Validity and Reliability of the Clinical Teaching Behavior Inventory (CTBI) for Nurse Preceptors in Korea

Myun Sook Jung; Eun Gyung Kim; Se Young Kim; Jong Kyung Kim; Sun Ju You

doi:10.4040/jkan.2019.49.5.526

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Jung, Kim, Kim, Kim, and You: Validity and Reliability of the Clinical Teaching Behavior Inventory (CTBI) for Nurse Preceptors in Korea

Original Article

J Korean Acad Nurs 2019;49(5):526-537.

Published online: 15 January 2019

DOI: https://doi.org/10.4040/jkan.2019.49.5.526

Validity and Reliability of the Clinical Teaching Behavior Inventory (CTBI) for Nurse Preceptors in Korea

Myun Sook Jung¹, Eun Gyung Kim^2,, Se Young Kim³, Jong Kyung Kim⁴, Sun Ju You⁵

¹College of Nursing · Research Institute of Health Sciences, Gyeongsang National University, Jinju

²Department of Nursing, Chungbuk National University, Cheongju

³Department of Nursing, Changwon National University, Changwon

⁴College of Nursing, Dankook University, Cheonan

⁵Department of Nursing, Mokpo National University, Muan, Korea

Address reprint requests to : Kim, Eun Gyung Department of Nursing, Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju 28644, Korea Tel: +82-43-292-1730 Fax: +82-43-266-1710 E-mail: kyung11@cbnu.ac.kr

Received 4 December 2018 Revised 23 May 2019 Accepted 21 June 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose

The aim of this study was to evaluate the validity and reliability of the Korean version of the Clinical Teaching Behavior Inventory (CTBI).

Methods

The English CTBI-23 was translated into Korean with forward and backward translation. Survey data were collected from 280 nurses’ preceptors at five acute-care hospitals in Korea. Content validity, construct validity, and criterion-related validity were evaluated. Cronbach's α was used to assess reliability. SPSS 24.0 and AMOS 22.0 software was used for data analysis.

Results

The CTBI Korean version consists of 22 items in six domains, including being committed to teaching, building a learning atmosphere, using appropriate teaching strategies, guiding inter-professional communication, providing feedback and evaluation, and showing concern and support. One of the items in the CTBI was excluded with a standardized factor loading of less than .05. The confirmatory factor analysis supported good fit and reliable scores for the Korean version of the CTBI model. A six-factor structure was validated (χ ²=366.30, p<.001, CMIN/df=2.0, RMSEA=.06, RMR=.03, SRMR=.05, GFI=.90, IFI=.94, TLI=.92, CFI=.94). The criterion validity of the core competency evaluation tool for preceptors was .77 (p<.001). The Cronbach's α for the overall scale was .93, and the six subscales ranged from .72 to .85.

Conclusion

The Korean version CTBI-22 is a valid and reliable instrument for identifying the clinical teaching behaviors of preceptors in Korea. The CTBI-22 also could be used as a guide for the effective teaching behavior of preceptors, which can help new nurses adapt to the practicalities of nursing.

Keywords: Preceptorship, Reliability and Validity, Nursing Education, Nurses, Scales

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Figure 1.

Measurement model of the Korean version clinical teaching behavior inventory (CTBI-22).

Table 1.

General Characteristics of Participations (N=280)

Characteristics	Categories	n (%)	M±SD (range)
Gender	Female	273 (97.5)
	Male	7 (2.5)
Age (yr)	≤29	78 (27.8)	34.27±6.14 (24.00~57.00)
	30~34	85 (30.4)
	35~39	47 (16.8)
	≥40	70 (25.0)
Educational level	Diploma	70 (25.0)
	Bachelor	127 (45.4)
	≥Master	83 (29.6)
Work unit	Medical units	92 (32.9)
	Surgical units	63 (22.5)
	Special units^†	75 (26.8)
	Others	50 (17.8)
Total clinical career (yr)	〈5	51 (18.2)	11.55±6.56 (1.83~30.00)
	5~9	77 (27.5)
	10~14	71 (25.4)
	≥15	81 (28.9)
Career of working unit (yr)	〈3	164 (58.6)	3.75±4.00 (0.08~21.67)
	3~5	61 (21.8)
	≥6	55 (19.6)
Preceptor career (yr)	〈1	51 (18.2)	4.49±4.32 (0.25~20.00)
	1~4	118 (42.1)
	5~9	73 (26.1)
	≥10	38 (13.6)

M=mean; SD=standard deviation.

^† Special units included emergency room, intensive care unit, and operating room.

Table 2.

Goodness-of-Fit for Comparative of the Korean Version-Clinical Teaching Behavior Inventory (K-CTBI)

	χ² (p)	df	CMIN/df	RMSEA	RMR	SRMR	GFI	IFI	TLI	CFI
Model 1	560.34 (<.001)	215	2.6	.08	.04	.07	.85	.88	.86	.88
Model 2	486.21 (<.001)	194	2.5	.07	.03	.06	.86	.90	.88	.90
Model 3	366.30 (<.001)	188	2.0	.06	.03	.05	.90	.94	.92	.94
Lee-Hsieh et al. [21]	-	-	-	.06	.02	.04	.91	.99	.99	.99

df=Degree of freedom; RMSEA=Root mean square error of approximation; RMR=Root mean square residual; SRMR=Standardized root mean square residual; GFI=Goodness of fit index; IFI=Incremental fit index; TLI=Tucker-Lewis index; CFI=Comparative fit index. Model 1: Korean version CTBI (23 items-original model). Model 2: Korean version CTBI (22 items-deleted one item). Model 3: Modified model of the model 2.

Table 3.

Contents Validity and Convergent Validity of the Korean Version-Clinical Teaching Behavior Inventory (K-CTBI) (N=280)

Factors	Item no.	Item CVI	Non-standardized estimate	SE	Standardized estimates (β)	C.R.	p	AVE	CR
Committing to teaching (CT)	Item 1	1.00	1.00	-	.74	-	<.001	.73	.89
	Item 2	1.00	0.85	.08	.73	10.90	<.001
	Item 3	1.00	0.89	.08	.71	10.66	<.001
Building a learning atmosphere (LA)	Item 4	0.80	1.00	-	.60	-	<.001	.75	.83
	Item 5	1.00	1.08	.15	.55	7.26	<.001
	Item 6	1.00	0.94	.13	.55	7.24	<.001
	Item 7	1.00	1.04	.14	.57	7.41	<.001
	Item 8	1.00	1.12	.16	.52	6.97	<.001
Using appropriate teaching strategics (TS)	Item 9	1.00	1.00	-	.72	-	<.001	.59	.59
	Item 10	1.00	0.84	.09	.58	9.37	<.001
	Item 11	1.00	0.89	.09	.61	9.89	<.001
	Item 12	1.00	0.99	.10	.61	9.81	<.001
	Item 13	1.00	0.90	.08	.68	11.02	<.001
Guiding Inter-professional communication (IC)	Item 14	1.00	1.00	-	.80	-	<.001	.75	.75
	Item 15	1.00	0.86	.06	.83	14.08	<.001
	Item 16	1.00	0.88	.07	.73	12.44	<.001
Providing feedback and evaluation (FE)	Item 17	1.00	1.00	-	.82	-	<.001	.71	.71
	Item 18	1.00	1.09	.08	.75	13.02	<.001
	Item 19	1.00	0.86	.07	.68	11.61	<.001
Showing concern and support (CS)	Item 20	0.80	1.00	-	.77	-	<.001	.80	.80
	Item 21	1.00	1.22	.08	.94	15.73	<.001
	Item 22	0.90	0.81	.06	.73	12.92	<.001

CVI=Content validity index; SE=Standard error; C.R.=Critical ratio; AVE=Average variance extracted; CR=Construct reliability.

Table 4.

Discriminant Validity of the Korean Version-Clinical Teaching Behavior Inventory (K-CTBI) (N=280)

Variables	Correlation coefficient (ρ²)						AVE	Discriminant validity 2 (ρ±2×S.E.≠1)
Variables	CT	LA	TS	IC	FE	CS	AVE		Estimate	S.E.	-2	+2	p
CT	1						.73	CT↔LA	0.81	0.03	0.76	0.86	.003
								CT↔TS	0.85	0.03	0.80	0.90	.004
								CT↔IC	0.65	0.03	0.59	0.71	.004
LA	.81* (.66)	1					.75	CT↔FE	0.72	0.03	0.67	0.77	.003
								CT↔CS	0.53	0.03	0.48	0.58	.003
TS	.85* (.72)	.83* (.69)	1				.59	LA↔TS	0.83	0.02	0.78	0.88	.003
								LA↔IC	0.71	0.03	0.65	0.77	.006
IC	.65* (.42)	.71* (.50)	.84* (.71)	1			.75	LA↔FE	0.78	0.03	0.73	0.83	.003
								LA↔CS	0.66	0.03	0.61	0.71	.005
								TS↔IC	0.84	0.03	0.78	0.90	.006
FE	.72* (.52)	.78* (.61)	.93* (.86)	.73* (.53)	1		.71	TS↔FE	0.93	0.03	0.87	0.99	.004
								TS↔CS	0.64	0.03	0.59	0.69	.003
								IC↔FE	0.73	0.03	0.67	0.79	.004
CS	.53* (.28)	.66* (.44)	.64* (.41)	.60* (.36)	.60* (.36)	1	.80	IC↔CS	0.60	0.03	0.54	0.66	.002
								FE↔CS	0.60	0.03	0.54	0.66	.005

CT=committing to teaching; LA=building a learning atmosphere; TS=using appropriate teaching strategics; IC=guiding Inter-professional communication; FE=providing feedback and evaluation; CS=showing concern and support; S.E.=Standard error.

^* p<.05, ρ²=(correlation coefficient).

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