More recently, it has been reported that according to the Board of Nursing (BON), “From 1952 to date (2008), the country has so far registered or licensed 480,992 Filipino nurses out of the 523,272 who actually passed the Philippine Nurse Licensure Examinations. The 400,000-plus refers to the actual cumulative stock of Filipino nurses, not unemployed nurses” (Uy, V. , 2008). In the country, nursing professionals linger on the issues of underutilization, unemployment, and more commonly, jobs and skills mismatch in the labor market as pointed out by the Department of Labor and
Employment (DOLE), which are crucial towards competitiveness and poverty alleviation. These realities are brought by Globalization, which underscore a paradigm shift in the current education and training of nurses throughout the world. Nursing education has moved, in response to these pressing issues to focus from the inputs of the educator to the outcomes of the learner also in response to the demands of a bigger community. This shift also explains the transition from the concept of education to lifelong learning and building competencies rather than just a transfer of expert knowledge.
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More recently this is evident through the reforms such as K to 12 Basic Education program (Department of Education, 201 2), the Revised General Education Program in tertiary level and the introduction of Outcome-Based Education (Commission on Higher Education, 2012). This scholastic paper accounts the development, implementation and sustenance of Outcomes Based Education (OBE) in Nursing Education amidst these challenges in the Philippine context. According to Spady, considered by many as the authority on OBE evident in his ideas and considerable influence this approach, “Outcome-Based
Education means clearly focusing and organizing everything in an educational system around what is essential for all students to be able to do successfully at the end of their learning experiences. ” (Spady, 1994). Discussion will focus on the inception of Outcomes-Based Education, how it is developed, implemented and sustained Philippine Nursing Education. Method: The literature that was used in this paper was taken mostly from EBSCO and others from various free online nursing journal, research, and academic sites.
This paper uses William Spadys concepts to describe the concept of OBE in etail due to his significant contribution to OBE, and being acknowledged by many as the world authority on OBE. Several textbooks on Curriculum Development and ten research articles relating to keywords used: Outcomes Based Education, OBE, outcomes, Philippine, Nursing and Education. Since there were only limited researches on OBE in the context of Nursing in the Philippines, the criteria for choosing the literature was based on the relatedness to the topic and to the profession.
Hence, researches on OBE in Nursing and Nursing-related disciplines were utilized. To highlight, one ystematic review was used on nursing educational outcomes, and a research on the best practices of implementing OBE in one university in Asia-Pacific was used. Finally, to put all the keystones from these references into context, literature from the authorities that govern nursing education in the country were also used. Discussion: Outcomes-Based Education as according to Sprady cited by Enriqueta, R. 2013) may be regarded in three ways”as a theory’ of education, as a systemic structure for education, or as classroom practice. Outcome-Based Education is a “means clearly focusing and organizing everything in an ducational system around what is essential for all students to be able to do successfully at the end of their learning experiences. This means starting with a clear picture of what is important for students to be able to do, then organizing the curriculum, instruction, and assessment to make sure this learning ultimately happens” (Sprady, 1994).
It is the methodology that emphasizes and systematizes the system on what is prerequisite for the learners to understand and value, accomplish the desired level competencies, develop of flexible life skills as critical thinking and problem-solving skills to e able to cope with the dynamics in the workplace (Uys,l_. , 2005). A competency-based education IS a “disciplined approach to specify the health problems to be addressed, identify the requisite competencies required of graduates for health system performance, tailor the curriculum to achieve competencies, and assess achievements and shortfalls” (Frenk et al. 2010). In comparison to OBE, curriculum development begins with the outcomes of education rather than with a predetermined set of contents to be included in an educational program. Outcomes/competencies are the grounds from here we distinguish key contents and processes for instruction in the educational system. Outcomes-based education not only compels contents to be singled out by outcomes but also assimilating competency-driven methodologies to instructional design. Hence, the “product defines the process” (Davis, M. , 2013).
We can view a curriculum as a tabula rasa upon which the faculty develop a program, which commences by establishing the learning outcomes to be accomplished brought by education (Kim, H. , 2012). There is a diversity of outcomes from OBE and these encompasses “critical utcomes, program outcomes, exit level outcomes, specific area outcomes, unit outcomes and lesson/lecture outcomes” (IJys L. , 2005). Herein, we have two approaches: Traditional and Transformational. The former is similar with content- or objectives- based education with focus on knowledge of traditional subject areas. Outcomes are used to focus and align the existing subjects.
Student nurses’ master small portions of the content or steps on a skill without a clear picture of long-term learning outcomes or relationship Of the objectives and into the society. Transformational OBE differs in many spects: First, it starts with critical outcomes used to plan the content and not the opposite. Second, the question on the outcomes’ value to society is always asked as opposed to simply judging it by virtue of their perceived intrinsic value. Lastly, the focus on the integration of knowledge, skills and attitudes as differed to concentrating on each domain independently (Uys L. 2005). It has the premise to equip students to become lifelong learners essential to keep up with a fast changing world and become competent future citizens contributing positively to a transformed society. Lifelong learning is identified with the following key competencies: “an understanding of evidence-based healthcare and critical appraisal, familiarity with informatics and literature search and retrieval strategies, practice-based learning and improvement methods, self-reflection and assessment, and other skill sets related to knowledge management’ (AACN, & AAMC, 2010).
Students must be able to put theory into practice and most importantly, be able to learn how to learn for themselves through opportunities for them to think independently (Kember, D. , 2005). “The outcomes reflect the omplexities of real life and give prominence to the life-roles that learners will face after they have finished their formal education” (Killen, R. , 2000). The Process A top down approach is utilized in Outcomes-based Education (Davis, M. , 2013). Curriculum development starts from a clear statement of what the students should know, be able to perform and value after graduating from the program.
The curriculum process in OBE as cited in IJys, L. (2005) entails the following steps: (1) developing a graduate role statement The role statement would answer the question ‘What should this person do, r be prepared for? ‘ Thereby, understanding first the student’s needs (Kember, D. , 2005). Formulating a role statement would indicate the purpose of the nurse in broadest terms, which must spring from the philosophy of the institution and from the situational analyses and must clearly indicate what are expected of the group of nurses distinct from other health professionals.
This statement should Cover the essentials with roles clearly identified without going into more specific detail. (2) determining graduate competencies in the form of program outcomes Competency Determination Establishing the required competencies entails recognition of graduate nurses’ tasks and expected competencies in executing specific tasks and defining elements for each competency. The graduates, employers of the alumnus, tenured practitioners, community members and incoming students (Kember, D. 2005) can be sources in determining these competencies and may require observation of nurses at work and writing down their daily routines and salient aspects of their job, conducting interviews, looking up official documents, such as job descriptions, and utilizing health statistics. For example, the gradual movement and utilization Information Technology or computers on data management that demands the need for nurses to be trained in nursing informatics.
During this step, it is important to note some tasks may share the same elements to prevent unnecessary duplication in teaching and learning (Uys, L. , 2005). Development of Program Outcomes Program outcomes are outcomes displayed by learners when after completion of the program based on the role statement. These should depict recognizable and measurable behaviors which will validate knowledge and its pplication, specified are the conditions, which the student must perform the behavior and the criteria for performance measurement. These outcomes must be alignment with the mission statements of its parent university, meets the curricular requirements.. in terms of general education and credit allocation, satisfies the requirements of a ? Board of Nursing, and addresses the requirements for accreditation.. ” (Kim,H. , 201 2) According to the American Nurses Credentialing Centers Commission on Accreditation (2012), Outcomes prove the institutions’ commitment to the quality of planning developing and mplementing teaching-learning activities that support nurse’ learners professional growth.
The first step involves establishments of mission, goals, and philosophies specific deciding on the program structure, ensuring that all outcomes are catered for in the program. Structuring the program includes deciding the fundamental, core and elective modules required depending on the qualification, and organizing of the curriculum according to different levels in a program. Fundamental modules deliver the basic subjects upon which the rest of the program builds, which will include pre-registration ursing subjects, anatomy and physiology, social sciences.
Core modules include the compulsory learning required in the qualification as a nurse, for instance, the nursing courses. Elective modules are those that can be chosen for supplementary credits to enhance the program or to help learners develop in certain areas. In designing the structure, OBE programs should not be closed ended. Multiple exit points should be provided for the learners and be able to merit some acknowledgement through a diploma or certificate for what they have accomplished. This does not only add to the desirability of the rogram but also flexibility to the learners who are unable to finish the program.
In addition to this, the curriculum should be organized so that different levels in the program can be distinguished with the duration specified, usually 3 to 4 years. Outcomes in short, must reflect the vision and mission; are clear and unambiguous; specific; manageable; defined at an appropriate level of generality and assist with development of enabling’ outcomes (Harden, R. , 1999). (3) identification and designing of modules/ course outlines “When a curriculum is built around outcomes, these utcomes should be formulated in a way that structures the teaching/ learning process adequately.
This is particularly true about module outcomes, which should be quite specific to direct the choices of learning experiences and assessment methods. To achieve this clarity the outcome statement itself should adhere to specific criteria, but each module outcome may also be augmented with a range of clarifying statements which defines it more specifically. ” (LJys, L. , 2005) Specific Outcomes At a module or micro-curriculum level, the outcomes must outline context- pecific competencies that learners must exhibit at the end of every module that must spring from and must promote the achievement of exit level outcomes.
Range statements must be used to describe the extent, profundity and level of complexity and measure of the accomplishment, which will include critical content areas, procedures and situations which the learners will be engaged in to reach the satisfactory level of competence but not too restrictive limiting the learners to a specific lists of learning items or activities. This method provides focus, flexibility in the choice learning strategies, ontent, process and assessment methods. Assessment Criteria Assessment criteria are broad statements that confirms that the learner has achieved the specified outcome.
To differentiate over outcome statement, it is useful to start every assessment criterion with a noun, expressing the result of the action in the outcome, which will designate the perceptible processes and products of learning ” the concluding evidences of learners’ competency. These statements should do not present plenty of details on precisely what and how much learning marks an acceptable level of the outcome to decide hat the learner is competent. “Feedback should be sought on all aspects of a curriculum and use made of it to iteratively fine-tune programmes and courses” (Kember, D. 2005). In the OBE curriculum, the similarity between developing outcomes and the assessment criteria is the process in all stages from the program, to level, module and finally to unit outcomes. The designing of a course or module outline which includes units that will contribute towards achieving the specific outcomes follows from identification of specific outcomes and assessment criteria. The level outcome s achieved through a number of modules made up of a number of units all contributing to the level outcomes and ultimately to the program outcomes (Uys, L. 2005). The content of a textbook or a traditional syllabus do not direct the course of OBE but are guided by specific Outcomes. The faculty have the accountability to decide what content is important, what teaching methods are relevant and effective and which assessment form is fit in consideration also of the characteristics of the students, and the resources available to facilitate the learners to meet outcomes (Killen, R. 2000). (4) planning the assessment and evaluation of learning.
Assessment should be interconnected to teaching and learning with twofold purpose: to recognize areas and level of competence, and to give feedback on learning. A basis for corrective action, whether to permit students to advance to the next level or not is also one of the purpose for assessment. This assist the students verify where they are in the learning process and where they are required to be to realize the outcomes set. The three areas of competence: foundational, applied and flexible competence are satisfied in OBE ssessment, which requires integrated assessment methods.
This refers to the usage of a number of assessment methods to assess the competence of the learner in relation to the cognitive, psychomotor and affective domains, and then assist in deciding whether a student is competent or not. This may include observations, self-directed projects, demonstrations, oral problem solving exercises, group work, Teacher-constructed performance tasks, portfolios, self-assessment, assignments and projects that may reflect real life problems.
Teachers must provide opportunities for students to exercise new nowledge and skills, and with proper guidance explore and research with their new learning, correct their misconceptions and change their thinking (Killen, R. , 2000). In addition, in consideration to the practice of nursing, evidence suggest that clinical experience and reflective practice can enhance students abilities to critically think when taking care for their patients (Spector, N. , 2006). Outcomes-based assessment fuel the growth of the learner has a vital role in the whole process of learning.
This should be for the benefit of the learner and not the institution and must facilitate the learner in xamining his or her own development including the discrepancies between his or her self-evaluations to external appraisals and most importantly, must reflect the competence required. Hence, in OBE, Learners are active members in the assessment. “Assessment in OBE is used as an instrument to facilitate learning, therefore it should be well planned and be constructive, motivational to the learners, in order to serve its purpose” (Uys, L. , 2005).
In summary, it vital to in OBE that the faculty understand and should be devoted to the OBE premises and principles as OBE. The principles may not e accommodated and may only focus, in direct contrary, in direct instruction (Ramoroka, N. , 2006). There should a well-defined description of outcomes the students must achieve, and prioritization of each outcomes must begin the process of OBE. This is followed by the teacher describing in detail, the KSA that students must acquire to realize these outcomes. The prerequisites needed should also be made known to support them in the acquisition Of this outcomes.
It is the teacher’s obligation to determine creative teaching and evaluation methods for a positive learning experience in order to helping tudents to achieve the outcomes, considering that not every student learn at the same pace or equivalently from the same learning experience. Planning develops instead of determining specific activities but as a process of foreseeing possible activities. Consequently, content serves only to support in facilitating students’ attainment of the outcomes, than being the end in itself.
Understanding this ought to guide teachers in identifying relative problems students would have in accomplishing each outcome, and in relation also to the outcomes interrelatedness to each other. On the process, when teachers re able to state explicitly how they will determine the student’s achievement of each outcome, and how to gauge their level of competence based from demonstrated outcomes, they will be ready to create an appropriate assessment method and reporting of the students progress, which will also reflect the improvement of the program. plications: In the Philippines, application of OBE is propelled by external entities such as the Regulatory bodies: the Professional Regulation Commission (PRC), Commission on Higher Education (CHED), and accreditors, like the Philippine Accrediting Association of Schools, Colleges and Universities (PAASCU). Based from the discussion, we can imply that application of OBE entailed detailed planning and preparation of the faculty especially on how to support them through the change process. nderstanding Of the OBE process and the outcomes of the program in line with the goals and objectives of the institutions and regulatory or accrediting bodies must be clear and the faculty should be properly guided on the course of outcomes-based curriculum development. With all that needs to be done mentioned during the discussion, there must be an action plan and clear timetable to begin with; ull support from the administration and a strong commitment from the faculty with Capacity building given highest priority.
A good method of communication must be in place for a continuous effort to disseminate information on the progress of the development process and results of the transition/implementation. Finally, there should be a continuous quality improvement initiative in all areas of OBE implementation. Conclusions Recommendation: The aforementioned challenges in the nursing profession in the Philippine context ” underutilization, unemployment, and job skills mismatch – clearly eflects that the dynamics in the workplaces and in the society have influenced the need to adapt OBE.