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:...................................................................................................2
1.1. Background of study:...............................................................................2
1.2. Research problem:....................................................................................4
1.3. Purpose of the study:.................................................................................4
1.4. Objectives:................................................................................................5
1.5. Significance..............................................................................................5
1.6. Conceptual definition:..............................................................................6
1.7. Variables:.................................................................................................6
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
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provide 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 &

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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
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process does not result in abrupt change of behavior so it is considerable for teachers to find

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
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qqqqto the clinical teacher, they feel how teacher understand their behavior. Lastly students

self efficacy beliefs 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
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achieved through effective clinical teaching and teachers. Thus the clinical teaching provides

the students proficient teaching. Therefore, the 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
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clinical practice, an agreeable nursing group, gratefulness for understudies, open doors for

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
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inventory is a part of instrument was developed Knox and Mogan in 1985.The NCTEL is a
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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ncbi.nlm.nih.gov/pmc/articles/PMC4291507/pdf/jamp-3-39.pdf

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

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ON NURSING STUDENTS LEARNING 15

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