Building the Capacity of Future Filipino Nurses: An Integrative Review

: This study envisions future Filipino nurses' capacity-building skills. It delves into the capabilities of a "Future Filipino Nurse," determining what makes them globally competitive and how technology might help them even more. The research examines significant themes and creates a capacity-building framework through content analysis of seven seminal publications. The study reveals three critical pillars for strengthening Filipino nursing: a Conducive Nursing Environment, Creating a supportive ecosystem through recognition, mentorship, flexible work arrangements, and collaborative initiatives to nurture skilled and resilient nurses; Enhancing Nurse Capacity and Performance: Equipping nurses with the tools and skills required for excellence, such as critical thinking, patient-centered care, leadership, ethical behavior, and This recalls Amartya Sen's emphasis on individual autonomy and full potential. To cultivate a future-oriented nursing landscape and foster continuous learning, adaptation, and innovation through seamless integration of education and practice, new skill development, and ongoing research, this is consistent with Donald Schon's ideas about reflective practice and continuous progress. By putting these pillars in place, the Philippines can raise a generation of competent, globally competitive, and mobile nurses who will be critical champions for patient well-being and architects of a resilient healthcare future. Further study is required to apply and assess these capacity-building measures, particularly in exploring the impact of technology and revising training curricula to educate Filipino nurses for the developing healthcare sector effectively. Investing in future Filipino nurses' capacity building is vital for improving the healthcare system and assuring quality treatment for future generations. The Philippines can build a strong nursing workforce that will prosper in the global healthcare arena by providing a supportive atmosphere, enhancing individual talents, and embracing a future-oriented perspective.


INTRODUCTION
The world's healthcare system has relied on Filipino nurses to deliver quality nursing care, and the care provided by Filipino nurses is distinct from that of other nurses worldwide.Because of Filipino culture, the driving factors of a Filipino nurse to continue in the profession are their family and their desire to serve, the empathy-driven service that reflects the distinct characteristics of a Filipino nurse (Cantor, 2020).The worldwide concern of the nursing workforce shortage has challenged the capacity of the Philippines to provide quality nursing graduates.By 2023, the world will need about 13 million nurses, about half our current estimated nursing workforce.The Philippines is not the only nurse-producing country that seeks employment worldwide.India and our neighboring countries in the Southeast Asian region are producing a good number of nurses that rival Filipino Nurses for work worldwide.Nurses live and work at the intersection of health, education, and communities, and because of that, the capacity and expertise of nursing must be strengthened (Wakefield et al., 2021).The current stature of Filipino nurses should be amplified, and the culture of Filipinos being family-oriented and their desire to serve shall be highlighted as a driving factor to increase the capacity of Filipino nursing practice.The improvement of quality care and patient safety is contributed mainly by nurses worldwide, and their roles in health promotion, health education, and disease prevention are vital.Moreover, nurses are challenged to be ethical and competent care providers in this age of globalization, where moral responsibility is extended beyond their local community and the world (Chavez et al., 2023).Moreover, Filipino nurses must be honed with the capacity of nursing schools to continue providing quality healthcare personnel for the world.Nurses in Asian countries are present in the healthcare systems of developed countries, and the Philippines, in particular, comprises 50% of foreign-trained nurses in the United States, with about 5% of the total registered nurses in the US being Filipinos (Nazareno et al., 2021).This migration of nurses, with an estimated 300,000 Filipino Nurses working abroad, directly affects the Philippine economy as drivers through remittances.Therefore, maintaining a globally competitive nurse ensures the status quo as the choice of the world, and this means that Filipino nurses will continue to seek employment abroad, subsequently ensuring a well-running economy.Some concerns arise regarding the possible effect on the quality of nursing graduates Philippine schools produce because of the changes in the curriculum, adoption of new teaching modalities, and the limitation of face-to-face related learning experiences due to the pandemic.However, an evaluation must ensure that the changes and challenges that the educational system fought during the pandemic did not affect the quality of nursing education and that the Philippines continues to produce nurses of good caliber.Both the Philippines and the world need a quality nursing workforce.As we fought the recent COVID-19 pandemic, the international community saw nurses' importance in ensuring an effective healthcare system and a stable economy.The Future of Nursing 2020-2030: Charting a Path to Achieving Health Equity, a study by Wakefield et al. (2021), emphasizes the need to investigate and evaluate innovations in nursing education and their impact on accessibility.Thus, by this recommendation, this study shall focus on analyzing how the capacity of the Philippine Nursing Practice is being built and sustained to remain competitive in the world.

A. Statement of the Problem
This study will investigate the capacity-building potential of future Filipino nurses, precisely what competencies a Filipino nursing graduate possesses, what makes Filipino nurses globally competitive, and how technology contributes to the future of nursing practice.

B. Objective of the Study
The study aims to determine the capacity-building initiative for the future Filipino Nursing Practice that will mainly focus on the following: 1. Determine the competencies of Filipino nursing graduates.2. Identify the factors that made Filipino nurses globally competitive.3. Articulate the contribution of technology in the Filipino Nursing Practice Capacity-Building.

C. Significance of the Study
The contribution of Filipino Nurses to the world's healthcare system has been established, and how they shaped nursing practice worldwide has been recognized.Building the capacity of the Filipino Nursing Practice shall determine the survival of its presence in the international healthcare scene and maintain its reputation as the top choice of the world.Moreover, it shall further contribute particularly in the following: 1. Ensure the continuation of the standards of quality Filipino nursing care.2. Develop future strategies of innovation and development for the future of nursing practice.3.As primary drivers of the economy, overseas Filipino nurses shall help the Philippine economy to keep on rolling.4. Locally employed nurses shall have a better grip on the future direction of the nursing practice.5.It shall help improve the Philippine National Healthcare System through an improved and sustainable nursing workforce.6. Continue to improve and standardize nursing education to produce quality nursing graduates.

D. Scope and Limitation of the Study
The study shall cover existing literature on nursing education and training challenges, essential skills and competencies, and technology in nursing practice.Since the study uses the systematic analysis approach through analyzing available literature, it shall not utilize human subjects.Due to the limited time, location, and resources, the gathering of existing literature shall be limited to online open sources and unpublished works of literature within the area of the research.

II.
Review of Related Literature and Theoretical Framework This section reviews different literature, primarily research on the capacity building of Filipino nurses.The review helps locate this study in its appropriate theoretical, conceptual, and methodological contexts.

A. Related Literature The Filipino Nursing Education and Training
Nurses developed their clinical competence through in-house education and learning sessions within the area of Practice (Suprapto, 2022).It is also suggested that nurses develop their skills and learning abilities during the formative stages of their Practice (Zhang et al., 2022).In-house education and the formative stages of nursing practice focus on the early stages of the nurse's professional career, usually the first three years; this suggests that nurses' full potential is only being developed when they are already in their practice.Somehow, the study of Ubas-Sumagasyay and Oducado (2020) suggests that new graduates already acquired the necessary skills and competencies needed by a nurse; this challenges the presented facts that nurses' skills are developed during their formative stage as professionals.Benner's Novice to Expert theory presents the stages of nursing competencies, a theoretical underpinning of the Dreyfus Model of Skills Acquisition.In their first year of professional practice, novice nurses are expected to rely more on their theoretical foundations than experiences; they depend on the senior nurses for guidance.This year is when nurses start to discover the fundamental nature of the profession when they independently function as professional nurses.This model has since been argued by Parra Jiménez (2023) that the Dreyfus model offers the concept of human experience for skills Acquisition as a skillful coping; it is further argued that the Dreyfus model focuses on the unreflective and practical aspects of human activity.They are setting the tone for Nursing Education and Skills Acquisition in the Philippines.Delving into the notions as to how Filipino nurses receive education and are prepared for real-world experiences is on point reflected by Ortega that the Philippine nursing schools are challenged in defining the professional knowledge needed by Filipino nurses due to the global demand for nursing care; this lead to constant changes in the curriculum and instructions.Moreover, it undermines the values and standards defining nursing in the Philippines.In addition to these challenges, there is an ongoing global shortage of nurse educators due to international migration, devaluation of faculties, disincentives, and reduction of full-time faculties (Nardi & Gyurko, 2013).These two concerns directly impact the production quality of nursing graduates.Good instructions from good instructors are needed to sustain the capability of Filipino nurses.The quality of nursing education in the Philippines is agreed to be synonymous with good quality with other top international universities.Including faculty members with sound clinical experience is substantial in developing a good nursing education program (Appiah, 2020).However, in 2010, the Philippines' Commission on Higher Education Imposed the banning of new nursing schools as a mitigating action to address the failure of compliance with the standards set by the Professional Regulation Commission; the moratorium has since been lifted to address the shortage of nurses (Bernardino Jr et al., 2023).The items presented lead to a possible discussion of how Philippine nursing schools maintain their good standards and ensure compliance with regulatory requirements to prevent another moratorium on banning nursing schools.In nursing education, skills practice is one of the most crucial parts of its curriculum.The theory-topractice transfer of learning is essential to ensure that nursing students are to become well-equipped professionals.Furthermore, it is understood that good delivery of theoretical instructions substantiates the quality of actual setting performance (Oducado et al., 2019).Therefore, improving nursing instructors' professional competence and interpersonal skills is crucial in delivering high-quality instructions to nursing students (Labrague et al., 2020).However, the sudden shift from face-to-face to remote online learning brought about by the restrictions implemented during the COVID-19 pandemic became a challenge in delivering instructions to the nursing faculty (Suliman et al., 2021).A sudden shift in teaching modalities challenges the need for good instruction and good instructors; exploring how these interrelated concerns can deliver the demand for quality nursing education is essential.The rigors of the nursing academic requirement and clinical experience affected the stress management capacity of the nursing students, and the integration of life skills competency is essential despite having a wide-ranging nursing curriculum (Sali, 2023).Stress negatively affects student nurses' resiliency, social support, mindfulness, and self-efficacy, while these factors positively influence psychological well-being (Berdida et al., 2023).Nurses must be able to learn to cope and manage stress.As suggested in both studies, psychological well-being is paramount; thus, exploring how this concern is addressed is crucial for planning capacity building.

Filipino Nurse Skills and Competencies
Filipino nurses possess high knowledge, competence, and a favorable attitude toward their role in patient care, leadership and management, and research (Balawag et al., 2018), and the Philippines, being the leading provider of nurses around the world has established the image as hard-working individuals with good clinical skills; however, lacks theoretical knowledge (Marcus et al., 2014).There is polarity among these articles suggesting the level of competencies between skills and theory foundation is equivocal.The empowerment of Filipino nurses grows as they gain more experience with age, employment status, and employment quality as predictors (Tan & Conde, 2021).Moreover, the nurses' assertiveness and empowerment are factored into their self-esteem and leaders' behaviors; thus, nurturing the nurse's healthy self-esteem and empowering conditions help them develop good work behavior (Oducado, 2021)  Character development is an integral part of developing the quality nursing skills of Filipino nurses, as cited in the studies, and their working environment influences the formation of nurses.Newly graduating Filipino nurses rated their transition experiences as a complex and demanding path, consistent with other international research results.Using evidence-based educational and structured organizational tactics, the nursing administration team and academic staff members can play essential roles in easing the transition and integrating newly graduated nurses into the nursing workforce (Labrague et al., 2019).In addition, nursing education ought to develop plans to guarantee that Filipino nurses are culturally competent in the future.Most Filipino nurses may work abroad, so they must be ready to deliver professional, culturally aware care (Cruz et al., 2016).The connection between the experience of novice nurses transitioning to professional practice and the capacity of nurses to be culturally competent is conjoined in exploring the plans and actions for developing a competitive Filipino nurse here and abroad.The mentor's primary tactic, servant leadership, enabled the mentee to follow her lead and accomplish her objectives.The presentation includes a range of servant leadership techniques.Both the mentor and the mentee gained knowledge and developed personally and professionally.The mentee's mentorship enabled her to start a national leadership institute to educate and guide the upcoming wave of nurse leaders.To guarantee that the nursing profession will continue to develop and advance is to set the path for future generations of nurse leaders (Irigo-Barcelo & Malabed-Llanes, 2023).Moreover, Filipino nurse's competency is affected by their demographic and work-related characteristics; high-level competency is observed among those with permanent work status (Feliciano et al., 2019).Therefore, the competency development of nurses does not only revolve around mentorship, but it includes their concerns and the work benefits they receive; this leads to the inquiry of which is more relevant in competency development and capacity building.

Technology in the Nursing Practice
The healthcare delivery trend has developed to involve technology as part of its practice.Since the early 2000s, nursing informatics has been a discussion in academic and clinical practice.Despite its rich evolution and dynamic nature, it remains an emerging field in the Philippines.It was understanding the contributions and implications of nursing informatics in the context of Philippine nursing practice and its initiation for a caring perspective in this technology-oriented society (Faustorilla, 2020).Even nursing students already acknowledge the roles and influence of informatics in their academic formation; however, technological advancement in the Philippines as a developing country is a challenge in offering quality education due to limited resources (Austria, 2017).Therefore, it must be explored that despite the acceptance of the learners to technology, it has not yet reached its full potential, which paves the way for the discussion on how the country brings up the capacity of technology use in the development of nursing practice.
Healthcare workers must possess excellent aptitude, experience, and competence to achieve high patient satisfaction.The development of nurses' capacity has been accomplished through internal training and education programs and evolving integrated nurse capacity-building patterns (Suprapto, 2022).

B. Theoretical Framework Capacity Building
This study shall be anchored to the Capacity Building theory, described as developing and strengthening capabilities to ensure survival and adaptability with the changing times (Capacity-Building | United Nations, n.d.).Moreover, Capability Building is a core component of the Capability Approach by Amartya Sen. The focus of Sen's theory emphasizes the importance of widening the individual's capabilities to achieve the desired outcome.

Reflective Practice
Another theory discussed and referenced in the study will be Donald Schon's Reflective Practice, which emphasizes mirroring individual experiences.Reflective practice often becomes the basis of capacity building by looking back to past experiences to plan and determine future actions to improve current practices and structures.

III.
Research Methodology This chapter discusses the research design and approach process, research instruments and data gathering, and research procedure and data analysis.

A. Research Design
This study employed the integrative literature review design to explore and describe the existing evidence on capacity building of Filipino nurses for the future.The integrative literature review design aims to provide a new understanding of a particular phenomenon or issue by summarizing theoretical or empirical evidence.Diverse primary research techniques may be able to play a more significant role in evidencebased practice initiatives thanks to an enhanced integrative review method (Whittemore & Knafl, 2005).

B. Source of Data
This policy paper gathered qualitative data through a systematic review of existing research on capacity building of future Filipino nurses.Content analysis was used to extract themes and concepts about the selected topic.Journals were gathered from Google Scholar using the keywords "Future Filipino Nurse" and "Capacity Building."Articles within the five years, from 2018-2022, were included in the study.There were 8,870 articles suggested, and out of them, the set that best fit the context of this policy was selected.

C. Analysis of Data
The gathered literature will be analyzed independently following the six steps of thematic analysis: Familiarization, Coding, Generating Themes, Reviewing Themes, Defining and Naming Themes, and Writing Up.

D. Ethical Consideration
No human subjects will be utilized in the conduct of this research; therefore, consent will not be necessary.However, this research will not mention possible agencies, organizations, and personnel that may be identified in analyzing the data; instead, they shall be given code names to ensure the privacy and confidentiality of their identity.

IV.
Analysis, Findings, and Discussion Nurses are like compassionate threads stitched into the structure of patient well-being in dynamic healthcare.To enable these components to take off, a healthy environment supported by three pillars-a future-focused vision, empowered nurses, and a foundation of care-is required.This policy paper draws on an extensive corpus of existing research to investigate the core characteristics of a "Future Filipino Nurse."A thorough search within Google Scholar, aided by the strategic use of keywords ("Future Filipino Nurse" and "Capacity Building"), yielded seven seminal works that provide valuable insights and pave the way for future endeavors.This paper's analysis attempts to synthesize and convey these significant learnings to inform the creation of practical capacity-building efforts for Filipino nurses in the coming years.Content analysis, a skilled weaver's tool, untangled these articles, extracting themes and concepts that resonate like vibrant colors on the canvas.Each theme whispers of a need, a challenge, or an opportunity: a call to strengthen critical thinking, nurture ethical leadership, and bridge the gap between education and real-world practice.All these threads, expertly woven together, form the very fabric of capacity building.This policy paper proposes a vision for the future of Filipino nursing, depicting a landscape populated by talented and motivated nurses.Within this framework, educational and support systems serve as rich soil, nurturing professional development and promoting resilience in adversity.The first pillar is to Create a Conducive Nursing Environment.The initial goal of this framework is to lay the groundwork for optimal development; this might be thought of as a thriving ecosystem: a blossoming landscape lit up by acknowledgment and support for both patients and nurses.Skilled and empowered nurses who advocate for patients flourish in this atmosphere despite financial constraints and tight workloads.This ecosystem's resilient support systems, such as flexible work arrangements and comprehensive mentorship programs, provide protection and nourishment.Furthermore, collaborative efforts between academics and institutions, like blossoming flowers, nurture future leaders capable of navigating the complexities of healthcare delivery.The second pillar is enhancing nurses' capacity and performance.This pillar focuses on providing nurses with the tools and skills they need to be effective.The metaphor of sharpened and gleaming instruments emphasizes the value of ongoing learning and skill development in honing professional expertise.However, cultivating resilience and boldness, like composting soil, lays the foundation for solid patient advocacy and ethical behaviors.Individual nurses' leadership qualities, woven into their fabric, further equip them to negotiate healthcare challenges with compassion and strategic vision.The second pillar emphasizes the nurse's competence to ensure quality practice by providing them with the necessary tools and skills.Resonating Amartya Sen's belief that people must realize their full potential resonates with this because employing one's full potential extends beyond the resources nurses require to become successful carers.Amartya Sen criticizes resource-based approaches to well-being, claiming that resources are merely means to an end.Similarly, the finding emphasizes the need to develop resilience, leadership, and advocacy skills and competence, demonstrating care for nurses' entire agency and ability to perform effectively.Cultivating a Future-Oriented Nursing Landscape is the third pillar.This pillar ensures the nursing profession's continuous relevance and adaptability.It envisions a future where educational programs and professional results are seamlessly integrated, ensuring graduates are well-equipped to tackle growing challenges and opportunities.This future supports the development of new skills and areas of expertise in response to changing healthcare requirements, allowing nurses to adapt effortlessly to changing landscapes.Like budding exotic orchids, continuous research propels innovation and raises care standards.Finally, this vision depends on strong collaboration and a dedication to continual improvement, which act as gentle breezes that keep the nursing sector dynamic and ever-changing.Bringing these three pillars together goes beyond supporting individual nurses.It symbolizes the construction of a more robust and resilient healthcare tapestry for future generations.We can ensure that the next generation of nurses not only survives but also thrives by paying attention to the cornerstone of patient-centered care, empowering every constituent element, and embracing a future-oriented viewpoint.As a result, they will become vital advocates for patient well-being and architects of a brighter, more resilient healthcare future.The third pillar has several ideas that resemble Donald Schon's concept of reflective practice.Schon's advocacy for nurses to continuously reflect on their experiences and actions, leading to improved practices, resonated with the vision of seamlessly integrating education and professional practice, continuous research innovation, and nurses' adaptability to change, reflecting a commitment to learning from experiences and evolving to meet future needs.

Conclusion
The practice of future Filipino nurses is emphasized with compassion, resilience, and dedication that rest on three pillars that are suggested to strengthen the capacity of future Filipino nurses.The first pillar, a rich ground of recognition and support, feeds nurses' development into confident patient advocates.Flexible job opportunities and mentorship programs provide strong roots against adversity, helping them survive despite financial constraints.The second pillar sharpens their superior tools.Continuous learning and critical thought make sparkling instruments.Their integrated resilience and leadership empower them to address problems with compassion and strategic vision.The final pillar propels them towards an exciting future.Research and innovation fuel educational threads that effortlessly blend with professional practice.Nurses quickly adapt to new environments, and their skills are evergreen.Collaboration acts as a gentle breeze, allowing the tapestry to evolve.This is a future not only for individual nurses but for future generations.Merging these pillars creates a strong healthcare practice.The next generation of Filipino nurses will survive and thrive, ensuring patient well-being remains the utmost priority.
(Macabasag et al., 2023)in this sense, is applied in the real-world setting to direct nursing care; however, it lacks enough AI experts in the profession and thus needs formal training or perhaps curriculum development that includes the use of AI(O'Connor et al., 2023).Concurrent studies suggest that the application of AI might significantly influence nursing practice, but many questions remain that further evaluation is needed (Van Bulck et al., 2023).Additionally, Nursing students have a favorable idea about adopting AI, and it is further suggested that nursing education should incorporate AI in school coursework(Labrague et al., 2023).Artificial Intelligence is just one aspect of technological advancement in nursing.The demand for the quick adoption of technology that can meet the health sector's ongoing and changing needs is rising.However, mutual alignment between technologies and the local environment is required to function in local health contexts(Macabasag et al., 2023).A higher level of knowledge, Intelligence, recognition of technology, and artificial Intelligence is required for nurses to render quality care.Technology's effectiveness significantly impacts the time allotted to care, allowing nurses to concentrate more on their (Vasquez et al., 2023)r central responsibility(Vasquez et al., 2023).Although there is still a gap in the alignment of technology with local capacity, it is recognized that technology improves the services provided.
To wit: 1. Develop a curriculum emphasizing critical thinking and patient-centered care principles, equipping aspiring nurses to work compassionately and negotiate challenging healthcare environments.2. Leadership development programs that produce courageous advocates who are ready to support ethical practices and patient safety.3. Mentorship and support systems that promote growth by instilling confidence and resilience in the face of adversity.4. Opportunities for continuous learning keep skills sharp and minds open, allowing nurses to manage the ever-changing healthcare landscape efficiently.Promoting research, collaboration, and innovation to enhance healthcare standards and patient care.