Competency-Based Nursing Education in the Philippines and the Global Community: A Systematic Review and Meta-Analysis

Competency-Based Nursing Education in the Philippines and the Global Community: A Systematic Review and Meta-Analysis

Lead Author:
Fernan N. Torreno
Affiliation: St. Paul University Manila Philippines
Email: [e-mail]
ORCID: 0009-0006-3884-0840

Famiela N. Torreno (corresponding author)
Affiliation: Unibersidad De Dagupan, Philippines
Email: [e-mail]
ORCID: 0009-0003-3808-3286

Abstract
Background:
Competency-Based Nursing Education (CBNE) shifts from time-based curricula to demonstrable skills and practice readiness【1,2】. While widely implemented globally【1,2】, limited evidence synthesizes outcomes in the Philippines relative to international contexts. This review aimed to evaluate CBNE outcomes in the Philippines versus the global community.
Methods:
Following PRISMA 2020, we searched PubMed, CINAHL, Scopus, and Philippine databases (2010–2025). Eligible studies included RCTs, quasi-experiments, observational studies, and qualitative inquiries. Quantitative outcomes (e.g., clinical competence, OSCE, knowledge, communication) were pooled using random-effects models. Qualitative evidence was synthesized per ENTREQ. Risk of bias was assessed with RoB2 and ROBINS-I. Figure 1 shows the PRISMA flow.
Results:
Fifty-two studies met inclusion (Philippines = 14; Global = 38).
● Global evidence: Chen et al. reported improvements in clinical ability (SMD 1.52, 95% CI 0.13–2.90), critical thinking (SMD 0.69, CI 0.43–0.95), communication (SMD 0.74, CI 0.51–0.97), and professional development (SMD 1.92, CI 1.41–2.42)【1】. Cho et al. found VR-based CBNE yielded large competency gains (g 0.88, CI 0.47–1.29)【2】.

● Philippines evidence: Guerrero et al. demonstrated simulation training significantly outperformed traditional methods in OSCE performance (g 3.12, CI 2.58–3.66)【4】.

Table 2 details outcomes by domain; Table 4 shows subgroup analysis (Philippines vs Global). Qualitative synthesis (Table 3) identified faculty readiness, simulation access, standardized assessment, and policy alignment as determinants【5–7】.
Conclusions:
CBNE improves competency outcomes across domains globally【1,2】. Philippine evidence confirms alignment with global frameworks but highlights resource gaps【4–6】. Investment in simulation, faculty development, and assessment fidelity is essential to maximize CBNE’s impact.
Keywords
Competency-Based Nursing Education; Systematic Review; Meta-Analysis; Philippines; Global Nursing Education; Simulation; OSCE; Faculty Development

《菲律宾及全球语境下基于能力的护理教育：系统综述与元分析》

第一作者：费南·N·托雷诺（Fernan N. Torreno）
所属机构：菲律宾马尼拉圣保罗大学
电子邮箱：[e-mail]
ORCID：0009-0006-3884-0840

法米埃拉·N·托雷诺（Famiela N. Torreno）（通讯作者）
所属机构：菲律宾达古潘大学
电子邮箱：[e-mail]
ORCID：0009-0003-3808-3286

摘要
背景：基于能力的护理教育（Competency-Based Nursing Education, CBNE）摒弃以学时为导向的课程体系，转向聚焦可验证技能掌握与实践就绪能力的培养【1,2】。尽管该模式已在全球范围内得到广泛推行【1,2】，但目前仍缺乏针对菲律宾与国际语境下相关结局的综合证据。本综述旨在对比评估菲律宾与全球范围内CBNE的应用结局。

方法：本研究严格遵循PRISMA 2020声明，检索了PubMed、CINAHL、Scopus以及菲律宾本土数据库，检索时限为2010年至2025年。纳入研究类型包括随机对照试验（Randomized Controlled Trial, RCT）、类实验研究、观察性研究以及质性研究。对于临床胜任能力、客观结构化临床考试（Objective Structured Clinical Examination, OSCE）、知识水平、沟通能力等定量结局指标，采用随机效应模型进行合并分析；质性证据则依据ENTREQ指南进行综合。采用RoB2与ROBINS-I工具评估研究偏倚风险。图1展示了PRISMA研究流程图。

结果：最终共有52项研究符合纳入标准，其中菲律宾本土研究14项，全球研究38项。
● 全球研究证据：Chen等的研究显示，临床能力（标准化均数差SMD=1.52，95%置信区间CI：0.13~2.90）、批判性思维能力（SMD=0.69，95%CI：0.43~0.95）、沟通能力（SMD=0.74，95%CI：0.51~0.97）以及专业发展水平（SMD=1.92，95%CI：1.41~2.42）均得到显著提升【1】。Cho等的研究发现，基于虚拟现实（Virtual Reality, VR）的CBNE可带来显著的胜任能力提升（g=0.88，95%CI：0.47~1.29）【2】。
● 菲律宾本土研究证据：Guerrero等的研究证实，模拟教学在OSCE表现上显著优于传统教学方法（g=3.12，95%CI：2.58~3.66）【4】。
表2按研究领域详细列出了各项结局指标；表4展示了菲律宾与全球研究的亚组分析结果。质性综合分析（表3）识别出师资就绪性、模拟教学资源可及性、标准化评估以及政策契合度作为核心影响因素【5-7】。

结论：CBNE可在全球范围内提升各领域的护理胜任能力结局【1,2】。菲律宾本土研究结果证实其与全球应用框架具有一致性，但同时也凸显了资源缺口问题【4-6】。加大对模拟教学、师资发展以及评估真实性的投入，是最大化CBNE应用效果的关键举措。

关键词：基于能力的护理教育；系统综述；元分析；菲律宾；全球护理教育；模拟教学；客观结构化临床考试（OSCE）；师资发展