INFLUENCE OF ENGLISH PROFICIENCY ON ABILITY

TO INCREASE PERFORMANCE IN NURSES

LICENSURE EXAMINATIONS

A Thesis Proposal
Presented to
The Faculty of the Graduate School
San Pablo Colleges
San Pablo City

In Partial Fulfillment of the Requirements

For the Degree of
Master of Arts in Nursing

By

MELCHOR FELIPE Q. SALVOSA

2008
 CHAPTER I

THE PROBLEM AND REVIEW OF RELATED LITERATURE

Introduction

Because English is so widely spoken, it has often been referred to

as a "world language", the lingua franca of the modern era. While

English is not an official language in most countries, it is currently the

language most often taught as a second language around the world.

(en.wikipedia.org/wiki/English_language)

National Council Licensure Examination-Registered Nurse and

the Philippine Nursing Licensure Examination are almost the same and

both given only in English. With the same objective of ensuring public

protection thus needed for all nurses to become a professional. The

only difference is that the local board examination is in a paper-and-

pencil format while the NCLEX-RN uses the Computerized Adaptive

Testing or CAT as method for administering tests.

Johnston (2001) reports that students whose first language was

English had a passing rate between 67.7% and 95% students for whom

English was a second language had a passing rate between 33.3% and

47%. Johnston (2001) concluded that language skills influence the ability

to pass the NCLEX-RN exam.

 There is an increasing number of as a second language (ESL)

student enrolling in nursing programs. They define ESL students as a

student whose primary language at home is not Standard English (Malu

and Figlear, 1998). In comparison between ESL and Non ESL students,

ESL students report more difficulty in the clinical courses than Non ESL

students. It has been suggested that this is due to the high level of

interactive communication skills that are needed (Jalili, Grenier & Chase,

1997).

Many times the academic problems are directly related to a

language problem. Nursing is dependent on written communication in

terms translating doctors order and recording patient data, but more

importantly, it is highly dependent on accurate verbal communication,

since much of the information and many are passed on verbalize orders.

Recognizing that the nursing profession has been transformed

from a product based model to an information-based model and later on

to an evidence-based practice, nursing education, which historically has

placed more emphasis on oral counseling skills, has begun to place

emphasis on communication skills (Hobson, Waite & Briceland, 2005).

In the field of nursing education it is really important to equip the

graduate students with the skills to cope with effective communication

because there is a general agreement that among the vital components

of nursing is effective communication and it is an essential prerequisite

for success in the nursing profession.

The students need to emphasize their strength in using the

English language, as we all participate in environment that is always

heavily influenced by global events. Moreover, in an increasingly

globalize world where the amount of knowledge grows by the minute,

much of this communication would have to be in English.

It is not as expected, and this has awakened in the students the

urgency of the need to improve their proficiency in English. Until and

unless the students are proficient in English, they will face difficulties in

their studies because science and mathematics courses at the tertiary

levels are being taught in English. In order to excel in their studies and

pass the nurses licensure examination, they need to be proficient in the

language.

Nurse educators continue to be concerned with factors that

influence academic success and attrition rates of students entering

programs of study for professional nursing. Successful English teaching

is undertaken in conditions where the key ingredients, namely time and

informed personnel, are available to enable learners to use English at an

appropriate level and in a meaningful way, to focus on aspects of the

language and skills needed, and to learn without due anxiety.

 It is therefore, essential to admit, retain, adequate students to

become professional nurses. To this end, it is important to identify

academic limitations in order that the nurse educators can assist

students to successfully meet the academic requirements leading to

licensure and the practice of professional nursing at the highest level

(Beeson and Kissling, 2001).

Furthermore, being one of the educators of nursing, it is for this

reason that the researcher was challenged to undertake a study with the

aim of assessing and evaluating these students on how proficient are

they in all the English subjects that will eventually shows the relationship

of respondents English proficiency leading to passing the nurses’

licensure examination

Background of the Study

This study will be conducted at San Pablo Colleges, a private

tertiary college of nursing in Laguna. It is an educational institution with a

Christian-Catholic outlook in its philosophy of education. San Pablo

Colleges College of Nursing is located at Maharlika Highway, Brgy. San

Rafael.

Specifically, the College of Nursing believes in the total

development of a student nurse to become productive member of the

healthcare system, who is scientifically informed, socially aware,

committed, and technically competent. Its primary concern is to promote

and restore health, prevent illness and alleviate human sufferings.

A. Theoretical Framework

The Chun Model (1997) has been expounded as the theoretical

paradigm of the study, which shows the research on text comprehension

in multimedia environments, language learning and technology.

As shown in Figure 1, the main premise of the model is how to

use text comprehension for studying people, and comprehend text in a

second language with the help of multimodal instructional materials.

The emphasis of the theory is to understand fully the meaning of

text. In 1988, it was extended with the so-called construction-integration

model (Kintsch, 1998), followed by a completely updated theory in 1998.

When a reader reads a text, an “understanding” of the text is

created in the readers mind. The process of constructing a situation

model is called the “comprehension process”. Kintsch and Van Dijk

(1998) assume that readers of a text build three different mental

representations of the text: a verbatim representation of the text, a

semantic representation that describes the meaning of the text and a

situational representation of the situation to which the text refers.

The propositional representations consist initially of a list of

propositions that are derived from the text. After having read a complete

sentence, this list of propositions is transformed into a network of

 propositions. If the text is coherent, all nodes of the network are

connected to each other. The situational representation is comparable

with the mental models described by Chun, (1997). Text comprehension

can be improved by instruction that helps readers use specific

comprehension strategies

Vocabulary Verbal
Acquisition Representation
Verbal
Information
Short-Term Referential Connections
Memory
Non-verbal
Information Non-verbal
Representation

Micro Level

------------------------------------------------------------------------------------------------

Macro Level Propositions in

Cognitive
Short-Term
Verbal Schemate
Memory
Information
Analog
Mental
Model
Visual Cognitive
Visual Representation in Schemate
Information Shot-Term Memory

Text -Amount of Invested Mental Effort (AIME)

Comprehension Perceived Self-Efficacy
 Figure 1
Text comprehension in multimedia environments.
Language Learning & Tecnology, by Chun M, 1997

B. Conceptual Framework

The theoretical paradigm provided the mechanism to build

concepts through a process to achieve a desired goal.

This study is anchored on the Chun Model (1997). The

Conceptual paradigm identifies the demographic profile of 2006-07

nursing graduates in terms of age, and sex and necessary text

comprehension model on the performance of nursing graduates in the

general point average of all English subjects in all levels namely: English

1 Basic skills in communication, English 2 Intermediate Communication

skills, English 3 Advance Communication skills which includes reading,

writing, listening, and speaking, English AN Conversational English, and

English BN Interviewing Skills in as shown in the first box. It shows the

link between the profile and the General Point Average (GPA) of all

General English subjects, as shown by the opposing arrow.

The second box is the process that shows the links which is the

rating of the National Licensure Examination of the respondents.

The third box is the results of the National Licensure examination

for nurses, which shows the relationship of English proficiency of the

respondents to passing the Board Examination

Independent Variables Dependent Variables

Profile
National
Graduate Student Licensure
- Age Examination
- Sex

Grade Point Ave.

- Engli Results of
sh 1 National
- Engli Licensure
sh 2 Examination
- Engli
sh 3

Figure 2
Research Paradigm of the Study

Statement of the Problem

This study is an attempt to identify the determinants of board

examination performance of nursing graduates of academic year 2006-07

in relation to English proficiency.

 Specifically, answers to the following questions are sought:

1. What is the demographic profile of 2006-2007 nursing graduates

according to the following variables:

1.1 Age,

1.2 Sex

2. How may performance of 2006-2007 nursing graduates be described

in terms of:

Grade Point Average

2.1 English 1 Basic Communication Skills

2.2 English 2 Intermediate Skills in Communication

2.3 English 3 Advance Communication Skills

2.4 English A Conversational English

2.5 English B Interviewing Skills in English

3. What is the board examination performance of nursing graduates in

terms of:

3.1 Age

3.2 Sex

3.3 Grade Point Average

3.3.1 English 1 Basic Communication Skills

3.1.2 English 2 Intermediate Skills in Communication

3.1.3 English 3 Advance Communication Skills

3.1.4 English A Conversational English

3.1.5 English B Interviewing Skills in English

 4. What is the importance of English proficiency in passing the nursing

licensure examination?

5. Is there a significant relationship of respondents English proficiency

to passing nurse licensure examination according to the following variable:

5.1 Age

5.2 Sex

5.3 Grade Point Average

5.3.1 English 1 Basic Communication Skills

5.3.2 English 2 Intermediate Skills in Communication

5.3.3 English 3 Advance Communication Skills

5.3.4 English A Conversational English

5.3.5 English B Interviewing Skills in English

Hypothesis

There is a significant relationship of respondents English

proficiency to passing nurse licensure examination in terms of age, sex

and GPA of general English subjects.

CHAPTER 2
 METHODOLOGY

This chapter contains the discussions on the research design, the

description of the respondents, the sampling technique, the instruments,

data gathering procedure, and statistical treatment of data.

Research Design

The retrospective design is correlation and descriptive methods to

determine the relationship among the variables (Burns & Grove, 2003).

Due to the nature of the study, ex-post facto techniques will be use for

analysis of data and to investigate possible cause and effects

relationship between the variables that measures academic success of

the student’s English proficiency.

In statistics, linear regression analysis can also be used as a

descriptive method of data analysis without relying on any assumptions

being satisfied.

The study will be based in analysis of subject’s demographic

profile in terms of age, sex and the academic performance in general

English GPA of SY 2006-2007nursing graduates

The main concern of the study is to determine the relationship of

respondents’ English proficiency to passing the nurse licensure

examination.

`
Respondents / Subject of the Study

Graduates of San Pablo College, College of Nursing in San Pablo

City class of SY 2006-2007 who took the Nurses Licensure Examination

in June and December 2007 will be the subjects of the study.

The survey population of the study consists of 282 nursing

graduates of SY 2006-2007. Total population sampling will be utilized in

the selection of graduate students with the following criteria: (1.) Must be

graduate of SY 2006-2007 of San Pablo Colleges, College of Nursing.;

(2.) Must be 21 yrs old and above; (3.) Those who took the Nurse

Licensure Examination in June and December 2007; (4.) first course is

BSN; and (5) Second courser. Or BSN is not the first course. No

sampling among the graduates will be done. All were subjects in the

study.

Research Instrument

Data from all general English subjects is the main instrument of

the study, it is statistically valid and reliable instrument and it will be

derived from the records of a selected college of nursing in San Pablo

City, Nursing graduates class SY2006-2007. The instrument consists of

two parts. The first part seeks information of the demographic profile of

the respondents in terms of age, and sex. The second part is in a form of

checklist consisting of the grade point average of all general English

subjects, the GPA generates an academic and learning profile of

potential board passer. The board examination evaluates areas that are

essential for academic success including English proficiency. It is a 282-

item centered only on all English subjects from level I to level IV. The

records of English subjects will be use as a tool to gather data for

specific variables:

The data’s will be evaluated to determine the validity and

reliability of the instrument to find out if there is a significant relationship

between the respondents English proficiency and passing the board

licensure examination.

Data Gathering Procedure

The permission to gather the data was secured by the researcher

from the Dean of College of Nursing of the selected school of nursing in

San Pablo City where the researchers work.

The data to be analyzed will come from the assessment scores of

the General English GPA, age, and sex to be taken from the evaluation

form of each students. List of board examinees will be taken from the

College of Nursing files.

.
Statistical Treatment of Data

The data that will be gathered from the academic records will be

utilized to analyze and to interpret the data:

1. For problem No.1, which asked for profile of nursing graduates,

frequency and percentage distribution in tabulating the scores will be use in

determining the profile of the subjects.

Frequency distribution is a systematic array of numeric values from

the lowest to the highest together with a count of the number of times

score values occur in a data set.

Formula :

%=f
--
N

Where: % = percent value

f = frequency
N = no. of cases

2. For problem no. 2and 3 which sought to describe the board

examination performance of nursing graduates in terms General English GPA,

linear regression analysis is to be use. In statistics, regression analysis is a

technique which examines the relation of a dependent variable (response

variable) to specified independent variables (explanatory variables).

3. For problem no. 3 which sought to determine the performance of

board examination in terms of age, sex, and general English subjects

GPA, Mean and standard deviation, will be use to analyze the data in

the descriptive level.

4. For problem no. 4 which determine the importance of English

proficiency to passing the board examination, ____________

5. For problem no. 5 and hypothesis testing, which determines the

significant relationship between board examination performance according to

age, sex and the general point average of general English subjects of the entire

nursing graduate, f-test will be utilize.