METROPOLITAN MEDICAL CENTER COLLEGE OF ARTS,

SCIENCE AND TECHNOLOGY

Formerly Metropolitan Hospital College of Nursing
1357G Masangkay St. Sta. Cruz, Manila 1003

Chapter I

THE PROBLEM AND ITS BACKGROUND

Introduction

For many years, nursing has had no formal training before practicing.
When one takes care of a sick family member or works with a priest, he is
considered as a nurse. This had continued the Crimean War when
Nightingale’s study suggested that nurses must be educated. It was supported
by studies of other nurses, leaders, and pioneers who advocated the needs of
the nurses to have formal education. Through these studies, the concept of
nursing has been expanded and subsequently, its definitions and roles have
become broader to meet the changing needs of the society.

Nursing, as dynamic discipline and vital component of any country’s

health system, is an art and science of caring for individuals, families, groups,
and communities toward the promotion and restoration of health, prevention
of illness, alleviation of sufferings and assisting client as he/she responds to
health/illness situation utilizing nursing process and guided by ethico-legal and
moral principles.

Since nursing is a dynamic discipline, it requires a formal education.

Nursing education is defined as teaching-learning, multi-disciplinary, cyclical
process aimed at seeking the truth. In collaboration with nursing service, it
aims to produce professional nurse who is responsible, nationalistic, creative,
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with critical thinking ability, and with knowledge and skills in communication
and in nursing research and leadership which will meet the needs of the
society in the light of global concerns. Incorporated in nursing curriculum is the
related learning experience. According to the Section 25 of Republic Act 9173,
nursing education program requires sound general and professional
foundation for the practice but learning experience must adhere strictly to
specific requirement embodied in prescribed curriculum as promulgated by
Commission on Higher Education’s policies and standard of nursing
education. CHED has formulated some conditions that must be observed in
related learning experience.

The nursing students have the responsibility to be prepared to clinical

practice, engage only in the skills for which they gained competence and seek
instruction necessarily. Students must not engage with activities without
proper preparation prior to validation of competence and appropriate
supervision by the instructor. Before, nursing students are responsible for their
own actions and liable for their own actions of negligence committed during
the course of clinical exposure because they are considered employees of the
hospital. But now, nursing students are no longer considered as employees of
the agencies which they receive clinical experience because usually nursing
program contract with agencies provide clinical exposure for students. In
cases of negligence involving such students, the hospital and the agency and
educational institution will be held potentially liable for negligent action by
students. According to Nightingale’s moral beliefs, nursing practice needs
theoretical basis. This study will try to determine the competence in skills of
the nursing students in clinical setting in order to find out how equipped they
are for their hospital exposure.
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Statement of the Problem

The study tried to determine Academic Preparation and the Level of

Readiness for RLE as perceived by the Level I students of MMC-CAST

Specifically sought answer to the following question:

1. What is the profile of the respondents in terms of:

a. Age
b. Gender
c. Type of Students

2. What are the preparations done by the students for their exposure at
MMC in terms of return demonstration and GP Tools?
3. What is the extent of readiness of the students to be exposed in the
clinical area/hospital for RLE?
4. Is there a significant relationship between the extent of readiness of the
respondents and their profile?

Hypothesis of the Study

There is no significant relationship between the readiness of the

respondents to be exposed in RLE and their profile.

Scope and Limitations

The research involves careful evaluation of the Academic Preparation

and the Level of Readiness for RLE as perceived by the Level I students of
MMC-CAST. This study aims to find out whether the respondents, who are
now under the newly implemented curriculum for Nursing, can apply the
theories and concepts they have learned in the institution in interacting with
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their patients and in facing situations in the clinical area. This study would use
in the return demonstration and GP tool in order to determine the readiness of
the respondents to be exposed in the hospital for RLE.

This study would tackle the issues regarding the early exposure of the
respondents in the clinical area and the concern as to whether they have
enough knowledge, skills and attitude to be in different clinical areas. The
respondents are currently enrolled in the 2nd semester as 1st year student of
MMC- CAST, academic year 2009-2010. The study would be completed
before or during the last week of January, year 2010 depending on the
availability of the respondents.

Significance of the Study

The study will benefit the following aspects of the nursing research.

Nursing Education. Result of the study may be utilized in improving the

weaknesses of the curriculum imposing the first year students to be exposed
in the clinical area on the first week of the first semester onwards. It may also
help the students to evaluate themselves and find out which areas and skills
they need to enhance in order to face the different problems in clinical areas

Nursing Practice. The outcome of the study will help the Level I students of
MMC-CAST in improving the knowledge, skills and attitude, and their overall
competence in the clinical area. The result of the research would decrease if
not eliminate the negative points and improves the good points of the Level 1
students as well as help them in proper application of theories, concept upon
interaction with client.
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Nursing Administration. The result of the study would give the staff nurses,
clinical instructors and other administrations empirical information regarding
the capabilities of the Level I student of MMC CAST. The empirical information
would help the administrators in supervising and reshaping competitive nurse
in order to render the best patient care for people who are seeking to improve
their quality of health.

Conceptual Framework

Academic Demographic Readiness of 1st

preparations for Profile: year students of
clinical rotation: MMC-CAST in
• Age the exposure in
 Return • Gender the MMC
demonstrati • Type of
on Student
 GP tools

Independent variable Intervening Variable Dependent Variable

The above paradigm validates that academic preparation such as

Return Demonstrations and the General Performance Tool (GP Tool) have a
great effect on the readiness for the exposure in the hospital. It also proves
that when a person prepares for the upcoming situation, this will give a greater
chance to survive the struggle.
Clinical practice is an important part of the nursing student’s
experience. This preparation allows the student to relate the theory versus
practice in caring for the clients. The clinical setting is fundamental to the
nursing students learning because it gives them the opportunities for them to
work with real clients. It is only in the clinical setting that student nurses can
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use knowledge in practice develop competency and become socialized in their

future role. But before being exposed to the clinical environment, every
nursing student must acquire particular knowledge in nursing care in order for
them to live the nursing experience (Reilley and Oermann, 1992)

On the other hand, Sister Callista Roy’s adaptation model “monkey

sees, monkey does” theory of learning proves that what a student’s sees in
the clinical area is what they will try to do. A student which was assessed
through return demonstrations by the GP tools on their clinical rotations.
Return demonstration, is usually given to the Level I nursing students to
evaluate the level of learning and absorption of the lectures during discussion.
It also serves as the training period of the students that required critical
thinking and practice. This is use to determine the strength and weaknesses of
the students. This shows that the extent of preparation one has done about a
particular activity and the amount of knowledge one acquires affect his
readiness to perform the said task. This means that if students are given
enough time to practice the theories they learned through return
demonstrations and have been given enough knowledge on nursing skills,
their level of readiness for the said task is higher.
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Definition of Terms

2nd Courser. These are the students that already finish a college degree and
are currently taking up nursing course

Alleviate. It is to diminish or make less severe

Clinical Instructor. Refers to the one who guides and educates nursing
students in the clinical area

Competence. It is the ability to do a task having acquired knowledge, skills,

and attitude in the clinical area as a preparation

GP Tools. A piece of paper that use as a tool to assess and evaluate students
general performance in the clinical area and return demonstration

Irregular Students. These are students that are classified as 2nd courser,
repeaters, shifters or transferees

Perception. It is views of the students regarding the clinical area

Regular Students. These are students who are taking up the prescribed
subjects for every semester

Repeaters. These are students who failed in a particular subject and are
currently retaking it

Return Demonstration. This is an activity performed by the nursing students

after observing the instructors’ demonstration of a nursing skill. This is where
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the students can clarify any uncertainties and are encouraged to ask
questions. This is a very important learning process for nursing students.

RLE (Related Learning Experience). It is a part of the nursing subject (Health

Care II) where the students are preparing for the clinical exposure. This is
where the students perform the return demonstration.

Shifters. These are students that fail to continue the previous course and shifts
to nursing course.

Type of Students. It is the academic standing of a student either regular or

irregular.