Enhancing nurse educator self-efficacy in teaching multilingual students: A single-group educational intervention study

This study used a single-group pretest–posttest educational intervention design to evaluate changes in nurse educators’ self-efficacy following a faculty development session. Blinding was not feasible due to the educational nature of the intervention. All participants received the intervention; no random assignment or comparison group was used. It was hypothesized that nurse educators would demonstrate significantly higher self-efficacy scores following the intervention. The FADE model (Focus, Analyze, Develop, Execute, and Evaluate) guided project planning and implementation.^[15] This framework was selected because it provides a structured, iterative approach to identifying educational gaps, implementing evidence-based solutions, and evaluating outcomes within academic settings. This design is consistent with preliminary educational intervention research aimed at evaluating short-term changes in educator outcomes.

During the Focus phase, challenges related to teaching multilingual nursing students were identified through faculty feedback and review of institutional student outcomes. The Analyze phase involved a focused review of current literature to identify evidence-based strategies that support multilingual learners. In the Develop phase, findings from the literature were synthesized to design a faculty development intervention aligned with educator needs. The Execute phase consisted of delivering the intervention during a scheduled faculty development session. Finally, the Evaluate phase assessed changes in nurse educators’ self-efficacy using a validated measurement tool.

The project was conducted at a private associate degree nursing program located in the Northeastern United States. Recruitment and data collection occurred between March 2025 and May 2025. Participants were recruited via an email invitation distributed by the Faculty Development Committee and attended the intervention during a regularly scheduled staff development session. Although attendance at the session was mandatory, participation in the study surveys was voluntary.

Inclusion criteria required participants to be nurse educators actively teaching in person didactic courses within the program and to hold a postgraduate degree (MSN, DNP, or PhD). Educators teaching exclusively in clinical or simulation settings were excluded to ensure alignment with the instructional focus of the intervention. A convenience sampling approach was used, reflecting the total accessible faculty population within a single institution.

Twenty-three nurse educators met inclusion criteria and completed both pre and post intervention assessments, representing the total accessible population. All eligible faculty completed both assessments, and no participants were lost to follow up. Sample size was determined using G*Power based on the total accessible population of 23 nurse educators, assuming a 95 percent confidence level, a margin of error of 0.05, and a population variance of 0.25, which indicated that a minimum of 22 participants was required.

The unit of delivery was a group-based faculty session delivered in a single one-hour exposure. The intervention consisted of an in-person educational session developed by the principal investigator and informed by a focused review of current literature conducted between January and August 2024. Evidence was appraised using the Johns Hopkins Level of Evidence Tool.^[16] Five evidence-based domains guided content development: (1) teaching strategies, (2) test-taking supports, (3) assigned reading and pre-work, (4) inclusive learning environments, and (5) additional success strategies, including peer mentoring and meditation.

The literature indicates that active, linguistically responsive teaching strategies improve engagement and comprehension among multilingual nursing students.^[11,12,14] Recommended practices include clear language, slowed pacing, multimodal visuals, flipped classrooms, and cooperative learning.^{[5, 17]} Linguistic modification of lectures and examinations improves clarity and reduces anxiety.^[18,19,20] Faculty who establish supportive, bias-aware learning environments promote student belonging and motivation.^[7,21,22] Stress-reduction strategies, including Sahaja Yoga Meditation, have demonstrated benefits for well-being and focus.^[23,24,25] Session content included practical applications of these strategies, with examples such as linguistically modified exam questions and sheltered lecture slides to illustrate inclusive instructional design. Time was allocated for faculty discussion and reflection to support vicarious learning and mastery experiences consistent with self-efficacy theory.

Self-efficacy was measured using the Self-Efficacy Toward Teaching Inventory for Nurse Educators (SETTI-NE),^[26] originally validated by Garner et al. with a reported Cronbach’s alpha of .98.^[27] Permission to adapt the instrument was obtained. The original instrument contains 54 items across course, clinical, and simulation teaching domains. For this project, 40 items related to clinical and simulation teaching were removed and only the 14 course focused items were retained. This adaptation was conceptually justified by the instructional focus of the study, which targeted didactic course teaching rather than clinical or simulation contexts. Retaining only items aligned with the study’s scope was intended to improve construct relevance and reduce respondent burden; however, it is acknowledged that item removal alters the original instrument’s structure and may affect its psychometric properties relative to the fully validated version. The adapted instrument should therefore be considered a modified measure pending independent psychometric evaluation in future studies. Internal consistency of the adapted 14-item instrument was evaluated in the present sample. Cronbach’s alpha demonstrated excellent reliability (α = 0.97). Principal factor analysis supported a unidimensional structure, with factor loadings ranging from 0.76 to 0.93 and 85.5% of variance explained (see Table 1). These psychometric findings provide preliminary evidence supporting the validity of the adapted instrument within this sample, though replication in larger and more diverse samples is needed to establish its broader measurement properties. A brief demographic survey collected information on age, education level, teaching experience, and prior training related to multilingual instruction. Data were collected electronically via Qualtrics XM. No secondary outcomes were assessed. Measurement quality was supported through anonymous electronic data collection and standardized pre- and post-administration.

Data were analyzed using Stata and Intellectus Statistics software.^{[28, 29]} No missing data were identified. No adjusted or multivariable analyses were conducted. Researchers compared baseline and post-intervention self-efficacy scores among participants using a dependent-samples t-test assuming equal variance at each time point. Normality of change scores was assessed using visual inspection of histograms and evaluation of skewness and kurtosis statistics. Assumptions for paired-samples t-testing were met, and no significant outliers were identified.

Institutional Review Board approval was obtained from two institutions prior to data collection. Participation was voluntary, and informed consent was obtained electronically from all participants. The project posed minimal risk, and anonymity and confidentiality were maintained throughout data collection, analysis, and reporting in accordance with institutional and federal ethical standards.

Participants were experienced nurse educators with an estimated average age of 53 years, with 52% reporting more than 11 years of academic teaching experience. Most held an MSN (78%), while 22% held a doctoral degree. Only 22% reported prior training related to multilingual instructional strategies. Sample characteristics are summarized in Table 2. Because this project used a single group pretest posttest design without a comparison group, baseline equivalence between groups was not applicable.

A paired-samples t-test demonstrated a statistically significant increase in self-efficacy following the intervention, t(22) = 7.64, p < .001. Mean scores increased from 34.22 (SD = 8.93) to 45.91 (SD = 5.49), representing a mean difference of 11.69 points (95% CI, 8.48–14.90). These scores represent the summed total across all 14 items, each rated on a 1 (“not confident”) to 4 (“completely confident”) scale, yielding a possible range of 14 to 56. The magnitude of effect was large (Cohen’s d = 1.59), indicating a substantial improvement in self-efficacy following the educational intervention (see Figure 1). Improvements were observed across all instructional domains, with the greatest gains in instructional strategy.

Figure 1.

The means of pre-intervention and post-intervention with 95.00% CI Error Bars

All 14 SETTI-NE items demonstrated statistically significant improvement following the intervention (see Table 3). The largest gains were observed in items related to instructional planning, particularly planning teaching and learning activities (mean difference = 1.13) and planning discussions in class or online (mean difference = 1.17), suggesting that educators felt notably more prepared to structure and facilitate active learning experiences for multilingual students. Items related to selecting readings and developing student assignments showed the smallest gains (mean difference = 0.70 each), though both remained statistically significant and reflect meaningful improvement.

Baseline self-efficacy was positively correlated with post-intervention scores (r = 0.57, p < .05), indicating that educators who entered the session with higher confidence tended to report higher confidence afterward as well. Exploratory mixed-effects regression models examining subgroup differences revealed that baseline self-efficacy varied modestly by years of experience, with early-career educators reporting the lowest baseline scores (M = 2.21), followed by the most experienced educators (M = 2.41), and those with 6–10 years of experience reporting the highest baseline scores (M = 2.71). Despite these baseline differences, post-intervention gains were comparable across all experience groups, as well as across education level and prior multilingual training. Given the small sample size, these subgroup findings are exploratory and should be interpreted cautiously. The study was not powered to detect inferential differences between demographic groups (see Figure 2).

Figure 2.

Estimated gains in multilingual instructional self-efficacy by years of academic nursing experience (n = 23)

The findings of this project have important implications for nursing education leadership and faculty development. As nursing programs enroll increasingly linguistically diverse student populations, relying on informal experience or individual educator initiative is insufficient. Instead, these findings suggest that nursing programs should deliberately ensure faculty possess the competencies necessary to implement inclusive, evidence-based teaching practices.

Strengthening educator self-efficacy in this area aligns directly with expectations outlined in the AACN Essentials.^[32] By enhancing faculty capacity to apply culturally and linguistically responsive pedagogy, programs advance Domain 1: Knowledge for Nursing Practice, ensuring that instructional decisions are grounded in educational science and evidence-based strategies.

Improved educator preparedness also supports Domain 3: Population Health, as faculty play a critical role in preparing graduates who can deliver equitable care to diverse populations. When educators are confident in adapting instruction, assessment, and classroom communication for multilingual learners, they are better positioned to create learning environments that promote engagement, belonging, and academic success.

The limited prior training reported by participants highlights a persistent gap in faculty preparation that mandates leadership attention. Addressing this gap through structured faculty development fulfills Domain 5: Quality and Safety by promoting consistency and equity in instructional practices across programs. Standardized, competency-focused faculty development reduces variability in student experiences and mitigates unintended academic barriers that disproportionately affect multilingual learners. From an accreditation perspective, intentional faculty development in this area also demonstrates alignment with expectations for systematic evaluation, continuous improvement, and equitable educational practices outlined in accreditation standards. Importantly, these competencies should not be viewed as optional or supplemental, but as integral to instruction quality and program accountability.

Finally, embedding this type of faculty development within ongoing professional development structures advances Domain 10: Personal, Professional, and Leadership Development by reinforcing faculty responsibility for continuous growth and inclusive excellence. Framing multilingual teaching competence as a leadership and systems-level priority supports alignment with evolving accreditation expectations while strengthening educator confidence and student success.

This study has several limitations that should be considered when interpreting the findings. The project was conducted at a single institution using a small convenience sample of nurse educators, which limits generalizability to other nursing programs and educational contexts. The homogeneity of the sample, drawn entirely from a single private associate degree program in the Northeastern United States, means findings may not be transferable to programs with different institutional characteristics, geographic locations, or student population demographics. The absence of a comparison group limits the ability to attribute observed changes exclusively to the intervention, as alternative explanations such as maturation or testing effects cannot be fully excluded.

Outcomes were based on self-reported measures of educator self-efficacy, which may be influenced by response bias or social desirability. In the context of faculty development interventions, participants may feel implicit pressure to report improvement following a session, particularly when the intervention is delivered by or associated with institutional leadership. This potential for socially desirable responding is a recognized limitation of single-group pre–post designs and should be considered when interpreting the magnitude of observed gains. Although the adapted 14-item version of the SETTI-NE demonstrated strong internal consistency within this sample (α = 0.97) and supported a unidimensional factor structure, the instrument modification has not undergone full independent psychometric validation. Specifically, item removal alters the original scale’s content coverage and norm-referenced properties, and the adapted version has not been tested for construct validity, criterion validity, or measurement invariance across populations. The small sample size further limits the stability of factor analytic findings, and results should be interpreted with appropriate caution pending replication.

Finally, the study measured immediate post-intervention outcomes only. Long-term sustainability of self-efficacy gains and the impact of educator self-efficacy on student-level outcomes were not assessed. It remains unknown whether the gains observed immediately following the intervention are maintained over time or result in meaningful changes to classroom practice and student outcomes. Future research using larger, multisite samples and comparison groups is needed to further evaluate intervention effectiveness and downstream educational impact.