title: A structural equation model on the attributes of a skills enhancement program affecting clinical competence of pre-graduate nursing students.
abstract: BACKGROUND
  Clinical competence remains an issue in nursing and has received greater emphasis than academic competence. Although skill enhancement programs are recommended and beneficial, there is limited evidence on its influence on the clinical competence of pre-graduate nursing students.
  
  
  OBJECTIVE
  This study explored the attributes of a skills enhancement program that affect the perceived clinical competence of pre-graduate nursing students.
  
  
  METHODS
  A cross-sectional study was conducted in a private higher education institution in the Philippines from April to May 2016.
  A total of 245 pre-graduate nursing students participated and completed a three-part survey composed of the respondent's robotfoto, the Skills Enhancement Program Questionnaire, and the Clinical Competence Questionnaire. Factor analysis explicated the attributes of the skills enhancement program while structural equation modeling and path analysis analyzed the variables' relationship.
  
  
  RESULTS
  Findings showed that a skills enhancement program has 4 attributes: supportive clinical instructor, comprehensive orientation, formative goals and objectives, and conducive learning environment. Although all attributes of the program positively affected clinical competence, a supportive clinical instructor had the strongest influence on all clinical competency dimensions.
  
  
  CONCLUSIONS
  A skills enhancement program that has a supportive clinical instructor, comprehensive orientation, formative goals and objectives, and conducive learning environment facilitates clinical competency development among pre-graduate nursing students. This knowledge provides momentum for nursing educators to review and refine their skills and the existing design of their skills enhancement program to further develop clinical competency among pre-graduate nursing students.
authors.affiliation: College of Nursing, University of Santo Tomas, España Boulevard, Manila 1015, Philippines. Electronic address: mdrebueno@ust.edu.ph.
authors.forename: Ma Carina D R
authors.initials: MC
authors.lastname: Rebueno
authors.affiliation: College of Nursing, University of Santo Tomas, España Boulevard, Manila 1015, Philippines. Electronic address: ddtiongco@ust.edu.ph.
authors.forename: Dyan Dee D
authors.initials: DD
authors.lastname: Tiongco
authors.affiliation: College of Nursing, University of Santo Tomas, España Boulevard, Manila 1015, Philippines. Electronic address: janrei.masindo@gmail.com.
authors.forename: John Rey B
authors.initials: JR
authors.lastname: Macindo
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003430:Cross-Sectional Studies; D004508:Education, Nursing, Baccalaureate / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D017145:Models, Educational; D010679:Philippines; D015397:Program Evaluation / Q000379:methods*; D013338:Students, Nursing; D011795:Surveys and Questionnaires
keywords: Clinical competence; Comprehensive orientation; Conducive learning environment; Formative goals and objectives; Pre-graduate nursing students; Skills enhancement program; Supportive clinical instructor