1 CHAPTER I THE PROBLEM AND ITS BACKGROUND

Introduction Exciting and challenging, nursing education demands much of the students time and energy. Nursing, after all, is a profession that requires patience and commitment to ensure comfort and wellness among patients and promote the patients beneficial interests.

In the Philippines, board examination is required to test the skills and theories learned by nursing graduates. To improve its students performance, Our Lady of Fatima University sponsors a review program in preparation for the Nursing Licensure

Examination (NLE).

The NLE considers the objectives of the nursing curriculum and the broad areas of nursing and related disciplines. In order to pass, an examinee must obtain a 75% minimum general average, with a 60% minimum rating in each test subject.

For

years,

however,

a great percentage

of

nursing

graduates flunk the NLE. In fact, the December 2010 NLE

2 produced the lowest percentage of board passers in NLEs history.

This prompted the government to focus its attention on nursing schools and their strict compliance to Commission on Higher Education regulations. Review centers were also looked into due to reports of test-questions leakage from the

Professional Regulation Commission.

These actions are done by the government to ensure credibility to the nursing profession inasmuch as the patients life depends on the nurses skills and technical know-how.

The focus on review institutions, however, misses the fact that NLE takers include those who did not enroll in review programs. Unfortunately, self-reviewees have no record of their passing percentage, having no stable organization to account for it.

The present study is conducted on graduating Nursing Students of Our Lady of Fatima University, Quezon City. It aims to gain insight about who between self-reviewees and review-

3 center-enrollees are more prepared and confident before taking the NLE. Statement of the Problem This study is an attempt to identify the Perception of graduating nursing students of our Lady Fatima University, Quezon City on the Preparedness of self Reviewees or enrolling in the Review Centers before Taking the Nursing Licensure Examination.

1. What are the factors affecting the students who are going to take the nursing licensure examination? a.) Family b.) Peers c.) Economic status 2. Where would nursing graduates benefit best before taking the NLE, avail of a review center or simply self-review? 3. How prepared are the students enrolled in review center and those who are self studying? 4. Is there any significant difference between the self-

preparedness among the nursing graduates enrolled in review centers and self-studying?

Hypothesis of the Study Null Hypothesis There is no significant difference between the

preparedness among the graduating nursing students enrolled in review centers and self-studying.

Alternative Hypothesis - There is significant difference between the preparedness among the graduating nursing students enrolled in review centers and self-studying.

Significance of the Study Specifically, the outcome of this study is beneficial to the following:

To the graduating nursing students of Our Lady of Fatima University, Quezon, City to be able to know which is better between the two methods of review; To the school to better equip their students in cultivating preparedness before taking the NLE exams;

5 To the professors to give enlightenment and discernment to their students as to what is best to avail; To the future researchers to come up with an appropriate data supported with studies and researches on the angles and scopes of each methods for the students to analyze; To the parents to be able to guide their children in choosing what method is best to use.

Scope and Limitation of the Study The study will focus on describing the preparedness utilized by level IV Bachelor of Science in Nursing regular students in the 2nd semester of school year 2011 - 2012 before taking the Nursing Licensure Exam enrolled in Our Lady of Fatima University Quezon City - College of Nursing, the data which will be utilized in this study will be gathered from the nursing students through a modified questionnaire. Limitations of the study include limited Philippine-based resources about exam preparedness, specifically in the nursing course.

This research does not include non-graduating nursing students since they havent finished yet the course; it also

does not include differences between the preparedness utilized by different year levels in Our Lady of Fatima University Quezon

6 City - College of Nursing since each level has different workloads and activities. Definition of Terms

Analysis - The separation of an intellectual or material whole into its constituent parts for individual study. Background - Information that is essential to understanding a situation or problem. BON Stands for the Board of Nursing, the special group of people that is mandated by the government to prepare licensure examinations and serves as a regulatory agency, which enforces legislation regulating the nursing practice in the Philippines. Data - Factual information, especially information organized for analysis or used to reason or make decisions. Factors - An element or cause that contributes to a result. Findings A conclusion reached after examination or

investigation. Framework - A fundamental structure, as for a written work. Hone To bring something to state of increased intensity, excellence, especially over a period of time. Interpretation - Explanation, as of the environment, a historical site, etc., provided by the use of original objects, personal experience, visual display material, etc.

7 Interview - A formal meeting in person, especially one arranged for the assessment of the qualifications of an applicant. Knowledge - Awareness, consciousness, or familiarity gained by experience or learning. Methods - A way of doing something, especially a systematic way; implies an orderly logical arrangement (usually in steps). NLE Acronym for Nursing Licensure Examinations, the other term for board examination. It is a 500-item multiple choice exam to test basic nursing level competency which considers the objectives of the nursing curriculum, the broad areas of nursing and other related disciplines and competencies. It is held twice a year, every June and December. Paradigm - A set of assumptions, concepts, values, and practices that constitutes a way of viewing reality for the community that shares them, especially in an intellectual discipline. Perception - Recognition and interpretation of sensory stimuli based chiefly on memory. PRC Acronym for Philippine Regulatory Commission; the agency regulating and screening individuals who desire to be licensed professional and practitioners. Preparedness - The state of being prepared or ready, esp. militarily ready for war.

8 Profile - Chart showing the number of people as a function of their ages. Respondents - One who responds to specific question or group of questions ask. Survey - A gathering of a sample of data or opinions considered to be representative of a whole. Understanding - The ability to learn, judge, make decisions, etc.; intelligence or sense.

9 CHAPTER II REVIEW OF RELATED LITERATURE AND STUDIES

Foreign Literature After the war and many other events that require health care, a nursing course was established; and to ensure credibility and responsibility of nurses to conduct nursing practice, a Nursing Licensure Examination was implemented. In 1905, the University Of California Board Of Regents was given power by the Legislature to set standards, administer examinations, approve educational programs, issue certificates, and revoke certificates of RNs. Use of title "registered nurse" without certification was a misdemeanor. In 1913, the US Legislature formed Bureau of Registration of Nurses under the State Board of Health. The Bureau was charged with administering the examinations, registering qualified registered nurses, accrediting nursing

schools, and revoking licenses of nurses found to be unsafe to practice. Finally, in 1927, the Bureau of Registration of Nurses was placed within the Department of Health under the State Board of Public Health.

10

Local Literature

In the Philippines, the Board of Nurse Examiners was created by legislation within the Department of Professional and Vocational Standards in the year 1939. The mandatory Nursing Practice Act was established, regulating nursing through

licensure of a defined scope of practice. Five registered nurse board members were appointed by the Governor. The first Nursing Board Examinations was instituted in 1946 but it was first called the 1946 State Board Test Pool Exam (SBTPE). In 1961, Board's name was changed to Board of Nursing Education and Nurse Registration. One public board member was added. In 1975, the Board's name was changed to current Board of Registered Nursing. The Nursing Practice Act was amended significantly to provide the current description of nursing. Certification of nurse midwives was established. 1977, to improve the quality of the Nursing Board Examinations, Board

member composition was established composing of three public members, three direct patient care RNs, one RN educator, one RN administrator, and one physician. And in 1978, voluntary certification of nurse practitioners was also established and continuing education became mandatory for license renewal. In

11 1993 Certification of public health nurses transferred from Department of Health Services to Board of Registered Nursing Legal Basis of Nursing Licensure Exam Article IV, Section 12 of the Philippines Republic Act No. 9173, states that all applicants for the license to practice the nursing profession shall be required to pass a written examination, which shall be given by the Board of Nursing in such places and dates as may be designated by the Philippine Regulatory Commission, provided that it shall be accordance with the Republic Act No. 8981, otherwise known as the PRC Modernization Act of 2000.

Foreign Study There is no right or wrong in choosing to follow a selfreview or going to a review center. The choice is entirely

personal and depends on what you think will be effective to help you study. Finances are also another consideration which factors into the decision between self-review or a review center. Examining the pros and cons of each would be a good way to decide if either or both is suitable to your needs. The ultimate decision is yours.

Review centers cost money. This depends on the type of review center and where it is located. Generally review centers

12 in the city cost more than those in sub-urban locations. If one

decides to attend a review center outside of their place of residence, then they would need to take on the cost of dormitories or boarding houses, transportation, food, and other living expenses on top of the cost for the basic review fees. Another consideration about joining a review center is convenience and practicality. If the review center is located far away, you could be away from your family for more than 6 months. Hence emotional anxiety may affect your review.

Choosing a review center closer to home will reduce the worries and stress of finances and emotions. Review centers also work on a set schedule. This can be awkward for fixing schedules as the times for the review centers are usually not flexible. There are also rules which students are expected to abide by at these centers. Oftentimes it may feel a wee bit too structured.

The school setting may also feel strange during vacation months.

Quality instruction and good guidance are two bonuses acquired at review centers. The review leaders are

knowledgeable about the type of tests that will be administered and thereby pattern the reviews to learn the skills so their students will excel at the exams. Some of the skills which will be honed at the review centers include problem-solving techniques,

13 critical thinking skills, and answering strategies. Some centers may even be able to customize the program according to the students needs.

Self-study is more cost-effective. You will not have any expenses for fees, transportation and other costs which you will encounter if you decide to attend a review center. You have the luxury of studying at your own time and at your own pace. There is no pressure to choose a review center. And you will not have any emotional anxieties to further worry you which may destruct your attention during the review.

However, self-study demands discipline. You have to have discipline to manage your time to allot to studying. Confidence is also necessary. You need confidence to admit if you need more help or if you think you have studied sufficiently. Resourcefulness is also imperative. You need to be able to manage finding other sources if you need to supplement your study material. Each and every one of us has our own style of studying. However there are guidelines suggested for self-study. The following is from Howard Richmans 11 free study tips:

14 1. Study in Short, Frequent Sessions. It has been proven that

short bursts of concentration repeated frequently are much more effective than one long session. So, even if you only have 10 minutes, DO IT. Take a break. Then study another 10 minutes. This distributed learning approach is highly efficient because it honors the way the brain likes to work. The brain needs recovery and recharging time for protein synthesis. The rest periods are when your brain assimilates your effort. They are a powerful tool which many teachers do not acknowledge. To sit and study for hours and hours is not only boring; it creates fatigue, stress, and distraction. You cannot learn if you are fatigued, stressed, and distracted! 2. Take Guilt-Free Days of Rest. This follows the same

principle as above, but on a longer, daily time cycle. The reason for resting is to refresh oneself. However, if you feel guilty (I really should be studying) then your precious rest period has been used to create more stress. The brain will not absorb new data if it is stressed. On days off from studying, really enjoy yourself and do not feel bad about not studying. 3. Honor Your Emotional State. Do not study if you are tired,

angry, distracted, or in a hurry. When the brain is relaxed, it is like a sponge and it naturally absorbs data without effort. If you are emotionally stressed, your brain literally repels data. Forcing

15 yourself to sit and study when your mind is on other things is a complete waste of time!

4.

Review the Same Day. When you learn something new, try

to go over the points the same day. If you wait a few days and then make efforts to review the material, it will seem much less familiar. However, a quick review later in the day will tend to cement the information into your brain so that the next official studies session; you will recognize it and it will seem easy. 5. Observe the Natural Learning Sequence. Think of the

activities you did when you were in nursery school. Using your whole arm, you probably performed the song that goes: Put your right hand in, Put your right hand out. Then, in kindergarten, using your hand, you might have been asked to draw lines or circles with crayons. Later, in first grade, now holding the pencil with your fingers, you drew smaller lines and circles to create letters. Believe it or not, this natural learning sequence, moving from large to small, coarse to fine, still remains effective even though we are now older. When you study, if you try first to grasp the big picture and then fill in the details, you often have a more likely chance of success. 6. Use Exaggerations. Why does a baseball batter warm up by

swinging two or three bats? Why do runners sometimes strap

16 lead weights to their legs? In both cases, exaggeration during practice makes the final result seem easy. This concept can be applied to studying anything. For example, if you are studying spelling, exaggerate the sound of the letters to help to remember them. So for studying purposes, naive would be pronounced NAY -IVY. By getting used to this exaggerated pronunciation, the correct spelling seems obvious. 7. Prepare Your Study Environment. If you require certain

elements in your environment to help you study, try to always make these a priority. For example, do you need special lighting, silence, music, privacy, available snacks, etc.? Pay attention to what works for you and repeat it each time you study for best success. 8. Respect Brain Fade. It is normal for the brain to have an

attrition rate and to forget things. This does not mean that you are stupid! Instead of getting mad about this fact, you should expect it and deal with it accordingly. See your brain as depositing layers of knowledge. As you place more information on top, the lower levels become older and less available to your immediate recall. The trick here is simply to review. Since we can anticipate the eventual fading of our memory, creating a review aspect to our study session will solve the problem. Once every two or three study sessions, simply review older material that

17 you will still need to remember. Often, a quick overview is sufficient. Sometimes, a complete detailed study session of the older material is required. Brain fade is completely normal. (Unless you are gifted with a photographic memory, which is extremely rare.) 9. Create a Study Routine. Generally, if you schedule certain

times of the day to study, you will get into a routine and accomplish more. If you just fit it in during your day, chances are that there will never be any time. An effective way to do this is to literally mark it down in your datebook calendar as if you have an appointment, like going to the doctor. For example: Tuesday 3-4:30 P.M. Study. 10. Set Reasonable Goals. One of the main reasons people do

not reach their goals is because they set them too high. If you set goals that are manageable, even if they seem too simple, you get in the habit of accomplishing them and gradually you can set higher goals. Also, recognize the difference

between long-term and short-term goals. Set your vision on the long-term dream, but your day-to-day activity should be focused exclusively on the short-term, enabling steps. 11. Avoid the Frustration Enemy. Ironically, the quicker the

persons nervous system, the faster they learn. Yet, this fast nervous system also works overtime in being self-critical. So they

18 are the ones who always think they arent going fast enough! In contrast, the Type B, less intense person who learns slower yet is more self-accepting, ends up ultimately learning the material in a shorter period of time. This is because he/she doesnt waste energy blocking, getting upset, and thinking that theyre not good enough they simply keep moving forward at a slower (but un-blocked) pace.

Parents, educators, and scientists know that one of the most potent predictors of adolescents' engagement in aggression or risky behavior is the extent to which adolescents' friends are engaging in similar behaviors," said Geoffrey L. Cohen, Ph.D., associate professor at the University of Colorado at Boulder. Yet, he noted, "we know little about how peer influence works, or about factors that might affect adolescents' vulnerability to peer influence." To better understand how peer influence works, Cohen and his co-author, Mitchell J. Prinstein, Ph.D., associate professor at the University of North Carolina at Chapel Hill, had adolescents participate in an experimental conversational forum over networked computers. Instead of real people on the other end of the computer, however, the teens responded to

computer-generated entities manipulated to appear like either highly popular/liked classmates or unpopular/unliked classmates.

19 The researchers found that adolescents publicly conformed to the behavior of high-status peers when others viewed their responses. They also privately internalized the aggressive and risky attitudes of highly popular/liked peers, endorsing these attitudes even when their responses were no longer visible to others.

"The effects of peer influence were remarkably strong," said Dr. Cohen, "predicting adolescents' aggressive and risky

responses even more than their overall levels of past aggressive behavior." The results also suggested that adolescents' social anxiety (i.e., their fears about others not liking them) may be one factor affecting their vulnerability to peer influence. Those high in social anxiety were especially likely to be influenced by peers, even if the peers were not highly popular/liked.

"These results offer implications for understanding and remedying adolescent aggression and risk behavior," said Dr. Prinstein. "For instance, many interventions try to change adolescents' arguments, aggressive persuasive and risk behavior and fear using rational that

information

appeals

emphasize the negative consequences that follow from such

20 behavior. But a more effective route involves changing not adolescents' own attitudes but their perceptions of the attitudes of their peers."

"You lead them to think, 'This behavior does not fit with my group, or with the group to which I want to belong,'" added Dr. Cohen. Do Not Pressure Yourself With the Expectations of Other People. You are determined to pass the examination, and what will people speak of your performance is irrelevant, they are not the ones that feed you or shouldered your collegiate fees and expenses. This is your fight not theirs and be sure you are giving your best shot.

Theoretical Framework It is noticeable during every exam and even during preparation for the exam, students feel mild to moderate anxiety. The fear of failing the exam and the apprehension about the consequences of the study preparation.

Anxiety is a physiologic state characterized by cognitive, emotional, and behavioral components. These components create the feeling one typically recognizes as fear, apprehension

21 or worry. Anxiety is often accompanied by physical sensation (palpitations, chest pain, stomach-aches, headache, etc.).

Sigmund Freud believe that we acquire anxious feeling through traumatic and stressful experiences (Kozier, 2007).

Anxiety felt by the student during the exam is considered to be healthy. This causes the stimulation of the brain that will make it more retentive. NOTE that mild to moderate anxiety is far different from severe or panic anxiety that would definitely need medical attention.

Test

anxiety

is

the

uneasiness,

apprehension

or

nervousness felt by the students who have fear of failing the exam. Sweating, dizziness, headache, increase heart rate, nausea and fidgeting are all common.

22

Conceptual Framework Figure 1

PERCEPTION
GRADUATING NURSING STUDENTS

PREPAREDNESS
SELF-STUDY REVIEW ENROLLED IN CENTERS

23

This figure describes nursing students behavior as types: Self-study and centers, respectively. the study, graduating looked up on how affect their

taking the NLE.

that graduating possess different categorized into two Enrolling in review As the respondents of nursing students are their methods of study preparedness before

Theoretical/Conceptual Framework Figure 2

PERCEPTION

PREPAREDNESS

GRADUATING NURSING STUDENTS

24

NURSING LICENSURE EXAMINATION

Research Paradigm

INPUT
1. What are the factors affecting the students who are going to take the nursing licensure examination? a.) Family b.) Peers c.) Economic status 2. Where would nursing graduates benefit best before taking the NLE, avail of a review center or simply self-review? 3. How prepared are the students enrolled in review center and those who are self studying? 4. Is there any significant difference between the preparedness among the nursing graduates enrolled in review centers and self-studying?

PROCESS
Distribution of survey forms, interviews, statistical treatment of the results analysis and interpretation of data.

25

OUTPUT
To improve understanding and knowledge among the respondents about the factors that gave an idea to choose which methods will help preparedness.

CHAPTER III RESEARCH METHODOLOGY

Research Design In this topic, Perception Of Graduating Nursing students Of Our Lady Of Fatima University, Quezon City On The Preparedness Of Self-reviewees Or Enrolling In Review Centers Before Taking The Nursing Licensure Examination (NLE), the researchers will choose research design that would help to come up with the different information and opinions of respondents about taking self-review or enrolling at review centers before taking Nursing Licensure Examination (NLE).

26 Descriptive Comparative The researchers have decided to use the descriptivecomparative method form to study a representative

characteristic of a population as a research design for the purpose, and will conduct various ways through personalize structured soft interview to gather appropriate information to defend this particular study as well as to collect pertinent data for the target subject.

Sampling Method The researchers will use the convenience sampling method and the respondents will be chosen based on their accessibility.

Research Setting The locale of the study will be conducted in Quezon City, particularly in Regalado Avenue since this area is accessible for the researchers to gather sufficient data not to mention the fact that most of the respondents resides in this area.

Research Subject The respondents were those Graduating Nursing students of Our Lady of Fatima University, March 2012 who encounters

27 confusion and preparedness prior to the Nursing Licensure Examination (NLE) if they are going to enroll in a review center of just review by themselves as their preparation.

Research Instruments The primary instrument that we are going to use to collect data is the Devised Questionnaire. This is a self-made instrument that was constructed by the researchers based on the nature of the study. The researchers chose this mainly because this was one of the fastest methods of gathering data since the distribution was easy, responses were easy to tabulate and the respondents responses were complimentary. The researchers will also use the letter an encoded matter that was in the form of request for assistance or permit in the conduct of study. The cover letter introduced the researchers to the respondents and the Interview portion a question and answer method to extract needed data from the respondents.

Questionnaires will be distributed to collect information on the Perception of Graduating Nursing Students of Our Lady of Fatima University, Quezon City on the preparedness of selfreviewees or enrolling in Review Centers before taking the Nursing Licensure Examination (NLE).

28

In this study the researchers will use closed-ended as well as an open-ended questionnaire, which was descriptive in form, since it offer answer choices that shall just be chosen by the respondents by checking the square that indicates their answers.

Statistical Treatment The Following procedures were performed to test the validity and reliability of the study.

Slovins Formula a 10% margin of error was used to determine the sample size of the population.

Formula:

n=

N 1 + Ne

29

Where: N = population size n = sample size e = margin of error