Running head: THE RELATIONSHIP OF NURSING FACULTY CLINICAL TEACHING

BEHAVIOR ON NURSING STUDENTS

LEARNING 1

Proposal Writing

The relationship of nursing faculty clinical teaching behavior on nursing students learning

Sonia Waseem

(BSN02141006)

Senior Elective Education (NUR 465)

Muhammad Afsar Ali

October,16, 2017
THE RELATIONSHIP OF NURSING FACULTY CLINICAL TEACHING BEHAVIOR
ON NURSING STUDENTS LEARNING 2

Contents
1. Introduction:.................................................................................................... 3
1.1. Background of study: ............................................................................... 3
1.2. Research problem: .................................................................................... 5
1.3. Purpose of the study:.................................................................................. 5
1.4. Objectives: ................................................................................................ 5
1.5. Significance .............................................................................................. 5
1.6. Conceptual definition: .............................................................................. 6
1.7. Variables: .................................................................................................. 7
1.8. Research Questions .................................................................................. 7
1.9. Hypothesis ................................................................................................ 7
2. Theoretical framework.................................................................................... 7
3. Literature review ............................................................................................. 9
4. Methodology ................................................................................................. 12
4.1. Study Design: ........................................................................................... 12
4.2. Study participants: .................................................................................... 12
4.3. Inclusion criteria ....................................................................................... 12
4.4. Exclusion criteria .................................................................................... 12
4.5. Sample Strategy ...................................................................................... 12
4.6. Research instrument ............................................................................... 12
5. Ethical consideration: ................................................................................... 13
6. Data collection: ............................................................................................. 13
7. Data Analysis: ............................................................................................... 13
References ........................................................................................................... 14
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ON NURSING STUDENTS LEARNING 3

1. Introduction:
1.1. Background of study:

Nursing is a growing filed globally and it is undoubtedly the back bone of the health

care settings. It is a fact that the nurses are the largest group which are present in the health

care teams globally. Further, to this ICN (international council of nurses) states that the

approximately 11 million nurses are working around the world and this is the estimation of

2000, thus the number of the working nurses would have been increased by this year. Nursing

education has two components: clinical teaching and academic (class room teaching). Both are

equally important for the nursing students however; the importance of the clinical education is

much more than the academic education. According to Heidari & Norouzadeh, (2015), the

clinical teaching in nursing is of utmost importance. They further aggrandize that this is the

part of the education that explains the quality and quantity of the nursing profession in the field.

Furthermore, the importance of the clinical education is undeniable in the professional and

clinical skills development. Okoronkwo, Onyia-pat, Agbo, Okpala, & Ndu (2013) have

described the importance of the clinical education in nursing. It is said that the effective clinical

teaching is an integral part of nursing education. Hence, it helps the students to prepare them

for the future practicing nurses. Additionally, the experience gained by the nursing students in

the clinical education helps them to take part actively in the health care setups and work

efficiently with the health care teams. So the importance of the clinical teaching in nursing is

very much.

The clinical teaching is also important to produce such nurses which can work

effectively in the hospitals. Thus, the good and effective clinical teaching can be got and

provided through the competent teachers and instructors at the clinical facilities. As a matter
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ON NURSING STUDENTS LEARNING 4

of fact, it can be seen that the clinical teaching is always designed to help the students in the

clinical settings. Moreover, the nursing students can attain knowledge and skills by

participating in the work setting under the supervision of the trained faculty members appointed

by the organizations.

As discussed above the attitude and the knowledge of the nursing instructor has lot to

do with the learning of the nursing students. Therefore, it is needed that the nursing instructors

should teach effectively and in well manner. According to Ismail, Aboushady, & Eswi, (2016),

the clinical instructors are with the opportunity to influence the student’s learning. Moreover,

the behavior of the instructor plays an important r ole to shape the future nurses for the best

practices. Similarly, the clinical instructor must have effective teaching characteristics. The

factors which are affecting the clinical teaching behaviors and student’s learning mainly

include the; teacher’s behaviors at the clinical settings, clinical environment (facilities,

behaviors of seniors) and student’s behavior towards learning. According to Kube 2010

Clinical experience is the most important component of nursing education. Additionally, it is

also important due to the reason that the students use their learned concepts into practical and

promote the patient care. Awuah-Peasah, Sarfo, & Asamoah, (2013), stated that the nursing

students must have an instructor with them all time during clinical timings who will observe

their behavior and skills to make them competent and to monitor them. Instructor should be

from their educational institution.

Several studies have been done to show the relationship between the effective clinical teaching

behaviors of the teachers and student’s learning. However, the existing clinical education does

not meet the competence of the students. it is necessary to find the issues in the effective clinical

education.. Furthermore, students are also blank about the objectives of the clinical education.
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1.2. Research problem:

Teacher’s behavior, student learning and clinical environment are interlinked to each other as

these are affecting in a positive or negative way. The learning directly depends upon the

teacher’s behavior and clinical environment. If the clinical environment is good and providing

facilities and opportunities to the teachers and students, then the learning will be more. If one

on the component is not appropriate, then the learning is hindered. The teacher’s skills, way of

teaching, way of dealing students and the clinical facilities and attitude of the people in the

clinical settings is always affecting the learning of the students. If the behavior is not

appropriate are needed by the students, these things can take place. Clinical skills can be

effected, there will be not a healthy relation between teacher and students. The students will

refrain asking the questions regarding their clinical practices. There will not a good output of

students learning. The related people and environment will effected. The patient care will be

neglected. Hence, we will see the relationship in these variables.

1.3. Purpose of the study:

The aim of the study is to assess a relationship between the nursing student’s learning with

the environment and the teacher’s behaviors. If there will have healthy relation more over

patient care will give appropriate as per needed by the patient. If there is good behavior of

teacher towards students, learning will be at maximum level. The patient will get good as

their need by which hospital will be considered with good words by the patient.

1.4. Objectives:
1 To assess the relationship of nursing faculty clinical behavior on nursing students

learning.

1.5. Significance
Clinical training in nursing education poses the core position as this helps in the development

of the competent nurses. Moreover, the teacher’s behavior and attitude also has a significant

role in the clinical education. The clinical instructors or teacher teaches the nursing students in

the clinical area to make them competent. Thus, the clinical teachers and environment provide
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ON NURSING STUDENTS LEARNING 6

an opportunity to the be professional and competent in the nursing profession. Therefore, the

learning environment and teachers play a pivotal role to make the nurses competent. Moreover,

their behavior is also an important component for the production of future nurses. Therefore,

this study will help to explore the main reasons and causes of better and worst learning in the

clinical environment. The exploration of teacher’s behavior and learning environment will help

the students as well the teachers to gain knowledge and skills. Furthermore, this study will

help to improve the studies and teaching skills at the institution levels. The institutions will be

able to pay attention on the rising issue of the teacher’s behavior and learning environment in

the govt hospitals. Additionally, this will help to produce the nurses that will be able to work

effectively in the communities. So this will work as a milestone to see where the nurses are

actually present at the present day and what is needed to improve the learning through teacher’s

behavior at the clinical area and clinical learning environment. Moreover, the nurse educators

and students can use the results of this study to know that the learning environment and

teacher’s behaviors help in learning so necessary actions can be taken to improve the clinical

learning. Moreover, this will also add knowledge for future curriculum setting and planning

for perfect clinical teaching.

Key Terms

Clinical teacher, Clinical teaching behavior, Learning,

1.6. Conceptual definition:

Learning

A “new experience (which) alters some unobservable mental processes that

may or may not be manifested by a change in behavior or performance” (Billings & Halstead,

2009, p. 190).

Clinical teacher behavior

A set of 47 actions, delineated on the NCTEI (Knox &

THE RELATIONSHIP OF NURSING FACULTY CLINICAL TEACHING BEHAVIOR
ON NURSING STUDENTS LEARNING 7

Mogan, 1985), used by nursing faculty for assisting students in the clinical learning process.

Clinical teacher

“Actions, activities, and verbalizations of the clinical instructor which facilitate student

learning in the clinical setting” (O‟Shea & Parsons, 1979, p. 411).

1.7. Variables:
Independent

A variable who changing does not affect the other

Independent: clinical environment and teacher’s behavior

Dependent

A variable when it change the other object will also change

Dependent: Students learning about the environment

1.8. Research Questions

Is there a connection between the relationships of nursing faculty teaching behavior on

nursing students learning?

1.9. Hypothesis
Ha: There is a relationship between the clinical teaching faculty’s behavior and clinical

teaching environment with the student’s effective learning

Ho: There is no relationship between the clinical teaching faculty’s behavior and clinical

teaching environment with the student’s effective learning.

2. Theoretical framework

This theoretical frame work was Albert’s social learning theory. This theory state that human

learning occurs in relation with human environment because personal factors ,human

behavior and human environment are interlinked with each other’s. It also state that learning

process does not result in abrupt change of behavior so it is considerable for teachers to find
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out what’s students understand about the environment of learning. The phases of social

learning theory are common factors; modeling and self-efficacy. The common factors are the

relationship of personal factors of the learner, environment and behavior. The personal

factors of the learner are intellectual, emotional and natural actions. when the learner connect

with the environment ,the personal factors effect to inspire act in a positive manner.

The learning do not learn to direct experience with the environment, they also learn by watching

and understanding the behaviors of others that are involve in a process. The learner keep the

knowledge in his mind that he take from the other model behavior .The personal factors that

are disturbing human behavior are self efficacy beliefs.Self efficacy belief mostly affect to

learning conditions because behavior is define further by what people believe that they have

talent to doing.people with great self efficacy take difficult task as a challenge and people with

low feeling of self efficacy to avoid take challenge. The Bandura’s social learning theory is

most suitable to clinical education because clinical experience include connect between

student and leaning environment. The learning environment contain of social connection with

clinical teacher, patients and their families. When the students contact qqqqto the clinical

teacher, they feel how teacher understand their behavior. Lastly students self efficacy beliefs
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have great effect on the product of clinical learning condition. The clinical condition create

anxiety in nursing students which can decrease the students self efficacy. The teaching behavior

of clinical teacher in this condition have the ability to increase or decrease the self efficacy

beliefs of students for more learning practices.

3. Literature review

According to (Jamshidi, Molazem, Torabizadeh, & Kalyan, 2016) nursing competencies are

based on the knowledge taught to them. Moreover, nursing education is the combination of

theoretical and practical that helps the students to acquire knowledge and skills. Furthermore,

the more part of the nursing education is carried in the clinical setting. Thus, the clinical

learning environment helps the students to convert the theoretical knowledge into the practice.

Additionally, the (Niederriter, Eyth, & Thoman, 2017) has further explained that the clinical

experience is a vital part of nursing and it helps for the development of the nursing students.

Therefore, the clinical teaching is different from the classroom teaching. Clinical learning takes

place in the complex environment. The clinical instructors are the persons who are with the

knowledge and tend to transfer the knowledge to the students to improve their skills. According

to (Niederriter, Eyth, & Thoman, 2017) have stated that the clinical instructor is an important

part of the clinical education. They are charged with the transfer of the knowledge that is

learned in the classroom settings. Adding to this idea (V.Sabog, C. Caranto, & T. David 2015),

clinical faculty member is having a particular role in the development of the nursing students.

The effective teaching is the dependent upon the teacher’s behavior and environment.

According to (Phillips, Mathew, Aktan, & Catano,2017), The clinical faculty is defined as the

person employed in a nursing institution to teach the practical nursing. Furthermore, the

excellence in the nursing education can be achieved through effective clinical teaching and

teachers. Thus the clinical teaching provides the students proficient teaching. Therefore, the
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nursing education in general and clinical education in specific is particular dependent upon the

teacher’s behavior.

The idea of clinical experience is complex to the point that understudies may should be

instructed how to gain from clinical experience built up an apparatus through which staff assess

the capacity to gain from clinical encounters. The instrument characterizes 32 practices of

discovering that understudies address in an intelligent procedure, for example, journaling. The

reflection enables understudies to concentrate on the learning procedure and their own

particular technique for gaining as a matter of fact so that "they can be trained on the most

proficient method to gain from it for future encounters" (Dumas, Villeneuve and Chevrier,

2000,).

According to (Basavanthapa, 2009), Clinical teaching and learning is the core of the nursing

education. It provides nursing students a direct experience in patient care. Additionally, it also

provides students an opportunity to make application of the theoretical knowledge into practice

and to provide improved patient centered nursing care. It is very important area that needs

attention throughout the country. Nursing students do not pay attention to practical or clinical

area because according to their point of view it’s not so much important.

According to (Girija,2012), excellence and student’s satisfaction in clinical teaching can be

achieved if the instructor is confident, competent, have good skills in practice, professional

communication, good interpersonal relationships with students and collaboration with other

health care personal.

The general air of the clinical condition is imperative in clinical learning. According to

(Kube,2010) detailed that the clinical condition ought to give a attractive environment, great

clinical practice, an agreeable nursing group, gratefulness for understudies, open doors for
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understudy interest and a positive clinical coach. It ought to be noticed that this investigation

was led in Finland where clinical tutors are staff medical attendants and instructors are viewed

as extra backings yet not the essential clinical asset for understudies. Invitational instruction

has been utilized as a part of the investigation of tension and bolster issues related with clinical

educating in nursing. Invitational instruction is a setting for correspondence and techniques by

which students are welcome to the learning background (Cain, 2008).

According to Kube (2010) considered clinical help and supervision of 60 sophomore and 29

junior nursing understudies at one college. Discoveries demonstrated that the supervision and

bolster wanted by the understudies was not as much as the supervision and bolster they

acquired. The combined ramifications of these investigations was that the workforce part and-

understudy instructor relationships are critical impacts in the clinical learning condition.

According to (Hsu, 2006) directed an exploratory subjective investigation of clinical showing

practices in Taiwan that was comparative in reason to Morgan‟s (1991). Hsu used direct

perception of ten clinical educators by two specialists yet did exclude interviews with them.

The two examinations yielded practically identical classes of instructing exercises that included

part demonstrating and emotional associations with understudies as imperative parts of the

instructing part.A significant portion of the research regarding teaching behaviors of clinical

nursing faculty revolved around the use of the term: effective. If nursing education is

to implement best practice, the best -most effective- teaching behaviors must be

known. Description of effective teaching is an important, albeit, difficult endeavor due

to its elusive and multidimensional nature. As a result, multiple perspectives have

been taken in research regarding effective teaching behaviors.

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4. Methodology

4.1. Study Design:

A quantitative descriptive correlational design will be used to perform this study. A

correlational study is a quantitative method of research in which have 2 or more quantitative

variables from the same group of participants and trying to determine if there is a relationship

between the 2 variables. Descriptive designs are useful to gain additional information about

characteristics within a particular area of study

4.2. Study participants:

The study participants will be nursing students from Mayo hospital and Lahore school of
nursing university of Lahore. Mayo hospital is one of the largest hospitals in Lahore. It is
government hospital. It has different departments. Lahore School of nursing is the first
nursing institute where MSN is started in Punjab at a Private university. The students here are
well known of technology and research programs.

4.3. Inclusion criteria

Nursing students of 2nd and 3rd year are included because there have more interaction with
their faculty and they are more efficient.

4.4. Exclusion criteria

Nursing students of 1st year are excluded because there have less interaction with their faculty
and they are less efficient.

4.5. Sample Strategy

Convenient sampling will be used in this research.

A convenient sampling is a type of sampling which is used to collect data from the
participants that are convenient to give data.
4.6. Research instrument
The instrument of my study is consisted of two parts. Demographic data, Nursing clinical
teaching effectiveness inventory. Demographic data: This information is collected from the
participant’s age, gender, name of the program and figure of clinical sequences. It contains of
“Fill in the blanks and circle the right point about age, number of clinical course completed,
gender and year, the program is taking place. The nursing clinical teaching effectiveness
inventory is a part of instrument was developed Knox and Mogan in 1985.The NCTEL is a
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ON NURSING STUDENTS LEARNING 13

47items of assessment tools on which in reappearance degree instructor use of clinical

teaching behavior on a seven point Likert scale. Its contain five groups. Teaching behavior,
personality traits, teaching ability, nursing competence and interpersonal relationship and
evaluation.

5. Ethical consideration:
Approval for this study will be taken from the principal of college of nursing and from the

directors of the colleges of nursing. The written informed consents will be taken prior to the

study and all the principals of ethics will be taken into consideration in the study

(confidentiality, dignity, privacy and beneficence).

6. Data collection:
Data will be collected by the structured questionnaire and reliability and content validity will

be assessed by the principal/ course teacher. I will take written approval letter from the nursing

institutes and take the data from the nursing students. An open ended question in which

encourage the person to give full and meaningful answer to use own knowledge and feelings

so i will use open ended question style.

7. Data Analysis:
Data will be analyzed by using the SPSS 20. Tables and graphs will be used along with
inferential data analysis. Independent t test will use to analysis the data.

Study timeline

The study of my study is 11 Sep,17 to 30 December.

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References
HEIDARI, M. R., & NOROUZADEH, R. (2015). Nursing students’ perspectives on clinical

education. Journal of Advances in Medical Education & Professionalism, 3(1), 39-43

Retrieved from https://www.

ncbi.nlm.nih.gov/pmc/articles/PMC4291507/pdf/jamp-3-39.pdf

Ismail, L. M., Aboushady, R. M., & Eswi, A. (2016). Clinical instructor's behavior: Nursing

student's perception toward effective clinical instructor's characteristics. Journal of Nursing

Education and Practice, 6(2), 96-105. doi:10.5430/jnep.v6n2p96

Jamshidi, N., Molazem, Z., Sharif, F., Torabizadeh, C., & Kalyan, M. N. (2016). The

Challenges of Nursing Students in the Clinical Learning Environment: A Qualitative

Study. the Scientific World Journal, 3016, 1-8. Retrieved from

org/10.1155/2016/184617

Niederriter, J. E., Eyth, D., & Thoman, J. (2017). Nursing Students’ Perceptions on

Characteristics of an Effective Clinical Instructor. SAGE Open Nursing, 3,

237796081668557. doi:10.1177/2377960816685571

Okoronkwo, I. L., Onyia-pat, J., Agbo, M. E., Okpala, P. U., & Ndu, A. C. (2013). Students’

perception of effective clinical teaching and teacher behaviour. Open Journal of

Nursing,03(01), 63-70. doi:10.4236/ojn.2013.31008

Papastavrou, E., Dimitriadou, M., Tsangari, H., & Andreou, C. (2016). Nursing students’

satisfaction of the clinical learning environment: a research study. BMC

Nursing, 15(1), 1-10. doi:10.1186/s12912-016-0164-4

Phillips, K. F., Mathew, L., Aktan, N., & Catano, B. (2017). Clinical education and student

satisfaction: An integrative literature review. International Journal of Nursing

Sciences, 4(2), 205-213. doi:10.1016/j.ijnss.2017.03.004

THE RELATIONSHIP OF NURSING FACULTY CLINICAL TEACHING BEHAVIOR
ON NURSING STUDENTS LEARNING 15

V.Sabog, R. F., C. Caranto, L., & T. David, J. J. (2015). Effective Characteristics of a Clinical

Instructor as Perceived by BSU Student Nurses.

Basavanthapa. (2009). Nursing education (2nd ed.). New Delhi: Jaypee Brothers Medical

Publishers.

Girija, K. M. (2012). Effective Clinical Instructor-A Step Toward Excellence in Clinical

Teaching. International Journal of Nursing Education, 4(1), 25-27. Retrieved from

http://www.indianjournals.com/ijor.aspx?target=ijor:ijone&volume=4&issue=1&artic

Kube, M. L. (2010). The Relationship of Nursing Faculty Clinical Teaching Behaviors to

Student Learning (Unpublished doctoral dissertation). College of Saint Mary, Omaha,

United State.
Hsu, L. (2006). An analysis of clinical teacher behavior in a nursing practicum in

Taiwan. Journal of Clinical Nursing, 15, 619-628.

Awuah-Peasah, D., Sarfo, L. A., & Asamoah, F. (2013). The attitudes of student nurses

toward clinical work. International Journal of Nursing and Midwifery Vol., 5(2), 22-

27. Retrieved from DOI: 10.5897/IJNM12.017