Mary Joan Therese Valera

UP College of Nursing, Philippines.

Title: Clinical Learning Environment, Learner’s Motivational and Learning Outcomes: the Philippine Nursing Education Experience


Mary Joan Therese Valera is currently enrolled in the Doctor of Communications degree in the University of the Philippines Open University. She has a master’s degree in public health in 2007, with specialty in Health Promotion and Education, and a bachelor’s degree in nursing in 1991 from the University of the Philippines Manila (UPM). Her nursing career started in 1992, when she worked as staff nurse in the adult medical-surgical ward of the Philippine General Hospital (PGH). In 1996, she was invited by the UPM College of Nursing (UPM-CN), and joined their roster of faculty that same year in June. In May, 1997, she had a seizure while undergoing teacher’s training, and was diagnosed to have low grade brain tumor. After five brain surgeries that left her with right-sided motor deficits, she went back to PGH as research assistant in the Adult Health Section of Medical Research Unit, and the National Poison Management and Control Center from December, 1999 to April, 2003. Prof Valera enrolled at UPM College of Public Health in June, 2003, and at the same time rejoined the UPM-CN faculty and is still currently teaching there.


In nursing, we are interested with learning outcomes of student nurses because these impact on how students would perform as professional nurses. Cognitive, Psychomotor, Affective are the expected aspects for which they are honed as student nurses. The Clinical Learning Environment (CLE) has been shown to be most influential in shaping and directing the development of student nurses (Saarikoski & Kilpi, 2002; Tiwari et al, 2005). CLE encompasses the clinical setting and placement of students studying to become professional nurses, and includes all practitioners that students are exposed to and work with, and the supervision that they receive from ward managers and classroom teachers. Additionally, learner’s characteristics reflect individual differences among student nurses in terms of motivational variables. Intrinsically motivated individuals’ engagement in learning is coupled with pleasure and enjoyment as this can bring challenge and arouse curiosity (Pintrich, 1999). Several researches done in higher education showed that a learning climate which involves respect for students, freedom to learn, and teacher enthusiasm encourages a deeper approach to learning.
CLE has been extensively used in most parts of the world. Ferguson's CLE study (2000) concluded that the diversity and complexity of clinical areas and the implications for student learning must be acknowledged. One of the most anxious times for a learner was entering a new clinical situation that they desire to ‘fit in’. And Ferguson's study discovered the importance of the “mentors” role at this time as she/he played an important role in assisting the student to ‘fit in’. And the uniqueness of nursing education in the Philippines is that the teacher in the university is mostly doing the clinical supervision in the hospital wards and other settings. This was evident in the unpublished study of Ramos & Valera (2012) where three factors, namely 1) Supervision in the hospital, 2) Academic Supervision, and 3) Nursing Care in the Ward is being done by the “clinical instructor” who is usually the teacher from the academe. Clinical learning is achieved when the student receives effective hospital and academic supervision, and sees the “teacher” as mentor and model in providing quality and safe nursing care. These enhance the student’s “intrinsic” or innate motivation.

CLE mirrors external factors namely academic supervision, supervision in the hospital and nursing care in the ward. The individual factors will be taken into account which represents the individual differences of nursing students in terms of motivational level in this study. Having both Clinical Learning Environment (external) and learner’s characteristics (internal) will provide us a model of good clinical learning outcomes. Thus, this study will test a model showing the effects of Clinical Learning Environment, Learner’s Characteristics and Clinical learning outcomes using Structural Equation Modelling (SEM).

Methods Research design This study will use exploratory cross- sectional design (Johnson 2001). This will test the model where Clinical learning Environment, Learner’s Motivational Factor as it affects clinical learning outcomes.