QUALITY ASSURANCE OF UNDERGRADUATE AND GRADUATE NURSING PROGRAMS: PHILIPPINE PERSPECTIVE By : Assoc. Prof.

Gisela Luna, RN, MAN Dean , St. Lukes College of Nursing, Trinity University of Asia, Philippines Delivered at International Conference on Benchmarking and Quality Assurance of Nursing Science Programs Siam City Hotel, Bangkok, Thailand January 20-21, 2011

PHILIPPINE EDUCATIONAL SYSTEM IN THE PHILIPPINES:

The Nursing program is part of a larger context emerging from the Philippine Education system. It is just one of many tertiary degree programs in the Philippines. Historically, the Philippine educational system is largely influenced by the American system of formal education ( Defensor, 2010) perhaps traced back to the time when the Thomasites landed in the shores of the Philippine Islands and established the beginnings of American formal educational systems. Structurally, the Philippine Education system is composed of three levels of educational systems responding to the different educational levels of students in the Philippines. Below is a structural diagram illustrating the continuing cycle of the levels of educational system in the Philippines.

DepEd DepEd: for basic Education

TESDA 1

TESDA: for Technicalvocational and Education CHED Middle

CHED: for Tertiary Education The Department of Education ( DepEd) supervises the basic education programs from Pre-elementary to Elementary and HighSchool ( secondary education), the Technical Educational and Skills Development Authority ( TESDA) supervises vocational. Technical and Middle Education, while Commission on Higher Education ( CHED) supervises Baccaluareate, Masters Degree and Doctorate programs.

Department of Education ( DepEd) D A Y C A R E N U R S E R y K I N D E R P R E P A R A T O R Y

TESDA/CHED Law program 6 year degree program Medical allied program

CHED

High Elementary School (4 years) ( 6 years)

Doctorate degree program

5 year Baccalaureate degree program: Architecture and Engineering Technology programs 4 year Baacaluareate degree programs Masters program Post secondary Middle education Vocational technology 3 months/6 months program Pre School Primary Education Secondary Education Post Secondary /Tertiary Education Graduate Education

Degree

THE COMMISSION ON HIGHER EDUCATION ( CHED); AGENCY FOR TERTIARY EDUCATION:

The Commission On Higher Education ( CHED) was created on May 18, 1994 by virtue of R.A. 7722 ( Higher Education Act of 2 1994).It is an agency attached to the Office of the President which covers both pubic and private higher education institutions as well as degree granting programs in all post secondary programs. It has the following functions: Performs both regulatory and developmental functions. Formulates and recommends plans, policies, priorities and programs on higher

recommended by panels of experts Responsible for developing policies to support quality improvement in the higher educational system. ( Pijano, 2010)

Among the mandates of the Commission are to ( Pijano, 2010) Formulate and recommend development plans, policies, priorities and programs on higher education and research Set minimum standards for programs and institutions of higher learning recommend by panel of experts in the field Monitor and evaluate the performance of programs and institutions of higher learning for appropriate incentives as well as the imposition of sanctions Identify support and development potential centers of excellence in program areas needed for the development of world class scholarship, nation building and national development.

The Commissioner composed of five ( 5) full time members: the Chairman and four Commissioners. They have the rank of Department Secretary ( Minister) and Undersecretary ( Vice-Minister) , respectively . As such , their compensation and other emoluments correspond to those of the Secretary and Undersecretary. ( Defensor, 2010) DISTRIBUTION OF HIGHER EDUCATIONAL INSTITUTIONS IN COUNTRY

The Philippine higher education system has a large college student population with a total of about 2, 726, 699 students as of August 2010. Of this number , 61% is accounted for the private schools, 30% come from the public the public HEIs ( Higher Education Institutions). The State Universities and Colleges are established by law and are financially supported by the national government , the private higher education instituions are supported by private groups or individulas organzied into a corporation. The private institutions are classified as either sectarian, non sectarian colleges. Sectarian institutions are usually classified as non-stock, non-profit institutions owned and operated by the religious orders. The non-sectarian institutions on the other hand , are owned by corporations which are not affiliated with any religious organizations.

It is in this context that the Nursing education is classified. The Nursing Higher 3

institutions could either be private owned or government owned, non sectarian or sectarian. NURSING EDUCATION IN THE PHILIPPINES:

The Philippines is known to produce nurses for global needs. It is largely influenced by the Western curriculum, specifically, the American Nursing curriculum. The medium of instruction is English, the reference books are in English . In the early 1950s, the only educational program for nursing was a three year course termed as a Graduate Nurse program, but as early as 1947, some universities have started to establish a Bachelors Degree of Nursing, which is a four year program. In 1965, the Graduate Nursing program in the Philippines was phased out and was replaced by the Bachelor of Science in Nursing, a four year baccalaureate nursing degree program. Today, 2011, the Philippines has only one undergraduate nursing educational program which is the Baccalaureate Nursing 4 year nursing program. Unlike the undergraduate nursing program, the graduate nursing program in the Philippines is diverse and comes from different perspectives. For the Masters degree programs, the more common degree is the Master of Arts in Nursing( MAN) with specializations in Nursing education , Nursing administration and Clinical Nursing. There are also Master of Science in Nursing programs, focusing on clinical nursing specializations. In the doctorate level, there are Universities that offer PHD in Nursing, others offer Doctor in Nursing, still others have become more specific, such as Doctor in Nursing Management.

The proliferation of Nursing Programs have become a growing concern of nursing educators and practitioners. The greatest growth experienced of the number of schools occurred after 2000 which corresponded to the opening of US markets for nurses. From 120 nursing schools in 1990, to 464 nursing schools in 2006. The number of students grew as much as the nursing schools and programs, from a raw count of 27,833 in 2000-2001, to 397,195 in 2005-2006 ( Acacio, Kristel, 2007). The subsequent increase in nursing schools had an impact in the declining passing average of nursing graduates in the National Licensure Examinations. Concurrent to this phenomena is the increasing number of unemployed new nurses in the Philippines. The need to ensure that Quality Nursing Education is still maintained, Nursing schools have been mandated to undergo quality assurance processes . In a recent pilot study led by the Board of Nursing in the Philippines in collaboration with key agencies in the Philippines, the study revealed that schools who underwent accreditation, which is a quality assurance mechanism, had higher percentage passing rates in the National Nurses Licensure eXamination ( Rosales, et.al. 2010) With this it has become apparent that certain quality assurance mechanisms must be put in place in the individual schools and institutions to ensure quality nursing education in the Philippines. The Educational system in the Philippines has established Quality Assurance mechanisms , which is addresses all sectors of the Philippine Educational system, from the Private sectors to the government sectors. 4

QUALITY ASSURANCE : PHILIPPINE PERSPECTIVE

QUALITY ASSURANCE is defined as a systematic review of educational programs to ensure that acceptable standards of education, scholarship and infrastructure are being maintained. Since Nursing education is part of the tertiary program in the Higher Educational system in the Philippines, mechanisms for quality assurance is also applied to nursing. The quality assurance mechanisms of the Educational system in the Philippines are: ( Pijano, C.2006) Commission on Higher Education The Accrediting Agencies The Federation of Accrediting Association of the Philippines The National Network for Quality Assurance in the Philippines.

The Quality Assurance System in the Philippines as illustrated below has two major components: institutional and program approaches.

Quality Assurance Mechanisms

Institutional Mechanisms Program based mechanisms

CHED authority to operate programs Permit Phase Recognition Phase CHED Standard Setting Policies , Standards and Guidelines set for Minimum standards ( mandatory : CHED assisted by Technical Panels, Regional Quality Assessment Teams) Accreditation Levels- level I to IV Conducted by accrediting bodies under FAAP and NNQAA ( voluntary in nature) Center of Excellence /Center of Development International Certifications -APEC Registry and Washington ACCORD 5

CHED Institutional Monitoring and Evaluation for Quality Assurance ( IQUAME) Autonomous /Deregulated Status Institutional Accreditation

Program based mechanism includes CHED authority to grant permits and recognition to operate academic programs; standards setting through its memoranda on policies , standards and guidelines; and the formulation of Regional Quality Assesment Teams. The Institutional mechanism include CHEDs own instrument, Institutional Monitoring and Evaluation through Quality Assurance ( IQUAME) , CHEDs own instrument for classifying State unviersities and Colleges and International Recognitions. EXTERNAL QUALITY ASSURANCE AND THE INTERNAL QUALITY ASSURANCE

In the Philippines, there are two ways by which the quality assurance in education is observed in the higher education institutions. These are the EXTERNAL QUALITY ASSURANCE MECHANISMS and the INTERNAL QUALITY ASSURANCE MECHANISMS The External Quality Assurance Mechanism is through the accreditation by the private accrediting bodies or quality assurance organziations including those coming from the CHED. The Internal Quality Assurance Mechanisms is through the internal processes that are being done within the organization framework of the institution. This refers to the systems, policies, practices, that academic institutions have in place to enable them to 6

implement, monitor, and improve the schools educational mission and objectives. EXTERNAL QUALITY ASSURANCE MECHANISMS THE ACCREDITING AGENCIES of PROGRAM BASED QUALITY ASSURANCE MECHANISMS COMMISSION OF HIGHER EDUCATION: ESTABLISHMENT OF HEIs The Commission on Higher Education issues government authority to the Higher Educational institutions ( HEIs, these are educational institutions who offer undergraduate and graduate degree programs.) to operate degree programs. There are two phases by which institutions undergo. 1. The permit phase 2. The recognition phase In going through this, the programs in a college or a university needs to comply with certain requirements, the technical panel visits the institution and reviews documents as well as the facilities of the institution as per the guidelines, policies and standards of the program. It is only when there is a full compliance with the minimum standards prescribed by the CHED that a government authority to operate is issued to the institution. ACCREDITING AGENCIES FOR THE PRIVATE AND GOVERNMENT SECTOR: PRIVATE SECTOR: FEDERATION OF ACCREDITING AGENCIES OF THE PHILIPPINES: (FAAP) The FEDERATION OF ACCREDITING AGENCIES OF THE PHILIPPINES is the umbrella agency under which the various accrediting agencies for private schools operate. It is a certifying body which grants the various levels of accreditation , upon the recommendations of the three accrediting agencies. It serves as the highest policy making body as far as private accreditation system in the country is concerned. ( Palispis, 2008) The Board of Trustees is composed of two representatives of the member agencies. The leadership of the Board rotates around the three pioneering agencies ( PAASCU, ASCUAAI and PACUCOA). Under the direction and supervision of the FAAP, the member agencies are expected to come up with the common standards and common tool for accreditation. The exectuvie directors of the three agencies meet regularly to discuss common plnas, concerns, issues concerning accreditation in the country.

ACCREDITING AGENCIES FOR THE PRIVATE SECTOR 7

Accrediting agencies Philippine Accrediting Association of Schools, Colleges and Universitye ( PAASCU) Philippine Association of Colleges and Unviersities Commission on Accreditation (PACU-COA) Association of Christian Schools, Colleges and Universities Accrediting Agency, Inc. ( ACSCU-AAI)

Year established 1957 1973

1976

THE GOVERNMENT SECTOR: NATIONAL NETWORK OF QUALITY ASSURANCE AGENCIES ( NQAA): Is the umbrella organization recognized by CHED to certify the accredited status of government institutions. The NQAA is composed of : Accrediting agencies Accreditng Agency of Chartered Colleges and Unviersities of the Philippines, ( AACUP) Association of Local Colleges and Universities Commission on Accreditation WHAT IS ACCREDITATION Year established 1987 2003

ACCREDITATION: concepts and principles Accreditation is a formal recognition of the quality of an educational program as possessing certain standards of quality and excellence , based upon the analysis of the merits of its operation in relation to its objectives and to its unique role in the community. Process by which a school is judged by a peer group to come up to the standards of quality as evidenced by its high quality of instruction and program.

Basis for these standards are: minimum requirements prescribed by the government educational agencies, Department of Education for the Basic Education, The Commission on Higher Education for the tertiary courses and the Technical Educational Skills and Development Authority ( TESDA) for technical/vocational programs. It is a concept of self-regulation which focuses on evaluation and continuing improvement of educational quality. It is a process and a product. As a process , it is a form of peer review, in which an association or an accrediting agency establishes criteria and procedures to encourage high standards of educational quality among its member schools. As a product, it is a form of certification or formal status granted by an accrediting agency to educational programs/institution which meets standards of quality over and above those prescribed as minimum requirements for government recognition. 8

It is a process by which institutions or programs continuously upgrade their educational quality and services through self evaluation and the judgement of peers. It refers to the status granted to an educational program/institution which meets commonly accepted standards of quality or excellence.

STEPS IN THE ACCREDITATION PROCESS A self-evaluation or self-survey done by the institution An on site evaluation conducted by the peers The decision of the governing board of the acrrediting body Periodic external review.

ACCREDITATION Is granted by the accrediting agencies when the institution has met the standards set by the government . It is Private and voluntary in nature. It has Four accreditation levels granted by the accrediting bodies--- Level I, Level II, Level III, Level IV. ACCREDITATION LEVELS BASED ON ched MEMO Order No.1, s.2005 STATUS Level I Level II Level III TERM Initial accreditation for three years Formal accreditation for five years Reaccreditation for five years BENEFITS Full adminsitrative and financial deregulation; grants and funding assistance All the benefits for Levels I/II; curricular deregulation; privelege to offer distance education and extension classes All of the above benefits; full autonomy for the program

Level IV

Re-accreditation for five years

INTERNAL QUALITY ASSURANCE MECHANISMS

Most Philippine higher education institutions have common features in terms of their internal quality assurance practices. These are processes that ensure internal evaluation of how far institutional goals are met through out the institution.

The Internal quality Assurance Process: PLANNING 9

IMPROVEMENTS

IMPLEMENTING

REVIEW

The Internal Quality Assurance Components: Support structures Systems Policies Procedures Practices

The internal quality assurance mechanisms in most higher educational institutions have the following features: Regulatory Policy Framework Each higher educational institution have policies on student admission, assessment of students competencies and the requirements for the academic standards of the institution. The person who graduates from a baccalaureate degree is presumed to have acquired the competencies of that program . The policies of the institution facilitates such acquisition of the expected competencies. Process for approval of the new Degree program- there are processes that the institution undergoes to acquire the authority to implement the program . By complying with the minimum standards set by the Commission and satisfying the expectation of the clients.

Periodic Review of the degree program it is essential, that a review of the degree program takes place with the participation of the stakeholders such as the students, faculty, administrators and the staff. By reviewing the degree program, it lends itself to the improvement of the program as well as aligning itself and making it relevant to the times and to the needs of the students and the society. It is a good 10

practice to review the degree program every 3 to 5 years .

Annual Reports from the Institution , School, or college An annual report produces a total picture of the institution and features the strengths and weakness of the institution. This paves the way for the constant improvement of the program/programs of the institution.

Mechanisms for Monitoring Instruction , Research and Extension- Internal policies that will allow for a system of evaluation of teachers and administrators as well as a system of feedback of the student competency , will allow for the improvement of the program.

OUTCOMES OF INTERNAL AND EXTERNAL QUALITY ASSURANCE MECHANISMS : ( Defensor, 2010) The Commission on Higher Education provides incentives for Higher Educational Institutions ( HEis) who have achieved a level of quality. Some of these outcomes are : Identification of Centers for Excellence and Centers of Development for Higher Educational Institutions: These are academic programs which has achieved the highest degree of levels of standards . Institutions who have achieved such a higher quality of academic standards receives this as a award of distinction. Identification of Autonomous and Deregulated status. This is a grant given to deserving private colleges and universities who have shown exemplary performance in the provision of instruction, research and extension.

Identification of best researches and best extension programs.These are awards given following a competitive process.

Research and Publication awards . this is a bi annual award given to individual faculty researcher with outstanding publications in refereed journals.

CHALLENGES AND CONCERNS IN QUALITY ASSURANCE : The proliferation of nursing schools is a challenge in maintaining the quality of nursing education, accreditation is voluntary, minimal percentage of nursing schools undergo accreditation. There are a number of nursing schools who are not performing well in the licensure examinations.

Since there are different accrediting agencies , the challenge is to maintain comparability and uniformity in the evaluating instruments among the different accrediting agencies. 11

The globalized nursing education poses a challenge to quality assurance mechanisms, which should keep in step with the trends of the globalized education.

The development of nursing education in the Philippines is externally driven, because its market is externally dictated. Therefore, quality assurance mechanisms must consider this as a factor in the evaluation instruments. REFERENCES:

Acacio, Krystel ( 2007) Producing the World-Class Nurse: The Philippine System of Nursing Education and Supply. Department of Sociology , University of California, Berkeley Defensor, Nenalyn ( 2010) Quality Assurance in SouthEast Asia: Philippine Experience, Bangkok, Thailand, Sept. 2010.

Palispis, Epitacio ( 2008). Voluntary Accreditation in the Philippines . Focus on the ACscu Accrediting Agency, Inc.

Pijano, Concepcion( 2010). Quality Assurance and Accreditation: The Philippine Experience

Workshop On Human Resources For Health And Migration MOBILITY, TRAINING AND THE GLOBAL SUPPLY OF

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