Challenges of Implementing Nurse Educator Core Competencies as Per-ceived by Clinical Instructors in Erbil City, Kurdistan Region, Iraq.


  • Newroz Ghazi Aziz Department of Nursing, College of Nursing, Hawler Medical University, Erbil, Iraq.
  • Vian Affan Naqshbandi Department of Nursing, College of Nursing, Hawler Medical University, Erbil, Iraq.
  • Halmat Authman Rasheed Department of Nursing, College of Nursing, Hawler Medical University, Erbil, Iraq.



Clinical Instructors, Clinical Educators, Clinical Education, Challenges, Competencies


Background and objective: The quality of nursing education in the clinical setting in nursing colleges, especially in the Middle East, is based solely on the clinical instructors’ ability to provide and creating the most productive clinical environment possible. The World Health Organization (WHO) identified eight domains as core competencies for clinical nurse educators. However, studies on contemporary clinical education and educators’ role indicate that clinical instructors continuously face challenges in adopting the competences recognized by the WHO. Therefore, this study aimed to explore the challenges of implementing the nurse educator core competencies as perceived by the clinical instructors in Erbil in the Kurdistan Region of Iraq.
Method: The interpretive phenomenological approach of the qualitative study and SWOT analysis was adopted to explore the clinical instructors’ experience of clinical education’s challenges.
Result: The main challenges of the academic institutions were shortages of qualified clinical instructors, lack of confidence among instructors, and difficulty in achieving learning outcomes. Challenges reported among health institutions include inappropriate selection for managerial roles, poor recognition of clinical education, and poor teaching environments.
Conclusion: The study results highlighted challenges for clinical instructors to carry out their role in a safe and less stressful environment, including inadequate strategic plans for clinical teaching from academic institutions and stakeholder involvement in health institutions.


Metrics Loading ...


Creswell JW, Poth CN. Qualitative inquiry and research design: Choosing among five approaches. SAGE Publications, Social Sci-ence; 2016. 76 p. Availablefrom: &pg=PP1&dq=Qualitative+Inquiry+26+Research+Design:+Choosing+Among+the+ Five+Approaches&ots=-gw777HOPB&sig=UfSJdmi42WX4JK9SwscVaKM3DkE. Accessed [10-11-2019]

Younas A, Zeb H, Aziz SB, Sana S, Albert JS, Khan IU, et al. Perceived challenges of nurse educators while teaching undergraduate nursing students in Pakistan: An exploratory mixed-methods study. Nurse Education To-day. 2019;81(7):39–48. Available from: Accessed [10-01-2020]

World Health Organization. Nurse Educator Core Competencies. WHO [Internet]. 2016;1–36. Available from:;jsessionid=8DCAD822F36D10F1B829697B0637542D?sequence=1. Accessed [10-11-2019]

van Wyngaarden A, Leech R, Coetzee I. Chal-lenges nurse educators experience with de-velopment of student nurses’ clinical reason-ing skills. Nurse Education in Practice [Internet]. 2019;40(October):102623. Availa-ble from: Accessed [11-02-2020]

Thuss M, Babenko-Mould Y, Andrusyszyn MA, Laschinger HKS. Nursing Clinical Instruc-tor Experiences of Empowerment in Rwan-da: Applying Kanter’s and Spreitzer’s Theo-ries. International Journal of Nursing Educa-tion. 2016;13(1):1–9. Accessed [04-02-2020].

DeSilets LD, DeSilets LD. SWOT is useful in your tool kit. Journal of Continuing Educa-tion in Nursing [Internet]. 2008;39(5):196–7. Available from: Accessed [03-08-2020]

Given LM. The Sage Encyclopedia of Quali-tative Research Methods: A-L ; Vol. 2, M-Z Index. In the USA: Sage Reference Publish-er; 2008. p. 10. Available from: sage encyclopedia of qual-itative research meth-ods&lr&pg=PP1#v=onepage&q=the sage encyclopedia of qualitative research meth-ods&f=false. Accessed [05-11-2020]

Kallio H, Pietilä AM, Johnson M, Kangas-niemi M. Systematic methodological re-view: developing a framework for a quali-tative semi-structured interview guide. Journal of Advanced Nursing. 2016;72(12):2954–65. Accessed [20-07-2020]

Braun V, Clarke V, Hayfield N, Terry G. Thematic Analysis. In: Liamputtong P, edi-tor. Handbook of Research Methods in Health Social Sciences. Singapore: Springer Singapore; 2019. p. 843–60. Available from: Accessed [30-08-2020]

Guest G, MacQueen KM, Namey EE. Ap-plied thematic analysis. Thousand Oaks, California: sage; 2011. 11 p. Available from: &ots=Xi5DyLzGqD&sig=zLPT0ky3ztISC64hICk5TvX3yUg. Accessed [01-06-2020]

Rosseter R. Fact Sheet: Nursing Faculty Shortage. American Association of Colleg-es of Nursing. 2019;(202):1–4. Available from: Accessed [21-07-2020]

Stamps A, Cockerell K, Opton L. A modern take on facilitating transition into the aca-demic nurse educator role. Teaching and Learning in Nursing. 2021 Jan 1;16(1):92-4. Available from: Accessed [30-01-2021]

Scammell J. The implications of nurse short-ages. British Journal of Nursing. 2019;28(3). Available from: Accessed [21-07-2020]

Berland A, Capone K, Etcher L, Ewing H, Keating S, Chickering M. Open education resources to support the WHO nurse educa-tor core competencies. International Nursing Review. 2020;67(2):282–7. Available from: Accessed [21-07-2020]

Levett-Jones T, Fahy K, Parsons K, Mitchell A. Enhancing nursing students’ clinical place-ment experiences: a quality improvement project. Contemporary Nurse. 2006 Oct 1;23(1):58-71. Available from: Accessed [15-03-2020]

Hee KC, Yee KJ. Influence of Nursing Stu-dents’ Clinical Practice Learning Environ-ment, Self-leadership, and Clinical Practice Belonging on Nursing Professionalism. Jour-nal Korean Academic Society of Nursing Education. 2019 Feb 28;25(1):5–16. Availa-ble from: Accessed [17-03-2020]

Ekstedt M, Lindblad M, Löfmark A. Nursing students’ perception of the clinical learning environment and supervision in relation to two different supervision models – a com-parative cross-sectional study. BMC Nursing. 2019;18(1):1–12. Available from: Ac-cessed [20-08-2020]

Manninen K, Henriksson EW, Scheja M, Silén C. Supervisors’ pedagogical role at a clinical education ward - an ethnographic study. BMC Nursing. 2015;14(1):1–8. Available from: Accessed [17-03-2020]

Pront L, McNeill L. Nursing students’ percep-tions of a clinical learning assessment activi-ty: ‘Linking the puzzle pieces of theory to practice.’ Nurse Education in Practice [Internet]. 2019;36:85–90. Available from: Accessed [01-11-2020]

Kalyani MN, Jamshidi N, Molazem Z, Tora-bizadeh C, Sharif F. How do nursing stu-dents experience the clinical learning envi-ronment and respond to their experienc-es? A qualitative study. BMJ Open. 2019;9(7):1–8. Available from: [17-03-2020]

Green J, Thorogood N. Qualitative meth-ods for health research. 4edition ed. sage. 2018. 116–117 p. Available from: +in+health+research&ots=quK9ZMKjXJ&sig=RnKO1k6QEGMTZhqY7Kdbb_MN QoY&redir_esc=y#v=onepage&q=Qualitative methods in health research&f=false. Accessed [15-11-2020]

Malterud K, Siersma VD, Guassora AD. Sample Size in Qualitative Interview Stud-ies: Guided by Information Power. Quality Health Research. 2016;26(13):1753–60. Available from: Ac-cessed [10-12-2020]

McGrath C, Palmgren PJ, Liljedahl M. Twelve tips for conducting qualitative re-search interviews. Medical Teacher. 2019 Sep 2;41(9):1002–6. Available from: Accessed [02-11-2019]




How to Cite

Aziz NG, Naqshbandi VA, Rasheed HA. Challenges of Implementing Nurse Educator Core Competencies as Per-ceived by Clinical Instructors in Erbil City, Kurdistan Region, Iraq. Erbil j. nurs. midwifery [Internet]. 2022 May 30 [cited 2024 May 18];5(1):30-42. Available from:



Original Articles