Adaptive leadership in advancing professionalism among clinical nurse educators: A mixed-methods study

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dc.contributor.authorWang, Xiyi
dc.contributor.authorCui, Nianqi
dc.contributor.authorWen, Fule
dc.contributor.authorWu, Lili
dc.contributor.authorJia, Yunhua
dc.contributor.authorNiu, Xiaoyin
dc.contributor.authorXu, Shu
dc.contributor.authorLee, Geraldine
dc.contributor.authorHu, Yun
dc.contributor.funderShanghai Association of Higher Education
dc.contributor.funderShanghai Jiao Tong University
dc.contributor.funderYonsei University
dc.date.accessioned2026-07-13T15:00:01Z
dc.date.available2026-07-13T15:00:01Z
dc.date.issued2026-04-30
dc.description.abstractObjectives To investigate the professionalism among clinical nurse educators and examine how adaptive leadership supports their transition from clinical practice to educational roles. Methods A sequential explanatory mixed-methods design, informed by Wheel of Professionalism in Nursing theory and Adaptive Leadership Theory, was conducted between December 2021 and January 2022. Participants comprised registered nurses from teaching hospitals across five provinces and municipalities in China (Shanghai, Zhejiang, Chongqing, Hebei, and Shanxi). Quantitative data were collected through a multi-center cross-sectional survey involving 669 respondents using the Behavioral Inventory for Professionalism in Nursin g . Qualitative data were obtained via focus group interviews with 12 purposively selected participants. Data integration was conducted through content analysis, structured around key dimensions of professionalism. Results The professionalism score was significantly lower among clinical nurse educators than among their managers [11.00 (8.50, 14.00) vs. 15.00 (9.25, 19.50), Z = −4.110, P < 0.001), indicating a discrepancy in perceived professionalism. No significant differences were observed in adherence to the code for nurse, theory-related domains or publication and communication ( P > 0.05), whereas significant differences were found across the remaining six dimensions ( P < 0.05). Qualitative findings yielded three themes: 1) adaptive alignment with institutional priorities; 2) driving change within complexity; and 3) contributing to social and professional impact. These findings illustrate how adaptive leadership processes shape the development and enactment of professionalism, particularly in navigating role transition and organizational expectations. Conclusions Clinical nurse educators demonstrate comparatively lower levels of professionalism than their managers’ expectations, with gaps concentrated in multiple practice domains. Adaptive leadership plays a pivotal role in bridging these gaps by enabling clinical nurse educators to respond to complex role demands and evolving institutional contexts. Targeted strategies, including structured training, organizational support, and policy-level interventions, are essential to strengthen professionalism and support sustainable workforce development.en
dc.description.sponsorshipShanghai Association of Higher Education|1QZD2409 Shanghai Jiao Tong University|SJTUHLXK2024
dc.description.versionPublished Version
dc.format.extent10
dc.format.mimetypeapplication/pdfen
dc.identifier.authororcidWang, Xiyi
dc.identifier.authororcidCui, Nianqi
dc.identifier.authororcidWen, Fule
dc.identifier.authororcidWu, Lili
dc.identifier.authororcidJia, Yunhua
dc.identifier.authororcidNiu, Xiaoyin
dc.identifier.authororcidXu, Shu
dc.identifier.authororcidLee, Geraldine§0000-0001-6385-8600
dc.identifier.authororcidHu, Yun
dc.identifier.citationWang, X, Cui, N, Wen, F, Wu, L, Jia, Y, Niu, X, Xu, S, Lee, G & Hu, Y 2026, 'Adaptive leadership in advancing professionalism among clinical nurse educators: A mixed-methods study', International Journal of Nursing Sciences, vol. 13, no. 4, pp. 1-10. https://doi.org/10.1016/j.ijnss.2026.04.017
dc.identifier.doi10.1016/j.ijnss.2026.04.017
dc.identifier.endpage10
dc.identifier.issn2352-0132
dc.identifier.issued4
dc.identifier.journaltitleInternational Journal of Nursing Sciences
dc.identifier.otherORCID: /0000-0001-6385-8600/work/220589067
dc.identifier.startpage1
dc.identifier.urihttps://hdl.handle.net/10468/19060
dc.identifier.volume13
dc.language.isoen
dc.publisherChinese Nursing Association
dc.rights© 2026, the Authors. Published by Elsevier B.V. on behalf of the Chinese Nursing Association. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
dc.rights.accessrightsopen access
dc.rights.licensenameAttribution-NonCommercial-NoDerivatives 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.statusPeer reviewed
dc.subjectAdaptive leadership
dc.subjectClinical nurse educator
dc.subjectCross-sectional study
dc.subjectMixed-methods design
dc.subjectProfessionalism
dc.subjectQualitative research
dc.subject[NursingMidwifery]
dc.titleAdaptive leadership in advancing professionalism among clinical nurse educators: A mixed-methods studyen
dc.typeArticle (peer-reviewed)
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