THE EFFECTS OF ONLINE LEARNING IN THE MENTAL HEALTH AND READINESS

OF MMSU- CHS STUDENTS FOR CLINICAL PRACTICE

GUDOY, CHARIES JAMILLE

BUGARIN, MARIA JONALYN B.

OCAMPO, ARVIE C.

PARAOAN, JULIUS CEASAR A.

VERGARA, LORIBEE-ANN E.

Submitted to the Faculty of the College of Health Sciences

Mariano Marcos State University
In Partial Fulfillment of the
Requirement for the
Degree
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BACHELOR OF SCIENCE IN PHYSICAL THERAPY

2021

CHAPTER I

THE PROBLEM

Rationale

The Coronavirus disease (COVID-19) pandemic that every country is facing and

overcoming today started in December 2019 in an unknown origin at Wuhan, China. It

was caused by the severe acute respiratory syndrome-coronavirus-2 (SARS‐CoV‐2), a

novel strain of coronavirus. The virus spread so rapidly that it was declared an

international public health emergency in January 2020, affecting all human life areas,

particularly education (Bedford, 2020).

Given this situation, many countries have agreed to immigration bans and

communities’ lock-down and avoid the outbreak (Bedford, 2020). This led people to

undertake multiple steps necessary to keep the virus from spreading, including working

from home, social distancing, information about proper hand-washing, and requesting
3

everyone to stay at home, thus improving health institutions to manage the infection.

Since around the second week of March, about 150 countries had temporarily closed

educational establishments involving 80% of the world student population (Bhaumik et

al., 2020). 

Many health determinants—including physical, social, psychological, and

spiritual- can considerably affect by the COVID-19. With the psychological aspect of

health, Aguglia et al. (2020) stated that it emerged progressively during the COVID-19

outbreaks, and some of these are stress, anxiety, and depression. On the other hand,

COVID-19 affects the spiritual aspect of health because some activities such as

chaplains and spiritual practices may be limited because of physical distancing for

infection control (Hoosen, 2020).

Kuttichira et al. (2020) stated that this disaster adversely affected the students’

education, predominantly undergraduate medical and premedical students. Some of the

students’ problems include temporary disruptions to weather-related or electricity

disruptions on the network and the internet. Students did not want the practice and skills

sessions to be made online, as they felt it could never be learned virtually. Any disaster,

including a public health crisis like COVID-19, adversely affects medical education.

There has been a consistent and supreme challenge in the pedagogical shift of

traditional learning to online learning. This includes how to adapt educational goals and

methods to new opportunities and technological challenges. It also questions the ability

to integrate these online learning most effectively into the new academic curriculum.

More specifically, it questions which technologies will help improve and augment

education, and more importantly, how one should use technology in cutting-edge ways

for better educational outcomes (Aslaminabadi et al., 2016).

4

Aslaminabadi et al. (2016) also stated that these changes require faculty and

staff to learn and use technology more effectively to educate students better, think

critically, express themselves more briefly and adequately, and solve complex problems

and situations more effectively. A significant challenge for the health sciences colleges is

maintaining and balancing a complex mix of activities, including clinical care, practical,

learning skills, education, and research and evaluation. Despite the students’ potential,

developing critical thinking skills in these virtual-based environments is still challenging

for educators and students. It involves using an inquiry-based environment to encourage

students to challenge their self-study skills and consider their own experiences with this

online learning.

Moreover, Tria (2020) stated that the number of COVID-19 infections in the

Philippines is still growing. The study presented some of the new normal situations in the

school setting. However, there were some posed challenges and issues presented while

recommending several approaches to the new normal. It is also stated by Tria (2020)

that the higher education sector, the Commission on Higher Education (CHED), gave

higher education institutions (HEIs) the academic freedom to implement available

distance learning, e-learning, and other alternative modes of delivery to students

(CHED, 2020). This new normal is to strengthen educational planning, and health is a

concern to provide quality, inclusive, and accessible education for every student. 

Determining the factors of online learning among health sciences students is the

first step in identifying its effect on mental health and readiness of the students to clinical

practice. With these facts and studies shown, the shift to online learning has challenges

encountered unexpectedly. This alone can affect student’s lives, especially their mental

health. In the locale setting of Mariano Marcos State University (MMSU), shifting to

online learning also occurred rapidly. In this condition, many students are not prepared
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for this kind of learning. This study will seek to determine the effect of online learning on

mental health and readiness to the clinical practice of health sciences students.

Objectives of the Study

This study will aim to investigate the effect of online learning on the mental health

and the readiness for the clinical practice of MMSU- College of Health Sciences (CHS)

students.

Precisely, this research will aim to:

1. Determine the factors of online learning that can have an effect on

students’ mental health and readiness to clinical practice, as to:

a. Amount of workload

b. Methods and media used

c. Teachers’ competency in online learning

d. Student motivation and concentration

2. Identify the effects of online learning on the mental health of the students,

specifically psychological well-being, as to:

a. Autonomy

b. Personal growth

c. Positive relations with others

d. Purpose of life

e. Self-acceptance

3. Identify the effects of online learning on the readiness of the students

before the clinical practice, as to:

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a. Understanding science

b. Practical skills and patient management

c. Holistic care

d. Prevention

e. Interpersonal skills

f. Confidence/ Coping skills

g. Collaboration

h. Self- directed learning

Significance of the Study

Since the country is in a pandemic, the government’s solution and CHED is to do

online teaching to learn the fundamental skills needed for the students’ profession in the

future. This study would benefit all students and even the general public in the

Philippines in being aware of the effects of online learning.

This study would also benefit the following individual:

Commission on Higher Education. This study will guide CHED to understand

the students fully; situation about online learning, thus providing them information on

how to be more permissive as classes shift online as a precautionary measure against

the spread of the COVID-19. 

MMSU. This study will guide them to develop a task force to plan and deal with

the crisis.
7

MMSU faculty and staff. This study will help create, modify, and apply more

effective learning strategies to deliver important content. It will also help them frame a

flexible assessment guideline to keep in mind that students are not disadvantaged.

MMSU students. Through the data gathered, they will be informed of their

current condition in taking up online learning concerning mental health and level of

confidence.

Parents. This investigation will give them an insight into the effect of online

learning on their children. The outcomes will provide the parents with more supervision

on what assistance they may provide to them, whether in financial, moral, and

academics.

LGUs. The collected data can provide LGUs an awareness to provide additional

funding support to basic public education and maximize available resources to assist

educational institutions without exposing them to the COVID-19 pandemic.

Future researchers. The data collected can provide a guide to gather more

information and ideas. It can also be their future reference in their conduct of a study on

the same field.

Scope and Delimitations of the Study

This study will aim to determine the effect of online learning on MMU-CHS

students. It will also focus on identifying the effects on the mental health and readiness

to the clinical practice of MMSU-CHS students. Specifically, the psychological well-being

as to self-acceptance, personal growth, purpose in life, environmental mastery,

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autonomy, and positive relation with others. Readiness to clinical practice as to

understanding science, practical skills and patient management, holistic care,

prevention, interpersonal skills, confidence/coping skills, collaboration, and self-directed

learning. However, few studies about the effects of online learning on the readiness of

students to clinical practice is found. This study would only focus determine on the

effects and not on its relationship to the other variables.

This study will employ quantitative research design specifically descriptive and

correlational design. A survey questionnaire shall be used in gathering data. The

investigation will be conducted in MMSU-CHS during February-June 2020. This process

will not include all aspects of mental health such as emotional, social, and physical well-

being, the students and religion, gross income, and parents’ occupation. This study will

focus on the Level II and Level III students of MMSU-CHS as level I students was not yet

enrolled in MMSU as college students last semester. The researchers will only involve

the CHS students because the study will aim to differentiate and identify their

understanding and skills in their future job as health professionals. This study will involve

only the students who had an online learning experience.

Operational Definition of Terms

Mental health. It is perceived by the respondents based on their level of anxiety

and depression in taking up online learning.

Online learning. The mode of creation, delivery, and application of concepts in

the students’ courses via electronic devices and telecommunication systems, including

both asynchronous and synchronous communication means. Its factors include the
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amount of workload, students’ motivation and concentration, teachers’ competency, and

methods and media used.

Psychological well-being. This refers to the respondents’ level of positive

functioning that includes one’s relatedness with others and one’s sense of mastery and

personal growth. The dimensions of psychological well-being are self-acceptance,

personal growth, purpose in life, environmental mastery, autonomy, and positive relation

with others.

Readiness to clinical practice. This refers to the preparedness of the students

to showcase their knowledge and skills related to health such as understanding science,

practical skills, holistic care, prevention, interpersonal skills, coping skills, collaboration,

and self-directed learning.

Specialized courses. These are classes offered by MMSU-CHS, which were

designed and concentrated uniquely for BSN, BSPh, and BSPT programs.
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CHAPTER II

REVIEW OF LITERATURE AND STUDIES

This chapter presents the review of related literature in which online learning,

mental health, and level of confidence in clinical practice. It shows related studies and

relevant theories that are of importance to the making of this new research. 

COVID-19

Definition and Manifestations

Coronavirus has a large family of viruses that are common in individuals and

many species of animals. The SARS-CoV-2 is a beta coronavirus like MERS-CoV and

SARS-CoV (American Academy of Physical Medicine and Rehabilitation, 2020). Bi et al.

(2020) stated that a phylogenetic analysis suggests that this virus emerged from

animals, especially bats, which has evidence that the intermediate vector may have

been a pangolin, a nocturnal anteater imported illegally for its flesh.

Besides, Hsueh et al. (2020) state that an infected person's lungs are the organs

most affected. Thus, respiratory manifestations such as cough, sputum production, and

shortness of breath remain the most common symptoms following fever. Also, upper

airway manifestations, including nasal congestion and sore throat, are observed in
11

patients exhibiting mild disease. Furthermore, respiratory tract specimens are the most

common clinical specimens obtained for real-time quantitative reverse transcription PCR

(RT-qPCR) detection of SARS-CoV-2.

Based on a preliminary understanding of COVID-19, the screening for SARS-

CoV-2 concerns infection in patients with fever or airway symptoms and characteristic

travel, occupation, contact, or cluster histories. However, the observance of that extra-

respiratory manifestation of SARS-CoV-2 infection is rapidly increasing the number of

COVID-19 cases. To reduce the risk of overlooking patients with COVID-19 who

manifest only extra respiratory symptoms, clinicians need better to understand the range

of SARS-CoV-2 infection-related extra-respiratory manifestations (Hsueh et al., 2020)

Today, the Philippines’ current case of COVID-19 is rapidly increasing, with 348

698 total cases and 48,040 active cases. The most affected region is NCR,

CALABARZON, Central Visayas, Central Luzon, and Western Visayas (Department of

Health, 2020).

Effect of COVID-19 in Education

In the report of Agham Youth National (2020), the increasing number of COVID-

19 cases in the Philippines makes it impossible to implement face-to-face classes for

most universities across the country safely. To continue education amidst the pandemic,

many universities expect to have transitioned to alternative modes of learning. Students

who experienced the shift to remote learning from March to July 2020 struggled with

their studies due to poor low internet connection, lack of appropriate devices,

deteriorating mental and physical health, and non-conducive home environment.

According to Araújo et al. (2020), UNESCO records more than 160 countries

implementing nationwide closures, which impacted over 87% of the world's student

population. Universities worldwide have been uncertain about how long the coronavirus

crisis will last and how it might affect students' and faculty's mental health. The
12

psychological impact has been a critical disruptor, creating anxiety and uncertainty. By

discussing online and distance education, the coronavirus opens an important and

urgent issue that affects mental health – these are virtually new topics, and their results

have not been validated yet. Blended learning was introduced as a tool in personalized

learning to adjust to the new normal. The article shows that anxiety and depression,

exacerbated by uncertainties of information flow, will grow extensively. Negative

physiological consequences of stress will manifest. For instance, loneliness seems to

harm education and psychological pain and suffering.

Similarly, the Technical Educational and Skills Development Authority’s (2020)

article discusses how COVID-19 affects the education of all students in the Philippines.

The untested online teaching method has suddenly become the norm even though its

effectiveness as a learning delivery platform. Also, the longevity of the issue remains

questionable. The global lockdown of education institutions is not a short-term issue, and

its consequences may be felt for a long time even after the pandemic is solved. The

careers of this year’s university graduates may also be severely affected by the COVID-

19 pandemic. They have experienced significant teaching interruptions in the final part of

their studies, they are experiencing significant interruptions in their assessments, and

finally, they are likely to graduate at the beginning of a major global recession.

Online learning

Background of Online learning

The 21st century drastically changes the world of education; gone are the days

where teaching occurs inside the four corners of a classroom. Even before the launch of

the internet, there is a practice of distance learning. It can be traced back to 1960 at the

University of Illinois, USA, where students began learning from computer terminals

interlinked to form a network (Sarkar, 2020). The University of Toronto offered the first-
13

ever complete online course in 1984, and the University of Phoenix became the first

academic institution in the world to launch a wholly collegiate institution that offers both

bachelor's and master's degrees (Sarkar, 2020). Currently, the Indira Gandhi National

Open University in India is the largest globally, with around 4 million students enrolled

(Sarkar, 2020). The invention of the World Wide Web made online learning accessible to

almost everyone in the world.

In the past years, the internet plays a significant role in the students' learning

process as it offers immense scope of topics where almost every question from the

customers has answers. Sarkar (2020) asserts that online learning evolved far from how

it started in the 1990s and now caters to a bigger market. It enables students to have an

active role in their learning process through regular feedback and assessment as the

internet now provides a two-way transaction mode. He also provides features that give

an edge to online learning, such as it is less expensive and flexible for everyone since

with online learning, students do not pay money for their allowance, transportation, and

food, and students can change their schedule that is convenient to their schedules.

Different applications and sites used for an online class. Educational applications,

platforms, and resources aim to help students, teachers, parents, and school facilitators

assist in student learning (United Nations Educational, Scientific, and Cultural

Organization, n.d.). According to Mercado and Pagtaconan (2014), a virtual learning

environment is a web-based package designed to create online courses. This facilitates

teacher-learner and peer-to-peer communication.

Scope of online learning in:

Delivery and discussions. The pedagogical paradigm shift in education to 24-h

learning environments, encompassing several delivery formats, including online learning

and blended learning, questions the student access and engagement into global, lifelong

learning. Many educators are experiencing greater flexibility in course design and
14

delivery, but some may not experience these kinds of benefits because of non-

technology-wise, not having access to gadgets, and internet stability (Van Doorn & Van

Doorn, 2014).

According to Dunn et al. (2011), the consideration of asynchronous learning is

now the most common delivery format in online learning worldwide, although there has

been a delay in instructor and student feedback. Another teaching style includes the

blended learning format consisting of synchronized (real-time feedback) and

asynchronous online.

Another delivery format is the flipped type, where students watch taped lectures

outside of classroom time (Van Doorn & Van Doorn, 2014). Prior research has indicated

the need for all universities to focus on successful knowledge transfer efficacy. With this,

they presented the Transfer of Learning Model in which has seven variables. These

include the planning process, learner characteristics and motivation, design and delivery

methods, learning context, immediate application, workplace environment, and

eliminating barriers.

One provider of a content-delivery tool in blended, online, and fluffed classes is

educational videos (Brame, 2017). It enhances by considering these three elements;

managing the videos’ cognitive load, promoting student engagement with the video, and

promoting active learning from the video.

According to Brame (2017), cognitive load suggests that memory has two

components, the sensory and working components. The former is the one collecting

information from the environment.

Student engagement is simple; if students do not watch videos, they cannot learn

from them. Keeping the video short and precise is the most important guideline for

maximizing student engagement in the video.

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Active learning in the classroom provides clear advantages over passive

encounters with course material through lectures. Self-regulation of learning requires

students to monitor their learning, to identify learning difficulties, and to respond to these

judgments; in other words, it requires students to actively build and interrogate mental

models, practicing metacognition about the learning process.

Assessment. The assessment of student learning encompasses how instructors

assess student progress, formative and summative, and how they distribute graded

activities across an entire course using online learning (Kearns, 2012). The identified

assessment methods that are particularly effective in online learning include projects,

portfolios, self-assessments, peer evaluations, peer evaluations with feedback, and

timed tests and quizzes.

In addition to this, Kearns (2012) also identifies the following to advance learning:

collect data to serve as evidence to inform assessment judgments and provide feedback

to students based on those judgments.

Advantages and disadvantages of online learning

Briggs et al. (2016) discuss the advantages of online learning, which allows

flexibility to work and learn at one's own pace with ready and repeatable access to

comprehensive information where there is a comparison on key perceived benefits of

online learning to a lecture mode. Ease of access to comprehensive information e-

learning was also valued by students who indicated they were likely to use e-learning

resources throughout their learning.

On the other hand, Brigss et al. (2016) also discuss the disadvantages of online

learning, whereas traditional lecture-style education usually requires students to attend

an education session physically, reported about the e-learning experience included: the

need to personally motivate to complete learning modules; and risk of "combing for

answers" to quizzes instead of active, comprehensive learning information. Students

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reported valuing particular face-to-face learning attributes, including the ability to deliver

clarity on topics as information. Students also appreciated verbal cues, such as tone of

voice, to emphasize key concepts' importance.

In addition to this, Alkattan et al. (2020) predicted that Covid-19 would adversely

impact online education internationally, and they felt that the transition to online learning

could be challenging. Challenges to online learning reported so far include time

management issues, use of technology tools, students’ assessment, communication,

unexpected power and weather interruption, and the lack of in-person interaction. Some

students may not have access to laptops or high-speed internet at home. Moreover,

some advantages and disadvantages are also discussed by Arooj et al. (2020), as

shown in Table 1.

Table 1

Advantages and disadvantages of online learning

Themes Sub-themes Excerpts

    Advantages

Flexibility Remote Learning “It is useful in distant learning and

                 during COVID-19 situation that

universities continue the education

system” as stated by one of the

subjects.

  Easy Administration The subject in this study states that

“teachers have the authority to unmute

our mics and videos. And see and

check whether we are listening

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attentively or not”

  Accessibility “The students who are not much

confident, they contact the WhatsApp

easily”

  Comfortable It can be used as easily and

comfortably to listen to lectures and

learn.

Student-centered Self-directed Learning The subject believes that ‘’online

Learning learning is making good students more

active and self-learner.”

  Asynchronous Learning Lectures have been recorded and

uploaded. It will be easy to go back and

go through the whole video for the

summary and even revising it

    Limitations

Inefficiency Unable to Teach Skills “In anatomy, the study through models

    was good. But hands-on training is not

possible, the students will not be able to

understand properly. Skills need an

actual hands-on training”.

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  Lack of Student Feedback “Subjects stated that they find it

  annoying that during lectures they don’t

have student’s feedback whether they

are getting the point or not”.

  Limited Attention Span “There is no continuity of the lecture.

  Students lose our concentration and the

syllabus is too lengthy.”

  Lack of Attentiveness “As the students know that they will get

the recordings, they don’t listen to

lecture properly” 

  Resource Intensive “Lots of people might not be having

  these gadgets. Buying these gadgets

brings an extra burden on them in such

stressful situations”.

Maintaining Lack of Discipline “There is some problem with discipline,

Academic Integrity   some students misbehave during

lectures”.

  Plagiarism “As this system is new to everyone, it is

    difficult to have an individual

    assessment. During an assignment,

  they easily copy-paste stuff from the

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web”.

Note: Reprinted from “Advantages, Limitations, and Recommendations for online

learning during COVID-19 pandemic,” by Arooj, M., Javed, K., Mukhtar, K. and Sethi, A.,

2020, Pakistan Journal of Medical Sciences, 36(COVID19-S4).

Factors of online learning

Amount of workload. As students’ progress to this school year, many

complaints from students are seen on social media about their increased stress and

difficulty due to perceived excessive workload in some of their online courses. As

students are learning, the context is entirely different from traditional in-person learning.

For most students, online learning is at least a little new, and the courses are probably a

little more challenging; however, learning is still important even during this time.

Although different courses have different time demands when joined together and

overlaps it is impossible to cope.

In the results of the study of Arif et al. (2016), online learning environments

increased the faculty and student workload. Online learning is an instrumental method

that allows students to learn at their own pace. While there is no significant improvement

in students' performance, they felt that online learning could fit their schedules better.

Students’ motivation and concentration. Motivation is the engine of learning.

Motivation can influence what, how, and when students choose to learn. Motivated

learners are more likely to undertake challenging activities, be actively engaged, adopt

an in-depth learning approach, and exhibit enhanced performance (Hartnett, 2016).

Motivation consists of the “factors and processes that initiate and direct the

magnitude, persistence, and quality of goal-directed behaviors” (Dweck & Legget, 1988).

Academic motivation cannot be defined as a single definition for there are four broad

theories about it. First is the “drive” theory, which defines motivation as a drive to
20

achieve success (Ashton & Paunomen, 2001). It generally talks about success and

focuses on aspirations and its affective nature rather than goals like getting good grades

or graduating with honors. Second would be “goal theory”, which defines motivation as

an effort of the student to achieve a particular goal. It focuses more on the external goals

of the students. The third is the “expectancy” theory, where motivation comes from the

student’s belief that they perform well on an academic task, such as when they perform

well in the past performance (Eccles & Wigfield, 2002). Lastly, the “self-worth” theory of

motivation, wherein students with positive self-confidence in their academic work will be

more motivated to learn more (Covington, n.d.). Students’ motivation has positive

desired outcomes in academic achievements such as academic engagement, more

tremendous success coping with stress, better study skills, adoption of self-regulated

learning strategies, and persistence (Trevisani, 2015).

According to Duncan et al. (2013), students’ motivation increases in a class when

they have an opportunity to interact with peers, as well as the instructor, and gain

exposure to other perspectives. Student motivation increases when learners can

construct relative knowledge and demonstrate learning. Thus, student motivations

towards online learning are enhanced with clear organization, communication,

interaction and instructor presence.

Concentration is relative and can be improved and strengthened by changing

some of the existing factors and students’ active participation due to positive interaction

with professors and motivation, leading to more concentration and better learning

(Rahiminia & Rahiminia, 2017). Most students blame outside distractions for their

problems on their concentration.

In the results of the study of Rahiminia and Rahiminia (2017), in responds of

female participants, the ‘sufficient knowledge and information of the professors about the

subject’ had the most important role in the domain of factors related to professors that
21

influence concentration, professor’s sufficient mastery of the subject mandates

continuous studying. On the other hand, ‘drowsiness’ is the most important role in

students’ related domains. It is common for medical students to suffer from insomnia or

delay in falling asleep, which leads to poor quality sleep, and this can disrupt their

concentration as well their ability to think in the class (Firouznia et al. 2009). Meanwhile,

in the responds of male participants, the ‘professor’s skill in creating motivation’ had the

most important role in professors related domains. They also cited that motivation is one

of the essential factors of learning; therefore, professors can motivate students to have

more learning and better concentration. Both male and female participants agreed that

‘noise pollution’ is the most important environmental domain factor. By decreasing

environmental distractors, it is possible to increase concentration alongside other

factors. With the result of their study, they found out that students sitting in the front row

have more increased concentration than those sitting in the back row, and it is reported

that there is higher concentration during 8-10 in the morning.

Teachers’ competency. In both face-to-face and online learning, much study

has centered on productive teaching methods. Bigatel et al. (2012) agreed to investigate

the topic of quality of undergraduate education, administrators, researchers, and

students. They have seven principles of effective teaching were derived and then

implemented, which served as an evaluative structure for improving the consistency of

the experience of face-to-face learning. The principles include encouraging contact

between students and faculty, developing reciprocity and cooperation among students,

encouraging active learning, giving prompt feedback, emphasizing time on task,

communicating high expectations, and respecting diverse talents and ways of learning.

These extended the seven concepts to the online learning world to varying

degrees. Four online courses were analyzed by Cagitay et al. (2000) using the seven

principles as their guidelines for assessing teaching and learning in the online world. The
22

researchers developed a list of lessons learned, based on their observations and

informed by student input, which corresponded to each principle. The outcome was a set

of basic guidelines linked to each principle, which is much more useful for faculty who

want to boost their teaching effectiveness and need more precise methods to

incorporate easily.

Deihl et al. (2009) noted that, while "the design of an online course reflects the

design of a face-to-face course in many ways, the fundamental practices for teaching

and facilitating interaction with learners are quite different. In their opinion, there are

three important variations. The following conditions must exist in order for an online

course to be successful: faculty must be socially present in the learning environment,

students must form a learning community, and students must be actively engaged in

learning activities.

Through the use of technology, the seven principles can be leveraged. Bigatel et

al. (2012) have written how face-to-face world to the online environment concepts can

be translated. Therefore, if the use of these seven principles in the conventional higher

education system has increased the standard of learning education classroom, their

adaptation to the online world needs to be integrated.

Bigatel et al. (2012) also add that in order to deliver quality online instruction, the

faculties need to be adequately trained to teach online effectively. Because online

enrollments in higher education have grown at a rate that far exceeds the growth rate for

the overall higher education student population, professional development efforts need

to be in place that will serve a growing population of online faculty.

Methods and media used. In the context of online education, the identified two

methods of communication are synchronous and asynchronous. Synchronous

communication requires participants to interact at the same time (Bates & Poole, 2003).

Examples are a live one-way broadcast of a lecture and live two-way interaction among
23

several students and instructors. Asynchronous communication does not require the

interacting participants to be present simultaneously, in which discussion forums and

emails can be used. In a meta-analysis of Lai et al. (2005), they examined the effects of

type of communication in distance courses. They found that courses incorporating both

synchronous and asynchronous communication means were more effective than

courses featuring only one type.

Blau and Capsi (2011) concluded that media choice is not necessarily dictated by

the level of media richness in distance education. Their research defined the technical

capabilities and social power of individuals as important factors influencing media

preferences. Similarly, Brunelle (2009) introduced new dimensions to the theory of

media richness and revealed that students’ media tastes differ based on gender,

technology comfort level, and the person they are engaging with. The media tastes of

the faculty of online learning are different from those of students. The faculty favored

two-way live lectures on TV, while students preferred two-way live video and internet-

based video and audio lectures. Nowadays, in distance education, online videos are

becoming increasingly popular, and some faculty members even record their lectures

and upload them to course websites.

Collins et al. (2013) found that online students tend to use technology for

interaction with learner content rather than for interaction between learner and teacher,

and that both faculty and students viewed online discussion platforms as the least

significant media. These results are consistent with an earlier study showing that in the

sense of distance learning, prior technology experience affects media choice. It indicates

that since distance learners are more likely to use technology to complete their

coursework relative to other students, previous distance learning experience may also

affect the media preferences of students. Finally, one would predict that their course

satisfaction would increase if online students use their preferred media.

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Furthermore, Cole (2016) reported that online students favor face-to-face

communication. Satisfaction with the course is independent of their face-to-face contact

preferences. These studies support Capsi and Gorsky (2005) argument that students

may not always favor rich media over lean media in the online learning context.

Dr. Edmund Centeno shared at least ten learning applications and sites for an

online class (Manila Bulletin, 2020). These include Google Classroom, wherein it helps

classes connect remotely, communicate, and organize the classes neatly. This

application can easily share files, announcements, and upcoming assignments.

Edmodo is a learning management system that serves as a social learning

network. It promotes an engaging environment for students and teachers. It has time

recitation questions, and teachers can see the students' progress. It also offers a variety

of languages (UNESCO, 2020).

A modular object-oriented dynamic learning environment or MOODLE helps the

different parties collaborate. It is a free online LMS that enables a community-driven and

globally-supported open learning platform. Similar to Edmodo, teachers can add

assignments, quizzes, and collaborative discussions.

Zoom and Google meet is a cloud platform for video and audio conferencing,

collaboration, and webinars.

Moreover, Mercado and Pagtaconan et al. (2014) innovate MMSU virtual

learning environment (mVLE) as one of the university's modes of delivery of instructions

in the pedagogic model shift learning. The use facilitates blended learning and distance

learning, improves content sharing within a course among faculty, and provides

convenient support for students.

Mental health

Definition of mental health

25

Motivation can influence what we learn, how we learn and when we choose to

learn (Schunk & Usher, 2012). Research shows that motivated learners are more likely

to undertake challenging activities, be actively engaged, enjoy and adopt a deep

approach to learning and exhibit enhanced performance, persistence and creativity.

Motivation can influence what we learn, how we learn and when we choose to learn

(Schunk & Usher, 2012). Research shows that motivated learners are more likely to

undertake challenging activities, be actively engaged, enjoy and adopt a deep approach

to learning and exhibit enhanced performance, persistence and creativity. Motivation

can influence what we learn, how we learn and when we choose to learn (Schunk &

Usher, 2012). Research shows that motivated learners are more likely to undertake

challenging activities, be actively engaged, enjoy and adopt a deep approach to learning

and exhibit enhanced performance, persistence and creativity. Mental health can be

defined as the absence of mental disease. It can be defined as a state of being that

includes the biological, psychological, or social factors that contribute to an individual's

mental state and ability to function within the environment (Barbic et al., 2015).

Similarly, in the study of Beezhold et al. (2017), the WHO organized the definition

of mental health around a hedonic and happiness perspective, in which a key role is

assigned to a person's well-being and productivity. While regarding well-being as a

desirable goal for many people, its inclusion in the definition of mental health raises

concerns. Well-being includes emotional, psychological, and social well-being and

involves positive feelings, positive attitudes towards their responsibilities and others, and

positive functioning.

On the other hand, Beezhold et al. (2017) propose a new definition of mental

health: "Mental health is a dynamic state of internal equilibrium that enables individuals

to use their abilities in harmony with universal values of society." Necessary cognitive

and social skills; ability to recognize, express, and modulate one's own emotions, as well
26

as empathize with others; flexibility and ability to cope with adverse life events and

function in social roles; and harmonious relationship between body and mind represent

essential components of mental health which contribute, to varying degrees, to the state

of internal equilibrium. Additionally, mental health's core components include realizing

one's potential, the ability to cope with everyday life stresses, and community

contributions. Other definitions extend beyond this to include intellectual, emotional, and

spiritual development, positive self-perception, and feelings of self-worth and physical

health, and intrapersonal harmony (Barbic et al., 2015).

Categories of mental health

According to the World Health Organization (2020), mental health is "a state of

well-being in which every individual realizes their potential, can cope with the normal

stresses of life, can work productively and fruitfully, and can contribute to her or his

community."

Social well-being. Darvishpour and Javadi-Pashaki (2018) discuss that social

well-being is the ability to perform social roles effectively and efficiently, monitor and

evaluate how they operate in the community, and the quality of relationships with people,

relatives, and social groups. The social health indicators include the following. Social

contribution is the feeling that one's life is useful to society, and others value the output

of one's activities. Social integration is the sense of belonging to a community, from

which one derives comfort and support. Social acceptance is a positive attitude toward

others while acknowledging and accepting people's differences. Social actualization is

the belief in people, groups, and societies' potential to evolve or grow positively. Lastly,

Social coherence is the interest in society or social life, feeling that society and culture

are intelligible, somewhat logical, predictable, and meaningful (Darvishpour & Javadi-

Pashaki, 2018). Similarly, Keyes (2007) also discusses that social well-being epitomizes

the more public and societal criteria whereby people evaluate their functioning in life.
27

Hedonia: Emotional Well-Being. Keyes (2007) reflected that emotional well-

being is the presence and absence of positive feelings about life operationalized as

evaluations of happiness and satisfaction with life and the balance of favorable to

negative affect experiences over some time. It can be conceptualized as the balance of

feelings (positive and negative) experienced in life and the perceived feelings (happiness

and satisfaction).

Psychological Well-Being. Subjective well-being is more than the presence and

absence of affective states. It also includes the perceived presence and absence of

positive functioning in life. The study focuses on this aspect of mental health, for it

encompasses self-acceptance, positive relations with others, personal growth, purpose

in life, environmental mastery, and autonomy that are important for the students as

future health care professional.

Keyes (2007) discusses the different dimension related to psychological well-

being which include the self-acceptance, personal growth, purpose in life, environmental

mastery, autonomy, and positive relation with others. Self-acceptance possesses

positive attitude toward the self, acknowledge and accept multiple aspects of self, and

feel positive about past life. Personal growth refers in having feelings of continued

development and potential and open to new experiences. The purpose of life refers to an

individual with goals, a sense of direction in life and hold beliefs that give purpose to life.

Feeling competent and able to manage a complex environment is associated with

environmental mastery. The autonomy simply refers to being self-determining,

independent, and regulate internally; resist social pressures to think and act in certain

ways; and can evaluate self by personal standards. Lastly, having warm, satisfying,

trusting relationships, and concerned about others’ welfare is having positive relations

with others.

Importance of mental health in education

28

Mental health plays an essential role in education. As supported by Barile (n.d.)

of Western Governor University, mental health awareness is a relevant issue for all

educators, who are often the first line of defense for their students. Education

professionals have acknowledged the impact that a student's mental health has on

learning and achievement, and they understand that there are multiple steps that should

be taken to help students with mental health issues. She stated vital elements, including

the concept of self-care and responsibility for their mental health and wellness,

highlighting the fact that mental health is an integral part of health, and the concept of

recovery from mental illness. Teachers and students should be provided with methods in

recognizing signs of developing mental health problems. There should be opportunities

around the awareness and management of mental health crisis involving the risk of

suicide or self-harm.

Some have mentioned that the school curriculum can be a way of spreading

mental awareness in schools. Health education is already a part of the school curriculum

for most students. Programs centering on things like physical fitness and good nutrition

begin as early as kindergarten. It is important to recognize that mental health and

physical health are not separated. They go hand-in-hand and have severe impacts on

each other. A person struggling with mental health issues may begin to neglect their

physical health-damaging bodies, leading to illnesses (Paradigm Treatment, 2019). The

Victoria State Government (n.d.) emphasized their assistance in teaching the mental

health, well-being, and resilience of all students in schools through the learning areas of

health and physical education, and the personal and social capability. It focuses on

students enhancing their own and others' health, safety, well-being, and physical activity

participation in varied and changing contexts. The curriculum supports students to

develop the understanding and skills they require to make healthy and safe choices that

will enhance their own and others' health and well-being.

29

For some selected universities in Manila, Philippines, Cleofas (2020) suggests

that school administrators, especially university student affairs officers, should

encourage more students to be involved in more co-curricular activities and extra-

curricular activities to improve the mental health and quality of life of these late

adolescents. Meeting the student organizations’ structure and goals, and

conceptualizing exciting activities must be considered to entice students to join. Also,

maintaining meaningful peer interactions among students and their connections with

other university entities must be guaranteed. Finally, the effects of these activities and

interactions on the students’ mental health and quality of life must be a component of the

evaluation of co-curricular and extracurricular programs.

The breakage of stigma and misconceptions about mental illness has to begin in

schools. School is where friendships start. It is a place teen hone their sense of self-

worth. Children need to learn that their behavior towards others can cause serious self-

worth issues (McLean, 2019). Similarly, Paradigm Treatment (2019) points to the direct

relationship between mental illness awareness and knowledge of the mental illness.

With more knowledge, there is less stigma. It implies that students who have suspected

themselves of having mental illnesses may feel more comfortable reaching out for help.

In connection with the COVID-19 Pandemic and implementation of online

learning, Barr (2014) concludes that the incidence of mental health problems in higher

education students corresponds to the incidence in the general population. The stress of

college coursework can lead to students’ emotional distress whether they are in

traditional classrooms or distance education classes.

At Mariano Marcos State University, psychological intervention is available

through electronic and online platforms. College guidance counselors continuously reach

out to their respective students and seek to know their current state and needs, enabling

them to address their concerns immediately (Toribio, 2020).

30

The highlighted positive dimension of mental health in the World Health

Organization (WHO) official definition of health: “Health is a state of complete physical,

mental and social well-being and not merely the absence of disease or infirmity.”

Concerning this, they define mental health as an integral part of health, more than the

absence of mental illness, and intimately connected with physical health and behavior.

This is synonymously suggested by Ryff and Singer (1998); health is not a medical

concept related to the absence of illness, but rather a philosophy explaining good life

with a sense of purpose, quality relationships with others, self-respect, and mastery.

According to WHO Investing Mental Health Manual in 2003, mental health

concepts include subjective well-being, perceived self-efficacy, autonomy, competence,

intergenerational dependence, and recognition of the ability to realize one’s intellectual

and emotional potential. Individuals recognize their ability to cope with the everyday

stresses of life to work productively and fruitfully and contribute to their communities.

Mental health enhances the competencies of individuals and communities and enables

them to achieve their self-determined goals.

On the other hand, in Friedli's (2009) report, resilience, health assets,

capabilities, and positive adaptation are fundamental elements of mental health that

allow people to cope with adversity in reaching potential and humanity. Mental health

has the importance of understanding the impact of inequalities and other outcomes.

The U.S. Department of Health & Human Services (n.d.) points out mental health

as significant from childhood and adolescence through adulthood, which includes

emotional, psychological, and social well-being. It is a determinant of how to handle

stress, relate to others, and make choices.

Factors affecting mental health in education

According to Eisenberg et al. (2009). mental health may affect college students'

academic outcomes along two margins; first, the decision to remain in school and
31

second, productivity, performance, and given tasks. They also mentioned that several

depressive symptoms might affect academic activities' productivity, such as reduced

interest, sleep disturbance, slow movements, and suicidal thoughts, which may

decrease interest in the future.

Besides, the marked anxiety disorder as having excessive worrying and difficulty

controlling it affects one's performance. They mentioned that at lower levels, anxiety

could be productive. However, with a higher level, they often become distracted and

unable to do tasks. Moreover, the two main types of eating disorders are anorexia

nervosa and bulimia nervosa. People are debilitated when suffering from anorexia

nervosa by physical symptoms such as fatigue, cardiac problems, and electrolyte

disturbances (Eisenberg et al., 2009).

Readiness to clinical practice

Psychomotor skills are essential in many healthcare professions. In the past,

these skills have been taught, reinforced, and evaluated to the new generation of health

care workers through in-class labs and simulations with a face-to-face instructor. With

emerging technology, online learning and other forms of computer-assisted learning

have become a critical part of education and have been implemented for healthcare

professions (Brown et al., 2018).

The clinical placement has always been an important component of the health

sciences curriculum. The health sciences curriculum prepares the students to carry out

clinical skills competently and confidently in clinical settings (Abdullah et al., 2011).

The study of Brown et al. (2018) was to determine whether an e-learning module

would improve health sciences students’ confidence, academic competence, and

psychomotor skills when provided in addition to traditional in-class training. The results

suggest no significant difference in confidence levels for students in the control and
32

study groups pre- or postintervention. The study observed an increase in confidence for

both groups by the end of the intervention. It also suggests that e-learning or other forms

of computer-assisted learning can improve academic competence when used in

conjunction with traditional techniques. Unexpectedly, the study found that students who

had access to the e-module did not improve their psychomotor skills more than students

who only received in-class training. This finding may suggest that psychomotor skills are

difficult to transfer through e-learning; however, this needs further validation, and e-

learning should not be dismissed as a possible means of transferring psychomotor skills

(Brown et al., 2018).

Readiness to clinical practice of physical therapy students

Clinical practice helps students use their classroom-taught knowledge and skills

in real life situations, giving them opportunities to learn the behaviors and attitudes to

succeed in the profession and become socially responsible. Practice within the clinical

arena is essential to all health professionals' undergraduate training and is recognized

as the best means to immerse students into the physical therapy profession (Talberg &

Scott, 2014).

The process of how the classroom taught knowledge will be applied to clinical

placement is one of the authors' concerns in the study, especially that there is a

difference between how a clinical educator works and the theoretical, hence the

difference between clinicians' and academics' expectations. This can result in a

discrepancy between the taught curriculum and the need for clinical placement, which

affects students' preparedness for competent clinical practice. Thus, some students

have a hard time shifting from classroom to clinical setting and using their skills in

inpatient management.
33

A recommendation from the Clinical Education Summit ( 2014) states that there

is a need for consistent student preparation for varying levels of clinical experiences,

described as "a requisite core set of knowledge, skills, attitudes and professional

behaviors" and "clinical core performance competencies" for each level of clinical

experience. Likewise, Talberg & Scott (2014) cited that there should be balanced core

skills and knowledge on basic sciences and generic skills such as communication,

interpersonal skills, awareness of one's attitudes, a continued commitment to

independent learning, the ability to adapt and change, and clinical reasoning in order to

achieve success in clinical practice.

According to clinical education literature, students often struggle to transition

from the classroom to the clinical field. On the contrary, Talberg and Scott's study

shows that the third year physical therapy students at UCT felt they are adequately

prepared in all aspects of clinical competencies on their clinical practice.

On the other hand, the results of a study by Timmerberg et al. (2018) shows that

most students have a shared sense of preparedness on their first clinical block; but in

terms of preparedness on specific competencies in knowledge, intervention and generic

skills, they reported an adequate level of preparedness. This may indicate that even if

students were anxious about starting their clinical practice independently, they felt the

support of their clinical educators in ensuring their safe learning environment that helps

to apply their knowledge and improve their confidence in their abilities.

Both of the studies show that the students' sense of readiness for clinical practice

is due to the improved alignment of the taught curriculum, clinical expectations, and

needs of the clinic they were assigned. They suggest that the basic sciences, technical

and generic skills and applications of ideas taught during their preclinical year are

aligned to the needs of the population seen to their assigned clinics.

Readiness to clinical practice of pharmacy students

34

According to Foppe Van Mil and Schulz (2006), the pharmacy profession has

experienced significant growth and development over the past decades – from

compounding to dispensing and then finally towards clinical pharmacy and

pharmaceutical care. As defined by Hepler and Strand in 1990, pharmaceutical care is

“the responsible provision of drug therapy for the purpose of achieving definite outcomes

that improve a patient’s quality of life” (Foppe Van Mil & Schulz, (2006). The

pharmacist’s role has evolved towards more patient-centered care and counselling,

expanded drug use monitoring, appropriate drug selection, and responsibility for the

patient’s outcomes to accommodate this shift in practice.

The study of Binos et al. (2011) about the perceptions of pharmacy students in

Metro Manila towards their preparedness to provide pharmaceutical care aimed to

explore the effects of demographic variables and pharmacy-related attributes on their

perceived preparedness. The result shows that the students generally felt positive and

confident towards their pharmacy-related attributes. However, some students were least

positive towards their experience in pharmaceutical practice settings. In addition, the

lack of integration of pharmaceutical care activities into actual pharmacy practice may

cause the students to feel less confident and dissatisfied of their internship experiences.

As pharmacists are increasingly called upon, they are significance to solve

problems, implement ethical choices based on their knowledge of socio-cultural

concerns, and during contact with patients and other members of the health care team,

they apply suitable interpersonal behaviors. In the study of Friesner et al. (2010),

students have considered themselves to be the most prepared in this specific field,

suggesting that current pharmacy education can be oriented towards this field of

practice. The result also shows that the perceived competencies of students (i.e.,

communication, psychological, technological, administrative) were comparable to those

35

of other organizations, and competency perceptions improved in a manner consistent

with the actual results of the program.

Readiness to clinical practice of nursing students

The role of clinical practice in nursing has long been the focus of research.

Undergraduate education and clinical placement experience aim to prepare nursing

student nurses with competence and confidence for independent practice upon

professional nurse registration—however, recent studies, as cited by Boulton et al.

(2018), show that the new graduate nurses lack skills in key clinical areas and there is a

lack of confidence in interprofessional collaboration. Before clinical exposure, theory

components of undergraduate degrees address the need for understanding systematic

health assessments. Practical patient simulations offer the unique and necessary

opportunity for undergraduates to practice these skills with no risk to live patients.

According to Durham and Alden (2008), the practical simulations should include

demonstrations by educators, and student role-plays, patient actors, use of anatomic

models, and, more recently, digital technology and high fidelity human manikins. In a

clinically supported environment, student nurses are required to apply acquired

assessment and procedural skills during clinical learning in their degrees across acute

and subacute, primary care and mental health settings.

In the study of Campbell et al. (2011), the students are very confident in their

communication skills with patients and families and ask for help from others. The most

significant confidence needs seemed to center on the management of care: delegation

of tasks, handling multiple patient assignments, calling the physician, responding to a

change in patient condition, and treating a dying patient. Students need opportunities to

practice their conflict management skills, assign tasks, defend decisions, and

assertiveness in handling verbally abusive situations.

Categories in learning skills for clinical practice

36

Universities provide lecture and laboratory sessions to introductory and major

health allied courses to determine a particular topic's understanding level. The used

lecture sessions to teach students the theories they need to know about the subject,

while the laboratory sessions are used to enhance skills and know when to incorporate

the theories learned into the patient's cases.

In the study of Finn et al. (2017), they argue that there is improved performance

and positive student and instructor's reaction in integrating lecture and laboratory

experiences in their classes. They also stated that offering hands-on work and

interaction with the instructors is one factor to consider to improve the college

experience.

Critical thinking skills are essential in the health sciences courses. The critical

base learning approach is more effective than the traditional lecture-based program in

developing students' critical thinking. According to Kaddoura (2011), critical thinking

develops through reflection, both from experience and knowledge. His study showed

that undergraduate students who finish the clinical base learning have higher critical

thinking scores than those who take lecture-based programs.

Lecture. The used lecture captures compare to traditional face to face lecture

delivery in the study of Euzent et al. (2011), which allows storing videos of the course

lectures on the college's computer server and will be available to students via their

websites. The students can view this in their free time and as often as they need. There

is no significant difference in the student's performance between the two lecture delivery

methods in their study. The flexibility and convenience of lecture capture compared to

face-to-face delivery caused positive results in the students. Their respondents said that

they better control their learning with this lecture delivery, resulting in more enhanced

performance than the face-to-face course despite having the same instructional

methods, assignments, exams, and instructors.

37

Laboratory. Euzent et al. (2011) find that laboratory performance influences the

student's internship performance in the physical therapy program. Physical Therapists

must practice with professional competence in the clinical domain, independent

decision-making, and engage in interprofessional collaboration since they are working

with multifaceted healthcare systems. The authors also stated that the student's

laboratory performance serves as an actual view of the students' competency in order

for them to demonstrate a particular application of what they have learned in theory.

In the study of Goulding et al. (2017), there are three issues raised about the

virtual laboratory in health allied students: ease of use, helpful feedback that was highly

valued claimed to be helpful in comprehension and reflection and layout of the virtual lab

was in the claim that it closely mirrored that hands-on laboratory.

Researchers also find that virtual labs enable students to become familiar with

the task before hands-on laboratory sessions resulting in improved performance and

allowing students to acquire knowledge faster. On the other hand, their study contradicts

the belief that students only prepare due to extrinsic motivational factors such as grades.

With their study, several educational implications arise, such as that virtual labs

can be a useful learning tool in studies of allied health students. Second, the virtual labs

should appropriately design before implementing, focusing on effective visualization,

learners’ control, ease of use, and feedback.

Related studies

Effects of online learning on mental health

Dwisona et al. (2020) used phenomenological qualitative research design in

conducting their study on the psychological impacts of students on online learning during

the COVID-19 pandemic. The research participants were 30 students of Mulawarman

University in Indonesia who were interviewed via telephone. Findings show that students
38

have started to get bored with online learning after the first two weeks of learning from

home, considerable anxiety on students whose parents have low income and mood

changes occur due to too many assignments being considered ineffective. The need for

strong efforts in assisting students’ psychological well-being through the involvement of

counselors and psychologists was recommended.

According to the investigation of Johnson (2015) on physical and psychological

well-being and university student satisfaction with e-Learning in Australia, one-third of

the variance in student e-learning satisfaction includes student social adjustment to

university, perception of family support, problematic use of alcohol, and obsessive-

compulsive tendencies. Fifty-eight first-year university e-students accomplished an

online survey that queried their satisfaction with various e-learning experiences and their

physical characteristics (i.e., activity level, perception of health, level of pain, sleep and

fatigue, diet and nutrition, and problematic use of alcohol) and psychological

characteristics (i.e., self-efficacy, stress, obsessive-compulsive behaviors, self-esteem,

loneliness, peer relations, social adjustment, and social support). Stepwise regression

analysis was utilized to determine which physical and psychological variables predicted

student satisfaction with e-learning.

The study of Amichai-Hamburger and Kurtz (2009) titled “Psychosocial Well-

Being and Attitudes toward E-Learning” shows that 120 Israeli students were asked to

answer a questionnaire. The research subjects were enrolled in three entirely online

academic courses similar in their instructional design approach but different in content. It

was reported that there is a correlation between high self-esteem and positive attitudes

toward e-learning in general and toward online interaction with the instructor in

particular. Furthermore, there is no relationship between loneliness and student attitudes

toward e-learning.
39

Psychological stress among Filipino medical students is prevalent due to the

pandemic. Students have difficulty in focusing on their studies. They expressed feelings

of anxiety, burnout, loneliness, homesickness, grief, and hopelessness. The students

worried about online assessments, plans in medical school, possible delays in training,

and their families’ safety from COVID-19. Overall, 86% reported experiencing some

degree of mental health difficulty. Difficulty adjusting learning styles and mental health

concerns were more common among female and non-binary respondents, those in the

first two years of medical school, and those with lower academic standing. This may

partly account for the observed differences in self-assessment of online learning

capacity (Alberto et al., 2020).

Effects of online learning on readiness to clinical practice

The study of Engelbert et al. (2020) is about preparing undergraduate students

for clinical work in a complex environment: evaluation of an e-learning module on

physiotherapy in the intensive care unit. This aims to investigate whether e-learning is a

feasible method in preparing physical therapy students for clinical work in complex ICU

environments, as perceived by students and experts. They used mixed methods for the

data collection. The result suggest that e-learning module is a feasible and valuable

teaching method to prepare international undergraduates for intensive care unit

physiotherapy (ICU-PT). The participants to this study perceived that they felt less

prepared for dealing with emergency situations, handling patients’ lines and

attachments, adapting to the variety in clinical expectations across international ICU

settings and utilizing higher-level clinical reasoning skills, such as designing tailor-made

interventions based on a patient’s clinical presentation. The study suggested that

because the e-learning did not fully succeed in removing the students anxiety when

handling complex cases, there should be a closer integration of this e-learning to

facilitate complex clinical reasoning and better clinical performance.

40

Gormley et al. (2009) assessed undergraduate medical students of School of

Medicine and Dentistry, at Queen’s University Belfast (QUB) in terms of perceived level

of IT ability and accessibility, and attitudes towards e-learning in basic clinical skills

education compared to other teaching methods. Using self-administered questionnaire,

the following were identified: a)respondents’ demographic details; b) perceived level of

IT accessibility, availability, ability, training and usage; c) experiences and attitudes

towards e-learning and clinical skill training and; d) attitudes towards e-learning

compared to other methods of clinical skills teaching. Most of students revealed their

confidence using IT through good access to computers and the internet, both on and off

campus. Also, they felt that e-learning had a positive impact on their learning of clinical

skills compared to other traditional forms of clinical skills teaching. Students who

displayed deep learning traits when using e-learning, performed better clinical skills in

objective structured clinical examination (OSCE).

Theoretical Framework

According to Anderson (2011), online learning has always been concerned with

providing access to the educational experience wherein there is more flexibility in time

and space than campus-based education. 

He considers numerous theories and works, but he focused on the work of

Bransford, Brown, and Cocking. These authors' works provided the foundational

framework for Anderson's approach to building an online education theory. He did add

one crucial element by distinguishing community/collaborative models from self-paced

instructional models—the designed self-paced instructional models are for independent

learning with much less interaction among students and teachers. 

This model would serve to guide the study by providing an approach to build a

framework on online learning by using the student and knowledge/ content interface.
41

The student part can be adapted to identify the effects of online learning on the mental

health and readiness of students to clinical practice. The knowledge/content interface

would serve as guide to explain the factors of online learning affecting the mental health

and readiness of students to clinical practice

Figure 1.

Anderson’s Online Learning Model

Note: This figure was produced by Anderson in 2011 that demonstrates the instructional

flow within the two sides and represents the beginnings of a model from the distance

education perspective (as reprinted in Picciano, 2017). 

42

Conceptual Framework 

The conceptual framework of this study was based on Anderson’s online learning

model by Anderson (2011).

Figure 2 shows the participants of the study which are the CHS students. It also

shows the main topic of this study- online learning. Moreover, it also determines the

effect of online learning based on mental health and level of confidence before the

clinical practice. The results would also then identify the challenges MMSU-CHS

students face towards online learning that need to be addressed.

Mental health
Psychological well-being
Autonomy
Purpose in life
Positive relations with others
Environmental mastery
Personal growth
Self-accpetance
 Amount of workload
Methods and media used
Teachers’ competency Readiness to clinical
43 Student motivation and practice
concentration Understanding science
Practical skills and patient
management
Holistic care
Prevention
Interpersonal skills
Confidence/ Coping skills
Collaboration
Self-directed learning

Figure 2. Research paradigm in determining the effect of online learning in the

mental health and readiness of CHS students to clinical practice.

CHAPTER III

METHODOLOGY
44

This chapter presents the research design, description of the sampling method

and locale, instruments will be used, research procedure, data analysis, and the

statistical treatment will be used.

Research Design

The research design would be quantitative. It specifically uses the descriptive

research design and correlational design. The descriptive research design would be

used to describe systematically and accurately the facts and characteristics of the

variables, to portray the characteristics of persons, situations, or groups and the

frequency with which particular phenomenon occur, and to answer questions based on

the on-going events of the present (Dulock, 1993). Descriptive studies aim to find out

"what is," so observational and survey methods are frequently used to collect descriptive

data (Borg & Gall, 1989). Descriptive designs are most useful for describing phenomena

or events about which little is known or identifying new or emerging phenomena. In

addition, the results of descriptive studies are usually used as the basis for further

research (Dulock, 1993).

It also specifically uses the correlational research design to simply measure the

relationship of the variables. Correlational research is concerned with establishing

relationships between two or more variables in the same population (Leedy and Ormrod

2010). In correlational studies, researchers gather quantitative data about two or more

characteristics for a particular group of people or other appropriate units of study (Leedy

and Ormrod 2010).

Using these designs will describe and correlate the new learning method, which

is online learning, and it will describe how online learning affects mental health and

readiness of students to the clinical practice.

Locale of the Study

45

The research investigation will be conducted at the MMSU-CHS located at #16

Quiling Sur, City of Batac, Ilocos Norte. MMSU-CHS offers degree programs, including

BSN, BSPh, and BSPT. These particular programs have been chosen to include in the

investigation because these are vital and closely connected to the on-going pandemic.

Health sciences students have been traditionally required to attend and practice in real-

life situations to gain practical and clinical experience (Donnan et al., 2007). According to

Jones and Regmi (2020), online learning has been well recognized as mainstreaming in

health sciences education (HSE) – physical therapy, pharmacy, public health, nursing,

and other allied healthcare education – but the role of online learning and its effect on

learners’ performance or enhancing their learning has been well debated. Due to these,

it raises concerns over whether online learning in medical education or health sciences

education would enhance learning, particularly “the extent to which knowledge-based

learning compared with alternative approaches to health education” (Jones & Regmi,

2020). MMSU will be the focused institution because of quarantine restrictions. There

will be encountered conflicts if other institutions will be included due to differences in

curriculum designs. However, this study's overall results can be a baseline for other

institutions to conduct research applicable to their system.

Population and Sampling Procedures

To know the respondents’ adequate number for the study, the researchers will

gather the total number of students of the three-degree programs of the MMSU-CHS,

namely: BSN, BSPh, and BSPT. The BSPT program has 62 level II students and 54

level III students. The BSN program has 164 level II students and 197 level III students.

The BSPh program has 81 level II students and 66 level III students. The researchers

will solve for the sample size using the Slovin’s formula to take into account the

confidence levels and margins of error. Given that the MMSU-CHS Level II and III have
46

a total of 624 students, 238 would be the sample size formulated with the Slovin’s

formula. Then, the respondents will be chosen using a stratified random sampling

method.

Inclusion Criteria. The respondents should be a full-time students of MMSU-

CHS enrolled as Level II and Level III students for Academic Year 2020-2021 attending

to an online mode of learning. Full-time students are registered for formal academic

credits and carry the full load for a given semester under the curriculum in which they

are enrolled (Mariano Marcos State University, n.d.). They must attend the last

Academic Year of 2019-2020 with the face-to-face type of learning, which will be

compared to the online learning mode in terms of their psychological well-being and

levels of confidence. The research participants should have enrolled in courses with both

lecture and laboratory parts in the previous and on-going academic year. Lecture and

laboratory courses are part of health sciences programs requiring students for minimum

competencies in knowledge, internship, related learning experience, research, and

regulatory practice areas (CHED, 2017). The students must be on-going with online

learning or blended learning methods to deliver the programs’ learning content under

evaluation.

Exclusion criteria. Student participants are excluded if they are transferees,

shiftees and deloaded Transferees are students from another institution and qualified for

admission to the university. Shiftees are from another curriculum in the same or another

college. Deloaded students refer to those registered for proper credits but carry less than

the full load for a given semester under the curriculum in which they enrolled due to

academic delinquencies (MMSU, n.d.).

Ethical Consideration
47

The study’s ethics approval will be issued by the Research Ethics Review Board

of the Mariano Marcos State University. This is to assure the protection, dignity, and

rights of the respondents. Upon approval, informed consent documents (ICD) will be

secured to ask the respondents to participate in the study.

The respondents’ participation in the study is voluntary. It is up to the

respondents to decide whether or not to take part in this study. After the respondents

sign the consent form, they are still free to withdraw at any time and without giving a

reason. Withdrawing from this study will not affect the relationship they have, if any, with

the researcher. If the respondents withdraw from the study before data collection is

completed, their data will be returned or destroyed. Since the study is not focused on

actively participating in terms of physical, the researchers will ensure to the respondents

that there will be no injury or related illness that would be incurred.

The researchers will approach the students via an online link to the surveys and

in friendly environments. Respondents will be provided with a brief description of the

study procedures. The response to the online survey will imply consent for participation

in the study's feedback component. The respondents will be given 3-4 days to complete

answering the survey questionnaires. However, consideration will be given to those who

need extra time. Since this is an online survey, the researchers will abide by the RA

10173 or Data Privacy Act of 2012. It is the State of the Philippines’ policy to protect the

fundamental human right of privacy, of communication while ensuring free flow of

information to promote innovation and growth. It recognizes the vital role of information

and communications technology in nation-building and its inherent obligation to ensure

that personal information in information and communications systems in the government

and the private sector are secured and protected (National Privacy Commission, 2012).

The respondents’ responses to the survey will be anonymous. Participant data will be

kept confidential except when the researcher is legally obligated to report specific
48

incidents. The survey answers will be stored in a password protected electronic format

and will use the Google Drive folder that only the researchers will have access to. The

researchers will not collect identifying information such as your name, email address, or

IP address. Therefore, the responses will remain anonymous. No one will identify the

respondents and their answers, and no one will know whether or not the respondents

participated in the study.

The study’s possible risks are minimal such as internet connection problem,

power interruption, and technical problems. The respondents may also feel a little

uncomfortable/embarrassed answering personal or sensitive survey questions. With this,

an extension will be given to the respondents.

The possible benefit the respondents may experience from the study described

in this research includes knowing the effects of online learning, which is the respondents’

learning mode, on their mental health and their confidence before clinical practice. This

research may also guide the university to gain further understanding of implementing

this online learning. After the study, no monetary incentives will be given to the

respondents. The respondents will be provided with the researchers’ and researchers

adviser’s contact number in case of an emergency regarding the study.

Research Instruments/ Outcome Measures

The questionnaire will be designed based on the information taken from earlier

studies and edited to suit the objectives. The structured survey questionnaire will be

administered online with the use of Google™ Form. The final version of the

questionnaire will contain questions divided into two main parts. The first part is about

the demographic features of the participants.

Part two will be designed to assess psychological wellbeing. In assessing the

mental health of the students, particularly in psychological well-being, the researchers

49

will be adapting and modifying the Ryff’s Psychological Well-Being Scale contextualized

to online learning. The Ryff’s Scales of Psychological Well-Being Scale composed of 42

items using a 7-point scale (1 = strongly agree; 7 = strongly disagree). The modified

questionnaire for this part will be composed of 12 items to suit the specific variables of

online learning and to suit the objective of this study.

Psychometric properties per se, all dimensions have high internal consistency

and test-retest reliability scores. In internal consistency, self-acceptance has a .93 score;

positive relations with others has a .91 score; autonomy has a .86 score; environmental

mastery and purpose in life have a .90 score, and personal growth has a .87 score.

Meanwhile, in test and pre-test reliability, self-acceptance has a .85 score; positive

relations with others has a .83 score; autonomy has a .88 score; environmental mastery

has .81; purpose in life has a .82 score, and personal growth has a .81 score. Over-all,

Ryff Scales of Psychological Well-Being is a valid and reliable measure of psychological

well-being. It can assist colleges and universities in understanding the degree to which

their students are self-accepting, are pursuing meaningful goals with a sense of purpose

in life, have established quality ties with others, are autonomous in thought and action,

can manage complex environments to suit personal needs and values, and continue to

grow and develop (Seifert, 2005).

Part three will include a survey that assessed the subjective feelings of the

students regarding their readiness to clinical practice. This survey was originally

designed and validated by Hill et al.(1998). Questions are arranged in 8 domains of

educational goals that include 1) understanding science, 2) practical skills and patient

management, 3) holistic care, 4) prevention, 5) interpersonal skills, 6) confidence and

coping skills, 7) collaboration, and 8) self-directed learning.

Online questionnaires will be distributed among the health sciences students

through emails to collect the required information. The study will be using a
50

questionnaire with Five Point Likert Scale to collect the information. The Five-Point Likert

Scale is a well-known and highly accepted scale that can assess the qualitative

magnitude of targeted outcomes. The collected information will be kept entirely

confidential.

Content and Face Validity of the instrument will be established through several

activities:

1. Extensive literature review will be done in students’ psychological well-being

and level of confidence before the clinical practice related to online learning.

2. Face validity will be established through independent expert opinion. The

questionnaire will be distributed to clinical and educational experts in the

field of nursing, pharmacy, and physical therapy. They will judge the

questionnaire using a checklist that contains items on clarity, relevance,

simplicity, breadth, appropriateness, length, and completion time.

3. Content validity will also be established by distributing the questionnaire

survey to 10 students. They will also judge it concerning clarity, relevance,

simplicity, breadth, appropriateness, length, and completion time.

Minor revisions will be made to the questionnaire based on the comments will be

received from the experts and students.

Data Gathering Process

The investigation will be conducted in MMSU-CHS during February-June 2020.

The data gathering procedure will follow systematic steps to secure relevant information

for the research study. First, the informed consent documents and documents for ethical

review will be reviewed by the University Research Ethics Review Board (URERB)

before distributing the research questionnaires. The researchers will forward a request

letter to the CHS dean, and CHS Department Chairs upon approval. Pilot testing will be
51

done first before the actual data collection. Pilot testing of the questionnaire will be

conducted first among fifteen (15) randomly selected health sciences students from the

MMSU-CHS and an expert for the topic of mental health in which they will be given a

informed consent via online to take part of the pilot testing, and after their approval to be

part of the study, they will answer and allowing them to give their feedbacks about how

the questionnaire is constructed. After the pilot testing, researchers will then evaluate the

feasibility and improve the content of the instrument based on the feedback on the pilot

testing.

After this, an informed consent will be given to the selected respondents and give

them approximately three days to decide if they want to be part of the study. Upon

accepting the ICD, the questionnaires will be sent for the respondents to answer, and

they will be given enough time to answer them via Google forms for an easy access and

due to the limit of face-to-face brought by the pandemic. It will require approximately 15-

20 minutes to complete. An explanation will be given in case items need clarification.

The respondents will be given a maximum of two days in answering the questionnaire to

avoid distraction to the respondents academic life. Lastly, the gathered data will be

carefully analyzed.

The researchers will secure all the data information in a folder document

restricting people to open it and copy it into a flash drive, after which the researchers will

now then analyze the answers, tally the scores, and perform a statistical analysis to

analyze and interpret the result of the study. The researchers will make sure that the

respondents will access the to the result of the study.

All of the information and data files collected from the respondents will be

completely discarded and removed from the folder files on the computers and the flash

drive storage after approximately two (2) years after the completion of the study in order
52

to preserve the identity of the respondents. The flow for the systematic steps of the data

gathering procedures is shown in Figure 3.

53

Forward request letters to the University Ethics Review Board, CHS Dean,

and each Department Chair of CHS

Approval of URERB, CHS Dean, and each Department Chair of CHS

Pilot testing of questionnaires

Identification of respondents

Distribution of informed consent forms to the respondents

Distribution of questionnaires

Respondents answer the questionnaires

Gathering of the questionnaires

Data analysis

Figure 3. Research procedure diagram

54

Statistical Analysis

A descriptive statistics (mean and frequency) using a prior confidence level of

95% will be performed to identify what the respondents’ refer to as average, including

respondents socio-demographic profile, respondents’ answer in the survey questionnaire

concerning the effect on mental health and readiness to clinical practice. For the five-

point likert scales, 5 will be the highest score while 1 will be the lowest. A measure of

dispersion such as the standard deviation will also be used. The collected data will be

analyzed using SPSS and Microsoft Excel.

Mean Level of agreement

4.20- 5.0 Strongly Agree

3.40 –
Agree
4.19

2.6 – 3.39 Neural

2.5 – 1.8 Disagree

1.7 - 1 Strongly Disagree

55

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69

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70

APPENDICES
71

APPENDIX 1

Survey Questionnaire about the Effects of Online Learning on the

Mental Health and Readiness of MMSU-CHS students to Clinical Practice

I. Socio-demographic Profile

Name (optional):

Course:

Year and Section:

II. Effects of online leaning in the mental health (psychological well-being)

Instructions: Below are the statements regarding the dimension of psychological well-

being. It questions you whether you agree or disagree in the statements about

how you have felt in the last 14 days. Check one response below to indicate how

much you agree or disagree in these each statement that relates to online

learning.

Legend:

5- Strongly Agree 4- Agree 3- Neither 2-Disagree 1- Strongly disagree

Statements about psychological well-being 5 4 3 2 1

1. My decisions in dealing with the number of tasks

are not usually influenced by what everyone else

is doing.
72

2. I often feel overwhelmed by my responsibilities

due to the amount of workload in my online

learning.

3. I think the amount of workload in my online

learning helps me to have new experiences that

challenge how I think about myself and the world.

4. When I look at my accomplishments from our

activities, I am pleased with how things have

turned out.

5. When I look at the effects of methods and media

used in my online classes, I am pleased with how

things have turned out.

6. I once experienced attending online classes

without thinking about my future at all.

7. I often not feel lonely because I have a few close

friends with whom to share my concerns on the

tasks that I find difficult to deal with.

8. The methods and media used in my online

learning make it difficult for me to voice my

suggestions and opinions.

9. With the methods and media used in my online

learning, I feel I can build a living environment

and a lifestyle for myself that is much to my liking.

10. I do not enjoy the new methods in online learning

that require me to change my old familiar ways of

73

doing things.

11. I have not experienced many warm and trusting

relationships with my teachers and classmates

using online learning methods and media.

12. The methods and media used in my online

learning often seem unimportant to me.

13. The way my teachers deliver their lessons online

guides me to become independent.

14. Through my teachers’ way of instruction in online

learning, I feel am quite good at managing my

responsibilities.

15. I have the sense that I have developed a lot as a

person over time based on my teachers’

performances.

16. With the way our teachers approach us in online

learning, I enjoy personal and mutual

conversations with them.

17. My teachers’ competencies in online learning give

me a sense of direction and purpose in life.

18. From the lessons I learn from my teachers, I feel

confident and positive about myself.

19. In online learning, I don’t worry about what other

people think of me.

20. I feel satisfied with my achievements in online

learning and makes me more motivated and

74

concentrated.

21. Maintaining close relationships with my friends

and family frustrates me and makes it difficult to

concentrate and be motivated in my online

classes.

22. The demands of online learning often let my

motivation and concentration down.

23. Online learning motivates me to learn, change,

and grow continuously.

III. Effects of online leaning on the readiness to clinical practice

Instructions: Below are the statements regarding the self-assessed readiness for

clinical practice. Assess yourself if you learned how to deal with the statements

given below with our new mode of learning, which is online learning. Check one

response below to indicate how much you agree or disagree whether you are

prepared or ready for these kinds of situations when you are placed in clinical

practice.

Legend:

5- Strongly Agree 4- Agree 3- Neither 2-Disagree 1- Strongly disagree

Description 5 4 3 2 1

Domain 1: Understanding Science

75

1. Understand the cellular basis of disease

2. Apply principles of basic science to clinical conditions

3. Justify drug uses on the basis of their mechanisms of

action

4. Select drugs on the basis on their costs, benefits, and

risks

Domain 2: Practical Skills and Patient Management

5. Record clinical data systematically

6. Carry out an efficient physical examination

7. Carry out basic practical procedures

 For nursing, vital signs assessment, head to toe

assessment, intradermal injection, intramuscular

injection, blood transfusion, and suctioning.

 For physical therapy, exercise treatment,

treatment modalities (ultrasound, electrical

stimulation, TENS, and objective examination

(range of motion, manual muscle strength,

special tests).

 For pharmacy,
76

8. Handle medical emergencies (e.g., infarction, stroke,

paralysis, epilepsy status, fractures and dislocations)

Domain 3: Holistic Care

9. Evaluate the impact of family factors on illness

10. Understand the interaction of social factors with disease

(e.g., poverty, unemployment)

11. Appreciate the importance of a patient’s cultural/ethnical

and religious background

Domain 4: Prevention

12. Take a drug and alcohol history with an initial

consultation

13. Encourage patients to improve their health status (e.g.,

unhealthy food, obesity, smoking…)

14. Provide education to patients and families about

prevention of disease

Domain 5: Interpersonal Skills

15. Feel competent to tell a patient that they have a terminal

illness
77

16. Deal with dying patient and their family

17. Feel competent to counsel a distraught patient

Domain 6: Confidence/Coping Skills

18. Cope with stress caused by my profession

19. Balance my study and personal life

20. Remain calm in difficult situations

21. Approach confidently instructors for help in interpreting

case and situations

Domain 7: Collaboration

22. Be sensitive to the needs of my profession’s staff

23. Be able to coordinate patient management plan with

other specialists and allied health professionals

24. Appreciate the importance of group dynamics when

working within a team environment

Domain 8: Self-directed Learning

25. Invest time in developing my knowledge and skills

78

26. Keep up to date with medicine

79

APPENDIX 2
LETTER TO THE RESPONDENTS

Dear Respondents,
Warmest greetings!
We are Level III Bachelor of Science in Physical Therapy students of this university
presently conducting a study titled “The Effects of Online Learning in the Mental
Health and Readiness of MMSU-CHS students for Clinical Practice” as part of the
requirement of the program.
Anent to this, may we solicit your kind indulgence and consideration by answering
every question included in the attached questionnaire to provide the necessary data for
our study. Please feel free with all honesty and sincerity in completing the questionnaire.
Rest assured that any information will be treated with the utmost confidentiality and
will be used for academic purposes only.
Your assistance and support in this particular research endeavor are much
appreciated.
Thank you very much for sharing your precious time and effort.

Very Truly Yours,

CHARIES JAMILLE GUDOY

MARIA JONALYN B.
BUGARIN

ARVIE C. OCAMPO

JULIUS CEASAR A. PARAOAN

LORIBEE-ANN E. VERGARA
Student Researchers
Noted by:

MYRA R. LAMPITOC, MSPT, PTRP

Thesis Adviser

CHERYLL DIDI NELLIE N. OBRA, PHD, MSPT, PTRP

Thesis Instructor
80

LETTER TO THE STATISTICIAN

PROF. RUWEEN NICKY GUZMAN

Instructor I
Department of Mathematics
College of Arts and Sciences

Sir:

Warmest greetings!

The undersigned are Level III Bachelor of Science in Physical Therapy students of
this university presently conducting a study titled ““The Effects of Online Learning in
the Mental Health and Readiness of MMSU-CHS students for Clinical Practice” as
part of the requirement of the program.

Along the process of our study, we will gather and analyze data through statistical
methods. This is considered crucial in correcting analyses as well as in the presentation
and interpretation of data sets.

In connection to this, we are humbly requesting your service and expertise to be our
official statistician for our thesis. We believe with your valuable knowledge and insights
will greatly enrich our work.

Thank you for your consideration. We hope you will be able to fulfill our request.

Respectfully,

CHARIES JAMILLE GUDOY

MARIA JONALYN B.
BUGARIN

ARVIE C. OCAMPO
81

JULIUS CEASAR A. PARAOAN

LORIBEE-ANN E. VERGARA
Student Researcher
Noted by:

MYRA R. LAMPITOC, MSPT, PTRP

Thesis Adviser

CHERYLL DIDI NELLIE N. OBRA, PHD, MSPT, PTRP

Thesis Instructor
LETTER TO THE DEAN
PROF. RYAN DEAN T. SUCGANG
OIC, Dean
College of Health Sciences

Sir:

Warmest greetings!

The undersigned are Level III Bachelor of Science in Physical Therapy students of
this university presently conducting a study titled ““The Effects of Online Learning in
the Mental Health and Readiness of MMSU-CHS students for Clinical Practice” as
part of the requirement of the program.

Anent to this, we would ask permission from your good office to conduct our study to
a total of two-hundred thirty-eight (238) students of your respective college. It involves
seventeen (17) Level II and seventeen (17) Level III full-time students in each section
from the Department of Nursing, Department of Pharmacy, and Department of Physical
Therapy. Attached herewith the questionnaire for this study.

The survey would last only about 3-5 minutes and would be arranged at a time
convenient to the students’ schedule. In this regard, we guarantee you that we will not
provide any form of disturbance and interruption in the class the students. Participation
in the survey is entirely voluntary. All information provided will be kept in utmost
confidentiality and would be used only for academic purposes. 

Your response to this letter is crucial in providing the necessary information in our
study to help us achieve the factual results.
82

Thank you very much for your approval and endorsement of this request.

Respectfully,

CHARIES JAMILLE GUDOY

MARIA JONALYN B.
BUGARIN

ARVIE C. OCAMPO

JULIUS CEASAR A. PARAOAN

LORIBEE-ANN E. VERGARA
Student Researchers
Noted by:

MYRA R. LAMPITOC, MSPT, PTRP

Thesis Adviser

CHERYLL DIDI NELLIE N. OBRA, PHD, MSPT, PTRP

Thesis Instructor

LETTER TO THE DEPARTMENT CHAIRS

CHERYLL DIDI NELLIE N. OBRA, PHD, MSPT, PTRP

Department Chairman
Department of Physical Therapy
College of Health Sciences

Ma’am:

Warmest greetings!

The undersigned are Level III Bachelor of Science in Physical Therapy students of
this university presently conducting a study titled ““The Effects of Online Learning in
the Mental Health and Readiness of MMSU-CHS students for Clinical Practice” as
part of the requirement of the program.

Anent to this, we would ask permission from your good office to conduct our study to
seventeen (17) Level II and seventeen (17) Level III full-time students in each section of
83

your respective department. Attached herewith the questionnaire for this study.

The survey would last only about 3-5 minutes and would be arranged at a time
convenient to the students’ schedule. In this regard, we guarantee you that we will not
provide any form of disturbance and interruption in the class of your students.
Participation in the survey is entirely voluntary. All information provided will be kept in
utmost confidentiality and would be used only for academic purposes. 

Your response to this letter is crucial in providing the necessary information in our
study to help us achieve the factual results.

Thank you very much for your approval and endorsement of this request.

Respectfully,

CHARIES JAMILLE GUDOY

MARIA JONALYN B.
BUGARIN

ARVIE C. OCAMPO

JULIUS CEASAR A. PARAOAN

LORIBEE-ANN E. VERGARA
Student Researchers
Noted by:

MYRA R. LAMPITOC, MSPT, PTRP

Thesis Adviser

ELMER SANTOS, RN., MAN., Ed. D.

Department Chairman
Department of Nursing
College of Health Sciences

Ma’am:

Warmest greetings!
84

The undersigned are Level III Bachelor of Science in Physical Therapy students of
this university presently conducting a study titled ““The Effects of Online Learning in
the Mental Health and Readiness of MMSU-CHS students for Clinical Practice” as
part of the requirement of the program.

Anent to this, we would ask permission from your good office to conduct our study to
seventeen (17) Level II and seventeen (17) Level III full-time students in each section of
your respective department. Attached herewith the questionnaire for this study.

The survey would last only about 3-5 minutes and would be arranged at a time
convenient to the students’ schedule. In this regard, we guarantee you that we will not
provide any form of disturbance and interruption in the class of your students.
Participation in the survey is entirely voluntary. All information provided will be kept in
utmost confidentiality and would be used only for academic purposes. 

Your response to this letter is crucial in providing the necessary information in our
study to help us achieve the factual results.

Thank you very much for your approval and endorsement of this request.

Respectfully,

CHARIES JAMILLE GUDOY

MARIA JONALYN B.
BUGARIN

ARVIE C. OCAMPO

JULIUS CEASAR A. PARAOAN

LORIBEE-ANN E. VERGARA
Student Researchers

Noted by:

MYRA R. LAMPITOC, MSPT, PTRP

Thesis Adviser
85

DR. AILEEN CAMANGEG

Department Chairman
Department of Pharmacy
College of Health Sciences

Ma’am:

Warmest greetings!

The undersigned are Level III Bachelor of Science in Physical Therapy students of
this university presently conducting a study titled ““The Effects of Online Learning in
the Mental Health and Readiness of MMSU-CHS students for Clinical Practice” as
part of the requirement of the program.

Anent to this, we would ask permission from your good office to conduct our study to
seventeen (17) Level II and seventeen (17) Level III full-time students in each section of
your respective department. Attached herewith the questionnaire for this study.

The survey would last only about 3-5 minutes and would be arranged at a time
convenient to the students’ schedule. In this regard, we guarantee you that we will not
provide any form of disturbance and interruption in the class of your students.
Participation in the survey is entirely voluntary. All information provided will be kept in
utmost confidentiality and would be used only for academic purposes. 

Your response to this letter is crucial in providing the necessary information in our
study to help us achieve the factual results.

Thank you very much for your approval and endorsement of this request.

Respectfully,

CHARIES JAMILLE GUDOY

86

MARIA JONALYN B.
BUGARIN

ARVIE C. OCAMPO

JULIUS CEASAR A. PARAOAN

LORIBEE-ANN E. VERGARA
Student Researchers
Noted by:

MYRA R. LAMPITOC, MSPT, PTRP

Thesis Adviser
APPENDIX 3
87

INFORMED CONSENT DOCUMENT

88
89

INFORMED CONSENT DOCUMENT

CURRICULUM VITAE

Name: Charies Jamille Gudoy

Nickname: Cha
Birthday: June 15, 2000
Address: Bagaoisan St., #7 Caunayan, City of Batac
Ilocos Norte
Name of Father: N/A
Occupation: N/A
Name of Mother: Janeth G. Franco
Occupation: Housewife

Schools Attended
Elementary: Mariano Marcos Memorial Elementary School
#1-S Valdez, City of Batac 2906 Ilocos Norte
2004-2012
Junior High School: City of Batac National High School (Poblacion)
Tabug, City of Batac 2906 Ilocos Norte
2012-2016
Senior High School: General Artemio Ricarte Senior High School
#35 Bil-loca, City of Batac, Ilocos Norte
2016-2018
College: Mariano Marcos State University
#16 Quiling Sur, City of Batac, Ilocos Norte
2018-present
Degree: Bachelor of Science in Physical Therapy
90

CURRICULUM VITAE

Name: Julius Ceasar Paraoan

Nickname: Juls
Birthday: July 30, 1999
Address: #2 Ablan, City of Batac Ilocos Norte
Name of Father: Amante FranciscoM. Paraoan
Occupation: Businessman
Name of Mother: Rubelyn A. Paraoan
Occupation: Businesswoman

Schools Attended
Elementary: Mariano Marcos Memorial Elementary School
#1-S Valdez, City of Batac, Ilocos Norte
2004-2012
Junior High School: City of Batac National High School (población)
#17 Tabug, City of Batac, Ilocos Norte
2012-2016
Senior High School: General Artemio Ricarte Senior High School
#35 Bil-loca, City of Batac, Ilocos Norte
2016-2018
College: Mariano Marcos State University
#16 Quiling Sur, City of Batac, Ilocos Norte
2018-present
Degree: Bachelor of Science in Physical Therapy
91

CURRICULUM VITAE
Name: Arvie Corpuz Ocampo
Nickname: Bits
Birthday: September 11, 1999
Address: Cabaritan Buguey Cagayan
Name of Father: Remando Valdez Ocampo
Occupation: Government Employee (Fire Fighter)
Name of Mother: Nida Pillon Corpuz
Occupation: N/A

Schools Attended
Elementary: Sta. Lina Elementary School
Sta. Lina Luna Apayao
2004-20112
Junior High School: Licerior Antiporda Sr. National High School
Centro Buguey, Cagayan
2012-2016
Senior High School: Licerior Antiporda Sr. National High School
Centro Buguey, Cagayan
2016-2018
College: Mariano Marcos State University
#16 Quiling Sur, City of Batac, Ilocos Norte
2018-present
Degree: Bachelor of Science in Physical Therapy
92

CURRICULUM VITAE
Name: Maria Jonalyn B. Bugarin
Nickname: Jona
Birthday: August 10, 2000
Address: Brgy. Paratong NArvacan Ilocos Sur
Name of Father: Juan C. Bugarin
Occupation: Tricycle Driver
Name of Mother: Benedicta B. Bugarin
Occupation: Unemployed

Schools Attended
Elementary: Narvacan Catholic School
Brgy. Sta Lucia, Narvancan, Ilocos Sur
2004-2012
Junior High School: Narvacan National Central High School
Brgy. Paratong, Narvacan, Ilocos Sur
2012- 2016
Senior High School: Narvacan National Central High School
Brgy. Paratong, Narvacan, Ilocos Sur
2016-2018
College: Mariano Marcos State University
#16 Quiling Sur, City of Batac, Ilocos Norte
2018-present
Degree: Bachelor of Science in Physical Therapy
93

CURRICULsUM VITAE
Name: Loribee-Ann Estate Vergara
Nickname: Loribee
Birthday: November 27, 1999
Address: 17-A Parang Badoc Ilocos Norte
Name of Father: Hermogenes Vergara
Occupation: Farmer
Name of Mother: Elizabeth Vergara
Occupation: Housewife

Schools Attended
Elementary: Mabusag Sur Elementary School
#18-B Mabusag Sur, Badoc, Ilocos Norte
2004-2012
Junior High School: Igama Colleges Foundation Incorporation
#2 Garreta, Badoc Ilocos Norte
2012-2016
Senior High School: Igama Colleges Foundation Incorporation
#2 Garreta, Badoc Ilocos Norte
2016-2018
College: Mariano Marcos State University
#16 Quiling Sur, City of Batac, Ilocos Norte
2018-present
Degree: Bachelor of Science in Physical Therapy