Chapter I THE PROBLEM AND ITS BACKGROUND Introduction Each student has his or her own way of learning,

knowledge, skills and abilities. Points of view depend on how well they are motivated and interested in the subject faced. There are students, who possess the capacity for great theoretical knowledge but are sadly lacking in clinical skills and vice versa. There are students who perform equally well in both theories and application of theories learned. And there are students who are sadly lacking in both theoretical and clinical skills and knowledge. It does not appear to be a big deal to the institution, but if youd look closer and focus on this, youd realize that this research is very serious and significant. Nursing today, as you will see is deteriorating and lacking of skillful and competent nurses as compared to the ratio of booming population. We all know that the root of this life threatening problem is the foundation in education and basic knowledge gained from the four year Bachelor of Science in Nursing curriculum undergraduate studies. Yes, nursing students are being taught the things a nurse must know to perform well in his or her profession but are the instructors assured that all their students are learning and absorbing all the data? Are the instructors effective in their teaching or are just lecturing without

2 giving further explanation to the students regarding the rationale and how a procedure is done properly? The problem in this is what will happen in the clinical setting if they lack data and knowledge on the field. Remember, these nurses-intraining are not handling puppets, nor robots, but the life of the patient. It is so important that the instructors keenly assess every students performance and focus on the students who seem to be having difficulty in learning the topics. All nursing education programs have a clinical component, in which students are supervised by clinicians in a clinical setting, such as a hospital, a clinic, home care or long-term care. There are students who are having difficulty in skills on clinical and RLE duty setting. These are the students that easily commit errors because of different factors like knowledge deficit, having concentration problems, difficulty when interacting with the client, not oriented at the field assigned, and being naturally incompetent due to lack of knowledge learned and desire to learn the right way. This is really a big deal on the client side, because these students are life threatening to them and also affects the C.I.s who are responsible for the students action and management because their license is the exchange of even a simple mistake made by the student. So they must make sure that all the students that they will supervise can perform well and do the right thing when handling patients.

3 This study aims to determine the relationship between academic performance in NCM103 lectures and clinical performance of NCM103 nursing students of OLFU, Quezon City. Teaching strategies that promote critical thinking engage students in an active learning process. An active learning process requires students to be directly involved in the learning process, thus they are more likely to commit to memory information associated with the lesson which would help them in doing their clinical duties. Statement of the Problem The purpose of this study is to determine if a relationship exists between academic performance in NCM103 (new curriculum) lectures (as determined by the cumulative/final point average) and the clinical performance of the said NCM103 nursing students of OLFU, Quezon City for the second semester of school year 2010-2011. Purposely, this study wants to answer the following: 1. What is the academic performance in NCM103 (new curriculum) of the nursing students of OLFU, Quezon City when measured according to their classroom performance? 2. What is the clinical performance in NCM103 (new curriculum) of the nursing students of OLFU, Quezon City when measured according to their RLE performance?

4 3. Does the academic performance of the NCM103 (new curriculum)

nursing students of OLFU, Quezon City have a significant relationship on their clinical performance? Hypothesis of the Study Null hypothesis There is no relationship in the nursing students academic and clinical performance according to their cumulative final point averages in both. Research hypothesis There is a significant relationship between the academic performance and the clinical performance of the NCM103 nursing students of OLFU, Quezon City. Significance of the Study The findings of the study would be beneficial to the following people: OLFU nursing students. This would provide the students with an awareness that if they do good in their academic performance, it will aid them in succeeding in their clinical performance and their careers as future nurses. Knowing what factors affect good and bad performance will also help them in reducing clinical errors and help them be more proficient in doing clinical work. The researchers. To develop the skills in nursing research primarily critical thinking. The study is difficult to do and requires skill,

5 patience, discipline, time and effort to complete. Armed with the

knowledge of how nursing research is done will provide a guide to the researchers nursing studies in the future. OLFU teaching staff. Part of effective training of undergraduate nurses is to provide excellent educators. This study will provide suggestions in improving their teaching methods and strategies that would help the student have a better understanding of their lessons and commit them to memory. OLFU Clinical Instructors. Together with the NCM subject professors, the clinical instructors would be able to use this study to improve their teaching methods and strategies to supplement textbook learning with actual duty learning of the students in training. Improvement of teaching strategies will help reduce the risk of revoked licenses of the instructors due to the negligence and errors of the

students doing clinical duties under their supervision. OLFU Nursing School Administrators. The study will provide insight on uplifting the standards of the institution in terms of clinical skills and performance of the nursing students. The curriculum is characterized by exposing the students from the very start of their attachment to the school, to patients, gradually through the different educational years. To ensure effective learning of nursing students, the nursing administrators will be able to utilize this

6 information to further improve their nursing curriculum and guide the professors they employ in providing quality nursing education. Future researchers. This will provide added research material that will guide them in doing further studies to discover other ways of improving retention skills of OLFU nursing students so they can be more efficient and effective in performing the skills necessary for them to know during their hospital duty rotations. If there is indeed a significant relationship between academic performance and clinical performance, additional studies can be done by future researchers to study the different effects on clinical performances on nursing students. Scope and Delimitation The purpose of this study is to investigate whether academic performance in NCM103 (new curriculum) lectures has a relationship with the clinical performance of NCM103 (new curriculum) nursing students of OLFU, Quezon City. With this in mind, the researchers selected 75 OLFU nursing students as participants in the study through systematic sampling out of the 282 total population of NCM103 (new curriculum) students enrolled for the second semester 2010-2011. This will be further discussed in the research methodology. The nursing students must be currently enrolled at Our Lady of Fatima University, Quezon City for the second semester of 2010-2011.

7 They should be attending NCM103 (new curriculum) lecture classes and doing RLE duties for the second semester. They should be irregular students, regardless of their student status and age. Academic performance will be based on their final cumulative grade in NCM103 (new curriculum) lecture for second semester 20102011. Clinical performance will be based on the final cumulative grade in NCM103 (new curriculum) RLE duties at the end of second semester 2010-2011. As for the exclusion criteria, the researchers excluded those students who are not currently enrolled in NCM103 (new curriculum) for the second semester 2010-2011 at the OLFU, Quezon City, those who are not enrolled and not doing NCM103 (new curriculum) RLE duties and regular students. Definition of Terms Academic Performance Generally refers to how well a student is accomplishing his or her tasks and studies; defined as cumulative grade point average based on a scale of 1.0-4.0 with 1.0 being the highest grade, including the requirements completed through the last semester enrolled. Anxiety A state of being uneasy, apprehensive, or worried about what may happen; concern about a possible future event.

8 Clinical duties Duties scheduled by the College of Nursing

administration for nursing students to do hands-on training at hospitals, clinics, community health care clinic or out-patient departments. Clinical performance Knowledge, skills and attitudes learned by

nursing students during their RLE duties; obtained from the average of ratings from various RLE clinical duty rotations during the semester graded from 1.0-4.0 with 1.0 being the highest grade. Clinical skills - Refers to clinical examination and procedural skills commonly performed in real or simulated environments. Clinical supervision - The formal process of professional support central to learning, where students and practitioners are called upon to deal with complex clinical situations under the supervision of a colleague. A nursing student is usually assigned to a clinical instructor (C.I.) assigned to a particular clinical duty location designated by the college. Cognition In psychology it is used to refer to the mental processes of an individual, with particular relation to a view that argues that the mind has internal mental states (such as beliefs, desires and intentions) and can be understood in terms of information processing involving knowledge, expertise or learning. Comprehension The act of grasping, with the mind, meaning and relationship or the knowledge that results from this action.

9 Depression A psychiatric disorder characterized by an inability to concentrate, insomnia, loss of appetite, feelings of extreme sadness, guilt, helplessness, hopelessness, and thoughts of death. Education The act or process of imparting knowledge or skills; systematic instruction; teaching. Effectiveness - A measure of the accuracy or success of a diagnostic or therapeutic technique when carried out in an average clinical

environment; the extent to which a treatment achieves its intended purpose. Learning Instruction, education, acquired wisdom, knowledge or skills Learning difficulty or disability - A generic term referring to the inability to easily attain a of rounded learning intellectual and development,

encompassing a wide range Depending on the specific

social difficulties.

problem, difficulties may be encountered understanding, remembering

in one or more of the following areas: or producing language.

Learning Styles/Strategies Various approaches or ways of learning. They involve educating methods particular to an individual that are presumed to allow that individual to learn best. Memory - In psychology, memory is an organism's ability to store, retain, and recall information. Motivation The driving force (desire) behind all actions of an organism

10 NCM 103 Nursing Care Management subjects dealing with Operating Room procedures and Medical-Surgical Nursing 1 proficiency. NCM 103 (new curriculum) 2010-2011 Those students enrolled in NCM103 who are following the new curriculum program structure. The new curriculum was implemented in 2008. Students who enrolled in October 2008, second coursers, transferees or those who previously failed in their prerequisite NCM subjects or NCM 103 the previous semester are currently enrolled for this subject during the second semester of 2010-2011. Nursing goal A general goal that the nurse hopes to achieve through nursing interventions and activities in connection with patients treatment for a specific condition or disorder, e.g. the development of the individuals ability to care for him or herself in regards to personal hygiene, nutrition and compliance with a prescribed medical or health promotion regimen. OLFU, Quezon City To mean Our Lady of Fatima University, Quezon City in this research study. Perception The reception of a conscious impression through the senses by which we distinguish objects one from another and recognize their qualities according to the different sensations they produce. Performance Criteria - Written descriptions of activities that an individual is expected to be able to perform. These will be used by an assessor to judge whether the individual has attained a certain level.

11 Recitation - Simply saying aloud the ideas that you want to remember. For example, after you have gathered your information in note form and have categorized and clustered your items, you recite them. Here's how: you cover your notes, and then recite aloud the covered material. After reciting, expose the notes and check for accuracy. Recall The process of bringing a past mental image or event into consciousness; to remember. Related Learning Experiences (RLE) Application of theories learned in the nursing lectures to hands-on practical experiences in the hospital setting or community health nursing setting. Retention - That aspect of memory that involves either short- or longterm holding of information. Self-Efficacy In psychology, it is the belief that one can perform a certain behavior, or learn to perform it. For example, self-efficacious persons believe that they have the ability to learn many skills.