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Clinical teaching competencies are fundamental for nurse educators, as they play a crucial role in enhancing the self-esteem of nurse teachers within clinical settings.
The aim of the study was to assess the training program to improve the clinical teaching competencies of nurse teachers and to evaluate its effect on their self-esteem.
A quasi-experimental design was employed, involving all available nurse teachers (N = 50) from the Technical Institute of Nursing, Faculty of Nursing, Ain Shams University, Cairo, Egypt. A total of three tools were utilized: (1) a knowledge questionnaire on clinical teaching competencies, (2) an observational checklist for clinical teaching competencies, and (3) the Rosenberg self-esteem scale.
There was a highly significant improvement in the knowledge and performance of the nurse teachers in relation to clinical teaching competencies. Knowledge scores increased to 100% in both the immediate post-training and follow-up phases, while performance scores improved to 96.0% in the immediate post-training phase and 60.0% in the follow-up phase. In addition, the majority of the nurse teachers (64%) demonstrated a high level of self-esteem immediately after the training program, and 62.0% maintained a high level in the follow-up phase, compared to only 4.0% before the training program.
There was a highly statistically significant positive correlation between total knowledge, performance related to clinical teaching competencies, and the self-esteem of nurse teachers in the immediate post-training program phases. In addition, there was a statistically significant positive correlation between total knowledge, performance related to clinical teaching competencies, and the self-esteem of nurse teachers in the follow-up phase.
Clinical teaching is essential and serves as the cornerstone of nursing education. Compared to theoretical classroom learning, it plays a significantly more important role in the educational process. The quality of interaction between nursing students and teachers in the clinical setting can facilitate or hinder the integration of theory with practice. The competencies required for clinical teaching constitute a dynamic process that takes place within a range of socio-cultural contexts (
Competency in clinical teaching improves the effectiveness of clinical education, aids in achieving laboratory-specific goals, fosters time management skills, and offers opportunities for new educational research endeavors. It also promotes good leadership quality, enhances interaction between nursing teachers and students, and motivates them to design and organize curricular and co-curricular activities. Therefore, trained nursing teachers are essential for nursing professional development (
A training program is an organized process designed to increase the knowledge and skills of nursing teachers for a certain purpose and helps them acquire the necessary knowledge and competencies to effectively perform their job duties (
Self-esteem refers to an individual’s overall positive or negative attitude toward themselves and their personal value assessment. Individuals who are driven to maintain high self-esteem show signs of positive self-consideration, which can be cultivated through daily experiences. It is a component of self-concept, defined as the totality of an individual’s thoughts and feelings that refer to themselves as an object (
Teachers with high self-esteem require students to actively participate in classroom tasks. Similarly, teachers with high self-esteem have been found to be more effective in the classroom and to feel less stressed about their work. However, stress reduces self-esteem and diminishes the scholastic effectiveness of teachers. There were no differences in effort, stress, or feelings of exhaustion between teachers based on gender, nor were these factors correlated with the number of years they had served (
Clinical teaching prepares nursing students to become competent practitioners capable of providing quality nursing care and promoting the health of the people they serve. Therefore, nursing teachers must have the knowledge and skills required to meet these competencies, which are gained through training (
Numerous studies have suggested that, to improve teaching roles, strategies, and methods in clinical settings, training programs should be implemented for all nursing teachers. In line with this,
The objectives of the study were as follows:
To assess nurse teachers’ knowledge regarding clinical teaching competencies.
To assess the levels of self-esteem among nurse teachers.
To develop and implement a training program on clinical teaching competencies for nurse teachers.
To evaluate the effects of the training program on nurse teachers’ self-esteem.
A quasi-experimental design was implemented using a one-group pretest, posttest, and follow-up (after 3 months). This study aimed to assess the impact of a clinical teaching competencies training program on nurse teachers’ knowledge, performance, and self-esteem. To achieve these objectives, a one-group pretest–posttest design with a follow-up phase was employed, enabling the measurement of changes over time.
The study enrolled a census sample of 50 nurse teachers and was conducted between August 2022 and July 2023. The sample size and the focus on a single institution (Ain Shams University) were determined by resource availability and the exploratory nature of this initial study. Given the study’s aim to evaluate the feasibility and immediate effects of a clinical teaching competencies training program, a focused institutional setting allowed for better control and consistency of the intervention.
The study was conducted at the Technical Institute of Nursing, Faculty of Nursing, Ain Shams University, Cairo, Egypt. The institute was established in 1986 and was initially affiliated with the Faculty of Medicine. It is now affiliated with the Faculty of Nursing as a division under the leadership of a manager who reports to the Dean of the Faculty of Nursing.
In Egypt, the program at the Technical Institute of Nursing consists of 2 years of academic study followed by a six-month internship at Ain Shams University Hospitals, Cairo. Upon completion, students are awarded the certificate “Technical Nursing Institute Diploma Above Average.” Students have the opportunity for admission to the Faculty of Nursing if they have a grade point average of 75%. This setting has 50 nurse teachers.
The training program was created in the form of an English-language booklet to improve the clinical teaching competencies of nurses. It was developed by the researchers in February 2024, based on a comprehensive review of relevant literature, including textbooks, scientific articles, and online searches. The researchers designed the training program for nurse teachers. The general objective of the program was to improve their clinical teaching competencies. The program content was divided into theoretical and practical components, and each session incorporated case studies, role-playing activities, and group discussions to reinforce learning. In addition, the teaching methods were identified, and the venue for conducting the program sessions was booked and prepared in collaboration with the Dean of the Faculty and the Director of Training and Development at Ain Shams University Hospital, Cairo, Egypt.
The program was implemented over 2 months (from March 2024 to the end of May 2024). The researchers distributed educational training booklets to the participants on the first day of the implementation of the training program. Daily feedback was provided at the beginning of each session about participants’ expectations and at the end of each session about the session and activity delivered to the participants. The training program was conducted over 12 weeks, with sessions held 2 days per week, totaling 6 h each week—3 h dedicated to theoretical content and 3 h to practical training. The program consisted of 12 sessions in total, as follows: First session: The researchers explained the purpose of the training program, the objectives, the content outline, the methods, and the evaluation process. They also provided an introduction to key concepts, such as definitions, determinants of learning, methods for assessing learning needs, and training on adult learning. Second session: This session covered the definition of teaching practice competence, its importance, general goals, characteristics, and challenges related to clinical teaching training (clinical teaching competencies). Third session: This session covered the definition of the components of competence in teaching practice, definitions, characteristics, influencing factors, types of educational objectives, and strategies for developing a clinical learning environment (effective clinical learning environment). Fourth session: This session focused on the definition, types of professional competence, advantages, characteristics, formulation, components, and levels of educational objectives (How to formulate educational objectives). Fifth session: This session focused on the definition of teaching practice competence, factors, types, and application of appropriate teaching strategies [clinical teaching strategies (Methods)]. Sixth session: This session covered the definition of knowledge competency, steps involved, materials, qualities, and the use of visual aids that reflect good instructional design properties, with training on effective presentation skills. Seventh session: This session focused on the definition of clinical competence, purpose of pre-clinical and post-clinical conferences in clinical settings, possible activities during a conference, and methods involved in the preparation of clinical conferences (conducting clinical conferences in the clinical setting). Eighth session: This session covered the definition and characteristics of the teaching method, such as lecture, demonstration and re-demonstration, seminars, role-playing, problem-solving, and simulation. This session also addressed the principles, characteristics, role of each member participating, steps, benefits, and disadvantages (problem-based learning effectively). Ninth session: This session covered the definition and types of professional competence and the role of the nursing teacher in laboratory sessions, briefing sessions, practice sessions, debriefing sessions, and clinical teaching. It also addressed the ethical responsibilities of the nursing teachers (responsibility of the nursing teachers in clinical teaching). Tenth session: This session focused on the definition and characteristics of personal competence, its importance, dimensions, levels, barriers, and strategies of critical thinking training (critical thinking). Eleventh session: This session focused on the definition of personal competence, its importance, principles, steps, strategies, barriers, and ways to use time more effectively (time management). Twelfth session: This session covered the definition of evaluation competence, its purpose, types, roles of the clinical supervisor, types of evaluation, methods, and effective feedback (Evaluation strategies in clinical teaching).
After the implementation of the training program, an immediate posttest was performed to assess the knowledge and performance of the nursing teachers regarding clinical teaching competencies, using the same tools as the pretest. This helped to evaluate the effect of the implemented training program. This was conducted immediately after the training program and again after 3 months as a follow-up. Data collection took place in December 2024.
Data were collected using self-administered questionnaires distributed by the researchers to all participating nurse teachers. A total of three distinct instruments were employed at three time points: before the training program (pretest), immediately after completion (posttest), and 3 months post-intervention (follow-up). The study spanned 9 months, from January to September 2024, with the training program implemented over 4 months, from September to December 2023.
The first instrument was a structured questionnaire assessing socio-demographic characteristics (age, gender, marital status, years of experience, and educational level) and the nurse teachers’ knowledge regarding clinical teaching competencies. The knowledge section included 50 items—multiple-choice and true/false questions—adapted from
The second instrument was an observational checklist evaluating the nurse teachers’ performance in clinical teaching competencies across five dimensions: professional, interpersonal, personal, teaching practice, and evaluation competence. This tool was also adapted from the same sources and consisted of 80 items scored on a binary scale (yes/no).
The third instrument was a self-esteem scale that combined the Rosenberg self-esteem scale (
The training program was developed by the researchers based on an extensive literature review, including textbooks, articles, and current research (
This tool consists of two parts: socio-demographic data and 50 knowledge items related to clinical teaching competencies. Responses are scored as 1 for correct and 0 for incorrect, with a maximum total score of 50. Scores ≥ 60% (≥30 points) indicate satisfactory knowledge, while scores below 60% (<30 points) are considered unsatisfactory.
The checklist contains 80 items across five competency dimensions: professional, interpersonal, personal, teaching practice, and evaluation. Each item is scored as 1 (yes) or 0 (no), with a maximum total score of 80. Scores ≥ 60% (≥48 points) reflect adequate competence, and scores below 60% (<48 points) reflect inadequate competence.
The combined Rosenberg and Sorenson self-esteem scale includes 20 items assessing positive self-esteem, negative self-esteem, and social personality. A total of four items are reverse-scored to reduce bias. This instrument measures nurse teachers’ self-perceptions related to their professional role.
The responses of the students were measured using a five-point Likert scale, ranging from “strongly agree” (5) to “strongly disagree” (1). The scoring was as follows: strongly agree = 5, agree = 4, somewhat agree = 3, disagree = 2, and strongly disagree = 1. For negative statements, the scores were reversed to ensure consistency in interpretation. The level of self-esteem was considered high if the percentage score was 80% or above, and low if it was below 80%.
In the current study, to achieve the objective of assessing nurse teachers’ knowledge of clinical teaching competencies, a structured questionnaire was administered at three time points: before the intervention (pretest), immediately after completion (posttest), and 3 months later (follow-up). This allowed for the evaluation of knowledge acquisition and retention. For the objective of evaluating clinical teaching competence, an observational checklist and a self-assessment tool covering dimensions such as professional skills, interpersonal communication, teaching, and evaluation were used at the same three time points. This approach enabled objective and subjective measurement of teaching performance and its development post-intervention. Regarding the objective of assessing changes in self-esteem, a validated self-esteem scale was administered alongside the other assessments at all three time points. This instrument captured shifts in the nurse teachers’ self-perception and confidence related to their professional role.
Face validity and content validity were established by a panel of five experts in nursing administration, including two professors from the Nursing Administration Department at Ain Shams University and three professors from the Nursing Administration Department at Cairo University, Egypt. The experts reviewed the tools for clarity, relevance, completeness, simplicity of language, and usability. Some changes were made when the final forms were being developed. In addition, the reliability of the developed tools was assessed using Cronbach’s alpha coefficients. The reliability coefficients were 0.908 for the self-esteem scale, 0.980 (using the Guttman split-half test) for the clinical teaching competencies knowledge questionnaire, and 0.967 for the observational checklist assessing clinical teaching competencies. Implementing principal component analysis (PCA) and confirmatory factor analysis (CFA) in future studies would offer a more robust evaluation of construct validity and increase confidence in the generalizability and interpretability of the findings across different populations and contexts.
A pilot study was conducted in January 2024 with 10% of the sample size (five nurse teachers) to evaluate the applicability, clarity, and effectiveness of the tools, as well as to estimate the time required to complete them, which ranged between 20 and 25 min. No adjustments or changes were made, and nurses were included in the study sample based solely on the findings of the pilot study.
Statistical analysis was performed using SPSS version 25. Quantitative data were presented as mean ± standard deviation, whereas categorical variables were presented as percentages. The internal consistency approach was used to assess the reliability of the tools, with the estimation of Cronbach’s alpha coefficients for the self-esteem tool and Guttman split-half coefficients for the knowledge and practice tools. Analytic statistics included chi-squared or Fisher’s exact tests for comparing categorical variables and Spearman’s rank correlation to examine the relations among quantitative and ranked variables. Multiple regression analysis was performed to identify independent predictors of knowledge, practice, and self-esteem scores. The level of statistical significance was set at a
Ethical approval for this study was obtained from the Research Ethics Committee of the Faculty of Nursing, Ain Shams University, Cairo, Egypt (Registered number 25.04.629). In addition, written informed consent was obtained from all participants. The participants were informed of their right to withdraw from the study at any time without providing a reason.
A total of 50 nurse teachers participated in the study, with ages ranging from 25 to 60 years. The mean age of the participants was 39.3 ± 11.2 years, with a median age of 37.5 years. The majority of the participants were married (
Demographic characteristics of the nurse teachers in the study sample.
| Characteristics | Frequency |
Percent |
|---|---|---|
| Age | ||
| <40 | 29 | 58.0 |
| 40+ | 21 | 42.0 |
| Range | 25–60 | |
| Mean ± SD | 39.3 ± 11.2 | |
| Median | 37.5 | |
| Marital status | ||
| Unmarried | 9 | 18.0 |
| Married | 41 | 82.0 |
| Nursing qualification | ||
| Bachelor’s degree | 21 | 42.0 |
| Higher degree | 29 | 58.0 |
| Experience years | ||
| <10 | 19 | 38.0 |
| 10+ | 31 | 62.0 |
| Range | <1–39 | |
| Mean ± SD | 15.4 ± 11.7 | |
| Median | 15.0 | |
| Training courses | ||
| No | 29 | 58.0 |
| Yes | 21 | 42.0 |
Data are expressed as percentages for categorical variables. SD, stander deviation;
To determine the knowledge of clinical teaching competencies among the nurse teachers, pretest, posttest, and follow-up assessments were conducted. The findings indicated statistically significant differences in the total satisfactory knowledge of clinical teaching competencies and their dimensions: professional, interpersonal, personal, teaching, and evaluation between the pretest and posttest phases of the training program, as well as between the pretest and follow-up phases. Moreover, there was a notable increase in the total satisfactory knowledge of the studied teachers in the post-training and follow-up phases compared to the pre-training phase (
Knowledge of clinical teaching competence among the nurse teachers across the study phases.
| Satisfactory (60%+) knowledge of clinical teaching competence: | TIME | |||||||
|---|---|---|---|---|---|---|---|---|
| Pretest | Posttest | FU | ||||||
| (%) | (%) | (%) | ||||||
| Professional | 1 | 2.0 | 50 | 100.0 | 50 | 100.0 | 96.07 (<0.001*) | 96.08 (<0.001*) |
| Interpersonal | 6 | 12.0 | 46 | 92.0 | 46 | 92.0 | 64.10 |
64.10 |
| Personal | 14 | 28.0 | 47 | 94.0 | 49 | 98.0 | 45.78 |
52.55 |
| Teaching | 1 | 2.0 | 50 | 100.0 | 50 | 100.0 | 96.08 |
96.08 |
| Evaluation | 1 | 2.0 | 50 | 100.0 | 49 | 98.0 | 96.08 |
92.16 |
| Total: | ||||||||
| Satisfactory | 1 | 2.0 | 50 | 100.0 | 50 | 100.0 | 96.08 | 96.08 |
| Unsatisfactory | 49 | 98.0 | 0 | 0.0 | 0 | 0.0 | (<0.001*) | (<0.001*) |
The differences between means were tested using an independent samples
The findings revealed statistically significant differences in the total adequate clinical teaching competence of the studied nurse teachers between the pretest and posttest phases, as well as between the pretest and follow-up phases of the training program. There was an increase in the total adequate clinical teaching competence in the posttest phase compared to the pretest phase, followed by a decline at the follow-up phase (
Total clinical teaching competence among the nurse teachers across the study phases.
| Total clinical teaching competence | TIME | |||||||
|---|---|---|---|---|---|---|---|---|
| Pretest | Posttest | FU | ||||||
| (%) | (%) | (%) | ||||||
| Adequate | 20 | 40.0 | 48 | 96.0 | 30 | 60.0 | 36.03 | 4.00 |
| Inadequate | 30 | 60.0 | 2 | 4.0 | 20 | 40.0 | (<0.001*) | (0.046*) |
The differences between means were tested using an independent samples
The findings showed statistically significant differences in the total high self-esteem of the studied nurse teachers and its total dimensions—positive and negative personality—between the pretest and posttest phases, as well as between the pretest and follow-up phases of the training program. There was an increase in the total high self-esteem and its dimensions in the posttest phase compared to the pretest phase, followed by a decline at the follow-up phase (
Self-esteem among the nurse teachers across the study phases.
| High (80 + %) self-esteem | TIME | |||||||
|---|---|---|---|---|---|---|---|---|
| Pretest | Posttest | FU | ||||||
| (%) | (%) | (%) | ||||||
| Positive personality | 22 | 44.0 | 47 | 94.0 | 45 | 90.0 | 29.21 (<0.001*) | 23.93 (<0.001*) |
| Negative personality | 17 | 34.0 | 46 | 92.0 | 36 | 72.0 | 36.08 |
14.49 |
| Social personality | 10 | 20.0 | 16 | 32.0 | 31 | 62.0 | 1.87 |
18.23 |
| Total | ||||||||
| High | 2 | 4.0 | 32 | 64.0 | 31 | 62.0 | 40.11 | 38.04 |
| Low | 48 | 96.0 | 18 | 36.0 | 19 | 38.0 | (<0.001*) | (<0.001*) |
The differences between means were tested using an independent samples
The correlation matrix demonstrated statistically significant correlations among the total scores of knowledge, competence, and self-esteem among nurse teachers. Specifically, there was a statistically significant positive correlation between total knowledge and total competence, as well as between total knowledge and total self-esteem (0.355,
Correlation matrix of the nurse teachers’ scores for total knowledge, competence, and self-esteem.
| Items | Spearman’s rank correlation coefficient | ||
|---|---|---|---|
| Knowledge | Competence | Self-esteem | |
| Knowledge | 1.000 | ||
| Competence | 0.355** | 1.000 | |
| Self-esteem | 0.526** | 0.223** | 1.000 |
**Correlation is highly statistically significant at
The findings showed that the only statistically significant independent positive predictor of the self-esteem score was the intervention, with a coefficient of 7.34 (
Best-fitting multiple linear regression model for the competence score.
| Predictor | Unstandardized coefficients | Standardized coefficients | 95% confidence interval for B | ||||
|---|---|---|---|---|---|---|---|
| Std. error | Lower | Upper | |||||
| Constant | 116.50 | 28.54 | 4.083 | <0.001 | 59.85 | 173.16 | |
| Intervention | 5.30 | 1.61 | 0.28 | 3.282 | 0.001 | 2.09 | 8.50 |
| Age | −2.67 | 1.11 | −1.57 | −2.409 | 0.018 | −4.87 | −0.47 |
| Higher qualification | 6.18 | 3.44 | 0.16 | 1.798 | 0.075 | −0.65 | 13.02 |
| Experience years | 2.47 | 1.06 | 1.52 | 2.326 | 0.022 | 0.36 | 4.57 |
| Previous training | 14.68 | 3.35 | 0.38 | 4.387 | <0.001 | 8.04 | 21.33 |
The differences between means were tested using an independent samples
The challenge for nursing education is to prepare graduates to deal with the demands of today’s healthcare setting, despite issues related to inadequate training (
Regarding professional clinical teaching competence among nurse teachers across the study phases, the current study results illustrated a statistically significant difference in the total adequate clinical teaching competence and its` dimensions: clinical support and knowledge between the pre- and post-training program phases. Moreover, there was a statistically significant difference in the total adequate support and knowledge of the studied nurse teachers between the pretest and follow-up phases, while there was no statistically significant difference in the total adequate clinical teaching competence of the studied nurse teachers and its clinical dimension between the pretest and follow-up phases. This suggests that the training program provided relevant skills, strategies, and resources that contributed to their professional growth in key teaching areas, such as clinical support and knowledge application. These results align with the idea that structured clinical teaching programs can significantly enhance the ability of nurse teachers to manage and support students effectively in clinical environments. In addition, there was an increase in their total adequate clinical teaching competence and its dimensions in the posttest phase compared to the pretest phase, followed by a slight decline in the clinical dimension and a severe decline in the total adequate clinical teaching competence, as well as knowledge and support dimensions, during the follow-up phase. The decline in the total adequate clinical teaching competence, particularly in the clinical and knowledge dimensions at the follow-up phase, suggests challenges in maintaining these gains over time. In line with the current study,
Concerning the total adequate clinical teaching competence among the nurse teachers across the study phases, the results revealed statistically significant differences between the pre- and post-phases and between the pre- and follow-up phases of the training program. There was an increase in the total adequate clinical teaching competence in the posttest phase compared to the pretest phase, followed by a decline in the follow-up phase. These results may be explained by the fact that the nurse teachers likely experienced a noticeable improvement in their clinical teaching competence immediately after the training program. This improvement could be due to the hands-on nature of the training, exposure to new teaching methods, and the development of skills such as effective communication, clinical supervision, and assessment. Supporting studies by
Concerning self-esteem among the nurse teachers across the study phases, the results showed statistically significant differences in the total high self-esteem and its dimensions—positive and negative personality—between the pre- and post-phases and between the pre- and follow-up phases of the training program. There was an increase in the total high self-esteem and its dimensions in the posttest phase compared to the pretest phase, followed by a decline in the follow-up phase. This may be due to the fact that the nurse teachers likely experienced a boost in self-esteem immediately after the training program, resulting from the acquisition of new skills, increased confidence in their teaching abilities, and validation through positive feedback. The decline during the follow-up phase could indicate that, although the training had a short-term impact on self-esteem, its effects were not sustained over time. This could be due to several factors, including a lack of continued support, the pressures of teaching, or external influences such as workload and institutional constraints, which may diminish the sense of accomplishment and competence over time. Nurse teachers may face challenges such as high workload, lack of administrative support, and burnout, along with a lack of ongoing reinforcement of the competencies learned during the training, which can negatively affect their self-esteem. These factors could lead to a decline in both positive personality traits and the overall perception of their teaching competencies over time. Consistent with the findings of the current study,
Regarding the correlation between nurse teachers’ scores for total knowledge, competence, and self-esteem, the current results revealed that there was a statistically significant correlation between total knowledge and total competence, as well as between total knowledge and total self-esteem. Moreover, there was a statistically significant correlation between total competence and total self-esteem. This may be explained by the fact that a high level of knowledge is generally a precursor to competence in any field, especially in nursing education. Nurse teachers with a deeper understanding of the subject matter are better equipped to teach and effectively guide their students. This direct relationship between knowledge and competence is not surprising, as teaching ability depends on both the breadth and depth of the educator’s knowledge. Moreover, self-esteem plays a crucial role in teaching effectiveness. These findings are supported by the findings of
The current study’s multivariate analysis results indicated that the only statistically significant independent positive predictor of the self-esteem score was the intervention. This finding can be explained by the notion that increased competence likely translates into higher self-esteem, as teachers recognize their ability to positively influence student learning and the quality of care delivered in clinical settings. Interventions specifically designed to improve self-awareness, emotional intelligence, and confidence can lead to significant improvements in self-esteem, which explains why the intervention emerged as the only significant predictor. Supporting this perspective,
In addition, this study is underpinned by established theories of self-esteem and professional development, particularly Rosenberg’s self-esteem theory, which emphasizes the role of self-worth and self-acceptance in individuals’ motivation and behavior, and Bandura’s social cognitive theory, which highlights self-efficacy as a key determinant of confidence in one’s abilities. The clinical teaching competencies training program was designed not only to enhance nurse teachers’ knowledge and skills but also to foster positive self-perception by increasing their confidence and sense of professional efficacy. By improving competence, the intervention aims to strengthen self-esteem, reflecting the reciprocal relationship between knowledge, skill mastery, and personal valuation. Although this study focused primarily on quantitative outcomes, future research incorporating qualitative methods, such as narrative reflections or interviews, could provide a deeper understanding of participants’ subjective experiences and the complex processes through which self-esteem is developed and sustained in professional educators.
The findings of this study, which assessed the effects of a clinical teaching competencies training program on the self-esteem levels of nurse teachers, showed improvements in both teaching competencies and self-esteem. The results reinforce the value of training and institutional support in empowering efficacy within nursing education. Nevertheless, the research is limited by a small sample size from a single institution, which raises generalizability concerns. Furthermore, the short follow-up period limits the understanding of the long-term impacts of the intervention. Subsequent studies should focus on employing broader multi-center samples and longitudinal approaches to strengthen these conclusions. To strengthen the generalizability and methodological rigor of findings in this area, future research should involve multiple nursing institutions and employ randomized controlled trial designs across diverse educational and cultural settings to enhance external validity. A longer-term longitudinal follow-up of 6–12 months or more is recommended to better assess the sustained impacts on clinical teaching competencies and self-esteem. Incorporating mixed-methods approaches, including qualitative data, could further enrich the understanding of how such interventions influence nurse teachers’ experiences and professional development. Despite this study’s valuable contributions, its one-group pretest–posttest design without a control group limits the ability to attribute improvements solely to the intervention, as alternative factors such as maturation or external influences cannot be ruled out. In addition, while validated instruments were used, the potential for response bias due to participants’ awareness of evaluation timing exists, possibly inflating results. Future studies should include more objective assessments, such as direct observations or external evaluations, alongside self-reports to provide a more comprehensive evaluation of clinical teaching competencies.
Recommendations: From an institutional perspective, developing orientation sessions, creating and issuing guides, and enhancing the psychosocial and physical learning environments are key priorities. The collaborative clinical learning environment provided by hospitals should be resourceful. Nurse educators are expected to utilize student-led formative feedback and adopt participatory evaluation approaches. More focus should be placed on the relationship between clinical teaching competence, professional development, and the perceived self-esteem of nurse educators in technical nursing colleges. This study should be conducted with a much larger sample size. Future research should incorporate longer follow-up intervals to more effectively evaluate the enduring impact of clinical teaching competency training on nurse teachers’ skills and self-esteem, as well as to identify factors that support sustained competence. In addition, employing mixed-methods approaches would enrich the understanding of how such training influences nurse teachers both quantitatively and qualitatively. Future studies should also aim to account for and control potential confounding variables, such as work environment stressors, administrative support, and prior teaching experience, to better isolate the effects of the training and provide a more comprehensive insight into the factors affecting nurse teachers’ professional development.
There was a highly statistically significant improvement in the nurse teachers’ knowledge and performance regarding clinical teaching competencies between the pre-training and immediate post-training program phases, as well as between the pre-program and follow-up phases. In addition, there was a highly statistically significant improvement in the nurse teachers’ self-esteem between the pre-training and immediate post-training program phases, as well as between the pre-program and follow-up phases. There was a highly statistically significant positive correlation between total knowledge, performance in clinical teaching competencies, and nurse teachers’ self-esteem at the immediate post-training program phase. Furthermore, there was a statistically significant positive correlation between total knowledge, performance in clinical teaching competencies, and nurse teachers’ self-esteem at the follow-up phase.
The datasets presented in this study can be found in online repositories. The names of the repository/repositories and accession number(s) can be found in the article/supplementary material.
The studies involving humans were approved by Ethical approval for this study was obtained from the Research Ethic Committee of Faculty of Nursing, Ain Shams University, Cairo, Egypt, Registered number 25.04.629, to carry out the study. In addition, written informed consent was obtained from all participants. Participants have the right to withdraw from the study without any rationale at any time. The studies were conducted in accordance with the local legislation and institutional requirements. Written informed consent for participation in this study was provided by the participants’ legal guardians/next of kin.
AM: Conceptualization, Methodology, Project administration, Supervision, Validation, Visualization, Writing – review & editing. MS: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing. DK: Data curation, Formal analysis, Investigation, Methodology, Software, Supervision, Validation, Visualization, Writing – review & editing.
The author(s) declare that no financial support was received for the research and/or publication of this article.
We are very grateful to the General Director of the Technical Institute of Nursing, Ain Shams University, Faculty of Nursing, Cairo, Egypt, as they paved the way to conduct the study by giving approval for data collection. We also extend our thanks to the Faculty of Nursing, Ain Shams University, and to the nurse teachers who actively participated in the study.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
The authors declare that no Gen AI was used in the creation of this manuscript.
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