CHAPTER 1

Introduction:

Nursing education plays a crucial role in preparing healthcare professionals by imparting clinical competency for
safe and effective patient care. Skill laboratories provide controlled environments for nursing students to practice
and refine clinical skills through simulation exercises, fostering their development in areas like wound care and
medication administration. Clinical learning experiences involve students providing care to real patients under
supervision, allowing them to apply theoretical knowledge in a practical setting.

Competency, defined as the application of appropriate knowledge, skills, behaviors, and judgment, is essential in
nursing. Various studies have explored the relationship of skill laboratories and clinical learning experiences on
nursing students' clinical competency.

It was reported by T M Mothiba, that the clinical skills laboratory of the Department of Nursing Science, University
of Limpopo, South Africa provided a conducive learning area for undergraduate nursing students. The skills
laboratory provides voluntary practice sessions across all modules of the nursing programme in general nursing
science, community nursing science, psychiatric nursing science and midwifery. In University of Santo Tomas,
College of Nursing, they established a skill laboratory to address issues on patient’s safety in order to increase
students’ competences and confidence before they perform the skill in an actual patient.

While the importance of skill laboratories and clinical experiences is widely recognized, ongoing research seeks to
understand the specific contributions of each component to nursing students' clinical competency. This study aims to
address these questions through literature analysis, data collection, and surveys with nursing students. The findings
are expected to enhance teaching methods, improve educational outcomes, and ultimately elevate patient care in the
nursing profession.

Statement of the Problem:

Our research seeks to answer the following questions:

1. What is the profile of the respondents in terms of sex?

By examining the demographics of our participants, we can better understand the characteristics of the nursing
student population involved in our study.

2. What is the skill laboratory grades/ratings of the Level 3 students?

We will analyze the skill laboratory performance of our Level 3 students to gain insights into their practical abilities
and proficiency.

3 and 4 Is there a relationship between the skill laboratory, clinical learning experience and clinical competency of
the students?

By examining the correlation between skill laboratory grades and clinical competency, we can determine if there is a
predictive relationship between the two. We aim to investigate the impact of hands-on skill development and real-
life clinical exposure on their overall clinical competency.

Significance of the Study:

Nursing Administrator

• It helps with improved curriculum planning and resource allocation for administrators.
• Enhances patient care and safety by producing nurses who are more prepared.

Nursing Education

• Raises the standard for nursing education.

• Better equips students for practical clinical experience.

Nursing Research

• Adds new knowledge to nursing research.

• Enhances evidence-based teaching methods and directs future research.

Nursing Students

• Provides students with a full understanding of the relationship between experiences and competency.

• Strengthens commitment to and readiness for patient-centered treatment.

Policies

• Shapes the workforce and educational policies.

• Establishes guidelines for efficient teaching, lab usage, and training.

People Services

• Discovers ways to improve clinical competency.

• Ensures communities receive quality care from skilled professionals.

Scope and Limitation:

The general aim of this study is to determine the relationship of skill laboratory and clinical learning experiences on
the clinical competency among third year nursing students at St. Scholastica’s College Tacloban. The research
sample, comprising a total of 140 respondents was randomly selected from different sections of the program based
on the Slovin’s formula. The research will specifically target bonafide students of SSCT, regular students of the
College of Nursing, and those of level 3 nursing students who were on duty in the ward area. Notably, the study will
exclude students from other levels including level I, II, and IV.

CHAPTER 2

RRL:

According to the study of American Nurses Association, 2020; (John et al., 2019). The integration of skill
laboratories in nursing education has garnered significant attention in recent years, aiming to enhance the clinical
competency of nursing students. Previous research has indicated the positive impact of skill laboratories on students'
practical abilities and overall clinical performance.

According to them, such development of this skill is enhanced when students are encouraged to ask or raise
questions towards their clinical instructors. At the same time collaboration between the different healthcare
providers during the student’s actual exposure also facilitates learning, thus also improving their critical thinking
ability (Acain, Acuesta, et. al., 2009).
RRS:

In nursing, clinical competency is still an issue and has been given more weight than academic competency. While
skill enhancement programs are helpful and advised, there is no evidence to support their impact on pre-graduate
nursing students' clinical competency.

In a journal article of Employers Viewpoint on Clinical Education (O'Brien.C.W.etc.,2017) Clinical education, as

implemented by many AH fields, imparts to students’ skills necessary for future professionals’ practice. Both
supervisor and students report benefits to learners, including the opportunity to practice in a realistic setting, the
application to visualize themselves in the professional roles of their discipline, and increased confidence regarding
their skills.

The research conducted by Curl, E.D., found that integrated simulation and clinical experiences are more effective
for nursing students than traditional clinical experiences. etc. (2016), the primary goal of the research is to determine
how successful it is to replace 50% of the typical clinical experiences in obstetrics, pediatrics, critical care, and
mental health nursing with high-fidelity simulation. were in the study looked into whether using simulations to
replace half of the traditional clinical experiences was just as successful as using the traditional clinical activities in
the relevant field.

In 2016, The study comprises two participant groups: level three students and clinical instructors. These
participants' areas of exposure are compared based on their experiences in 3-day and 5-day programs in the medical-
surgical departments of the several Cebu City hospitals with which the school is now affiliated. The male and female
medical wards, surgical wards, pediatric wards, orthopedic wards, emergency rooms, and operating rooms are the
medical-surgical areas. Of the thirty-eight (38) clinical instructors at the aforementioned institution, only five (5)
were eligible to serve as study informants. For these informants to be included, a teacher must have a permanent
position in the clinical setting. The study's informants were chosen through the application of purposeful sampling.
Several students from each scheme were selected as subjects. Since the aforementioned five informants had been
supervising them, fifty-eight (58) student nurses from the 5-day plan and fifty-one (51) from the 3-day scheme
qualified as subjects. Subsequently, the researcher selected sixty percent at random from each scheme, resulting in
thirty-eight (38) from the 5-day scheme and thirty-one (31) from the 3-day strategy. Six interview questions
covering level three student performance in both schemes were used by the researcher as a guide. Graneheim and
Lundman (2004) outlined approaches to qualitative content analysis from which the techniques utilized to classify
and categorize individual data were adopted.

Theoretical Framework:

Albert Bandura's Social Learning Theory emphasizes learning through observation and modeling, stating that
individuals acquire new behaviors and knowledge by watching others. Applied in nursing education, it underscores
how students enhance clinical competencies by observing and imitating experienced practitioners in skill
laboratories and clinical settings, learning both clinical skills and essential patient care skills through observation.

David Kolb's Experiential Learning Theory asserts that learning is a cyclical process involving concrete experience,
reflective observation, abstract conceptualization, and active experimentation. In nursing education, this theory is
evident as students engage in hands-on clinical experiences, reflecting on and making sense of these experiences,
and actively applying their learning in real-world scenarios. The cycle emphasizes the integration of theory and
practice, crucial for the development of clinical competencies in nursing students.

Patricia Benner's Novice to Expert Model outlines a developmental progression in nursing skills from novice to
expert, emphasizing the circular, non-linear nature of the process. It highlights the importance of practical
experience alongside theoretical knowledge for the continuous development of clinical competence in nursing
students. The Novice to Expert Model helps nursing students and educators recognize the ongoing developmental
process from novice to expert. It emphasizes that clinical competence is not solely based on theoretical knowledge
but also on the accumulation of practical experience and the ability to apply knowledge in real clinical situations.

Albert Bandura's Self-Efficacy Theory asserts that students' belief in their ability to perform clinical tasks, influenced
by skill laboratory and clinical experiences, directly impacts their motivation and performance. Self-efficacy, rooted
in one's confidence to succeed in specific situations, plays a crucial role in how nursing students approach and
handle clinical challenges.

Constructivist Learning Theory emphasizes active learner engagement in knowledge construction. In nursing
education, this means that students develop clinical competencies not by passively receiving information but by
actively participating in hands-on skill laboratory and clinical experiences. The theory underscores the importance of
connecting theory with practice, allowing students to construct meaningful knowledge through reflection and hands-
on learning.

Conceptual Framework:

This conceptual framework shows how the researcher conducted the study. It comprises of input, process and
output. The inputs include the demographic profile of 3 rd year nursing students, as well as their skill laboratory and
clinical learning experience, which represent the foundational elements of the study.

The study will adapt a descriptive and correlational research design. The researchers will get the grades of the
respondents both in their skill laboratory and clinical duty in order to analyze if there is a correlation between the
two variables. After the collection of data, different statistical treatments will be used to treat and analyze the data.

The findings of the study will serve as a basis for assessing the clinical competency, indicating the relationship of
skill laboratory and clinical learning experience on the clinical competency among third year nursing students.

CHAPTER 3: Methodology

Research Design:

This investigation used a quantitative research methodology and will utilized the descriptive and correlational
research design.

This design aligns with the study's objective of assessing and determining the relationship of skill laboratory and
clinical learning experiences on the clinical competency of nursing students through a quantitative inquiry.

Locale:

This study was conducted at St. Scholastica's College Tacloban Inc., located in Maharlika Highway Palo, Leyte and
is renowned for its commitment to academic excellence and holistic education. This environment serves as an ideal
setting to determine how skill laboratory training influences the clinical competence of nursing students. The
comprehensive nature of the environment allows for a thorough exploration of this relationship, offering diverse
scenarios and contexts for the research investigation. Additionally, the setting enhances the depth and breadth of
understanding in assessing the effect of skill laboratory training or learning on nursing students' clinical competency.

Population and Sample:

In research studies, determining an appropriate sample size is crucial for obtaining reliable and meaningful results.
One commonly used method is Slovin's Formula, which helps calculate the sample size needed for a given
population.

Slovin's Formula is expressed as n = N / (1 + Ne²), where:

- n represents the desired sample size

- N represents the size of the entire population

- e represents the desired margin of error

With our research, we have a population size of 215 and a desired margin of error of 0.05 (e).

Using the formula n = N / (1 + Ne²), we substitute the values:

n = 215 / (1 + (215 x 0.05^2))

n = 215 / (1 + (215 x 0.0025))

n = 215 / (1 + 0.5375)

n = 215 / 1.5375

n ≈ 139.92

Rounding off to the nearest whole number, the sample size needed for our study was 140.

In addition, stratified random sampling will be used to ensure representation from each section of the level three
nursing students

Nh
Stratified Random Sampling Formula: n h= ×n
N

nh= Sample size for hth stratum

Nh= Population size for hth stratum

N = Size of entire population

n = Size of entire sample

140
Na = × 41=26. 9∨27
215
 140
Nb = × 45=29
215

140
Nc = × 42=27
215

140
Nd = × 44=28.6∨29
215

140
Ne = × 43=28
215

Data collection procedure:

For a systematic way of approaching this study, the researchers first sought permission from the Dean of Nursing
and subsequently from the Dean of College to conduct the study and sought permission to obtain the grades of 3rd
year nursing students based on their skill level, laboratory performance, and grades during clinical. After permission
was granted, the researchers were going to analyze and compare the grades in both skills’ laboratory and clinical
duties. The researchers ensured that the data gathered was treated thoroughly as confidential. Finally, upon
completion, the researchers diligently collected and interpreted the data for analysis.

Instrument:

The researchers will reference the checklist for each third-year respondents’ which consist of their final
ratings or grades in their skills laboratory and clinical performance, anonymously. The grades will be gathered by
submitting a request on the registrar office in order for the researchers to have access to the grades from each current
third-year student. These grades or ratings are greatly needed in order for the researchers to establish important data
on the correlational status between skills laboratory and clinical performance. Therefore, it is expected, that by
having access to such confidential, it will be utilized with utmost responsibility.

Data Analysis:

The gathered data was subjected to different statistical treatments in order to answer the

research questions. The data gathered were categorized and tabulated to facilitate the analysis.

For research objective 1, on the on the demographic profile of the respondent in terms of sex;

the frequency and percentage were used.

Percentage. To analyze the percentage value of a variable associated with a sample, the following

formula was used:

𝑥
𝑝=
 𝑛

where

𝑝 – percentage
𝑛 – sample size

𝑥 – number of observations

For research objective 2, on the skill laboratory grades/ratings of the Level 3 students; the

mean and standard deviation were used.

Mean. To analyze the skill laboratory grades/ratings and the clinical competency (on duty) grades

of the variables, the following formula was used:

∑𝑥
𝑥̄ =
𝑛

where

𝑥̄ – mean

𝑛 – number of observations

∑𝑥 – sum of the combined grades/ratings

Standard Deviation. To analyze the sample standard deviation of the observations in the

variables, the following formula was used:

where

𝑠 – standard deviation 𝑥̄ – mean

𝑛 – number of observations 𝑥𝑖 – observation

Pearson Correlation Coefficient. To analyze the relationship between Skill Laboratory and

Clinical Competency (Question 3) and the relationship between Clinical Learning Experience and Clinical

Competency (Question 4), the following

formula was used:

r = Pearson correlation coefficient

x = Values in the first set of data (the mean of the skill laboratory grades)

y = Values in the second set of data (the mean of the clinical competency grades)

n = Total number of values.