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Research Article

The Relation Between the Oral Revalida Program and Philippine Nursing Licensure Examination Performance

Regie P De Jesus*

Corresponding Author: Regie P De Jesus, Dr. Yanga’s Colleges, Inc. Philippines.

Received: May 27, 2024 ;    Revised: June 02, 2024 ;    Accepted: June 05, 2024 ;   Available Online: June 28, 2024

Citation: De Jesus RP. (2024) The Relation Between the Oral Revalida Program and Philippine Nursing Licensure Examination Performance. J Nurs Midwifery Res, 3(1): 1-6.

Copyrights: ©2024 De Jesus RP. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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This study investigates the relationship between participation in the oral Revalida program and performance in the Philippine Nursing Licensure Examination (PNLE) among nursing students at Dr. Yanga's Colleges, Inc. (DYCI). Employing a correlational research design, linear regression analysis was utilized to assess the predictive value of the Revalida program on licensure exam outcomes. The sample consisted of 100 nursing students who completed both the Revalida program and the PNLE. The results indicate a strong positive correlation between Revalida program participation and PNLE scores, with an R2 value of 0.880. The model explains 77.5% of the variance in PNLE performance (R2=0.775), highlighting the program's significant impact on exam outcomes. The regression coefficient for the Revalida program was 0.733 (p < .001), demonstrating that higher performance in the Revalida is associated with higher PNLE scores. The Q-Q plot analysis confirmed the normality of residuals, supporting the validity and reliability of the regression model. These findings suggest that the oral Revalida program is an effective preparatory tool for nursing licensure examinations, enhancing critical thinking, clinical reasoning, and communication skills. The study underscores the importance of integrating rigorous oral assessments in nursing curricula to better prepare students for professional practice. Future research should explore additional factors influencing licensure performance and the potential for expanding the Revalida program to further improve educational outcomes.

Keywords: Oral revalida program, Philippine nursing licensure examination, Nursing education, Linear regression, Critical thinking, Clinical reasoning, Educational assessment

INTRODUCTION

The journey from nursing education to professional practice involves a crucial evaluation of students' competencies through licensure examinations. In the Philippines, the Philippine Nursing Licensure Examination (PNLE) serves as the critical benchmark for nursing graduates, assessing their readiness to enter professional practice. Previous studies have underscored the importance of comprehensive preparatory programs in enhancing licensure examination performance. For instance, Borines & Adare-Tasiwoopa [1] emphasized that structured review programs significantly contribute to higher pass rates in nursing licensure examinations. Similarly, enhanced preparatory activities, such as simulated exams and targeted review sessions, have been linked to improved student outcomes [2]. To better prepare their students for this significant milestone, the College of Health Sciences at Dr. Yanga's Colleges, Inc. (DYCI) has instituted an oral Revalida program. This program aims to reinforce the students' clinical knowledge and skills through comprehensive oral examinations that mimic real-life clinical scenarios. This program, a unique feature of the DYCI College of Health Sciences, simulates real-life clinical scenarios and demands a high level of critical thinking and problem-solving skills from students. Moreover, it is designed to provide an intensive review and practical assessment, focusing on students' ability to articulate their knowledge and apply clinical reasoning effectively. According to Melnyk [3] oral examinations can effectively gauge a student's ability to apply theoretical knowledge in practical settings, a skill crucial for success in the PNLE. The effectiveness of oral examinations in nursing education has been supported by various studies that highlight their role in improving students' communication skills, clinical reasoning, and overall preparedness for professional practice [4]. Despite the recognized benefits of oral examinations, there is limited empirical research specifically examining the correlation between oral Revalida programs and licensure examination performance. This study addresses this gap by employing a linear regression analysis to quantify the relationship between participation in the oral Revalida program and PNLE performance among nursing students at DYCI. Understanding the impact of the oral Revalida program on PNLE performance is crucial for curriculum developers, educators, and policymakers at DYCI and similar institutions. Positive correlations could justify the continued or expanded use of such programs, while negative or insignificant correlations might prompt a reevaluation of current preparatory methods. This study not only aims to contribute to the academic discourse on nursing education but also seeks to provide actionable insights that can enhance the educational strategies employed to prepare nursing students for their licensure examinations.

RESEARCH OBJECTIVE

The primary objective of this study is to investigate the relationship between participation in the oral Revalida program at Dr. Yanga's Colleges, Inc. and the performance of nursing students in the Philippine Nursing Licensure Examination (PNLE). Specifically, the study aims to:

  1. Evaluate the extent to which the oral Revalida program predicts PNLE performance among nursing students.
  2. Determine the strength and direction of the relationship between Revalida program participation and licensure exam scores using linear regression analysis.
  3. Assess the normality and homoscedasticity of residuals in the regression model to ensure the validity and reliability of the findings.
  4. Provide evidence-based recommendations for the integration and enhancement of oral Revalida programs within nursing curricula to improve student outcomes in licensure examinations.

RESEARCH HYPOTHESIS

Participation in the oral Revalida program at Dr. Yanga's Colleges, Inc. (DYCI) positively correlates with higher performance in the Philippine Nursing Licensure Examination (PNLE) among nursing students. Specifically, the researcher hypothesizes that nursing students who engage in the oral Revalida program will achieve higher PNLE scores compared to those who do not participate in the program."

METHODOLOGY

Research Design

This study utilized a correlational research design to examine the relationship between participation in the oral Revalida program and the performance of nursing students in the Philippine Nursing Licensure Examination (PNLE). Correlational research is appropriate for this study as it aims to identify and quantify the degree to which two variables are related without manipulating any variables [5].

Research Locale

The study was conducted at Dr. Yanga's Colleges, Inc. (DYCI) College of Health Sciences (CHS), where the oral Revalida program is implemented as adjunct to the nursing curriculum.

Research Sample

The participants in this study were nursing students from Dr. Yanga's Colleges, Inc. (DYCI) College of Health Sciences (CHS) who have completed the oral Revalida program and subsequently taken the PNLE. The sample consisted of nursing students who met the inclusion criteria.

Sample Type, Size, Calculation of Sample Size, Sampling Technique

A convenience sampling technique was employed to select participants from multiple cohorts to ensure a robust sample size. The inclusion criteria were: a) completion of the oral Revalida program, and b) participation in the PNLE within six months of completing the Revalida program. The sample size of 100 participants was determined based on the power analysis, which indicated that this sample size would provide sufficient statistical power to detect the hypothesized relationship between Revalida program participation and PNLE performance. In this research, power analysis was utilized to determine the appropriate sample size needed to detect the hypothesized relationship between participation in the oral Revalida program and performance in the Philippine Nursing Licensure Examination (PNLE) with adequate statistical power. Power analysis is a crucial component of research design, particularly in studies aiming to detect significant effects or relationships [6]. Power analysis involves calculating the statistical power of a study, which represents the probability of correctly rejecting the null hypothesis when it is false. In other words, it assesses the likelihood of detecting a true effect or relationship if it exists. The power of a study is influenced by several factors, including sample size, effect size, alpha level (significance level), and the chosen statistical test. In the context of this research, power analysis helped determine the minimum sample size required to achieve a desired level of statistical power, typically set at 0.80 or higher. To conduct power analysis, researchers typically specify the effect size they expect to detect, the desired level of statistical power, and the alpha level. In this study, the effect size was based on the expected strength of the relationship between Revalida program participation and PNLE performance. Once the effect size, desired power, and alpha level were determined, researchers could use statistical software or calculators to calculate the necessary sample size. By conducting power analysis, researchers can ensure that their study has sufficient power to detect meaningful effects or relationships, thus enhancing the validity and reliability of their findings.

Research Instrument

As for the research instrument and data source, records of students who completed the oral Revalida program were obtained from the College of Health Sciences at DYCI in the last four years. This data included the students’ scores in the Revalida program from a pre-validated rubric with a Cronbach’s alpha reliability score of 0.89. On the other hand, the performance data for the PNLE were sourced from official examination results from the Professional Regulation Commission (PRC). This included each student’s overall PNLE score and scores in individual subject areas.

Data Collection Procedure

The data collection process involved retrieving Revalida program scores and PNLE performance data from the respective sources. The research team ensured that all personal information was kept confidential and anonymized. Informed consent was obtained from all participants before collecting data. Participants were informed about the purpose of the study, the data to be collected, and their right to withdraw from the study at any time without penalty. All personal information was kept confidential and anonymized. Data are stored securely, and only the research team has access to it. In addition, the study was reviewed and approved by the Institutional Review Board (IRB) of Dr. Yanga's Colleges, Inc. to ensure that all ethical guidelines are followed.

Statistical Analysis

Descriptive statistics were used to summarize mean, standard deviation, and range for continuous variables. In addition, Pearson’s correlation coefficient was calculated using Jamovi software to determine the strength and direction of the relationship between participation in the oral Revalida program and PNLE scores. Additionally, a linear regression analysis was conducted to further explore the relationship between the independent variable (participation in the oral Revalida program) and the dependent variable (PNLE performance). Linear regression is a robust statistical method that allows for the assessment of the strength and direction of the relationship between independent and dependent variables, making it an ideal tool for this investigation [6]. The regression equation was formulated as: PNLE Score=β0+β1(Revalida Participation). The significance of the regression coefficients was tested using t-tests, and the overall fit of the model was evaluated using R-squared and adjusted R-squared values.

RESULTS AND DISCUSSION

The results of this study reveal a significant and robust relationship between participation in the oral Revalida program and performance in the Philippine Nursing Licensure Examination (PNLE) among nursing students at Dr. Yanga's Colleges, Inc. (DYCI). These findings are consistent with and supported by existing literature on the effectiveness of intensive preparatory programs in nursing education (Tables 1 & 2).

The model fit statistics indicate a strong model, with an R value of 0.880, an R2 value of 0.775, and an adjusted R2 value of 0.773. This suggests that 77.5% of the variance in PNLE scores can be explained by students' participation in the oral Revalida program. Such a high R2 value demonstrates the program's substantial impact on licensure exam outcomes. This finding aligns with previous research that underscores the importance of structured review programs in improving licensure examination performance. Santa Mina [7] found that well-organized preparatory sessions significantly enhance students' success rates in licensure exams. Similarly, Lai [8] highlight that simulation-based learning and rigorous review courses play a crucial role in bolstering students' exam performance by enhancing their clinical reasoning and critical thinking skills. The regression coefficients further elucidate the relationship between the oral Revalida program and PNLE scores. The coefficient for the oral Revalida variable (0.733) is highly significant (p < .001), indicating that for every one-unit increase in Revalida performance, the PNLE score increases by approximately 0.733 points. This substantial positive effect suggests that the Revalida program effectively prepares students for the PNLE by improving their knowledge and practical skills [2,9]. Coombe emphasize the value of oral assessments in nursing education, noting that such evaluations are critical in developing students' ability to articulate their knowledge and apply it in practical scenarios. This form of assessment is particularly effective in enhancing critical thinking and clinical decision-making skills, which are essential for success in licensure examinations. The significant results from this study reinforce the effectiveness of oral Revalida programs in preparing nursing students for professional practice. Oral Revalida programs, or oral examinations in general, are increasingly recognized as crucial components of nursing education that significantly contribute to preparing students for licensure examinations like the Philippine Nursing Licensure Examination (PNLE). These programs emphasize critical thinking, clinical reasoning, and the ability to articulate knowledge, all of which are essential skills for nursing professionals [10]. One of the primary advantages of oral Revalida programs is their ability to enhance students' critical thinking and clinical reasoning skills [11]. Unlike written exams, oral examinations require students to think on their feet, analyze complex scenarios, and provide coherent and logical responses. This mirrors the real-world situations nurses encounter, where quick and accurate decision-making is crucial [12]. According to a study by Granger [13] oral examinations challenge students to synthesize and apply their knowledge in a dynamic setting, which is essential for developing higher-order thinking skills. This type of assessment requires students to not only recall information but also to understand and manipulate it in a practical context. This aligns well with the demands of the PNLE, which assesses not just theoretical knowledge but also the application of that knowledge in clinical settings. Elaborately, effective communication is a cornerstone of nursing practice, and oral Revalida programs provide an excellent platform for students to hone these skills. During oral exams, students must clearly and concisely articulate their thought processes, diagnoses, and care plans, which is critical for patient care and collaboration with other healthcare professionals [2]. Ignatavicius and Coombe [9] highlight that oral assessments improve students' ability to convey complex information in an understandable manner. This skill is directly transferable to the clinical environment [14] where nurses must explain conditions and treatments to patients and families, often under stressful conditions [15]. The ability to communicate effectively is also a key competency assessed by the PNLE, making the practice gained through oral Revalida invaluable. Moreover, oral Revalida programs often simulate real-life clinical scenarios, providing a safe yet challenging environment for students to practice their skills. These simulations can range from patient interactions to emergency care situations, requiring students to apply their theoretical knowledge in practical, often unpredictable contexts. A study by [8] found that simulation-based education, including oral exams, significantly enhances students' clinical competence and confidence. By mimicking the conditions under which nurses operate, these programs help students become more adept at handling the stress and complexity of real clinical environments. This experiential learning is critical for performing well in the PNLE, which tests students' readiness to handle various clinical situations effectively. Furthermore, oral Revalida programs typically involve immediate feedback from examiners, allowing students to understand their strengths and areas for improvement. This continuous feedback loop is essential for learning and development, as it provides specific, actionable insights into how students can enhance their performance.

Montgomery, [4] emphasize the importance of feedback in educational assessments, noting that it helps students refine their skills and knowledge over time. In the context of oral Revalida, feedback from experienced practitioners and educators helps students align their preparation strategies with the expectations of the PNLE, thereby improving their chances of success. Preparing for and participating in oral Revalida exams can also improve students' psychological readiness for the PNLE. The format of these exams helps students become accustomed to high-pressure situations, reducing anxiety and building confidence. Tahir [16] found that students who undergo rigorous oral examinations tend to perform better in high-stakes licensure exams due to increased familiarity with the exam format and reduced performance anxiety. Confidence gained through repeated practice and successful performance in oral exams translates into better handling of the stress associated with licensure examinations (Figure 1).

The scatter diagram provided is a Q-Q (quantile-quantile) plot, which is used to assess whether the residuals of a regression model follow a normal distribution. In the context of the study examining the relationship between participation in the oral Revalida program and performance in the Philippine Nursing Licensure Examination (PNLE), the interpretation of this Q-Q plot can provide insights into the assumptions of the linear regression analysis. The points in the plot closely follow the diagonal line, which suggests that the residuals are approximately normally distributed. This is a positive indication that the normality assumption for the residuals in the linear regression model is satisfied. There are a few points at the extremes (both ends of the plot) that deviate from the line. These deviations could indicate the presence of outliers in the residuals. However, minor deviations at the tails are often acceptable and do not necessarily indicate a significant violation of the normality assumption. In addition, the consistency of the points along the diagonal line also implies homoscedasticity, meaning the variance of the residuals is constant across different levels of the predicted values. This is another important assumption for linear regression models. In the study on the impact of the oral Revalida program on PNLE performance, ensuring that the residuals of the regression model are normally distributed and exhibit homoscedasticity is crucial for the validity of the regression results. Polit & Beck [6] emphasize that homoscedasticity is essential for the validity of the standard errors of the regression coefficients, which in turn affects the reliability of hypothesis tests and confidence intervals. Inconsistent variance (heteroscedasticity) can lead to biased estimates of the coefficients' standard errors, making statistical tests unreliable. The Q-Q plot provided supports the following conclusions: a) since the residuals are approximately normally distributed, the results of the linear regression model (such as the coefficients, standard errors, t-values, and p-values) are reliable. This strengthens the validity of the finding that participation in the oral Revalida program significantly affects PNLE performance. The adherence to the normality assumption implies that the confidence intervals and hypothesis tests conducted as part of the regression analysis are accurate. This means that the reported significance levels (p-values) for the predictors, such as the significant positive impact of the Revalida program on PNLE scores, are trustworthy. The homogeneity of variance (homoscedasticity) suggests that the model’s predictive power is stable across different levels of the predicted PNLE scores. This adds robustness to the model, indicating that it can reliably predict PNLE performance based on Revalida participation scores [17-19].

CONCLUSION

This study provides compelling evidence of the positive and significant impact of the oral Revalida program on PNLE performance among nursing students at DYCI. DYCI Oral Revalida program plays a pivotal role in preparing nursing students for licensure examinations like the PNLE by enhancing critical thinking, communication, and clinical skills through realistic simulations and continuous feedback. The development of these competencies not only improves exam performance but also prepares students for effective professional practice. The findings support the existing literature on the importance of intensive preparatory programs and highlight the critical role of oral assessments in developing essential clinical skills. These insights can guide educators and policymakers in optimizing nursing education strategies to better prepare students for licensure examinations and professional practice.

PRACTICAL IMPLICATIONS

The high level of explained variance and significant predictor coefficients indicate that the oral Revalida program is a crucial component of the educational preparation for nursing students at DYCI. These findings suggest several practical implications for nursing education:

  1. Enhancement and Continuation of the Program: The oral Revalida program should be maintained and potentially expanded to cover more diverse clinical scenarios and more frequent assessments. This would further reinforce students' readiness for the PNLE.
  2. Incorporation of Continuous Feedback: Implementing continuous feedback mechanisms within the program can help students identify areas for improvement and adjust their learning strategies accordingly. This continuous feedback loop can further enhance the program's effectiveness
  3. Further Research: Future studies should explore additional variables that may influence PNLE performance, such as academic background, clinical experience, and individual student characteristics. Understanding these factors can provide a more comprehensive picture of what contributes to successful licensure exam outcomes and inform the development of more targeted preparatory programs.
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