Current status and influencing factors of clinical teachers’ teaching abilities for Master of Nursing Specialist postgraduates: a cross-sectional study^†

High-quality education is indispensable for the advancement of the nursing profession.¹ In response to society’s escalating demand for skilled nursing professionals, numerous countries are actively developing postgraduate programs aimed at cultivating high-level, applied, and specialized talent.^2,3 In 2010, the Academic Degrees Committee of the State Council of China reviewed and approved a proposal to establish a Master of Nursing Specialist (MNS) degree program.⁴ The objective was to train highly competent nursing professionals with robust research capabilities who can engage directly in clinical practice.⁵ The development of MNS postgraduates carries significant implications for healthcare delivery.⁶ With continuous advancements in medical technology and an ever-increasing demand for health services among populations, there is an urgent need for high-quality and professional nursing talent. MNS postgraduate education not only emphasizes deepening and broadening theoretical knowledge but also prioritizes enhancing clinical practical skills and fostering innovative competencies. Through specialized training within MNS graduate programs, students gain advanced nursing concepts and techniques. Consequently, they can assume leadership roles in clinical settings by delivering meticulous scientific care that is patient-centered—thereby promoting recovery while improving overall efficiency within medical services.⁷ Therefore, prioritizing the cultivation of MNS postgraduates is crucial for advancing the profession.

The essence of cultivating MNS postgraduates lies in enhancing their clinical skills, with clinical teachers playing a pivotal role in this educational process.^8,9

The postgraduate education of MNS both domestically and internationally focuses on the development of theoretical foundations, specialized practical skills, and academic research abilities.¹⁰ In comparison, foreign institutions offer a more systematic and comprehensive curriculum in research project guidance and thesis writing skills. Domestic MNS postgraduate education in China primarily adopts traditional face-to-face teaching models, while foreign institutions tend to favor unstructured teaching approaches, offering students more choices and flexibility.¹¹ In terms of clinical practice, nursing graduate programs in Australia cover both clinical and non-clinical directions, with particular emphasis on enhancing practical abilities in course design.¹² For instance, the Nurse Practitioner program requires at least 300 h of clinical practice. By contrast, the MNS graduate training model at Capital Medical University includes 28 months of clinical practice and a thesis focused on clinical applied research. Overall, both domestic and international MNS graduate education place great importance on the development of clinical practice. Clinical teachers serve as guides and practical instructors for the professional development of MNS postgraduates. Typically, they possess extensive clinical experience that enables them to assist MNS postgraduates in translating theoretical knowledge into clinical practice. They also provide ongoing mentorship and supervision, offering MNS postgraduates invaluable insights into clinical decision-making, patient care, and critical thinking. However, enhancing MNS graduates’ professional competencies and comprehensive skill sets equips them to effectively navigate complex clinical situations, acting as role models and facilitators throughout the clinical learning journey.¹³ Currently, there is a growing demand for MNS postgraduates within the field of clinical nursing.¹⁴ Consequently, the number of clinical teachers is also increasing. However, many clinical nurses selected to serve as educators for MNS postgraduates have not undergone systematic teaching training,¹⁵ resulting in varying levels of teaching competence among them.¹⁶These disparities can directly impact the quality of training provided to MNS postgraduates and may obstruct the achievement of teaching objectives. Numerous scholars have conducted research on the teaching abilities of clinical teachers working with MNS postgraduates. However, existing studies primarily focus on either student or clinic perspectives. Some investigations have explored nursing students’ expectations prior to their clinical internships from their viewpoint,¹⁷ aiming to gain insight into their genuine needs. Nevertheless, due to voluntary participation in these studies, data were collected predominantly from more proactive students, rendering it challenging to generalize findings across all student populations. A study conducted by Robyn Cant examined nursing students’ satisfaction with their internship experiences. While overall evaluations regarding both experiences and satisfaction levels were positive, further exploration is warranted. Additionally, social desirability bias may be present within this research context, complicating efforts to accurately represent student experiences.¹⁸ A cross-sectional study in Ethiopia revealed that nursing educators often lack the necessary competencies to fulfill essential teaching roles, resulting in subpar educational quality.¹⁹ Furthermore, studies have investigated nursing students’ perspectives on the attributes of effective clinical teachers, indicating that those who possess strong interpersonal skills and clinical expertise are more favored during the teaching process.²⁰ There is a lack of research focused on the competencies of clinical teachers in MNS postgraduate education. Therefore, it is crucial to investigate the teaching competencies of clinical teachers in MNS postgraduate programs to gain a comprehensive understanding of the current state of clinical teaching. By collecting the perceptions of clinical educators regarding postgraduate training in MNS, this study was able to better identify the essential competencies needed for effective teaching, ultimately informing improvements in clinical teaching and the overall quality of postgraduate education.

Clinical practice represents a structured and organized form of educational activity. Graduate students pursuing a Master of Nursing degree engage in defined clinical nursing practice environments as part of their studies; these environments have specific objectives and timelines. Moreover, universities impose certain requirements related to the clinical practices of these graduate students. Consequently, the implementation of students’ clinical practice plans along with adherence to fundamental teaching standards in clinical settings serves as indicators—to some extent—of the instructional capabilities of clinical educators. Despite this significance, previous research has addressed these dimensions only minimally. There is a notable lack of research regarding the competencies of clinical instructors for MNS postgraduates, particularly from the perspective of postgraduate practical management. Consequently, this study employs a questionnaire survey method to derive insights into the actual implementation of clinical teaching for MNS postgraduates and to evaluate the pedagogical capabilities of clinical educators. This study aimed to collect and analyze the perceptions of clinical teachers regarding the development of postgraduate education in MNS within the context of postgraduate practical training management. The primary objectives were to assess the current status of clinical instructors’ teaching competencies, evaluate the reasonableness of the criteria for selecting clinical teachers, and identify the various factors influencing teaching effectiveness. By analyzing these aspects, this study seeks to provide valuable insights into how to enhance the clinical teaching of incoming MNS postgraduates, identify key teaching competencies, and promote the overall development of MNS postgraduate education.

This study evaluated the effectiveness of clinical teaching by gathering insights from clinical teachers regarding the cultivation of MNS postgraduates within the framework of postgraduate practical training management. It aimed to identify various factors that influence teaching effectiveness, thereby facilitating a more accurate assessment of the essential competencies required for clinical educators. Furthermore, it examined the rationale behind the selection criteria for clinical teachers. A questionnaire survey method was employed to capture clinical teachers’ perceptions concerning MNS postgraduate training from a curriculum management perspective and to assess their teaching competencies. This study provides valuable evidence for enhancing the pedagogical capabilities of clinical instructors and advancing the development of MNS postgraduate training programs. Clinical teachers play a crucial role in training MNS postgraduates and serve as key contributors to cultivating high-quality graduates.²⁵ The teaching capabilities of clinical instructors significantly influence the clinical learning experiences of MNS postgraduates. However, existing research primarily concentrates on students’ perspectives, assessing the efficacy of clinical instruction through their experiences and examining factors that affect the teaching competencies of clinical educators. Investigating the effectiveness of clinical teaching for MNS postgraduates solely from student and practical application viewpoints is insufficient; it is imperative to conduct an in-depth analysis considering practice management perspectives.

This study confirms that a substantial majority of clinical teachers can distinctly identify the training objectives associated with academic versus professional postgraduate degrees, although few possess an in-depth understanding of these 2 categories. This gap may be attributable to the relatively recent establishment of professional master’s education within our country and a limited comprehension among clinical teachers regarding the specialized training required for MNS postgraduates.²⁶ Furthermore, this finding indicates that the training framework for MNS postgraduates remains largely exploratory at this stage.²⁷ Given these considerations, it is essential to gain insight into how clinical educators perceive postgraduate training in nursing science as well as their foundational teaching competencies.

In this study, we analyzed the general information of clinical teachers as a factor influencing their core competencies. The demographic characteristics, work experience, and teaching experience were found to be unrelated to their teaching abilities. This finding aligns with a cross-sectional study conducted by Rasi et al.²⁸ Correlation analysis revealed that the research experience and specialized practice experience of clinical teachers exhibited weak correlations with their core competencies, which were not statistically significant. This suggests that the development of core competencies is affected by multiple factors rather than being solely contingent on research or specialized practice experiences.

In our survey of the core competencies of clinical teachers, participants demonstrated high scores in areas related to clinical procedural skills, assessing patient conditions, making appropriate judgments and interventions, as well as demonstrating the thought processes and steps involved in clinical decision-making to students. These results may indicate that clinical teachers possess robust professional knowledge and are capable of effectively guiding MNS postgraduates in practical settings. Conversely, their scores were lower on items related to understanding trends in scientific development and identifying current research hotspots. This may be attributed to the fact that clinical educators have predominantly focused on clinical practice capabilities due to their extensive engagement in clinical work, often at the expense of developing research skills. Additionally, clinical educators typically bear significant responsibilities associated with both clinical nursing tasks and teaching duties, which further limits their availability for engaging in research activities.²⁹ This observation corroborates findings from Wang et al.,¹⁶ indicating that MNS postgraduate clinical teachers exhibit relatively limited research capabilities. Consequently, it is essential to rigorously control the selection criteria and evaluation procedures for clinical teachers while placing greater emphasis on enhancing their research capabilities. Current research primarily focuses on developing core competency assessment tools for clinical teachers, while studies on how to enhance clinical teachers’ research capabilities are relatively limited. Future research could improve the research abilities of teaching faculty by further exploring and refining training programs for clinical teachers. A key focus of these training programs could be helping teaching faculty master basic research methods and skills, as well as enhancing their research thinking and innovative abilities. Additionally, it is recommended to encourage clinical teachers to participate in academic conferences both domestically and internationally to stay updated on the latest research trends. Meanwhile, clinical practice departments should also provide more research opportunities and resources to improve the research capabilities of clinical teachers.

This study revealed that only 39% of supervisors were able to maintain effective communication with clinical practice departments. Graduate supervisors typically bear a substantial workload encompassing both teaching and research, while clinical educators concentrate on clinical nursing and instructional responsibilities. As a result, both parties are often preoccupied with their respective duties, making it challenging to find mutually available time for dialog. Furthermore, some supervisors may possess extensive experience in theoretical research but lack practical clinical exposure, which limits their understanding of the operations and needs of clinical practice departments.³⁰ This gap contributes to communication barriers between the 2 groups. Additionally, this issue may stem from an inadequate comprehension of the training framework for Master of Nursing Science (MNS) students by both supervisors and clinical educators. They might not fully appreciate the significance of clinical practice in preparing MNS students and consequently exhibit a lack of initiative and motivation to engage in meaningful communication.³¹ This indicates a significant insufficiency in communication and collaboration between the supervisors of MNS postgraduates and the clinical teachers. The lack of effective dialog may adversely impact the guidance and support provided to MNS postgraduates during their clinical practice, subsequently influencing their development of clinical skills and professional growth. Therefore, enhancing communication and cooperation between supervisors and clinical practice departments emerges as an urgent issue that necessitates immediate attention. Furthermore, the performance of MNS postgraduates during their clinical practice also deserves careful consideration. The study revealed that only 32.9% of MNS postgraduates had presented their clinical practice plans to the respective clinical instructors prior to commencing their departmental practices. This phenomenon indicates a deficiency in self-management skills and proactivity among MNS graduate students. Such shortcomings may be linked to their future career aspirations, as they tend to favor roles as nursing educators over practicing nurses upon graduation.³² These circumstances not only undermine the efficiency and quality of clinical practice but also highlight the urgent need for further investigation into strategies aimed at enhancing self-management capabilities and proactivity within this cohort. Additionally, this issue may stem from an incomplete framework within the clinical practice department for managing the clinical learning experiences of MNS postgraduates.³³ It is imperative for clinical practice departments to deepen their understanding of MNS postgraduate training, establish a robust management mechanism, and promote enhancements in the quality of clinical teaching.

This study aimed to evaluate the current teaching competencies of clinical educators through a comprehensive questionnaire survey. It identified the factors influencing teaching effectiveness and assessed the appropriateness of teacher selection criteria. Ultimately, this research sought to delineate the core competencies required of clinical teachers within the MNS postgraduate training framework, with the objective of effectively enhancing the quality of MNS postgraduate education. The results indicate that there is no significant relationship between the demographic information of clinical teachers and their core competencies. Moreover, clinical teachers exhibit relatively weak research capabilities as well as inadequate awareness regarding trends in scientific development and emerging research hotspots. Communication and collaboration between MNS postgraduate supervisors and clinical educators are also insufficient. The specialized Master’s education landscape in our country still presents substantial opportunities for growth. Clinical teachers predominantly consist of senior nurses with extensive practical experience coupled with strong professional abilities that contribute positively to developing MNS postgraduates’ practical skills; however, there remains a lack of deep understanding concerning their roles throughout the training process. Additionally, efforts must be made to enhance their research capabilities moving forward. Future initiatives should aim to establish more scientific and standardized criteria for selecting clinical educators.