GRP3 Chap1-2

Lived Experiences of Third Year Nursing Students of Davao Doctors
College on the Integration of Online-Related Learning Experiences

Modalities
A Thesis Proposal Presented to the Faculty of the
Nursing Program of Davao Doctors College, Inc.
Davao City
In Partial Fulfilment of the Requirements for the
Degree of Bachelor of Science in Nursing
Alajar, Mary Angeline

Albia, Delcris
Cruz, Kimberly
Gudelos, Arlyn
Llanos, Princess Diana
Sumampong, Norwich
Tingzon, Francis Don
Viran, Daniela Joy
August, 2020
DAVAO DOCTORS COLLEGE, INC.
Gen. Malvar St., Davao City 8000
Bachelor of Science in Nursing
CHAPTER I
INTRODUCTION
With the fast-paced modernization that has been taking place in today’s
generation and the revolution in the information and communication technology
for the past decade, universities and colleges have been starting to integrate, if
not totally shift into, online modes of delivering education to its students. In fact,
according to a new report, Grade Increase: Tracking Distance Education in the
United States, by Babson Survey Research Group in 2018, there has been an
increased in the number of enrolments of distance students for the fourteenth
straight year in 2016 (Babson College, 2018). This reflects a surge of over 30
percent of students in higher education are taking at least one online course in
the United States.
Relatively, the nursing education has also responded to this evolution in
the pedagogy of this profession. Concurrently, according to Van Schyndel
(2015), nursing programs are adding online courses as well as degree programs
in trying to meet the demand for more qualified nurses (American Association of
Colleges of Nursing, 2009; American Association of Colleges of Nursing, 2011;
Mancuso, 2009). According to an infographics presented by the National League
for Nursing, online/distance learning places second, with a percentage of 75%,


on the top three technology used today with video for skills in the topmost (84
percent) and virtual
simulation (65 percent), tied closely with adaptive quizzing and testing (64
percent) , on the last place (Forneris & Tiffany, 2018)
With that said, nursing programs are already integrating the online
approach in conducting classes and even students’ activity; and that includes
conducting some of the Related Learning Experience activities and its
requirements online. Related Learning Experiences are teaching-learning
opportunities provided to the nursing students to develop their skills and
competencies in utilizing processes in different health situations (Candelasa,
2016). It is not only limited to the clinical duties in hospitals and clinical areas
affiliated to the school as well as facilities, such as lying in clinics, but also the
RLE activities conducted in the schools such as skills-oriented performance
tasks. With the incorporation of the online modality in the undergraduate nursing
education, requirements associated with Related Learning Experience are also
expected to be done through online.
With the introduction of online method of delivering the nursing education,
varied perceptions have been garnered. According to the study Nursing
Student’s Learning Experiences in an Online Learning Course (Sinaga et al.,
2018), most students (more than 70%) responded that they had a positive

experience on the online (blended) learning. However, it was also noted 27-28%
(a quarter of the students) had less motivation to do online learning.
In the Philippines, as the country has been gravely hit with COVID-19 with
49, 034 active cases as of August 17, 2020 (DOH, 2020), schools in all levels,
including the universities and colleges, have opted to shift to different modes of
delivering education which includes online learning. As the school year 2020-
2021 has opened in some schools all over the country, online learning has been
rampantly practiced.
Locally, some schools in Davao City has already incorporated blended
learning for the school year 2020 to 2021. However, face-to-face exams and
classes are yet to take place on September 1, 2020 in Davao City Higher
Educational Institutions (HEIs) (Colina IV, 2020). Davao Doctors College, on the
other hand, have already started their classes last August 3, 2020; in which the
institution has conducted classes through online, including classes of the
students from the nursing program. With this given, they have already
experienced utilizing different modalities in making requirements and activities in
lieu with their program. Thus, this study aims to explore and understand the lived
experiences of the nursing students, specifically the third year students, on the
integration of online related learning experiences modalities, since they have
already going through it currently.
Purpose of the Study


The purpose of this phenomenological study is to develop an
understanding of the lived experience of third year nursing students of Davao
Doctors College on the Integration of online-related learning experiences
modalities. The study aims to perceive the experiences of nursing students on
the change of learning modalities from traditional-learning to online-related
learning. Furthermore, it aims to explore the perception of the third year nursing
students who currently experiencing the new method of learning specifically the
online-related learning. The study also aims to know the differences of traditional-
learning to online-related learning from the experiences of the students. Lastly,
the study will describe how students cope up with the new challenges they face
from the integration of online-related learning experiences modalities.
Research Questions
1. How does the effectiveness of having online related learning experiences
modalities compare with that face-to-face RLEs
2. What are the lived experiences of nursing students of Davao doctors
college having online related learning experiences
3. Does supplementing face-to-face instructions with online instruction
enhance learning?
4. How do students perceive and describe their online related learning
experiences with online course content?
5. How do students describe their interaction with clinical instructors during
online related learning experience?

Review of Related Literature
It is necessary to incorporate e-learning in the nursing curriculum, since it
enables learners to learn at their own location and time. It allows learners to be
self-directed, and also gives them the ability to link to access resources online
which are necessary for their use of teaching requirements. This holds a number
of potential benefits and the apprentices need access to tools and resources
include text, audio, video, email and online conversations and assessment. It is
valuable method for increasing teaching content and education to read. It is an
innovative approach to delivery of education via electronic formats of information
which boost the knowledge of learners and its skills (Ali, 2016).
According to Ali (2016), E-learning is a method which can be included in
the Nursing undergraduate training. For this reason, the university will establish
e-learning as an instrument to enhance student learning as they are ready to
learn by themselves, whether what year or age they are. No more obstacles to
learning via e-learning.
According to a study conducted by Karaman (2011), results show nurses,
in general, perceives online leaning positively. Moreover, there has been a


significant difference between those nurses who are using computers least and
those with the most usage of computer in terms of their perceptions. Also, it was
also found out that there is no significant relation of perception to online
programs to neither the nurses’ age nor the length of their work experience.
However, there
is a significant difference between the nurses’ perception and where they are
working. It can therefore be concluded that online learning is viewed by the
nurses to be suitable for their works. Continuous training should be constantly
provided to them through online learning modification, regardless of their
attributing factors.
According to Varvel (2020), he stated that compared to the traditional
face-to-face teaching, students who are enrolled in online distance learning
program does not have an instructor who can recognize unmotivated students or
make them participate. Oftentimes, online program courses depend on person’s
personal motivation based upon the interest in the subject materials or desire to
get credit in the course. A research was conducted by a group of researcher from
Nigeria, wherein they intend to investigate the nursing students perception on
online distance learning and base on their findings it appears that 99.4%
concured that e-learning is user friendly, 92.6% agreed that it is easier for them
to become skilful when it comes to e-learning usage, while 97.1% agreed that e-
learning has improved their performance (Opeyemi, 2019).


According to Sinaga et al., (2018), Online learning can improve and
support nursing education and skills but there are some students does not want
applied online learning. However, some factors are considered as part of using
online learning and affect their experiences. The research was conducted by the
researcher in Indonesia, wherein they investigate nursing students experience in
an online learning context. Based on their findings most students (>70%) shows
that online learning improved their learnings and gives them positive outcome,
and some students (22-28%) shows that through online learning their motivation
to develop their critical thinking was less.
According to Jafaraghaie et al., (2017), Nursing students need changes in
education such as approaches that modern that lead the students to become
good and skilled nurses. The online learning today is one of the most used
method. The research was conducted in iran, where the researcher survey the
nursing students view and experiences in using online learning such as flipped
classroom. Based on their findings majority of the students (79.1 %) choose
flipped classroom online learning rather than the traditional one. The students
has good views and experiences in using flipped classrrom.
Nurse educators' use of technology in teaching continues to expand at a
dizzying pace. It is hard to imagine planning a course or class without thinking
about technology that might be used to engage students in learning and meet
other instructional goals. The most recent Horizon Report1 indicates that a shift
is taking place across higher education in which students are learning by creating
rather than consuming content delivered by the teacher. In more and more

nursing programs, students work in groups solving problems, analyzing cases,
and discussing higher-level questions about nursing. They create Web sites,
podcasts, videos, and other multimedia. Students are learning together and from
each other and developing products of their learning. Price and
colleagues2 described how they used digital storytelling as a means for students
to create and share their stories about palliative care concepts, leading to a deep
understanding of the concepts.
Technology also exposes students to clinical scenarios they would not
encounter in their practice and helps to bridge the gap between theory and
practice. With technology, we can add reality to a scenario and make traditional
case studies more realistic. Shellenbarger and Robb described how faculty can
integrate technology in a case history, for example, by adding podcasts,
hyperlinks, video clips, and images, to provide the context for the case, engage
students in meaningful learning, and develop their clinical reasoning skills
(Oerman, 2015)
The use of technology in nursing education is simulations with electronic,
training mannequins. Instructors can program the mannequins to mimic
scenarios nurses might see in clinical practice. Students can take vital signs and
make decisions based on the mannequin’s symptoms. It is a safe environment
where students can practice their critical thinking and decision-making skills,
knowing the mannequin will not stay dead if it dies, according to an article at
Advance for Nurses.


While mannequins require a physical presence, online virtual realities can
simulate patients as well. Using screen-based simulation such as serious
gaming, a nursing student can respond to simulated patients in real-time using
the appropriate tools and procedures. Companies make virtual simulation
software to help educate nurses and other healthcare professionals like the flight
simulation software that helps train aircraft pilots.
The use of mobile technology in nursing gives students (and working nurses)
instant access to drug references, diagnoses, medical textbooks and more using
apps and online guides on smartphones and tablets. “These devices are
becoming more important in the health care environment with an advantage of
providing a compendium of drug, nursing procedures and treatments, and
disease information to nursing students,” according to a study published in the
Fall 2015 issue of The ABNF Journal.(University of Texas Arlington, 2016)
According to Jamshidi (2016). Nurses’ competence is based on the
knowledge and skill taught to them. Nursing training is a combination of
theoretical and practical learning experiences that enable nursing students to
acquire the knowledge, skills, and attitudes for providing nursing care. Nursing
education is composed of two complementary parts: theoretical training and
practical training. A large part of nursing education is carried out in clinical
environments. In Iran and many other countries, clinical education forms more

than half of the formal educational courses in nursing. Therefore, clinical
education is considered to be an essential and integral part of the nursing
education program. Since nursing is a performance-based profession, clinical
learning environments play an important role in the acquisition of professional
abilities and train the nursing students to enter the nursing profession and
become a registered nurse. Moreover, the clinical area of nursing education is of
great importance for nursing students in the selection or rejection of nursing as a
profession.
Unlike classroom education, clinical training in nursing occurs in a
complex clinical learning environment which is influenced by many factors. This
environment provides an opportunity for nursing students to learn experimentally
and to convert theoretical knowledge to a variety of mental, psychological, and
psychomotor skills which are of significance for patient care. Students’ exposure
and preparation to enter the clinical setting are one of the important factors
affecting the quality of clinical education.
According to Tiwaken et.al (2015). Lived experiences of student nurses
during their clinical practice from the phenomenological point of view of nine
student nurses. Student nurses are found to be on the verge of developing the
sense of responsibility for the health and well-being of others as having been
introduced to the threshold of clinical practice at early adulthood. Leaving the


safe and supportive teaching environments of their school, they are placed into
clinical environments that are perceived as unfamiliar and complex and that
require dealings with diverse human relations. Notably, the group’s experiences
in clinical practice provide greater insight to develop an effective clinical teaching
strategy in nursing education. Focus group discussions and interviews were the
main methods of data gathering. Employment of Colaizzi's strategy in descriptive
phenomenology established the data analysis. The participants considered
clinical practice to be an essential component of their learning process.
The integration of both theory and practice and opportunities for
application and laboratory skills enable student nurses to learn effectively, to feel
confident
with their skills, and to become competent in taking care of patients. Meanwhile,
problems and concerns may be addressed better if good interpersonal relations
and sustained communication are practiced. Findings suggest that there is a
need to rethink about the clinical skills training in the field of nursing. Distinctly,
approaches in order to decrease the gap that exists between the academic and
the clinical component of nursing education should be explored, clinical
instructors on the other hand need to design strategies and new innovative ways
for more effective clinical teaching. Finally, there is a necessity to use
approaches that facilitate learning in clinical practice in beyond creating a
conducive clinical learning environment.

Theoretical Lens
Now that everyone is in the middle of a pandemic where the traditional
face-to-face teaching has to be restricted, students and teachers needs to find an
alternative learning modalities that will enable them to continue learning and
acquire new knowledge from their perspective courses. Determination of student
nurses lived experiences on the program that they are currently enrolled in is
important in identifying acceptance of online programs. So to further understand
the lived experiences of Third Year Nursing students’ of Davao Doctors College
on the Integration of Online-Related Learning Experience Modalities, the study
will utilize the Technology Acceptance Model of Fred Davis and Richard Bagozzi
(1989).
According to Technology Acceptance Model (TAM) by Fred Davis and
Richard Bagozzi, there are two primary factors that influence an individual’s
intention to use new technology and these are the perceived ease of use and
perceived usefulness. In perceived usefulness, it is defined as user’s subjective
likelihood that utilizing a particular application system will improve his or her work
or life performance. Perceived ease of use, on the other hand, can be
characterized as how much the forthcoming client anticipates that the system will
be effortless to use. Thus, this model provides an empirical theoretical system or
framework that will enable the researchers to understand the computer usage

and computer acceptance behaviour in the context of the integration of online-
related learning modalities on nursing students lived experiences.
Through Technology Acceptance Model (TAM) it helps the researcher and
this study, to provide information when collecting necessary data to investigate
the live experiences of nursing students on integration of online-related learning
experience modalities. This theory is the basis to the study because it is about
the perception which is the readiness, difficulties and to recognized the
usefulness of the technology based on the online related learning modalities that
used by the students. It matches the factors that value the usefulness and ease
of used that enhances the skills and obtaining the information system and
technology in using the online related learning modalities. Despite of this
Pandemic, nursing students can apply, express their understanding and
experience on the integration of online-
related learning experience modalities and can deliver quality of care using
technology.
Importance of the study
This study aims to benefit the following persons: 1.) Nursing students, 2.)
Clinical Instructors, 3.) Nursing Department


This study will be beneficial to the nursing students as their readiness and
capability are being noted and evaluated in adapting the technology-based
modalities mainly in the related learning experience. In addition, the difficulties
and limitations of the 3 rd year nursing students will be brought to light aside from
the perceived advantages of the modalities being mentioned.
Also, this study aims to benefit the clinical instructors of the institution in a
way that knowing the perception of the students towards the modalities, they will
be able to intervene and implement appropriate measures to address the
concerns of the nursing students.
Moreover, this study will also be beneficial to the nursing department in
general since technology or online-based modalities are undeniably essential in
promoting efficiency towards the nursing student’s related learning experience.
The study will serve as a guide as to which part the modalities still needs
enhancement and additional instruction basing from the student’s perception.
This can also serve as a steppingstone to implement online related learning
experience modalities to improve nursing care starting from a simple nursing
documentation like the online-generated nursing care plans.
Delimitation and Limitation of the Study
This study tends to know the lived experiences towards integration of
online-related learning experiences modalities. The sample selected for this
study are specifically students who are pursuing a health profession career and

as a result, are identified as nursing students. Initially, this study will confine to
individual interview conducted to third year nursing students of Davao Doctors
College. The live experiences are determined only by the questions designed by
the researchers. The results obtained in this study may not be applicable to
students outside of this designation.
CHAPTER II
METHODOLOGY
Research Design
The study will be utilizing the qualitative research design in order to gather
qualitative data on the lived experiences of the third year nursing student of
Davao Doctors College on the integration of online related learning experience


modalities in the curriculum. Moreover, the data gathered will undergo a
descriptive approach so as to fully grasp and understand the lived experiences of
the participants. In order to do so, the researchers will have an in-depth interview
with the respondents, guided with guideline questions.
Since delivering RLE modalities through online was just recently
incorporated in the nursing program in Davao Doctors College, the study will be
dwelling on describing the experiences of the participants. It will then be
understood and a description of these experiences will be constructed, given the
fact that the third year nursing students of DDC are one of the pioneering batch
to experience this modification in the learning experience of education systems.
Research Participants
Random selection will be done in selecting of participants for this study,
which will include 10 participants to reach the information based on qualitative
research.
The selection of participants will include the Third Year Nursing Students
of Davao Doctors College and has been on online-related learning since March
2020.
Data Sources
The essential information needed for this study will be gathered from the
verbalization of the 10 participanting Third Year Nursing students of Davao
Doctors College. The participants who will agree to participate in this study will
be considered as primary sources, and as for related literature, it will be
considered as secondary sources for this study, that will be necessary to support
the data that will be gathered from the primary sources.
Data Collection Procedure
This study will follow through the following procedures for the data collection:
Secure the approval from the Nursing program Chair of Davao Doctors College,
to conduct the study, the informed consent of the participating Third Year Nursing
Student will be secured prior to data gathering. 2) Actual data gathering will be
conducted. 3) The participants, prior to data gathering, will be oriented about the
nature of the study, it’s purpose, and the data collection procedure. Also, to be
included in the orientation, are the rights to ask questions during interview, right
to refuse to give information, and right to withdraw from the study.In the interview
the participants right to privacy and confidentiality will be observed. 4) The
participants will be informed that the interview will be recorded. The recordings
will then be transcribe word for word after the interview to ensure data accuracy.

5) Interview will be used in gathering data for the study. The interview will be
guided with questionnaire guideline. 6) If the data are gathered, the interview will
end and the participants will be given appreciation for participating in the
research study.
Trustworthiness of the Study
Credibility. Numerous distinct questions will be asked concerning topics that is
correlated to online-related learning experiences modalities. Participants will be
encouraged to make a support about their answers with real-life examples and
the interviewer will throw follow-up queries. From the interview, the researcher
will make use of the raw material to study until they will emerge with a theory that
could provide them the scope under their study.
Transferability. Researchers must consider that the results of the research are
transferrable to other settings with other respondents. They should provide a
thick description of the research process to let the reader evaluate whether the
findings are transferrable to their own setting.
Dependability. Study should be consistent and stable over time. The findings,
interpretation and recommendation of the study will be evaluated by the
participants that will be supported by the data as received from participants of the
study. The audit trial is the most needed strategy for this criterion. The
researcher will provide a comprehensive set of notes on decision made


throughout the research process because this permit the researcher to study the
transparency of the research path.
Reflexivity. The researcher will recognize the significance of being self-aware
and reflexive about their own role in the process of collecting, analyzing and
interpreting data. Assumptions, preconceptions, values, conceptual lens and how
all of these will affect research decision in all aspects of the study.
Role of the Researcher
The researcher will conduct interviews properly and according to the
research design used to the third year nursing students on their experiences on
the integration of online-related learning experience modalitites. The researcher
is responsible on collecting the data from the participants. The researcher is in
charge of analyzing and interpreting the data collected from the participants. The
researcher will be responsible on securing thr data collected from the
participants. The researcher will have role, to act honestly and ethically towards
the path of their study.
Ethical Consideration
In conducting the study, the researcher will ensure and follow ethical
considerations. The researcher will observe the following; informed consent,
beneficence, respect for anonymity and confidentiality, and respect for privacy.

Before gathering the data, informed consent will be given to the participant.
Participation in the study is voluntary and shall be based by the autonomous
decision of the participants to sign the consent. The researcher will explain the
purpose of the study, the nature of the study, the right to refuse participation, the
right to withdraw anytime from participating from the study, the right to privacy
and confidentiality, and the risks and benefits of the study before asking them to
sign the informed consent. Recordings from the interview will be stored and
carefully handled thus respondents shall be assured that responses will be
treated anonymously and with confidentiality.
Data Analysis
In this study, the end result is a concise yet all-encompassing description of the
phenomenological study based on the method of Colaizzi, validated by the
participants that created it. The method depends upon first person accounts of
experience; these may come from face-to-face interviews; but can also be
obtained in multiple others ways such as written narratives, blogs, research
diaries, online interview and so on. (Morrow et al., 2015)
There are distinctive seven step process that provides a thorough analysis, with
each step staying close to the data and these are 1) familiarisation which the
researcher familiarises him or herself with the data, by reading through all the
participant accounts several times, 2) Identifying significant statements which
The researcher identifies all statements in the accounts that are of direct
relevance to the phenomenon under investigation, 3) Formulating meanings in


which the researcher identifies meanings relevant to the phenomenon that arise
from a careful consideration of the significant statements. The researcher must
reflexively “bracket” his or her pre-suppositions to stick closely to the
phenomenon as experienced (though Colaizzi recognizes that complete
bracketing is never possible), 4) Clustering themes in which the researcher The
researcher clusters the identified meanings into themes that are common across
all accounts. Again bracketing of pre-suppositions is crucial, especially to avoid
any potential influence of existing theory. 5) Developing an exhaustive
description where the researcher writes a full and inclusive description of the
phenomenon, incorporating all the themes produced at step 4. 6)Producing the
fundamental structure where the researcher condenses the exhaustive
description down to a short, dense statement that captures just those aspects
deemed to be essential to the structure of the phenomenon. 7)Seeking
verification of the fundamental structure where the researcher returns the
fundamental structure statement to all participants (or sometimes a sub-sample
in larger studies) to ask whether it captures their experience. He or she may go
back and modify earlier steps in the analysis in the light of this feedback. (Morrow
et al., 2015)
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Lived Experiences of Third Year Nursing Students of Davao Doctors

College on the Integration of Online-Related Learning Experiences

A Thesis Proposal Presented to the Faculty of the

Nursing Program of Davao Doctors College, Inc.

In Partial Fulfilment of the Requirements for the

Degree of Bachelor of Science in Nursing

Alajar, Mary Angeline

Bachelor of Science in Nursing

generation and the revolution in the information and communication technology

according to a new report, Grade Increase: Tracking Distance Education in the

increased in the number of enrolments of distance students for the fourteenth

the United States.

Relatively, the nursing education has also responded to this evolution in

the pedagogy of this profession. Concurrently, according to Van Schyndel

Colleges of Nursing, 2009; American Association of Colleges of Nursing, 2011;

Mancuso, 2009). According to an infographics presented by the National League

for Nursing, online/distance learning places second, with a percentage of 75%,

Bachelor of Science in Nursing

percent) and virtual

percent) , on the last place (Forneris & Tiffany, 2018)

conducting some of the Related Learning Experience activities and its

requirements online. Related Learning Experiences are teaching-learning

opportunities provided to the nursing students to develop their skills and

competencies in utilizing processes in different health situations (Candelasa,

RLE activities conducted in the schools such as skills-oriented performance

education, requirements associated with Related Learning Experience are also

expected to be done through online.

With the introduction of online method of delivering the nursing education,

varied perceptions have been garnered. According to the study Nursing

Student’s Learning Experiences in an Online Learning Course (Sinaga et al.,

Bachelor of Science in Nursing

(a quarter of the students) had less motivation to do online learning.

Locally, some schools in Davao City has already incorporated blended

institution has conducted classes through online, including classes of the

experienced utilizing different modalities in making requirements and activities in

integration of online related learning experiences modalities, since they have

already going through it currently.

Purpose of the Study

Bachelor of Science in Nursing

understanding of the lived experience of third year nursing students of Davao

Doctors College on the Integration of online-related learning experiences

modalities. The study aims to perceive the experiences of nursing students on

the change of learning modalities from traditional-learning to online-related

learning to online-related learning from the experiences of the students. Lastly,

from the integration of online-related learning experiences modalities.

1. How does the effectiveness of having online related learning experiences

modalities compare with that face-to-face RLEs

2. What are the lived experiences of nursing students of Davao doctors

college having online related learning experiences

3. Does supplementing face-to-face instructions with online instruction

4. How do students perceive and describe their online related learning

experiences with online course content?

5. How do students describe their interaction with clinical instructors during

online related learning experience?

Bachelor of Science in Nursing

Review of Related Literature

It is necessary to incorporate e-learning in the nursing curriculum, since it

valuable method for increasing teaching content and education to read. It is an

innovative approach to delivery of education via electronic formats of information