The Effectiveness of Preparation Programs for Clinical Nurse Educators on Role Confidence

Purpose: Teaching nursing in clinical settings is considered complex and challenging. The quality of clinical teaching can directly affect the quality of the learning experience for students. Although a variety of orientation, support and preparation strategies have been in place, clinical nurse educators continue to report feeling under-prepared and lacking confidence to undertake their role (Eta, Atanga, Atashili, & D’Cruz, 2011; Heydari, Hosseini, & Moonaghi, 2015; Suplee, Gardner, & Jerome-D'Emilia, 2014). Review of the relevant literature indicates a lack of evidence to guide the effective preparation of clinical nurse educators (Dahlke, Baumbusch, Affleck, & Kwon, 2012; Suplee et al., 2014; World Health Organisation, 2013). Likewise, little is known about which preparation strategies contribute to the development of confidence in performing the role of clinical nurse educators. This study was conducted to explore (1) how clinical nurse educators in Vietnam are prepared for their role, (2) what level of confidence do they have in the clinical teaching role, and (3) the association between preparation methods and perceived confidence.

Methods: Cross-sectional surveys were used to collect data via web-based and paper-based modes from January to March 2015. The surveys included two parts: (a) questions about demographics, preparation and clinical teaching activities, and (b) the Clinical Nurse Educator Skill Acquisition Assessment instrument (CNESAA). The CNESAA was fully validated for use in the Vietnamese setting (Nguyen, Forbes, Mohebbi, & Duke, 2017). There were 334 clinical nurse educators and 19 institutions in Vietnam participating in this study. Descriptive, bi-variate and regression analysis using Statistical Package for the Social Sciences (SPSS) version 22.0 were applied.

Results: Eight different preparation methods were commonly used in Vietnam. The majority of participants perceived themselves as having moderate (n = 90, 26.9%) and high (n = 127, 38%) levels of confidence in their clinical teaching role. The participants at very low, low and very high levels of perceived confidence account for 9% (n = 30), 15.9% (n = 53) and 10.2% (n = 34) respectively. Overall, preparation had significant effects on clinical nurse educators’ perceived confidence level. However, the effects varied depending on how formally they were implemented. Of the eight, three methods were positively associated with the development of confidence in the clinical teaching role, including pedagogical courses, workshops in clinical nursing education, and a period of simultaneous practice and clinical teaching. Informal mentorship was associated with an adverse effect on perceived confidence while the other four preparation strategies showed no effect on clinical nurse educators’ perceived confidence.

Conclusion: The findings of this study are important to the use of evidence-based methods to effectively and efficiently prepare clinical nurse educators for their complex role. This study could be replicated in other health-related disciplines to evaluate the quality of methods currently used to prepare clinical educators. Applying evidence in the preparation of clinical educators is integral to the transformation, expansion and scaling-up of health educational systems to meet increasing diverse needs of different populations for healthcare services.