West Visayas State University Research Journal Vol. 9 No. 2 pp.

1-8 (December 2020)

RELATIONSHIP BETWEEN STUDENTS’ ACADEMIC AND

CLINICAL PERFORMANCE IN MATERNAL AND CHILD
NURSING COURSE IN A SELECTED COLLEGE OF NURSING

Gil P. Soriano1*, Ryan Michael F. Oducado2, Ronnell D. Dela Rosa3

1
College of Nursing, San Beda University, Manila, Philippines
2
West Visayas State University, Iloilo, Philippines
3
Graduate School, Bataan Peninsula State University
gil.p.soriano@gmail.com

Abstract

Performance in the classroom may not always be reflective of nursing

students’ clinical competence. On this perspective, this study was conducted
to determine the relationship between academic performance in the classroom
and clinical performance of nursing students in a selected college of nursing
in the Philippines. A descriptive-correlational research design was used
and the records of all 212 second-year nursing students in their Maternal
and Child Nursing course were reviewed. Data were analyzed using SPSS
and Pearson’s r correlation result indicated that academic performance had
a statistically significant relationship with clinical performance. Academic
performance has a significant role in the clinical performance of nursing
students. Nursing schools should ensure that students are provided with good
theoretical instruction in nursing courses to enhance and facilitate success in
the actual clinical placements.

Keywords: Academic performance, clinical performance, nursing students,

nursing schools, Philippines

The World Health Organization reported that there are just 28 million
nurses worldwide, and there is a global shortfall of nurses of about 5.9 million
with the greatest gaps in Africa, South East Asia, Eastern Mediterranean region
as well as some parts of Latin America (World Health Organization, 2020).
Given the rising demand for Filipino nurses locally and abroad, it is necessary
to improve the quality of nursing education and practice by learning the

© West Visayas State University Research Journal

ISSN 2244 - 4335 (print)
ISSN 2651 - 6659 (online)
2 SORIANO, ODUCADO, DELA ROSA

needed competencies (Magno, 2010; Ubas-Sumagaysay & Oducado, 2020).

Nurses must be competent enough to perform in the real nursing environment,
since there is an implied expectancy that nurses will function efficiently once
in the healthcare setting. Supporting the notion that nursing requires a lot
of psychomotor competencies and that nurses learn by doing so, means that
the mastery of clinical skills is an integral part for nursing courses leading
to becoming licensed professional nurses (Chan, 2001). Hence, clinical
placements are considered a vital component of nursing education. Thus,
it is imperative that clinical placements where students learn clinical skills
and practice should provide the needed competencies necessary to become
professional nurses (Gemuhay et al., 2019). During this time, students are
expected to develop relevant competency for their professional role (Kaviani
& Stilwell 2006).
Despite the widespread agreement that clinical placement is critical to
learn nursing, Ironside et al. (2014) reported that students tend to focus more on
the completion of the nursing task rather than having a deeper understanding
of the course. And without proper guidance by competent clinical instructors,
it can lead to dissonance in terms of the learned theoretical concepts in the
classroom with the intuition-based clinical setting (Meyer & Xu, 2005).
Greenwood et al. (2000) added that nursing students believe that nursing
theories and concepts can only be learned from the classroom while clinical
skills can only be learned through clinical placements. These perceived
misconceptions by nursing students can be a great challenge as students’
academic performance might not be reflected in their clinical competence
(Buhat-Mendoza et al., 2014).
With this, there is a need to close the gap between the academic
performance and clinical performance among nursing students as clinical
environments necessitate the application of classroom theories to provide
concrete clinical experiences (Soriano & Aquino 2017; Oducado et al.,
2019). It was earlier reported that new nursing graduates often lack the
competence to perform in the real nursing environment (Liou et al., 2013).
Knowing the variables that influence clinical performance may help in the
early identification of students at risk of performing poorly and allow for
the implementation of supportive interventions during the actual placement
(Johnston et al., 2018). Moreover, it is important to study factors associated
with the clinical performance of students since previous studies have shown
that students’ clinical or Related Learning Experience performance is
significantly correlated with the Nurse Licensure Exam (Banua, 2017; Llego
et al., 2020).
 Relationship Between Students’ Academic and Clinical Performance 3

Hence, this research was conducted to determine the relationship

between academic performance in the classroom and clinical performance of
students in a selected College of Nursing in the Philippines.

Methods
The study utilized descriptive-correlational research to determine the
relationship between academic performance in the classroom and clinical
performance of students in a selected college of nursing in the Philippines.
The data of all 212 Level 2 or second-year nursing students in the Maternal
and Child Nursing 1 (MCN 1) were analyzed. The MCN is one of the major
nursing subjects in the nursing curriculum in the second-year of the 4-year
Bachelor of Science in Nursing program. The final grade in the lecture
component of the subject assessed through quizzes and tests reflected the
academic performance of students. On the other hand, the clinical performance
grades consist of performance skills ratings in the Obstetric Ward, Out-Patient
Department, Pediatric Ward, Delivery Room, and Neonatal Intensive Care
Unit. The said clinical placements are the areas where the students are fielded
to reinforce their knowledge on the lecture component of the subject. The
data were analyzed using descriptive statistics wherein inferential statistics
specifically Pearson’s r was used to determine the relationship between the
academic and clinical performance of the nursing students. Data were encoded
in the Microsoft excel and were processed using IBM SPSS version 20.

Results and Discussion

Table 1 shows that the mean age of the participants was 20.18
(SD=1.33). There were 142 (66.98%) female and 70 (33.02%) male students.
The mean grade for the MCN 1 lecture was 82.15 (SD=3.42), while the
mean MCN 1 clinical grade was 84.75 (SD=1.42). Based on the results, it
can be noted that students had higher grades in the clinical performance than
in their lecture grades. In the Philippines, a typical nursing lecture class is
being handled by one nursing instructor consisting of 40 students, while in
the clinical setting, one nursing instructor will handle a group consisting of 10
to 12 students, hence, a class of 40 students will have four different nursing
instructors. This learning scenario may be susceptible to rater bias given that
different nursing instructors handle different student groups. The problems
with assessment and issue of grade inflation have been well documented in
the nursing education literature (Elie, 2017; Del Prato & Bankert, 2021).
4 SORIANO, ODUCADO, DELA ROSA

Table 1
Students’ profile and descriptives of grades in MCN 1

Profile Mean (SD) n (%)

Age 20.18 (1.33)
Sex Male 70 (33.02)
Female 142 (66.98)
MCN 1 lecture grade 82.15 (3.42)
MCN 1 clinical grade 84.75 (1.42)

To determine if there was a significant relationship between academic

performance and clinical performance, Pearson’s r was utilized. The results
revealed that MCN 1 lecture grade (r=0.912, p=0.000) was significantly
correlated with clinical performance grade. It was revealed in this study that
nursing students’ academic performance in the lecture or theoretical classroom
component of the course was highly significantly related to their clinical grade
or performance. This result may not be surprising since grade in the lecture
and grade in clinical are course-specific. The finding of this study is consistent
with previous research on the influence of academic performance on clinical
performance. Grade Point Average (GPA) was significantly correlated with
postgraduate clinical performance among medical students (Kim, et al., 2016)
and with clinical performance of baccalaureate nursing students (Johnston
et al., 2018). A study among nursing students in Libya also found a positive
correlation between academic and clinical performance indicating that
students who are generally good in the classroom tend to perform similarly
well in the clinical setting (Buhat-Mendoza et al., 2014). Likewise, in a
similar local context, grades in lecture predicted nursing students’ clinical-
grade or performance (Oducado et al., 2019. Findings suggest the importance
of adequate theoretical preparation prior to nursing students’ clinical exposure
(Dela Rosa & Maniago, 2018).

Table 2
Relationship between academic and clinical performance

Variables r coefficient p-value

MCN 1 lecture and clinical grade 0.912 0.000
 Relationship Between Students’ Academic and Clinical Performance 5

Although this study generated some important evidence, this study

has limitations. The academic and clinical performance grades of the students
are susceptible to the subjective grading of teachers or clinical instructors.
In addition, this study cannot infer a causal relationship between variables
because of the cross-sectional nature of the study. Also, this study is limited
to a single course and school, therefore could only be relevant to the study
context and similar settings.

Conclusions

This study concludes that academic performance in the classroom

has a significant role in the clinical performance of nursing students. Hence,
enriching the knowledge of students in the classroom can significantly
contribute to the performance of students in the clinical environment. Nursing
schools committed to students’ success must provide nursing students with
adequate theoretical preparation prior to their clinical exposure and develop
strategies that are appropriate to specific student cohorts and context. Attempts
should be made to ensure that students are provided with good theoretical
instruction in nursing courses to enhance and facilitate success in actual
clinical placements.
6 SORIANO, ODUCADO, DELA ROSA

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