The Nursing Clinical Teacher Effectiveness Inventory (NCTEI)
The Nursing Clinical Teacher Effectiveness Inventory (NCTEI) was developed as a survey
tool for nursing students, graduates and faculty to rate the characteristics of the best
and worst clinical teacher behaviour that they had experienced. The tool was used in
the following article. The NCTEI survey instrument and the Reliability Data for it are
included here as an Appendix.
Knox, J.E. & Mogan, J. (1985). Important clinical teacher behaviours as perceived by
university nursing faculty, students and graduates. J. Adv. Nurs. 10, 25-30.
doi:10.1111/j.1365-2648.1985.tb00488.x
Abstract
This study compared the importance of five categories of clinical teacher
behaviours as perceived by university nursing faculty, students and practising
baccalaureate graduates. A survey tool, developed for this study, contained 47
items; each item describing a clinical teacher behaviour. Participants were asked
to rate the importance of each item on a seven-point Likert-type scale. Results
showed similar perceptions of the importance of clinical teacher behaviours
between the three groups of participants. However, significant differences were
found between all groups when the perceptions of students in each of the 4 years
of the nursing programme, faculty and graduates were compared. These results
indicate a greater variability among students than between students, faculty and
practising baccalaureate graduates. The importance of this study lies not only in
the perceptions of the three groups and the questions this raises, but also in
the conflicting findings between this and other studies1.
PMID: 3844410
1
Abstract from PubMed
Permanent URL http://www.ncbi.nlm.nih.gov/3844410
Appendix: NCTEI survey instrument; NCTEI reliability and validity
NCTEI Survey Instrument: Best Clinical Teacher
DIRECTIONS Picture the best clinical teacher you have ever had. Think back specifically what his person did to make him/her the best clinical teacher. For each
statement circle the number whish indicates how descriptive the behaviour is of this individual
For Worst Clinical teacher change best to worst
Not at all Very
Teaching Behaviours Descriptive Descriptive
Teaching Ability 1 2 3 4 5 6 7
1. Explains clearly 1 2 3 4 5 6 7
2. Emphasizes what is important 1 2 3 4 5 6 7
3. Stimulates student interest in the subject 1 2 3 4 5 6 7
4. Remains accessible to students 1 2 3 4 5 6 7
5. Demonstrates clinical procedures and techniques 1 2 3 4 5 6 7
6. Guides students’ development of clinical skills 1 2 3 4 5 6 7
7. Provides specific practise opportunity 1 2 3 4 5 6 7
8. Offers special help when difficulties arise 1 2 3 4 5 6 7
9. Is well prepared for teaching 1 2 3 4 5 6 7
10. Enjoys teaching 1 2 3 4 5 6 7
11. Encourages active participation in discussion 1 2 3 4 5 6 7
12. Gears instruction to students level of readiness 1 2 3 4 5 6 7
13. Quickly grasps what students are asking or telling 1 2 3 4 5 6 7
14. Answers carefully and precisely questions raised by students 1 2 3 4 5 6 7
15. Questions students to elicit underlying reasoning 1 2 3 4 5 6 7
16. Helps students organize their thoughts about patient problems 1 2 3 4 5 6 7
17. Promotes student independence 1 2 3 4 5 6 7
Nursing Competence 1 2 3 4 5 6 7
18. Demonstrates clinical skill and judgment 1 2 3 4 5 6 7
19. Demonstrates communication skills 1 2 3 4 5 6 7
20. Reveals broad reading in his/her area of interest 1 2 3 4 5 6 7
21. Discusses current development in his/her field 1 2 3 4 5 6 7
22. Directs students to useful literature in nursing 1 2 3 4 5 6 7
23. Demonstrates a breadth of knowledge in nursing 1 2 3 4 5 6 7
24. Recognizes own limitations 1 2 3 4 5 6 7
25. Takes responsibility of own actions 1 2 3 4 5 6 7
26. Is a good role model 1 2 3 4 5 6 7
Evaluation 1 2 3 4 5 6 7
27. Makes specific suggestions for improvement 1 2 3 4 5 6 7
28. Provides frequent feedback on students’ performance 1 2 3 4 5 6 7
29. Identifies students’ strengths and limitations objectively 1 2 3 4 5 6 7
30. Observes students’ performance frequently 1 2 3 4 5 6 7
31. Communicates expectations of students 1 2 3 4 5 6 7
32. Gives students positive reinforcement for good contributions, observations 1 2 3 4 5 6 7
or performance
33. Corrects students’ mistakes without belittling them 1 2 3 4 5 6 7
34. Does not criticize students in front of others 1 2 3 4 5 6 7
Interpersonal Relations 1 2 3 4 5 6 7
35. Provides support and encouragement to students 1 2 3 4 5 6 7
36. Is approachable 1 2 3 4 5 6 7
37. Encourages a climate of mutual respect 1 2 3 4 5 6 7
38. Listens attentively 1 2 3 4 5 6 7
39. Shows a personal interest in students 1 2 3 4 5 6 7
40. Demonstrates empathy 1 2 3 4 5 6 7
Personality 1 2 3 4 5 6 7
41. Demonstrates enthusiasm 1 2 3 4 5 6 7
42. Is a dynamic and energetic person 1 2 3 4 5 6 7
43. Self -confidence 1 2 3 4 5 6 7
44. Is self-critical 1 2 3 4 5 6 7
45. Is open-minded and non-judgemental 1 2 3 4 5 6 7
46. Has a good sense of humour 1 2 3 4 5 6 7
47. Appeasers [Appears] organized 1 2 3 4 5 6 7
NCTEI Reliability and Validity
Instrument Development
To test the questions of this study, a 47 item survey instrument was developed. The items,
divided into five categories, evolved from a former study eliciting students’ perceptions of
clinical teacher effectiveness (Mogan & Knox, 1983) and from an extensive review of the
literature, especially Irby (1977). The respondents were asked to rate each item on a 7 point
Likert-type scale. Two other responses were also incorporated into the instrument: don’t know
and non-applicable. Space was provided for remarks for each item.
Reliability
According to Nunnally (1978), the major source of measurement error is likely to be content
sampling. Therefore, he advocates obtaining co-efficient alpha’s before other types of reliability
estimates are conducted (p.230). The subprogram reliability in the SPSS system was used for this
purpose. This program is designed to evaluate the reliability of multiple item additive scales by
computation of co-efficients of reliability (Nie, Hull, Jenkins, Steinbrenner, & Bent 1975).
Reliability estimates were established for each of the five categories of teacher characteristics
with reliability coefficients .89 for Teaching, .84 for Nursing Competence, .82 for
Evaluation, .86 for Interpersonal Relationship, and .83 for Personality. Reliability of
each item was also estimated with reliability co-efficients ranging from .79 for item 42 (is a
dynamic and energetic person), to .88 for item #2 (Emphasizes what is important).
Test - Retest Reliability
The questionnaire was submitted to 69 3rd year generic students in a baccalaureate program in
nursing. Four weeks later, the same group was asked to complete the questionnaire again. T o
assure anonymity, the students were not identified. Therefore group means for each of the five
categories were compared using t-tests. The results showed no significant difference between
first and second testing. Probability ranged from p = =.5 to p = .9. These results are well within
the range of accepted reliability (see Table 2).
Validity
The ultimate purpose of this instrument is to measure clinical teacher effectiveness. Absolute
validity of such an instrument is difficult to assess in view of the lack of clear definition of
effective leaching and an even more nebulous concept regarding effective clinical teaching. In
view of this limitation validity was assessed in the following way.
Content validity “is the representativeness or sampling adequacy of the content . . . of a
measuring instrument” (Kerlinger, 1973, p. 458). Adequacy and representativeness of content
can be assumed to be met in two ways.
Table 2
Test - Retest Reliability
Category M SD MODE MEDIAN Variance t df P
Teaching * 93.9 11.94 99 95.8 142.6 .07 129 .94
** 93.8 10.3 92 95.6 106.9
Nursing
Competence * 52.9 7.4 57 53.8 55.4 .34 139 .74
** 52.5 6.4 52 52.4 40.9
Evaluations * 61.4 6.2 56 52.8 38.1 -.08 140 .94
** 51.5 5.1 51 52.2 25.9
Relationship * 36.6 4.9 42 37.1 24.1 -.66 140 .51
** 37.2 4.6 42 38.2 21
Personality * 39.9 6.6 41 41.1 43.1 -.46 134 .65
** 40.4 5.1 41 40.0 26
* first questionnaire
** second questionnaire
1) Items of the tool evolved from student descriptions of effective and ineffective
teaching behaviours (Mogan & Know, 1983) and from the literature. For each teacher behaviour
described by students, corresponding traits were found in the literature. Conversely, for every
behaviour described in the literature, similar traits were mentioned by students.
2) The importance of items was determined by all groups generally involved in
teacher evaluation (Seldin, 1980): students, peers, and graduates (administrators were included in
the faculty group in view of the small number and the dual role or administrator-teacher they
play in our school). All items were high rated by the entire group of faculty, students and
graduate x = 269.7 or 82% of a possible score of 329. Mean rating per item was 6.33 of a
possible rating of 7.
Furthermore, although some items were added in the “remarks” column, only two items
were mentioned by several respondents and were added to the evaluation instrument. It can thus
be assumed that no teaching behaviour of major importance was omitted.
Face validity “is the appeal of the instrument to potential users” (Nunnally, 1978, p. 111)
and can be assumed in view of the positive comment received from respondents. For example:
“Relevant, appropriate questions!”, “All these things are very important”, “Your list was very
well compiled and very organized”.
