الفهرس 
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Abstract
Promoting of nurse educators’ abilities for the 21st century practice is increasingly demanding due to the complexities of global healthcare and meeting the needs and learning styles of the nursing students. Thus, training and development for nurse educators remains a great concern that reflected on fit preparation of nurse graduates with adequate work and professional competencies. Since 2017, in Egypt, leading agencies went through a massive state of transition from traditional content-saturated teacher-centered curriculum to Competency-Based Education (CBE) which is more student-focused and actively engage students in the learning process. Therefore, they have gathered internal and external nursing expertise to provide guidance for nursing educators about the CBE reform process. One of suitable guidance methodology with nurse educators is the instruction module which, is a self-enclosed unit that emphasis on an exact learning goal or instructional focus, with specific objectives, documents, multi-media experiences, and multiple learning strategies in relation to particular teaching content. The CBE’ instruction module is designed to represent a set of dynamic, flexible guideline for building effective CBE instruction material to be a framework and help nurse educators in following and practicing CBE approach.
The aim of this study was to
Determine the effect of implementing instruction module about CBE on educators’ knowledge, skills and attitude at Faculty of Nursing -Damanhour University.
The following hypotheses were examined and approved in the current study:
Nursing educators who attend instruction module about CBE exhibit higher CBE knowledge mean scores than those who do not.
Nursing educators who attend instruction module about CBE exhibit higher CBE planning skills mean scores than those who do not.
Nursing educators who attend instruction module about CBE exhibit higher attitude mean scores than those who do not.
Research design:
A quasi-experimental research design was used in this study.
Setting:
This study was carried out at Faculty of Nursing, Damanhour University in all its nine scientific departments. And, the Quality Assurance Unit (QAU), from where the CBE’s course specifications and its matrixes were obtained. The venue at which the study was carried out was a Medical- Surgical laboratory which was suitable and available for capacity, organization, facilities, seats, and time of data collection to conduct the study sessions. This laboratory is equipped with adequate space, whiteboard, data show, proper ventilation, and lightening.
Subjects:
The subjects of this study included two samples as follow:
1- Nursing Educators: It included nurse educators at the Faculty of Nursing, Damanhour University. 61 out of146 from all the nine scientific nursing departments, who were selected by convenient sampling technique with the following inclusion criteria; had a doctoral degree, shared and contributed in writing CBE courses specification and matrixes evidently and accepted to join the study.
2. Documents: They were 25 course specifications and 25 course matrixes (for nursing subjects only as core courses). This sample had been calculated by Epi Info 2019, they were selected by convenient sampling technique from the previously written courses specification and matrixes at the second semester 2022-2023from the Quality Assurance Unit at Faculty of Nursing, Damanhour University.
Three tools were used in this study for data collection:
Tool I: Nurse Educators’ Competency- Based Education Knowledge Questionnaire:
This tool was developed by the researcher after a comprehensive review of the related literature (Gravina, 2017; NARS 2017; Fukada, 2018; Ibrahim et al., 2021) to determine nurse educators’ knowledge needs about CBE. It was comprised of 20 Multiple Choice Questions (MCQ), 15 were need one correct answer response and 5 questions in form of multi–select MCQ type response. In addition to, nursing educators’ personal and academic data were attached and included 6 MCQ questions about, gender, academic position, academic department, academic years’ experience, teaching load hours and previous attendance to CBE workshops or instructionand participation in CBE committee.
Tool II: Nurse Educators’ Competency- Based Education Attitude Rating Scale:
This tool was developed by the researcher after a comprehensive review of the related literature (Kellogg, 2018; Salman et al., 2020; Ibrahim et al., 2021; Prokes et al., 2021) to assess nurse educators’ attitude toward CBE at Faculty of Nursing- Damanhour University, Egypt. This tool included 52 statements in a form of self-reporting scale, with a 3 point likert scale ranging from 1= disagree, 2= neutral and 3= agree.
Tool III: Nurse Educators’ Competency- Based Education Planning Skills Rubric:
This tool was developed by the researcher after a comprehensive review of the related literature (National Authority for Quality Assurance and Accreditation of Education, 2017;Salem et al., 2018; Bates, 2020; Ibrahim et al., 2021) to determine nursing educators’ CBE planning skills through assessing the quality of filling the courses’ specifications and its matrixes according the rules of NARS 2017 in nursing education. It included 5 dimensions which followed by description and criteria of such dimensions and rated against three levels of performance that constituted the construction of the rubric, which are; inadequate = 1, adequate = 2, and exemplary = 3.
Method:
- Approval from the Research Ethics Committee, Faculty of Nursing, Alexandria University was obtained before carrying out this study.
- A letter to conduct the study was obtained from the Dean of Faculty of Nursing, Alexandria University, and was directed to the Faculty of Nursing, Damanhour University.
- Permission to conduct the study was obtained from the Dean, Vice Dean of students’ affair and the Heads of the nine academic departments, at Faculty of Nursing, Damanhour University, Egypt, after explanation of the study purpose.
- Study tools (I, II and III) were developed by the researcher after a thorough review of the related literature.
- Study tools were tested for their content validity by five experts in the field of Nursing Education and Psychiatric Nursing and the necessary modifications were done.
- A pilot study was carried out on 6 nursing educators out of the first study sample to test tools I and II clarity and applicability and necessary modifications were done.
- A pilot study was carried out on 3 courses specification and 3 courses matrixes, at the second semester 2022-2023 from Faculty of Nursing – Damanhour University, Egypt, out of the documents sample 3 to test tool III clarity and applicability and necessary modifications were done.
- Study tools were tested for their reliability using Cronbach’s Alpha test. The tools were reliable, and the reliability coefficient was 0.850 for Tool I, 0.928 for Tool II and 0.844 for Tool III.
- The study was conducted through four phases: assessment, planning, implementation, and evaluation phase.
Phase (I): Assessment phase: During this phase, the researcher interviewed and asked the nurse educators in both groups to fill- out the study Tools (I and II) on individualized bases. For document sample, the researcher received the needed documents from previously written nursing course specifications (25 and 25 matrixes hard and soft copies), second semester 2022-2023, investigated and detected to which extent these documents matched the settled criteria according to NARS 2017 using Tool III.
Phase (II): Planning phase: During this phase, the researcher, CBE’ instruction module, and study subjects were prepared.
Phase (III):Implementation phase:
For study group:The researcher distributed study group into two subgroups; each subgroup was announced by the researcher about the day, time, and location of each session. The developed CBE instruction module was implemented for two sessions over two days, each session lasted about two hours in each day with half an hour breakthrough two parts; theoretical and practical. At the end of the sessions, the researcher gave empty templates of course specifications and their matrix to the nurse educators to fill them. Then, the researcher collected the filled templates from them to be evaluated using Tool III against the standard criteria for writing course specifications.
For the control group:The control group followed CBE instructions as guided by Quality Assurance Unitwithout any interference from the researcher. The researcher gave them empty templates of course specification and its matrix to be filled by them, then, collected the filled templates from them to be evaluated using Tool III against the standard criteria for writing course specifications.
Phase (IV): Evaluation phase:
- Both groups were asked to fill- out the study Tools (I & II) again and returned them back to the researcher as a post- test to evaluate the effectiveness of implementing the CBE’sinstruction module on educators’ knowledge and attitude.
- The researcher collected the filled templates of course specifications and their matrixes from both groups and investigated them using Tool III as a post- test to evaluate the effectiveness of implementing the CBE instruction module on educators’ planning skills and writing CBCS.
- To evaluate the effectiveness of implementing the developed CBE instruction module on educators’ knowledge, skills and attitude, the researcher compared the differences between pretest and posttest scores of the study tools that were filled by the nursing educators for both; study and control group.
- Statistical analysis: data were organized; computerized; tabulated and analyzed using quantitative approach.
Results of this study
The main results of the current study revealedthat:
There was statistically significant differences between both groups in relation to their overall level of knowledge about CBE after implementing the CBE’s instruction module (P<0.001) in favor of the study group.
There was statistically significant differences between both groups in relation to their overall attitude toward CBE after implementing the module (p<0.001) in favor of the study group.
There was statistically significant differences between both groups after implementation of the module in relation to their level of planning skills performance (p<0.001) in favor of the study group.
There was statistically significant intermediate positive correlation between the study group’s CBE overall knowledge and their attitude toward CBE after the intervention where Pearson coefficient test r = 0.376*.
There was no statistically significant correlation between overall CBE’s knowledge and CBE’s planning skills, and negative statistically significant correlation between overall attitude toward CBE and CBE’s planning skills where Pearson coefficient test r = - 0.378 after the intervention among the study and the control group.
It can be concluded from the present study that:
The developed CBE’s instruction module showed beneficial effects, significant value, and positive impact in improving their CBE knowledge, planning skills, and attitude toward CBE. CBE’s major concepts, CBE’s features, and course specifications’ features were recognized, understood, and improved after the intervention among the study group. Furthermore, nurse educators have been prepared and equipped to plan, write, and implement the CBE approach effectively, which was clearly revealed in their CBE’s planning skills performance scores. Consequently, nurse educators’ attitude toward CBE was positively changed and improved by such sessions. So, it could be a valuable, unique, and worthy instructional trial to guide, direct, and support nurse educators in practicing and implementing the CBE approach.
Based on the findings of the present study, the following recommendations are offered:
Recommendations for nurse educators
• Provide periodic professional training by the Faculties of Nursing in Egypt for nurse educators to improve their competency in implementing CBE through workshops, sessions about CBE’s teaching and evaluation approaches, and modules.
• Guarantee adequate instructional learning resources, human and nonhuman, such as an adequate staff- student ratio, financial support, infrastructure, and equipment that could serve CBE implementation.
• Provide continuous orientation and guidance for nursing students about their roles during CBE implementation; therefore, this could help educators in easy application of such approach.
Recommendations for further studies
• Conducting the study in different nursing faculties in Egypt to generalize the results of the study and raise the competence of nurse educators in CBE implementation.
• Development of an electronic module about CBE for nurse educators.
• Assessment of CBE’s implementation progress in most of nursing faculties in Egypt.
• Evaluate the effectiveness of CBE on nursing students’ achievement, engagement, and patients’ satisfaction.