IOSR Journal of Nursing and Health Science (IOSR-JNHS)

e-ISSN: 2320–1959.p- ISSN: 2320–1940 Volume 10, Issue 2 Ser. I (Mar. – Apr. 2021), PP 36-41
www.iosrjournals.org

Assessment of clinical instructors' competencies in the nursing

field
Nagat sayed Mohamed hassan 1, Gehan Mohamed Ahmed Mostafa 2, Dalal
Talaat Akel 3
1
(Nursing Administration, Faculty of Nursing / Helwan University , Egypt)
2
(Nursing Administration, Faculty of Nursing/ Helwan University, Egypt)
3(Nursing Administration, Faculty of Nursing/ Ain Shams University, Egypt)

Abstract
Background: Clinical instructors competency play a key role in nursing education and in development of
nursing student and integrate theoretical knowledge with practice in the clinical learning environment..
Materials and Methods: the current study was carried out at Technical Health Institute of nursing in Imababa .
A Descriptive research design was used to survey all available clinical instructors of academic year (2018-
2019) ,(N= 50) competencies in the nursing field was used to identify clinical instructors competencies ,
,factors affecting competencies was used to identify factors affecting competencies .
Results: the study indicated There was statistically significant between age, level of education, experience
years, training courses and their competencies level, There was a significant between, marital status, attended
training courses and factors affect their competencies.., there were positive correlation between factors
affecting competencies level among the clinical instructors in correlate to each of other with statistically
significant differences. positive correlation between work environmental, educational, psychological, social
and clinical instructor's competencies level with statistically significant differences.
Conclusion: there was a significant between age, level of education, experience years, training courses, There
was a significant between, marital status, attended training courses and factors affect their competencies.., It
was recommended an implementation of training program for clinical instructors with regarding their needs.
Periodic evaluate competencies of clinicat instructors' ,and further studies to assess competencies of clinical
instructors 'in nursing field .
Key Word: competence ; clinicat instructors' .
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Date of Submission: 26-02-2021 Date of acceptance: 11-03-2021
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I. Introduction
Education is process , the chief goal of which is to bring about changes in human behavior. Nursing has
a practical component which is integral to its educational process. A Major focus of education today is the
responsibility of the educational institutions to produce graduates who can perform in real life situations because
education in nursing without application is meaningless (Gaberson & McFetridge, 2014: Ballantine,
HammacFetridge, 2014: Ballantine, Hammack & Stuber ,2017 :Shinners, 2019). 1
Competence is defined in terms of functional adequacy and the capacity to integrate knowledge, skills,
attitudes and values in specific contextual situations of practice ((Luhanga, 2018) 2. Nursing competence of the
nurse teacher refers both to theoretical and clinical nursing knowledge and skills and attitudes toward nursing
practice. It includes the ability to integrate theory and practice, the use of nursing scientific knowledge as a basis
for teaching, co-operation with clinical supervisors, and guidance of students into the nursing culture.
Encouraging students to integrate theory and practice is one of the key issues for the nurse teacher’s competence
(Koharchik, 2014). 3
Assessment of clinical competence is an essential requirement of health professional education
(Mitchell, Henderson, Groves , Dalton & Nulty, (2009) 4. According to Busse, Aboneh & Tefera, ( 2014);
Smrekar ,Ledinski & Hosnjak, (2017) 5. The assessment of the performance of clinical skills should be designed
in such a way that students are tested in terms that are related to their future professional function.
Technical nurse clinical instructor will be required to have a strong knowledge base in theories of
teaching, training and evaluation; be able to design curricula and programs that reflect sound clinical training
principles; be able to assess learner needs; and be innovative and enjoy teaching (Omid, et al., 2016) 6

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 Assessment of clinical instructors' competencies in the nursing field

Those who training in academic setting also need to be future-oriented so they can anticipate the role
of the nurse in the future and adapt curriculum and teaching methods in response to innovations in nursing
science and ongoing changes in the environment training (D’souza et al., 2015 ) 7
The clinical setting is one of the most valuable educational resources available to nursing education,
students are able to transfer knowledge from classroom to real life situations and apply theory into practice. The
clinical experiences gained at these clinical setting provide nursing students with the opportunity to combine
cognitive, psychomotor, and effective skills. It enhance students professional responsibility: assist students with
self directed learning acquiring decision making and problem solving skills (Abouelfottoh & Mumtin,( 2015):
pitkanen, et al,2018) 8

II. Material and Methods

The study was conducted at Technical Health Institute of nursing in Imababa,. It is consisted from six
department. It is the only health institute that receive students from rural and urban areas all over Cairo
governorate This study was carried out in the clinical setting ( Om Elmasserine , Imbaba Alam , Bulak
Eldakror , Al Homiate hospital ).
Study Design: Descriptive research design was used in this study.
Study Duration: April 2019
Sample size:50 clinical instructors .
Sampling: convenient .

Procedure methodology
Competencies checklist consisted of three tools; tool( 1) consist of : Part 1: Demographic data of
clinical instructors.' . This part includes demographic data of clinical instructors.' as (as age, sex, marital states,
education level, years of experience… etc.). Part 2 Competencies checklist was adapted from (Jennilyn, 2010) .
This tool was used to assess clinical instructors competencies in the clinical settings . This tool is scale questions
it was ranged from done to not done. tool( 2) factors affecting competencies questionnaire was adapted from
(institute of interdisciplinary business research(2011) ,(Jennilyn, 2010) This tool was used to to assess factors
affecting competencies of clinical instructors in the clinical setting in their technical institute of nursing . This
tool is scale questions it was ranged from 5-point likert scale scored (5) strongly agree, (4) agree, (3) neutral,
(2) disagree and (1) strongly disagree. tool( 3) Clinical instructors competencies questionnaire : This tool was
adopted from (Essa and Adam ( 1998 ) to describe the actual role of the clinical instructors in the nursing
field. The response to each item is on 5-point likert scale scored (5) strongly agree, (4) agree, (3) neutral, (2)
disagree and (1) strongly disagree
An agreement was obtained from dean of Imbaba technical health institute to carry out the study.
Individual oral consent was also obtained from clinical instructors . The tool was tested by 3 experts in the field
of the study for their content validity through an opinionaire sheet. Accordingly, the necessary modifications
had been done. The pilot study was carried out after validity of the tools and before starting the actual data
collection. The aim of the pilot study was to confirm understanding, clarity, and applicability of the tool, to
determine required time to fulfill the tool. The pilot study was carried out on 10% of the total sample size, (5)
from clinical instructors . Those participants were included in the study sample as there was no major
modifications. Test of reliability for competencies tool yielded (0.84),factors affecting competencies (0.87)
indicating good level of internal consistency.
The researcher explains the aim of the study to participants. All participants were assured that
anonymity and confidentiality guaranteed and the right to withdraw from the study at any time. The researcher
collected data by through meeting the subjects and explaining the purpose of the study to them in the study
settings. The researcher was present all the time during fulfilling the forms to answer any questions. The time
needed by researcher to complete competencies checklist was 3 days 9-12 , The time needed by clinical
instructors to complete competencies questionnaire was ranged between (10-15). The researcher checked the
completeness of each filled sheet after the subjects completed it to ensure the absence of any missing data.

Statistical analysis
Data entry and statistical analysis were performed, the statistical package for social sciences (SPSS),
version 20. Reliability of the questionnaire was assessed using Cronbach’s alpha reliability coefficient. Pearson
correlation coefficient was used to determine significant correlations between the variables. The significance
level was set at P ≤ 0.05.

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 Assessment of clinical instructors' competencies in the nursing field

III. Result
Table no (1) shows that 54% of the clinical instructors are in their thirties with mean±SD of 37.5±2.7,
which is considered the highest percentage. In relation to residence, the result revealed that two-thirds (64%) of
them lived in urban areas. In addition, the percentage of married instructors was 66%, while the percentage of
the single instructors was 34%. The result showed that the highest percentage (60%) of the sample is related to
bachelor degree holders. Although more than 52% of them had more than 10 years of experience in the field,
78% claimed that they did not receive any training courses.

Table no (1): Demographic characteristics of clinical instructor's (N=50).

Variables No %
Age in year
20 ≤ 30 8 16
30 < 40 27 54
≥40 15 30
Mean ±SD 37.5±2.7
Residence
Urban 32 64
Rural 18 36
Marital status
Single 17 34
Married 33 66
Level of education
Bachelor 30 60
Master degree 16 32
PHD 4 8
Experience years:
<5 7 14
5-10 17 34
≥10 26 52
Mean ±SD 14.1±2.3
Training courses
Yes 11 22
No 39 78

Table no (2) shows that the Mean ±SD of the work environmental, educational, psychological, social and
administrative were 24.2±1.2, 23.5±1.7, 12.2±0.8, 9.3±1.6 & 8.1±1.3 respectively. The total factors were
77.3±6.6.

Table no (2).Means scores of clinical instructors according to the factors affecting their competencies (n=50)

Factors Mean ±SD Level of Competency

Work Environmental 24.2±1.2 Moderate

Educational 23.5±1.7 Moderate
Psychological 12.2±0.8 Low
Social 9.3±1.6 Low
Administrative 8.1±1.3 Low
Total 77.3±6.6 Moderate

Table (3) displays the distribution of the clinical instructors according to their total competencies level. It shows
that the highest percentage (56%) of clinical instructors was at moderate level, while the lowest percentage
(18%) was at low competencies level.

Table no (3) Distribution of the clinical instructors according to their total competencies level (No.=50)
Levels No. %
High 13 26
Moderate 28 56
Low 9 18

Table no (4) statistically significant associations between marital status, attended training courses of the clinical
instructors and factors affecting their competencies (P ≤0.05). There were statistically insignificant associations
between age, level of education, Years of Experience of the clinical instructors and the factors affecting their
competencies (P >0.05)

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 Assessment of clinical instructors' competencies in the nursing field

Table no (4) Relations between factors affecting clinical instructor's competencies level and their
characteristics
Factors Effect
Variables Low Moderate High X2 test P-Value
(n=10) (n=26) (n=14)
No % No % No %
Age
20 ≤ 30 1 10 5 19.2 2 14
30 ≤ 40 6 60 5 29.2 4 29 5.8 0.21
>40 3 30 16 61.6 8 57
Residence
Urban 8 80 20 76.9 4 29 10.6 **0.004
Rural 2 20 6 23.1 10 71
Marital status
Single 7 70 8 30.8 2 14 8.3 *0.02
Married 3 30 18 69.2 12 86
Level of education
Bachelor 4 40 15 57.7 11 79
Master degree 4 40 10 38.5 2 14 5.8 0.21
PHD 2 20 1 3.8 1 7
Years of experience
<5 2 20 3 11.5 2 14
5-10 3 30 6 23.1 8 57 4.9 0.29
≥10 5 50 17 65.4 4 29
Training courses
Yes 6 60 3 11.5 2 14 10.5 **0.005
No 4 40 23 88.5 12 86

Table no (5) shows clears positive correlation between factors affecting clinical instructor's competencies level
among the clinical instructors in correlation to each other with statistically significant differences at p ≤ 0.05.

Table no (5) Correlations between factors affecting clinical instructor's competencies level
Factors Work Environmental Educational Psychological Social Administrative

Work Environmental

Educational 0.83**

Psychological 0.65* 0.49

Social 0.71* 0.44 0.92**

Administrative 0.31 0.73* 0.90** 0.79*

Total 0.62* 0.55* 0.91** 0.84** 0.72*

Table no (5) positive correlation between work environmental, educational, psychological, social and clinical
instructor's competencies level with statistically significant differences at p ≤ 0.05. Moreover there was positive
correlation between total factors affecting and their competencies level of clinical instructors with statistically
significant difference at p ≤ 0.05. Meanwhile, there was statistically insignificant difference between
administrative factor and clinical instructors competencies level (p >0.05).

Table no (5) Correlations between factors and their competencies level of clinical instructors
Clinical Instructor Competency
Factors
Correlation
p-value
coefficient (r)
Work Environmental 0.90 *0. 01
Educational 0.82 *0.02
Psychological 0. 73 *0.03
Social 0.70 *0.04
Administrative 0. 47 0.08
Total 0.70 *0.04

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 Assessment of clinical instructors' competencies in the nursing field

IV. Discussion
Clinical teaching is the essence of all nursing education because clinical education is the way by which
clinical instructors facilitate nursing students to acquire knowledge and skills in the real practical setting to
become competent and skilled nurses. The nursing profession is considered one of the most complex jobs that
provide care to healthy and ill people in diverse settings by using explicit knowledge and skills (Marco et al.,
2019) 11.
The findings of the current study revealed that more than half of them their age ranged between 30 to
less than 40 years old with mean. This study findings were supported by the study of Hassan and Bassuoni,
(2017), undergraduate nursing students’ and clinical instructors’ perceptions of the characteristics of an effective
clinical instructor at the faculty of nursing and reveals that majority of the clinical instructors had from 25 years
to less than 30 years and the highest percentages of them were female.
Regarding the educational level less than two thirds of the clinical instructors had bachelor degree,
more than half of them had more than 10 years’ experience. Meanwhile, more than three quarters of the clinical
instructors did not attend training courses. This study was in accordance with the study of Eta et al (2011), who
studied the Nurses and challenges faced as clinical educators: A survey of a group of nurses in Cameroon and
found that, the age range of the clinical nurse educators who participated in the study were (25–54) years and
the number of years of clinical teaching of the participants ranged from 3 to 25 years.
This result was not in agreement with the results of Hassan and Bassuoni, (2017), found that, the
highest percentages of participants had a master degree and about half of them had less than five years of
experience. This study was in an agreement with the study of Ahmed, Abdou and Josephin, (2020), who studied
the challenges facing clinical nurse educators and nursing students in Egyptian and Saudi clinical learning
environment and found that, the age range of the Egyptian and Saudi clinical nursing educators were 24–53
years and the range of years of teaching experience for Saudi and Egyptian clinical nurse educators were 1–25
years.
Regarding the total competency of the studied subjects the findings of the current study displayed that,
the highest percentage of clinical instructors were at moderate level, while the lowest percentage of them were
at low competencies level. This study was in an accordance with the study of Lotfy, Mostafa and Fathy, (2018),
who studied the Core Competencies of Nurse Educator at Technical institutes of Nursing, Egyptian Journal of
Health Care found, that slightly more than fourth of them had high agreement upon core competencies.
WHO, (2016), mentioned that, using the core competencies of nurse educators in intentional and
innovative ways, nurse educators are empowered to shape their own practice and advance the education and
lifelong learning of all nurse educators.
This result was in agreement with the result of Roghieh and Eesa, (2015), mentioned that, a competent
trainer has an active clinical presence, pays inclusive attention to patients, has clinical experience and
proficiency and is capable of providing learning opportunities for the students by using the available facilities.
There were a positive correlation between work environmental, educational, psychological, social and
clinical instructor's competencies level with statistically significant differences. Moreover was positive
correlation between total factors affects and their competencies level of clinical instructors with statistically
significant difference. Meanwhile there was statistically insignificant difference between administrative factor
and clinical instructor’s competencies level. This result was in agreement with the result of Lotfy, Mostafa and
Fathy, (2018), who found that, a significant positive correlation between nurse educators' core competencies of
engaging in scholarship and their age. This is quite plausible since maturation with advancing age increases the
likelihood of the nurse educator to design activities based on won experience, publish educational and nursing
science materials, and demonstrate integrity, perseverance, and creativities as qualities of a scholar.
The current finding goes in the same line with the results of the study conducted by Mohamed (2009),
who studied the competency of clinical instructor as perceived by students and clinical instructors themselves at
faculty of nursing Mansoura University found that, there is no significant correlation could be revealed between
age and total competency of nurse educators.

V. Conclusion
highest percentage of them were moderate affected, while the lowest percentage were low affected on
competencies level Moreover, the highest percentage of clinical instructors were at moderate level, while the
lowest percentage of them were at low competencies level. statistically significant associations between marital
status, attended training courses of the clinical instructors and factors affect their competencies. There were
statistically significant associations between age, level of education, year of experience , training courses of the
clinical instructors and their competencies level. In addition, there were positive correlation between factors
affecting clinical instructor's competencies level among the clinical instructors in correlate to each of other with
statistically significant differences. Finally there were positive correlation between work environmental,
educational, psychological, social and clinical instructor's competencies level with statistically significant

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 Assessment of clinical instructors' competencies in the nursing field

differences It was recommended training programs to improve the clinical instructor in the nursing field
performance competency and Periodic evaluate competencies of the clinical instructor in the nursing field is
necessary to improve their knowledge and practices.and Further research study is recommended to focus on the
clinical instructor competencies in the nursing field.

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Nagat sayed Mohamed hassan, et. al. “Assessment of clinical instructors' competencies in the nursing field
.” IOSR Journal of Nursing and Health Science (IOSR-JNHS), 10(2), 2021, pp. 36-41.

DOI: 10.9790/1959-1002013641 www.iosrjournals.org 41 | Page