Assessing the Impact of Competency-Based Curriculum Innovation on Nursing Students' Clinical Performance: A Structural Equation Modeling Approach

Abstract

This study evaluates the effectiveness of the global shift toward Competency-Based Education (CBE) in preparing nursing students in the Philippines. Nursing education globally emphasizes core competencies like clinical reasoning and patient-centered care. Although the Philippine Commission on Higher Education (CHED) mandates these competency-based frameworks, a research gap exists in assessing their specific impact within the local healthcare context.
A Sequential Explanatory Mixed-Methods Research Design was employed, combined with a Structural Equation Modeling (SEM) Approach, to examine the complex direct and indirect relationships between CBE factors and clinical performance outcomes. The conceptual framework positioned perceived challenges and barriers as crucial mediating variables affecting the translation of curriculum into clinical success. Participants included nursing students and faculty from selected Philippine nursing schools.
Findings confirm that the CBE provides a necessary foundation, with students expressing confidence in applying theoretical knowledge and performing basic clinical tasks. However, the study reveals that perceived challenges significantly mediate and hinder clinical performance. Major barriers included high levels of emotional strain and stress management difficulty (30–35% reported struggle), difficulties with time management (30%), and feeling unprepared for specialized clinical tasks (25%). Students also struggled with complex clinical decision-making and interprofessional collaboration (30% reported difficulty).
The study concludes that while CBE is vital, nursing programs must integrate enhanced simulation training, dedicated stress management, and improved instruction on decision-making. This refinement will better prepare graduates for the complex and diverse demands of real-world clinical practice in the Philippines.