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The researcher wish to express her heartfelt gratitude and appreciation to those who assisted her towards the completion of the study. The following are given special acknowledgement: Mrs. Merlyn A. Ouano, Research Adviser, for her unselfish advises, valuable assistance, patience, consideration, motivation and for putting up with her throughout the period of formulating the study and always reminding us to work on our research leaving us no choice but to finish the study until it’s completion.

Mrs. Norma A. Hinoguin, Dean – College of Nursing of the University of Southern Philippines Foundation, for the permission granted to conduct the study in the university. To her valued respondents, the senior nursing students of the University of Southern Philippines Foundation Batch 2008, for their cooperation in answering the questionnaire completely and with all honesty. To the author’s of the different books, articles, and other research studies in the internet, which served as reference materials to make the study worthwhile.

To her mentors at Leyte Normal University who unselfishly edited her study and to the Math Unit who help interpret the result of her survey questionnaire …………. To her parents for their love and concern, which gave her the strength to strive harder and for providing her financial support, which catered her expenses in the making of the study. And to God Almighty, the researcher want to give the study back to Him with humble heart. Thank you very much. vi Chapter I THE PROBLEM AND ITS SCOPE Background of the study

Nursing education is now one of the most in demand courses in the Philippines due to a surge in the demand for Filipino nurses among hospitals abroad. Nursing education is being retrofitted to meet the demands of the global market. As of April 2004, CHED record show that there are 370 nursing schools, an increase of 100 percent from 2000 to 2001 and only about 122 schools have been given permits to operate. Because of the huge demand for nurses abroad, some owners open nursing schools, not to provide quality-nursing education, but to obtain quick returns on investments.

The name of the game is quantity rather than good quality nursing education, and lots of it, says Carmelita Divinagracia, President of the Association of Deans of Philippines Colleges of Nursing. [1] Each year the Philippines is producing increasing numbers of nursing graduates. But as in any other boom, quality has suffered as numbers increase in large part, because of skewed priorities. However, nursing, like any other profession, has certain professional standards to live up to; so that hospitals that hire them are assured that they hire qualified personnel.

This is why there is a licensure examination conducted by the Professional Regulation Commission, Board of Nursing so as to regulate incompetent and inefficient nurses. Although these fresh graduate-nursing students are able to keep up with the 4-5 year tough pace of the Nursing course, they would still have to be tested before they are allowed to work as entry- level licensed registered nurses. Nursing Licensure Examination is a turning point in the life of all nursing graduates’ needs to finally become a full pledge nurse.

Since such examination is difficult, much is indeed at stake and adequate preparation is a must. 1 Each of us is aware of the decrease in the percentage of passing rate of fresh graduate students at the University of Southern Philippines Foundation who took the nursing licensure examination in June 2008 as compared to the previous performance of the nursing graduates who took the licensure examination in June 2007. Is this because of a). Students’ degree of learning or knowledge gained; b).

The students’ learning readiness or the students’ learning motivation to pass in order to give justice to their efforts of more than four years of schooling c). Is it of the student’s inadequate training in the hospitals or is it the substandard quality of nursing educators d). Simply the result of “open enrolment”, or “selective retention” and or the false hopes given to those who do not have the ability to pass the tough nursing education? A Nursing School shall maintain an average board passing percentage of 30% and above for a period of 3 years starting December 2008 up to December 2010.

Within a 3-year period there shall be the two assessments to be conducted by the commission on the Nursing School including conference to the Dean, Vice President of the Academic Affairs and the school owner to institutionalize mechanisms for improvements. If the average board passing percentage will show no improvement, i. e. the passing percentage results remain to be less than 30% all throughout the 3-year consecutive period, the phase out order will be instituted by the CHED. Hence, the researcher is motivated to conduct a study which identifies areas of difficulty of the Core Competency Content as perceived by the Level IV nursing students at the University of Southern Philippines SY 2008-2009 as a deterrents in passing the board examination whether they take it in December 2008 or in June 2009 and to know the factors that contribute to the inadequacy of learning in the level of knowledge and application. Besides this study would serve as basis for the Knowledge, Skills and Attitude (KSA) Enhancement Program of the University of Southern Philippines. Theoretical Framework Six learning theories are applied in this research that have serve as the backbone of the study. Among these are as follows: Informal Adult Education by Malcolm Knowles3 can be applied in this study since it states that a friendly and informal climate is needed for a student to learn. This need implies that there must be flexibility of the learning process, a correct use of experience, and the enthusiasm and commitment of the students.

Likewise, the Instructors are required in order that students can completely comprehend the theories and the related learning experiences taught to them both in classroom and hospital instructions. Ausbel’s Meaningful Reception Learning4 can also be applied to the study since for a learning to take place; a student must undertake series of processes. First, the Derivative subsumption; the student will first identify the new concept taught to him is a concept that has already been learned.

Second, the student will step into the Correlative subsumption; in order to accommodate the new concept, students will consider that the newly learned concept has altered or extended his learning on that specific concept. Third, Superordinate learning; with the new concept taught to the student, the student will have a broader understanding of the concept and identify some examples related to the concept. Fourth, Combinatorial learning; here the student can already correlate the new concept as a derivative from another idea.

Aptitude- Treatment Interaction by L. Cronbach and R. Snow5 is another learning theory that is applicable in this study since it is easier for student to learn a new concept if the instructional strategies or treatments used to deliver the said concept is understandable within there level of understanding. Optimal learning results when instruction is exactly matched to the aptitude of the learner. 3 Thorndike’s Theory of Connection6 mentioned in the Law, which is the Law of readiness. It states that when a person is ready to perform, it is satisfying to do so.

This means that when action is demanded and a state of readiness exists on the learner, then he will be able to act independently and satisfactorily. To the study, this means that when the learner is really interested to learn and feels that there is a need for him to learn, then he would be happy to do so. Another theory that will be one of the groundwork for this study is the Humanistic Theory. 7 Learning tends to be highly value-driven and hence more like prescriptions rather than descriptions.

This emphasizes that for a learning to take place, a natural desire of the student to learn must be present. In connection with this study, there is really a need that the student posses its natural desire to learn. Lastly, is the John Dewey’s Theory of Learning8 According to him learning is starting within. In this study, for a student to learn the necessary knowledge and concepts, student must have that motivation to learn. He must stand as an active learner and involves organic assimilation departure from him.

It is he and not the subject matter, which determines both the quality and quantity of learning. 4 Challenges confronting nurses In today’s health care environments have highlighted the necessity for graduating students to feel both competent and prepared for practice. There are core competency and area of responsibility in each core competency which the graduating students feels they are least knowledgeable and think incompetent which further affects their possibility of passing the licensure examination as basis for knowledge, skills and attitude enhancement program.

In effect are some intervening factors to students’ learning and understanding of these competencies and area of responsibility; (1) Motivation that keeps the students from moving forward in spite of difficulties. (2) Time Management, the ability of the student to balance multiple responsibilities in a given period of time. (3) Perseverance, ability of the students not to give up easily in learning new skills which requires a commitment of time and mental energy. 4) Ability to apply concepts to different situations and uses its genuine understanding of the meaning of that concept being learn and go beyond its facts to understand that concept and be able to apply it. (5) No fear of failure, the ability of the student not to become discourage when things don’t workout and learn from his mistakes and move on. (7) Independence, ability of the student to do task or study his/her lesson by his own and do task immediately after being told and not doing it on the last minute cramming. 8) Self-confidence helps student to trust herself and become independent. (9) Ability to delay gratification is the ability of student to remain motivated in spite of lack of feedback. (10) Ability to balance between critical, analytical and creative thinking which are all learned abilities and skills. (11) Good teaching strategies is the effectiveness of the instructors to impart theories and transfer it into practice likewise their ability to provided quality and quantity learning to the students. (12) Group support is the student’s presence of friends, family and relative to ive encouragement. (13) Resources are the presence of financial support for tuition, expenses for books and other things needed for effective learning experience. 5 Figure 1 Conceptual Framework Figure 2 |INPUT |PROCESS |OUTPUT | |What is the profile of the Level IV |> non- experimental type of research | | |Nursing Students SY 2008-2009 of USPF|Utilized Descriptive method. | |College of Nursing in terms of: |Formula in determining sample size: |Basis for Knowledge, Skills, and | | |Desired sample size = Total number of |Attitude Enhancement Program in | |Age |population X ( % in decimal form) |Preparation for USPF Level IV | |Sex |Utilized Systematic Sampling Technique |Nursing Students SY 2008-2009 in | |Civil Status |Survey Questionnaire |passing the Nursing Licensure | |No. f years |Checklist |Examination whether they take it in | |in the course | |November 2008 or in June 2009 and | |Transferee/ |Survey Questionnaire |thus increasing the passing rate | |Shifty |Checklist |from 52% to 70% or more. | |Frequent Count and Percentage | | | | | | |What core competency content does the| | | |Level IV nursing students SY | | |2008-2009 of USPF considers they are | | | |least knowledgeable of and can hinder|Survey Questionnaire | | |them from passing the Nursing |Checklist | | |Licensure Examination? |Frequent Count & Percentage | | |3.

What are the factors contributing | | | |to the inadequacy in the level of | | | |knowledge and application of this | | | |core competency content to among the |> based on the findings gathered from the | | |Level IV nursing students SY |survey questionnaire. | |2008-2009 of USPF? | | | |4. What Knowledge, Skills, and | | | |Attitude enhancement program can be | | | |proposed based on the findings of the| | | |study? | | Review of Related Literature The study presents a review of research and literatures, which have a direct or indirect bearing on the research problem and variables considered in the study. Core Competencies have continued to confound the nursing profession throughout the years. The challenge it presents for healthcare regulators is learning to objectively measure competencies across various settings, specialties, years of experience and various regions.

According to Oppewal, et al. , (2006),9 core competencies have been developed in different specialty areas, but even nurses’ awareness and implementation of such standards vary. Competence in the context of this research is understood as the technical knowledge, skills and expertise pertinent to a given profession. Character, on the other hand, refers to the “human” side of the person – – his/her personal values, attitudes and virtues; his/her relationship to subordinates and motivational skills; his/her leadership and ethical qualities.

The Core Competencies required for Nursing Students focus on critical thinking, communication and assessment and technical skills to promote health, reduce risk and manage disease. 10 It promotes nationalism, professionalism, transcultural consciousness, ethico-moral integrity and spirituality in the development of a professional nurse within the context of the Philippine society and even worldwide. A strong liberal arts and sciences education with a transdisciplinary approach enhances this belief. 1 Nursing Education therefore, aims to prepare a nurse who, upon completion of the program, demonstrates beginning professional competencies and shall continue to assume responsibility for professional development and utilize research findings in the practice of the profession. 6 As stipulated in the CHED Memorandum Order S. 2007, re: Policies and Standards for Nursing Education, the following are the eleven (11) Core Competency Content for which the nurse should demonstrate competence. 12 1. Safe and Quality Nursing Care 2.

Management of Resources and Environment 3. Health Education 4. Legal Responsibility 5. Ethico-moral Responsibility 6. Personal and Professional Development 7. Quality Improvement 8. Research 9. Record Management 10. Communication 11. Collaboration and Teamwork The Philippine Nursing Licensure Examination is a multiple choice examination designed to test the basic core competencies of fresh nursing graduates which considers the objectives of the nursing curriculum, the broad areas of nursing and other related disciplines and competencies.

It is annually held every June and December in various public schools throughout the Philippines. As stipulated in Article IV, Section 12 of the Philippine Republic Act No. 9173, all applicants for license to practice nursing shall be required to pass a written examination, which shall be given by the Board of Nursing in such places and dates as may be designated by the Commission, provided that it shall be in accordance with Republic Act No. 8981, otherwise known as the PRC Modernization Act of 2000. 3 Nursing Students therefore needs to acquire adequate knowledge’s, skills and attitudes specified in the Core Competencies above mentioned before they can finish the four year nursing course and apply for licensure examination. 7 The Integral CPE paradigm used these three basic learning content14 in training and developing Filipino Professionals amidst globalization. The basic components of the paradigm are as follows: Stage-Level I: Information/Updating. Information refers broadly to whatever shapes the value system of the professional.

Updating, on the other hand, refers to the profession -related, technical data and know-how. Updating also presents the emerging trends and developments including current events in the professional field. This phase basically involves the transmission and acquisition of knowledge, skills and values defined as the movement or transfer of knowledge from the teacher to the student, or the discovery of information or knowledge by the student with the guidance of the teacher. Knowledge here refers to selected and processed information, sifted through universal principles and stored in the mind of the teacher.

Skills, on the other hand, pertain to the educator’s acquired abilities, which are useful in communicating effectively his knowledge and wisdom to the students. At this level, the effectiveness and success of the teacher in transmitting his knowledge and skills to students enable them to acquire sound criteria in gathering information needed for judicious decision-making. Moreover the students are aided in building of their value system. This stage describes the teacher as technician, i. e. one who merely imparts knowledge and skills.

The general tendency of many educational institutions to provide students with a fragmented kind of education, one that leans heavily on the technical side or academics and has little or no regard for the affective and moral development of the students, is a paradigm that we want to veer away from. We have observed that there are currently many higher education institutions which parry from this integrative goal of education. 15 They treat academics and character 8 development as two separate domains that have nothing to do with each other.

Hence, schools and professional associations have relegated themselves to concerns of technical and academic achievement, to the sole task of transmitting knowledge and skills. The philosopher Mortimer Adler16 criticized this current trend. Beyond information and knowledge, students should be equipped with things they need to face and live up to the challenges of daily life. Bellah et al. echo a similar belief: “We must recover an enlarged paradigm of knowledge, which recognizes the value of science but acknowledges that other ways of knowing have equal dignity.

Practical reason, in its classical sense of moral reason, must regain its importance in our educational life”. 17 Certainly the prevailing phenomenon observed in professional schools is at variance with the contention that “all educational and formative work” of the schools aims at no less than influencing “the student’s whole personality”. 18 Hence, the rationale for proposing two higher levels to the realm of teaching and learning. Stage-Level II: Formation/Competence-Building. This refers to the strengthening of sound criteria or standards (i. . based on universal values or principles), the molding of positive attitudes to guide learners in making moral choices or decisions, and the translation of technical know-how to competence. The teacher commits himself to enhancing the moral, cognition or reason of the students and improving their work competencies as well; the educator’s intent is to have the students adopt or identify with a set of criteria or standards and attitudes. At this level, the teacher helps and empowers students to make educated choices in professional life.

To be effective, however, the teacher should teach the criteria or standards within the context of the professional experience. Otherwise, they become decontextualized or irrelevant. Decontextualized 9 learning of these criteria, here, refers to their lack of “relation or connectedness” with the professional theme being studied. Doyle19 asserts that teachers ought to integrate these standards in a context. To do this, teachers ought to have the keenness to discover the “natural or uncontrived applications” of these standards to the professional content being pursued.

This is a feasible task because value-laden standards are intrinsic to academic learning (e. g. coming up with excellent work, submitting deadlines on time, listening attentively in class, participating in discussions, cooperating responsibly in group work, solving problems skillfully and creatively, making sound and prudent decisions, etc. ). A well-disposed student necessarily gets formed in meeting these standards. The mutual commitment of the teacher and the students to these academic standards, i. e. he teacher’s consistent enforcement and the students’ assiduous observance of these standards, is a natural, yet effective way of positively forming the students’ character. Teachers with this educational paradigm would certainly not allow themselves to become boringly pedantic or moralistic in class. Being open to the formative and “mentor” role of educators in the exercise of their profession; teachers can transmit moral values and professional competence by being very good professionals and persons. Character and competence are both taught and caught.

Intellectual honesty and professionalism are values which students can learn through the example of their mentors. By being demanding, and yet gentle, with the students, educators can teach indirectly patience, discipline, order and respect for the laws of nature. Moreover, by training their students to be responsible in their professional requirements and duties, teachers are sharing in the task of helping them to become productive and respectable citizens in civil society. Stage-Level III: Transformation/Performance-Enhancement. This involves transformation/performance-enhancement.

At this level, expected and desired 10 behaviors are manifested. This also concerns exercising influence over a student’s moral reason, affectivity, and professional behavior by means of the teacher’s inspiring example and by his commitment to and consistent demonstration of excellence in teaching. Such influence impels the student to embody the ideals proposed by the teacher, and help him espouse lifelong commitments to learning and service. According to Harned,20 transformation consists of enabling people to pursue “higher causes. Both teachers and students must learn how to look beyond themselves and pursue their work in service of others. Doing so, they multiply the possibilities of learning and growing professionally and personally. The transformational process, however, morally obliges the teacher to lead the students by edifying example. The transformational teacher must exemplify the convictions he is striving to instill in the students. A true educator is distinguished by his ability to effect the transformational level of teaching.

All throughout the educational process, information/updating, formation / competence-building and transformation/performance-enhancement ought to take place simultaneously. It is important, however, for the teacher to ensure the integrity of the information he transmits to the students. For only true or genuine knowledge can be the foundation of effective formational and transformational teaching. The teacher, should not, however, settle for the mere imparting of veritable knowledge. Through the knowledge that he imparts, the teacher must set the impetus to shape the students’ minds ccording to ethical ideals naturally drawn from it; such formidable task is further propelled and intensified by the teacher’s illustrious example so that these ideals do not only stimulate the students’ minds, but move their hearts and transform their actions as well. At the stage of transformation/ performance-enhancement, the student is not just content with knowledge and decision-making skills. On the basis of the good that he knows, he realizes, discovers the seriousness of life that he decides to change not just his worldview or outlook in life but his whole life. 1 This sometimes may include a 180-degree turn that a person takes after a deep realization about committing himself to a more noble purpose in his professional and personal life. On the part of the teachers, they see their work not just as a matter of passing information, no matter how well they may do it. Moreover, they are not content with just helping the students to do well in their decisions. These teachers take it upon themselves to help develop good professionals and good persons simultaneously.

While not neglecting the need to be excellent teachers or instructors, they see their duty as “formers” and “transformers” of men and women. The Schools/ Universities should also look into how they can positively and fruitfully influence the decision-making patterns and lifelong goals of the students they are committed to train and form well. One can only be ethically formed, for instance, if he is continually informed by ethical principles and examples nurtured within and without an educational institution’s culture. And one can be transformed personally only through constant, lifelong formation.

Thus, the continuity of formation and transformation of a person also depends on the commitment of the school to develop oriented goals and ideals. To move from one phase of the paradigm to the next, the key factor is personal commitment to the ideals embedded in the paradigm. The student, as well as the teacher, must be a docile, willing and intelligent subject and protagonist in the educational process. Moving from one stage to the next requires a firm personal decision guided by an awareness of what is truly good for people. Moreover, the student needs the encouragement of the teacher.

And the teacher, on the other hand, needs the support of the professional association. 12 THE PROBLEM Statement of the Problem This study attempts to determine the Areas of Difficulties in the Core Competency Content of the Nursing Licensure Examination as Perceived by the Level IV Nursing Students at the University of Southern Philippines Foundation SY 2008-2009 : Basis for Knowledge, Skills, and Attitude Enhancement Program. Specifically, the study sought to answer the following questions: 1. What is the Profile of the USPF Level IV Nursing Students SY 2008- 2009 in terms of: . Age 2. Sex 3. Civil Status 4. No. of Years in the Nursing Education 5. Status of Enrolment 1. What Core Competency Content do the Level IV Nursing Students at the University of Southern Philippines Foundation SY 2008-2009 consider least knowledgeable of that can hinder them in passing the Nursing Licensure Examination? 2. What are the factors that contribute to the inadequacy learning in the level of knowledge and application of the Core Competency Content to the Level IV Nursing Students at the University of Southern Philippines Foundation SY 2008-2009? . What Knowledge, Skills, and Attitude Enhancement Program can be proposed based on the findings of the study? 13 Significance of the Study The study provides several advantages to the Level IV nursing students at the University of Southern Philippines SY 2008-2009 and those involved in the study. Clinical Instructors. This study serves as a tool in providing quality and quantity learning for preparing nursing students to achieve a higher chance in passing the board examination. Nursing Students.

This allows them to measure their capabilities and help them identify their strengths and weaknesses and focus more on the core competency for which they think as deterrents in passing the board examination. Patients. For safe, effective and quality nursing care rendered to them by the nursing students. Knowledge, Skills and Attitude Enhancement Program (KSA). This study would serve as a basis for an effective review program for senior nursing students in preparation for the board examination thereby aiding them get a passing rate in the Nursing Licensure Examination. The University of Southern Philippines Foundation.

This study serves as basis in formulation and planning of rules and regulations and objectives about effective classroom instructions, RLE learning activities that would provide adequate resources for learning and an effective KSA review program to obtain higher percentage rating of board passers, a “prestige” to the University. Future researchers. This study may yield finding that will encourage them to undertake another study making use of other variables. 14 SCOPE AND LIMITATIONS Scope and Limitation of the Study The study deals on areas of difficulties of Core Competency content in the

Philippine Nurses Licensure Examination as perceived by the Level IV Nursing Students at the University of Southern Philippines Foundation SY 2008-2009 which pose as deterrent in passing the licensure examination. The study also deals on the factors that may contribute to the inadequacy of student’s knowledge or difficulty in understanding the subject matter content and their application to the learning of clinical practice. Furthermore the study focuses only on the selected Level IV nursing students at the University of Southern Philippines Foundation SY 2008-2009.

The study too, did not deal on how many students will take the Nursing Licensure Examination in November 2008 or June 2009. RESEARCH METHODOLOGY Research Design The study is a non- experimental research utilizing descriptive method in obtaining data using survey questionnaires for gathering of data’s followed by obtaining facts through analysis, interpretation and ranking of areas of difficulty in the core competency contents and the factors that contribute to the inadequacy…the nursing education…the people involve and such as the students and clinical instructors and the nursing school.

The study was conducted at the ground of University of Southern Philippines Foundation, Salinas Drive, Cebu City where the subjects of the study are the 96 students (20% of 481 enrolled level IV nursing students SY 2008-2009). 15 Sampling technique In the determination of sample size, the researcher got the 20%of the total population senior nursing students at the University of Southern Philippines Foundation. Since the total population is 481, the researcher multiplied it to . 20, which is the equivalent of 20% in decimal form. The formula used was : N = n x (% in decimal form) here: N = desired sample size; n = the total number of population; % = the percentage of population to be utilized. To illustrate: N = 481 x . 20 = 96. 2 or 96 level IV nursing students This study utilized the systematic sampling technique. Taking the K unit from an ordered population does this. The formula used was: K = N / n where: K = sampling interval; N = the total number of unit in the population; and n = the desired sample size. Since the total number of unit in the population is 481 and the desired sample size are 96 Level IV nursing students.

This then was substituted to the formula. To illustrate: K = N / n; K = 481 / 96 = 5. 01 or 5 sampling interval The researcher then started the random place from the list of sampling frame (arrange alphabetically according to section), using the sampling interval, which is 5, until the desired sample size was reached. 16 Instrumentation A checklist was provided for the data gathering procedure for the convenience on the part of both the respondents and the researcher.

A final copy of 5 pages was then obtained consisting of three (3) parts, ( I ) the demographic profile of the level IV nursing students showing the initials, age, sex, status of enrolment and number of years in the nursing course; ( II ) of questionnaire proper designed to provide the level IV nursing students the opportunity to express themselves which they consider least knowledgeable of and can hinder them in passing the board examination of the 11 Core Competency Content stipulated in the CHED Memorandum for the scope f Nursing Education; ( III ) of questionnaire proper designed to identify factors that contribute to the inadequacy of their knowledge and difficulty with the application of Core Competencies to among the level IV nursing students. The items in the questionnaire, which were drawn up from the USPF Nursing Manual, Philippine Board of Nursing Competency and CHED Memorandum Scope of Nursing Education, were of a checklist type. Data Gathering

Before the initiation of the study, a permission to conduct the survey was obtained from the Dean of the College of Nursing of University of Southern Philippines Foundation. Permission was also sought from the senior nursing students of the said university making use of the permit obtained from the Dean. The questionnaires were distributed last August 23 –27, 2008 among the selected 96 level IV nursing students of the University of Southern Philippines Foundation SY 2008-2009.

The researcher personally handed it out to the respondents with the request to retrieve the questionnaires after class. In a span of two weeks 88 out of 96 questionnaire were retrieved resulting a 92% rate of retrieval. 17 Statistical Tool After the data collection, the responses were tallied and tabulated according to their respective classification, frequencies were recorded and the corresponding percentages to each item were computed by dividing the number of responses by the total number of respondents, and then multiplied by 100%.

Percentage was computed for every item in each category to easily determine the top five (5) core competency content which obtained the highest number of vote likewise the area of difficulty as perceived by level IV nursing students at the University of Southern Philippines Foundation SY 2008-2009 as basis for knowledge, skills and attitude enhancement program and the factors that gained highest result which they think or feel have contributed to the inadequacy of their knowledge on such competencies.

DEFINITION OF TERMS The important terms defined within the context of the study are as follows: Areas of Difficulty refer to the Core Competency Contents or courses specified in the Nursing Licensure Examination, which the Level IV nursing students think their knowledge gained is inadequate.. Core Competency Content refer to the syllabus of subject matter, that is the scope of the Nursing Licensure Examination the Level IV nursing students need to know.

Nursing Licensure Examination refer to the test taken either in the June or December of the year by holders of the degree in Nursing in order to be considered Nursing Professionals who can officially practice their profession either in public or private institutions. Perceive refers to the understanding of the Level IV Nursing Students in their knowledge gained and learning needs from each of the Competency Contents specified in the Nursing Licensure Examination.

Level IV Nursing Students refers to the senior nursing students of the University of Southern Philippines Foundation College of Nursing, expected to have gained the Core Competencies required for passing the Nursing Licensure Examination upon finishing the tough Nursing course. KSA Enhancement Program refers to the proposed program that centers towards the enhancement of skills, knowledge and attitudes of the Level IV nursing students to develop their Core Competencies required for the Nursing Profession and possible increase passing percentage rate in the Nursing Licensure Examination for the University.

ORGANIZATION OF THE STUDY The organization of the study is divided into three chapters. Chapter I discusses the background of the study that relates to the context of the problem, historical background, authorities viewpoints, expresses researcher interest and it also states the purpose of why the researcher would like to conduct this study. Theoretical Framework that explains the theory that support the study.

Conceptual Framework that operationalize the theoretical framework, and shows the flow of the study. Review of Related Literature that includes collections of literatures that is related to the study. The chapter also discusses the problem of the study that consists of Statement of the Problem followed by a series of questions, significance of the Study, that point out vital contributions of the study benefiting the school, clinical instructors, and student nurses as well as future researchers.

Then scope and limitations that stated the coverage of the study, in terms of location, and the type/size of respondents that was used in the study. It also includes the research boundaries. The research methodology that tackle about the research design, sampling technique, instrumentation, data gathering, and statistical tools. And lastly, the operational definition of terms of the variables used in the study and the organization of the study. Chapter II presents, analyzes and evaluate the findings of the study and interpret data’s gathered.

The scope of the study includes: the demographic profile of the respondents, the perceived areas of difficulty in the core competency content, perceived areas of difficulty on the areas of responsibilities and the factors that contribute to the inadequacy with regards to the level of knowledge and application of the concepts learned. Chapter III covers on the summary of the findings of the study, conclusions, and recommendations. BIBLIOGRAPHY A. INTERNET http: // www. infed. org / thinkers / et – knowl. htm http://www. newfoundations. com/GALLERY/Dewey. tml http://www. skyscrapercity. com/showthread. php http://www. ched. gov. ph/policies/CMO http://www. csudh. edu/dearhabermas/advorgbk02. htm http://www. work911. com/cgi-bin/links/jump. cgi? ID= 4506 http://neuron-ai. tuke. sk/NCS/VOL1/P3_html/node10. html http://teach. valdosta. edu/whuitt/col/affsys/humed. html http://www. ohnurses. org/AM/Template. cfm http://www. uttyler. edu/WEB%20CAT/nurs_under. htm http://www. ched. gov. ph/whatsnew. pdf http://pascn. pids. gov. ph/DiscList/d02/s02-02. pdf 21 CHAPTER II PRESENTATION, ANAYSIS AND INTERPRETATION OF DATA

The collected data presents, analyzes and evaluates the findings in four parts. First part, on the demographic profile of the respondents. Second part, perceived areas of difficulty in the Core Competency Content of Nursing Licensure Examination as perceived by the Level IV nursing students and the presentation of the perceived areas of difficulty on the area of responsibilities of each core competency content. Third part, are the perceived factors that contribute to the inadequacy with the level of knowledge and application of the concepts that are learned.

The results are presented in tables followed by its interpretation. TABLE I Frequency and Percentage of USPF Level IV Nursing Students According to Age |Age Bracket |f |Percentage | |24 – up |4 |4. 55 | |22 – 23 |21 |23. 86 | |20 – 21 |56 |63. 64 | |18 – 19 |7 |7. 95 | |Total |88 |100 |

Majority age of the respondents is 20-21 years old which is 63. 64 percent while 24 years old up is the least majority which has a 4. 54 percent. It shows there that almost all of the respondents are on their young adult stage. 22 Table 2 Frequency and Percentage of USPF Level IV Nursing Students According to Gender |Gender |f |Percentage | |Male |28 |31. 82 | |Female |60 |68. 18 | |Total |88 |100 |

This implies that most of the respondents consist of female student nurses which is about 68. 18 percent and only 31. 82 percent were dominated to male student nurses. Table 3 Frequency and Percentage of USPF Level IV Nursing Students According to Civil Status |Civil Status |f |Percentage | |Single |87 |98. 86 | |Married | 1 | 1. 14 | |Total |88 | 100 | There is 1. 4 percent of nursing student who enrolled here that is already married while 98. 86 percent who are still single. 23 Table 4 Frequency and Percentage of USPF Level IV Nursing Students According to No. of Years in Nursing Course | No. of Years |f |Percentage | |6 |14 |15. 91 | |5 | 30 | 34. 09 | |4 |43 |48. 86 | |3 |1 |1. 4 | |Total |88 | 100 | From the 88 respondents, majority of the Level IV nursing students has been with the nursing course for four (4) years which has 48. 86 percent followed with those who have been in the course for five (5) years which has 34. 09 percent and the least majority are those with the course for six (6) years which has 15. 91 percent. Table 5 Frequency and Percentage of USPF Level IV Nursing Students

According to Status of Enrolment | Status of Enrolment |f |Percentage | |Regular |42 |47. 73 | |Shiftee |6 |6. 82 | |Transferee | 40 | 45. 45 | |Total |88 | 100 | 24 This implies that most of the respondents of the Level IV nursing students are regular students which has 47. 9 percent and only 45. 45 percent of the Level IV nursing students are transferee while 6. 82 percent of the Level IV nursing students are shifter from another course. Table 6 Percentage distribution on the perceived areas of difficulty |Core Competency Content |f |Percentage |R | | Safe & Quality Nursing Care |55 |62. 5 |8 | | Management of Resources & Environment |57 |64. 7 |7 | | Health Education |61 |69. 32 |4 | | Legal Responsibility |59 |67. 05 |6 | | Ethico-moral Responsibility |59 |67. 05 |6 | | Personal and Professional Development |57 |64. 77 |7 | | Quality Improvement |63 |71. |2 | | Research |64 |72. 73 |1 | | Records Management |63 |71. 6 |2 | | Communication |60 |68. 18 |5 | | Collaboration and Teamwork |62 |70. 45 |3 |

The table above shows that among the 11 Core Competencies, it is Research which got the highest number of votes receiving 64 votes or 72. 73 percent. It is the core competency which the respondents seemed they are least knowledgeable. This only implies that the respondents are not up to date with the new existing theories and principles of nursing practice. Research is designed to guide nursing practice and become independent from other medical professions. It is used to improve existing theories and principles and enhances the quality of life of our patient’s.

Nursing student’s and even registered nurses needs to update with these improvements to guide them in their practice. Second, is Records Management and Quality Improvement receiving 63 votes or 71. 6 percent. This only implies that the respondents aren’t very particular with the technicalities and do’s and don’ts of charting. Nursing Student’s must be very careful in handling the patient’s chart for it is a legal document and is admissible in court. All care rendered to patients and outcomes of nursing care must be documented thoroughly to prevent oneself from lawsuits.

Quality Improvement (QI) is designed to improve outcomes based on costumer’s needs. It emphasizes doing the right thing for customers, and the end result is to satisfy the patient and its significant others. Nursing students should commit to never being satisfied in their care to patients. Good and very good is not enough. Quality can always be improved. In this case, the respondents are only satisfied of complying with the requirements rather than improving oneself for the benefit of improving the quality of care. Third, is Collaboration and Teamwork receiving 62 votes or 70. 45 percent.

This only implies that the respondents do not collaborate with other members of the health team as well as the nursing staff for any variances. Nursing students must collaborate with other members of the health team to establish a harmonious relationship with team members and with all the nursing staff. It promotes smooth sailing of work in every unit. Fourth, is Health Education receiving 61 votes or 69. 32 percent. It only indicates that the respondents do not render health education to their patients effectively. Health education is part and partial the responsibility of nursing students need to fulfill.

It is undertaken for the purpose of achieving a higher level of health and well – being, directed toward improving the health potential of individuals, families, groups, and communities. Fifth is Communication receiving 60 votes or 68. 18 percent. It only implies that the respondents could not establish rapport with their patients and render health education effectively. It Encompasses Nurse – Patient relationship by establishing rapport and effectively affecting patients through rendering health education based on the ability of the nursing student to effectively render health teachings to their patients and its support persons.

Sixth is Legal responsibility and Ethico – Moral responsibility receiving 59 votes and 67. 05 percent. Nursing students must adhere to practices in accordance with the nursing law and other relevant legislation including contracts, informed consent. They also must adhere to organizational policies and procedures, either local or national. All documents must be rendered to patients to prevent legal actions. Nursing students must also adhere to national and international code of ethics for nurses, be responsible for own actions and decisions and respects the right of their patient’s.

Seventh is Management of Resources & Environment receiving 57 votes or 64. 77 percent. It includes the organization of workload to facilitate patient care utilizing whatever resources there is to support the patient and ensuring functioning of equipments being used to provide and maintain a safe environment. Lastly, the least difficult for them is Safe and Quality Nursing Care receiving 55 votes or 62. 5 percent. It encompasses different responsibilities in the areas of nursing profession.

It is very vital in rendering care to patients to protect both parties from harm. To rank the Top 5 Core Competencies the Level IV nursing students perceives as hindrance to them in passing the Nursing Licensure Examination are as follows: 1. Research; 2. Records Management and Quality Improvement; 3. Collaboration and Teamwork; 4. Health Education; and 5. Communication Table 6. 1 Frequency and Percentage of Perceived Areas of Difficulty in Area of Responsibility on Safety and Quality Nursing Care n = 88 Area of Responsibility |f |Percentage | |Demonstrate knowledge base on the health/illness status of individual/group | | | | |67 |76. 14 | |Provides sound decision-making in the care of | | | |individual or group |43 |48. 6 | |Promotes safety and comfort of patients |57 |64. 77 | |Sets priorities in nursing care based on patient’s need |60 |68. 18 | |Ensures continuity of care |53 |60. 23 | |Administers medications & other health therapeutics |44 |50 | |Utilizes the nursing process as framework for nursing. | | |Performs comprehensive & systematic nursing assessment |57 |64. 77 | |Formulates a plan of care in collaboration with patients | | | |and other health care team. |46 |52. 27 | |Implements planned nursing care to achieve identified | | | |outcomes |48 |54. 4 | |Evaluates progress toward expected outcomes |59 |67. 05 | |Responds to the urgency of the patient’s condition. |68 |77. 27 | | |602/11=5|684. 08/ 11= | | |5 |62. 19/100= | | | |. 6219×88= 55 |

Table 6. 2 Frequency and Percentage of Perceived Areas of Difficulty in Area of Responsibility on Management of Resource and Environment n = 88 |Areas of Responsibility |f |Percentage | |Organizes workload to facilitate patient care. |61 |69. 31 | |Utilizes resources to support patient care. |57 |64. 77 | |Ensures functioning of resources. |55 |62. 5 | |Checks proper functioning of equipment. |55 |62. 5 | |Maintains a safe environment. 56 |63. 64 | | |284/5=57|322. 72/5= 64. 54/100= | |Total | |. 6454×88= 57 | Table 6. 3 Frequency and Percentage of Perceived Areas of Difficulty in Area of Responsibility on Health Education |Areas of Responsibility |f |Percentage | |Assess the learning needs of the patient and family |68 |77. 7 | |Develops health education plan based assessed | | | |and anticipated needs. |62 |69. 32 | |Develops learning materials for health education. |52 |59. 09 | |Implements the health education plan. |58 |65. 91 | |Evaluates the outcomes of health education. |64 |72. 73 | | Total |304/5=61|344. 32/5= 68. 86/100=| | | |. 886×88 = 61 | Table 6. 4 Frequency and Percentage of Perceived Areas of Difficulty in Area of Responsibility on Legal Responsibility |Areas of Responsibility |f |Percentage | |Adheres to practices in accordance with the nursing law and other relevant | | | |legislation including contracts, informed consent. |64 |72. 73 | |Adheres to organizational policies and procedures, | | | |local and national. |57 |64. 7 | |Documents care rendered to patients |56 |63. 64 | | |177/3=59|201. 14/3= 67. 05/100=| |Total | |. 6705×88= 59 | Table 6. 5 Frequency and Percentage of Perceived Areas of Difficulty in Area of Responsibility on Ethico-moral Responsibility |Areas of Responsibility |f |Percentage | |Respects the rights of individual or group. 54 |61. 36 | |Accepts responsibility and accountability for own decisions and actions. | | | | |62 |70. 35 | |Adheres to the national and international Code of | | | |Ethics for nurses. |56 |63. 64 | | |172/3= |195. 35/3= 65. 12/100=| |Total |57 |. 6512×88= 57 | Table 6. Frequency and Percentage of Perceived Areas of Difficulty in Area of Responsibility on Personal and Professional Development |Areas of Responsibility |f |Percentage | |Identifies own learning needs. |59 |67. 05 | |Pursues continuing education. |58 |65. 91 | |Gets involved in professional organizations | | | |and civic activities |62 |70. 45 | |Projects a professional image of the nurse. 47 |53. 41 | |Possesses positive attitude towards change and | | | |criticism. |61 |69. 32 | |Performs function according to professional standards. | | | | |54 |61. 36 | | |341/6= 57 |387. 5/6= 64. 58/100= | |Total | |. 6458×88= 57 |

Table 6. 7 Frequency and Percentage of Perceived Areas of Difficulty in Area of Responsibility on Quality Improvement |Areas of Responsibility |f |Percentage | |Gathers data for quality improvement. |77 |87. 5 | |Participates in nursing audits and rounds. |47 |53. 41 | |Identifies and reports variances. |67 |76. 14 | |Recommends solutions to identified problems. |61 |69. 32 | | |252/4= |286. 7/4= 71. 59/100=| |Total |63 |. 7159×88= 63 | Table 6. 8 Frequency and Percentage of Perceived Areas of Difficulty in Area of Responsibility on Research |Areas of Responsibility |f |Percentage | |Gather data using different methodologies. |65 |73. 86 | |Recommends actions for implementation. |64 |72. 73 | |Disseminates results of research finding. |58 |65. 91 | |Applies research findings in nursing practice. 67 |76. 14 | | |254/4= |288. 64/4= 72. 16/100=| |Total |63 |. 7216×88= 63 | Table 6. 9 Frequency and Percentage of Perceived Areas of Difficulty in Area of Responsibility on Records Management |Areas of Responsibility |f |Percentage | |Maintains accurate and updated documentation of | | | |patients care. |72 |81. 2 | |Records outcomes of patient care. |59 |67. 05 | |Observes legal imperatives in record keeping. |58 |65. 91 | | Total |189/3= |214. 78/3= 71. 59/100=| | |63 |. 7159×88= 63 | Table 6. 10 Frequency and Percentage of Perceived Areas of Difficulty in Area of Responsibility on Communication |Areas of Responsibility |f |Percentage | |Establishes rapport with patients. 60 |68. 18 | |Listens attentively to client’s queries and requests. |55 |62. 5 | |Identifies verbal and non-verbal cues. |60 |68. 18 | |Utilizes formal and informal channels. |63 |71. 59 | |Responds to needs of individuals, family, group, | | | |and community. |54 |61. 36 | |Uses appropriate information technology to | | | |facilitate communication. |70 |79. 5 | | Total |362/6= |411. 36/6= 68. 56/100=| | |60 |. 6856×88= 60 | Table 6. 11 Frequency and Percentage of Perceived Areas of Difficulty in Area of Responsibility on Collaboration and Teamwork |Areas of Responsibility |f |Percentage | |Establishes collaborative relationship with | | | |colleagues and other members of the health team. 66 |75 | |Collaborates plan of care with other members of the health team. | | | | |58 |65. 90 | | Total |124/2= |140. 9/2= 70. 45/100= | | |62 |. 7045×88= 62 | Table 7 Frequency and Percentage of Factors Contributing to the Inadequacy in the level of knowledge and application f the Core Competency Content |Contributory Factors to Inadequacy |f |P |Rank | |Teaching Strategies of Clinical Instructor |72 |81. 82 |1 | |Availability of Resources |71 |80. 68 |2 | |Fear of Failure |69 |78. 41 |3 | |Poor Time Management |68 |77. 7 |4 | |Lack of Motivation |59 |67. 05 |6 | |Lack of balance between critical, analytical |51 |67. 95 |5 | |Lack of Perseverance-giving up too easily |50 |56. 82 |7 | |Availability of Support |48 |54. 55 |8 | |Fear of Failure |47 |53. 1 |9 | |Too little or too self confidence |47 |53. 41 |9 | |Excessive Dependency |43 |48. 86 |10 | |Inability to apply concepts to different situation |40 |45. 45 |11 | |Inability to delay gratification |35 |39. 77 |12 | | Total |700/13= 54 |805. 5/13= | | | | |61. 96/100= | | | | |. 6196×88= 54 | | CHAPTER III SUMMARY, CONCLUSIONS AND RECOMMENDATION Summary The profile of the majority of the respondent were subjugated by female inhabitants particularly those in the single state. Considerable, most of the respondents were at the stage of young adult, and a 47. 73 percent of the respondents were regular nursing students as to the status of their enrolment likewise a 48. 6 percent as to their number of year in the nursing course of the majority of the respondents. As to the responses of students’ least knowledgeable perceived areas of difficulty in the Core Competency Content, 19. 68 percent perceived they are least knowledgeable in rendering Safe and Quality Nursing Care which is very vital in rendering care to patient, 11. 83 percent on Communication which encompasses nurse-patient relationship in establishing rapport and effectively affecting patients based on the ability of the nursing students to effectively render health teachings to their patient and its support persons, 11. 4 percent ( you continue nalang you know better he he he) 39 Conclusion Base on the overall data that has been gathered and organized, the researcher therefore conclude that ( you continued the sentence you know better ) Recommendations From the result of the research, the researcher has the following recommendation. On students, that they must focus and give more attention to their least knowledgeable area of difficulty on the core competency contents. This serves as a guide in preparing for the licensure examination. Since, the tudy provided us with the result it would then be imperative that they must focus harder on the areas they find difficult. Also having determined the factors that contributed to the inadequacy, students must try to develop better studying habits and change their characteristics or outlooks if needed. 40 To the faculty, knowing what areas of core competency content the students are having, much difficulty in, it would be recommendable for the instructors to improve their skills and abilities in rendering nursing knowledge to the students.

Perhaps it would be best for further enrichment activities and lectures on the areas of difficulty the students having difficulty on. To the administration, after learning what the difficulty of the students mostly have, consideration should be given to student nurses in developing some programs to be implemented in the nursing department to enhance their student’s learning of the subject since the student’s will be carrying the name of the university as they take the Nursing Licensure Examination (NLE).

It would also be righteous that the administration take action to enhance the learning capacity of the students through proper compliance to the five requirements of the CHED’s technical committee which includes: adherence to the nursing curriculum, availability of facilities, ratio of faculty to students, affiliation with or existence of an active tertiary hospital to serve as base for students, and a qualified faculty. What knowledge , skills and attitude enhancement program can be proposed based on the findings of the study? ( you wait for these adto pa ginhihimo ni Ms. Daga)

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