RUNNING HEAD: Nursing Quality

Integrating Nursing Quality with Achievement and Aptitude:

Towards Assessing Nursing Potential

Carlo Magno

De La Salle University - Manila

Marife M. Mamauag

De La Salle-College of Saint Benilde

Nursing Quality

Abstract

The study integrated the qualities of nursing students (N=227) with their aptitude and academic

achievement in a tripartite model. A battery of tests called in the Assessment for Nursing

Potential (ANP) composed of the (a) Nursing Quality Scale (NQS) with factors on caring,

compassion, commitment and connectedness; (b) Achievement test; and (c) Aptitude test was

used in the study. Using a three-wave longitudinal design, the NQS was first administered

followed by the aptitude, then the achievement tests. The effects of the nursing qualities on

achievement and aptitude were analyzed using Structural Equation Modeling (SEM). The first

model indicates that nursing quality as a latent factor has no significant effects on both

achievement and aptitude, obtaining a moderate goodness of fit (RMSEA=.09). However, when

the same model was tested including the effect of aptitude on achievement, it resulted to a better

fit (RMSEA=.06). In the second model, aptitude has a significant effect on achievement, p<.05.

The model explains that attitudinal characteristics of nurses are independent of cognitive abilities

such as their aptitude and achievement, and thus supports the belief that it is possible to integrate

them in assessing nursing potential. Although effective nurses may possess the necessary

characteristics such as caring, compassion, commitment, and connectedness, these quality traits

do not affect their abilities.

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Nursing Quality

Integrating Nursing Quality with Achievement and Aptitude:

Towards Assessing Nursing Potential

Considering the growing demand of Filipino nurses abroad, there is a great need for them

to improve nursing quality by learning necessary competencies and characteristics to succeed in

the profession. Valanis (2000) argued that nurses need additional competencies in order to

function effectively. The Joint Commission on the Accreditation of Healthcare Organization also

states that nurses need to develop more competencies to perform well in their job functions.

These competencies refer to knowledge, skills, behaviors as well as personal characteristics.

Different studies on nursing quality focused on exploring trait on caring as a primary

characteristic (e. g. Blasdell & Hudgins-Brewer, 1999; Gunther & Thomas, 2006; Tise, 1988).

On the other hand, most of the studies on the achievement of nurses focused on predicting their

success using licensure examination scores as the criterion (e. g. Lam, 2000; Waterhouse &

Beeman, 2003; Giddens & Gloeckner, 2005). The current literature on nursing characteristics

and achievement were studied separately considering that there is a growing attention in

describing the complexity of nurses’ characteristics as well as their changing roles.

The present study proposes to integrate both quality and abilities of nurses because

providing services with care needs to be aligned with their ability to handle the technical aspects

of their job. The study further tested a model showing the direction from qualities of nursing

students (caring, compassion, commitment, and connectedness) directly affecting their aptitude

and academic achievement. The model implies that there should be an integration of the

knowledge, skills, and behaviors of nurses to optimize their potential for success in the nursing

profession..

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Nursing Quality

Nursing Quality Traits

Nursing quality is defined as an experiential judgment emerging from the nurse-patient

interaction. Most of the studies on nursing quality and traits focused on a single factor such as

emphasizing on nursing care while neglecting other characteristics and components. The study

by Mamauag and Magno (2005), however, elaborates varied nursing qualities extracted from

factor analysis. The resulting framework of nursing qualities does not only emphasize the

importance of caring but also other factors such as compassion, commitment, and connectedness.

In the said study, a scale composed of these four factors was constructed showing that caring,

compassion, commitment, and connectedness have items that highly load for each factor. Using

the Rasch model application, the items were further calibrated to generate a pool comprising

those that have goodness of fit. These four characteristics are culturally relevant for Filipino

nurses because they are described and defined in a collectivist orientation grounded on in-depth

interviews among nursing students and practitioner-experts. These factors of nursing quality are

all directed towards others where caring means providing comfort, compassion is sympathetic

consciousness of others, commitment is responsibility to others and to the profession, and

connectedness is the nurse-patient bond.

Valanis (2000) has a different model on nursing quality that entails the concern of

developing nursing competencies rather than personal characteristics and qualities. She

advocates that nurses must: (1) independently practice the profession and evaluate one’s own

performance, (2) have the aptitude for self-motivation and autonomy, (3) be able to identify gaps

in knowledge and plan appropriate professional development activities, (4) be able to translate

learning into practice, (5) assess patient needs, (6) elicit patient and family values, (7) provide

patients with continuity of service, (8) synthesize knowledge and skills, (9) have a broad view of

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Nursing Quality

health, (10) assess potential contribution to technology, (11) be skilled in behavior change

theory, (12) be able to differentiate nursing functions from those of other professions, and (13)

exert leadership in ensuring nursing’s unique contribution to policy on the preventive and

remedial aspects of illness. These 13 competencies proposed by Valanis calls for greater demand

from nurses to recognize their growing role in the health care profession. These competencies

entail aspects of abilities more than affective qualities. Valanis contended a more crucial need for

nurses to possess competencies rather than focus on the separate etymological concepts.

Gunther and Thomas (2006) were able to extract the same nursing characteristics found

in the study of Mamauag and Magno (2005). Using the qualitative research approach, Gunther

and Thomas explored the experiences in caring for patients in contemporary hospitals among 46

nurses. Running themes identified were the following: (1) extraordinary care giving events, (2)

incomprehensibility, (3) isolation experienced by nurses while giving care as well as profound

moment of connection with patients, and (4) questioning what other things could have been

done.

The study of Blasdell and Hudgins-Brewer (1999) used different measures to determine

the personality characteristics and attributes that guidance counselors believe to be important for

a career in nursing. It was found that “other orientation” subscale (includes traits such as

compassion, kindness, sincerity, altruism, and concern for others) was ranked the most important

followed by the academic achievement, conformity and lastly leadership. They also found out

that leadership and academic achievement is significantly more important for BSN-prepared

nurses (Bachelor of Science in Nursing) compared to those taking AND (Associate Degree in

Nursing). The study also recognized that academic achievement is the most important factor for

a career in medicine than in nursing. It is also important to note in the study of Blasdell and

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Nursing Quality

Hudgins-Brewer that nursing students need to be compassionate, kind, obedient, and moderately

academically able. This moderate achievement level is enough evidence pointing to the need for

nurses to improve their cognitive abilities such as critical, thinking, achievement, and aptitude as

advocated by Valanis (2000).

Guidance counselors had realistic perceptions of nursing and identified personal and

cognitive attributes of students that would promote success in nursing as investigated by Bolan

and Grainger (2005). This supports the earlier findings of Blasdell and Hudgins-Brewer (1999).

However, Bolan and Grainger further argued that nurses involved in the recruitment of students

need to ensure that guidance counselors have more accurate perceptions of the changing role of

nurses, their opportunities for practice outside hospital settings, and the importance of problem-

solving and leadership skills for nurses. Considering that high school guidance counselors can

influence the career choices of students, it is also imperative that they be equipped with

information on what characteristics will make successful, competent and caring nurse-

practitioners.

Nursing Achievement and Aptitude

Majority of studies in nursing shows that nursing achievement is moderately perceived as

important. This concerns a great concern to improve the abilities of nurses such as their aptitude

and academic achievement. The common measure of nursing achievement in published studies

on nursing education can be found in the results of licensure examinations such as the NCLEX

(National Council Licensure Examination). In the Philippine setting, the Philippine Regulation

Commission also uses a test for the licensure of nurses, although there are no published studies

using the said instrument.

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Nursing Quality

Three studies are published in reviews using the NCLEX as a measure of nursing

achievement. The study by Lamm and McCaniel (2000) used the State Board Test Pool

Examination (SBTPE), Grade Point Average (GPA), parental education level, and age as

predictors of the NCLEX. The purpose of the study was to identify which variables accurately

predict the success of practical nursing students on the NCLEX-PN. The results indicate that

among all predictors, the General Mental Ability (GMA-subscale of SBTPE) was the only

significant predictor of the NCLEX-PN. A recent study by Waterhouse and Beeman (2003) was

able to identify more significant predictors of the NCLEX such as scores in the Risk Appraisal

Instrument (RAI), grades in the different nursing courses, and the nursing achievement test. In a

more recent study, Giddens and Gloekner (2005) investigated the relationship between critical

thinking and the performance scores on the NCLEX. Their study showed that both measures of

critical thinking (California Critical Thinking Test and California Critical Thinking Disposition

Inventory) did not significantly predict the NCLEX scores. The study recognized the need to

explore other dispositional variables in explaining nursing achievement scores.

The studies on nursing achievement usually correlated other cognitive measures such as

critical thinking, mental ability, grades, with demographic factors such as age, gender, and

parents’ educational level. Previous studies did not explore other dispositional factors such as

nursing quality traits in predicting nursing achievement levels because these concurrent studies

were driven by the factors explained by other previous studies. This poses a need to explore and

use other kinds of disposition such as quality traits in explaining nursing achievement and

aptitude.

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Nursing Quality

Conceptual Framework

Valanis (2000) proposes that there should be an integration of the knowledge, skills, and

behaviors of nurses and there should be a framework to explain this. Most studies on nursing

achievement use other cognitive factors to predict nursing achievement and this pattern results to

very limited models in explaining nursing affect and cognition. This study tested a model

integrating nursing quality traits as a latent variable composed of caring, commitment,

connectedness, and compassion with achievement and aptitude in nursing. This integration is

based on Bandura’s framework of triadic reciprocity of the social cognitive theory. The said

framework contends that human functioning is explained in terms of a model of triadic

reciprocality in which behavior, cognitive and other personal factors, and environmental events

all operate as interacting determinants of each other (Bandura, 1986). In applying this

framework, the nurses’ function is made more effective by the interaction of their quality traits as

personal factors, and their achievement and aptitude as cognition. In the present study, two

models were tested: one model testing the effect of nursing quality traits on achievement and

aptitude, and another model, the effect of aptitude on achievement was included.

Method

Participants

A total of 227 second year college nursing students from a private educational institution

participated in the study. Their ages range from 16-18 years old.

Instruments

The Assessment for Nursing Potential (ANP) was used as the research instrument of this

study. Developed by the Asian Psychological Services and Assessment, Inc., the ANP is a valid

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Nursing Quality

and reliable measure to form a strong base for selecting students for admission to the upper

nursing division level. It is composed of a combination of three tests, namely: (1) nursing

attitudinal inventory (earlier known as the Nursing Quality Scale) which assesses the traits that

are essential in contributing to one’s success in the nursing profession; (2) aptitude test that

measures the “innate-based” learned abilities; and (3) achievement test measuring what has been

learned in the lower nursing division level. The ANP test battery has been widely used by

nursing schools in the Philippines. It is the only locally-made test used for selection and

placement of nursing students. It has been seen as a good preparation for the Nursing Board

Examinations and foreign-based tests such as the NCLEX and CGFNS.

Nursing Quality Scale (NQS). Developed by Mamauag and Magno (2005)which

measures nursing quality traits with factors such as caring, commitment, compassion, and

connectedness. It is composed of 160 items with 40 items for each factor, using a 4-point Likert

scale (4-strongly agree, 3-striongly disagree, 2-disagree, 1-strongly disagree). High scores

indicate possession of strong characteristics of the domains measured. Two forms of the NQS

obtained high correlation coefficients. The test also indicates a very high internal consistency

among the items with a Cronbach’s alpha value of .95. Principal components analysis with

varimax rotation was conducted where the items highly loaded for each factor. All items in the

calibration procedure using the IRT application of the Rasch Model indicated high goodness of

fit.

Nursing Achievement Test. The achievement test measures the proficiency in the general

education course taken during the first two years of the nursing education. The subscales include

general psychology, college algebra, physical science, life science, and communication skills.

The Cronbach’s alpha for the subscales are .55, .60, .37, .63, and .86, respectively. The overall

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Nursing Quality

internal consistency of the scale is .86. The items were reviewed by three measurement experts

to establish the instrument’s content validity. Factor analysis was conducted where the items

highly loaded on their specified subscales. All the factors measured in the nursing achievement

test are significantly related with each other.

Nursing Aptitude Test. The aptitude test measures fundamental intellectual abilities. It

consists of abstract reasoning, verbal reasoning, and numerical reasoning. The Cronbach’s alpha

for the subscales are .43, .75, and .75, respectively. The overall internal consistency of the items

is .83. Content validity of the items was established through a review by three content area

experts. Factor analysis was conducted to establish the construct validity of the test. Significant

correlations were obtained for each subscale.

Procedure

The three tests (NQS, achievement and aptitude) were administered to second year

college students in a private nursing school in the Philippines. The tests were accomplished by

the nursing students as part of their annual diagnostic assessment. The researchers ensured that

the standard procedures of test administration were followed. The instruments were administered

in three time waves. The NQS was first administered, followed by the aptitude, and finally the

achievement. After three subsequent test administrations, the students were debriefed about the

purpose of the study and their permission was asked to include their test scores as part of the

analysis in this study.

Data Analysis

The Pearson’s r was used to determine the inter-correlations among the factors in the

subscales of each test.

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Nursing Quality

The Structural Equation Modeling (SEM) was the primary analysis used in this study.

The SEM is a statistical technique that takes a confirmatory approach to the analysis of a

structural theory bearing certain constructs or concepts. Typically, this structural theory

represents “causal” processes that generate observations on multiple variables.

Applying the SEM, two models were tested in the study. In the first model (the default

model), the effects of NQS on achievement and aptitude were tested. In Model 2 (constrained

model), the same paths were tested but this time the effects of aptitude on achievement included.

The obtained Root Mean Square Error Approximation (RMSEA) was used to determine the best

fitting model, as well as measures of noncentrality and single sample fit indices. Single sample

goodness of fit indices were also used to evaluate the models (Joreskog GFI/AGFI, Akaike

Information Criterion, Schwarz's Bayesian Criterion, Browne-Cudeck Cross Validation Index,

Bentler-Bonett, James-Mulaik-Brett Parsimonious Fit Index, and Bollen's Rho).

Results

Table 1 shows the mean scores and standard deviations of the NQS factors as well as of

the achievement and aptitude tests. In the NQS, the respondents obtained high scores across all

factors that are close to the highest score of 4.00. Scores on the achievement and aptitude scales,

on the other hand, are moderate where most respondents obtained scores within the mean range.

These scores may be interpreted that the students are apparently not meeting the standards of

nursing education that they have earned so far in their first two years.

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Nursing Quality

Table 1

Mean and Standard Deviation of the NQS, Aptitude, and Achievement

M SD

Nursing Quality Scale (NQS)

Caring 3.81 0.41

Compassion 3.80 0.38

Commitment 3.87 0.37

Connectedness 3.51 0.42

Achievement

Psychology 73.12 4.34

Algebra 67.29 5.99

General Science 69.37 5.03

Life Science 69.37 4.89

Communication 78.52 4.89

Overall Achievement 71.53 2.90

Aptitude

Abstract Reasoning 77.96 6.81

Verbal Aptitude 75.19 5.99

Numerical Aptitude 73.87 5.42

Overall Aptitude 75.71 4.49

To establish the relationship among the factors, Pearson’s r was used. Table 2 shows the

matrix of the correlation coefficients. The factors of the NQS are significantly correlated with

each other, p<.05, although they do not correlate highly with the factors of achievement and

aptitude. Only the factor on compassion correlated significantly with the factors on verbal and

numerical aptitude. No significant correlations were found between the factors of the NQS with

any of the achievement factors. Some of the achievement factors, however, are significantly

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Nursing Quality

related with some factors of the aptitude component. Moreover, the scores on psychology

achievement are significantly related with all the factors of the achievement and aptitude scales.

Table 2

Correlation Matrix among the Factors of NQS, Aptitude, and Achievement

1 2 3 4 5 6 7 8 9 10 11 12

(1) Caring 1.00

(2) Compassion 0.77* 1.00

(3) Commitment 0.83* 0.79* 1.00

(4) Connectedness 0.72* 0.68* 0.69* 1.00

(5) Psychology -0.03 0.07 -0.03 0.03 1.00

(6) Algebra 0.03 0.08 0.00 0.01 -0.20 1.00

(7) General Science -0.05 0.00 -0.06 -0.01 0.25* -0.01 1.00

(8) Life Science -0.05 0.05 0.03 0.07 0.17* 0.17* 0.10 1.00

(9) Communication 0.08 0.13 0.10 0.11 0.24* 0.10 0.25* 0.04 1.00

(10) Abstract Reasoning -0.01 0.07 0.00 0.04 0.16* 0.03 0.13* 0.07 0.10 1.00

(11) Verbal Aptitude 0.09 0.22* 0.08 0.15* 0.42* 0.01 0.07 0.10 0.35* 0.20* 1.00

(12) Numerical Aptitude 0.01 0.16* 0.07 0.04 0.25* -0.08 0.17* 0.21* 0.31* 0.39* 0.39* 1.00

*p<.05

The Structural Equation Modeling was conducted to test the integration of nursing quality

traits with achievement and aptitude in a model.

The default model has rather an acceptable fit with a RMSEA of 0.096. The noncentrality

fit indices and single sample fit indices are consistent in declaring a rather good fit of the model.

In the path estimates, all factors are significant components of their latent construct. The path

estimates show that nursing quality does not significantly affect both aptitude and achievement

(see Figure 1).

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Nursing Quality

Figure 1

Default Model

NursingQuality

Compassion Commitment ConnectednessCaring

.33*0.37*.34*.33*

Aptitude Achievement

.32 .12Algebra

GeneralScience

Life Science

Communication

Psychology

.90*

1.00*

.95*

.91*

.46*Verbal Aptitude

AbstractReasoning

NumericalAptitude

.89*

1.48*

1.00*

31.07*

e5

19.93*

e6

22.52*

e7

18.90*

e8

12.92*

e9

.03*

e1

.04*

e2

.02*

e3.07*

e4

9.42*

e13

5.82*

e14

36.71*

e10

28.25*

e11

8.52*

e12

The second model is a constrained model where the same paths are studied with the

inclusion of the effect of aptitude on achievement. The constrained model is a better fitting

model as compared with the default model with a RMSEA value of 0.067, all other noncentrality

fit indices and single sample fit indices also showing improvement. The path estimates are

consistent with the first model where nursing quality has no significant effect on aptitude and

achievement, but it is shown that aptitude has a significant effect on achievement, p<.05. When

the effect of aptitude on achievement was included, the path estimates from nursing quality to

aptitude increased and the effect on aptitude became negative although not significant.

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Nursing Quality

There are changes in the parameter estimates for aptitude in the constrained model. The

errors for each factor increased except for the verbal aptitude. The errors for both aptitude and

achievement as endogenous variables decreased in the constrained model (e13 and e14).

Figure 2

Constrained Model

NursingQuality

Compassion Commitment ConnectednessCaring

.33*0.37*.34*.33*

Aptitude Achievement

.41 -.17Algebra

GeneralScience

Life Science

Communication

Psychology

.98*

1.00*

.75*

1.02*

.53*Verbal Aptitude

AbstractReasoning

NumericalAptitude

1.15*

1.28*

1.00*

30.36*

e5

22.01*

e6

22.19*

e7

17.94*

e8

13.10*

e9

.03*

e1

.04*

e2

.02*

e3.07*

e4

8.80*

e13

1.57*

e14

37.27*

e10

23.85*

e11

14.53*

e12

.68*

In comparing the two models in their fit indices, the default model has a larger

discrepancy function (0.60) as compared to the constrained model (0.37). In the same way the

RMS standardized residual for the default is larger (0.098) than the second model (0.052). The

Maximum Likelihood chi-square values decreased from the default (2=160.618) to the second

model (2=102.30) which shows improvement in the model.

In terms of the model’s noncentrality indices, there is consistent improvement in fitting

the data from the default model to the constrained model. The Population Noncentrality

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Nursing Quality

Parameter decreased (model 1=0.32, model 2=0.12) as well as the RMSEA (model 1=.07, model

2=.04). The McDonald Noncentrality Index (model 1=0.85, model 2=.94), Population Gamma

Index (model 1=0.94, model 2=0.98), and Adjusted Population Gamma Index (model 1=0.92,

model 2=0.97) all increased. All other goodness of fit indices likewise improved in the

constrained model (see Table 3).

Table 3Single Sample Fit Indices

Goodness of Fit Indices Default Model Constrained Model

Joreskog GFI 0.901 0.933

Joreskog AGFI 0.851 0.898

Akaike Information Criterion 212.618 156.299

Schwarz's Bayesian Criterion 1.219 1.016

Browne-Cudeck Cross Validation Index 0.839 0.622

Independence Model Chi-Square 933.096 933.096

Independence Model df 15.047 15.047

Bentler-Bonett Normed Fit Index (NFI) 0.838 0.897

Bentler-Bonett Non-Normed Fit Index (TLI) 0.851 0.928

Bentler Comparative Fit Index (CFI) 0.883 0.945

James-Mulaik-Brett Parsimonious Fit Index (PCFI) 0.696 0.730

Bollen's Relative Fit Index (RFI) 0.795 0.867

Bollen's Incremental Fit Index (IFI) 0.885 0.946

Discussion

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Nursing Quality

Is the Integration of Nursing Quality with Ability Measures a Good Model?

Integrating nursing quality with both aptitude and achievement shows a considerable

good fit for the proposed model and more so with the constrained model as indicated in the

noncentrality fit indices and single sample fit indices. The good fit of the resulting model may be

attributed to the three distinct measures of the NQS, Aptitude, and Achievement tests.

Considering that these all belong in a single test battery, the participants of the study most likely

saw the parallelism in the measures used. It also indicates that the structure of the three variables

fit together because all the items were calibrated with person ability by using the same one

parameter Rasch model in a binary response type of scaling (“0” and “1”). The technique of

calibrating the infit and outfit characteristics of items for all the factors in a model increases its

fit indices.

Unlike earlier studies that generated multivariate procedures, the SEM takes a

confirmatory rather than exploratory approach to data analysis as illustrated in this study. While

most of the multivariate techniques from previous studies provides regression and predictive

models of nursing achievement, the present study showed that the factors of nursing quality,

achievement, and aptitude fits together in a structural model. As depicted in this study, the

constructs of nursing quality, aptitude, and achievement in nursing were shown to be

independent measures of both non-cognitive and cognitive abilities. The integration of the

nursing quality with ability measures was apparently good as a model but the model also showed

that affective qualities are independent of cognitive abilities.

Aside from citing statistical considerations and benefits of using the SEM and Rasch

model applications as shown in this study, nurses in the academic setting are expected to possess

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all the necessary competencies, skills, attributes to be effective in their profession (Valanis,

2000).

Do Nursing Quality Traits affect Ability Measures?

Nursing quality traits do not affect ability measures, but aptitude affects achievement in

nursing. These findings support previous models of using cognitive factors to predict cognitive

criterion as well. Current literature describes nursing licensure exams like NCLEX as a measure

of nursing achievement. Most often, studies indicate factors such as general mental abilities,

Grade Point Average (GPA), parental education level and age as best predictors of success in

passing board examinations. None ever described yet that empirically, personality or personal

attributes can also predict success in the nursing profession.

The findings indicate that affective measures such as traits are not good predictors of

ability measures such as achievement and aptitude. The nursing traits having no effect on both

aptitude and achievement further indicate that nursing quality is distinct with the two ability

measures. The distinction is indicated by the nature of the constructs itself – where the nursing

traits are non-cognitive and the ability measures as cognitive. The traits were self-reported that

may be subject to social desirability in the measurement, while the ability measures are tests of

one’s achievement and aptitude that are assumed objective. Previous studies that used affective

predictors also did not yield significant effects for ability measures like the risk appraisal

assessment (Waterhouse & Beeman, 2003).

Apparently there is a need to explore and use other measures of disposition aside from

quality traits in explaining nursing aptitude and achievement. However, the belief that human

functioning includes behaviors, person variables, and the environment that are interacting with

and shaping with one another (Bandura, 1986) has been further strengthened as indicated in the

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resulting model tested in this study. Further studies can include other disposition measures such

as interest, motivation, and self-efficacy in exploring the predictability of successful careers in

nursing. A further analysis using a larger sample needs to be undertaken to increase the power of

the statistics.

References

Bandura, A. (1986). Social foundations of thought and action: A social cognitive

theory. Englewood Cliffs, NJ: Prentice Hall.

Blasdell, A. & Hudgins-Brewer, S. (1999). High school counselors’ perceptions of

the academic and personality attributes important for a career in nursing.

Journal of Nursing Education, 38, 176-179.

Bolan, C. M. & Grainger, P. (2005). What do high school guidance counselors

really think of nursing? Journal of Nursing Education, 44, 135-138.

Giddens, J. & Gloekner, G. (2005). The relationship of critical thinking in

performance on the NCLEX-RN. Journal of Nursing Education, 44, 85-89.

Gunther, M. & Thomas, S. (2006). Nurses’ narratives of unforgettable patient

care events. Journal of Nursing Scholarship, 4, 370-377.

Lamm, G. & McCaniel, A. (2000). Factors that predict success on the NCLEX-

PN. Journal of Nursing Education, 39, 315-318.

Mamauag, M. & Magno, C. (2005). Nursing quality scale: Test development.

Unpublished manuscript, Asian Psychological Services and Assessment, Inc.

Tise, S. (1988). To be or not to be a registered nurse. Occupational Outlook

Quarterly. 32, 8-17.

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Valanis, B. (2000). Professional nursing practices in an HMO: The future is now.

Journal of Nursing Education, 39, 13-26.

Waterhouse, J. & Beeman, P. (2003). Predicting NCLEX-RN success: Can it be

simplified? Nursing Education Perspectives, 24, 35-40.

Author’s Note

This study was presented at the 7th Biennial Conference of the Asian Association of Social

Psychology (AASP 2007) at Kota Kinabalu, Sabah, Malaysia, July 25-28, 2007. Further

correspondence can be addressed to Mr. Carlo Magno, Counseling and Educational Psychology

Department, De La Salle University-Manila, magnoc@dlsu.edu.ph and Marife Mamauag, Center

for Learning and Performance Assessment, De La Salle-College of Saint Benilde,

mamauagm@dls-csb.edu.ph.

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