desire for more hands-on in person education and postgraduate support. With the
reduction in clinical hours during COVID-19, Learning Techniques and Trials and Tribulations
revealed diminished readiness. Low scores within the Trials and Tribulations subgroup impacted
feelings of comfort when performing nursing skills independently. Conclusion: COVID-19
dramatically changed how undergraduate nurses were educated. The transition from live didactic
instruction and in person clinical experience to online learning and simulated clinical experience
impacted nursing students' readiness for practice. As this topic is still evolving, additional research
will be needed to fully understand the impact on healthcare.

This study aims to use the artificial neural network as a novel approach to explore factors
that determine and predict successful performance of nursing interns in Saudi Arabia on the Saudi
Nursing Licensure Examination (SNLE). The study employed a cross-sectional, analytic approach.
A total of 62 nursing interns were recruited by convenience sampling from the University of Hail to
participate. Data collection was conducted from September to December 2019. Descriptive statistics
were used to describe the demographic characteristics of the nursing interns and their responses
regarding examination determinants. Neural network analysis was used to identify factors that are
highly predictive of the success of the nursing interns on the SNLE. Overall, the nursing interns
were undecided (3.94 ± 0.14) about the influential factors determining their success. Their study
hours (100%) and grade point average (GPA) (96.9%) were identified as strong determinants
reflective of the tenacity and vigor of the nursing interns, based on the predictive power of the
model. Meanwhile, age (45.7%), marital status (21.3%), gender (15.2%), and the type of academic
program (5.9%) were considered the least important of the sociodemographic variables. Exam
preparation activities such as preparation programs, review classes, and exam simulations must be
promoted and enhanced to increase the passing tendencies of the nursing interns in the SNLE. The
GPA and increased study hours make the most significant contributions to success on the SNLE as
compared to other variables such as age, gender, marital status, and the academic program. This
study serves as a springboard for nursing educators and administrators in laying tailored strategies
to strengthen the nurse interns’ GPA and time management.

The purpose of this study was to examine efficacious instructional strategies that the New
England Community College (NECC) nursing program could implement in the curricula to improve
National Council Licensure Examination Registered Nurse (NCLEX-RN) first-time pass rates.
Effective strategies from students and nursing program faculty had used were investigated. Such
strategies support student nurses in their efforts to succeed on the first administration of the exit
examination. The rationale for this study and resulting project was that they could improve NCLEX-
RN first-time pass rates and positively impact the local hiring of qualified nurses. Guided by
Knowles’s adult learning theory, key results of the study and resulting project were developed from
effective instructional strategies discovered from former NECC students. The central research
question focused on identifying which teaching-learning strategies in the NECC nursing curricula
improved students’ critical thinking skills and problem-solving skills. A qualitative case study design
was employed with a purposeful sample of 15 former NECC nursing program graduates. Participant
focus groups and annual program/accreditation documents were used to collect data to address
how student nurses learn best to be successful on the exit examination. The project was the
creation of a 3-day seminar in the first semester curriculum that focuses on effective licensure
preparation instructional strategies to establish and maintain high NCLEX-RN pass rates.
Implications for positive social change include, but are not limited to, improving students’ problem-
solving skills and application of critical thinking strategies in order to positively impact the lives of the
patients whom they will serve.
 THE IMPACT OF INITIAL CONTACT IN THE CLINICAL LEARNING ENVIRONMENT ON THE
DETERMINATION TO CONTINUE NURSING AS A CAREER OF SECOND YEAR STUDENT
NURSES OF OUR LADY OF FATIMA UNIVERSITY ANTIPOLO CAMPUS

Review of Related Literature

Foreign literature

Clinical learning environment (CLE) is define as a interactive network of forces within the clinical
setting that influence the students clinical learning outcomes. CLE is a way of preparing student
nurses in the actual hospital settings, also In this new environment they actually apply the
knowledge and skills that they learned in the school setting. In CLE the students gained new set of
skills, knowledge and improve decision making though unwanted events thus influencing their well
being and their choice of future careers. CLE is effective in honing future nursing through
competence and increasing confidence to become independent. In this study it shows that CLE
affects the students behavior and decision making. In this current study the proponents want to
know if there is a change in their reasoning to continue to pursue nursing as a career in their life.

Nursing as a career

Nursing is a career pursue by many with different reasons. According to a study, students chooses
nursing as a career for different reasons this reasons such as helping people, easy access job,
diverse opportunities it offers and some is just purely coincidence. The researchers want to know if
this reasons will be still their reasons in pursuing nursing after clinical learning environment. The
proponents want to know what are the students initial reason and how will it affect by CLE before
and after.

CLE helps to pursue nursing

According to a study, Clinical learning environment influences the students formation of professional
identity. Nurses and Doctors will be viewed as role models to the students and this is a essential
role in shaping medical learners professional values and identity. In addition professional setting like
this really help the student to decide wether to continue in this profession or not.
 Local literature

According to a study entitled ―Family and caregiving values: Factors influencing career choice of
Filipino nursing students‖ although choosing a career is relatively personal, it can be influence by
others ―in this study by their family‖. This influence can affect the decision making of the student to
choose a career. The researchers thought that people around you can affect or influence your
decisions and in the Clinical environment there are people that also will influence the determination
of the student to continue nursing as a career or not.

According to a study entitled A Quantitative Study of Clinical Learning as Evaluated by Student

Nurses of Bulacan State University the researchers stated that there are factors that affects the
determination of a students who is under CLE these are age, sex, type of hospital etc. With this the
proponents have an Idea that there are factors to look at that furthermore affect or influence the
determination of students to continue nursing as a career.

References:

Family and caregiving values: Factors influencing career choice of ... (n.d.). Retrieved February 14,
2023, from https://core.ac.uk/download/pdf/230830608.pdf

Lozano, F. (2017, November 30). A quantitative study of clinical learning as evaluated by student
nurses of Bulacan State University (reduplication of Cles + t). Academia.edu. Retrieved
February 14, 2023, from
https://www.academia.edu/35306676/A_Quantitative_Study_of_Clinical_Learning_as_Evaluat
e

Marcinowicz, L., Owlasiuk, A., Slusarska, B., Zarzycka, D., & Pawlikowska, T. (2016, September
20). Choice and perception of the nursing profession from the perspective of Polish nursing
students: A FOCUS Group Study - BMC Medical Education. BioMed Central. Retrieved
February 14, 2023, from https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-016-
0765-3

Wang, Q., Cao, X., & Du, T. (2022, August 23). First-year nursing students' initial contact with the
Clinical Learning Environment: Impacts on their empathy levels and perceptions of
professional identity - BMC nursing. BioMed Central. Retrieved February 14, 2023, from
https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-022-01016-8

Zhang, J., Shields, L., Ma, B., Yin, Y., Wang, J., Zhang, R., & Hui, X. (2022, July 15). The Clinical
Learning Environment, supervision and future intention to work as a nurse in nursing students:
A cross-sectional and descriptive study - BMC Medical Education. BioMed Central. Retrieved
February 14, 2023, from https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-022-
03609-y#ref-CR6
EFFECT OF PROVIDING CARE FOR OUR CAREGIVERS: COMPOSING POSSIBLE EFFECTIVE
STRATEGIES TO MAINTAIN THE MENTAL AND EMOTIONAL HEALTH OF FILIPINO NURSES’
AMID THE FATIGUING PANDEMIC

Review of Related Literature

Foreign Literature

Assessment of mental health among nursing staff at different levels

To assess the mental health of nurses and to find the post responsibility and psychological
status of clinical nurses. A total of 447 nursing staff at different levels in a teaching hospital
was assessed by nursing post responsibility scale and mental symptom checklist (SCL-90)
then compared with each other. The study period was from April 1, 2018 to April 30, 2018.
There was a positive correlation between the responsibility of post and interpersonal
relationships (r = 0.11, P < .05), depression (r = 0.10, P < .05) and hostility (r = 0.10, P <
.05). Post risk was negatively correlated with somatization (r = −0.10, P < .05), job
involvement scope and communication ability were negatively correlated (r = −0.11, P <
.05). Based on the multiple linear regression, knowledge and skills (β = −0.20, P = .02) and
risks of the post (β=0.20, P < .01) both significantly related to SCL-90 total score. In
conclusion, knowledge and skills and risks of the post are associated with the mental health
of clinical nurses. The sustainable development of nursing post responsibility requires
healthy physiological and mental health.

Occupational Mental Health: A Study of Work-Related Mental Health among Clinical

Nurses

This paper reports a study performed to investigate and assess the mental health as well as
the demographic characteristics of nurses to examine their mental health status based on
four physical, anxiety, social-function and depression items.

This descriptive cross-sectional study was accomplished on 86 nurses working at three

hospitals, affiliated to the Iranian health ministry, in Ilam city(western Iran) all the cases
were selected by purposeful sampling method.
Data was collected by a two-part questionnaire containing individual data and GHQ -28
Standardized Questionnaire. The GHO-28 was developed by Goldberg, in 1978, as a
screening tool to detect those likely to have or be at risk of developing psychiatric disorders.

The GHQ-28 is a 28-item measure of emotional distress in medical settings. Analysis was
done by SPSS 18 software.

The majority of participants were females(50.6 vs.49.4) of 35-40 years old(27.2% ), 84

percent were married(vs.16%), 35.8 percent with 10-15 years of record(vs.33.3% less than
5), 22.2% with 5-10, and 8.6% with more than 15-years of work record. The majority of
participants have worked in surgical wards of hospitals. The analysis of GHQ results
showed that 43.2%(n=35) of participants were suspected to suffer from mental
disorders(vs.56.8% n=46 healthy participants); of all the suspected cases, 12.3% were
supposed to have physical symptoms, 16% anxiety symptoms, 42% social dysfunction, and
6.2% symptoms of depression. In general, the participants demonstrated a Mean±SD of
mental health score equal to 23.65±9.43.

Research results showed that the high prevalence of depression, anxiety and stress
symptoms among nurses is alarming. It was concluded that providing efficient, adequate,
and appropriate support services for this group can result in more healthy nurses as well as
promotion of public health.

Prioritizing the Mental Health and Well-Being of Healthcare Workers: An Urgent

Global Public Health Priority

The COVID-19 pandemic has had an unprecedented impact on health systems in most
countries, and in particular, on the mental health and well-being of health workers on the
frontlines of pandemic response efforts. The purpose of this article is to provide an
evidence-based overview of the adverse mental health impacts on healthcare workers
during times of crisis and other challenging working conditions and to highlight the
importance of prioritizing and protecting the mental health and well-being of the healthcare
workforce, particularly in the context of the COVID-19 pandemic. First, we provide a broad
overview of the elevated risk of stress, burnout, moral injury, depression, trauma, and other
mental health challenges among healthcare workers. Second, we consider how public
health emergencies exacerbate these concerns, as reflected in emerging research on the
negative mental health impacts of the COVID-19 pandemic on healthcare workers. Further,
we consider potential approaches for overcoming these threats to mental health by
exploring the value of practicing self-care strategies, and implementing evidence based
interventions and organizational measures to help protect and support the mental health
and well-being of the healthcare workforce. Lastly, we highlight systemic changes to
empower healthcare workers and protect their mental health and well-being in the long run,
and propose policy recommendations to guide healthcare leaders and health systems in
this endeavor. This paper acknowledges the stressors, burdens, and psychological needs
of the healthcare workforce across health systems and disciplines, and calls for renewed
efforts to mitigate these challenges among those working on the frontlines during public
health emergencies such as the COVID-19 pandemic.

LOCAL LITERATURE

“Risk perception, mental health impacts and coping strategies during COVID-19
pandemic among Filipino healthcare workers”

COVID-19 pandemic has caused an extraordinary situation, especially for the healthcare
workers (HCWs), leading to increased psychological stress. The aim of the study was to
estimate the prevalence of different grades of anxiety and depression across different
centers in the Philippines and identify demographic factors associated with them.

A cross-sectional, web-based, multi-center study was conducted among HCWs of

Philippines from April 20- May 20, 2020. The study instruments used were the Generalized
Anxiety Disorder (GAD-7) scale and Patient Health Questionnaire (PHQ-9). Risk perception
scores were analyzed using Mann-Whitney and Kruskal-Wallis test. Logistic regression was
done to identify factors significantly associated with symptoms of anxiety and depression
determined.

A total of 516 HCWs were included in the study. Most of them have anxiety symptoms
(70.74%), but only half of them have symptoms of depression (50.97%). In addition,
gender, age, marital status, living status, occupation, work premises, and availability of
mental health services were significantly associated with the participants' anxiety
symptoms. In contrast, gender, marital status, occupation, and work premises were
significantly associated with depression symptoms. This study reiterates the fact and
demonstrates that COVID-19 has disrupted the mental well-being of HCWs in the
Philippines. Majority of HCW was psychologically affected by COVID-19. Therefore, there is
a dire need to address mental illness amongst HCWs and frame guidelines based on
proven algorithms to overcome these mental illnesses.

“Behavioral design interventions for the promotion of wellbeing among Filipino

healthcare workers during the COVID-19 pandemic”

Frontline healthcare workers (HCWs) in hospitals have been among the most vulnerable
members of the population since the COVID-19 pandemic, affecting not only physical but
also mental health. Complementary approaches to providing information for HCWs on
taking care of their mental health need development and scaling-up. Behaviorally designed
interventions take into consideration the context, resistance, and impact in facilitating
behavior change in a specific target segment towards an intended aspiration. The
behaviorally designed interventions sought to build individual resilience aligned with the
Mental Health and Psychosocial Support Services framework. These included
strengthening the provision of non-specialized services and community support among the
range of interventions that address mental health problems. These benefit the vulnerable
sectors of the population who are at most risk of experiencing chronic stress. Scaling-up of
low-cost and subtle tools is a worthy investment for government institutions to ensure that
HCWs are continuously supported so they can continue to provide adequate and quality
care to those afflicted by COVID-19.

References:
Du, Man-Li RNa; Deng, Wan-Xin RNa; Sun, Wen RNa; Chien, Ching-Wen PhDb; Tung, Tao-Hsin
PhDc,∗; Zou, Xin-Chun MSd,∗. Assessment of mental health among nursing staff at different levels.
Medicine 99(6):p e19049, February 2020. | DOI: 10.1097/MD.0000000000019049

Taghinejad H, Suhrabi Z, Kikhavani S, Jaafarpour M, Azadi A. Occupational Mental Health: A Study

of Work-Related Mental Health among Clinical Nurses. J Clin Diagn Res. 2014 Sep;8(9):WC01-3.
doi: 10.7860/JCDR/2014/8247.4835. Epub 2014 Sep 20. PMID: 25386506; PMCID: PMC4225958.
Søvold LE, Naslund JA, Kousoulis AA, Saxena S, Qoronfleh MW, Grobler C and Münter L (2021)
Prioritizing the Mental Health and Well-Being of Healthcare Workers: An Urgent Global Public
Health Priority. Front. Public Health 9:679397. doi: 10.3389/fpubh.2021.679397

Rillera Marzo R, Villanueva Iii EQ, Chandra U, Htay MNN, Shrestha R, Shrestha S. Risk perception,
mental health impacts and coping strategies during COVID-19 pandemic among Filipino healthcare
workers. J Public Health Res. 2021 Dec 15;10(s2):jphr.2021.2604. doi: 10.4081/jphr.2021.2604.
PMID: 34911287; PMCID: PMC9131489.

Mantaring MA, Bello MSA, Agulto TJ, Romualdez CMI, Guevara AMI, Lizarondo NR (2022)
Behavioral design interventions for the promotion of wellbeing among Filipino healthcare workers
during the COVID-19 pandemic. The Lancet Regional Health doi:
https://doi.org/10.1016/j.lanwpc.2022.100627
FACE TO FACE AND HYBRID LEARNING APPROACH AS AN EFFECTIVE STRATEGY
FOR LEARNING UTILIZED BY NURSING OF OUR LADY OF FATIMA.

Review of Related Literature

“Potentials and limitations of Face to Face and Hybrid Teaching Modes”

(Monika Bubacz, Pooya Niksiar, Gafar Elamin, Deirdre Ragan, Patrick Bass Mechanical
Engineering Department, The Citadel, Charleston, SC)

Higher education has been faced with a particular set of challenges in response to COVID-
19. To ensure continuous and quality education for students, The Citadel has adopted two
teaching modes: a traditional mode and a hybrid mode, which incorporates alternating
online and in- person attendance. Through surveys and daily class-comprehension quizzes,
we are able to correlate academic performance with class attendance mode. Quizzes are
tracked to specifically assess the impact of online versus in-person attendance. Surveys
were implemented at the beginning and the end of the semester to probe student
perception and sentiment toward these two teaching modes. To improve the statistics and
generalizability of the results, this study was conducted in several courses across five
different instructors. Potentials and friction points for each mode of instruction are identified
from the results.

Comparing Students’ Evaluation of Online, Hybrid, and Face-to-Face Classes

(Cindy Zhiling TU School of Computer Science and Information Systems, Northwest
Missouri State University Maryville, MO 64468, USA Joni ADKINS School of Computer
Science and Information Systems, Northwest Missouri State University Maryville, MO
64468, USA)

This study compares students’ evaluation of the effectiveness of four different class
settings: face-to-face, synchronous online, asynchronous online, and hybrid. The results
directly show us how students compare the four types of teaching and learning formats.
Overall, students like the traditional face-to-face class the most and the asynchronous
online class the least. Furthermore, students feel the hybrid class is most flexible while the
face-to-face class has the least flexibility.
Online, Hybrid, and Face-to-Face Learning Through the Eyes of Faculty, Students,
Administrators, and Instructional Designers: Lessons Learned and Directions for the
Post-Vaccine and Post-Pandemic/COVID-19 World
(Jitendra Singh , Erica Evans,and Hannah Wiersma+ Volume 50, Issue 3)

This exploratory study builds upon the expertise of a panel of faculty, administrators,
students, and instructional designers (IDs) who lived through the pandemic and dealt with
the associated challenges firsthand. These participants provided insight on how to establish
systems that would create successful online teaching and learning opportunities in the post-
vaccine and post-pandemic world. Four major themes emerged: (a) integrating technology
to facilitate and enhance education; (b) structural support and resources needed to build
sound processes for effective online education; (c) establishing faculty presence to facilitate
learning; and (d) joint ownership and responsibility of learning—everyone must play a part.
These themes have been described in light of theoretical frameworks, such as the
Technological Pedagogical and Content Knowledge (TPACK) model, Community of Inquiry
(COI), and Continuous Quality Improvement (CQI). Finally, evidence-based tips will allow
academic institutions to successfully emerge out of the pandemic while still making plans to
adjust and adapt in the post-vaccine world.

“Success Level Of A Hybrid Training In Teacher Education: Experiences In A

Developing Country”
December 2017Information Technologies and Learning Tools 62(6):140
DOI:10.33407/itlt.v62i6.1806
LicenseCC BY-NC-SA 4.0
Authors:
Dave Marcial
Dae P. Habalo

Studies show that blended learning promotes collaborative learning. However, blended
learning is always a challenge when Internet infrastructure is limited. This paper describes
the success levels of the 6-month blended learning course for teacher educators in four
provinces in the central part of the Philippines. The blended training was aimed to increase
the ability to add value to economic output by applying knowledge of school subjects to
solve complex problems encountered in the real world situations of work and life. Success
levels were measured using retention rate, Constructivist Online Learning Environment
model, Online Environment Elements model, and New Kirkpatrick Model. Of the 60
registered teacher-trainees, only 15 completed the training. It was concluded that the
blended training was evaluated very successfully.

“Transitioning To Blended Learning: Understanding Student And Faculty

Perceptions”
(Nannette P. Napier, Sonal Dekhane, Stella Smith Georgia Gwinnet College)

This paper describes the conversion of an introductory computing course to the blended
learning model at a small, public liberal arts college. Blended learning significantly reduces
face-to-face instruction by incorporating rich, online learning experiences. To assess the
impact of blended learning on students, survey data was collected at the midpoint and end
of semester, and student performance on the final exam was compared in traditional and
blended learning sections. To capture faculty perspectives on teaching blended learning
courses, written reflections and discussions from faculty teaching blended learning sections
were analyzed. Results indicate that student performance in the traditional and blended
learning sections of the course were comparable and that students reported high levels of
interaction with their instructor. Faculty teaching the course share insights on transitioning
to the blended learning format.

―Learning from the problems and challenges in blended learning: Basis for faculty
development and program enhancement”
(Asian Journal of Distance Education Volume 15, Issue 2, 2020 Abel V. Alvarez, Jr.)

Blended learning in the Philippines is still considered new and young. However, this
growing demand for blended learning possesses problems and challenges that are
noteworthy to investigate, specifically in emerging higher education institutions, which
hinder effective and efficient delivery of teaching and learning. This paper reflects different
lenses of experiences encountered by five purposively selected facilitators teaching
National Service Training Program (NSTP) in a certain university in Manila, Philippines. A
qualitative case study research method was employed to interview the participants. The
data were collected using a semi-structured interview questionnaire, and analyze
thematically. There were five themes or ―roadblocks‖ reported in this study: technological,
instructional, class size, technical support, and collaboration. Findings were also discussed
in the lenses of various literatures, particularly in terms of design and development,
implementation, and assessment and evaluation of blended learning. An overarching
proposal, which is aligned to the results of this research study, was presented.
Nevertheless, it aims to add to the pool of teachers’ voices who are experiencing problems
and challenges in the delivery of blended learning. The results of this study can serve as a
basis for continuous faculty training and development, as well as for the improvement of the
NSTP course, in general.

Independent Variable
Dependent Variable

Estrada, Aaron Charles

Ambrocio, Maria Princess
Fernando, Sheika
Paragas, Katrina
Silagan, Joselle
Tibay, Jann Selvon
Zaballa, Dennice