Using a person-centred latent profile analysis anchored in the WHO Nurse Educator Core Competencies, we identified three distinct competency profiles among specialist-nurse clinical educators. The selected three-profile solution showed robust between-profile separation and high classification accuracy, indicating meaningful subgroups rather than sampling fluctuation. Profile membership varied by education level, professional title, and training experience. Training needs also varied by profile, with advanced-profile educators reporting a higher overall demand for development and giving priority to curriculum and course design, while those in the intermediate and foundational profiles placed greater emphasis on clinical teaching methods and instructional technologies. Taken together, these results characterise a structurally heterogeneous educator workforce with divergent training needs and they support profile-responsive development, rather than one-size-fits-all upskilling, to strengthen specialist-nurse education.
Competency distribution across profiles and associated characteristics
Based on participants’ responses, the advanced and intermediate profiles accounted for 48.4% and 43.0% respectively, indicating that most clinical nurse educators demonstrated moderate-to-high levels of competency. The concentration of competency in the mid-to-high range is consistent with reports from academic and tertiary-hospital settings, where nurse-educator and preceptor competency is generally evaluated positively [23]. Consistent with this distribution, a large cross-sectional study in a university hospital likewise identified three discrete competency profiles and found that a large proportion of participants reported intermediate-to-advanced orientation competency [43].
The three profiles identified in this study differed in demographic characteristics and training exposure. In multivariable regression, professional title, employment duration and prior educator training were independent correlates of advanced-profile membership, whereas age was not. This pattern indicates that competency is shaped more by role exposure and formal preparation than by chronological ageing [44]. It is consistent with evidence that participation in educator development is associated with more effective clinical teaching and that higher competency clusters among educators who complete orientation or mentoring education and who hold more senior roles [23, 43]. Studies of clinicians transitioning into educator roles provide additional context, describing lower preparedness and marked transition shock driven by workload, limited pedagogical preparation and role ambiguity, which depresses capability early in the educator trajectory [45, 46]. Taken together, these findings point to training as a strong and actionable lever, and interventional evidence links educator education to subsequent gains in competency, supporting a causal pathway from educator preparation to learner outcomes [47]. Accordingly, systematic educator training and structured orientation should be treated as core requirements, and the present study provides empirical support for the necessity of orientation in strengthening the specialist-nurse educator workforce.
Domain-level strengths and gaps in educator competency
In this study, three profiles exhibited significant disparities across the eight competency domains; in domain-specific analyses, all profiles consistently ranked ethical/legal principles and professionalism as the highest-scoring domain. This finding is aligned with prior evidence emphasising strong professional-ethics competency among SNCEs [28]. Ethical competency has been conceptualised from both nursing and education perspectives [48]. In light of a changing clinical environment and rising professional stressors, ethics teaching is critical for developing healthcare professionals’ ethical competency [49]. From a nursing perspective, specialist nurses function as clinical experts and confront ethical decisions routinely in daily practice [50]; ethics education should therefore equip them to identify ethical problems and to develop ethical competency through guided practice and reflection [51]. From an education perspective, clinical educators’ ethical competency comprises a foundation of ethical values and attitudes and a personal commitment to ethical action [48]; it is evidenced by the promotion of equality, the capacity to make ethically sustainable decisions, and appropriate conduct in morally challenging situations [49, 52]. However, self-ratings in ethics and professionalism are vulnerable to social desirability and halo effects, and the accuracy of self-assessment in health professions is often limited, with overestimation more common among lower performers [53]. Accordingly, interpretation of the uniformly high scores should be cautious, and future evaluations should triangulate self-ratings with observed behaviours and multi-source feedback to establish convergent validity and mitigate self-assessment bias [53, 54].
Meanwhile, three groups of SNCEs all rate lowest on their “communication, coordination and partnership”. According to the World Health Organisation (WHO), this domain involves nurse educators demonstrating effective communication skills that promote collaborative teamwork and enhance partnerships among health professionals [13]. Effective communication is essential in clinical settings, as it influences the learning environment, motivates trainees, and enhances their acquisition of technical, psychological, and interpersonal skills [55]. The competency of communication and collaboration involves reciprocal interest or communication between two or more people, which is critical for the relationship with trainees [56]. However, a qualitative study focused on the teaching experience of those clinical educators has shown that they often face challenges due to a lack of time for communication [57], which may be the reason leading to potential deficits in confidence and relationship-building with trainees. Besides, Communication behaviours are also sensitive to psychological safety, since low safety climates suppress speaking up and timely clarification and thereby weaken collaboration [58]. Therefore, these findings underscore the need for administrators to ensure that SNCEs have sufficient time to engage in meaningful communication and collaboration with their trainees. Additionally, implementing targeted training programmes to enhance the communication and cooperation skills of clinical educators could further improve their effectiveness in fostering an inclusive and supportive learning environment.
Training needs by competency profile
When further exploring the training needs of SNCEs within three competency profiles, we find that higher-competency educators have a greater demand for training than their less competent peers. Similar findings have been reported in other settings; for example, a study in Thailand showed that although nurse educators rated their current competencies at a high level, they simultaneously expressed a desire to further strengthen these competencies [28]. This apparent paradox can be understood through several complementary theoretical perspectives. Self-determination theory (SDT) posits that individuals are motivated to grow and change by three inherent and universal psychological needs: competency, autonomy, and relatedness [59]. Higher-competency professionals, who already experience a strong sense of competency, are inclined to seek further training that preserves autonomy in decision-making, deepens mastery of advanced role components and sustains meaningful professional relationships; such participation is typically driven by autonomous motivation and alignment with personal goals rather than external pressures [60, 61]. This pattern is also compatible with mastery goal orientation, which predicts preference for challenging learning opportunities and deliberate practice in competency-based education contexts [62, 63]. By contrast, lower-competency groups may under-signal training needs when expectancy of success is low or when perceived costs are high. Situated expectancy–value theory predicts that participation hinges on perceived value relative to cost, and recent reviews emphasise that value, cost and contextual supports shape engagement and persistence [64]. Nursing continuing professional development syntheses similarly show that organisational culture, access, and support strongly influence willingness to engage, with barriers reducing uptake even when needs are present [65, 66]. In practical terms, these mechanisms imply that motivating the lower-competency subgroup is pivotal. Programmes should raise expectancy through scaffolded mastery experiences and credible feedback, increase perceived value by linking development to role requirements and career progression, and reduce perceived cost via protected time and streamlined access, while maintaining autonomy-supportive design to sustain intrinsic motivation [67, 68].
The three competency profiles assigned different priorities across the surveyed training projects. Among advanced-competency SNCEs, the most frequently cited training need was curriculum and course design. Effective curriculum design involves a structured, iterative process of problem identification, needs assessment, goal setting, strategy selection, implementation, and evaluation [69]. Unlike general nursing education, which primarily emphasises knowledge acquisition and skill development, specialist nursing education focuses on fostering critical thinking, leadership, and advanced clinical skills [70]. Advanced-competency SNCEs likely recognise the importance of refining curriculum design to meet the evolving demands of speciality nursing education. Future research should examine best practices in curriculum development for speciality nursing and assess the effectiveness of targeted training programmes in improving educators’ curriculum-design skills.
Among SNCEs in the intermediate competency group, clinical-teaching methods and techniques received the highest proportion of training-need endorsements, indicating a prioritisation of method-focused development at this stage. Workplace-based teaching in speciality contexts benefits from a repertoire that combines unstructured approaches—modelling, think-aloud reasoning, brief coaching and guided reflection—which can be integrated into routine encounters [71, 72]. Structured, portable methods with evidence of effectiveness include the One-Minute Preceptor microskills for focused on-shift teaching, SNAPPS for structured case discussion, and Peyton’s four-step approach for procedural instruction [73,74,75,76,77]. Supervision intensity can be modulated to task complexity and observed performance using entrustment frameworks and levels of supervision, including nursing adaptations of entrustable professional activities [78, 79]. Accordingly, faculty development for the intermediate group should prioritise practical rehearsal of these unstructured and structured approaches to enable consistent and time-efficient instruction during clinical service.
For SNCEs in foundational competency profiles, the highest training needs centred on common pedagogical methods and instructional technologies. While not specific to bedside teaching, this domain encompasses core pedagogical competencies such as organising instructional content, using multimedia resources, facilitating group learning, and applying digital tools in teaching. In contemporary nursing education, clinical educators are increasingly involved in structured teaching formats beyond traditional supervision—such as simulation-based instruction, clinical-skills workshops, and blended-learning modules. The increasing integration of digital learning tools has highlighted the importance of technological proficiency in nursing education [80, 81]. Innovative teaching methodologies such as problem-based learning (PBL) and flipped classrooms have demonstrated effectiveness in fostering critical thinking and bridging theoretical knowledge with clinical application [82]. However, SNCEs with foundational competency levels may lack prior exposure to, or training in, these methods, limiting their instructional effectiveness. Faculty-development programmes targeting foundational SNCEs should thus emphasise basic pedagogical principles, instructional organisation, and the practical application of educational technologies within clinical-teaching settings.
Implications for specialist nursing education and clinical practice
The present findings have several implications for specialist-nursing education. First, as educators involved in specialist programmes often supervise heterogeneous learner groups, clinical teaching bases should ensure that, when SNCEs are assigned to teach specialist nurses who already practise at an advanced level, a minimum competency threshold is met, particularly in communication, coordination and partnership, so that instructional quality is maintained across settings. Second, the associations between competency profiles and prior educator training highlight the importance of preparation; institutions may therefore prioritise structured orientation for newly appointed SNCEs and provide sustained continuing professional development, with engagement supports to encourage participation among lower-competency subgroups. Third, because training-need priorities differed across profiles, faculty development can remain uniform in standards while varying its emphasis by profile, thereby directing limited resources to domains of greatest marginal benefit and supporting all SNCEs to meet a shared performance threshold. Tailored programmes might adopt short, work-integrated modules; for foundational profiles, the focus may be basic pedagogy and digital fluency; for intermediate profiles, workplace teaching methods, calibrated supervision and routine formative assessment; for advanced profiles, curriculum and assessment design and programme evaluation. A cross-cutting component on communication, coordination and partnership should be embedded in all strands, and progress may be monitored with simple milestones and periodic re-profiling to adjust individual plans. Finally, given that the standards and expectations for teaching specialist nurses differ substantially from those for other learner groups, further research should pay more attention to this educator group to support standard-setting and targeted faculty development in specialist nursing education.
Strengths and limitations
This study offers several notable methodological strengths. It is among the few empirical investigations to apply Latent Profile Analysis (LPA) to examine SNCEs’ competencies within the context of specialist nursing education, enabling a nuanced, person-centred exploration of heterogeneous competency patterns. The large sample size (n = 3945) exceeded recommended thresholds for LPA, enhancing statistical power, precision of profile estimation, and representativeness. The use of a validated WHO-based competency scale with high internal consistency further ensured measurement reliability and contextual relevance. In addition, integrating LPA with supplementary statistical analyses allowed for a comprehensive understanding of both profile characteristics and their associated training needs.
Despite these strengths, several limitations should be acknowledged. First, while the convenience-sampling strategy facilitated broad reach, it was non-random and may have introduced selection bias; therefore, generalisability to all clinical educators should be interpreted with caution. Second, because the survey link was distributed by participating institutions, the denominator for a response-rate calculation was not available. The response rate is therefore unknown, and non-response bias cannot be ruled out. Third, both competency and training needs were assessed using self-reported instruments: while the competency scale was validated, the training needs questionnaire was self-developed without formal psychometric evaluation, which may reduce measurement accuracy and consistency. Fourth, reliance on self-assessment rather than third-party evaluations may produce discrepancies between perceived and actual competency levels, and may introduce response bias that inflates ratings in socially valued domains; results should therefore be interpreted with caution. Another methodological consideration concerns common method bias, as both competency and training needs data were collected via self-report at a single time point. Although the two instruments served distinct measurement purposes, subsequent analyses examined relationships between them. No procedural remedies, such as temporal separation or alternative data sources, were applied; therefore, the observed associations should be interpreted with caution.
Finally, we did not conduct a formal a priori sample size calculation. Although the achieved sample size was adequate for latent profile analysis, the absence of predefined parameters may limit the robustness and generalisability of the results. Larger samples increase statistical power and can raise the likelihood of detecting statistically significant but practically trivial differences between competing models. To mitigate these risks, we used a transparent model selection procedure and reported classification diagnostics, including entropy, average posterior probabilities and odds of correct classification, to evaluate model quality and reduce the potential influence of sample size on the chosen profile solution.
Future studies could enhance methodological rigour by employing probability-based sampling, conducting formal sample size estimations, incorporating validated instruments for all key variables, and combining self-assessment with objective competency measures. Such refinements would further improve the reliability, validity, and applicability of research findings in specialist nursing education.
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