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CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES A Research Study Submitted to the Director of Research of St. Paul University Philippines Submitted by: BRYIANE P. MEDINA, RN, MAN
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CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

Nov 15, 2014

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This research study aims to investigate the learning experiences of the BSN 4 students in their clinical practice from the affiliated hospitals of St. Paul University Philippines.
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Page 1: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE

AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

A Research Study Submitted

to the Director of Research

of St. Paul University Philippines

Submitted by:

BRYIANE P. MEDINA, RN, MAN

SHS FACULTY

S.Y. 2008-2009

Page 2: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

Chapter 1

THE PROBLEM AND REVIEW OF RELATED LITERATURE

Introduction

St. Paul University Philippines is the seat of quality

education in nursing. In fact, among other nursing schools in the

Philippines, the university garnered the highest score in the

search for Center of Excellence in Nursing by the Commission on

Higher Education last 2008. The University is consistently on the

list of the top performing schools nationwide in the Nurse

Licensure Examination.

The School of Health Sciences College of Nursing

continuously upholds the standards as center of excellence in

nursing. The school assured that the quality of nursing practice

is evidenced not only through academic performance but more so in

the related learning experience (RLE) both clinical and

community.

Clinical experience has been the vital part of nursing

education. According to Dunn and Burnette (1995), it is the

avenue for the students to utilize the theories that they’ve

learned in their discussion. It prepares student nurses to be

able of "doing" as well as "knowing" the clinical principles in

Page 3: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

practice. The clinical practice stimulates students to use their

critical thinking skills for problem solving. It is where the

student nurses enhance their knowledge in nursing concepts and

principles as well as to develop and improve their skills and

attitude towards rendering quality of nursing services.

Nursing student's experiences of their clinical practice

provide greater insight to develop an effective clinical teaching

strategy in nursing education. The main objective of this study

was to investigate student nurses' experience about their

clinical practice.

Nursing is known to be a caring profession. In fact,

Florence Nightingale, the founder of nursing, initiated and

developed this role utilizing environmental resources. This

brilliant founder also instituted specialized roles in health

care setting through the years.

In the Philippines, nursing course is evidently enrolled

most of the college students. And the challenge among nursing

schools is to provide this quality education. Evidently, St. Paul

University Philippines College of Nursing does not fail its

students in this quality education.

Page 4: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

Review of Related Literature

Nursing students need sufficient practical experience to

qualify with the full range of skills required for effective

practice. The study considers the variety of support to the

criteria in determining the accuracy of the analysis.

Ensuring that nursing students receive sufficient

practical experience to develop the full range of skills they

need for effective practice has become a focus in nurse education

(DOH, 1999).

The clinical placement experience is a significant

learning component within the nursing curriculum. It provides

nursing students with an opportunity to use the theory and skills

they have learned in the classroom and laboratory settings

(Barney).

The rapid changed in the health care environment have

many implications for nursing education and nursing practice. The

rapidity of knowledge changes have resulted in knowledge become

obsolete. Thus, nurses need to keep learning in response to the

rapidly changing healthcare environmenr so they can keep abreast

of expectations of patient and the health care system (Studdy,

Nicol & ox-Hiley, 1994).

Clinical education is a vital component in the curricula of

pre-registration nursing courses and provides student nurses with

Page 5: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

the opportunity to combine cognitive, psychomotor, and affective

domains. Various studies have suggested that not all practice

settings are able to provide nursing students with a positive

learning environment. In order to maximize nursing students'

clinical learning outcomes, there is a need to examine the

clinical learning environment. (Chan,)

However, the literature suggests that there is a gap between

theory and practice. It has been identified by Allmark and Tolly

(1994). The development of practice theory, theory which is

developed from practice, for practice, is one way of reducing the

theory-practice gap. Rolfe (1995) suggests that by reconsidering

the relationship between theory and practice the gap can be

closed. He suggests facilitating reflection on the realities of

clinical life by nursing theorists will reduce the theory-

practice gap. The theory- practice gap is felt most acutely by

student nurses. They find themselves torn between the demands of

their tutor and practicing nurses in real clinical situations.

They were faced with different real clinical situations and are

unable to generalize from what they learnt in theory.

Theoretical Framework

Dr. Patricia Benner is well known in the nursing community

for her work over the past 21 years with the Dreyfus model of

skill acquisition. Recently she has written about her studies in

nursing using the Dreyfus model, in an article entitled “Using

Page 6: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

the Dreyfus model of skill acquisition to describe and interpret

skill acquisition and clinical judgment in nursing practice and

education” (Benner, 2004). The Dreyfus model is developmental and

is based on experiential learning.

Benner writes that nursing requires both techné and

phronesis. Techné is defined as explicit knowledge that can be

captured from procedural or scientific knowledge. For techné,

Benner gives the example of providing clear parameters and

guidelines to students for determining fluid balance. At this

stage the learner cannot rely on previous experience, so the

student must be given safe, clear directions on how to proceed.

For adequately teaching techné the nursing program must provide

for specific situated learning in the clinical situation, though

students would benefit from previous simulated experiences.

Phronesis, on the other hand, is more complex; it is a

reasoned practice employed by expert clinicians through

experiential learning, where the nurse is continually improving

her or his practice. According to Benner, the integrated, rapid

response is the hallmark of phronesis (Benner, 2004, p. 196).

Benner (2004, p. 197) gives a complex example of phronesis where

the nurse made some rapid decisions when the patient developed a

carotid hemorrhage. Phronesis is learned in the authentic

situation with patients and feedback from experts.

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Dr. Benner’s stages of skill acquisition include the

“novice,” or the period in the nursing program when students have

no experiential background on which to base their approach or

their understanding of the clinical situation; “advanced

beginner” or new graduate; “competent” or one to two years in

practice; “proficiency,” a transitional stage on the way to

expertise; and “expertise,” which involves practical wisdom or

phronesis. For the purpose of this position statement, the focus

is on the stages of the novice and advanced beginner. In the

novice stage the nursing instructor carefully selects patients

that are stable and predictable. As with the earlier discussion

of techné, Benner (2004) suggests that the novice operates from

the perspective of inflexible, rule-governed behavior. Benner

(2004, p. 191) states, “Skills that are performed easily on a

mannequin in a skills lab require adaptation and communication

and reassurance skills when performed on a range of patients who

may be calm or highly anxious.” Qualified faculty provides

coaching, feedback and reflection throughout the nursing

education program. As graduation approaches, students are

expected to function at the “advanced beginner” stage of skill

acquisition. Newly licensed graduates, who function as advanced

beginners, have a heightened awareness of feedback and they

frequently experience anxiety and excessive fatigue (Benner,

2004).

Page 8: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

Conceptual Framework

Ensuring that nursing students receive sufficient

practical experience to develop the full range of skills they

need for effective practice has become a focus in nurse education

(DOH, 1999).

The hospital related learning experience is an important

learning factoring nursing education. In the research paradigm,

nursing students have given the opportunity to utilize the theory

and skills they have learned in the classroom discussion and

skills laboratory.

The related learning experience (RLE) duties in the

hospital will serve as a tool to enhance more the knowledge,

develop the skills, and improve the attitude of the nursing

students.

Research Paradigm

Input Process Output

Figure 1. A paradigm showing the relationships of the input,

process and output of the study.

Theories and Skills learned in the discussion

And in the SimulationLaboratory

Clinical Practice/RLE Duties

Effective performance:

-Enhanced Knowledge-Developed Skills-Improved Attitude

Page 9: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

Statement of the Problem

This research study aims to investigate the learning

experiences of the BSN 4 students in their clinical practice from

the affiliated hospitals of St. Paul University Philippines.

Specifically, it answers the following questions:

1. What are the expectations of the BSN 4 students in the

affiliated hospitals of St. Paul University Philippines?

2. How extent from which these expectations have been met?

3. What is the rate of the students on the

managerial/leadership aspects of their Clinical Instructors?

4. How do the students rate the importance of the clinical

activities in the area?

5. How do the students rate their clinical performance as to

their:

a. Knowledge

b. Skills

c. Attitude

6. What are the problems encountered by the students during

their clinical practice?

7. What are the suggestions of the students to improve the

program of the school in the clinical practice?

Significance of the Study

Page 10: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

This study will benefit the following groups of people:

Administrators of the University where the researchers as

faculty members are working could use the findings as inputs for

enhancing their administrative and supervisory skills for the

improvement of the nursing program on Related Learning

Experience.

Faculty members who will follow up the students in the

clinical area to improve their managerial/leadership aspects as

clinical instructors.

Students who will enroll and currently enrolled in nursing,

to motivate them to focus on their studies for them to apply the

theories and skills effectively in the clinical practice.

Researcher of the study who is also one of the clinical

instructors of the students to know whether the activities in the

area are performed by the students as well as to know what to

improve on in terms of managerial/leadership aspects in the

clinical practice.

Scope and Delimitation

The study had focused on the BSN 4 students of the School

of Health Sciences and it is limited only to the second batch of

RLE.

The study had utilized survey questionnaire to

investigate the learning experiences of the students.

Page 11: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

Definition of Terms

Affective Domain. Refers to the area on attitude, feelings

and/or emotion of an individual.

Affiliated Hospital. Refers to the clinical placement of

nursing students or any health-related course with an opportunity

to use the theory and skills they have learned in the classroom

and laboratory settings.

Cognitive Domain. Refer to the area of knowledge.

Clinical Instructor. Refers to the person who supervises,

guides and teaches students during the clinical practice in the

hospital.

Clinical Practice. Refers to the related learning experience

of the students in the hospital.

Nursing. Is a profession that utilizes a body of knowledge

integrating physiological and biopsychosocial sciences. It is a

practice discipline using a holistic, caring approach across the

Health – Illness continuum.

Nursing education. Is a systematic, dynamic process through

which the learner acquires knowledge of the science and art of

nursing. This process is accomplished through the transfer of

Page 12: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

theory to practice through meaningful clinical experiences in a

variety of settings.

The nursing curriculum. Is built upon and uniquely

integrated with the humanities, arts and sciences.

Psychomotor. Refers to an area of skills, talent or

abilities of a person.

Chapter 2

RESEARCH METHODOLOGY AND PROCEDURES

Page 13: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

This chapter presents the methods and procedures used in the

study. It includes the research design, locale of the study,

respondents and sampling procedure, data gathering procedure, and

statistical treatment of data.

Research Design

The study had made use of Descriptive Method utilizing both

Quantitative and Qualitative methods to investigate the learning

experiences of the BSN 4 students in the clinical practice.

Locale of the Study

The study was conducted at the School of Health Sciences of

St. Paul University Philippines.

Respondents of the Study

The respondents of the study were the BSN 4 students Batch 2

of RLE on the 2nd semester of the S.Y. 2008-2009.

Research Instrument

Page 14: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

A Survey Questionnaire as devised by the researcher was

being used in the study.

Data collection

The researcher floated the questionnaire during the

scheduled plenary sessions. Before the start of the session, the

researcher distributed the questionnaire and then collected them

after the session.

Statistical Treatment of Data

The researchers will use the more efficient and effective

methods of analyzing data in connection with the research

objectives. The use of appropriate statistical instrument

provided a systematic structure for the organization, analysis

and interpretation of research data.

For problem number 1, the frequency distribution and

percentage was used.

For problem numbers 2-5, weighted mean was used and

interpreted by using the Likert scale.

Likert scale interpretation:

POINT SCALE MEAN RANGE QUALITATIVE

Page 15: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

INTERPRETATION5 4.20-5.00 Excellent4 3.40-4.19 Very Satisfactory3 2.60-3.39 Satisfactory2 1.80-2.59 Fair1 1.00-1.79 Poor

Chapter 3

Page 16: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

PRESENTATION, INTERPRETATION AND ANALYSIS OF DATA

1. What are your expectations from the affiliated hospitals of

the School of Health Sciences-College of Nursing regarding

your clinical practice? Please check all that applied.

Table 1: Frequency Count and Percentage of Respondents with their expectations from the affiliated hospitals

EXPECTATIONS FREQUENCY PERCENTAGEa. Provides opportunities to render health services and practice nursing in the hospital

101 100%

b. Provides therapeutic climate for learning experience 101 100%c. Opens communication between the school and the hospital to ensure the safety of the students

101 100%

d. Allows students to manipulate facilities or equipment available in the area

101 100%

e. Nursing staff assumes Role Models as to practices of punctuality, honesty and integrity

101 100%

f. Medical and Nursing Staff share theories and experiences in their practice

101 100%

g. Involves students as members of the health team 101 100%h. Keeping communication lines open

101 100%i. Securing the student the enhancement of knowledge, improvement of skills, and development of good attitude in the area

101 100%

j. Screening competent and knowledgeable Clinical instructors or preceptors to qualify in guiding and supervising the students

101 100%

Page 17: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

Based from the data at the previous page, 100% of the

respondents had checked all the given possible expectations

from the affiliated hospitals.

2. How will you rate the extent to which these expectations

have been met?

Table 2: Extent to which the respondents’ expectations have been met

EXPECTATIONS HOSP WEIGHTED MEAN

INTERPRETATION

a. Provides opportunities to render health services and practice nursing in the hospital

SPH4.29

Excellent

CVMC4.10

Very Satisfactory

NDH 4.46 Excellent

b. Provides therapeutic climate for learning experience

SPH 4.48 ExcellentCVMC 4.13 Very Satisfactory

NDH 4.29 Excellent

c. Opens communication between the school and the hospital to ensure the safety of the students

SPH 4.35 ExcellentCVMC 4.16 Very SatisfactoryNDH

4.17Very Satisfactory

d. Allows students to manipulate facilities or equipment available in the area

SPH4.42

Excellent

CVMC 4.31 ExcellentNDH 4.37 Excellent

e. Nursing staff assumes Role Models as to practices of punctuality, honesty and integrity

SPH4.70

Excellent

CVMC 3.85 Very SatisfactoryNDH 4.18 Very Satisfactory

f. Medical and Nursing Staff share theories and experiences in their

SPH4.16

Very Satisfactory

CVMC 4.41 ExcellentNDH 4.31 Excellent

Page 18: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

practiceg. Involves students as members of the health team

SPH 4.63 ExcellentCVMC 4.48 ExcellentNDH 4.48 Excellent

h. Keeping communication lines open

SPH 4.52 ExcellentCVMC 4.14 Very Satisfactory

NDH 4.82 Excellenti. Securing the student the enhancement of knowledge, improvement of skills, and development of good attitude in the area

SPH4.62

Excellent

CVMC4.27

Excellent

NDH4.50

Excellent

j. Screening competent and knowledgeable Clinical instructors or preceptors to qualify in guiding and supervising the students

SPH4.35

Excellent

CVMC4.71

Excellent

NDH

4.33

Excellent

3. How do you rate the importance of RLE activities? Have you

experience them?

Table 3.1: Frequency Count and Percentage of the respondents who experienced RLE activities

RLE ACTIVITIES YES NO

a. Attending the general endorsement

FREQUENCY PERCENT FREQUENCY PERCENT

101 100%

b. Orientation before going to patients 101 100%c. Participating in the Nursing rounds 101 100%d. Utilizing the nursing care plan as tool in patient care

101 100%

e. Performing nursing activities s/a- Vital signs taking

101 100%

Page 19: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

- turning.positioning- bronchial tapping- suctioning- NGT feeding- Medication administration- Health Teachings- others: please specify

Based from the table above, all of the respondents or 100%

of the population experienced the RLE activities in the area.

Table 3.2: Respondents’ rate of importance on the RLE activities

RLE ACTIVITIES WEIGHTED MEAN

INTEPRETATION

a. Attending the general endorsement3.88 Very much

importantb. Orientation before going to patients

3.11 Much Important

c. Participating in the Nursing rounds 3.92 Very much important

d. Utilizing the nursing care plan as tool in patient care

3.95 Very much important

e. Performing nursing activities s/a- Vital signs taking- turning.positioning- bronchial tapping- suctioning- NGT feeding- Medication administration- Health Teachings- others: please specify

4.00 Very much important

4. How would you rate the managerial/leadership aspects of the Clinical Instructors?

Page 20: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

MANAGERIAL/LEADERSHIP ASPECTS WEIGHTED MEAN

INTERPRETATION

a. Creative and innovative in organizing clinical activities

3.78 Very satisfactory

b. Secures team work and cooperation among students

3.72 Very satisfactory

c. Demonstrates competence in the area 3.17 Satisfactoryd. Lets all students involved in goal setting/planning for patient care

3.12 Satisfactory

e. Secures that the responsibilities in the ares are all shared equally

3.11 Satisfactory

f. Gives the SNs a free access to the facilities to enrich their clinical experience

3.77 Very satisfactory

g. Recognizes students as vital members of the health team

3.76 Very satisfactory

h. Alerts in identifying student’s needs

3.13 Satisfactory

i. Keeps students satisfied in the assigned tasks

3.16 Satisfactory

j. Treats students fairly and as a team 3.52 Very Satisfactory

5. How would you rate your clinical performance?

CLINICAL PERFORMANCE WEIGHTED MEAN

INTERPRETATION

ATTITUDEa. Reports for duty on time, neat and properly groomed

4.74 Excellent

b. Reports for duty with complete paraphernalia

4.70Excellent

c. Shows respect to CI, staff and other students

5.00Excellent

d. Collaborates well with others for patient care

4.86Excellent

e. Shows willingness to learn 4.88 Excellentf. Uses self therapeutically 4.69 Excellentg. Opens to corrections and suggestion 5.00 Excellenth. Possesses caring behavior 4.94 Excellenti. Shows concern, privacy and comfort to the patient

4.93Excellent

j. Accepts negative feedback as learning strategy

5.00Excellent

KNOWLEDGEa. Assesses the needs of the patient 4.97

Excellent

Page 21: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

b. Identifies well the problem based on the needs of the patient 4.96

Excellent

c. Plans with patient and other members appropriate nursing action 4.91

Excellent

d. explains the rationale behind each intervention 4.73

Excellent

e. evaluates the patient accurately and effectively 4.88

Excellent

SKILLSa. utilizes NCP effectively for patient care 4.67

Excellent

b. Performs with accuracy the nursing procedures 4.61

Excellent

c. Records and reports accurately the patient’s status/improvement 4.71

Excellent

d. Manipulates instruments safely 4.70 Excellente. Guides and motivates groupmates in doing responsibility task 4.50

Excellent

6. What are the problems encountered by the students during

their clinical practice?

Several students stated that one of their problems

during their clinical practice is their clinical instructor.

“There are some clinical instructors who embarrass

their students in front of the patient”

“Some of the Clinical Instructors are not approachable”

“There are Clinical Instructors who does not treat

their students fairly”

“Some of the Clinical Instructors are toxic, which

eventually makes me anxious”

There are also some who stated that one of their

problems was that their patients and significant others

(SOs).

Page 22: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

“There are patients who do not want the students to

stay with them inside the room”

“Some of the patients and SOs always ask questions that

sometimes I’m unprepared to answer.”

“Some of the SOs scold the students and even to the

CI.”

The sudden shifting of the schedule was also their

problems during the clinical practice.

“The five-day continuous duty made me so stressed and

always tired that eventually affected my performance in the

area.”

They also had encountered staff nurses who are not

approachable and annoying.

“There are staff nurses particularly at Notre Dame de

Chartres Hospital Baguio City are demanding, not

approachable and always angry with us.”

“Some staff nurses are moody and not approachable.”

7. What are the suggestions of the students to improve the

program of the school in the clinical practice?

Most of the respondents suggested bringing back the

previous schedule which is three days RLE duty every week to

prevent the toxicity.

”They should change our schedule back to original.”

Page 23: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

“The schedule was very toxic. In fact, when the third

day comes, I am already exhausted. Therefore, for the 4th

and 5th day, I can no longer function well.”

Clinical instructors also have to treat the students

fairly and become role models to them.

“The Clinical Instructors should treat the students in

a fair manner to avoid biases.”

“The Clinical Instructors should assume role model to

their students most especially when coming in for duty, they

should not be late.”

“The Clinical Instructor should always be available at

all times and be approachable.”

“The hospital administration should allow the students

utilize all the resources and operate the equipment

available in the area.”

“The hospital should have enough facilities to have

better opportunity for good clinical practice.”

Chapter 4

SUMMARY

Summary

This study was aimed to investigate the clinical practice

experience of the BSN IV students in the affiliated hospitals of

St. Paul University Philippines.

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The researcher had designed a survey questionnaire for the

investigation. It involves seven questions. The last two

questions serve for qualitative study and the rest are

quantitative study.

After collecting the survey questionnaire, the researcher

collated the data and tabulated them. After the process of

tabulation, the researcher used statistical tool which is the

frequency count and percentage as well as utilizing likert scale

for evaluation.

From this study, it was found out that the BSN IV students

excellently performed in their clinical practice from the

different affiliated hospitals of the school.

It was found out from this study also that there were

problems encountered by these students during their clinical

practice which include their clinical instructor, sudden change

of schedule, the staff and the patient and significant others.

REFERENCES

A. Books:

Benner, P. (2004). Using the Dreyfus model of skill acquisition to describe and interpret skill acquisition and clinical judgment in nursing practice and education. Bulletin of Science, Technology & Society, 24, 188-199.

Page 25: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

Rolfe G. (1994). Listening to students: Course evaluation as action research. Nurse Education Today, 14(3):223-227

Studdy, S.J., Nicol, M., $ Fox-Hiley, A. (1994). Teaching and Learning clinical skills (Part 2: Development of teaching model and schedule of skills development. Nurse Education Today, 14. 186-193.

B. Journals:

Allmark P. (1995). Classical view of the theory-practice gap in nursing. Journal of Advanced Nursing, 22(1):18-23

Dunn SV., Burnette P. (1995). The Development of a Clinical Learning Environment Scale. Journal of Advanced Nursing, 22: 1166-1173.

Tolley K (1995). Theory from practice for practice: Is this a reality? Journal of Advanced Nursing, 21(1):184-190

C. Internet:

Barney, Amanda. (). Nurses from Across the State Learn the Importance of Providing A Welcoming Environment. http://www.hari.org/press/06profdevelop.pdf) April 2, 2009.5:15PM.

Chan, D. (). Nursing Student’s Perceptions of Hospital Learning Environments: An Australian Perspective. http://www.bepress.com/ijnes/vol1/iss1/art4. April 2, 2009.5:10 PM.

APPENDIX A

(Survey questionnaire)

St. Paul University PhilippinesSCHOOL OF HEALTH SCIENCES

Tuguegarao City, Cagayan North

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March 18, 2009

Dear respondent,

Warm Paulinian Greetings!

I am currently conducting my study entitled: “CLINICAL

PRACTICE OF THE BSN IV STUDENTS IN THE DIFFERENT AFFILIATED

HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES.”

In this connection, may I ask your genuine participation by

answering the enclosed questionnaire needed for this research

study. Your active participation is highly appreciated.

Thank you and more power!

Respectfully,

BRYIANE P. MEDINA,MANSHS Faculty

Name (optional):__________________________________________________________

Age: __________________ Sex: _________________

Please answer the following questions correctly and honestly.

Page 27: CLINICAL PRACTICE EXPERIENCE BY THE BSN IV STUDENTS IN THE AFFILIATED HOSPITALS OF ST. PAUL UNIVERSITY PHILIPPINES

1. What are your expectations from the affiliated hospitals of the School of Health Sciences-College of Nursing regarding your clinical practice? Please check all that applied.

EXPECTATIONSa. Provides opportunities to render health

services and practice nursing in the hospital

b. Provides therapeutic climate for learning experience

c. Opens communication between the school and the hospital to ensure the safety of the students

d. Allows students to manipulate facilities or equipment available in the area

e. Nursing staff assumes Role Models as to practices of punctuality, honesty and integrity

f. Medical and Nursing Staff share theories and experiences in their practice

g. Involves students as members of the health team

h. Keeping communication lines openi. Securing the student the enhancement of

knowledge, improvement of skills, and development of good attitude in the area

j. Screening competent and knowledgeable Clinical instructors or preceptors to qualify in guiding and supervising the students

2. How will you rate the extent to which these expectations have been met?Use the following scale:5 – Very much4 – Much3 – Moderate2 – Little1 – Not at all

EXPECTATIONS HOSP 5 4 3 2 1a. Provides opportunities to

render health services and practice nursing in the hospital

SPHCVMCNDH

b. Provides therapeutic climate SPH

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for learning experience CVMCNDH

c. Opens communication between the school and the hospital to ensure the safety of the students

SPHCVMCNDH

d. Allows students to manipulate facilities or equipment available in the area

SPHCVMCNDH

e. Nursing staff assumes Role Models as to practices of punctuality, honesty and integrity

SPHCVMCNDH

f. Medical and Nursing Staff share theories and experiences in their practice

SPHCVMCNDH

g. Involves students as members of the health team

SPHCVMCNDH

h. Keeping communication lines open

SPHCVMCNDH

i. Securing the student the enhancement of knowledge, improvement of skills, and development of good attitude in the area

SPH

CVMCNDH

j. Screening competent and knowledgeable Clinical instructors or preceptors to qualify in guiding and supervising the students

SPHCVMCNDH

3. How do you rate the importance of RLE activities? Have you experience them? Use the following scale:4 – very much3 – much2 – little1 – unimportant

RLE ACTIVITIES YES NO 4 3 2 1

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a. Attending the general endorsementb. Orientation before going to patientsc. Participating in the Nursing roundsd. Utilizing the nursing care plan as tool in patient caree. Performing nursing activities s/a- Vital signs taking- turning.positioning- bronchial tapping- suctioning- NGT feeding- Medication administration- Health Teachings- others: please specify

4. How would you rate the managerial/leadership aspects of the Clinical Instructors?

Use the following scale:5 – Excellent4 – Very Satisfactory3 – Satisfactory2 – Good1 – Poor

MANAGERIAL/LEADERSHIP ASPECTS 5 4 3 2 1a. Creative and innovative in organizing clinical activitiesb. Secures team work and cooperation among studentsc. Demonstrates competence in the aread. Lets all students involved in goal setting/planning for patient caree. Secures that the responsibilities in the ares are all shared equallyf. Gives the SNs a free access to the facilities to enrich their clinical experienceg. Recognizes students as vital members of the health teamh. Alerts in identifying student’s needsi. Keeps students satisfied in the assigned tasks

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j. Treats students fairly and as a team

5. How would you rate your clinical performance?Use the following scale:5 – Excellent4 – Very Satisfactory3 – Satisfactory2 – Good1 – Poor

CLINICAL PERFORMANCE 5 4 3 2 1ATTITUDEa. Reports for duty on time, neat and properly groomedb. Reports for duty with complete paraphernaliac. Shows respect to CI, staff and other studentsd. Collaborates well with others for patient caree. Shows willingness to learnf. Uses self therapeuticallyg. Opens to corrections and suggestionh. Possesses caring behaviori. Shows concern, privacy and comfort to the patientj. Accepts negative feedback as learning strategyKNOWLEDGEa. Assesses the needs of the patientb. Identifies well the problem based on the needs of the patientc. Plans with patient and other members appropriate nursing actiond. explains the rationale behind each interventione. evaluates the patient accurately and effectivelySKILLSa. utilizes NCP effectively for patient careb. Performs with accuracy the nursing proceduresc. Records and reports accurately the patient’s status/improvementd. Manipulates instruments safely

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e. Guides and motivates groupmates in doing responsibility task

6. What are the problems evolved during the Clinical Practice?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

7. What are your suggestions to improve the Related Learning Experience?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________