Nursing Aptitude Test and Philippine Nursing Licensure Examination

CHAPTER I

THE PROBLEM AND ITS SETTING

Introduction

The growing demand for Filipino nurses abroad has given the

country’s administrators a responsibility of ensuring the quality of care

rendered and the competency of Filipino nurses. It has to be made sure

that they get the best education and that they render effective quality

care to clients. Nurses are required to have the necessary skills to be

able to achieve this. According to Valanis (2000), nurses need

additional competencies in order to function effectively, a term which

refers to their skills, knowledge and attitude. The Joint Commission on

Accreditation of Health Organizations also said that nurses need to

develop competencies to perform well in their job function. The

competencies stated refer to skills, knowledge and behaviors, as well

as personal characteristics.

The Nursing Aptitude Test (NAT) was first used as a criterion for

retention in the college of nursing, to determine a student’s learning

preferences and talents. However, on March 10, 2009, Dr. Rizalina

Mitra-Pangan approved the recommendation to temporarily adopt the

NAT in the BSN program for diagnostic purposes rather than qualifying

criteria (Malimbag, 2009). On a study made by del Rosario, et al., the

outcome of major nursing subjects and the entrance exam were

perceived to be in the position to determine cut-offs which are

predictors for passing the Philippine Licensure Examination (Malimbag,

2009).

Many studies that have been done on nursing quality focused on

a single factor such as putting emphasis on nursing care while

neglecting other characteristics and components (Mamaoag and

Magno, 2005). The study involved four culturally relevant

characteristics of Filipino nurses: caring, compassion, commitment and

connectedness. As stated, these factors of nursing quality are directed

towards the others where caring means providing comfort, compassion

is sympathetic consciousness of others, commitment is responsibility

to others and the profession, and connectedness is the nurse-patient

bond.

A growing concern now exists on the decline in the quality of

care given by nurses and their ability to render effective care. This has

been the reason why the Commission on Higher Education has

identified several ways of upholding nursing quality. Schools with

passing rates below the national standards have been given warnings

2

by the Commission on Higher Education making it a must for school

administrators to know firsthand possible ways of determining the

performance of their students in the said examination in order for them

to identify their course of action. The researchers of this study aim to

discover and understand the relationship that students’ performance in

the Nursing Aptitude Test may possibly have to their performance and

ability to pass the Philippine Nursing Licensure Examination, determine

whether the Nursing Aptitude Test can be used as a predictor for

passing the Philippine Nursing Licensure Examination.

The proponents prompted this research study due to the low

passing rate of our institution. For the past years, the average passing

rate of the Notre Dame of Midsayap College – College of Nursing has

been above the national passing rate. However, with the school’s aim

for academic excellence, this is still not enough. This study may be

helpful by providing a basis for improvement and selecting measures

to not only ensure that the students receive quality nursing education,

but also to know who among the students are ready to take the

Philippine Nursing Licensure Examination and what steps to take in

order to have a high passing rate.

Statement of the Problem

3

The main purpose of this study is to determine if a relationship

exists between the result of the students’ NAT examination and their

performance in the Nursing Licensure Examination, and to refine our

understanding on how preferences and skills in learning, which are

assessed through the Nursing Aptitude Test, affect the performance of

nursing students in the Philippine Nursing Licensure Examination. This

study aims to answer the following questions:

1. What are the scores of the students in the Nursing Aptitude Test

and the Philippine Nursing Licensure Examination?

2. Is there a significant relationship between the students’

performance in the Nursing Aptitude Test and the Nursing Licensure

Examination?

Scope and Limitation

The study is limited only to the analysis of the scores of the

students in the Nursing Aptitude Test and the Nursing Licensure

Examination and determining whether their performance in the

Nursing Aptitude Test can be used as a criterion for determining the

students’ performance in the Licensure Examination. This also includes

assessment of the strengths and weaknesses of the students in the

Philippine Nursing Licensure Examination and analysis of the

4

correlation of the performance of the students in the Nursing Aptitude

Test and the different subjects of the Philippine Nursing Licensure

Examination.

Although this study includes students’ performance in the NLE

and the NAT examination, it excludes other factors like time for review,

values, beliefs, and others. As stated by Mamaoag and Magno (2005)

based on the model on nursing quality by Valanis (2000), nurse

competencies entail aspects of abilities more than affective qualities.

Valanis contended a more crucial need for nurses to possess

competencies rather than focus on the separate etymological

concepts.

Significance of the Study

This study may help in the evaluation of the effectiveness of the

implementation of utilizing the Nursing Aptitude Test for ensuring

excellent nursing education for students. It may serve as a preliminary

investigation on Nursing Aptitude Test (NAT) as a predictor for passing

the Philippine Nursing Licensure Examination (PNLE) and as basis for

making changes, policies and teaching strategies to ensure quality of

education. The NAT, being a test for evaluation of students’ readiness

for the course, may be a probable criterion for evaluating students’

5

ability to pass the Nursing Licensure Examination. And because the

test evaluates a student’s skills and learning preferences, it can be

used to study the effect of their skills and learning preferences on their

performance in the Board Exam and their performance as future

nurses. Knowledge on this topic would be helpful to administrators in

selecting actions to be taken to improve performance and quality of

education the students receive and ensure a high passing rate in the

Philippine Nursing Licensure Examination.

This could be helpful to the College of Nursing by providing the

department an insight on several factors affecting the performance

and competence that the students have. A refined understanding on

the relationships between NLE performance, competence, and learning

preferences as well as readiness may be helpful in providing a basis for

improvement and selecting measures to not only to ensure that the

students receive quality nursing education but also know who among

them are ready for the Philippine Nursing Licensure Examination and

ways of ensuring a high passing rate.

Definition of Terms

For clarity of terms used in the study, the following operational

definitions are given:

6

Affective Qualities . refers to qualities related to a person’s

attitude and behavior rather than competence or performance

Community Health Nursing. refers to a nursing subject which is

part of the Bachelor of Science in Nursing Curriculum and the

subject 3 of the Philippine Nursing Licensure Examination focused

on concepts and principles in the provision of basic care in terms of

health promotion, disease prevention and health maintenance of

the individual, family, community and special population groups. It

also includes the study of the Philippine Health Care Delivery

System and the general context of public health. It describes public

health in the context of the Philippine Health Care Delivery System.

Competence. refers skills, knowledge, personal characteristics

and ability to render effective client care.

Fundamentals in Nursing. refers to a nursing subject part of the

Bachelor of Science in Nursing Curriculum and subject 1 of the

Philippine Nursing Licensure Examination that is about standard

operating procedures, basic principles in nursing, normal values and

the nursing process.

Learning. refers to a change in a person’s behavior, perception,

skills and attitude that occurs through teaching, practice and

experience.

7

Learning Preferences. refers to the type of learning or teaching

strategy that a student(s) find most comfortable and easily

understandable.

Medical – Surgical Nursing. refers to a nursing subject part of the

Bachelor of Science in Nursing Curriculum and subject 4 of the

Philippine Nursing Licensure Examination that is about techniques

and principles in nursing management of sick clients across the

lifespan in any setting.

Nursing. refers to the protection and promotion of optimal health

and prevention of injuries, alleviation of suffering through diagnosis

and treatment of human responses, focusing not only on the

individual but also includes the family and the community.

Nursing Aptitude Test (NAT). refers to a diagnostic test given to

nursing students giving an insight on the profile of a student on four

areas: verbal reasoning, numerical facility, science and health and

spatial aptitude.

Philippine Nursing Licensure examination (PNLE). refers a test

given to nursing graduates to determine whether they are qualified

for the nursing profession.

Psychiatric Nursing. refers to a nursing subject part of the

Bachelor of Science in Nursing Curriculum and subject 5 of the

Philippine Nursing Licensure Examination that is about techniques

and principles in nursing management of sick clients across the

8

lifespan with maladaptive behaviors and alterations in cognition in

any setting.

Quality Care. refers to effective care rendered by nurses and

other health care professionals to their clients/patients.

Related Learning Experience. refers to a component of the

Bachelor of Science in Nursing Curriculum which is the clinical

application of the principles taught in the classroom.

9

CHAPTER II

REVIEW OF RELATED LITERATURE, STUDIES AND CONCEPTUAL

FRAMEWORK

Related Literature

This section presents related topics regarding the types of tests, NAT

Examination, The Nursing Licensure Examination and Nurse

Competence.

Nursing Achievement and Aptitude

Majority of studies in nursing shows that nursing achievement is

moderately perceived as important. This concerns a great concern to

improve the abilities of nurses such as their aptitude and academic

achievement. The common measure of nursing achievement in

published studies on nursing education can be found in the results of

licensure examinations such as the NCLEX (National Council Licensure

Examination). In the Philippine setting, the Philippine Regulation

10

Commission also uses a test for the licensure of nurses, although there

are no published studies using the said instrument.

Three studies are published in reviews using the NCLEX as a

measure of nursing achievement. The study by Lamm and McCaniel

(2000) used the State Board Test Pool Examination (SBTPE), Grade

Point Average (GPA), parental education level, and age as predictors of

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

accurately predict the success of practical nursing students on the

NCLEX-PN. The results indicate that among all predictors, the General

Mental Ability (GMA-subscale of SBTPE) was the only significant

predictor of the NCLEX-PN. A recent study by Waterhouse and Beeman

(2003) was able to identify more significant predictors of the NCLEX

such as scores in the Risk Appraisal Instrument (RAI), grades in the

different nursing courses, and the nursing achievement test. In a more

recent study, Giddens and Gloekner (2005) investigated the

relationship between critical thinking and the performance scores on

the NCLEX. Their study showed that both measures of critical thinking

(California Critical Thinking Test and California Critical Thinking

Disposition Inventory) did not significantly predict the NCLEX scores.

The study recognized the need to explore other dispositional variables

in explaining nursing achievement scores.

11

The studies on nursing achievement usually correlated other

cognitive measures such as critical thinking, mental ability, grades,

with demographic factors such as age, gender, and parents’

educational level. Previous studies did not explore other dispositional

factors such as nursing quality traits in predicting nursing achievement

levels because these concurrent studies were driven by the factors

explained by other previous studies. This poses a need to explore and

use other kinds of disposition such as quality traits in explaining

nursing achievement and aptitude (Mamaoag and Magno, 2005).

Education/Licensure

Students of nursing bring abilities and attitudes to their nursing

courses. Within the course the knowledge and skills of nursing are

presented. Together the educators and students attempt to integrate

knowledge with caring, abilities with skills, skills with knowledge and so

on. Not all students of nursing in formal courses are beginners. Many

possess valuable skills and knowledge that are relevant to nursing. The

Recognition of Prior Learning (RPL) of skills, experience and

qualifications can be expedited by the use of Competencies. If a

student or nurse believes they already possess the integrated

attributes required in some aspect of nursing, they could be assessed

against the Competency and gain RPL. Savings in costs of education

12

and time for the learner can be achieved in this way. However to date,

this aspect of the use of Competencies in nursing has not been widely

used.

Another definition of Competency is the ability to perform the

activities within an occupation or function to the standard expected in

employment.' (Heywood, Gonczi & Hager, 1992).

One of the central themes of the use of Competencies in

education is the change of focus from what a student is taught and the

knowledge they learn, to outcomes, or demonstration of what the

learner can actually do. Many nurses have difficulty in understanding

the competency movement because nursing has traditionally prepared

its students in settings and in a manner that closely resembles this

description. Hospital-based schools of nursing presented theory and

skills for learning that were highly relevant and functional to the

standard expected in the hospital ward. Since the move of nursing

education to tertiary settings, the workplace nature of much of the

learning and application of that learning has altered. However, nursing

courses for Enrolled and Registered nurses remain based upon the

knowledge, skills and attitudes nurses are expected to demonstrate in

employment in a wide variety of contexts and settings. More emphasis

is placed on ensuring every participant gains and is able to apply the

required competencies in the course of their occupation or profession.

13

Competency-based Education and Training have been introduced to

many occupational and trade vocational preparation programs as well

as to some professional programs and courses such as nursing.

Another distinct feature of Competency-based education or

training is the emphasis on assessment in real-life settings and

situations. The demonstration of knowledge is frequently assessed by

judging its application in the work situation rather than by undertaking

written exams.

Although students of nursing may no longer be employees of the

hospital where they gain clinical experience, much of the assessment

of their suitability to qualify as a nurse, or their competency in nursing,

takes place in the real-life setting. This may be in the context of

planning the care of a patient upon admission to the surgical ward of a

hospital, providing care at the bedside of a patient in the nursing

home, caring for a child in the operating room, assessing a client in a

community clinic or their home or teaching the patient and their family

about medications.

Using descriptions of the performance competencies required of

RNs or ENs throughout Australia (for example, the standards of a nurse

who undertook basic preparation in Western Australia can be

compared with one who graduated in Queensland), the equivalence of

professional performance can be determined. A nurse from Argentina

14

or Thailand or Great Britain can also be assessed for suitability for

recognition in any state, by assessing each individual's nursing

performance and knowledge using the Australian nursing

competencies(Hird, 1995).

Do Nursing Quality Traits affect Ability Measures?

Nursing quality traits do not affect ability measures, but aptitude

affects achievement in nursing. These findings support previous

models of using cognitive factors to predict cognitive criterion as well.

Current literature describes nursing licensure exams like NCLEX as a

measure of nursing achievement. Most often, studies indicate factors

such as general mental abilities, Grade Point Average (GPA), parental

education level and age as best predictors of success in passing board

examinations. None ever described yet that empirically, personality or

personal attributes can also predict success in the nursing profession.

The findings indicate that affective measures such as traits are

not good predictors of ability measures such as achievement and

aptitude. The nursing traits having no effect on both aptitude and

achievement further indicate that nursing quality is distinct with the

two ability measures. The distinction is indicated by the nature of the

constructs itself – where the nursing traits are non-cognitive and the

ability measures as cognitive. The traits were self-reported that may

15

be subject to social desirability in the measurement, while the ability

measures are tests of one’s achievement and aptitude that are

assumed objective. Previous studies that used affective predictors also

did not yield significant effects for ability measures like the risk

appraisal assessment (Waterhouse & Beeman, 2003).

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

disposition aside from quality traits in explaining nursing aptitude and

achievement. However, the belief that human functioning includes

behaviors, person variables, and the environment that are interacting

with and shaping with one another (Bandura, 1986) has been further

strengthened as indicated in the resulting model tested in this study.

Further studies can include other disposition measures such as

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

successful careers in nursing. A further analysis using a larger sample

needs to be undertaken to increase the power of the statistics (Magno

and Mamauag, 2007).

Is the Integration of Nursing Quality with Ability Measures a Good

Model?

Integrating nursing quality with both aptitude and achievement

shows a considerable good fit for the proposed model and more so with

the constrained model as indicated in the noncentrality fit indices and

16

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

attributed to the three distinct measures of the NQS, Aptitude, and

Achievement tests. Considering that these all belong in a single test

battery, the participants of the study most likely saw the parallelism in

the measures used. It also indicates that the structure of the three

variables fit together because all the items were calibrated with person

ability by using the same one parameter Rasch model in a binary

response type of scaling (“0” and “1”). The technique of calibrating the

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

increases its fit indices.

Unlike earlier studies that generated multivariate procedures,

the SEM takes a confirmatory rather than exploratory approach to data

analysis as illustrated in this study. While most of the multivariate

techniques from previous studies provides regression and predictive

models of nursing achievement, the present study showed that the

factors of nursing quality, achievement, and aptitude fits together in a

structural model. As depicted in this study, the constructs of nursing

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

independent measures of both non-cognitive and cognitive abilities.

The integration of the nursing quality with ability measures was

apparently good as a model but the model also showed that affective

qualities are independent of cognitive abilities.

17

Aside from citing statistical considerations and benefits of using

the SEM and Rasch model applications as shown in this study, nurses

in the academic setting are expected to possess all the necessary

competencies, skills, attributes to be effective in their profession

(Valanis, 2000).

Standardized Tests

A standardized test is one that is administered under

standardized or controlled conditions that specify where, when, how,

and for how long children may respond to the questions or "prompts."

Standardized tests should meet acceptable standards for technical

qualities in construction, administration, and use.

Goodwin and Driscoll (1980, pp. 59-60) note that standardized tests

have the following qualities:

1. They provide a "systematic procedure for describing

behaviors, whether in terms of numbers or categories."

2. They include specified procedures for administration and

scoring.

3. The test items are derived from experience, either by

experiment or observation, rather than theory.

4. They have an established format and set of materials.

18

5. They present the same tasks and require the same response

modes from all test takers.

6. They provide tables of norms (see standards for technical

qualities) to which the scores of test takers can be compared

in order to ascertain their relative standing.

The great majority of standardized tests are marketed by

commercial test publishers, who have prepared them for use in a

broad array of educational institutions in many different settings. This

means that they are based on educational objectives common to such

diverse schools, and "rarely will these common objectives coincide

exactly with the specific objectives of the individual classroom teacher

or project director" (Goodwin & Driscoll, 1980, p. 60).

Individually administered standardized tests can serve important

purposes when they are selected wisely and used as intended by the

test developers, and their results are not overgeneralized or

misinterpreted. Hills (1992) notes:

"The primary strengths of standardized tests, if they are properly

designed and properly used, are that they can eliminate biases

in assessment of individual children and that they provide data

that can be aggregated, permitting comparisons of groups to a

standard." (p. 49)

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School personnel must not, however, limit assessment to such

tests or allow the tests to dominate assessment of the test takers.

Can readiness be considered as an important aspect of learning?

Readiness may be included in the factors that affect education

and learning. As stated by Nunnery (2005), readiness is an important

concept in learning, regardless of the learner’s chronological age. For

teaching to be effective and learning to take place, the readiness of

the learner must be a prime consideration.

How Learning, Readiness, Cognitive Aspects and Understand are

Related

Learning is the perception of and assimilation of the information

presented in a variety of ways. Learning has the following aspects:

1. perception of new information

2. initial reaction to the information

3. ability to recall or repeat the information (simple

knowledge level)

4. rejection or acceptance of the information (understanding)

5. use of the information in a similar situation (application)

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6. critical analysis of the information

7. incorporation of the information in the values system

(evaluation)

8. use of the information in various situations and

combinations 9creation)

an increasing complexity emerges here as the learner moves from

receiving and recalling information through:

1. understanding

2. application

3. analysis

4. evaluation of the knowledge acquired and creation of new

applications

Learning can also be enhanced with specific strategies or

approaches: individual styles vary, motivation strengthens learning,

arousal influences attention, application in varied context broadens

generalization, personal history shapes the perception of the

experience (Nunnery, 2005).

In terms of learning and cognitive aspects, what has to be

remembered is that to achieve a lasting change in observed behavior

(which is the goal of learning), the value of that change (affective

21

domain of learning) and the intellectual capacity (cognitive domain)

must first be present (Nunnery, 2005).

Main Areas of the Nursing Aptitude Test

Nursing career is getting attention all around the world.

However, unlike mechanical and technical professions you need some

qualities of heart for nursing jobs. The best in the nursing services

have been generous, loving and compassionate.

Still nursing career is not considered personal because it involves a lot

of team work. You will have to take care of physically or mentally ill

people. You have to perform in different roles such as a disciplined

care giver, a counselor, a manager, a teacher etc. Your every action

shall focus upon benevolence of the patients.

Furthermore, you need not only to be responsible and dependable but

also capable to accept truths of death and life.

Most of the nursing jobs screen you through nursing aptitude tests. The

psychologists build them around the following main areas:

A. Applied Sciences

22

1. Physics - The multiple choice questionnaire tries to measure your

comprehensions for mechanics, measurements, laws of

thermodynamics, acceleration, momentum etc.

2. Organic and Inorganic Chemistry - You have to take care of the

patients with certain medicines and chemicals. You are expected to

know basics of solvents, electrons, titration, periodic table etc.

3. Daly Life Science - You need to learn basics of TCA cycle, ATP,

cardiac control, human nervous system, endocrine glands, ECG basics,

cardiovascular system, lungs and respiratory effects, thyroid

hormones, etc. You are expected to hear and use these basic things

about the human medical science for your life long nursing career.

4. Vocabulary Skills - The nursing career requires you to have correct

knowledge of different words. Sometimes, your wrong perception of

words can put lives of the patients in severe danger. That’s why

vocabulary skills are tested with nursing aptitude test.

5. Mathematics Skills - Though the nursing aptitude tests include only a

portion of math to test your mathematical reasoning but it is still a

important to know about real numbers, fractions, trigonometry, area

calculations, logarithmic scale etc.

6. Reading Comprehension - In your nursing career you will have often

to read the instructions issued by the doctors during their visits. When

23

you fail to comprehend the simple instructions, you can’t help the

patients in any way. So your reading comprehension is also tested

before you qualify for entry level nursing jobs.

7. Analytical Reasoning - Analytical reasoning helps you to make quick

decisions during emergency. Most of the nursing aptitude tests include

this portion before you are selected for a nursing career.

Conceptual Framework

Independent Variable Dependent

Variable

Figure 1.1 shows the conceptual framework of the study demonstrating

how the student’s abilities, which are assessed through the Nursing

Philippine Nursing Licensure Examination

Fundamentals of NursingCommunity Health Nursing, Maternal and Child Health NursingMedical-Surgical Nursing Part IMedical-Surgical Nursing Part IIPsychiatric Nursing

24

Nursing Aptitude Test

1. Judgment in Nursing Situations

2. Visual Memory3. Memory for Content4. Information5. Scientific Vocabulary6. Ability to Understand

and Follow Instructions

Aptitude Test (NAT) which include all important skills that nurses

require such as judgment in nursing situations, visual memory,

memory for content, information, scientific vocabulary and ability to

understand and follow instructions, affect their performance in the

Philippine Nursing Licensure Examination.

CHAPTER III

METHODOLOGY

This chapter presents a brief description of the method used in

the research including the research design, study subject, method of

sampling used, research instrument, data gathering procedure and

methods of data processing.

Research Design

The researchers used the descriptive correlational design. It does

not infer cause-and-effect but describes the relationships between two

variables namely the students’ performance in the Nursing Aptitude

Test and their performance in the Philippine Nursing Licensure

Examination.

Respondents and Locale of the Study

25

The population of this study is defined as the 4th year nursing

students of Notre Dame of Midsayap College during the school years

2006-2007 and 2007-2008 who have taken the Nursing Aptitude Test,

graduated, complied with the requirements and have taken the

Philippine Nursling Licensure Examination regardless of whether they

passed or not.

Sampling Design

The researchers utilized complete enumeration to select the

respondents for the study. This is due to the small number of students

in the nursing department of Notre Dame of Midsayap College and to

ensure higher reliability of the results of the statistical treatment.

Research Instrument

The research instrument in the study mainly composes of official

records of the outcomes of their Nursing Aptitude Test of the

respondents from the Notre Dame of Midsayap College Guidance Office

and records of their scores during the Philippine Nursing Licensure

Examination with permission from the dean of the College of Nursing,

Psychometrician and Guidance Counselor.

26

Data Gathering Procedure

The data needed for the study are official records of the results

of the Philippine Nursing Licensure Examination and the records of the

results of the Nursing Aptitude Test in the Guidance Office of Notre

Dame of Midsayap College.

Data gathering began by obtaining the approval of the dean of

the College of Nursing to conduct this study and gather the data,

permission and approval of the Guidance Office of Notre Dame of

Midsayap College to have access to the grades and scores of the

respondents included in the study. Reviewing these materials ad

securing our own copy of these materials were the most crucial parts

of this process.

Statistical Treatment

The statistical treatment used to analyze the data and determine

the degree of association and closeness of relationship between the

two variables is the Pearson r or the Pearson Product-Moment

Correlational Coefficient.

27

The correlational coefficient in this method is measured on a

scale that varies from positive one through zero to negative one. When

one variable increases as the other does, then the correlation is

positive; when one decreases as the other does, the correlation is

negative. Complete absence of correlation between two variables

would mean an r-value of zero (Basilio et al, 2003).

CHAPTER IV

PRESENTATION, ANALYSIS AND INTERPRETATION OF DATA

This chapter contains a presentation and analysis of all the data

collected as part of the research. These data include scores of the

respondents in the Nursing Aptitude Test and the Philippine Nursing

Licensure Examination which is also comprised of different subjects

namely: Fundamentals of Nursing (Subject 1), Community Health

Nursing (Subject 2), Psychiatric Nursing (Subject 3), Medical-Surgical

Nursing (Subject 4), and (Subject 5).

The demographic profiles of the respondents have not been

included since the only factors that have been considered were the

Nursing Aptitude Test and the Philippine Nursing Licensure

Examination results.

28

The results of the Nursing Aptitude Test have been correlated to

every subject of the Philippine Nursing Licensure Examination.

Scores of the Respondents in the Nursing Aptitude Test and the

Philippine Nursing Licensure Examination

The Nursing Aptitude Test which is given to nursing students

before they proceed to Level 2 may have a significant relationship to

their performance in the Philippine Nursing Licensure Examination. The

5 areas of the Nursing Aptitude Test namely: Judgment in Nursing

Situations, Visual Memory, Memory for Content, Information, Scientific

Vocabulary, and the Ability to Understand and Follow Directions are all

necessary characteristics that nursing students and nurses alike should

possess. Therefore, the performance of nursing students in the

Philippine Nursing Licensure Examination may be affected by their

skills in these areas.

On these grounds, the following discussions present the scores of

the respondents in the Nursing Aptitude Test and the Philippine

Nursing Licensure Examination including both the general average and

their scores in 5 different subject areas of the Philippine Nursing

29

Licensure Examination, and the correlation between these scores. Data

regarding these are presented in the following tables.

Table 1.1

Table 1.1 presents the respondents’ scores in the Nursing Aptitude Test.

Number of Respondent

Nursing Aptitude Test

1 702 773 744 775 756 777 828 799 7510 8311 7812 7813 7814 7515 7516 8117 7218 7319 7320 8021 7222 7623 7424 8525 7726 8527 8128 7929 7630 8631 7932 7933 82

34 8235 8236 9037 7138 8039 7840 7741 8542 7343 8544 7645 7946 7647 7748 7149 8250 7651 7552 7253 7554 8755 8156 7857 7958 7759 8360 7261 8562 7863 7464 8065 8266 8067 7468 85

30

69 8070 7371 74

31

Table 1.2

Table 1.2 presents the ranks, range of scores, frequency and

percentage of scores in the Nursing Aptitude Test.

RANK RANGE OF SCORE FREQUENCY PERCENTAGE

Low Average 17-30 0 0%

Average 31-68 0 0%

High Average 69-86 69 97.18%

Above Average 87-96 2 2.9%

Superior 97-98 0 0%

Excellent 99-100 0 0%

Based on the data presented above, 69 or 97.18 percent of the

respondents ranked high average (R=69-86) while 2 or 2.9 percent

ranked above average (R=87-96). These findings indicate that majority

of the respondents ranked high average in the Nursing Aptitude Test

while only a few of them have ranked Above Average. This reflects the

effectiveness of the methods that the College of Nursing uses in

screening students. Students that are accepted are required not only

to have satisfactory grades but also good performance and aptitude.

This is the reason why the use of the Nursing Aptitude Test to measure

these things is considered as an important part of ensuring that the

Notre Dame of Midsayap College – College of Nursing is not only able

to produce very capable graduates but also maintain a high passing

rate in the Philippine Nursing Licensure Examination.

Scores in the Philippine Nursing Licensure Examination

The Philippine Nursing Licensure Examination has 5 areas

namely the Nursing Practice I (Fundamentals of Nursing), Nursing

Practice II (Maternal and Child Health Nursing, Community Health

Nursing), Nursing Practice III (Medical-Surgical Nursing part 1), Nursing

Practice IV (Medical-Surgical Nursing part 2), and Nursing Practice 5

(Neurological Medical-Surgical Nursing, Psychiatric Nursing). These are

all key areas in the nursing profession. The examination also assesses

the skills of a nurse in different key areas of competency which mainly

revolve on responsibilities of nurses and how to give quality care to

patients in different stages of life.

Learning preferences and skills are very important not only for a

graduate who takes or is about to take the Philippine Nursing Licensure

Examination but also for professional nurses because learning does not

stop when one becomes a registered nurse. Judgment in nursing

situations, visual memory, and memory for content, information,

scientific vocabulary and ability to understand and follow instructions

are skills that all nurses must possess. Experiences in the clinical

setting prove that nurses are regularly faced with situations wherein

they are required to make decisions when they care for their patients.

Making the right decision in these situations is crucial because nurses

are held responsible for the lives and welfare of patients. The

knowledge they have can become basis for the decisions they make

and their vocabulary and ability to understand and follow instructions

are all important when it comes to carrying-out doctors’ orders.

On these grounds, the following discussions present the mean of

scores of students in the Philippine Nursing Licensure Examination per

subject area and as a whole, the passing rates in the different areas,

standard deviation of their scores and the value of r which shows the

correlation of the variables.

Table 1.3

Table 1.3 presents the mean of the scores of the respondents in

the Philippine Nursing Licensure as a whole and per subject area, the

passing rates in these areas, the standard deviation of the scores and

the value of r.

SCORE MEAN OF

SCORES

PASSING

RATE

STANDARD

DEVIATION

VALUE OF

R

General Average in PNLE

73.06 52.11 5.66 0.51

Subject I 77.73 98.59 5.72 0.53

Subject II 73.58 90.14 6.67 0.35

Subject III 74.32 91.55 6.37 0.25

Subject IV 66.59 56.34 9.4 0.41

Subject V 72.86 81.69 7.85 0.46

Based on the data presented above, subject I (Fundamentals of

Nursing) has the highest mean (77.73). It is followed by subject III with

a mean of 74.32, subject II with 73.58, subject V with 72.86 and finally

subject IV with a mean of 66.59.

When analyzed by passing rates, subject I (Fundamentals of

Nursing) has the highest passing rate (98.59%) suggesting that

students have been able to receive good foundation on this subject.

Subject IV (Medical-Surgical Nursing part 2) on the other hand, has the

lowest passing rate (56.34%) although the passing rate of students in

subject III which is part 1 of Medical-Surgical Nursing is quite high. This

shows that Medical-Surgical Nursing is indeed a broad subject. A low

passing rate in subject IV means that not all concepts in this subject

area (Medical-Surgical Nursing) have been discussed. Since it involves

all concepts regarding care of patients in all stages of life with illnesses

in different systems or organs, all medications, medical managements,

nursing responsibilities and even assessments, students need more

time to familiarize themselves with these different concepts. Since the

time they have for review is limited, it is crucial that they be given a

background of these concepts as early as possible in the school

setting. The very high standard deviation of the respondents’ scores in

this subject (9.4) shows the inconsistency in their performance. As

presented above, subject I (Fundamentals of Nursing) has the lowest

standard deviation suggesting that the scores of the respondents has

the least difference in this area.

When analyzed by their correlation to the independent variable,

subject I (Fundamentals of Nursing has the highest correlation (r=0.53)

which is even higher than the correlation of the Nursing Aptitude Test

to the general average of the respondents in the Philippine Nursing

Licensure Examination (r=0.51). These show a very high positive

correlation to the Nursing Aptitude Test suggesting that the

performance of students in the Nursing Aptitude Test can determine

their performance in subject I (Fundamentals of Nursing) and the

Philippine Nursing Licensure Examination as a whole. Performance in

subjects II, IV and V have moderate positive correlation to their

performance in the Nursing Aptitude Test which means that the

Nursing Aptitude Test can also determine performance of students in

these areas. As presented above, there is a moderately small positive

correlation between the performance in the Nursing Aptitude Test and

subject III or Medical-Surgical Nursing part 1 (r=0.25). Although there

is a positive correlation between the two, it is the least. The low

correlation in this area suggests that performance in subject III is not

affected so much by a person’s skills (those assessed in the Nursing

Aptitude Test). This may be where factors such as teaching strategies,

time for learning, and review come in. This shows how important

quality education is. The high mean of the scores and passing rate in

this subject area suggests that the College of Nursing has been able to

give the students this kind of education.

CHAPTER V

SUMMARY OF FINDINGS, CONCLUSIONS AND RECOMMENDATIONS

Restatement of the Problem

The main purpose of this study is to determine the relationship

between the result of the students’ NAT examination and their

performance in the Nursing Licensure Examination. Another is to refine

our understanding on how preferences and skills in learning which are

assessed through the Nursing Aptitude Test affect the performance of

nursing students in the Philippine Nursing Licensure Examination. This

study aims to answer the following questions:

1) What are the scores of the students in the: Nursing Aptitude Test

and Philippine Nursing Licensure Examination?

2) Is there a significant relationship between the students’

performance in the Nursing Aptitude Test and the Nursing Licensure

Examination?

Summary of Findings

Based on the presentation, analyses and interpretation of data,

the following are the major findings of the study:

1. Analysis of the scores of the respondents in the Philippine

Nursing Licensure Examination revealed that the highest scores

are Subject 1 (Fundamentals of Nursing) with a passing rate of

98.59 percent and a mean of 77.72. This is followed by Subject 3

(Medical-Surgical Nursing part 1) with a passing rate of 91.55

percent and a mean of 74.32. Subject 2 (Maternal and Child

Health Nursing, Community Health Nursing) follows with a

passing rate of 90.14 and a mean of 73.58 then Subject 5

(Neurologic Medical-Surgical Nursing, Psychiatric Nursing) with a

passing rate of 81.69 percent and a mean of 72.86. The lowest

scores that the respondents had during the Philippine Nursing

Licensure Examination were in Subject 4 (Medical-Surgical

Nursing part 2) where only 56.34 percent passed the subject and

the mean is only 66.59.

2. With the scores of the students we can say that they have a

good foundation in the Fundamentals of Nursing, Maternal and

Child Health Nursing, Community Health Nursing, Psychiatric

Nursing and Medical-Surgical Nursing part 1. As of their

performance in Subject 4 (Medical – Surgical Nursing), it

demonstrates a weak point in their education and a need for

strengthening their foundations in this subject (Medical – Surgical

Nursing). The high passing rate in the first part of this subject

suggests that the result of the low passing rate in the second

part would be that the students were not able to encounter the

concepts included in the second part of Medical-Surgical Nursing.

This may be a result of the lack of time allotted for the subject.

2 Analysis of the correlation of the scores of the respondents in the

Nursing Aptitude Test and the Philippine Nursing Licensure

Examination as a whole and by subject showed that there is a

strong relationship between the variables. Correlating the scores

in the Nursing Aptitude Test and the general average of the

respondents in the Philippine Nursing Licensure Examination

showed that there is a high correlation between the two

variables (r=0.5125). Upon correlation of the scores in the

Nursing Aptitude Test and the scores in the 5 different subjects

in the Philippine Nursing Licensure Examination, researchers

have identified that the subject with the greatest correlation to

the Nursing Aptitude Test is the Subject 1 or the Fundamentals of

Nursing (r=0.53), followed by Subject 5 or Psychiatric Nursing

(r=0.46), Subject 4 or Medical Surgical Nursing part 2 (r=0.41),

Subject 2 or Maternal and Child Health Nursing, and Community

Health Nursing (r=0.35), and Subject 3 or Medical-Surgical

Nursing part 1 with the least correlation (r=0.25).

Conclusions

Based on the findings of the study, the researchers have

formulated the following conclusions:

1. The College of Nursing especially the Clinical Instructors have

been able to give the students a good foundation on these

subjects:

a. Fundamentals of Nursing

b. Maternal and Child Health Nursing

c. Community Health Nursing

d. Psychiatric Nursing

This is demonstrated by a high passing rate and high average

score of students in these subjects.

2. Nursing education given to students should focus on

strengthening their foundations

3. More time must be given to Medical-Surgical Nursing to be able

to cover all the important concepts and further strengthen the

foundation and understanding of students in this subject.

4. The Nursing Aptitude Test can be used as a predictor for the

performance of students in the Philippine Nursing Licensure

Examination and may also be used to determine how well they

perform in the different subjects of the Philippine Nursing

Licensure Examination particularly on Subjects 1, 4 and 5 which

have the moderate and high correlation to the scores in the

Nursing Aptitude Test.

Recommendations

In the light of the findings of the study, the researchers have made the

following recommendations:

A. Possible Course of Action

1. Clinical Instructors assigned on these subjects should have a

good background on the subject for him to be able to impart

knowledge to students and be able to properly discuss the topics

so students would be able to completely understand the subject.

2. Clinical Instructors should always be updated about current

issues related to nursing for them to be able to share this to

students.

3. Clinical Instructors should monitor the performance of students.

Clinical instructors should then take the necessary steps to

improve their performance in areas where it is not satisfactory.

4. The Nursing Skills Laboratory should have better equipment and

facilities where students can practice and simulate clinical skills.

5. There should be more books and other updated sources of

information on Medical – Surgical Nursing in the library which are

accessible to nursing students.

6. In terms of Related Learning Experience, ward classes should be

practiced to reinforce the knowledge that students receive in the

classroom and also help them understand cases that they

encounter in the area.

7. Students need to have more review sessions on Medical –

Surgical Nursing. And the review center must be well-chosen to

ensure that the students receive the best lectures and

instructions.

8. Nursing students should do their best to expand their knowledge

and understanding of topics related to Medical – Surgical

Nursing.

9. Administrators should monitor the performance of the students

and instructors.

B. Further Studies

In the light of the findings of the study, the researchers

recommend the following for further studies:

1. Further studies should include the academic performance of

students as a predictor for their performance in the Philippine

Nursing Licensure Examination.

2. Further studies should also utilize other statistical tools or

treatment to determine the correlation of the variables (e.g.

regression).

BIBLIOGRAPHY

A) BOOKS

1. Divinagracia, C. (2008). Bachelor of Science in Nursing

Curriculum. Manila, Philippines: ADPCN Inc.

2. Mamauag, M. & mango, C. (2005). Nursing Quality Scale:

Test Development. Unpublished manuscript. Asian

Psychological Services and Assessment, Inc.

3. Subong, P. (2005). Statistics for Research. Quezon City:

Rex Printing Company Inc., 2005

4. Theodore, C. A. (1982). Managerial Statistics. Belmont,

California: Kent Publishing Company, 1982

5. Valanis, B. (2000). Professional Nurisng Pracices in an

HMO: the future is now. Journal of Nursing Education. 39,

13-26.

6. Polit, D. and Beck, C. (2005). Nursing Research.

Philadelphia: Lipincott Williams and Wilkins

B) INTERNET

1. Roman, M. (2005). Assessing Nursing Competency.

Available at: http://www.docstoc.com

2. How to Find the Correlation Coefficient When Doing

Statistics. Available at: http://www.ehow.com

3. Main Areas of Nursing Aptitude Tests. Available

at:http://www.wikipedia.com

4. Hird, V. Nursing Competencies. Available at:

http://www.medcenter.com

APPENDICES

Scores of the respondents in the Nursing Aptitude Test

Number of Respondent

Nursing Aptitude Test

1 702 773 744 775 756 777 828 799 7510 8311 7812 7813 7814 7515 7516 8117 7218 7319 7320 8021 7222 7623 7424 8525 7726 8527 8128 7929 76

30 8631 7932 7933 8234 8235 8236 9037 7138 8039 7840 7741 8542 7343 8544 7645 7946 7647 7748 7149 8250 7651 7552 7253 7554 8755 8156 7857 7958 7759 8360 72

61 8562 7863 7464 8065 8266 8067 7468 8569 8070 73

71 74

Scores of the Respondents in the Philippine Nursing Licensure

Examination.

Number of Respondent

PHILIPPINE NURSING LICENSURE EXAMINATIONSubject 1

Subject 2

Subject 3

Subject 4

Subject 5

Gen. Ave.

1 80 72 80 57 63 70.42 81 67 82 73 72 753 79 78 77 76 77 77.44 70 75 75 52 61 66.65 85 67 83 77 78 786 86 69 80 76 77 77.67 80 74 80 70 72 75.28 67 60 74 56 65 64.49 75 77 76 77 70 75

10 61 61 76 56 62 63.211 75 72 72 59 61 67.812 75 70 74 76 67 72.413 86 76 83 76 76 79.414 78 76 77 63 52 69.215 76 69 77 77 76 7516 82 69 82 70 79 76.417 77 76 79 76 70 75.618 76 66 72 71 75 7219 77 71 75 57 54 66.820 74 59 65 48 65 62.221 74 69 72 56 60 66.222 88 81 85 79 79 82.423 82 73 78 71 71 7524 75 78 79 65 80 75.425 77 67 67 60 63 66.826 82 82 79 75 79 79.427 76 67 77 65 70 7128 72 70 69 59 71 68.229 86 71 82 76 72 77.430 77 74 79 63 69 72.431 82 78 85 64 80 77.8

32 75 63 77 57 69 68.233 66 62 75 56 61 6434 83 84 84 80 83 82.835 72 65 76 67 66 69.236 80 80 70 65 77 7537 61 72 79 56 56 64.838 72 78 71 68 77 73.239 81 79 76 75 80 78.240 77 77 61 59 77 70.241 77 59 65 60 64 6642 79 75 61 60 78 7143 79 77 76 69 81 76.444 79 79 77 74 80 77.845 88 87 79 79 80 82.646 65 76 69 63 75 69.647 76 62 75 46 64 64.648 83 82 71 77 78 78.249 76 65 62 53 68 64.850 85 79 80 74 83 80.251 80 79 76 63 79 75.452 76 69 72 50 66 66.653 78 77 71 69 80 7554 72 65 61 57 75 6655 79 75 71 57 75 71.456 85 85 83 85 83 84.257 87 81 78 82 83 82.258 80 79 78 77 79 78.659 80 78 71 75 80 76.860 77 77 71 60 72 71.461 80 79 76 77 82 78.862 71 68 58 56 71 64.863 83 81 72 76 81 78.664 74 77 66 59 81 71.465 82 80 72 68 72 76.266 78 77 77 72 79 76.667 74 68 59 57 72 6668 84 81 76 74 80 7969 82 79 71 63 81 75.270 75 78 66 59 59 67.471 77 76 77 78 80 77.6

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