The Journal of Nursing Research h VOL. 20, NO.
2, JUNE 2012
Clinical Nurse Preceptor Teaching
Competencies: Relationship to Locus of
Control and Self-Directed Learning
Ya-Lin Chen1 & Li-Ling Hsu2* & Suh-Ing Hsieh3
1
RN, MSN, Head Nurse, Department of Nursing, Tri-Service General Hospital & 2RN, EdD, Associate Professor,
Graduate Institute of Health Allied Education, National Taipei University of Nursing and Health Sciences &
3
RN, PhD, Associate Professor, Department of Nursing, Chang Gung University of Science and Technology.
ABSTRACT
Background: An effective preceptor is a vital component of
a strong learning experience for learners. Many clinical precep-
tors provide on-site supervision and clinical teaching but lack
the skills necessary to be effective teachers. Few studies have
examined the factors related to teaching competence among
clinical nurse preceptors.
Purpose: This article is a report of a study that examined (a) the
differences in teaching competence by preceptor background,
(b) the influence of locus of control on self-evaluated teaching
competence, (c) the association between self-directed learning
and self-evaluated teaching competence, and (d) the predictors
of self-evaluated teaching competence among clinical nurse
preceptors.
Methods: This descriptive and correlational study used a cross-
sectional survey of a convenience sample of 243 clinical nurse
preceptors from a medical center in northern Taiwan. Of these,
242 completed questionnaires for an effective response rate
of 99.6%. The self-evaluated Teaching Competencies Scale,
InternalYExternal Scale, and Self-Directed Learning Instrument
were used to assess teaching competencies and related fac-
tors among clinical nurse preceptors. Descriptive statistics,
one-way ANOVA, MannYWhitney test, and multivariate linear
regression were used to analyze data.
Results: Clinical nurse preceptors averaged 4.03 in teaching
competence, indicating a moderately above average score.
Higher teaching competence was associated with older age,
being married, 910-year work experience, not assigned by
unit manager, and good internal locus of control. Self-directed
learning significantly correlated with teaching competence
(r = .62). Internal locus of control and self-directed learning
were significant independent predictors of teaching compe-
tence after adjusting for age, marital status, total years as a
clinical nurse preceptor, and willingness to be a clinical nurse
preceptor. Together, these accounted for 33.6% of teaching
competence variance.
Conclusions: Nurse managers should recognize all factors
and characteristics of clinical nurse preceptors that influence
teaching competence to help achieve optimal learning out-
comes for nursing staff and students.
142
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KEY WORDS:
clinical nurse preceptor, locus of control, self-directed learning,
teaching competence.
Introduction
Clinical nurse preceptors have long been an important
part of the nursing field. Implemented in North America
in the 1960s, clinical nurse preceptors became an official
category of the International Nursing Index in 1975. Given
good clinical skills and familiarity with the routines of the
nursing unit, preceptors can have one-on-one instruction
with new nursing staff, formulate training goals and eval-
uate progress, evaluate new nursing staff, bridge the gap
between managerial level and new nursing staff, and raise
new nursing staff professional skills and job satisfaction
(Chen, Lu, & Chen, 2001; Dube & Jooste, 2006). Speer,
Strzyzewski, and Ziolkowski (2004) pointed out that the
role and function of preceptors requires the ability to de-
velop teaching skills, meet students’ everyday needs, and
manage students’ sense of insecurity. Therefore, preceptors
undertake multiple responsibilities in stressful, diverse en-
vironments. Clinical teaching competence is the key to ful-
filling such responsibilities while meeting teaching goals.
Such competence includes the ability to assess students’
learning needs, design learning plans that address student
capabilities, answer questions, model appropriate behavior,
provide feedback, and evaluate students’ class outcomes
(Sonthisombat, 2008).
In recent years, researchers worldwide have identified
potential factors of influence on preceptor effectiveness in-
cluding willingness to teach and personal characteristics
such as age, level of education, years of service, and position
on the clinical career ladder (Dou, Chang, Hu, & Liao,
Accepted for publication: March 3, 2012
*Address correspondence to: Li-Ling Hsu, No. 365, Ming-Te Rd.,
Beitou District, Taipei City 11219, Taiwan, ROC.
Tel: +886 (2) 2822-7101 ext. 3169;
E-mail: hsu.liling@msa.hinet.net
doi:10.1097/JNR.0b013e318254ea72
Teaching Competencies
1998; Johnsen, Aasgarrd, Whal, & Salminen, 2002). Most
preceptors demonstrate internal locus of control. Instruc-
tors with internal locus of control tend to have higher scores
relative to those with external locus of control in terms of
teaching competence, job satisfaction, ability to assess stu-
dent experience-determined needs, and a more personal-
ized teaching style (Chen, 2000; Sun, 2010). In addition,
clinical nurse preceptors capable of self-directed learning
show significant dedication to work, highly refined teach-
ing skills, ability to reflect and apply knowledge, and rapid
professional growth (Li, 2008; Sun, 2007). Currently, few
studies have examined the factors related to self-evaluated
teaching competence among clinical nurse preceptors. There-
fore, this study sought to reveal the relationship between
locus of control, self-directed learning, and self-evaluated
teaching competence among clinical nurse preceptors. Study
results may help improve clinical nursing teaching quality.
Literature Review
Teaching competence of nursing clinical preceptors
Kaviani and Stillwell (2000) indicated that clinical nurse
preceptors must promote critical thinking among students
and give them the freedom to think to foster new nursing
professionals. Furthermore, Oermann and Gravin (2002)
found that the optimal intern experience for nursing stu-
dents requires that clinical nurse preceptors have the follow-
ing characteristics: sensitivity to patient needs, enthusiasm
for teaching, ability to encourage students, skills to operate
medical devices, ability to interpret data, ability to demon-
strate clinical nursing techniques, and ability to create op-
portunities for students to practice and redemonstrate. In
addition, Lu (2004) pointed out that clinical nurse precep-
tors can incorporate the concepts of information technology
into clinical teaching so that students will gain command
over statistical analysis, Internet-based research, and medical
and clinical nursing information systems. McDonough and
Bennett (2006) observed that good communication skills al-
low nursing preceptors to effectively exchange information
with other healthcare professionals.
In addition, Altmann (2006) suggested that nursing pre-
ceptors must fairly and objectively evaluate students’ knowl-
edge, attitude, and skills. Their timely observation of student
performance can serve as the basis for improving and ad-
vancing teaching skills or programs. Lastly, Kim (2007) be-
lieved that the teaching competence of nursing preceptors
includes an organized teaching style, time management, ap-
preciation of insufficiencies in student interns’ experience,
meticulous planning for clinical teaching, emphasis on stu-
dent responsibilities as interns, and an ability to match clin-
ical teaching objectives with student learning goals. In
summary, a competent nurse preceptor should have the
following characteristics: ability to assess students’ pre-
paredness, student-centered teaching goals and strategies,
timely feedback and objective evaluation for students, en-
thusiasm in clinical practice, and nursing knowledge.
Copyright @ 2012 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
VOL. 20, NO. 2, JUNE 2012
Factors associated with teaching competence
A number of factors influence the teaching competence of
clinical nurse preceptors. For example, in their study of
clinical nursing teachers teaching competence in nursing
administration practice, Chang, Liao, Dou, and Hu (2000)
found that personal characteristics influence preceptor teach-
ing skills. In addition, a phenomenological study by Ohrling
and Hallberg (2001) explored the life experiences of clin-
ical nursing preceptors and found that voluntary precep-
tors have a higher sense of achievement than nonvolunteers.
Kuo and Kao (2006) researched the teaching effectiveness
of clinical nursing teachers in technological and vocational
schools and discovered it to be influenced by personal fac-
tors including age, years of teaching experience, years of
clinical nursing experience, and advanced education. Cheng,
Kuo, Lin, and Lee-Hsieh (2010) adopted self-rating instru-
ments to assess the teaching competence of nursing staff in
various clinical ladder positions and discovered a signifi-
cant difference in self-rated teaching competence between
N3-level nursing staff and other nurses. Their findings thus
indicated preceptor teaching abilities to be affected by age,
marital status, teacher qualifications, years of teaching ex-
perience, position on the clinical ladder, personal character-
istics, and willingness to be a clinical teacher.
Locus of control is a concept of social cognitive learn-
ing described by Rotter (1966), who described it as an
experience-based tendency of belief reinforced by the in-
terplay between an individual’s actions and the conse-
quences of those actions. According to Rotter, a person can
perceive an event through an internal or external control
mechanism. Those with internal locus of control tend to
believe that they can control life events and, hence, are con-
vinced that they can achieve desired goals through their own
efforts. On the other hand, people with external locus of
control passively perceive life events as influenced by fate,
luck, or chance, which lie beyond their control. Researchers
in Taiwan have noted that most teachers have internal
control tendencies. These teachers demonstrate active per-
sonalities, a willingness to offer consulting service, higher
self-directed learning, and an ability to assess student needs
(Sun, 2010). Studies in other countries revealed that people
with internal locus of control have stronger communication
skills that heighten both their confidence and positive
attitude toward teaching (Kukula, Buldukoğlu, Kuladac, &
Koksal, 2006; Wishart & Ward, 2002).
According to Knowles (1975), self-directed learning re-
quires two elements, namely (a) a learning process in which
learners actively assess their own needs, set goals, determine
resources, select and execute strategies, and evaluate learn-
ing effectiveness and (b) a mature individual capable of self-
directed growth whose learning motivation is derived from
internal urges. Researchers in Taiwan found that teachers
who exhibit significant self-directed learning tendencies often
show strong love for learning, good understanding of them-
selves, dedication to their job, high teaching competence,
ability to reflect and apply knowledge, and fast professional
143
The Journal of Nursing Research
growth (Li, 2008; Sun, 2007). Studies in other countries
have pointed out that personal attitudes, values, and com-
munication skills also influence self-directed learning
(Braman, 1998; Stephenson, 2008).
Studies related to teaching competence
Altmann (2006) surveyed 156 principals of colleges with
baccalaureate nursing programs in western and southern
United States. Results showed factors influencing clinical
preceptor teaching competence to include clinical skills, wil-
lingness to teach, devotion to the role of clinical teacher,
effective communication skills, professionalism, application
of nursing process skills, evaluation, active professional de-
velopment, and application of knowledge from nursing re-
search to clinical practice. According to Kuo and Kao (2006),
the teaching effectiveness of clinical nursing teachers in tech-
nological and vocational schools is impacted by the following
personal factors: age, years of teaching experience, years of
clinical nursing experience, and advanced education. Carlson,
Wann-Hansson, and Pilhammar (2009) conducted focus
groups of clinical nurse preceptors and found that, when
teaching nursing students, clinical preceptors adjust learning
goals according to students’ past experiences to establish a
sense of mutual trust. Clinical preceptors also adopt teaching
strategies such as timely feedback and evaluation.
Purposes
This study aimed to clarify (a) the differences in teaching
competence based on nurse preceptor background, (b) the
influence of locus of control on self-evaluated teaching
competence, (c) the association between self-directed learn-
ing and self-evaluated teaching competence, and (d) pre-
dictors of self-evaluated teaching competence among clinical
nurse preceptors.
Methods
Sample/Participants
This was a descriptive and correlational study that used
a cross-sectional survey. A convenience sample was used
to recruit participants from a medical center in northern
Taiwan. Nurses at this medical center certified at nursing
clinical ladder II and above who held a valid registered
nursing license were considered eligible and recruited as
participants. Of the 243 self-structured questionnaires dis-
tributed, 242 were returned (valid response rate = 99.6%).
The total sample size met a post hoc power estimate using
G*Power 3.1 (Faul, Erdfelder, Buchner, & Lang, 2009)
with ! = .05, power = 0.8, and effect size = 0.5 for logistic
regressions.
Data Collection
A pilot study on 30 nurses was conducted between
September 28 and October 1, 2010. The rest of the self-
structured questionnaires were distributed, with results and
144
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Ya-Lin Chen et al.
signed consent forms collected (Y.-L.C.) between October 10
and November 10, 2010, during morning staff meetings.
Chiu (2010) constructed the Self-Evaluated Clinical Teach-
ing Competencies (SECTC) questionnaire to evaluate the
clinical teaching competencies of nursing preceptors. The
original 60-item SECTC questionnaire was constructed
by adapting Sonthisombat’s (2008) 47-item survey instru-
ment; conducting interviews with six male or female nurses
with 4Y11 years of nursing clinical preceptor experience
in medical, surgical, or psychiatric units; and conducting a
review of the literature. After deleting four items, the itemY
content validity index and scaleYcontent validity index for the
SECTC questionnaire were calculated as .95 and .75, respec-
tively. All items were scored on a 5-point Likert scale ranging
from 1 (incompletely met) to 5 (completely met). Time to com-
plete the SECTC questionnaire was 20 minutes. Possible
total scores of the final version of the 56-item SECTC ques-
tionnaire ranged from 56 to 280, with a higher score in-
dicating a higher level of clinical teaching competency.
Internal consistency of the scale was Cronbach’s ! of .93
for this study.
The Locus of Control Scale was adapted from Chen
(2001), who constructed the scale using Rotter’s (1966)
InternalYExternal Personality Scale, which included 23
items with a Cronbach’s ! of .8. Each item contained two
statements from which the user chose the one that best
matched their understanding of self. Answers indicating in-
ternal locus of control were rated 1, whereas those indicating
external locus of control were rated 0. Possible total scores
ranged from 0 to 23. Higher scores indicated an internal locus
of control, and lower scores indicated an external locus of
control. The cutoff score between internal and external locus
of control was 12. For the Locus of Control Scale, the inter-
nal consistency of Cronbach’s ! for this study was .69.
The Self-Directed Learning Instrument (SDLI) was de-
veloped by Cheng et al. (2010). The SDLI is a 20-item ques-
tionnaire that uses a 5-point Likert scale ranging from 1
(strongly disagree) to 5 (strongly agree). It measures the four
dimensions of learning motivation, plan and execution, self-
monitoring, and interpersonal relationships, with a range of
total scores from 20 to 100. Higher scores reflect greater
self-directed learning. SDLI has good validity with internal
consistency measured by a Cronbach’s ! of .92.
Ethical Considerations
The human research ethics committee of the participating
hospital approved this study. Participation was voluntary,
and each participant signed a consent form before com-
pleting the questionnaire.
Data Analysis
Data were analyzed using SPSS version 18.0 (SPSS Inc.,
Chicago, IL, USA). Descriptive statistics checked assump-
tions and described participant demographic characteristics,
teaching competencies, self-directed learning, and locus of
Teaching Competencies VOL. 20, NO. 2, JUNE 2012

control. A one-way ANOVA with Gabriel’s post hoc anal-
ysis and MannYWhitney test evaluated background- and
locus-of-control-based differences in teaching competence;
Pearson’s correlation examined the association between self-
directed learning and teaching competence. Multiple linear
regressions examined factors affecting teaching competence
with ! e .20 in simple linear regression. Level of signifi-
cance was defined as G.05 (bilateral).
Results
Demographic Characteristics
Table 1 shows participants’ demographic (background)
characteristics. Averaged participant age was 34.68 years
(SD = 6.25). More than half were unmarried (54.2%), and
57.5% had a college degree. Most (64.5%) were N2 on
the clinical nursing ladder, and 86 (35.5%) were N3 or
higher. Work experience ranged from 2 to 32 years,
averaging 12.28 years (SD = 6.35 years). Close to two-
thirds (61.7%) had served as clinical nurse preceptors for
92 years. Most (81.2%) were clinical nurse preceptors due
to unit manager assignment.
Teaching Competence of Clinical
Nurse Preceptors
Clinical nurse preceptors scored an average of 4.03 points
in self-evaluated teaching competence, reflecting medium-
level capability or better. Average scores for individual
questions ranged from 3.58 to 4.24. The three questions
with the highest average scores were ‘‘securing a safe learn-
ing environment for nursing interns’’ (mean = 4.24, SD =
0.68), ‘‘ability to establish good relationships with patients’’
(mean = 4.21, SD = 0.66), and ‘‘ability to provide quality
care for patients’’ (mean = 4.20, SD = 0.60). The three
questions with the lowest scores were ‘‘demonstrating all
related clinical data using a chart’’ (mean = 3.58, SD =
0.87), ‘‘having a sense of humor during teaching’’ (mean =
3.74, SD = 0.81), and ‘‘spending sufficient time on stu-
dents’’ (mean = 3.83, SD = 0.74).
Difference in Teaching Competence
by Background
As shown in Table 2, the following background data sig-
nificantly impacted teaching competence among clinical nurse

TABLE 1.
Participant Characteristics (N = 242)
Variable M SD n %

Age (years) 34.68 6.25

Range 25Y54
Gender
Female 237 97.9
Male 5 2.1
Marital statusa
Single 129 54.2
Married 109 45.8
Educational levela
eJunior college 73 30.4
University or technology college 138 57.5
Master’s program 29 12.1
Nursing clinical ladder
N2 156 64.5
QN3 86 35.5
Total working experience in years 12.28 6.35
Range 1Y32
Total years as a clinical nurse preceptora 2.86 1.15
Range 1Y4
e2 years 90 38.3
92 years 145 61.7
Willingness to be a clinical nurse preceptora
Assigned by unit manager 194 81.2
Not assigned by unit manager 45 18.8

Note. aMissing data.

145

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The Journal of Nursing Research Ya-Lin Chen et al.

preceptors: age (F(2, 219) = 8.21, p G .001), marital status
(Z = j2.95, p = .003), years of nursing practice (F(1, 226) =
13.32, p G .001), willingness to be a preceptor (F(1, 224) =
4.05, p = .045), and internal or external locus of control
personality (Z = j2.98, p = .003). Clinical preceptors
aged 940 years had higher teaching competence than those
in age groups of e30 years (p G .001) and 31Y40 years (p =
.006). Married preceptors showed higher teaching compe-
tence than their unmarried peers; Those with 910 years of
teaching experience had higher teaching competence than
those with less. Those not assigned by their managers showed
higher teaching competence than those assigned by their
managers. Those with a tendency toward internal control
showed higher teaching competence than those with a ten-
dency toward external control.
Relationship Between Self-Directed
Learning and Teaching Competence
This study found a statistically significant positive, medi-
um magnitude correlation between self-directed learning
and teaching competence among participants (r = .62, p G
.001). In other words, teaching competence rose as self-
directed learning increased.

TABLE 2.
Self-Evaluated Teaching Competence of Participants by Background
Post Hoc p (Two- Effect
Variable n % Mean SD MR Statistics Analysis Z Tailed) Size

Age (years)a F(2, 219) = 8.21 G.001 0.26

b
1 e30
° 56 25.23 217.23 23.86 1 3
°G° G.001
2 31Y40
° 124 55.85 224.39 25.72 2 3b
°G° .006
3 940
° 42 18.92 237.88 25.18
Marital statusc j2.95 .003 j0.20
Single 122 53.98 220.57 25.51 101.65
Married 104 46.02 231.21 25.67 127.40
Educationa F(2, 225) = 0.76 .47 0.08
eVocational school 71 27.84 228.59 27.23
College or technical 128 50.20 224.80 26.78
college
Graduate school 56 21.96 222.24 19.34
Nursing clinical F(1, 226) = 3.51 .06 0.12
laddera
N2 148 64.91 223.29 25.83
QN3 80 35.09 230.04 26.15
Total working F(1, 226) = 13.32 G.001 0.24
experience (years)a
e10 118 51.75 219.73 23.98
910 110 48.25 232.02 26.86
Experience as a clinical F(1, 219) = 1.98 .16 0.10
nurse preceptor
(years)a
e2 83 37.56 22.83 28.09
92 138 62.44 227.88 24.42
Willingness to be a F(1, 224) = 4.05 .045 0.13
clinical nurse
preceptora
Assigned by unit 183 80.97 223.79 26.18
manager
Not assigned by 43 19.03 232.58 24.02
unit manager
Locus of controlc j2.98 .003 j0.20
Internal 189 82.89 228.25 24.47 120.42
External 39 17.11 213.08 30.11 85.83

Note. Locus of control: Internal Q 12 and external G 12. MR = mean rank. Values in bold indicate significant findings.
a
One-way ANOVA. bGabriel’s post hoc analysis. cMannYWhitney test.

146

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Teaching Competencies VOL. 20, NO. 2, JUNE 2012

Predictors of Teaching Competence ingness to be a clinical nurse preceptor, internal control

Among Clinical Nurse Preceptors
Table 3 shows predictors of participant teaching compe-
tence as identified, respectively, by bivariate and multivar-
iate linear regression analysis. Predictors identified by
bivariate linear regression analysis included being 940 years
versus G30 years (p = .001), being married (p = .002), years
as a clinical nurse preceptor (p = .16), willingness to be a
clinical nurse preceptor (p = .045), internal locus of control
(p = .001), and self-directed learning (p G .001). However,
marital status, years of being a clinical nurse preceptor, and
willingness to be a clinical nurse preceptor became insignif-
icant after controlling for age in multivariate regression anal-
ysis. Thus, this study identified only internal locus of control
(p = .006) and self-directed learning (p G .001) as significant
predictors of clinical nurse preceptor teaching competence.
In other words, clinical nurse preceptors with internal
control personalities are likely to have higher teaching com-
petence than their external control personality peers (b =
10.94, SE = 3.96). Those capable of self-directed learning
had higher teaching competence than those without (b =
25.52, SE = 3.00). The six independent variables of age,
marital status, years of being a clinical nurse preceptor, will-
personality, and self-directed learning accounted for 33.6%
of variation in participant teaching competence (F(7, 212) =
15.29, p G .001).
Discussion
Participants in this study scored an average of 4.03 (SD =
0.63) in self-rated teaching competence, suggesting overall
medium to high competence (4.03/5). This corresponds to
a study by Johnsen et al. (2002). The three questions
earning the highest scores were ‘‘securing a safe learning
environment for nursing interns,’’ ‘‘ability to establish good
relationship with patients,’’ and ‘‘ability to provide quality
care for patients.’’ Our findings agree with those of Balas,
Casey, and Happ (2010), who pointed out that clinical nurse
preceptors must provide a safe environment for interns, al-
low students to ask questions arising from the internship,
share internship experiences, and give timely instructions
on learning styles. Among the qualities studied, Kuo’s (2005)
study of self-rated clinical nurse preceptor teaching compe-
tence found the following also important: ‘‘ability to estab-
lish good relationship with patients’’ and ‘‘ability to provide
quality care for patients.’’ In Kuo, the two questions with the

TABLE 3.
Predictors of Participant Teaching Competence Using Standard Bivariate and
Multivariate Linear Regressions
Bivariate Analyses Multivariate Analyses
Variable b SE p t 95% CI b SE p t 95% CI

Intercept 194.84 5.61 G.001 34.74 [183.79, 205.90]

Age (years)
31Y40 (1) vs. G30 (0) 4.47 3.96 .26 1.13 [j3.34, 12.28] 0.65 3.84 .87 0.17 [ j6.92, 8.22]
940 (1) vs. G30 (0) 17.96 5.09 .001 3.53 [ 7.93, 27.99] 4.07 5.83 .49 0.70 [ j7.41, 15.56]
Marital status
Single (1) vs. Married (0) 10.64 3.41 .002 3.12 [ 3.91, 17.37] 4.64 3.13 .14 1.48 [ j1.53, 10.81]
Experience as a
clinical nurse
preceptor (years)
92 (1) vs. e2 (0) 5.05 3.59 .16 1.41 [j2.03, 12.13] 5.06 3.66 .17 1.38 [ j2.16, 12.28]
Willingness to be a clinical
nurse preceptor
Assigned by unit 8.80 4.37 .045 2.01 [ 0.18, 17.41] 0.80 3.86 .84 0.21 [ j6.81, 8.42]
manager (1) vs.
Not assigned by unit
manager (0)
Locus of control
Internal (1) vs. External (0) 15.18 4.49 .001 3.38 [ 6.34, 24.02] 10.94 3.96 .006 2.76 [ 3.13, 18.75]
Self-directed learning
High (1) vs. Low (0) 27.24 3.00 G.001 9.08 [ 21.33, 33.15] 25.52 3.00 G.001 8.52 [ 19.62, 31.43]
2 2
Note. 0 = the referent group; R = .336; adjusted R = .314; overall model, F(7, 212) = 15.29. p G .001. 95% CI = 95% confidence interval. Values in bold
indicate significant findings.

147

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The Journal of Nursing Research
highest scores were ‘‘I have good interaction with patients’’
and ‘‘I have good interaction with healthcare staff.’’ In this
study, the three questions with the lowest scores were ‘‘dem-
onstrating all related clinical data using a chart,’’ ‘‘having a
sense of humor during teaching,’’ and ‘‘spending sufficient
time on students.’’ The first question, ‘‘demonstrating all re-
lated clinical data using a chart,’’ represents one aspect of
communication skills in teaching competence.
Our findings disagree with Sonthisombat’s (2008)
study of pharmacy preceptors, in which students self-rated
their communication skills highest among their teaching
competencies. The discrepancy may be due to the fact that
pharmacists are responsible for counseling patients on drug
use and educating them about drug safety. Such responsibil-
ities differ from the skills required of clinical nurses. In ad-
dition, our finding of a low rating for ‘‘having a sense of
humor during teaching’’ corresponds with Carlson et al.
(2009), which also found ‘‘sense of humor’’ most insuffi-
cient in teaching strategies. In this study, the low score on
the question ‘‘spending sufficient time on students’’ agrees
with Johnsen et al. (2002), which found that ‘‘the real-
ization that students have other interests’’ earned the third
lowest score. In general, as clinical thinking and teaching
evaluation requirements change over time, the focus of
clinical nursing teachers’ self-rated teaching competence
has shifted from professional nursing techniques to a uni-
fied understanding of the theory and practice of nursing.
In other words, teachers must be able to combine their pre-
existing knowledge and clinical experience to teach effec-
tively. Furthermore, in self-rating their teaching skills, clinical
nursing teachers felt they lacked a sense of humor and of-
fered too little time to students. We suggest that such issues
be addressed in future professional development programs
for clinical nurse preceptors.
Our results revealed that participant background had a
significant impact on teaching competence. Clinical nurse
preceptors aged 940 years showed higher self-rated teach-
ing competence compared with both younger groups (i.e.,
those G30 years and those 31Y40 years). This finding cor-
responds with that of Hoover (2008). Married clinical nurse
preceptors also showed higher self-rated teaching compe-
tence than unmarried preceptors. Our finding disagrees with
that of Yang, Kao, Huang, and Lee (2007), who found higher
teaching competence among unmarried clinical teachers. It is
possible that, because most families nowadays rely on two
salaries, married clinical nurse preceptors must advance
their skills in all respects to maintain their jobs. We found
more years of nursing practice associated with higher self-
rated teaching competence, which corresponds with the
results of Yang et al. (2007), which pointed out that a clinical
nursing preceptor with more service experience tends to
show stronger teaching competence. We also discovered that
those clinical nurse preceptors who assumed the position due
to manager assignment had lower self-rated teaching com-
petence. This finding is similar to Ohrling and Hallberg
(2001), which found voluntary clinical nurse preceptors
148
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Ya-Lin Chen et al.
had a higher sense of achievement. In our study, clinical nurse
preceptors with stronger internal locus of control had better
self-rated teaching competence. This finding agrees with that
of Wishart and Ward (2002) that nursing staff and teachers
with internal locus of control personalities tend to have a
positive view of work and are willing to help students apply
knowledge in professional fields. Our analysis revealed a
significant positive correlation between self-directed learning
and teaching competence in all aspects, which agrees with a
study by Hmelo-Silver (2004).
Hmelo-Silver (2004) maintained that nursing teachers
must be strongly self-directed in their learning to motivate
their students to learn. In our study, predictive statistical
analysis revealed that having an internal locus of control
personality and showing self-directed learning were sig-
nificant predictors of teaching competence. This finding
corresponds with that of Speer et al. (2004), which found
that clinical preceptors with stronger control over their own
emotions, more tolerance, positive attitudes, and more en-
thusiasm for clinical teaching tend to have better teaching
competence.
Limitations
This study had some limitations. First, its use of a con-
venience sample from a single medical center may limit the
generalizability of results. Second, clinical nurse preceptors
evaluated their own teaching competence without outside
validation by nursing students.
Conclusions
Older, married clinical preceptors with more than 10 years
of work experience, whose position was not assigned by
unit managers, and who had an internal locus of control
tended to have significantly higher self-rated teaching com-
petence compared to those with other characteristics. In ad-
dition, self-directed learning was significantly and positively
correlated with the teaching competence of clinical nurse
preceptors. Last, internal locus of control and self-directed
learning were significant independent predictors of teach-
ing competence for clinical nurse preceptors. This study
suggests that older, married, senior nurses who chose to be
clinical nurse preceptors and who had internal locus of
control and high self-directed learning characteristics make
the most effective clinical preceptors for nursing students
during the clinical practicum. Stone et al. (2002) argued
that, when faculty identify themselves as teachers, this
identification may impact upon their desire to teach and
improve their teaching skills, their satisfaction with teach-
ing, and, ultimately, their teaching efficacy. It is con-
sidered important to enhance clinical nurse preceptors’
teaching roles as they guide nurses/students in clinical prac-
tice. They are in an optimal position to guide nursing stu-
dents to learn and adopt professional nursing behavior to
better prepare them for a challenging future in healthcare.
Nurse managers should recognize the characteristics of
Teaching Competencies
effective clinical nurse preceptors that contribute to optimal
learning outcomes for nursing staff and students. Admin-
istrators should seek out such individuals and encourage
them to serve as clinical preceptors for nursing students.
The teaching competence scale has the potential to help
clinical nurse preceptors assess their own teaching ability
and identify areas in need of improvement. Further studies
would be of use in validating the criterion-related validity
of the scale and examining the consistency between clinical
nursing preceptors and student nurses during nursing
clinical practice.
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教學能力 The Journal of Nursing Research VOL. 20, NO. 2, JUNE 2012

護理臨床教師內外控人格、自我導向學習及
自評教學能力之相關性研究
陳雅琳1 許麗齡2* 謝素英3

1
三軍總醫院護理部護理長 2國立臺北護理健康大學醫護教育研究所副教授
3
長庚科技大學護理系副教授

背 景 一位有效護理臨床教師可提供學習者豐富之學習經驗，護理臨床教師常提供床邊指導
及臨床教學，唯較欠缺有效教師應有之教學能力。此外，亦缺乏與教學能力相關因素
之研究。

目 的 本研究之目的在探討：⑴基本資料屬性不同對護理臨床教師自評教學能力之差異；⑵
內外控人格特質對護理臨床教師自評教學能力之影響；⑶自我導向學習與護理臨床教
師自評教學能力之相關性；⑷探討護理臨床教師自評教學能力之預測因子。

方 法 本研究為描述性及相關性之設計，採橫斷性調查法，調查北部一所醫學中心243位護理
臨床教師，回收242份有效問卷，回收率99.6%。以SPSS 18.0進行資料分析，採用描述
性統計（descriptive statistics）、單因子變異數分析（one-way ANOVA）、曼惠二氏U檢
定法（Mann-Whitney test）、及多元線性迴歸（multivariate linear regression）等方法來
進行統計分析。

結 果 本研究發現，護理臨床教師自評教學能力平均得分為4.03分（最高為5分），能力已達
中等程度以上。年齡愈大、已婚、護理工作年資愈資深、非單位主管指派及內控人格
特質的護理臨床教師，教學能力較高；自我導向學習則與護理臨床教師教學能力呈中
度正相關（r = .62）；自變項之年齡、婚姻、擔任護理臨床教師工作年資、擔任護理臨
床教師意願、內外控人格特質、及自我導向學習，可共同解釋33.6%護理臨床教師之臨
床教學能力。

結 論 此結果可提供醫院管理者，了解影響護理臨床教師教學能力之相關因素與特質，期望
實務應用 護理臨床教師展現有效教學能力，將可協助護理人員及學生達成學習成效。

關鍵詞：護理臨床教師、內外控人格、自我導向學習、教學能力。

接受刊載：101年3月3日
*通訊作者地址：許麗齡 11219台北市北投區明德路365號
電話：（02）28227101－3169 E-mail: llhsu@ntunhs.edu.tw

151

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