Nursing Virtual Return Demonstration Affecting Capitol

University Students: A Phenomenological Study

Submitted to

The Faculty of the College of Nursing

Capitol University

Cagayan de Oro City

In Partial Fulfillment of the Requirements

In Nursing Research 2 (NCM 115)

Submitted by:

Colanse, Kent Myron E.

Lorenzana, Jennifer B.

Sarte, Mark Derek Anton S.

May 2022
 Chapter I
Introduction

Background and Rationale

 The COVID-19, also known as corona pandemic is an ongoing global

pandemic of corona virus disease 2019 (COVID-19) caused by severed acute

respiratory syndrome coronavirus 19 (SARS-Covid19). The virus was first identified

in December 2019 in Wuhan, China (WHO, 2019) and because of this global crisis

many institutions were force to close including schools and universities (education

sciences, October 2020)

The use of distance education using digital tools in higher education has

increased over the last decade, particularly during the COVID-19 pandemic (BMC

Nursing 20, Article:23 2021). Face-to-face teaching and learning were converted to

virtual remote learning and clinical experiences suspended and converted though

virtual return demonstration to protect the students from the pandemic. Specific but

broader responses to the pandemic in the Capitol University and other developing

countries have been shaped by financial, political and other contextual factors,

especially the level of information technology infrastructure development, and the

attendant inequities in access to such technology between the rural and urban areas.

Internet accessibility, affordability and reliability in certain areas seem to affect the

delivery of nursing education and especially in their clinical practice during the

COVID-19 lockdown. 

Return demonstration is an essential component of the nursing practice that

paves way for student nurses to gain knowledge of the nursing procedures. It
enables them to grasp ideas of what nurses do in the hospitals or communities when

they take care of patients and of how they do these procedures to them (benefits of

return demonstration in nursing) The pandemic has impacted all sectors, including

nursing education. 

As the crises escalated, many governments closed schools, colleges and

universities to ensure the safety of students, teachers and nations. With the onset of

the pandemic, globally, face-to-face classes, clinical skills laboratories and the

clinical placement of students were either suspended or restricted and more

especially in countries that were critically affected by the outbreak in order to

maintain and safeguard the health of students and faculty as a whole. 

Statement of the Problem

  The Global Campaign for Education (GCE) acknowledges the public health

decision to close schools, the researcher believe that contingency plans should be in

place to ensure the right to education even in times of crisis (Philani, 2020). The

undergraduate nursing students’ academic performance were affected by the

COVID-19 pandemic and resulted in poor (37%) to fair (50%) academic performance

and were considerably (43.6%) and greatly (30.6%) affected by the pandemic.

Stress negatively impacts the undergraduate nursing students’ satisfaction and

academic performance (Oducado, R. M. F., & Estoque, H. (2021). 

Capitol University's nursing students faced a tough problem in completing an

online return demonstration due to a variety of reasons such as limited internet

connectivity, a shortage of supplies. The classical teaching and learning process

involving interaction between students was shifted into online learning as mandated

due to the coronavirus (COVID-19) pandemic (Nurhidayati, T., Rahayu, D. A., &
Alfiyanti, D. (2021). That ideal condition could not be reached. As a result, the online

learning during the COVID-19 pandemic triggers students to deal with stressors such

as academic assignments, the difficulty in adapting to home environment, no face-to-

face meeting with the fellow students (Nurhidayati, T., Rahayu, D. A., & Alfiyanti, D.

(2021).

Objective Statement: 

This research aims to produce knowledge that can define and comprehend

the importance of virtual return demonstrations that can advantage students and

clinical instructors. 

Significance of the Study

          Clinical skills are one of the most important things It enables nurses to grasp

ideas of what nurses do in the hospitals or communities when they take care of

patients and of how they do these procedures to them. Due to this pandemic, we

have no choice but to adjust our education. Ever since the pandemic has started, the

researcher had been using virtual learning as main way of education. It also created

several unique challenges for colleges and universities and especially, Schools of

Nursing.

         The importance of this study is to perceive the students on this new norm. It

affects the students, not only by a little, but immense. As the nurses, they have big

responsibility they need to shoulder as they are part of the medical personnel which

they take care and save lives.

 Nursing research - This research serves as the reference for the future nursing

student and give them idea to better improve this research problem in the future.
 And helps to implement changes to provide excellence in nursing care, and helps

locate resources. Nurses need to understand, evaluate and utilize research in

their careers. Nursing schools teach these skills to help nurses progress in their

careers. (Nurse Leader Insider,2020).

 Nursing practice - This research enables them to grasp ideas of what nurses do

by having a return demonstration by the time when they take care of patients and

of how they do these procedures to them. It is also Improves nursing practice,

interventions or approaches to enhance professional practice. Also, it may help

the nursing student for the preparation of their career in the future and improve

their clinical practice as a student nurse.  (Altman, 2020).

 Nursing education - The research will help to gain understanding and have a

convenience and flexibility learning, because online learning offers students who

are trying to balance a family, career, and other commitments the opportunity to

earn a degree without sacrificing their other interests and obligations. Research

help nurses determine effective best practices and improve patient care.

(northeastern university,2017). Also, this research can be the foundation for the

nursing department on how they will improve their learning strategies for a better

learning delivery system that will increase their expectation for incoming nursing

students. These are necessary to enable nurses to develop a relationship with

those they serve. (Pare, 2003).

Scope and Delimitation 
          The study focuses on the discover of learning experiences and the

expectations about the changes in education of nursing students enrolled in Capitol

University and expound the meaning of virtual return demonstration among students.

The data collection will be concluded after the researcher’s conducted the survey on

students. This will not cover other problems that are not related to the meaning of

virtual return demonstration. This qualitative research should be done through

google form questionnaire. The researchers will limit the study to 25 students coming

from senior nursing students currently enrolled in Capitol University. Each of the

respondent are given a questionnaire about the topic. The researcher will use

snowball sampling technique for this study.

 CHAPTER II
Review of related literature

This chapter provides ideas and an overview of related research and literature

which contributed to the development of the study’s conceptual framework and

methodology. The diverse sources of evidence were discussed in both foreign and

local contexts. Those ideas included in this chapter will help to give knowledge of

information that are relevant and similar to the present studies.

Related Literature

           The current state of alarm due to the COVID-19 pandemic has led to the

urgent change in the education of nursing students from traditional to distance

learning. The objective of this study was to discover the learning experiences and

the expectations about the changes in education in light of the abrupt change from

face-to-face to e-learning education during months of confinement due to the

COVID-19 pandemic (Ramos-Morcillo et al., 2020). After conducting interviews with

the respondents, there were factors that they should consider; the older students,

students who live in rural areas, limited electronic resources. Corresponding with the

researcher’s study, it also considers the factors affecting the virtual return

demonstration learning like limited resources of materials to use during virtual

learning, limited access to internet connection, limited access of devices, & etc. One

of the things that this research needs to pay attention to is the limited access of

internet connection and students who live in rural areas. Not all people have

unlimited access to internet connection, some used to connect with their neighbors

and some use mobile data to access online learning especially students from rural
areas. Some parts of the place have less connection to the internet and worst is no

connection at all.

During pandemic, the Nursing educators (teachers, managers) must

guarantee that the students meet the academic requirements, and at the same time,

recognize the current conditions faced by the health services and the needs of

simultaneously satisfying the demands from students, parents, partners, and the

multiple roles every individual play in their day-to-day lives. The fast shift to e-

learning education has not ceased to be a continuation of teaching and education

through online resources, although it has not been clearly planned and adapted for

e-learning. Our results clearly present various relevant ideas related to this in the first

place, and related with the clinical training, the health science degrees and more

specifically the nursing degree have an essential need to be developed in a clinical

context.

There is an expectation that pre-registration students will quickly acquire

academic writing skills when most will have had little or no prior experience. They

appeared to have been little emphasis placed on facilitating the development of

these skills in the educational program. The lack of emphasis and support proved to

be problematic for these nursing students. The emergence of a theory-practice

divided also figured strongly. This element clearly cannot be substituted, and is

perceived by all the students as being essential (Ramos-Morcillo, 2020). Students

were, however, able to appreciate the need and place for academic writing skills and

most were able to identify the structural processes that were integral to acquiring

such skills (Whitehead, 2002). This study was to measure the nursing student ability
on having a virtual return demonstration and concluded that both social media and e-

learning platforms are utilized in teaching and learning by the college especially the

nursing student who has a clinical platform. The findings of this study also suggest

that a better understanding of online learning experiences of college students may

inform the capitol faculty staff, college of nursing, parents and lecturers to put in

place measures that would ensure a better online learning experience (Eugene,

2020). In classroom, the laboratory and clinical placements are the traditional

settings where nursing education has prepared students for practice. Each setting

serves a specific, valuable purpose; classroom experiences expose students to

essential knowledge and skills and clinical placements provide a place for students

to encounter the real world and apply their newly acquired knowledge under the

supervision of experienced nurses (Verkuyl, M., & Mastrilli, P., 2017). As we can

see, virtual sessions in nursing education were already studied back in 2017, their

objective was to give nurse educators a virtual experience to students as a means to

combine theory and practice.

The scoping review's goal is to look at virtual simulation in nursing education

to improve your problem-solving abilities. The study, “Nursing Virtual Return

Demonstration Affecting Capitol University Student: A Phenomenal Study”, is focus

on the main problem which is the ongoing pandemic that occurred since the summer

of 2019. It affected the daily occurrences of education which eventually turned into

online classes. But as we all experienced, we all grew up from experiencing face-to-

face classes and the sudden change of the norm will have a big impact on student’s

mental health as well as their urge to study. But still, virtual simulations (VS) have

the potential to eliminate geographical boundaries, safely prepare students to care

for their clients, and offer a learning experience that is interesting and familiar to our
tech savvy students. This scoping review was conducted to assess and analyze

current studies on the use and success of VS in nursing education. The results will

be useful in informing future research and providing direction for the development of

VS in nursing education (Verkuyl, M. & Mastrilli, P., 2017). 

  The technological evolution gives way to new opportunities through new

pedagogical strategies. Some limitations found in high-fidelity simulators can be

overcome by clinical virtual simulation (CVS) (Padilha, J. M., Machado, P. P.,

Ribeiro, A. L., & Ramos, J. L. (2018). This article talks about how virtual simulation

can also be an option in teaching nursing undergrad students. We are currently in

the age of technology where multimedia and the internet rule the world. By taking

advantage of that matter, we can make new innovative instructional techniques that

pave the path for new chances. At a time where the pandemic is still ongoing, nurses

are needed. Because of that fact, we cannot delay our education further. The

introduction of simulation has produced significant improvements in nursing

education (Padilha, J. M., Machado, P. P., Ribeiro, A. L., & Ramos, J. L. (2018). The

results of this study were quite successful and the conclusion of the students were

positive. We are the future nurses that will graduate and will start to work in medical

establishments. Nurses are supposed to be flexible as they can be able to adjust in

any sort of predicament and will overcome it, virtual simulations are not an

exemption. Based on this study, the pre-graduate nursing students revealed

perceived ease, usefulness, and intention to use virtual return demonstration as an

important complementary strategy for their nursing education programmes (Padilha,

J. M., Machado, P. P., Ribeiro, A. L., & Ramos, J. L. (2018). The purpose of this

study was to learn about the experiences of nurse educators who switched from a

traditional classroom to an online learning environment, either entirely online or in a

hybrid format. Online education is an efficient means to reach students;

nevertheless, it necessitates a different pedagogy than traditional classroom

instruction. Nurse educators who transitioned from traditional classrooms to online

environments (100 percent online or hybrid) were interviewed using 13 guided

interview questions designed to explore the challenges they faced. Challenges nurse

educators faced included the need for professional development to learn a new

pedagogy and learning management system, technological support, mentorship in

transitioning to the new mode of teaching, and a mind shift. The findings are useful

for nurse educators who might be interested in teaching online courses (Barbara,

2021).
 CHAPTER III

Methodology

Research Design

This study will be conducted through semi-structured interviews. This type of

interview will give the researcher a lot of freedom to probe the respondents while still

adhering to the basic interview structure. Even if it is supervised interaction between

researchers and interviewees, the researchers are given a lot of leeway, an

appreciable flexibility is offered to the researcher. Semi-structured interview

questions are provided in advance of the scheduled interview, giving the researcher

time to prepare and examine the questions.

Research Locale

This research study is to identify the experience of Capitol University nursing

student on having a virtual return demonstration and will be conducted inside the

vicinity of Capitol University, Cagayan de Oro City. It is a non-sectarian, co-

educational private university, registered with the Securities and Exchange

Commission as a stock corporation and operates with the authority of the

Department of Education. This place was chosen to know the different and personal

experiences of the 3rd year Bachelor of Science in Nursing students in Capitol

University. The target nursing students who are currently engaged in virtual learning

by sending them a survey questionnaire using Google Form, which will be collected

and carefully analyzed by the researchers to come up with a final interpretation of

the data.
Sampling Technique

Due to the specificity of the study, any person who is qualified based on the in

criteria who is willing to share his/her lived experience was invited to be part of the

study, and was encourage to refer anyone who is coming from 2 nd year, 3rd year, and

4th year nursing students from Capitol University. The researcher will use a snowball

sampling technique for this study. This type of sampling technique is also known as

chain-referral sampling, it is a non-probability sampling approach in which the

samples have hard-to-find characteristics. It is also a very effective technique when

researchers want to learn more about stigmatized groups or behavior. As the study

progresses, the researcher’s sample grows larger, similar to how a snowball grows

larger as it rolls in the snow, it gets bigger. Qualitative researchers usually choose

sample strategies that allow them to gain a thorough knowledge of the phenomena

they’re investigating.

Research Instrument

In order to fully understand the lived experience of nursing student having

virtual return demonstration, the researcher will use interview as a tool to gather data

and information from the selected respondents. Interview will be conducted through

personal meet-up or virtual interview. The survey questionnaire contains a short

introduction about the study, informed consent, respondent’s profile which includes

their email address, gender, age, and year level and the survey questions the

respondent may choose among the said set-up of interview whether where the

respondent is comfortable. Researchers also considered having a virtual interview in

gathering data and information to consider the situation we are facing today to
protect respondents from Covid-19. The instrument that will be used in this study is

an online survey questionnaire through Google Forms which will be disseminated to

the target participants.

Data Gathering

The researchers secured the written consent from the Capitol University

faculty. After receiving approval, the researches took up the time and explained the

purpose and intent of the study to the key informants. The researchers collected the

data by means of face-to-face interviews, online google forms, and voice messages

through messenger. The data and information gathered from the respondents will be

collated and is subject for further analysis and interpretation. Warm-up questions,

main questions, and closing questions will be answered by the selected key

informants, please refer to Appendix A. Warm-up questions focus on the main

informants' perspectives and interview expectations. The key informant’s

experiences and realizations during virtual return demonstrations will be the focus of

our main questions.

Ethical Consideration

A set of principles that guide your research designs and practices.

Scientists and researchers must always adhere to a certain code of conduct when

collecting data from people (Pritha Bhandari, 2021). The participants will voluntarily

participate in the study and have right to withdraw the participation of the study and

willing to participate without any compensation. An inform consent will be given to

the participants before the interview that will give proof of their willingness to the

study, understanding and purpose of the study. To protect the rights of all research

subjects or participants is the primary purpose of the Belmont Report. The Belmont
Report also serves as an ethical framework for research. There are 3 major

components: (1) respect for persons, (2) beneficence, and (3) justice. The

informed consent provided to key informants is intended to inform them about the

purpose of the study, the benefits that family members will receive if they

participate in the study, and to reassure them that the individuals’ safety and

confidentiality, as well as the data to be used, are solely for research purposes.

Key informants will be told to answer the questions honestly and will have the

option of refusing to do so. Republic Act No. 10173, otherwise known as the Data

Privacy Act is a law that seeks to protect all forms of information of the participants,

be it private, personal, or sensitive It is meant to cover both natural and juridical

persons involved in the processing of personal information (Data Privacy FAQs,

n.d.).

Data Statistical Analysis

It’s easy to collect this data, but to make meaning of it, you’ll want to

statistically analyze the data to assess the performance of individuals, teams, and

the company. Statistically analyzing your team is important, not only because it helps

you to hold them accountable, but also because it ensures their performance is

measured by unbiased numerical standards rather than opinions (Shelby Hiter,

2021). Although many groups, organizations, and experts have different ways to

approach data analysis, most of them can be distilled into a one-size-fits-all

definition. Data analysis is the process of cleaning, changing, and processing raw

data, and extracting actionable, relevant information that helps businesses make

informed decisions (Karin Kelley, 2022).

 CHAPTER 4

FINDINGS AND ANALYSIS

Key Informants’ Profile

Key Informant 1 (KI1) KI1 is a female, age 20. She goes to school at Capitol

University (CU), located in Corrales extension barangay 22, Cagayan de Oro City.

She currently resides 27th Amethyst St., Gusa, Cagayan de Oro City. The informant

is currently a 2nd year student, bachelor of science in nursing, in Capitol university.

Key Informant 2 (KI2) KI2 is a male, age 21. He goes to school at Capitol

University (CU) located in, Corrales extension barangay 22, Cagayan de Oro City.

He currently resides in barangay Gusa, Cagayan de Oro City. The informant is

currently a 2nd year student, bachelor of science in nursing, in Capitol university.

Key Informant 3 (KI3) KI3 is a female, age 20 and is currently studying at Capitol

University (CU), located in Corrales extension barangay 22, as a second-year

nursing student. She currently resides in Blk 27 Lot 40 Villa Angela Subd.,

Balulang, Cagayan de Oro City.

Key Informant 4 (KI4) KI4 is a female, age 21 and is currently studying at Capitol

University as a third-year student. She currently resides in Cagayan de Oro.

According to the informant, she got isolated last October, 2021. She experienced

cough and fever and her rtpcr test result turned out to be positive. She was then

isolated for 14 days after her test turned out to be negative.

Key Informant 5 (KI5) KI5 is a male, age 21 is currently residing in Consolacion,

Cagayan de Oro City. He is currently studying at Xavier University as a third-year

student. According to the informant, he got isolated last October 18, 2021. He said

that his family got suspicious of his symptoms and decided to get tested for rt pcr.

When the result turned out to be positive, they immediately isolate themselves in

the room for 14 days after his test turned out to be negative.

Key Informant 6 (KI6) KI6 is a female, age 22 is currently residing in Lapasan,

Cagayan de Oro City. She is currently studying at Capitol University as a third-year

student. According to informant, she got isolated last December 18, 2021. She was

exposed to his dad who got positive for Covid-19 but no presence of symptoms.

When she got positive for COVID-19 she immediately isolate herself for 7 days,

she was isolated in 3 days after her test turned out to be negative.

Key Informant 7 (KI7) KI7 is a female, age 22 and is currently residing in Gran

Europa, Lumbia Cagayan de Oro. She is 4th year nursing student at capitol

university. She graduated high school at Pilgrim Christian College. As stated by

KI7, “Pandemic brought me so many realizations in life which inspired me to

continue nursing.”

Key Informant 8 (KI8) KI8 is a 22-years-old young and independent female

student, and is currently a 4th year nursing student at Capitol University. She

resides at Mauswagon, Laguindingan, Mis.Or. She graduated high school at Santo

Nino high school. As stated by KI8, “Being a student nurse we should appreciate

return demonstration because this brings us into a competitive nurse.”

Key Informant 9 (KI9) KI9 is a 23-years-old female who currently resides at

Tagoloan, Cagayan de Oro city. With her dedication and determination, she’s now
a 4th year nursing student at Capitol University. She graduated high school at

Tagoloan High school. Being a small person does not determine your capability of

being a nurse, what matters the most is your dedication and fashion to become a

nurse.

Thematic Analysis

The data gathered from the nine (9) participants using the researcher-made

interview guide were transcribed and read repeatedly for several times until the

statements were fully understood in their full contexts before they were translated

into English.

From the verbatim of the KIs, 36 significant statements (SS) were extracted.

The significant statements were arranged into tables and grouped together

according to their respective themes. Some notable statements, in their whole,

suggest meanings that span many themes and subthemes, and as a result, they

were repeatedly grouped under various themes and subthemes. A table on the

significant statements and their respective themes is attached in the Appendix.

The emerging themes were extracted after thorough interpretation of the

texts which were then grouped into five parts a.) Practice the nursing care; b.)

Uncertainty; c.) Time; d.) Teaching Methodologies; and e.) Face-to-face win.

These theme groups are discussed in this study and presented in five separate

parts.
Summary Table

Themes Subthemes Formulated Meaning

Practice the  The value of

nursing care clinical training The nursing care practice includes
advocating for the rights of patients
 To help and their families. It also entails
advocating for nursing practice in
management and organizational
systems. Nurses are aware of their
responsibility for delegating care to
junior colleagues and other health
care providers as needed.
Uncertainty  Fear of insufficient Uncertainty derives from the many
knowledge situations in which students’
competencies are tested or put at
display in different ways, such as when
they take a written exam, when their
hand-ins are discussed at a seminar,
when asked questions during a lecture,
or having to explain themselves during
group work
Time  Phases: 1st shock
The adjustment period for the sudden
and 2nd
change of education and the
normalization
adaptability to how to adapt to the
 Time management
new change. Online classes mean
 Future
more time, more time means more
school works and some students
doesn’t know how to manage their
time properly.

Teaching  Video Conference `They are some methods that

methodologies students can’t really adjust to
 Interaction with the as it is very different with the
teachers method we grew up. It limits
on how students can ask
questions about certain
topics.
 Face-to-face  Face-to-face is As the method of education
win better for that we grew up in, face-to-
everything face would be much better
for everything as it has a lot
of advantages that can help
the students and teachers. It
gives meaning to teaching
on a whole another level.

THEME 1: PRACTICE THE NURSING CARE

The outstandingly practical component of care in nursing education was the
most emotional aspect for the students. The experiences found were differentiated
according to the group of students, depending on if they had or not practice-based
subjects during the education period affected by the state of alarm, the proximity to
ending their training as nurses, or if they were health professionals who were
conducting post-graduate studies.

Subtheme 1: The value of clinical nursing

According to the interview data gathered, K1 expressed fear of insufficient

knowledge and described her experience with this following statement:

“Considering that nursing is a very practical course I would like to say that instead of

having an extended way of acquiring resources and knowledge during virtual classes and

virtual return demonstration, we are able to acquire knowledge and practices as a contrary

of how we supposed to learn as a nursing student” (SS7.KI2)

And added
“...I was feeling a little regret that I take for granted the face to face return

demonstration before” (SS28,KI7)

Subtheme 2:To Help

According to the interview data gathered, KI Practice the nursing care to help

and described her experience with this following statement:

 “ Will back in my first year , I definitely say my experience during virtual

demonstration was hard to us to acquire and completely understand what we will be doing , i

can really compared it to what we are doing now , we will able to perform procedures in

actual manner , during this time i was able to understand that does procedure is always vital

to us to perform our  responsibilities as a nursing student ”( SS6, Key informant 2).

And added:

“felts a lot more pressured from doing it know from face to face and again i dont have
some rely on if what I'm doing is right or if the procedures correctly done”( SS11, Key
Informant 3)

Theme 2: Uncertainty

The researchers identified the theme of uncertainty which addresses the

lack of concretion about the different aspects related with their studies. This

uncertainty is accompanied by unpleasant situations due to the possible outcomes.

The subthemes address the concerns that the key informants shared.

Subtheme I: Fear of insufficient knowledge

According to the interview data gathered, K1 expressed fear of insufficient

knowledge and described her experience with this following statement,

“ Actually, it's difficult because this course or field requires practical

practice because it’s dealing with patient life. You should know what are you doing

because you are the first hand to response and you need a guidance of your teacher

to do this cause it's different in virtual to face to face” (SS1, Key Informant 1)

And added,
 “…main thought is I didn’t learn anything, what to do, how can I give care
and the quality care the patient needs if it continues in virtual return demonstration”
(SS3, Key informant 1)

As far as the amount of knowledge is concerned, each person has a pair of eyes and

a pair of ears, and there are only twenty-four hours a day, and the amount of

knowledge that can be contacted and grasped is limited (Shreesham Pandey, 2021).

Theme 3 :Time

Time is a determinant transversal aspect. Two differentiated phases are

observed as the state of alarm moved forward (1st shock and 2nd normalization).
Besides, participants reflected regarding a necessary time management and the
influence in the future

Subtheme:Phases: 1st shock and 2nd normalization

According to the interview data gathered, K1 expressed time 1st shock and 2nd
normalization and described her experience with this following statement :

“At first, it wasn’t fine. As time goes by, I adjust to it.”( SS18,key informant 15)

And added:

“It's so much struggling especially adjusting the laptop for the seek of CI to see the
procedure and not only that i also need to adjust my connectivity of of the wi-fi”(SS26, Key
informant 7).
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