Chapter 1

Introduction
The Commission on Higher Education (CHED) was created on May 18, 1994 through the passage of Republic Act No. 7722, or the Higher Education Act of 1994. [1] Commission on higher education making changes to nursing curriculum to ensure the quality of nursing graduates in order to provide relevant and quality health services locally and internationally, Commission on higher education changes the nursing curriculum, as follows, Commission on higher education Memorandum orders, CMO no. 10 series of 1998, CMO no.30 series of 2001, CMO no. 27 series of 2004, CMO no.28 series of 2004, CMO no 16, series of 2007, CMO no.05 series of 2008,and the CHED memorandum order no. 14 series of 2009. [2] Commission on higher education revised the CMO no. 05 to Republic of the Philippines office of the president commission on higher education memorandum order no. 14 series of 2009 is concern with Policies And Standards For Bachelor Of Science In Nursing (BSN) Program, it emphasizes the Bachelor of Science in Nursing (BSN) curriculum is a competencybased and community-oriented curriculum in the Philippines. [3] Commission on Higher Education making changes to nursing curriculum to address low passing rate of graduated nursing students here in the Philippines. Commission on higher education noted that while a growing number of students graduate from nursing schools, not even 50 percent pass the licensure exams. The commission on higher education said it is making changes to the college of nursing curriculum as well as ensure a better passing rate for the Filipino nursing graduates. [4] Another facet emerges amidst the issue of the Philippines oversupply of nurses. As government agencies such as the department of labor and employment (DOLE) and professional regulations commission (PRC) said that the there are enough demand in the global market to neutralize the surplus of Filipino nurses; recruitment agencies said that the real problem lies in the fact that many nursing graduates are unqualified. [5] Under the new curriculum Commission on higher education implemented, students would have to spend an additional 561 hours in their required learning experience or hospital hours. The commission asserted that changing the curriculum is their way of further improving the quality of nursing education in the country. The Bachelor of Science in nursing program

therefore, aims to prepare a nurse, who, upon completion of the program, demonstrates beginning professional competencies and shall continue to assume responsibility for professional development and utilizes research findings in the practice of the profession. Commission on higher education memorandum order provides 11 key areas of responsibilities that graduating nursing students should demonstrate to display her competence, otherwise known as the 11 core competencies. These core competencies are necessary in transforming nursing graduates to professional nurses. Graduates of bachelor in science and nursing program must be able to apply analytical and critical thinking in the nursing practice. The nurse must be competent in the 11 key areas of responsibility with their respective core competency standards and indicators. [6] According to Commission on higher education they will implement the closure of nursing SCHOOLS BY 2013, based on CMO 14. They are already monitoring 16 government schools that offer nursing but are not performing well including the private schools. A report from Commission on higher education informed that more than half (55%) of all nursing schools in the country had a passing grade that fell short of the 40.70 percent national passing average. The statistics was taken from the licensure examinations the Professional Regulations Commission (PRC) supervised in June and November 2009. According to the Commission on higher education Memorandum Order (CMO) No. 14 Series of 2009, the minimum passing rate of nursing schools should not be lower than 30%. If their passing rate remains below 30 percent by 2013, then their nursing program will be phased out. Commission on higher education promised to ensure the quality of nursing education in the Philippines by closely monitoring and evaluating the performance of nursing schools nationwide. [7] What prompted CHED to revise the nursing curriculum is the low passing rate of graduates in the Nursing Licensure Examination (NLE). The passing rate in December 2007 was 42.71%. There were only 28,924 passers out of 67,728 total examinees. International standards are adopted into the local curriculum. This is to ensure better performance of nursing graduates in the NLE (GMANews.TV, April 30, 2008). . [8] A report from professional regulation commission states the numbers of nursing board passers in year 2009-2012. 32,612 out of 77,901 on June 2009, 37,527 out of 94,462 on November 2009, 37,679 out of 91,008 on July 2010, 29,711 out of 84,287 on December 2010, 37,513 out of 78,135 on July 2011, 22,760 out of on December 2011,

27,823 out of 60,895 on June 2012(45.69%) And 16,908 out of 49,066 on December 2012(34.46%). [9]

A report from CHED informed that more than half (55%) of all nursing schools in the country had a passing grade that fell short of the 40.70 percent national passing average. The statistics was taken from the licensure examinations the professional regulations commission supervised in June and November 2009. Commission on higher education chairperson promised to ensure the quality of nursing education in the Philippines by closely monitoring and evaluating the performance of nursing schools nationwide that is why they continue to monitor and supervised the curriculum in nursing. [4] The commission on higher education memorandum order no. 14 program descriptions the Bachelor of Science in nursing as a four-year program provides an intensive nursing practicum that will refine clinical skills from the first year level to ensure basic clinical competencies required of a beginning nurse practitioner. The student shall be given opportunities to be exposed to the various levels of health care (health promotion, disease prevention, risk reduction, curative and restoration of health) with various client groups (individual, family, population groups and community) in various settings (hospital, community). These opportunities shall be given in graduated experiences to ensure that the competencies per course, per level and for the whole program are developed. Before graduation, the student shall approximate the competencies of a professional nurse as they assume the various roles and responsibilities. [4] This study aims to evaluate the competency of graduate nursing students in some schools in Cainta and Marikina in terms of total number of hours of their related learning experience under the CMO14. Specifically: To be able to identify the graduate nursing students level of competency in clinical exposure. To evaluate the number of hours allotted by CMO14 for related learning experience of graduating nursing students. To assess the skills and knowledge of graduating nursing students level of competency under CMO14 as perceived by the clinical instructors. To understand the importance and effectiveness of CMO14 in relation to 11 core competencies.

Background of the study

A new nursing curriculum is implemented in all colleges of nursing in the Philippines which took effect in the Academic Year 2009-2010. The newly published Commission of Higher Education (CHED) CMO No. 14 Series of 2009 (April 28, 2009) is concern with Policies and Standards for Bachelor of Science in Nursing (BSN) Program. The reasons for incorporating changes into the nursing curriculum are to: [1] improve the level of competency of Filipino nursing graduates, potentially increasing the passing rate in the Nursing Licensure Exam (NLE), and [2] produce nurses that are highly qualified and globally competent in the health care field (GMANews.TV, April 30, 2008). [12]

It emphasizes the Bachelor of Science in nursing curriculum as a competency-based and community-oriented curriculum in the Philippines. The nurse must be competent in the following Key Areas of Responsibility for which a nurse should demonstrate competence in Safe and quality nursing care, Management of resources and environment, Health education, Legal responsibility, Ethico-moral responsibility, Personal and professional development, Quality improvement, Research, Record Management, Communication, Collaboration and teamwork. [3] One particular interest of the researchers in the new curriculum is the difference of the CMO 5 to the CMO14.This CHED CMO No. 14 has again some difference with CMO No. 5 s. 2008 in terms of third and fourth year subjects. With CHED CMO No. 14, students shall choose at least two Electives [Elective 1 and 2] to complete the BS Nursing Program. Elective 1 is taken in the 3rd Year 2nd Semester. Choices for Elective I are Parent-Child Nursing, Spiritual Care Nursing, and Hospice Palliative Care. Elective 2 are taken in the 4th Year, 1st Semester. Choices for Elective II are Acute/Critical Care Nursing, Quality Health Care and Nursing, and Care of the chronically ill and the Older Person. In addition, an Intensive Nursing Practicum subject during the 4th year corresponds to 8 units of clinical work. CHED CMO No. 14 still mandates a 4-year curriculum for nursing. [4] Under the new curriculum, a nursing student is required to complete 2346 hours of related learning experience. Related learning experiences are teaching-learning opportunities designed to develop the competencies of students utilizing processes in various health situations. These could be sourced from, but not limited to: lying-in clinics, schools, industrial establishments, community, out-patient clinics and general and specialty hospitals. The related

learning experience activities are carefully selected to develop competencies utilizing the nursing process in varying health situations. [3] In the global setting, a problem faced by health care institutions is the shortage of nurses. Filipino nurses had been the preference of foreign employers especially in the United States. Employers not only seek Filipino nurses for their caring nature, but also because of the quality education Filipino nurses have. However, with technology evolving together with health practices, the local curriculum must keep up with the current innovations if we want our nurses to meet the global demand. In the local setting, the problem identified by CHED is the low passing rate in the Nursing Licensure Exam (GMANews.TV, April 30, 2008). Only about half of the total examinees pass the local board exam. The Professional Regulation Commission (PRC) announced that at least 32,617 or 41.87% out of 77,901 examinees passed the NLE for June 2009. For the November 2009 Nursing Board Exam, PRC announced that 37,527 or 39.73% out of 94,462 examinees passed (Philippine Board Exam Results). [9]

According to CHED memorandum order no. 14 series of 2009 article I upon completion of a BSN programs institution should produce nursing graduates that are professionally competent and would be ready to assume responsibility for professional development and are ready to use researches while practicing the profession. [4] The solution of CHED to ensure a better passing rate is the CMO No.14. However, the effectiveness of the new curriculum is not yet supported by research because it is a newly implemented curriculum.

To assess the effectiveness of the new curriculum, the researchers will investigate the competency level of the graduating students on their related learning experience based on the evaluation of their clinical instructors. This is stated in Article IV competency standards section 5. Graduates of Bachelor of Science in nursing program must be able to apply analytical and critical thinking in the nursing practice. The nurse must be competent in 11 key areas of responsibility with their respective core competency standards and indicators. [4] The Core Competency Standards, developed by the Board of Nursing (BON) with the Technical Committee on Nursing Education (TCNE) of the Commission on Higher Education (CHED), served as a basis in the curriculum reform. By focusing on the Eleven (11) Core

Competencies, the new curriculum will ensure quality education for nursing students if it is implemented well (Tamse, July-Dec 2004). [11] Using the Core Competency Standards as an evaluation tool, this study will determine if the new curriculum CMO 14, s.2009 is effective in improving the level of competency of graduating nursing students in some schools in Cainta and Marikina in terms of their related learning experience under the CMO14.