临床护理带教职业素养现状及提升策略的混合方法研究OA
Adaptive leadership in advancing professionalism among clinical nurse educators:A mixed-methods study
目的 探讨临床护理带教的职业素养水平,并分析适应性领导力在其从临床实践角色向教育角色转型过程中的支持作用.方法 采用解释性顺序混合研究设计,以护理职业素养轮理论和适应性领导理论为指导,于2021年12月至2022年1月开展.研究对象为来自中国五个省(市)(上海、浙江、重庆、河北和山西)教学医院的临床护理带教.定量研究采用多中心横断面调查,共纳入669名临床护理带教,使用护理职业素养行为量表收集数据;定性研究通过目的抽样选取12名参与者进行焦点小组访谈.围绕职业素养的核心维度进行内容分析,实现定量与定性资料的整合.结果 临床护理带教的职业素养得分显著低于护理管理者[11.00(8.50,14.00)比15.00(9.25,19.50),Z=-4.110,P＜0.001],组间差异的比较有统计学意义.在护理伦理素养、理论发展应用评价或成果发表与学术交流方面,组间差异的比较无统计学意义(P＞0.05),而在其余6个维度上,差异均有统计学意义(P＜0.05).研究确认了9个职业素养核心维度,并进一步提炼出3项与临床护理教师专业成长密切相关的适应性领导力主题:1)与机构目标和优先事项的适应性对齐;2)在多变与复杂情境中引领与推动变革;3)持续提升专业贡献度与社会影响力.结论 临床护理带教的职业素养总体水平低于管理者,差距主要体现在学历准备、科研进展、应用及评价、胜任力和继续教育、自我调节和自主性、专业组织参与和社区服务实践领域.建议相关管理人员通过系统化培训、组织支持和政策干预,有针对性地提升临床护理带教的职业素养,促进护理人才队伍的可持续发展.
Objectives:To investigate the professionalism among clinical nurse educators and examine how adap-tive leadership supports their transition from clinical practice to educational roles. Methods:A sequential explanatory mixed-methods design,informed by Wheel of Professionalism in Nursing theory and Adaptive Leadership Theory,was conducted between December 2021 and January 2022.Participants comprised registered nurses from teaching hospitals across five provinces and mu-nicipalities in China(Shanghai,Zhejiang,Chongqing,Hebei,and Shanxi).Quantitative data were collected through a multi-center cross-sectional survey involving 669 respondents using the Behavioral Inventory for Professionalism in Nursing.Qualitative data were obtained via focus group interviews with 12 purposively selected participants.Data integration was conducted through content analysis,struc-tured around key dimensions of professionalism. Results:The professionalism score was significantly lower among clinical nurse educators than among their managers[11.00(8.50,14.00)vs.15.00(9.25,19.50),Z=-4.110,P＜0.001],indicating a discrepancy in perceived professionalism.No significant differences were observed in adherence to the code for nurse,theory-related domains or publication and communication(P＞0.05),whereas significant dif-ferences were found across the remaining six dimensions(P＜0.05).Qualitative findings yielded three themes:1)adaptive alignment with institutional priorities;2)driving change within complexity;and 3)contributing to social and professional impact.These findings illustrate how adaptive leadership pro-cesses shape the development and enactment of professionalism,particularly in navigating role tran-sition and organizational expectations. Conclusions:Clinical nurse educators demonstrate comparatively lower levels of professionalism than their managers' expectations,with gaps concentrated in multiple practice domains.Adaptive leadership plays a pivotal role in bridging these gaps by enabling clinical nurse educators to respond to complex role demands and evolving institutional contexts.Targeted strategies,including structured training,organizational support,and policy-level interventions,are essential to strengthen professionalism and support sustainable workforce development.
王喜益;崔念奇;温弗乐;吴黎莉;贾云华;钮晓音;许姝;Geraldine Lee;胡韵
临床护理带教职业素养适应性领导混合方法研究横断面研究定性研究
Adaptive leadershipClinical nurse educatorCross-sectional studyMixed-methods designProfessionalismQualitative research
《国际护理科学（英文）》 2026 (4)
396-405,10
This study was supported by the Shanghai Municipal Education Commission Young Teacher Cultivation Program.The funding body had no role in the study design,data collection,analysis,or interpretation. We would like to thank all the participants involved in this study,as well as the hospitals for their generous support.The authors also acknowledge the support of the Shanghai Association of Higher Education(Grant No.1QZD2409),the Shanghai Jiao Tong University School of Medicine Nursing Development Program(Grant No.SJTUHLXK2024),and Shanghai Jiao Tong University-Yonsei University Joint Nursing Fund for their support of the study procedures.
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