CORRELATION ACAD RLE 8

Chapter II

THEORETICAL BACKGROUND

This chapter highlights the literatures and studies found relevant to the present

problem which helped in the formulation of the theoretical and conceptual frameworks,

and their respective paradigms.

Related Literature

Foreign

Nursing is a profession focused on advocacy in the care of individuals, families,

and communities in attaining, maintaining, and recovering optimal health and

functioning. Modern definitions of nursing describe it as a science and an art that focuses

on promoting quality of life as defined by populations, communities, families, and

individuals, throughout their life experiences from birth through the end of life.

Nursing comes in various forms in every culture, although the definition of the

term and the practice of nursing have changed greatly over time. Formerly, nurses were

as a “wet nurse” and the later being as a “dry nurse”.

In the 15th century, this developed into the idea of looking after or advising

another, not necessarily meaning a woman looking after a child. Nursing has continued to

develop in this latter sense, although the idea of nourishing in the broadest sense refers in

modern nursing to promoting quality of life.

In the 19th century, Florence Nightingale revealed the need for reforms in Nursing,

and by the end of the century, England and the US had adopted some of her principles.
 CORRELATION ACAD RLE 9

Modern Nursing provides a broad range of service, with standards set by relevant

professional bodies (Walker, 2006).

Through its distinguished history, nursing has had a significant effect on people’s

lives. As rapid change continues to transform the profession of nursing and the health

care system with which it is intricately linked, nurses embrace broader opportunities to

influence human well- being. Today, nurses bring knowledge, leadership, spirit, and vital

expertise to expanding roles that afford increased participation, responsibility, and

rewards. However nursing continues to evolve, underlying all is a time- honoured,

fervent, and profound commitment to caring (Kozier, 2004).

As Nursing profession continues to evolve and develop, there is a greater need to

enhance the knowledge of a nurse to be able to give a holistic and competent care. Being

a profession, one must study nursing to be able to practice it and thus education started.

Nurses are interested in human experiences and phenomenological research is a

rigorous, critical, systematic, investigative method to enhance knowledge about lived

experiences which can stimulate changes in the nurse- person process (Pearson, 2007).

Gaberson (2009) declares that nursing is a practiced discipline. What nurses and

nursing students practice in the clinical area is more important than what they can

demonstrate in the classroom. Furthermore, she stated that some learners who perform

well in the classroom cannot apply knowledge in the clinical practice.

Classroom setting is quite different from the clinical setting. In the classroom,

theories are taught while in the clinical practices, these theories are applied. A person’s

academic performance maybe good but that does not necessarily mean that he is already

good in the clinical performance. Academic Performance alone is a complex matter.

 CORRELATION ACAD RLE 10

Measuring of academic performance of students is challenging since student

performance is a product of socio-economic, psychological and environmental factors

(Hizahil, 2006).

Francis Bacon, a philosopher known for his inductive reasoning and his line

“knowledge is power,” stated that one’s academic performance is an important

component of education because it is the single vehicle which seems to achieve at school

level all these values of learning, which are functional, logical and aesthetic (Bacon,

1998).

Salve Regina University (2009) cited in their study entitled “Factors that can

contribute to Academic Difficulty” some of the general reasons why many students

experience academic problems. The factors were the motivation and purpose, difficulty

adjusting to college life, study skills and personal issues. Academic difficulty can stem

from the events outside the academic arena, or outside collegiate life. Student might have

been dealing with an issue for a period of tine, or unexpectedly faced with something that

challenges their academic performance. Furthermore, SRU cited health related issues,

which are often a factor affecting academic performance, as are personal relationships,

familial responsibilities and financial instability.

The behaviour of teachers and students is often affected by organizational and

political factors operating in schools. Factors that exert powerful effects on the behaviour

of teachers and students include the broad school wide and even nationwide norms

governing a) the organization of classrooms, b) assignment of students to classes, c)

schedules and frequency of examinations, d) quantity of curricular material, and e)

 CORRELATION ACAD RLE 11

students’ long-standing attitudes and expectations developed through the years of

exposure to traditional forms of schooling (Geok, 2007).

“The most valuable gift you can offer as an educator is you: your passion, your

creativity, and your zest for learning. This is what leaves impact on your students,” said

Silsbee (2005).

Related learning experience, on the other hand, is a complex matter as well. On

this note, Gaberson (2009) exhorted that clinical teaching and evaluation are more

important than classroom teaching and evaluation. In the clinical setting, students are

exposed to the real life situations which they would be dealing before and after being a

registered nurse.

Values and beliefs provide structure and coherence for a curriculum, but are

meaningless if contraindicated by practice (Gaberson, 2009). Nursing is a practiced

discipline that is why what the students do in the clinical setting is of great importance.

The students in the clinical setting are learners, not a nurse. They need to engage

in activities that promote learning and to practice skills before they are evaluated for

grade. Students should spend more time learning and Clinical teachers should spend more

time teaching rather than evaluating. As what Harvey Mackay said, “Measure success by

success, not by the failure it takes to achieve it” (Gaberson, 2009).

Pearson (2000) cited “Experience, Expertise and Tradition” as a component in the

evidence based nursing. Experience is “knowledge of” and “skill in” something gained

through being involved in or exposed to it over a period of time. It generally refers to the

know-how or procedural knowledge, rather than propositional knowledge and plays a

major role in health care practice. When a practitioner makes a health decision, it is
 CORRELATION ACAD RLE 12

usually to weigh available external evidence with the practitioner’s own experience.

Thus, experience itself is a source of evidence in health practice.

According to Pearson (2000), expertise is essentially linked to the ability of a

practitioner to have at hand relevant information in a given area of practice. It is generally

associated with the possession of large amount of knowledge, and fluency in applying

this knowledge. Expertise is difficult to quantify, and even more difficult to rank in terms

of its reliability. However a large proportion of health care practise relies on expertise.

Practitioners who have expertise are fitted experts, and the opinion of experts often

represents the best available evidence in areas where research is limited, or where

research on a specific question is difficult to conduct.

Local

It is a truism that the source of wealth in this era is knowledge. It seen this clearly

in the birth and growth of services related to knowledge and information, this was stated

by Puangco (2007), a CEO of an enterprise.

According to the Presidential Decree No. 603 Article 2 Section 6, every child has

the right to an education commensurate with his abilities and to the development of his

skills for the improvement of his capacity for service to himself and to his fellowmen.

And one of the services he can give to his fellowmen is caring for the sick or by Nursing.

Geronimo (2006) defines nursing as “an occupation requiring a unique body of

knowledge and skills which serve the society”. Furthermore he stressed that nurses are

always equated with the mission of enhancing the quality of health care provided to the

public because inherent to professionalism is a dedication to providing quality service to

 CORRELATION ACAD RLE 13

the consumers. Thus, evaluation and monitoring have become a widely accepted trend for

instituting and maintaining a quality care. Performance of nursing functions is inherently

based on the nursing process which is considered as the universal guideline in all actions

of a professional nurse.

The Philippine Nursing Act of 2002, known as Republic Act 9173 Article VI

Section 28, discusses nursing practice and its provisions for the curative, preventive, and

rehabilitative aspects of care; restoration of health, alleviation of suffering, and when

recovery is not possible, towards a peaceful death.

Created during the reign of President Ferdinand Marcos, under Presidential

Decree No. 223 (2009), the Professional Regulation Commission (PRC) regulates and

supervises the practice of the professionals who constitute the highly skilled manpower of

the country. All registered nurses in the Philippine should finish the Bachelor’s Degree in

Nursing; pass the licensure exam after which the PRC oversees the licensing of registered

nurses as authorized by the Philippine Nursing Act of 2002.

The Professional Regulatory Board of Nursing (PRBON) implements and

enforces the Nursing Act. The board is composed of a chairperson and six additional

members, all of whom are nurses with at least a master's degree and ten years of nursing

experience the five years of which practiced in the country. The board inspects nursing

schools, conducts licensure examinations, issues and monitors certificates of licensure,

promulgates a code of ethics, participates in recognizing nursing specialty organizations,

and prescribes guidelines and regulations governing the profession under the Nursing

Act.
 CORRELATION ACAD RLE 14

“It is discerned as an increasing trend that there are lesser people who would like

to take on such a remarkable career. In order to fill in the manpower shortage, many

countries in the world are importing nursing talents from the Philippines. In the

Philippines, nursing is considered as a professional qualification as compared to most

countries that subject nursing as vocational qualification equivalence.” this was stated in

an article for nursing made by Arc Idea Co.

Related Studies

Foreign

"Very much more time must be hereafter given to those practical portions of the

examinations which afford the only true test of a (student's) fitness to enter the

profession. The day of the theoretical examinations is over." (Sir William Osler, 1885)

This statement gives a hint in our study about the significant relationships of academic

performance and clinical performance towards better competency of every student.

Stacey and Whittaker studied about Predicting Academic Performance and

Clinical Competency for International Dental Students as for Seeking the Most Efficient

and Effective Measures. Measures used in the selection of international dental students to

a U.S. D.D.S. program were examined to identify the grouping that most effectively and

efficiently predicted academic performance and clinical competency. Archival records

from the International Dental Program (IDP) at Loma Linda University provided data on

171 students who had trained in countries outside the United States. The students sought

admission to the D.D.S. degree program, successful completion of which qualified them

to sit for U.S. licensure. As with most dental schools, competition is high for admission to
 CORRELATION ACAD RLE 15

the D.D.S. program. The study’s goal was to identify what measures contributed to a fair

and accurate selection process for dental school applicants from other nations. Multiple

regression analyses identified National Board Part II and dexterity measures as significant

predictors of academic performance and clinical competency. National Board Part I,

TOEFL, and faculty interviews added no significant additional help in predicting eventual

academic performance and clinical competency.

White, Dey and Fantone (2007) conducted an “Analysis of Factors that Predict

Clinical Performance in Medical School”. According to their research, Academic

achievement indices including GPAs and MCAT scores are used to predict the spectrum

of medical student academic performance types. However, use of these measures ignores

two changes influencing medical school admissions: student diversity and affirmative

action, and an increased focus on communication skills. To determine if GPA and MCAT

predict performance in medical school consistently across students, and whether either

predicts clinical performance in clerkships a path model was developed to examine

relationships among indices of medical student performance during the first three years of

medical school for five cohorts of medical students. A structural equation approach was

used to calculate the coefficients hypothesized in the model for majority and minority

students. Significant differences between majority and minority students were observed.

MCAT scores, for example, did not predict performance of minority students in the first

year of medical school but did predict performance of majority students. This information

may be of use to medical school admissions and resident selection committees.

On the other hand, the study of Gough and Hall (2005) about “The Prediction of

Academic and Clinical Performance in Medical School” states prior studies have
 CORRELATION ACAD RLE 16

suggested the importance of distinguishing between performance in the earlier and later

years of medical education. Factor analysis of grades by year and faculty ratings of

clinical and general medical competence for 661 medical students identified two

uncorrelated factors clearly reflecting this distinction. The clinical performance factor,

accounting for 48 percent of the communality of the matrix, was more or less

unpredictable from aptitude and premedical academic achievement indices; it was

marginally predictable from scales on the Adjective Check List. The academic

performance factor, accounting for 31% of the variance among criteria, was forecast with

acceptable accuracy (cross-validated R=0.43) by equations based on the Medical College

Admission Test and premedical grade point average. Future study should stress the

clinical performance factor; this criterion appears to be more important than academic

attainment, and it is also less accurately predicted by current measures.

Most studies show poor or no correlation between academic performances in the

first two years of medical school with clinical performance in the third year (Parenti,

2001). One study suggested that psychosocial characteristics measured in the second year

correlated weakly with clinical performance in the third year (Ginsburg, 2000). A large

number of studies demonstrate poor to fair (r≤5) correlation of clinical performance with

objective examinations such as oral exams, multiple-choice examinations and subtests of

NBME Part II (moderate correlation: r=.5-.75, good correlations: r = ≥.75).The best

correlation between ratings of clinical performance in a third year clerkship in internal

medicine and the NBME subtest was 0.59. However, 38% of students with satisfactory

clinical performance ratings had marginal or failing test scores. Thus, there was a "halo"

effect, students who appeared motivated and attentive to patient care were usually graded
 CORRELATION ACAD RLE 17

higher in knowledge than their performance in knowledge testing demonstrated. Studies

of inter-rater reliability of assessment of student clinical performance have shown good

reliability but it requires a number of observations and observers to have a high

reliability. In one study, increasing the numbers of rates per student from 2 to 5 increased

reliability (Keynan, 2001). Additionally, to achieve a reliability of 0.8, there is a need for

observations to determine an overall clinical rating and 27 observations to assess

interpersonal relationship with patients.

A study of Opacic (2003) about “The Relationship Between Self-Efficacy and

Student Physician Assistant Clinical Performance” states that the purpose of the study

was to investigate the predictive relationship between student self-efficacy beliefs,

achievement expectations, perceived outcome values, and subsequent clinical

performance. The study investigated whether measures of self-efficacy, measures of

achievement expectancy, or measures of perceived task value (relevance) correlated

significantly with physician assistant clinical performance; also, it investigated whether

utilizing both noncognitive criteria and cognitive criteria will improve upon the

predictability of physician assistant clinical performance. The independent variables

include grade point average, previous health care experience, self-efficacy, values, and

outcome expectations. The research population comprised a group of approximately 300

students attending the 14 accredited programs within Pennsylvania who, at the time of the

surveys, were beginning the clinical year of their professional education. Data collection

methods included surveys and quantitative data sources. The data were subjected to

multivariate statistical methods including multiple regression and discriminate analysis.

The analysis included both correlation and regression to predict clinical performance
 CORRELATION ACAD RLE 18

from the noncognitive and cognitive variables. The results reveal that self-efficacy, and

not just academic performance, is a significant predictor of a student's clinical

performance. Utilizing both noncognitive and cognitive variables can improve upon the

predictability of the student physician assistant's clinical performance.

In the study of Sansgiry, Bhosle and Sail (2006) about “Factors That Affect

Academic Performance among Pharmacy Students” the primary objective was to

examine factors such as academic competence, test competence, time management,

strategic studying, and test anxiety, and identify whether these factors could distinguish

differences among students, based on academic performance and enrolment in the

experiential program. A cross-sectional study design utilizing questionnaires measuring

previously validated constructs was used to evaluate the effect of these factors on

students with low and high cumulative grade point averages (GPAs). Pharmacy students

(N = 198) enrolled at the University of Houston participated in the study. Based from the

results, academic performance was significantly associated with factors such as academic

competence and test competence. Students with a cumulative GPA of 3.0 or greater

significantly differed in their level of test competence than those with a GPA of less than

3.0. Students enrolled in their experiential year differed from students enrolled in their

second year of curriculum on factors such as test anxiety, academic competence, test

competence, and time management skills. Test competence was an important factor to

distinguish students with low vs. high academic performance. Factors such as academic

competence, test competence, test anxiety and time management improve as students'

progress in their experiential year.

 CORRELATION ACAD RLE 19

Evans and Wen (2003) tackled the query of “Does the Medical College

Admission Test Predict Global Academic Performance in Osteopathic Medical School?”

Medical College Admission Test (MCAT) sub scores predict the overall academic

performance of osteopathic medical students. They examined the value of MCAT sub

scores in predicting students' global academic performance in osteopathic medical school,

as defined by grade point average in basic science (basic GPA), clinical instruction

(clinical GPA), cumulative grade point average (total GPA), and national licensing

examination scores on the Comprehensive Osteopathic Medical Licensing Examination-

USA (COMLEX-USA) Level 1 and Level 2. Subjects were 434 osteopathic medical

students of the Oklahoma State University College of Osteopathic Medicine in Tulsa who

either graduated or were expected to graduate between the years 1999 and 2003.

Standard, multivariate linear regression analyses were conducted for each of the five

performance variables to assess the relative importance of MCAT subtest scores and

cumulative undergraduate GPA (total UGPA) in predicting academic performance. Total

UGPA was the most important, significant predictor (ß=.13-.33) in overall student

academic performance for all five analyzed variables. Less predictive of overall academic

performance (ß=-.01-.21) were MCAT subcores. However, the MCAT biological

sciences subscore was a significant predictor of basic GPA (ß=.14), the MCAT physical

sciences subscore significantly predicted COMLEX-USA Level 1 scores (ß=.15), and the

MCAT verbal reasoning subscore significantly predicted COMLEX-USA Level 2 scores

(ß=.21). The subscore for the MCAT writing sample was not a significant predictor of

overall academic performance. In conclusion, total undergraduate GPA had the highest

predictive value for academic performance as measured by basic GPA, clinical GPA, total
 CORRELATION ACAD RLE 20

GPA, and COMLEX-USA Level 1 and Level 2 scores. Subsequently, the study found out

MCAT sub scores to be of limited predictive value in determining global academic

performance.

“Relationship Between Academic Achievement and Clinical Performance in a

Physical Therapy Education Program” by Rheault and Coulson (2005) states that the

study was performed to ascertain whether a relationship exists between physical therapy

students' pre-professional academic achievement and their academic or clinical

performance while attending professional school. A comparison was also made between

professional academic achievement and clinical performance. The records of three classes

of graduates (N = 65) were examined in relation to pre-professional grade point average,

professional grade point average, and clinical performance. Pearson product-moment

correlations showed no significant relationship between pre-professional and professional

academic achievement or pre-professional academic achievement and clinical

performance. The correlation between professional academic achievement and clinical

performance was higher, but did not reach statistical significance. This study did find that

pre-professional and professional grade point averages were related. The authors urge

further study of current admission criteria and their relationship to clinical performance.

A study of Ruth (2002) deemed to identify radiologic technology program

admission criteria that can explain the variance associated with measures of performance

in the professional program, both academic and clinical. The sample included 63 first

year radiologic technology students enrolled in radiologic technology programs in

Missouri. Eight variables were investigated: six admission variables, and two

professional program performance measures. Pearson correlation and multiple linear

 CORRELATION ACAD RLE 21

regression analyses were performed. Each hypothesis was tested at the 0.05 level of

significance. According to the findings, professional program academic performance was

best predicted by a combination of ACT composite score, high school GPA, and

Occupational Work Ethic Inventory Interpersonal, Initiative, and Dependability scores,

this combination of variables accounted for 25 percent of the variance associated with

academic performance. Occupational Work Ethic Inventory Initiative and Total scores

were the only admission variables significantly related to clinical performance. A

significant relationship was not found between professional program academic and

clinical performance. No combination of admission variables and professional program

academic performance was able to explain the variance associated with clinical

performance. In conclusion, a) a combination of ACT score, high school grade point

average, Occupational Work Ethic Inventory interpersonal, initiative, and dependability

scores can be used to predict professional program academic performance; b) students

with a higher Occupational Work Ethic Initiative score are more likely to have higher

clinical performance scores; and c) students with a higher Occupational Work Ethic

Inventory Total score are more likely to have higher clinical performance scores.

Local

Palad (2006) conducted a study on performance of the graduate of the Revised

BSN Curriculum as perceived by Nurse-managers and Nurse Graduates of Selected

Hospitals in Cagayan De Oro. The following were revealed in the study: nurse graduates

25 years and above have a very satisfactory performance rating. However, it differed

significantly when grouped according to their nursing experience. There was no

 CORRELATION ACAD RLE 22

significant difference in the performance rating of the nurse graduates of the revised

Bachelor of Science in Nursing Curriculum in terms of the selected indicators like the

school where they graduate and area of assignment. Other indicators used to rate their

performance: 1. Centralization of the nursing process in patient care; 2. Interpersonal

relations; 3. Utilization of management skills and health care setting; 4. utilization of

research findings in the care of clients and personal and professional development.

The research conducted by Arcos (2006) aimed so assess the benefits and impacts

of the Post-Baccalaureate nurses training program (PBNTP). It was also designed for the

new graduate nurses in acquiring new knowledge, strengthen skills and assess as well as

re-direct attitude on patient care, nursing research, supervision and evaluation. The group

of respondents was composed of the nursing service department, the trainees and the

patients. For trainees, the research revealed the following salient findings: 1. the

Baccalaureate nurses training program along cognitive, effective and psychomotor

domain was found to be highly significant; 2. the profile variables such as age, eligibility,

experience, and place of residence were found to be statistically significant with the

learning gained by the trainees; 3. skills learned by the newly graduate nurse are still

inadequate in relation to the needs of the hospitals; 4. the related learning experience is

also inadequate to attain quality nursing graduates; and 5. learning by doing is better

purely theoretical.

Palad’s and Arcos’s studies assessed BSN Curriculum and the impact of Post-

Baccalaureate Nurses Training Program, therefore present different investigation.

Although the two studies mentioned together with the present study utilized nursing

students as the respondents, this study is utilized for the level IV nursing students to
 CORRELATION ACAD RLE 23

evaluate their competency in terms of the correlation of academic performance and

clinical performance.

Facto (2005) determined the relationship between the management of nursing

service of Bicol Tertiary Hospitals and student nurse’s clinical performance. The student

clinical performances were indicated as perceived by the clinical instructors.

A study of Aban (2007) on the clinical experience program of nursing students

affiliates of Bataan Provincial Hospital revealed the clinical Learning Activities (CLA)

included requiring students to submit one (1) nursing case study to gain deeper

knowledge through the intensive and extensive utilization of nursing process in the care

of patients; conduct of pre and post conferences to review diseases on special area of

assignments and evaluate students performance and attitude in the care of patient;

organize and conduct for health teaching programs to enhance students creativity in

dissemination information, improve communication skills and strengthen sense of

responsibility in giving health teaching. On the effectiveness of patient’s assignments,

students were allowed to handle patients in their area of assignments; providing

opportunity to apply classroom theory to clinical practice; requiring students to provide

individualized care for their patient; choosing patients that will enrich students learning

experiences; utilizing case methods of assignments to enable the student to know about

their patients. And lastly, problems encountered were mostly, lack of staff concern to

students learning experiences as demonstrated in students’ exploitation, inadequate

orientation, not welcoming in the ward; to short scheduling of clinical learning activities

per area and not working well with classroom schedule; and insufficient of exposure is to

cover more learning activities.

 CORRELATION ACAD RLE 24

Sanchez (2007) delved into the problems encountered during the Manila Hospital

Affiliation of nursing students of Northern Christian College of Laoag where it revealed

the following as most stressing problems: limited and poorly ventilated area for lecture

and conferences; limited exposure of clinical areas; insufficient number of patients to

handle for the related learning experience; difficulty in accomplishing and submitting

requirements on time, theory was not related to practice; clinical instructors do not

discuss assignments.

Agustin (2007) studied on the problems affecting the performance in the clinical

area of the 3rd and 4th year nursing students of AGO Medical Educational Center revealed

related learning experience (RLE) as to abort schedules per area, fear of committing

mistakes in executing nursing procedure and care fear in handling serious patient and

feeling inadequate in skills and competence.

Gianan (2006) assessed the status of students training and affiliation services of

the IPHO-EBMC in a province of Catanduanes. This study covered 149 respondents

comprising 52 nursing services personnel, 20 clinical instructors and 77 level IV nursing

students. This investigation was perceived beneficial to several entities such as the

students-affiliate, nursing services personnel, the hospital administrator, the

administration of the Catanduanes State Colleges, College of Nursing in the Local

Government unit, the Commission on Higher Education (CHED) and the community as a

whole.

An evaluation of the performance of selected colleges of nursing in the

Philippines was conducted by Saludar (2007). She recommended however, that the

performance of the colleges of nursing must be evaluated and that the DECS should issue
 CORRELATION ACAD RLE 25

a moratorium on the opening and re-opening of the colleges of nursing based on the

results of the evaluation.

The study of Saludar (2007) evaluated the performance of selected colleges of

nursing in Philippines in the Philippines while the present study will not just focus on the

competencies of 4th year nursing students based on the significant relationship of

academic performance and clinical performance, but also this study may be used as a

basis for policy making of the school specifically of the nursing department.

Synthesis of the Art

Different people define nursing differently. To Gaberson, nursing is a practice

discipline. To Walker, it is a profession, while to Geronimo, it is an occupation.

Bacon and Silsbee pointed out the importance of academic performance while the

Salve Regina University and Tan provided samples of the factors affecting the academic

performance. Gaberson on the other hand, cited the importance of the clinical

performance and its difference from the academic performance.

Many studies were made with regards to the academic and clinical performance.

Stacey and Whittaker, White, Dey and Fantone, and Gough and Hall all made

studies on predicting the academic and clinical performance in the clinical setting.

Rheault and Coulson found out in their study that there is no significant

relationship between preprofessional academic achievement and clinical performance.

Evans and Wen also conducted study which focused on the ways of predicting

academic performance. He concluded that admission test does not predict the academic
 CORRELATION ACAD RLE 26

performance. Furthermore, he stated that the total undergraduate GPA (Grade Point

Average) had the highest predictive value for academic performance.

Sansgiry, Bhosle and Sail discovered that factors such as test anxiety, academic

competence, test competence and time management skills were different with the

students enrolled in their experiential years and students enrolled in their second years of

curriculum.

Opacic, Sanchez and Agustin conducted studies on factors affecting the clinical

performance of the students such as the problems being encountered in the clinical

settings and many more.

The studies of Palad, Gianan, Facto, Aban, and Saludan are centred on aiming a

higher quality of nursing education especially on the clinical area or the clinical

performance.

The above studies were significant in the current study which is the correlation of

the academic performance to clinical performance. They aided in attaining the aim of this

study which is to find the correlation between the academic performance and related

learning experience of level IV nursing students.

Gap Bridged by the Study

Based on the foregoing review of related literature and studies, it can be said that

there is an abundance of resource materials and studies regarding factors affecting the

academic and clinical performance that affect the focus of the present undertaking.

However, there is still no evidence of any study conducted on Aquinas University of

Legazpi, particularly in the College of Nursing and Health Sciences. It is certain that no
 CORRELATION ACAD RLE 27

correlation study of academic performance and related learning experience has ever been

done specifically with the present Level IV nursing students. Owing to the fact that

almost 50 percent or more of the population of the students of Aquinas University are

taking up the nursing course, it follows that, this study endeavoured to unfold a clear

scenario how nursing students fare in the academic as well as in the related learning

experience. By such virtue, it is therefore, the gap the researchers strived to bridge.

Theoretical Framework

The study employed theories of Aristotle, Klausmeier, Garman and Infante in the

formation of the theoretical framework model as shown in Figure 1 on page 31.

Anchored on Aristotle’s Modes of Activity: theoria, praxis and poíésis, the study

utilized the first two modes of activity which are theoria and praxis. Theoria which is the

study of truth is called theoretically because it is uninfluenced of practical purposes, use

and interest. Theoria in its simple term means theory which is basically knowledge.

Praxis in definition is doing, acting, or action, in more strict sense, confined to rational

action on a decision and most strictly confined to rational action which is its own end.

Praxis literally means practice which is enhanced through acquisition of skills.

Klausmeier’s Theory of Transfer is the ability to use acquired knowledge, skill

and attitude from initial learning experience to succeeding similar situations (Calleja,

2007). In this study, only knowledge and skill are given primary attention. Retention is

the extent to which knowledge is stored, remembered and applied to improve the

performance of tasks in succeeding similar situation. It aids in emphasizing usefulness to

the learner. Transfer is where development of skill and mastery occurs. Transfer is
 CORRELATION ACAD RLE 28

considered to be the most significant criterion of learning in which abilities learned in a

particular situation can be applied to a new different situation.

Garman’s Theory has five stages: non-readiness, readiness, development,

practice, demonstration and maintenance phase. Non-readiness is lacking prerequisite

knowledge, skills or attitudes and anxiety is a major barrier. Readiness has prerequisite

knowledge, skills or attitudes but has not yet put the skill components together.

Development has begun to combine knowledge and performance yet performance is

fragmented. Practice is performance of skill prior to mastery but needs more practice

before desired level of skill is achieved. Demonstration is able to perform skill at

expected level of performance, meeting all criteria for satisfactory skill performance.

Maintenance is performance of skill within the established criteria; it is the consistent

maintenance of skill.

Infante’s Theory of Effective and Efficient Use of Clinical Laboratory is

developed through three stages—competency, proficiency and mastery. Competency is

knowing how to do something, proficiency is knowing how to do it well and mastery is

doing it brilliantly.

Combining Aristotle’s Modes of Activity and Klausmeier’s Theory of Transfer in

the academic and related learning experience performance of nursing students, theoria

which is knowledge acquired by students in the classroom is the subject of retention

while praxis which is literally practice of skills learned is the subject for transfer. In the

non-readiness state, a nursing student has neither theoria nor praxis exhibited which is

primarily veritable among the newly admitted first year nursing students. The individual

is at stage of anxiety and uncertainty. Theoria is cultivated in the readiness stage of

 CORRELATION ACAD RLE 29

Garman’s Theory where knowledge and skills are prerequisites; however, knowledge is

the primary component in this stage as it represents theoria; skill is yet to be established.

During their first year, nursing students are required to take up the general education

subjects Math, English, Filipino including Chemistry which may not be a major subject

but is a pre-requisite in the nursing course. The first major subject to be taken up by first

years is Anatomy and Physiology which serves as foundation for the upcoming subject

course in the progressive year level. In the development stage, knowledge (theoria) is in a

stable form and progressive. Since, the individual is developing, knowledge learned and

acquired are started to be put to practice, thus, little by little skill is developed. As the

nursing students enter their second year, more major subjects such as Fundamentals in

Nursing, Nursing Process, Family Health Nursing, Community Health Nursing and

Public Health Nursing are being taught. Related Learning Experience (RLE) is given

focused inside the classroom to develop skills which are to be applied in hospitals or

community. As the term implies, practice is the stage where praxis is executed by

transfer of theoria. To test the theories learned inside the classroom and apply what is

learned in RLE, nursing students are exposed in the hospitals and the community set-up

by the summer of their second year course. This clinical exposure continues until the

students reach the fourth year level.

Skill is performed prior to mastery and needs high level of vigilance and

concentration before it reaches the expected level of satisfactory performance meeting all

the criteria which is the demonstration phase. As nursing students approach their junior

and senior years in the course, more major subjects are lectured and the emphasis of

learning is converted from the normal healthy condition of every individual to the
 CORRELATION ACAD RLE 30

abnormal and severe state of health and illness continuum. The subjects taught are more

specific and thorough—Oxygenation comprising of the Cardiovascular and Respiratory

System, Fluids and Electrolytes, Maternal and Child Nursing, Paediatrics, Pharmacology,

and so forth. Nursing students are also exposed to specialized areas like the emergency

room (ER), operating room (OR), delivery room (DR), intensive care unit (ICU) and

specialized wards. Furthermore, at the summer of their third year, nursing students are

sent to Manila for a more intensive clinical practice.

At the end of Ganmar’s Theory, maintenance is fulfilled if theoria et praxis goes

within the established criteria and is consistent of the knowledge and skill desired. If

academic performance is congruent to clinical performance, therefore the maintenance

phase of Ganmar’s Theory is achieved, henceforth, it can be deduced that competency

which is derived from Infante’s Theory is attained. Moreover, as nursing students acquire

more knowledge inside the classroom and enhance their skills inside the clinical areas,

their competency level improve and escalate further into the next level which is

proficiency.

Finally, mastery, the end goal of every nursing student, is achieved if all the

requirements needed are met, maintained and executed in a brilliant manner to give

quality nursing care.

 CORRELATION ACAD RLE 31

THEORY ON ACQUIRING MASTERY OF NURSING STUDENTS

Aristotle’s

Mode of Activity

Figure 1. Theoretical Framework Model

THE
 CORRELATION ACAD RLE 32

Conceptual Framework

A modified system approach by Hoz and Miskel was applied in the

conceptualization of the study.

The academic performance and related learning experience of level IV nursing

students are the inputs of the conceptual framework model. The academic subjects—PHC

101, PHC 102, NCM 100, NCM 101 and NCM 102 are the bases for quantifying

academic performance while the evaluation sheets in PHC 101.1, PHC 102.1, NCM

100.1, NCM 101.1 and NCM 102.1 are the bases for measuring related learning

experience.

The process is to find the degree of relationship between the two variables based

from the correlation between academic performance and related learning experience.

The output of the study which is deduced from the implications of the result

showed a moderate degree of correlation between related learning experience and

academic performance.

Figure 2 on page 33 illustrates the conceptual framework model.

 CORRELATION ACAD RLE 33

CORRELATION ACADEMIC PERFORMANCE AND RELATED LEARNING

EXPERIENCE OF LEVEL IV NURSING STUDENTS
OF AQUINAS UNIVERSITY OF LEGAZPI

ACADEM
PERFORMA

 PHC1
 PHC1
Figure 2. Conceptual Framework Model
 CORRELATION ACAD RLE 34

Definition of Terms:

For the purpose of getting common interpretation of terms used in this paper, the

following terms are conceptually and operationally defined.

Correlation: This refers to the degree to which two or more attributes or

measurements on the same group of elements show a tendency to vary together. In the

study, correlation will be used to find and describe the relationship between the two

variables—academic performance and related learning experience.

Academic Performance: This refers to how students deal with their studies and

how they cope with or accomplish different tasks given to them by their teachers. In

educational institutions, success is measured by academic performance, or how well a

student meets standards set out by local government and the institution itself. In the

study, this refers to one of the variables in finding the correlation of academic

performance and related learning experience.

Related Learning Experience: This refers to the result of the performance of the

students in the clinical setting. In the study, this refers to one of the variables in finding

the correlation of academic performance and related learning experience.

Level IV Nursing Students: refers to the senior nursing students who have been

qualified, completed, & passed the subjects that are prerequisite in qualifying for the

fourth year of the educational degree. In the study, this refers to the subjects, particularly

the Level IV Nursing Students of Aquinas University of Legazpi A.Y. 2009-2010.