the effects of modern skills laboratory on nursing students clinical performance
TRANSCRIPT
Chapter 1
The Problem and Its Background
Introduction
The learning of nursing skills in a laboratory is an essential part of the
curriculum. It is here that students are introduced to skills, concept and procedures that
they then take into their clinical settings. Prior to caring for patients, students get to
practice in the lab first where they become familiar and safe with nursing care before
caring for patients in the hospital or community setting. Students come to the nursing
skills lab to practice basic advanced nursing skills during faculty supervised
classes/demonstrations and independent practice time.
The curriculum of nursing schools is characterized by exposing the
students, from the very early beginning of their attachment to the school, to patients
gradually through the different educational years. This is done in a suitable environment
which avoids the student nurse/patient contact being used for initial practice. This
suitable environment is the modern skills laboratory. The Clinical Skills Laboratories are
committed in delivering a first class service to students, providing a safe environment for
the teaching and learning of skills. Based in the nursing schools here in Rizal, the
laboratories consist of one child and midwifery laboratory, two general clinical skills
laboratories and two moving and handling laboratories. Nursing students develop their
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skills by using simulated environments and equipment. Props such as mannequins are
used to practice the different types of procedures and personal hygiene needs of the
would-be patient. Throughout their skills laboratory practice, students are also
shown how to wash their hands properly(hand washing), surgical hand washing
which is very important in the hospital area. All nursing students were able to practice
certain procedures like measuring blood pressure, intradermal intramuscular and
subcutaneous injection, Intravenous injection, rectal examination, vaginal examination
and IUD introduction, male and female genitalia examination, male catheterization,
female catheterization, nasal pack, attendance of normal labor, administering a BT/IVF,
proper gowning and gloving, and other different procedures characterized on each
different areas in the hospital. The researchers focused their study on the effects of
modern skill laboratories on nursing student’s clinical performance. The study will be
conducted on two nursing colleges school in Rizal. The scope of the study focused on
173 students, 90 girl and 83 boy, third year level.
Create a stress-free learning environment that incorporates practice and
reflective learning that will help the students, as well as to provide real world to
independent level of functioning. This is where the researchers would like to work on.
The modern skills laboratory creates and evaluate rich interactive learning
environment that are usable in classroom practice and that push forwards the envelope of
learning technologies including three dimensional visualization model manipulation,
multi sensory feedback and design based on learning this distal creatures will be
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presented so as to allow both interactive viewing and simulated physical and chemical
manipulation, anatomical models, electronic stimulator, modules for conducting
standardized patient encounter and will encourage students to go beyond traditional
learning methods and to apply the learning that they experience in the modern skills
laboratory to their clinical performance.
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Statement of the Problem
To determine the effects of modern skills laboratory to nursing students clinical
performance.
Sub – Problems
Based on the problem stated, the researchers attempted to answer the following questions.
1) How the respondents profile be described in terms of:
1.1 Age
1.2 Gender
1.3 Year level
1.4 Marital Status
2) How does modern skills laboratory affecting nursing students clinical performance be
describe, in terms of:
2.1 Anatomical Model
2.2 Electronic Stimulator
2.3 Modules for conducting standardized patient encounter
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3) How does modern skills laboratory affect the clinical performance of nursing students
in terms of:
3.1 Anatomical Model
3.2 Electronic Stimulator
3.3 Modules for conducting standardized patient encounter
4) Is there any significant relationship between Modern Skills Laboratory in the clinical
performance of Nursing Students in terms of:
4.1 Anatomical Model
4.2 Electronic Stimulator
4.3 Modules for conducting standardized patient encounter
5) To what extent does the modern skill laboratory affect the clinical performance of
nursing students, in terms of:
5.1 Anatomical Model
5.2 Electronic Stimulator
5.3 Modules for conducting standardized patient encoun
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Purpose of the study
Create a stress-free learning environment that incorporates practice and
reflective learning that will help the students, as well as to provide real world to
independent level of functioning. This is where the researchers would like to work on.
Significance of the Study
Nursing Students: The result of this study could be beneficial to students and expand
their comprehension on how important Modern Skill Laboratories to their clinical
performance.
Instructors: The outcome of this study will be able to help the instructors to teach
more effectively and facilitates good transmission of knowledge with their students.
Patient: This would give the patient optimum level of wellness rendered by the
student’s nurses that are well trained on their modern skills laboratories.
Researchers: The study will give the researcher additional knowledge and
understanding about the effects of modern skill laboratories towards nursing students’
clinical performance. The result of this study might encourage others to conduct further
studies and can be used to advance research in the concept of the effects of modern skills
laboratory on nursing student clinical performance
Scope and Delimitations of the Study
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The researchers focused their study on the effects of modern skill laboratories on
nursing student’s clinical performance. The study will be conducted on two nursing
college’s school in Rizal. The scope of the study focused on 173 students, 90 female and
83 male and third year level.
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THEORETICAL FRAMEWORK
This study is anchored on the theory of performance goal theory by Nicholls, the theory
of simulation by PennState Hersly, and the theory of evaluating clinical simulation for
learning procedural skills by Kneebone R.
According to Nicholls Performance Goal Theory, the central proposition of this theory
revolves around the manner in which individuals determine their goals in achievement
settings such as sport, PE, and the classroom.
According to this theory three factors interact to determine a persons motivation:
Performance goals.
Perceived ability.
Achievement behavior.
This proposition indicates that individuals in Performance settings are typically oriented
to one of two goals when determining whether or not they have been successful in these
contexts.
Someone may have a ‘task goal orientation’ where the focus is on improving
performance relative to past performance, not on comparison with others. They
have a stronger work ethic, are more persistent, and are better motivated because
the factors they focus on are internal and more controllable.
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Others may have an ‘outcome goal orientation’ where they constantly compare
themselves with others. Such factors are external and uncontrollable. They tend to
give up more easily, and select tasks that are easier to perform.
Individuals who determine success based on self-improvement and task mastery are
displaying a task orientation. For example, runners primarily concerned with improving
their technical form and race times are displaying a task orientation. Conversely,
individuals who determine success by comparing their own performances with those of
others are displaying an ego orientation. For example, runners who focus on beating their
competition regardless of time or technique are displaying an ego orientation.
(For a more complete understanding of achievement goal theory see Nicholls, 1984, 1989
and Dweck & Leggett, 1988.)
Although researchers continue to debate whether task orientation or ego orientation is
more desirable, the majority of the literature tends to support that a task orientation is
more conducive to positive behaviors in achievement settings. Moreover, researchers
have now begun to develop pedagogical practices that seem to influence the achievement
goal orientation of individuals. Therefore, the primary purpose of this paper is to describe
the methods that one can use to positively influence an individual to engage in
achievement settings with a task orientation.
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Motivational Climates Ames (1992a, 1992b) has argued that individual goal orientations
may be influenced by the motivational climates that are created by what teachers and
significant others say and do. Moreover, Ames (1992a, 1992b) suggested that climates
focused on skill learning and self-improvement influence task orientation, while climates
focused on comparisons of performance and ability with peers foster an ego orientation.
Climates that foster a task orientation are called task-involving while climates that foster
an ego orientation are called ego-involving.
Principles described by Ames (1992b) and Epstein (1988) concerning classroom structure
and resulting climates are used to design motivational climates that influence task or ego
orientation. These principles are based on the alterable elements of a lesson which are,
task, authority, rewards, grouping, evaluation, and time. These elements have been
referred to by using the acronym TARGET (Ames, 1992b; Epstein, 1988). The choices
teachers make about these elements determine the degree to which an instructional
climate is more task- or ego-involving
According to PennState Hersly’s Simulation Theory, Simulation training is
incorporated into a medical curriculum using a stepwise procedure (see diagram). First
task trainers are used to grasp the basic concepts of a technique and to practice the related
psychomotor skills.
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Then a computer program or a more detailed anatomic model is incorporated to illustrate
the three dimensional anatomy of the procedure or to give a physical context into which
the basic tasks fit.
The next step is to incorporate multiple basic tasks into a complex task using the anatomy
to understand the order and necessity of each task. This step can be accomplished initially
on a flat screen computer program, in order to establish the sequence of events, and then
moved to a virtual reality trainer to practice the steps of the task in sequence and to make
the environment more realistic.
The last training module would be to perform the entire operation from beginning to end
on a high fidelity simulator or instructor driven simulator. The additional challenge at this
stage is to incorporate the complex tasks into a realistic setting. Trainees are required to
perform multiple, unrelated complex tasks amid the usual distractions not only under
"ideal" conditions, but also to see how these tasks change when there is a problem. The
trainee must now sort relevant information from the environment and make real time
decisions on how to modify the complex tasks based on constantly changing conditions
as the patient responds to their interventions.
There only remains the fine tuning of skills and judgment on a real patient in the
operating room, under the supervision of a skilled health care provider.
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Imagine you are a patient in a hospital in the 1890's. You have had trouble with upper
abdominal pain and your doctor says he has to remove your gall bladder. You are moved
from the ward into the operating room where several young men are standing around the
room, attentively watching the surgeon prepare his equipment. They are the residents, or
doctors in training. Another resident, obviously more advanced than the others, is
assisting the surgeon with preparations. As they begin putting you to sleep, you hear the
doctor giving instructions to the assistant regarding where to make the incision and what
to look for. The doctor is going to talk the resident through the operation. If the resident
(and you) are lucky, he has already observed several operations and has probably assisted
with a couple of them. Now it is his turn to be "in the driver's seat" for the first time, with
you on the other end of those instruments.
The following excerpt is from Dr. Floyd Burroughs. It chronicles one of his real life
experiences as he began his residency in June, 1897. (from "Reminiscences from the
Turn of the Century" by Floyd Burroughs, M.D. New York State Journal of Medicine, 66
(23), 1 Dec 1966, p 3072-5.)
"Later on, I revisited a forlorn, cheerless room in a sequestered corner of the second
floor, reserved as an arena for conducting surgical operations. My classmates and I were
required to attend surgical clinics in this room. Across its rear was a row of two or three
wooden benches on which we sat in patient misery.
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During an operation we students were summoned in groups of three to approach the table
on which the unfortunate patient was stretched, and were permitted to peer over a
surgeon's shoulder at the field of action and this attempt to memorize with almost
photographic ability the technique displayed by a nimble surgeon. We were expected to
acquire enough information to qualify us to tackle a similar job someday..."
This method of teaching is called the apprenticeship model. "Learning on the job" has
been used for thousands of years to teach everything from the proper way to waterproof a
canoe to the best time of year to trim back a garden. Until recently, it was also the only
way to teach doctors how to practice medicine. Trial and error, with hopefully not too
many of the latter. Of course, many safeguards were developed over the years for the
patient's well-being, but the resident still had to start somewhere. Cadavers were used to
learn anatomy, but you cannot see inadvertent bleeding or understand the difference in
texture, consistency, and appearance between good and bad tissue if the tissue has been
preserved. Animal labs have been a necessary adjunct to medical training, but still do not
give a completely realistic experience.
When learning to drive, no one would suggest that a teenager read the driving manual,
then jump into a car for the first time and merge onto a 6 lane highway during rush hour.
Teenagers have already spent time observing others driving. When it is their turn to get
behind the wheel for the first time, they are taken to a parking lot or some other safe area,
and are allowed to get the feel of the car in a sheltered, protected environment. From
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there, they will progress to side streets, then maybe a highway when there is little traffic.
Only after learning the basics are they ready to learn the advanced skills of handling their
own car while at the same time interacting with the other cars on a crowded road, or
dealing with dangerous conditions like icy roads or thick fog.
Today technology has enabled the medical community (and other professions as well) to
learn in a sheltered, protected environment. Simulated patients are replacing real ones in
the early parts of education. Beginning doctors can now make their most common, most
dangerous, and most preventable mistakes on a simulated patient, where the worst
possible outcome has to restart the program. A technique can be practiced over and over
until the trainee is comfortable with the steps and safeguards.
The proper handling of an emergency condition is very difficult to teach during the actual
emergency. Preparation is essential in the form of lectures and rehearsal. During an
emergency situation, however, there is no time to stop and think about what the next step
should be. The actions and protocols should come naturally; they should be second
nature. An instructor cannot withhold treatment during a code and allow the patient to
deteriorate while he waits for the resident to stop and think through the protocol on his
own, or allow the resident to administer inappropriate treatments just to make a teaching
point. Unless, the patient isn't real. The only way to practice a crisis without endangering
a patient is to learn in a simulated environment.
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Another boon of the simulated environment is the ability to allow every student the
opportunity to see any disease they may encounter in their practice. In the example at the
beginning of this page, the doctor from the 1890's was required to recognize a limited
number of diseases and to know only a handful of operations commonly practiced in his
day. Today's doctor is expected to recognize and treat literally hundreds of conditions,
some of which are rare enough that he may not encounter them during his entire
residency. For those less common illnesses, residents can use simulation to gain
experience, and practicing physicians can use simulation to keep their knowledge and
skills current.
Instead of the old adage "see one, do one, teach one", medical education now has the
option of "see one, practice safely, do one, teach one". After learning from lectures and
observation, residents can practice on a realistic - but not real - patient. When they are
ready to perform the task for the first time on a real patient, they are merely fine tuning
their technique.
Nothing will completely replace learning by interacting with real patients, but the early
learning should take place in a controlled, safe way.
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According to Kneebone R.’s Evaluating clinical simulations for learning
procedural skills: a theory-based approach.
Simulation-based learning is becoming widely established within medical education. It
offers obvious benefits to novices learning invasive procedural skills, especially in a
climate of decreasing clinical exposure. However, simulations are often accepted
uncritically, with undue emphasis being placed on technological sophistication at the
expense of theory-based design. The author proposes four key areas that underpin
simulation-based learning, and summarizes the theoretical grounding for each. These are
(1) gaining technical proficiency (psychomotor skills and learning theory, the importance
of repeated practice and regular reinforcement), (2) the place of expert assistance (a
Vygotskian interpretation of tutor support, where assistance is tailored to each learner's
needs), (3) learning within a professional context (situated learning and contemporary
apprenticeship theory), and (4) the affective component of learning (the effect of emotion
on learning). The author then offers four criteria for critically evaluating new or existing
simulations, based on the theoretical framework outlined above. These are: (1)
Simulations should allow for sustained, deliberate practice within a safe environment,
ensuring that recently-acquired skills are consolidated within a defined curriculum which
assures regular reinforcement; (2) simulations should provide access to expert tutors
when appropriate, ensuring that such support fades when no longer needed; (3)
simulations should map onto real-life clinical experience, ensuring that learning supports
the experience gained within communities of actual practice; and (4) simulation-based
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learning environments should provide a supportive, motivational, and learner-centered
milieu which is conducive to learning.
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INPUT PROCESS/TROUGHPUT OUTPUT
Respondent’s Profile Age Gender Year level
Martial status
Data Bank Updated
Modern skills Laboratory affecting nursing students’ clinical performance describe, in terms of:
Anatomical Model Electronic stimulator Modules for
conducting standardized patient en counter
Describe the effects of modern skills on nursing students clinical performance, in terms of:
Anatomical Model Electronic stimulator Modules for conducting
standardized patient en counter
Describe the effects of modern skills laboratory to nursing students clinical performance.
Modern skills laboratory effects to nursing students clinical performance in terms of:
Anatomical Model Electronic stimulator Modules for
conducting standardized patient en counter
Assess the effects of modern skills laboratory to nursing students clinical performance through:
Anatomical Model Electronic stimulator Modules for conducting
standardized patient en counter
Identify the effects of modern skills laboratory to nursing students’ clinical performance.
Significant relationship between modern skills laboratory to nursing students clinical performance in terms of:
Anatomical Model Electronic stimulator Modules for
conducting standardized patient en counter
Assess the significant relationship of modern skills laboratory to nursing students clinical performance through:
Anatomical Model Electronic stimulator Modules for conducting
standardized patient en counter
Determine the significant relationship of modern skills laboratory to nursing students’ clinical performance.
The extent of effects of modern skills laboratory on nursing students clinical performance in terms of:
Anatomical Model Electronic stimulator Modules for
conducting standardized patient en counter
Assess the extent of effects of modern skills laboratory on nursing students clinical performance through:
Anatomical Model Electronic stimulator Modules for conducting
standardized patient en counter
To determine the extent of effects of modern skills laboratory on nursing students clinical performance.
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Conceptual ParadigmFigure 1
The Input-Process-Output (IPO) Model guides the readers and the researchers to
think systematically which means looking at outputs or key results, and from this
perspective to examine the required inputs and necessary process of through outputs, then
the systematic logic becomes easier logic becomes easier. (Franco) Input-Process-Output
model also known as the IPO Model is a functional model and conceptual schema of a
general system. An IPO chart identifies programs inputs, its output, and the processing
steps required to transform the inputs into the outputs. The IPO model has many
interdisciplinary applications, and is used to convey systems fundamentals in IT overview
education and as a brainstorming, preliminary investigation tool in systems development
processes such as the SDLC. It consists of at least three, and sometimes four, distinct
components. In contemporary Information Technology, it is almost always discussed as a
four component model in which the fourth is a named optional.
The components of the IPO model are defined as:
I: Input - The information, ideas, and resources used
P: Processing - Actions taken upon/using input or stored material
O: Output - Results of the processing that then exit the system
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Based on the data obtained and with the background of the study, the researchers made an
easy and more understandable means of studying the research. Profile of the respondent
in terms of age, gender, year level and marital status we gathered the questionnaires that
will serve as data base.
Modern skills laboratory affecting the nursing students’ clinical performance were
assessed through the use of anatomical models, electronic simulators and modules for
conducting standardized patient encounter the effects of modern skill laboratory to
nursing students’ clinical performance.
Modern skills laboratory effects to the nursing students’ clinical performance was
assessed through the use of anatomical models, electronic simulators and modules for
conducting standardized patient encounter the effects of modern skill laboratory to
nursing students’ clinical performance.
Determine the significant relationship of modern skills laboratory to nursing
students’ clinical performance was determined through the use of anatomical models,
electronic stimulators and modules for conducting standardized patient encounter and
identify the significant relationship of modern skill laboratory in nursing students’
clinical performance.
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The extent of the
effects of the modern skills laboratory to nursing student’s clinical performance will be
asses through the use of anatomical models, electronic stimulators and modules for
conducting standardized patient encounter and find out the extent of the effects of
modern skill laboratory in nursing student clinical performance.
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Hypothesis
There is no significant relationship between modern skills laboratory to nursing student
clinical performance in terms of anatomical model, electronic stimulator, and modules for
conducting standardized patient encounter.
Definition of Terms
In order to facilitate better understanding of the problem and avoid ambiguous
meaning to items that can be otherwise interpreted in different ways, the following terms
are used in the study and operationally defined.
Modern Skills Laboratory: Environment for practicing and demonstrating nursing skills
electronic teaching aids such as computers, mannequins, models and other equipment
provide a non-threatening, hands-on learning environment for skill acquisition.
Clinical Performance: refers to the application of learned skills by nursing student in the
clinical area
Anatomical Model: comprehensive guide to anatomy and physiology of the human body
can be aided by practical experience examining histological preparations with practical
experience.
Electronic Stimulator: electronic devices use in hospital
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Modules for conducting standardized patient en counter: methods of preparing
students for high-stakes standardized patient examinations . Purposes: The purpose is to
compare the impact of two formats of a formative SP examination (Web-based vs. in-
person) on scores on a subsequent high-stakes SP examination and to compare students'
satisfaction with each formative examination format.
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Chapter II
Review of Related Literature and Study
This chapter reviewed different literature and studies on the effects of modern
skills laboratory to nursing students’ clinical performance which were taken from local
and foreign sources. The literature and studies were reviewed to provide a clearest
perception of the problem in the study.
Foreign Literature
The Clinical Performance & Simulation Laboratory provides a supportive environment
for students to learn and master nursing skills. Our philosophy of auto-tutorial learning
fosters the development of critical thinking. The laboratory accommodates students by
providing unscheduled time for both skills practice and patient-specific preparation.
Scheduled time is available for physical assessment classes and clinical groups.
The laboratory is staffed with two full time, three part time, and supplemental preceptors.
All preceptors must have a BSN and clinical experience working as Registered Nurses.
The five current preceptors have over 100 cumulative years as RNs. The role of the
preceptor is to support student learning by assisting the students with skills practice and
developing critical thinking. Preceptors do not have responsibility for formal evaluation
of student performance. Behind the scenes the preceptors stay very busy maintaining
equipment and updating the skills modules.
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Skills Modules have been developed for essential basic as well as advanced nursing
skills. They prepare students for practice in the lab by guiding them through each skill
using objectives and learning activities such as reading, videos, and Computer Assisted
Instruction. All modules are evidence based and are reviewed and updated biannually to
reflect changes in nursing practice and research.
The Clinical Performance and Simulation Laboratory have a wealth of resources and
equipment to enhance both student learning and student teaching projects. Equipment
includes items such as: simulators, life-size manikins, models, and site-specific I.V.
pumps and set-ups. Nursing texts, pamphlets, and posters, as well as policy and
procedure manuals for the major clinical sites are maintained within the laboratory.
Resources and equipment are available to use within the laboratory and also may be
checked out during regular academic year semesters. Materials are available to students
enrolled at all WSU campuses. Faculties are provided with resources to support clinical
and classroom instruction.
Clinical Learning Experience of nursing students, the Board of Registered Nursing is
statutorily authorized to interpret, implement, and enforce the
Nursing Practice Act and its regulations. Business and Professions Code § Section 2729
statutorily authorizes that nursing services may be rendered by a student nurse when
these services are incidental to the course of study when the nursing student is enrolled in
a board-approved nursing program.
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BRN Position: Nursing faculty of a California board approved nursing program is
authorized by the above law to initiate and continue to allow nursing student’s clinical
education functions including administration of medication. The role of the nursing
faculty is to provide direct and indirect supervision of nursing students in all clinical
activities. The Board of Registered Nursing has relied on Business and Professions Code
Section 2729 and does not consider nursing students as unlicensed assistive personnel for
the purpose of clinical nursing education.
Faculty determines the amount of supervision to provide to any individual nursing
student. When
determining the appropriate level of supervision, faculty must consider the severity and
stability of the assigned patient, the patient’s condition, as well as the student’s
competency and ability to adapt to changing situations in the clinical setting. Faculty
should also consider the types of treatments, procedures, and medications to be
administered to the patient. When engaged in clinical learning experiences the nursing
student is under the supervision of the clinical faculty and the RN in the facility. Both the
clinical faculty and the RN in the clinical facility are responsible for the quality of care
delivered by students under their supervision.
Expanding clinical technology such as electronic medical records, medication distribution
systems, and bar-coding electronic medication administration processes require faculty
and nursing students to attend training sessions allowing them to gain the knowledge
necessary to use these systems. The board expects nursing faculty to ensure that the
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learning experiences chosen provide the student with the opportunity to develop those
skills necessary to ensure that they will become safe, competent practitioners. Since these
technologies are here today and will be a future part of healthcare delivery, faculty and
nursing students must have hands on experiences with these systems while learning to
provide registered nursing care to patients.
Evaluating nursing clinical performance, the formative and summative evaluation.
When determining the types of information and forms used to complete student clinical
evaluations, it is important to differentiate between evaluative information that permit
additional student growth and evaluation at the end point when no further opportunities
for learning are available.
Clinical evaluation serves two purposes: formative and summative. Through evaluation
the teacher monitors student’s progress toward meeting the clinical objectives and
demonstrating competency in clinical practice. Formative evaluation provides
information about learning needs of students and where additional clinical instruction is
needed. Clinical evaluation that is formative is not intended for grading purposes; instead
it is designed to diagnose learning needs as a basis for further instruction.
Summative evaluation, in contrast, takes place at the end of the learning process to
ascertain if the objectives have been achieved and competencies developed. Summative
evaluation is the basis for determining grades in clinical practice. (Gaberson and
Oermann, 2006.)
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You will provide formative evaluation both informally and formally. The reassuring
thumbs up after a student’s first injection communicating success is informal formative
evaluation. In the same manner if the student was unable to identify correct anatomical
landmarks, needed reminding to don gloves and not to recap the needle after injecting
medication, then a formal written formative evaluation is required. You will need to
determine the appropriate form used by your program to give written feedback. Some
programs use conference summaries or critical incidents forms.
In cases of clinical skills deficiency the most effective formative evaluation would
include feedback on the skill deficiency and a referral to the nursing skills lab to practice.
As part of the formative evaluation at a future clinical experience for the student
mentioned above you would want to verify that the student had improved the injection
skill by providing another opportunity for the student to demonstrate competency. This
would be particularly important in this example if using correct technique is a mandatory
aspect of safe medication administration that must be mastered by the time of the
summative evaluation to pass clinical.
Self directed learning, both faculty and student share responsibility in promoting clinical
growth. Holding students accountable for their own learning coupled with your providing
those opportunities to master skills, apply knowledge and use critical thinking will
enhance a respectful and trusting learning partnership. In addition students will develop
life long learning strategies, a career necessity,
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Obermann and Gaberson (2005) identify that the ultimate goal is for students to progress
to a point at which they judge their own performance, identify resources for their learning
and use those resources to develop competency further.
Student aptitude for self directed learning progresses both through individual rotations
and throughout the entire program. As a new clinical faculty member initially you will
most likely feel more comfortable planning the learning environment especially in the
beginning semesters. Some programs have students record skills acquisitions, to share
with clinical faculty, to encourage assigning patients and learning skills to meet student
needs.
Feedback, students are much more accepting of feedback when they are given specific
criteria that must be improved, suggestions for making the improvement, and another
opportunity to show mastery. Give your feedback, as close to the incident as possible to
permit discussion while the event is fresh in both your and the student’s memory. Be
open to the student assessment and rationale of their behavior. A student that you are
identifying as needing time management skills for inability to complete her assignment
may self identify the need for assertiveness training in gaining patient or staff cooperation
to complete her assignment.
Fairness, students receiving your feedback will demand fairness. If you refer one student
with poor injection technique to the skills lab is sure to refer all students with similar
deficiencies. You’re being discreet and confidential when giving students negative
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feedback will not prevent students from sharing every detail of their clinical
shortcomings with each other. Clinical failure is dreaded and causes students very high
anxiety. Students are very curious to know how other students performances compare to
their own, especially if a given students may be experiencing difficulty in mastering
skills. Student competition is frequently higher when clinical is evaluated with letter or
numerical grades.
In a discussion on competition in nursing school (Dunham, 2007) one student relates that
“there was competition over who had/has the easiest/hardest patient. Some were
extremely jealous if one person got to do a ton of skills in clinical while others didn’t.”
It is extremely important that you do not participate in student comparisons; you must
protect the confidentiality of students with clinical deficits and remind peers who are
inquisitive to focus on their own individual practice. Do not discuss, corroborate, or
correct any information about one student’s performance with another student. Focus on
fairness in making the assignments and the amount of supervision you provide. Even
when you have concerns about one student’s ability to provide safe care maintain a
balance of your time with all students. Providing more supervision of a weaker student is
differential treatment.
Norm-referenced and criterion-referenced evaluation, the discussion of comparison of
students lends itself to the mentioning at this point to two other types of evaluations;
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norm-referenced evaluation and criterion-referenced evaluation. Norm referenced
evaluation compares and ranks a student’s performance with that of the others in the
group. This is not desired in the clinical setting as all students ideally could meet
outcomes. Criterion-referenced evaluation is based on performance standards that are
predetermined and shared with all students and evaluators; it minimizes comparisons
among students.
A further concern in using norm referenced evaluation beyond unfairness and
competition is that once a student starts demonstrating success in the clinical areas there
is a tendency to assign him/her the more challenging learning experiences than the
student showing less skill and judgment. This process can lend itself to your not
challenging the weaker students who need your vote of confidence and the opportunity to
grow. Furthermore when it’s time to complete the summative evaluation you may not
have enough information to clearly establish whether or not they have met outcomes for
the end of the rotation. The unfortunate outcome is that you will by default promote them
to a higher level of student practice, not having challenged them to prove their ability and
aptitude or to remediate their identified weaknesses. Students develop skills at different
rates so part of your responsibility is to keep abreast of each student’s progress and
provide opportunities for all students to continue on the learning trajectory.
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Students do need to receive positive feedback on the behaviors that meet desired
outcomes so that they will continue to be developed and enhanced. Students with ability
and aptitude require challenges, just not all the challenges.
Failures, the need to fail a student who has not met outcomes can lead the instructor to
feelings of failure. As a new faculty member myself I had been working with a student
who was very unsuccessful in all aspects of clinical practice. She was consistently
disorganized, omitting care that compromised patient safety. She did not seek assistance
and was not honest about admitting her omissions. I felt that I just hadn’t found the right
patients for her to achieve; I struggled and continued to provide her new opportunities.
When I sought out my course leader for direction, she asked me if I would be
comfortable having this student provide care for my mother. I honestly had to say no. Her
answer was that it was my responsibility to remove the opportunity for her to
irresponsibly omit care for any one else’s mother. Only then did I put aside my feelings
of failure and addressed the student's performance in terms of patient safety and course
outcomes. From that perspective it was clearly evident that the failure belonged to the
student not me.
Clinical failure can be a less stressful process if there is a clear written record of your
providing feedback, suggesting remediation, providing new opportunities, and clarifying
that the student’s performance still does not meet the set standards. Failing nursing
students sometimes initiate grievance procedures, because many students want to blame
32
the instructor rather than accept responsibility for their shortcomings; in their perception
a career has been thwarted, a dream has been squelched. In the similar manner, students
who have had difficulty accepting responsibility for their actions in clinical practice,
continue to not accept the failure as a consequence of their behavior. Grievance proceeds
in the favor of the faculty when there is clear indication that due process has been
followed and the student has received notice of the unsatisfactory performance in a
timely manner. Review both the department and your college’s policies on student
grievances.
With this discussion on formative, summative, norm-referenced and criterion-referenced
evaluation, you can see why you need to get all the answers to your questions prior to the
start of the rotation. To recap, you need to know the level of performance and rating scale
and have frequent team caucus to be consistent with the team, use criterion-referenced
evaluation, and employ fairness. You need to know what evaluation tools are use to
insure that you give notice to deficient students, You need to know the student’s
familiarity with the evaluation and remediation process so that they can actively
participate in their learning And finally you need to know the evaluation intervals so you
can provide timely opportunities to remediate when possible.
The development of a clinical learning environment scale, within nursing, there is a
strong demand for high-quality, cost-effective clinical education experiences that
facilitate student learning in the clinical setting. The clinical learning environment (CLE)
33
is the interactive network of forces within the clinical setting that influence the students'
clinical learning outcomes. The identification of factors that characterize CLE could lead
to strategies that foster the factors most predictive of desirable student learning outcomes
and ameliorate those which may have a negative impact on student outcomes. The CLE
scale is a 23-item instrument with five subscales: staff-student relationships, nurse
manager commitment, patient relationships, interpersonal relationships, and student
satisfaction. These factors have strong substantive face validity and construct validity, as
determined by confirmatory factor analysis. Reliability coefficients range from high
(0.85) to marginal (0.63). The CLE scale provides the educator with a valid and reliable
instrument to evaluate affectively relevant factors in the CLE, direct resources to areas
where improvement may be required, and nurture those areas functioning well. It will
assist in the application of resources in a cost-effective, efficient, productive manner, and
will ensure that the clinical learning experience offers the nursing student the best
possible learning outcomes.
Assessing the Clinical Skills Performance of Nursing Students
This records the development of assessment criteria for the clinical skills performance by
pre-registration nursing students within a problem-based learning curriculum.
Questionnaires allowed informally established provisional criteria to be exposed to
students, practitioners and lecturers from all branches. Any opinions given and
suggestions made by the participants were taken into account and the improved set of
criteria was discussed in branch-specific focus groups, thus further enhancing them. A
34
pilot study with a group of children's nursing students and their supervisors was set up to
test the assessment criteria in practice. The students' skills performances were assessed by
their supervisors as well as by themselves. Interviews with all participants tested the
accuracy of the criteria, most of which were supported by the data. The improved criteria
are used as part of the summative assessment of practice within a problem-based nursing
curriculum.
Critical elements are the required and essential abilities that an individual must
effectively demonstrate as an Excelsior College Associate Degree nursing student taking
the Clinical Performance Nursing Examination (CPNE®).
Excelsior College School of Nursing is committed to providing educational opportunities
to students with disabilities and is in compliance with the Americans with Disabilities
Act of 1990 and Section 504 of the Rehabilitation Act of 1973. The College provides
reasonable accommodations based on the specifics of each case.
The CPNE tests a student's application of the nursing process and technical components
for nursing practice in the care of adults and children in the acute care setting. Therefore
the nursing student must be able to perform the following:
Assess, perceive and understand the condition of assigned patients;
See, hear, smell, touch and detect subtle changes in colors;
35
Communicate (both verbally and in writing) with English speaking patients and/or
family members/significant others as well as members of the health care team,
including nurses, physicians, support staff and faculty;
Read and understand documents written in English;
Perform diagnostic and therapeutic functions necessary for the provision of
general care and emergency treatment to the hospital patient
Stand, sit, move and tolerate the required physical exertion necessary to meet the
demands of providing safe clinical care;
Solve problems involving measurement, calculation, reasoning, analysis and
synthesis; and
Perform nursing skills in the face of stressful conditions, exposure to infectious agents
and blood-borne pathogens.
Critical elements are the required and essential abilities that an individual must
effectively demonstrate as an Excelsior College Associate Degree nursing student taking
the Clinical Performance Nursing Examination (CPNE®).
Excelsior College School of Nursing is committed to providing educational opportunities
to students with disabilities and is in compliance with the Americans with Disabilities
36
Act of 1990 and Section 504 of the Rehabilitation Act of 1973. The College provides
reasonable accommodations based on the specifics of each case.
The CPNE tests a student's application of the nursing process and technical components
for nursing practice in the care of adults and children in the acute care setting. Therefore
the nursing student must be able to perform the following:
Assess, perceive and understand the condition of assigned patients;
See, hear, smell, touch and detect subtle changes in colors;
Communicate (both verbally and in writing) with English speaking patients and/or
family members/significant others as well as members of the health care team,
including nurses, physicians, support staff and faculty;
Read and understand documents written in English;
Perform diagnostic and therapeutic functions necessary for the provision of
general care and emergency treatment to the hospital patient
Stand, sit, move and tolerate the required physical exertion necessary to meet the
demands of providing safe clinical care;
Solve problems involving measurement, calculation, reasoning, analysis and
synthesis; and
37
Perform nursing skills in the face of stressful conditions, exposure to infectious agents
and blood-borne pathogens.
According to VREL), published by East Carolina University Modern
equipments in the laboratories in the schools is a peer reviewed publication of the Virtual
Laboratory and Education Laboratory (VREL), published by East Carolina University.
Virtual Review in her schools addresses issues of incorporating virtual reality into the
education system of new modern equipments in the laboratories. It can be graphics based
(e.g., a walk through the building) or text based (e.g. a description of activity where
participants can interact with one another.
Modern Laboratories in the schools is published by the Education Laboratory
(VREL) in the College of Education at East Carolina University.. World wide web
provides the fastest dissemination of information which is necessary in the field of
Modern Equipments due to the subjects rapidly changing technology. The Virtual Reality
and Education Laboratory at East Carolina University is dedicated to finding ways to
study the implications of Virtual Reality and Education Lab. at East Carolina in 2006.
The current co-directors are Dr. Pantelids & Mr. David Vinciguerra.
According to College of Nursing at South University 2005 to graduate competent
nurses who are able to offer primary health care in the hospital, community as well as
38
secondary and tertiary care in any community all over the world. Since its establishment
in 2005, the school has been putting heavy emphasis on ethical considerations and
mastery of basic clinical skills which constitute an important component of clinical
competence. The basic clinical skills refer to those practical skills that are necessary in
encounters with patients; these skills are ranging from history taking to examining
different body systems and performing some procedures which should be mastered by
any physician.
Dr. Luanne Linnard-Palmer, chair of Dominican’s Department of Nursing. The
curriculum is characterized by exposing the students, from the very early beginning of
their attachment to the school, to patients gradually through the different educational
years. This is done in a suitable environment which avoids the doctor/patient contact
being used for initial practice. This suitable environment is the clinical skills lab.
The training in the clinical skills lab is not meant to be a substitute of clinical training
with real patients, but rather a preparatory step to it, so that the students become in a
much better shape as they start their training with patients.
The clinical skills lab started its activities in 2005; it was the first skills lab which has
been established in Egypt at that time. The objectives of lab are:
Standardized training and evaluation of basic clinical skills; using the same tools
for all the students.
39
Promotion of the humanistic attitudes in students approach to the patients.
The students are not allowed to examine any patient except after successful performance
of examinations on their peers and/or models.
Integration of the clinical training into the curriculum Training in Integration of
the clinical training into the curriculum is to serve the two main educational strategies of
the College, which are the community-based education and the problem-based learning.
The link of the clinical skills with either strategy varies according to the educational
phase.
In phase I (pre-pathogenesis), the educational problems are organized into blocks which
address sequential phases of human development from pre-natal life to senescence. In
their community-based activities in the primary health care centers, students examine
patients of the same phase of life as in the problems in their blocks. They have to perform
certain clinical skills for each age group such as examination of visual acuity for school
children, measuring pulse and blood pressure of the aged subjects, etc. In the skills lab,
they are trained to perform these skills, using the standard checklists, before practicing on
real patients.
In phase II (pathogenesis), the educational problems are grouped around diseases of the
body systems and those problems form the core around which most other activities are
organized. During this phase, medical problems are utilized to motivate the students to
learn mainly basic medical sciences in addition to clinical sciences. At this level, students
are not requested to make diagnosis or to discuss management plans; instead, they are
40
supposed to be able to explain underlying basic mechanisms of the symptoms and signs
of various diseases. Thus, the skills on which students are trained, in the skills lab, are
intimately related to the problems they take in their small-group classes. For example,
they are trained on the clinical examination of the heart during the block of
cardiovascular problems.
In phase III (clerkship), students learn clinical interventional skills e.g. wound suturing,
urinary catheterization, in order to be more confident and less liable to commit accidental
mistakes as they practice such skills on the patients in the clerkship. The simulation lab,
will allow students to respond in real time to patient situations, said Dr. Luanne Linnard-
Palmer, chair of Dominican’s Department of Nursing.
“This simulation lab, with two programmable mannequins, will put Dominican in the
forefront of nursing education today by providing our students with the real-world
clinical experience they need to transition quickly into the role of an independently
functioning caregiver,” said Linnard-Palmer. “Simulation eliminates the serious risks
inherent in practicing health care skills on live patients and creates a stress-free learning
environment that incorporates practice and reflective learning.”
Two computer-controlled mannequins — an infant and an adult — are the main
simulation tools. The mannequins can be programmed to simulate common medical
conditions such as croup or asthma or more critical conditions like cardiac arrest or
grand mal seizure. If the mannequin is experiencing a grand mal seizure, for example,
the virtual patient will turn blue from lack of oxygen; the vital signs will change and can
41
show a stress response through impending cardiac arrest or septic shock. The student has
only minutes to respond to changes in heart rate, blood pressure, and breathing. A two-
way walkie-talkie in the mannequin enables the teacher — located in a nearby control
center—to serve as the voice of the mannequin so that the virtual patient can describe
symptoms and discomfort. These simulated scenarios will give nursing students the
opportunity to learn correct interventions in a risk-free environment. Errors can be
allowed to occur and play out, providing students with information and feedback about
their individual performance and work as a team. While the mannequins come with pre-
set scenarios, Dominican’s nursing faculty currently are working on creating specialized
scenarios, many of which incorporate psychological components. For example, Linnard-
Palmer, who still practices as a pediatric oncology nurse, has created a three-step
scenario for an infant with leukemia. In the first scenario, the nursing student not only
must recognize the symptoms of leukemia, but also must be able to provide emotional
support to the parents of the newly diagnosed patient the walkie-talkie in the pediatric
mannequin will be linked to a ‘parent.’ In the second scenario, the mannequin is
undergoing intensive chemotherapy and the student must recognize and treat the
complications of chemotherapy. In the third scenario, the child has ended a year-long
course of treatment and the nursing student is providing instructions to the parents while
discharging the patient.
Each mannequin will come equipped with a laptop computer for programming medical
42
scenarios, and monitors for tracking the results of the medical interventions undertaken
by the students. The lab will also include a video system for documenting classroom
training, student testing, and for immediate feedback via group debriefing of cognitive,
behavioral, and affective skills.
The Skills Lab is equipped with numerous anatomical models. The models are accessible
to the students at all times and they are used extensively during individual and group
study sessions or tutorial sessions
Classes are taught in a safe, non-threatening and friendly environment. One of the
best ways to learn is by discussion and debate. The lab provides a comfortable
atmosphere for students to talk with peers and more experienced practitioners about
issues and dilemmas in patient care.
The Nursing Skills Lab houses a variety of equipment and supplies to assist
students in learning and mastering nursing skills and knowledge. Students are
encouraged to use instruments to practice physical examination (blood pressure cuffs,
stethoscopes, ophthalmoscopes, tuning forks etc), mannequins to practice psychomotor
skills examinations of the ear, eye, breast, prostate, pelvis; dressing changes, urinary
catheter insertions, enema administration, injection pads etc), videotapes, CD-ROMs and
other media, journals, reference materials. Sim Man and Vital Sim are computerized
mannequins used for various adult health.
Practice: The Nursing Skills Lab is a place for students to practice beginning and
advanced nursing skills while supervised by instructors and the skills lab staff or other
43
students. Although the lab is coordinated by an experienced registered nurse, the
Department hires student assistants to assist with instruction and skill validation.
Use multi-media: While at the lab, students can view videotapes, computerized clinical
simulation, and other multi-media that have been assigned or recommended by faculty.
This can be done alone or in small groups.
Competency verification of clinical skills: Students are required to have their competency
in performing certain skills validated. Students first receive instruction in the skill by
their instructor. Students can practice the skill at the lab. Appointment times are listed
on the bulletin board, Skills Lab windows and at the nursing office front desk. Students
are asked to call if they are unable to keep their scheduled appointment.
Supervised Tutoring: Many students take advantage of tutoring that is available by the
Project Manager: Nursing Skills Lab. Flyers are posted with dates and times of tutorial
sessions.
Camaraderie: One of the best ways to learn is by discussion and debate. The lab
provides a comfortable atmosphere for students to talk with peers and more experienced
students about issues and dilemmas in patient care.
The laboratory's centerpiece is a Human Patient Simulator (HPS) developed by
Medical Education Technologies, Inc. The simulator is life-sized and fully interactive.
Cardiovascular features of the HPS include palpable radial and carotid artery pulsations,
44
heart sounds (normal and abnormal), 5-lead electrocardiogram, noninvasive blood
pressure measurements, direct arterial blood pressure, central venous pressure, pulmonary
artery pressure, pulmonary artery occlusion (wedge) pressure, and thermo dilution
cardiac output. All measurements are made using standard monitoring instruments.
Other clinical features include breath sounds, and physiological and pharmacological
models which direct simulated patient responses to drugs, mechanical ventilation, and
other therapies. Virtually all simulator responses are automatic and dynamically
determined by sophisticated physiological and pharmacological models.
The HPS allows us to train students to manage emergencies in a safe, controlled, and
replicable environment. It can be used to expose students to circumstances which they
may see only rarely in the operating room, yet which require immediate and correct
intervention. The simulator is also currently being used to teach such varied subjects as
physiology, pathophysiology, pharmacology, and basic and advanced anesthesia
techniques. It is the first simulator in the United States which is owned by a School of
Nursing.
In addition to the Human Patient Simulator, the Simulation Laboratory contains a variety
of virtual reality and computer-assisted learning resources, as well as texts and journals
related to anesthesia practice.
The Nursing Multimedia Center (NMC) faculty and staff provide supportive
services to departmental faculties and students in the educational components of the
45
curriculum. The NMC faculty assists in providing limited guidance and instruction for
students as they progress with assignments in the NMC. In addition, the NMC faculty
serves as a resource for both faculties and students, and acts as a liaison between the
NMC and individual courses in the curriculum. With input from the School of Nursing
Curriculum Committee, the NMC faculty identifies resources appropriate to support and
enhance the curriculum, and meet specified outcomes for students.
Integral to the functioning of the center, staff provides assistance in locating and using
learning materials and equipment in the NMC. Staff assists in maintaining learning
equipment and supplies, and assembles needed resources in setting-up lab experiences. In
addition, staff also grades and posts tests, and maintains a test file record on each student.
Both faculty and staff provide a formal orientation to the use of the NMC for new
students in the School of Nursing.
The faculty and staff work collaboratively with departmental faculties and administration
to provide coordinated efforts in meeting learning needs of students in the NMC. New
technology and learning materials are identified and brought to the attention of all
faculties as a result of monitoring and previewing media. Faculties participate in the
selection process of learning materials for purchase and use in the NMC.
The Computer Support Staff assists students with the utilization and troubleshooting of
assigned computer based support instruction/software, as well as other resources
available to students on computers located in the NMC. She also works with the School
of Nursing Computer Support personnel on hardware troubleshooting and updates.
46
At the University of Hawaii at Manoa, students at the SONDH utilize a simulation
laboratory to learn basic patient care as well as gain exposure to critical care situations.
Through computerized simulation, a mannequin man and baby can reproduce health
situations and medical conditions such as: cardio arrest, respiratory disorders and internal
maladies. "SimMan" and "SimBaby" can simulate up to 2000 different medical
conditions as well as moans and cries. The use of clinical simulations as an active
learning strategy enhances the students' ability to engage in exploration, inquiry, critical
thinking, reasoning and decision making without jeopardizing client safety.
Students' ability to engage in critical thinking is enhanced
The students' ability to respond appropriately in an emergency situation is
improved
Valuable clinical time is more efficiently utilized with the use of simulations as
teaching tool
Simulations allow students to work through realistic patient problems and allow
them to make mistakes, learn and be evaluated without exposing a real patient to
risk
The nursing program had previously received a federal grant for the “Sim/Man”
mannequins but space for the virtual lab has been an issue. The college is now scrambling
to find an appropriate space to locate the lab. The equipment is mobile and can be moved
when the college is finally able to build its planned Allied Health and Sciences building.
47
, Nursing Director Kathy researcher and practitioners Wells said. The college is limited
to the number of students it can accept into the nursing program because CWC is “maxed
out” on its clinical hours at regional health care facilities. With the virtual lab, clinical
time in the hospitals can be reduced. Last year alone, CWC had to turn away 100
qualified applicants to the nursing program. Wells is most excited about giving students
the flexibility of dealing with particular illnesses or traumas at the time they are being
taught as the simulators will respond like a real patient and can be programmed to suffer
any medical malady.
If a student reacts properly to the signals of the simulated patient, its vital signs
improve. If the nursing student responds incorrectly, “it will go downhill,” Wells
explained. The program’s graduates will be much more marketable to hospitals and other
acute care facilities when employers know they have been trained to deal with trauma and
illnesses not normally seen at rural clinic sites, she added.
“We can expose students to things that typically would only be seen in large urban
hospitals,” said Vice President for Academic Services J.D. Rottweiler. “We can simulate
things rural nurses may not see during their entire career.”
48
The “Sim/Man” mannequins provide a sampling of various medical
emergencies in which our nurses need training. “The simulation lab will present these
symptoms and train our nurses to immediately recognize and provide needed assistance;
thus saving lives,” he said
The Virtual Medical Skills Lab in California (2008) can also be used by
practicing health care professionals for continuing education and refresher courses that
are required by law “Instead of sending doctors and nurses away for continuing medical
education, the lab will allow them to get it locally,” Rottweiler added.
The simulated mannequins can be programmed to produce any medical condition.
The nursing faculty will have the recipes for all bodily fluids so that students can learn to
test, for example, urine with high and low Ph levels. The new appropriation allows the
college to purchase simulated mannequins for different stages in life, from infants to
elderly. The dummies can even deliver babies in the breech position. Two nursing
faculty, as well as the nursing director, will attend training in Texas this summer to learn
moderate and advanced operational applications of the equipment. In an effort to give
nursing and medical students more hands-on experience in a safe setting, hospitals and
colleges throughout the country are increasingly training with high-tech mannequins
49
which can, among other things, bleed, sweat and have a pulse. (By CityTownInfo.com
Staff)
According to Leo Manor the University of Phoenix unveiled its brand-new
immersive learning nursing center which features mannequins that cry, talk, cough and
breathe. The school invested more than $400,000 to renovate and equip the facility,
which will be used in its nursing degree programs.
University of Phoenix's immersive learning environment different is that our
nursing students are putting both their clinical and critical thinking skills to work," noted
Pam Fuller, dean of the school's College of Nursing, who was quoted by Reuters. "In
short, they are assessing a patient's condition, prioritizing their responsibilities and
actions, communicating what needs to be done, and then acting on the conclusions they
draw from the situation at hand."
Officials at the Brooklyn Hospital Center in New York, which recently opened a new
Simulation Center for its residency training program, said that the new technology allows
students to learn procedures such as inserting a central venous catheter line or performing
laparoscopic surgery.
"The technology used in the Simulation Center is changing the face of medical
education," said Dr. Benson Yeh, the hospital's chief academic officer, who was quoted
in the Brooklyn Daily Eagle. "Nearly all residency-level education used to take place in a
traditional hospital setting. By creating a 'virtual' patient in a virtual clinical setting, we
50
can provide residents and nurses with real-life scenarios and give them hands-on
experience with procedures, laparoscopic techniques and cardiac arrest."
Foreign Study
According to John L.P, 2003, this study compliments Health Resources Services Virtual
Medical Skills Lab and the use of sophisticated mannequins which can replicate any type
of illness or medical disorder that a student or practicing nurse in a rural setting may not
normally encounter.
While the virtual medical skills lab enhances a all the student’s clinical experience, it
may also make it possible to expand the number well qualified student nurses basic skills.
this study also give the students the flexibility of dealing with particular illnesses or
traumas at the time they are being taught as the simulators will respond like a real patient
and can be programmed to suffer any medical malady.
If a student reacts properly to the signals of the simulated patient, its vital signs improve.
If the nursing student responds incorrectly, “it will go downhill,”
“We can expose students to things that typically would only be seen in large urban
hospitals, “said John L. P.. “We can simulate things rural nurses may not see during their
entire career.”
51
The “Sim/Man” mannequins provide a sampling of various medical emergencies in
which our nurses need training. “The simulation lab will present these symptoms and
train our nurses to immediately recognize and provide needed assistance; thus saving
lives,” he said.
The Virtual Medical Skills Lab can also be used by practicing health care professionals
for continuing education and refresher courses that are required by law. “Instead of
sending doctors and nurses away for continuing medical education, the lab will allow
them to get it locally,”
The simulated mannequins can be programmed to produce any medical condition. The
nursing faculty will have the recipes for all bodily fluids so that students can learn to test,
for example, urine with high and low Ph levels.
The new appropriation allows the college to purchase simulated mannequins for different
stages in life, from infants to elderly. The dummies can even deliver babies in the breech
position.
According to Louie M, virtual lab simulation, 2005, simulation labs will provide almost
all nursing students with clinical experience in a risk-free virtual reality environment. The
simulation lab allows students the opportunity to respond in real time to patient
situations. It also promotes appropriate, timely decision-making in a safe, repeatable
52
environment. The goal is accuracy and competency of skills before the student enters the
clinical environment.
Each simulation lab has multiple programmable mannequins, including SimMan*, a
computer based programmable human patient simulator. This study has put forefront of
nursing education today by providing student nurses with the real-world clinical
experience they need to transition quickly into the role of an independently functioning
caregiver. By providing simulation, it eliminates the serious risks inherent in practicing
health care skills on live patients and creates a stress-free learning environment that
incorporates practice and reflective learning.
State-of-the-art clinical simulation equipment allows practice of nursing skills in a
realistic clinical environment. Having a full spectrum of simulation equipment from task
trainers to virtual skill simulators allows critical thinking practice for a wide range of
conditions. Scenarios can range anywhere from common medical conditions such as
croup or asthma to more critical conditions like cardiac arrest or grand mal seizure.
These simulated scenarios will give nursing students the opportunity to learn correct
interventions in a risk-free environment. Errors can be allowed to occur and play out,
providing students with information and feedback about their individual performance and
work as a team.
Each of the mannequins comes equipped with a laptop computer for programming
medical scenarios, and monitors for tracking the results of the medical interventions
undertaken by the students. The labs also include an IT system for documenting
53
classroom training, student testing, and for immediate feedback via group debriefing of
cognitive, behavioral, and affective skills.
This study may served as a model to all nursing schools to enhance the skills, knowledge
and experienced of their students in the most realistic way.
According to the Relevance of Nursing skills laboratory a study by Dominican
Laboratory, 2006 this study will served as a significant learning resource environment all
the students to practice independently, peer-to-peer, faculty-to-student, or with a skills lab
assistant. The Lab provides an atmosphere to learn and begin to transfer nursing skills to
the “real world” clinical setting.
The learning of nursing skills in a laboratory is an essential part of the curriculum. It is
here that students are introduced to skills, concepts and procedures that they then take
into their clinical settings. Prior to caring for patients, students get to practice in the lab
first where they become familiar and safe with nursing care before caring for patients in
the hospital or community setting. Students come to the Nursing Skills lab to practice
basic and advanced nursing skills during faculty supervised classes/demonstrations and
independent practice time. This study included the use 6 patient beds with functional
head walls units that are equipped with suction and “oxygen” which is actually just air for
manikins. Practice ranges from simple bed making to advanced skills that would be used
in an intensive care setting.
54
In addition to practicing Nursing Skills in the lab, students often come in to work on the
computers or to watch videos that augment the information in their text. The Nursing
Skills Lab is a Smart Classroom equipped with internet access to projected display.
Instructors and students alike can project their classroom materials via PowerPoint or
locate information on the internet to be projected and used in class. There must be always
a Nursing Skills instructor or a qualified and trained professors to help students with any
skills, math or general nursing knowledge. Nursing Students find the Nursing Skills Lab
a welcome place to gather and to study.
According to the study of Dr. Benjamin Dart,2009 a Medical Director for the Clinical
Skills and Simulation Center.
One of the unique elements of a medical field courses is a state-of-the-art Clinical Skills
and Simulation Center that houses both a surgical skills lab and a human patient
simulation lab. Both sections of this center provide an innovative and progressive facility
with stimulating educational experience in a multidisciplinary learning environment in
which residents, practicing physicians, and allied health professionals can train and learn
to provide better patient care
"It is good to have this vital educational element available to all students, residents, and
practicing staff at our institution," according to Dr. R. Phillip Burns, Professor and Chair
of the Department of Surgery and original Medical Director for the Medical Surgical
Skills Laboratory. "Skills training have become more and more frequently required by
55
credentialing agencies such as the Residency Review Committee as an important part of
medical education."
This study emphasized that all skills lab need a two state-of-the-art operating rooms (up
to 12 beds), micro-surgery rooms and anatomical study room, and a classroom. Residents
and practicing physicians are supervised in the acquisition of new skills and the practice
of new medical techniques, including those involved with orthopedic surgery and
arthroscopy, anatomical study, surgical skills practice, microsurgery, and vascular
procedures.
The Skills Lab facilities must enabled professors to teach new techniques and procedures
including specialized courses such as Advanced Trauma Life Support, Pediatric
Advanced Life Support, Laparoscopic Cholescystectomy, and GYN Laparoscopy Lasers.
The adjoining high-fidelity, human patient simulation lab is used to teach skills to all
health care professionals and students in a team environment. This study will help
medical students, residents, faculty, nurses, paramedics, physician assistants, and other
allied health personnel to work in an interdisciplinary patient environment to
improve patient care skills.
Further studies have shown that simulation can be used to reliably measure and
demonstrate resident competencies in acute care management. A simulation lab can take
the form of a trauma bay, operating room, intensive care unit, emergency department, or
56
a micro-surgery room. The accompanying classroom has audio visual equipment with
computer-controlled cameras, and state-of-the-art multimedia features.
The traditional method of bedside training does not give students as genuine an
experience as working with virtual, although tangible, patients. The Simulation Lab
utilizes a novel approach to education where not only medical care is taught, but an
environment is created where interpersonal, teamwork, and patient-safety skills can be
demonstrated and tested.
According to the study of Canterbury Christ Church University (2006) the
modern skills laboratory most practice related teaching was carried out in actual clinical
settings with patients used as the main teaching aids. This was not always appropriate,
especially for the learning of new skills, as it placed both students and patients potentially
at risk.
Canterbury Christ Church University has three well equipped Skills laboratories, located
on its Broadstairs, Canterbury and Chatham campuses, which provide an integral part of
the teaching component of programmes within the Faculty of Health and Social Care.
The first laboratory to be established was on the Canterbury campus in 2006, followed by
Broadstairs (nursing only) in 2008 and Chatham in 2009.
57
Each laboratory is well equipped with training aids such as simulators and replicates both
the hospital and community setting. The laboratory at Chatham is also equipped to a high
specification with radiography and occupational therapy suites.
The laboratories are divided into specialist practice areas for skills development in
nursing (adult, child and mental health), midwifery, operating department practice,
occupational therapy and radiography.
In addition, ward areas to replicate the hospital setting are complete with hospital beds,
lockers, nurse call system, hoists and patient monitoring equipment similar to the
facilities found in a hospital environment.
The Canterbury and Chatham laboratories each have community areas consisting of a
fully equipped bedroom, bathroom and kitchen to reflect the home setting. Dedicated
workshops for teaching the development of woodworking or creative skills and for
undertaking vocational and occupational assessment are integral.
Each laboratory has teaching and discussion areas (fitted with power point projectors)
where group debate can take place. In addition, the Canterbury and Chatham laboratories
have video cameras and microphones in situ so that audio visual recordings can be made.
This is of particular use for assessing students in relation to OSCEs.
Each skill laboratory houses a variety of computer assisted learning packages, and have
access to the World Wide Web and Clinic, in line with contemporary practice in learning
58
and teaching. Most recent acquisitions include two SimMan simulators (Housed in
Canterbury and Chatham) with ancillary modules and additional medical imaging
equipment to meet the needs of qualified practitioners.
Each site has excellent technician support by way of a dedicated Faculty of Health and
Social Care team of technicians. Faculty technicians co-ordinate skills laboratory
teaching by preparing the area and equipment and providing demonstration support. They
are also responsible for managing consumables and ensuring stock control.
The skills laboratories provide students and practitioners the opportunity to practice
clinical and other techniques, in order to gain competence and confidence in skill
acquisition from the start of training through to the development of advanced skills.
Learning new or 'brushing up' on infrequently used skills is more effectively
accomplished in a nonthreatening environment which is designed to be a 'real life'
representation.
As the skills laboratories also house computerized equipment and seminar rooms,
theoretical aspects of learning can be integrated with practice, thus providing the ideal
environment for the integration of theory and experiential learning, without fear of
harming a real patient or fear of failure.
59
Students or practitioners can learn under supervision and be assessed within the skills
laboratories. Learners can be taught and supervised either on a one to one basis or more
usually in small groups and they are able to develop a variety of perspectives including
that of being a patient, a care or a health professional.
According International Nursing Assessment Consortium (INAC)8 The School
of Nursing provides you with the expert learning and support you need to make your
career in nursing a reality. Nursing can offer you an exciting, varied career with excellent
employment prospects and salaries of up to 100k at Nurse Consultant level.
Our nursing courses cover the core knowledge base that underpins nursing practice
including physiology, pathophysiology, psychology, sociology and clinical skills. You
will also study communication and interpersonal skills, social psychology, ethics and
professional accountability.
Our teaching staff are healthcare experts who are familiar with the care and treatment of
patients, and who understand the need to redefine and adapt knowledge and skills for
real-life scenarios.
We have well equipped laboratories where students can use clinical equipment and
practice on teaching models and mannequins.
Practice placements are an essential part of the nursing programme and enable
students to gain hands-on experience of working under supervision with real patients and
60
clients. Placements are provided in partnership with a variety of employers – for a list of
some of those employers see Partners and collaborations6.
An online directory of nursing placement providers is planned for 2009. In the meantime,
students wishing to find out more about their placements can contact the Nursing
Programme Office, listed on StudentSpace7
Students' work is regularly assessed through a combination of different methods
including essays, examinations, projects and presentations. All modules are individually
assessed to provide students with continuous feedback on their progress and to enable
them to move on to the next phase of the programme.
The Faculty is a member of the International Nursing Assessment Consortium (INAC)8,
through which we contribute to developing international standards in assessing nursing
competence.
Nursing is both academically and personally demanding and students are
supported through their studies to help them succeed. Support includes numeracy help for
those struggling with maths, supervision and mentorship on clinical placements, and help
and advice from other students.
The Nursing Clinical Skills Unit (NCSU) is a state-of-the-art practice laboratory
for nursing students. It is a simulated ward. The NCSU provides students a practice
environment that closely resembles the actual ward environment. For students, the
61
opportunity to practice within a simulated ward environment will assist them to develop
confidence and familiarity before they experience the actual ward environment. Clinical
Nursing Skills are taught in the SU. The NCSU Coordinator closely supervises the
students’ practice sessions. Students are expected to practice as much as possible all
nursing clinical skills that have been taught.
The main area of the NCSU consists of the simulated bed area for patients. With modern
equipment, DDA medication cupboard, blue linen, curtains for privacy, bed side tables,
patient cabinets, eight manual crank beds, two child cots and two basinets, this area is a
definite attraction for all nursing students.
Further simulation is offered by life-size comprehensive practice mannequins (Simon and
Suzie) and they can be found resting in their beds at opposite ends of the ward. Also, a
convincingly realistic ‘baby’ mannequin (Mindy) is often lying awake in the baby cot.
The students find great satisfaction interacting and practicing with Simon, Suzie, and
Mindy. In the future, these mannequins will be instrumental for the students to practice
the more invasive nursing clinical skills required of professional nurses today. Across
from the beds, one can find the dual nurses stations well equipped with tables, chairs, and
a medical case file for patient information. Definitely, learning nursing skills can be a
great challenge, however, the School of Nursing at UCSI University takes pride in how
62
the NCSU empowers the students to become confident and proficient with their clinical
skills, in their journey towards becoming a registered nurse.
The Nursing Clinical Skills Unit (NCSU) is a state-of-the-art practice laboratory
for nursing students. It is a simulated ward. The NCSU provides students a practice
environment that closely resembles the actual ward environment. For students, the
opportunity to practice within a simulated ward environment will assist them to develop
confidence and familiarity before they experience the actual ward environment. Clinical
Nursing Skills are taught in the SU. The NCSU Coordinator closely supervises the
students’ practice sessions. Students are expected to practice as much as possible all
nursing clinical skills that have been taught.
The main area of the NCSU consists of the simulated bed area for patients. With modern
equipment, DDA medication cupboard, blue linen, curtains for privacy, bed side tables,
patient cabinets, eight manual crank beds, two child cots and two basinets, this area is a
definite attraction for all nursing students.
Further simulation is offered by life-size comprehensive practice mannequins (Simon and
Suzie) and they can be found resting in their beds at opposite ends of the ward. Also, a
63
convincingly realistic ‘baby’ mannequin (Mindy) is often lying awake in the baby cot.
The students find great satisfaction interacting and practicing with Simon, Suzie, and
Mindy. In the future, these mannequins will be instrumental for the students to practice
the more invasive nursing clinical skills required of professional nurses today. Across
from the beds, one can find the dual nurses stations well equipped with tables, chairs, and
a medical case file for patient information. Definitely, learning nursing skills can be a
great challenge, however, the School of Nursing at UCSI University takes pride in how
the NCSU empowers the students to become confident and proficient with their clinical
skills, in their journey towards becoming a registered nurse.
LOCAL LITERARTURES
According to Manila doctors Hospital and Manila doctors College ( MDC 2006 ).
The Top 3 Reasons To Use Anatomical Models And Charts in the Philippines Often
doctors need to explain certain medical concepts to their patients, which can be very
tough as the patients may not know about the details of the human body, medical terms,
etc. Also, in schools and medical colleges in Philippines teachers need to explain various
medical issues or the working of the human body in details. All this cannot be done
verbally. If the patients or students get to see what they are hearing, then understanding
that is easier for them. To make this job easier for doctors, teachers, students and
patients, anatomical charts and anatomical models are used. These models and charts
64
include brain models, heart models, skeleton models, spine models, torso models, etc.
Likewise, anatomical charts include detailed diagrams of the entire body or only a
particular part of the body. You may need the help of these anatomical charts and models
for many reasons; some of them are cited below:
By using anatomical charts and models, medical teachers can have the detailed anatomy
of the entire human body in front of them while they are explaining it to the students. In
schools, colleges, and medical institutes, it is easier for students to understand the human
body in a better way with the help of these anatomical models and charts. They are often
updated with new medical researches and discoveries so that any student going through
these charts or models can getup-to-date information.
Having a detailed description for all the small and big parts of the body is a great
help for the doctors and physicians. Anatomical models include all parts of the body, be it
ears, eyes, nose, legs or any other part. When a patient gets to understand properly what
and where a problem has occurred and how it can be removed or cured, then it becomes
easier for them to face any surgery or treatment. This not only makes the patients calm
before a surgery, rather they themselves can understand what limitations and restrictions
the doctor is facing.
Doctors can explain to their patients about the disease they are suffering from and
how it affects their body, using these anatomical models and charts. In certain cases,
especially after surgery, such models of the human body can be used to explain to
patients why they shouldn’t move a particular part of their body, for quick recovery.
65
Health Science Education (AHSE) 2005 introduces an advanced chart or model
of the human body is more suitable for senior students, doctors, and the like. But school
children may find them difficult to understand. So, the less complicated and larger than
life anatomical models are mainly used in junior schools. Different levels of anatomical
models and charts are available for students of different age groups. Anatomy models and
anatomy charts are also commonly used by fitness trainers, buying groups, chiropractors,
hospitals, physical therapists, and many other health care professionals. Veterinary clinics
also require animal anatomy models and charts.
Charts and diagram of human anatomy have been the cornerstone of the nursing
colleges in the Philippines (2004-2005) with a level III status since its inception.
Anatomical charts are essential teaching tools for understanding the man complex
elements of human anatomy and the effect of disease and trauma on those elements.
Elaborate illustrations provide a window into the human body that is clear and accessible
whether you are a medical professional, student or patient. More than just a tool of
medical education, anatomical charts also serve a valuable purpose as a practical
reference for both physician and patient. Complex and confusing medical procedures can
be more easily explained to the lay patient with the use of well made anatomical chart
allows nursing students to practice on make-believe patients to learn, sharpen and
66
improve skills. May nursing schools use high-tech mannequins to simulate real- life
patient situations.
The mannequins can be used to teach nurses simple techniques, such as how to
bathe patients and more complicated techniques, as well as how to react in emergency
situations.
The mannequins are programmed to act and react like humans they breathe, talk and
make other sound. Instructors can control interactions between the mannequin and the
nurses from central control room theses interactions are recorded and used as a teaching
tool.
The use of technology in nursing schools is viewed as a vital complement to hands – on
clinical experience. Along with patient simulations, the national league for nursing
believes nursing information technology should be a part all nursing schools curriculum.
Local Studies
According to FEU (2007) the Primus Interprets of first among equals in the
Philippines to have a real nursing Modern Laboratory uniquely designed as a stimulated
hospital proudly carries “Gold Standard” the yardstick by which all other nursing skills
are measured. The hospital set-up closely approximates the standards of the Joint
Commission, the leading health care accrediting body in the USA and other international
hospitals and infection standard in terms of bed-to-sink ratios, hospital door widths,
67
functionally and work and patient flow. In addition, AUSTCO, the leader in quality nurse
call system in the Philippines. With the nurse call system, students will learn to respond
to patient calls within two minute of the call enhancing the student’s customer service
and interpersonal relation skills.
Competence, consistency and cognitive skills of nursing students by adapting
those kind of responses. And innovative spirit, FEU aims to bring the institute of nursing
to the forefront of nursing education in the Philippines, preparing its students to take on
the demands of a global tomorrow. Step into the FEU institute of nursing’s new state of
the art virtual laboratory which opened its doors in December 2006. The uniquely
designed simulated laboratory proudly carries the “Gold Standard”, the yardstick by
which all other nursing skills laboratories are measured. The hospital set up closely
approximates the standards of the Joint Commission. The leading health care accrediting
body in the USA and other international hospital and infection standards in terms of bed-
to-sink ratios, hospital door widths, functionality and work and point flow. In addition,
AUSTCO, the leader in quality nurse call systems , has partnered with FEU to house the
only advanced, cutting edge nurse call system has partnered with FEU to house the only
advanced, cutting edge nurse call system in the Philippines. With the nurse all system,
students will learn to respond to patient calls within two minutes of the call enhancing the
student’s customer service and interpersonal or relational skills. Dean of FEU IN
Anabelle Borromeo proudly announced “The Virtual Laboratory provides a learning
platform that allows our students to practice real life situations, training them to be nurses
68
of tomorrow.” Using third-operation computer-based simulations instead of the
traditional mannequins, the virtual laboratory at FEU_IN provides its realistic conditions
through the use of advance technology. Meet HAL, the human patient simulation who is
capable of taking breaths, talking having his pulses palpated and his blood pressure
obtained. The instructor controls HAL through a wireless computer, as such, HAL can be
programmed to experience realistic medical, which students can learn from. Besides
HAL, the FEU virtual laboratory likewise boasts or Noelle, the maternal interactive
birthing models with which nursing are able to assess pregnancies and births. FEU-IN’s
virtual laboratory aims the advantage nursing education in the Philippines by providing
its students with cutting edge training and equipment, creating the nurses of tomorrow.
On the top of the high-tech human patient simulators, the laboratory also boasts of an IV
insertion simulator. The device presents varying é of difficulty and complications in the
IV therapy procedure, simulating skin stretching, blood flashback, threading off of the
catheter and even provides the realistic pop of venipuncture, allowing the user to
experience the feel of realistic IV procedures. The Virtual Laboratory will also be
equipped with video conferencing terminals to capture master lectures and
demonstrations of nursing procedures. Captured video will be steamed live other
classrooms or computer laboratories where viewers are able to call the lecture and ask
questions. In some cases, the material will be saved for later viewing either in group
settings at classrooms or laboratories, or for download by students to their own portable
devices. Later, additional learning hospitals or schools so that students can, for example,
69
follow an actual operation taking place at a remote operating room via the video
conferncing technology.
According to Dean Borromeo, a nurse today, to be globally competitive,
must acquire basic skills in three areas while still in nursing school; these are technical,
relational and critical thinking skills. The virtual laboratory is an opportunity to fast track
the acquisition. Research on students show that those who have undergone stimulator
classes have exhibited improved preparedness and self-efficacy. The virtual laboratory is
FEU contribution to the development of nursing education in the PHILIPPINES by
providing quality education and advance training FEU creates globally competitive
nurses who are well-equiped for the demands of the tomorrow. For what sets these
graduates apart from the rest is that day are equipped with an in-depth nursing foundation
allowing them is function in any setting.” Dean Borromeo proudly commented by
supporting the advancement of quality nursing education and state of the art equipment,
FEU aims to be in the forefront of nursing education in the Philippines.
According to Manila Times (Sunday, March 25, 2008) FEU Institute of
Nursing transforms Philippine nursing education via its modern Virtual Laboratory.
Reflecting the rapid changes and developments in medical science and technology, Far
Eastern University’s Institute of Nursing to takes nursing education to the next level,
providing its students with the advantage of world class educations right here in the
Philippines through its traditional of excellence.
70
According to the Fatima News Team (Thursday, August 16, 2007) Modern Skills
Laboratory is the most extensive clinical simulation Laboratory in the country today,
features state of the art computer-model-driven-full sized human patient. Simulations
(HPS) that allow Fatima’s nursing students to experiences true to life clinical scenarios
that greatly augment their clinical treining. Will the nurse call system, students will learn
to respond to patient calls within two minutes of delivery.
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Chapter III
Research Methodology
This chapter presents the discussion on the research methodology of the study, the
subjects, population frame, and sample, research instrument, design, data gathering
procedure and statistical treatment used to analyze and interpret data.
Research Design:
The descriptive study, according to John W. Best (1999) is concerned with the
condition or relationship that exists practices that prevail, beliefs point of view or
attitudes that are held, processes that are going on; effect that are being felt; or trends
that are developing .
In view of this descriptive method used of research because this method has been
proven to be useful in the collection and organization of research data in order to arrive at
findings in conclusive form. The study extended to determine the relationship of nurses
clinical working strategy to patient level of satisfaction. Moreover the study would
72
determine the significant difference from one another of the three variables that affects
the patient level of satisfaction.
All of these justify the appropriateness of the descriptive method in the present
study
Research Settings
The study will be conducted in two Colleges of Nursing in Rizal.
Sampling Procedure
The researcher made use of stratified random sampling technique to assure that every
member of the population would have an equal chance to be chosen as respondents.
Respondents of the study
Respondents were chosen by the researchers to give questionnaire on specific
respondents that will supply us the needed information. Researchers will be giving
questionnaires to all third year nursing students who are presently with modern skill
laboratory.
Research Instrument
The instruments ]are the letter of approval and the questionnaires that will be
filled by the 3rd year Nursing Students in Colleges of Rizal. The letter of approval serves
as the permission in conducting research in one Nursing College in Rizal.
73
The use of self constructed questionnaire method as a research instrument to
gather data from the selected population. The researchers will distribute survey
questionnaires at the target population to be able to gathered data regarding their
attitudes, opinions and practices of effects of modern skills laboratories of nursing
student level competency. The questions are structured in which it requires straight
forward factual information without any unnecessary interaction in respondents and
presented in English dialect. The effect of modern skills laboratories the nursing students’
clinical survey will be answered on a Likert Scale of five point ranking system:
Strongly Agree (5), Agree (4), Uncertain (3), Disagree (2) and Strongly Disagree (1).
SUBJECT OF THE STUDY
The subjects of the study were composed of 173 nursing students 90 female and
83 male in two nursing colleges in Rizal.
Data Gathering Procedures
In the process of gathering data for this study, the researchers were accompanied
by the following phases:
74
Foremost, the researchers must obtain a formal letter of request that will be signed
by the research adviser to conduct a survey among 3rd year nursing students in two
nursing colleges in Rizal. Afterwards, they will identify the total number of their subjects
and make ready of the questionnaires that will going to distribute. Next, the researcher
will finalize the questionnaire. They will spread out the questionnaire out to their
respondents personally and secured them confidentiality of the resources and
information. When all questionnaires are returned, the researcher will allies the result of
the survey and employs the statistical treatment to the guide of their statistician.
Statistical Treatment of Data
Two forms of analysis is used in the study; namely, descriptive statistics such as
percent, F-test, mean and standard deviation to assess the relationship of nurses clinical
working strategies to the patient level of satisfaction. In addition, Pearson “r’ and
weighted mean was also used to determine the relationship between the variables.
A. The researchers made use of the percentage method to treat the data statically for
problem no.1 which respond to respondents’ profile, the formula used was:
Formula:
% = _ f__ x 100%
N
75
Where:
f --- Frequency
N --- Total Population
The results of the data gathered will be presented and analyzed with the use of tables
corresponding average in percent (%).
B. For problem no.2, the researchers used Weighted Mean as their statistical formula to
determine the effects of modern skills laboratory on the clinical performance of nursing
students. The formula used was weighted mean
Formula:
WX = ∑fx
______
N
Where:
WX --- Weighted Mean
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fx --- Summation of Frequency
N --- Total Population
C. For problem no.3, which deals with the significant difference of the effects of modern
skills laboratory on the clinical performance of nursing students, data where subjected to
analysis of variance in which the F-test T-test were used.
Formula:
F = MSAG
MSWG
Where:
F --- The F – Test
MSAG --- Mean Squared Among Group
MSWG --- Mean Squared Within Group
Formula:
t = X1 – X2
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Where:
t = the t-test
X1 = the mean of Group 1
X2 = the mean of Group 2
SS1 = the Sum of Squares of Group 1
SS2 = the Sum of Squares of Group 2
n1 = the number of Observation in Group 1
n2 = the number of observation in Group 2
D. The researchers utilized the Pearson’s R formula to determine the significant
relationship between the independent and dependent variable to obtain the value of R
from ungroup data, the formula is as follows:
78
Formula:
r = (∑dx) (∑dy)
______________
√ (∑dx 2) (∑dy 2)
∑dx 2 = ∑x2 - (∑x) 2
∑dy 2 = ∑y2 - (∑y) 2
(∑dx) (∑dy) = ∑dxy - (∑dx) (∑dy)
n
Where:
r --- Correlation between x and y
∑dx --- Sum of Test x
∑dy --- Sum of Test y
∑dx 2 --- Sum of Squared x Scores
∑dy 2 --- Sum of Squared y Scores
(∑dx) (∑dy) --- Product of the sum of x and y
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E. The sample mean standard deviation were used to identify the extent of the effects of
modern skills laboratory of the clinical performance of nursing student and the mean
formula was used
Formula:
x = ∑x
n
Where:
x = sample mean
∑x = sum of the sample observation
n = sample size
Formula:
√ SD = i∑ fd2 - (∑ fd)2
n – 1
80
Where:
SD = Standard Deviation
∑ fd2 = Sum of the product between the frequency and fd.
n = Sample size
i = Interval
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CHAPTER 4
PRESENTATION, ANALYSIS AND INTERPRETATION OF DATA
This chapter deals with the presentation, analysis and interpretation of data
gathered regarding the effects of modern skills laboratory on nursing students’ clinical
performance.
Problem 1
The profile of the respondents in terms of Age, Gender and Civil Status.
Table 1 presents the frequency and percentage of the respondents in terms of
age, gender and civil status.
Table 1.1
Frequency distribution of the respondents in terms of age, gender and civil status.
Age Frequency Percentage
18-20 153 88.43%
21-23 6 9.24%
24-26 1 .6%
27-29 1 .6%
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30-32 2 1.16%
Total 173 100%
Table 1.1 shows the distribution of respondents according to age. The age group 18-20
years old among all the respondents got the 1st highest percentage which is 88.43%; the
age group of 21-23 years old among all respondents got the 2nd highest percentage which
is 9.24%, the age group of 30-32 years old among all respondents got the 3rd highest
percentage which is 1.16%; there is an equal distribution of respondents according to age.
It’s composed of the age group between 24-26 and 27-29 which is .6% of the student
respondents.
The age group of 18-20 got the highest percentage. This is maybe due to the
year level of the respondents. It can be inferred that college students’ age really falls on
that age bracket during this year level of studying.
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Table 1.2
Frequency Distribution showing the gender of the respondents.
Gender Frequency Percentage
Male 83 48%
Female 90 52%
Total 173 100%
As seen in the table 1.2 there are more female respondents which
comprised 52% that male respondents which comprises only 48%.
The trend about gender in the education ascertained the prevalent finding
that the female and males. It implies that both male and female are more persistent in
taking the nursing course.
Table 1.3
Frequency Distribution showing the civil status of the respondents.
Civil Status Frequency Percentage
Single 151 87%
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Married 22 13%
Total 173 100%
Table 1.3 dearly shows the frequency and percentage distribution in terms
of civil status. As shown from the table there are 22 or 13% married and 151 or 87% of
them are single.
Based on the age group, the respondents are expected to be single (18-20);
which comprised the highest percentage.
Problem 2
The descriptionof the modern skills laboratory affecting the nursing students’ clinical
performance..
Table 2
The computed weighted mean of anatomical model
Anatomical Model Wx Verbal Interpretation
Rank
1. Facilitates better knowledge transmission through demonstration on all the nursing procedure.
4.48 Strongly Agree
1
2. Anatomical chart allows nursing students to practice on make believe patient to learn, sharpen and improved skills.
4.23 Strongly Agree
3
3. By using anatomical charts and model, teachers can have detailed anatomy of the entire human body.
4.39 Strongly Agree
2
Average 4.37 Strongly Agree
85
It was seen from the table that item number one got a mean of 4.48% which
is rank 1st with a verbal interpretation of “strongly agree”. item number three is second in
rank which got a mean of 4.39 and with a verbal interpretation of “strongly agree”. Third
in rank with a mean of 4.23 was item number 2 with a verbal interpretation of” strongly
agree”. Summing it up the average mean was 4.37 for the 3 given item with the verbal
interpretation of “Strongly Agree”.
It implies that students strongly agreed that anatomical models facilitates
better knowledge transmission through demonstration on all the nursing procedure, as the
most basic function of these anatomical model, because through the presence of
anatomical models, nursing procedures, and nursing actions are well practiced by the
students on a systematized and timely manner.
Table 2.2
Computed Weighted Mean of the Effects of Modern Skills Laboratory in Nursing
Students Clinical Performance in terms of Electronic Simulators.
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Table 2.2 presents the computed weighted mean of the effects of modern skills laboratory
in nursing student’s clinical performance in terms of electronic simulator.
A. ELECTRONIC SIMULATORS Wx Verbal Interpretation
Rank
1. Nursing students have undergone simulators classes have exhibited and improved preparedness to clinical areas.
4.14 MA 1
2. Simulators allow the students to practice basic skills such as recognizing cardiac sounds (normal and pathologic), central and peripheral vein access, pelvic exam and to use ECG, cardiac monitor and defibrillator just prior to entering the clinical setting.
4.5 MA 2
3. Student nurses know how to interpret the results produced by the instrument they use and aware of the limitations and possibilities of errors uncritical reliance on values obtains by the electronic simulators or machines use in hospital.
4.06 MA 3
Average 4.23 SA
87
As we can see in the table, the item “nursing students have undergone simulators
classes have exhibited and improved preparedness to clinical areas” ranked first with the
weighted mean of 4.14, the second rank belong to the item “simulators allow the students
to practice basic skills such as recognizing cardiac sounds (normal and pathologic),
central and peripheral vein access, pelvic exam and to use ECG, cardiac monitor and
defibrillator just prior to entering the clinical setting” with the weighted mean of 4.5, and
the third ranked with a weighted mean of 4.06 belongs to the item “student nurses know
how to interpret the results produced by the instrument they use and aware of the
limitations and possibilities of errors uncritical reliance on values obtains by the
electronic simulators or machines use in hospital”. All of the three items has a verbal
interpretation of “mostly agree”
It implies that students mostly agreed that nursing students who have undergone
simulator classes have exhibited and improved preparedness to clinical areas, because
through these simulation classes, the students are experiencing the natural act on hospital
area that prepared themselves on their first clinical visit, errors are known in advanced
that prevented it when real life are handled.
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Table 2.3
Computed Weighted Mean of the Effects of Modern Skills Laboratory in Nursing
Students Clinical Performance in terms of Modules for conducting standardized patient
encounter.
B. Modules for conducting standardized
patient encounter
Wx Verbal
Interpretation
Rank
1. Standard and nursing skill procedures written in
the module helps the student nurse in easy delivery
of services to patient.
4.19 MA 3
2. Module helps the student nurse in easy access of
things encountered in the clinical area.
4.47 SA 1
3. Procedures done in the clinical areas are
systematized through the guidelines on the
module.
4.23 SA 2
Average 4.30 SA
89
The table 2.3 reveals that item “module helps the student nurse in easy access of
things encountered in the clinical area” ranked first with a weighted mean of 4.47, ranked
second was the item “procedures done in the clinical areas are systematized through the
guidelines on the module” with a weighted mean of 4.23, both the first and second rank
are verbally interpreted as strongly agree, while the third rank “standard and nursing skill
procedures written in the module helps the student nurse in easy delivery of services to
patient” verbally interpreted as mostly agree, with a weighted mean of 4.19.
It implies that modules play a great help to nursing students for giving easy access
of things encountered in the clinical areas
Table 2.4
Composite table on the Effects of Modern Skills Laboratory in Nursing Students Clinical
Performance
Table 2.4 presents the effects of modern skills laboratory in nursing student’s clinical
performance.
Wx Verbal
Interpretation
Rank
ANATOMICAL MODEL 4.37 SA 1
ELECTRONIC SIMULATOR 4.23 SA 3
MODULES FOR CONDUCTING 4.30 SA 2
90
STANDARDIZE PATIENT ENCOUNTER
AVERAGE WX 4.3 MA
As shown in the table “anatomical model” ranked first with a weighted mean of
4.37, followed by “modules for conducting standardized patient encounter” with a
weighted mean of 4.30. Last in rank was “electronic simulator” with a weighted mean of
4.23 and all were verbally interpreted as strongly agree. The average sum of all the
weighted mean was 4.3 with a verbal interpretation of “mostly agree”.
The result implies that third year nursing students perceived that modern skills
laboratory affects their level of clinical performance as evident by high weighted mean.
Anatomical model has the highest mean among the three model skills laboratory
that affects the clinical performance of nursing students. This inferred that it may be
giving the great effect to the clinical performance of nursing students for most of the
students now are becoming more visuals than non-visuals.
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Problem 3
Table 3.1
Variance Analysis in terms of sum of the variance on the Effect of Modern Skills
Laboratory on Nursing Students Clinical Performance
Sum of
Variance
df Sum of
Square
Mean of
Square
S F. Value
Sum Among
Group
2 0.02 0.01 0.31
Sum Within
Group
6 0.19 0.032 0.18
Total 8 0.21 4.82 Critical Value: 5.143
Table 3.1 present the computed F-test on the effect of modern skills laboratory on
nursing student’s clinical performance in terms of anatomical model, electronic simulator
and modules for conducting standardized patient encounter.
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The F-test of variance of the Effect of Modern Skills Laboratory on Nursing
Students Clinical Performance yielded a value of 0.31. Since the computed f value is
smaller than the critical value of 5.143 at 5% level of significance for the indicated
degree of freedom the null hypothesis was accepted. The result indicated that the
variables of Modern Skills Laboratory have an effect on Nursing Students Clinical
Performance but no significant difference with each other.
Problem No. 4
The Significant Relationship on the Effects of Modern Skills Laboratory on
Nursing Student’s Clinical Performance in terms of Anatomical model, Electronic
Simulator and Modules for conducting standardized patient encounter.
In order to determine the relationship between the effects of modern skills
laboratory on nursing student’s clinical performance, the researcher has measured the
degree of correlation using Pearson’s coefficient of correlation. The table 4.1 summarizes
the result of this test.
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Table 4.1
Computed R-value on the relationship of the effects of modern skills laboratory on
nursing student’s clinical performance.
Variables R r² Interpretation Hypothesis
Anatomical model 0.87 0.76 Significant Reject Ho
Electronic simulator 0.87 0.76 Significant Reject Ho
Modules for conducting
standardized patient encounter
0.87 0.76 Significant Reject Ho
Critical Value: .829
The distribution could lead support to analysis of the correlation between the
effects of modern skills laboratory to nursing student’s clinical performance in terms of
anatomical model, electronic simulator and modules for conducting standardized patient
encounter.
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The computed value of r between anatomical model, electronic simulator and
modules for conducting standardized patient encounter is 0.87 respectively.
It can be inferred that anatomical model, electronic simulator and modules for
conducting standardized patient encounter inflict effects to nursing students clinical
performance because all of them provides the essential hands-on learning, thorough
explanation on humjan body, ways of handling proper care and gives a guided
explorations on different nursing skills that enable the students to gain abilities to
rendered oiptimum level of c
Problem 5
To what extent does the modern skills laboratory to nursing student’s clinical
performance in terms of:
5.1 anatomical model
5.2 electronic simulator
5.3 modules for conducting standardized patient encounter
Table 5
Result of computed mean standard deviation
Variables X Standard Deviation Verbal Interpretation
Anatomical model 13.1 8.47 Strongly AgreeElectronic simulator 12.7 8.75 Strongly Agree
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Modules for conducting standardized patient encounter
12.89 8.59 Strongly Agree
The table 5 presents the result of computed mean and standard deviation.
Anatomical model with a weighted mean of 13.1 and a standard deviation of 8.47, the
item modules for conducting standardized patient encounter with a weighted mean of
12.89 and a standard deviation of 8.59, to electronic simulator with a weighted mean of
12.7 and a standard deviation of 8.75
. All of the items has a verbal interpretation of strongly agree.
It may be inferred that anatomical model has the greatest extent in effecting
nursing students clinical performance because it is the most reliable and easiest way on
transferring knowledge and demonstrating all nursing procedures. The basic of science
and such nursing skills can be summarized as a set of steps that helps the students
transmits skills and abilities through the use of anatomical models.
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CHAPTER 5
SUMMARY, CONCLUSION AND RECOMMENDATION
This chapter presents the summary of findings, conclusion and
recommendations of the study and for further research and investigation. This piece of
work revealed the effect s of modern skills laboratory on nursing students’ clinical
performance such as anatomical model, electronic simulator and modules for conducting
standardized patient en counter.
SUMMARY OF THE STUDY
This study attempted to determine the Effects of Modern Skills Laboratory on
Nursing Students Clinical Performance.
The descriptive method of research was used with the assessment examination
as the main tool for gathering data.
The respondents of the study were 173 third year nursing students of two nursing
colleges in rizal.
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The summaries of findings of the study are as follows:
Problem 1.
1. The profile of the respondents in terms of Age, Gender and Civil status.
1.1 In terms of age, ranked number one was the age bracket of 18-20 with a
frequency of 153 and 88 percentage.
1.2 In terms of gender, the female respondents outnumbered the male with a
frequency of 83 and a percentage of 48%.
1.3 In terms of civil status, single students outnumbered the married with a
frequency of 151 and a percentage of 87%.
2. description of modern skills laboratory affecting on nursing students’ clinical
performance in terms of anatomical model, electronic simulator and modules for
conducting standardized patient en counter.
2.1 In terms of Anatomical Model, the item “facilitates better knowledge
transmission through demonstration on all the nursing procedure” ranked
first with a weighted mean of 4.48 and verbally interpreted as “strongly
agree”.
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2.2 In terms of Electronic simulator, the item “nursing students have
undergone simulator classes have exhibited and improved preparedness
to clinical areas” ranked first with a weighted mean of 4.14 and verbally
interpreted as mostly agree.
2.3 In terms of Modules for conducting standardized patient en counter, the
item “module helps the student nurse in easy access of things
encountered in the clinical area.
3. Effects of modern skills laboratory on nursing students clinical performance.
3.1 Nursing students clinical performance did not differ in terms of modern
skills laboratory.
4. The Significant Relationship of Modern skills laboratory to nursing students’
clinical performance in terms of anatomical model, electronic simulator and
modules for conducting standardized patient en counter.
4.1 Anatomical Model and electronic stimulator are significantly related to
nursing students’ clinical performance.
4.2 Electronic Simulator and modules for conducting standardized are
significantly related to nursing students’ clinical performance.
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4.3 Modules for conducting standardize patient encounter and anatomical
model are significantly related to nursing students’ clinical performance.
5. The Extent of the Effects of Modern Skills Laboratory on Nursing Students
clinical performance.
5.1 .It may be inferred that anatomical model has the greatest extent in effecting
nursing students clinical performance because it is the most reliable and easiest way
on transferring knowledge and demonstrating all nursing procedures. The basic of
science and such nursing skills can be summarized as a set of steps that helps the
students transmits skills and abilities through the use of anatomical models.
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CONCLUSION
On the basis of the findings of the study, the following conclusions were drawn:
1. The respondents profile described in terms of age, gender and civil status. In
terms of age, ranked first was age 18-20 with 88.43% percentage, in terms of
gender the female and the male with a percentage of 52%, and in terms of civil
status the third year nursing students who are single ranked first with a percentage
of 87%.
2. Modern skills laboratory was described in terms of anatomical model, electronic
simulator and modules for conducting standardized patient en counter. There’s an
indication on that, there exist an effect on all the variables to the nursing students’
clinical performance.
3. Modern skills laboratory affects the nursing students’ clinical performance with
regards to anatomical model, electronic simulator and modules for conducting
standardized patient encounter, but are not significantly different with each other.
4. There is a significant relationship between modern skills laboratory to nursing
students clinical performance. The significant relationship exists between the
three variables and nursing students’ clinical performance.
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5. The extent of the effects of modern skills laboratory to nursing students’ clinical
performance was greatly affected by the anatomical model.
RECOMMENDATIONS
1. There should be a continuous search of knowledge and practice of skills with the
use of modern skills laboratory, on the part of the nursing students for them to
gain and develop the skills
2. All nursing students need to have improvement of their capabilities and the care
they will be brought and administer on the clinical area.
3. All nursing students should try their best on making used of the advantages the
modern skills laboratory could give to them.
4. The School of nursing should improve their Modern skills laboratory facilities to
attract and retain high quality nursing students, with a ultimate goal of improving
the nursing students abilities, potential and knowledge in terms of all the nursing
procedures that a nursing student should mastered to be able for them to give the
optimum level of care.
5. The administration of the college of nursing should try their best to come up with
the good and modern facilities to maintain the best knowledge transmission for
their students.
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6. Other researchers in other setting may look into other variables and bigger
population may be linked in nursing students’ clinical performance to arrive at
more conclusive findings.
TOMAS CLAUDIO MEMORIAL COLLEGE
COLLEGE OF NURSING
MORONG, RIZAL
April 05, 2010
Dean College of Nursing
Dear Madam,
The undersigned is presently conducting a study entitled “the effect of modern
skills laboratory on the students clinical performance” Knowing your outmost interest in
the value of research as a tool for development. We would like to request a permission to
distribute questionnaires to 3rd year nursing student.
Thank you for your cooperation and immediate response.
Respectfully yours,
Verdillo, Princess D
Villaran, Mariel A.
Researchers
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Noted by:
Liwayway M. Piedad RN, RM, MAeD, MAN, Ph.D
TOMAS CLAUDIO MEMORIAL COLLEGECollege of Nursing
Morong, Rizal
_______________April 5, 2010
Dear Sir/Madam:
Good day!The undersigned nursing students of Tomas Claudio Memorial College, is
presently conducting a study entitled “The Effects of Modern skills Laboratory on the Nursing student Clinical performance” which is undertaken in partial fulfillment of the requirements of Nursing Research under the supervision of Dr. Liwayway M. Piedad DEAN, College of Nursing, Tomas Claudio Memorial College.
The study aims to determine The effects of modern skills laboratory on nursing students clinical performance. This could help to evaluate the quality of clinical performance of Nursing Students.
In the line with the, may we request from your good office the permission to distribute questionnaires to our respondents (3rd yr students of Our Lady of Fatima), as our chosen respondents to collect data to this study.
This study will assure the confidentiality of the students.
Respectfully yours,
Princess D. Verdillo
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Mariel A. Villaran
Approved by:DR. LIWAYWAY PIEDADDean College of Nursing
Survey Questionnaire
To the Respondents:
This study aims to assess the effects of modern skills laboratory in Level III
nursing students towards their human functioning. The result will help the researcher in
completing the material needed for the accuracy of the study. All the information will be
treated confidentially. Thank you.
I. Profile of the Respondents
( Please supply the necessary information.)
Name: (optional) _______________________ Gender: Male Female
Age: ______ Year Level:_______ Civil Status: Single Married
Effects of Modern Skills Laboratory on the Clinical Performance of Nursing Students
Questionnaire.
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The following are statements about the effects of modern skills laboratory on the
clinical performance of nursing students.
Kindly put a [√] check mark on the corresponding statements that you think the most
applicable.
5 -- Strongly Agree4 – Agree3 – Uncertain2 – Disagree 1 – Strongly Disagree
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This include the average grades of nursing student, level III, enrolled in two of the
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Questions 5 4 3 2 1
1.)Anatomical models
1.1. ) Facilitates better knowledge transmission
through demonstration on all the nursing
procedures.
1.2. ) Anatomical chart allows nursing students to
practice on make-believe patients to learn,
sharpen and improve skills.
1.3. ) By using anatomical charts and model,
teachers can have detailed anatomy of the
entire human body.
2.)Electronic Simulator
2.1) Nursing students have undergone stimulators
classes have exhibited and improved preparedness to
the clinical areas.
2.2) Simulators allows students to practice basic
skills such as recognizing cardiac sounds (normal and
pathologic), central and peripheral vein access, pelvic
exam, and to use ECG, cardiac monitor and
defibrillator just prior to entering the clinical setting.
2.3). student nurses know how to interpret the results
produced by the instruments they use and aware
of the limitations and possibilities of error
uncritical reliance on values obtained by the
electronic stimulators or machines use in the
hospital.
3.) Modules for conducting standardized patient
encounter
3.1) Standard and Nursing Skill procedures written
College of Nursing in the province of Rizal during the School year 2009-2010.
COLLEGE A.
RESPONDENTS BLOCK A BLOCK B1 2.4 1.82 2.5 2.43 2.0 2.14 2.1 2.15 1.9 1.86 2.3 2.07 2.3 2.18 2.5 1.89 2.3 1.810 2.3 1.811 2.4 2.012 2.2 1.713 1.9 2.214 1.6 1.915 2.1 2.316 2.0 2.3
17 2.1 2.5
18 1.8 2.3
19 1.8 2.3
20 2.0 2.4
21 1.9 2.2
22 2.3 1.923 2.4 1.624 2.0 2.125 2.2 2.026 1.8 2.127 2.5 1.828 2.5 1.829 1.8 2.030 2.2 1.831 1.8 1.832 2.4 2.033 2.4 1.7
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34 1.9 2.235 2.1 1.936 2.6 2.337 1.8 2.238 2.2 1.539 2.4 2.140 2.6 1.841 2.0 1.742 2.2 2.543 1.8 2.344 2.4 1.945 2.1 2.4
46 2.1 2.5
47 1.8 2.0
48 2.0 2.1
49 2.1 1.9
50 1.8 2.3
51 1.8 2.3
52 1.8 2.5
53 2.0 2.3
54 1.7 2.3
55 2.2 2.4
56 1.9 2.2
57 2.3 1.958 2.2 1.659 1.5 2.160 2.1 2.061 1.8 2.162 1.7 1.863 2.5 1.864 2.3 1.965 1.9 2.3
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College B.
RESPONDENTS BLOCK A. BLOCK B. BLOCK C. BLOCK D.1 2.5 2 2.5 22 3 2 2.5 23 3 1.75 3 1.754 2 3 2.75 35 2.75 2 3 26 2 2.25 2.5 2.257 1.7 3 2.25 38 2.75 2.75 3 2.759 2 2.75 2.25 2.7510 2 2.25 3 2.2511 1.75 2.25 2.5 2.2512 3 2.25 2 2.2513 2 3 2.75 314 2.25 2.5 2.25 2.515 3 2 3 216 2.75 2.75 3 2.7517 2.75 2.25 2.5 2.2518 2.25 3 2.75 319 2.25 3 2 320 2.25 2.5 1.7 2.521 3 2 2.75 222 2.5 2 2 223 2 2.75 2 2.7524 2.75 1.75 1.75 1.7525 2.25 2 3 226 3 2.5 2 2.527 3 2.5 2.25 2.528 2.5 2.25 3 2.2529 2 3 2 330 2 2.5 2.75 2.531 2.75 2 2 232 1.75 2.75 1.7 2.7533 2 2.25 2.75 2.2534 2.5 3 2 335 2.5 3 2 336 3 2.5 1.75 2.5
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37 2.75 2.5 3 2.538 3 3 2 339 2.5 3 2.25 340 2.25 2 3 241 3 2.75 2.75 2.7542 2.25 2 2.75 243 3 1.7 2.25 1.744 2.5 2.75 2.25 2.7545 2 2 2.25 246 2.75 2.7547 2.25 248 3 1.749 3 2.7550 2.5 251 252 1.7553 2.554 355 356 257 2.75
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CURICULLUM VITAE
Princess D. Verdillo 732 Sumulong St. Brgy. San Juan Morong Rizal213-6002/ [email protected]
Personal Information
Date of Birth: May 03, 1987
Place of Birth: Caloocan City
Citizenship: Filipino
Gender: Female
Civil Status: Single
TertiaryOur Lady of Fatima University 2005 - 2006 Bachelor of Valenzuela City. Science in NursingTomas Claudio Memorial College 2007 up to present Bachelor of ScienceTaghangin, Rizal in Nursing
SecondarySt Mary’s Academy of Caloocan City 2000-2004 1st – 4th yrCaloocan City
Elementary St Mary’s Academy of Caloocan City 1993- 2000 Kinder – Grade 6Caloocan City
Awards and Accomplishment Bronze medalist in Caloocan Taekwondo Regional Schools Division Active member of Taekwondo club in High Schoo
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CURICULLUM VITAE
PERSONAL DATA:
Name: Mariel A. VillaranAddress: 489 M. Alejandro St.
Jalajala, RizalGender: FemaleCivil Status: SingleCitizenship: FilipinoAge: 19Date of Birth: May 22, 1991Birth Place: Morong RizalReligion: UNACAEDName of Father: Marcello F. VillaranName of Mother: Luzviminda A. Villaran
EDUCATIONAL BACKGROUND:ELEMENTARY: Sipsipin Elemantary School 1998-2003SECONDARY: Saint Michael Parochial School (SMPS) 2003-2005 Jiane Therese International School (JTIS) 2005-2007TERTIARY: Tomas Claudio Memorial College (TCMC) 2007-Present
AWARDS AND RECOGNITION Gold medalist in Chess girl school division in Rizal. 2002-2003
(Player of the year) Silver medalist Secondary division on Chess.
(Representative to REPRISA) Active member of Badminton, Drama and Chess club during High school. Received a 5th place academic award during third year high school. Graduate as First Honourable mention in High school.
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