Clinical Teaching Quality Scale (CTQS)
Clinical Teaching Quality Scale · Also known as: Teaching Quality Assessment, Clinical Instructor Effectiveness Scale
The CTQS is a self-report questionnaire measuring students' perceptions of their clinical educator's (preceptor, clinical instructor, or mentor) teaching quality and effectiveness. Developed by Ohrling, Hallberg, and Gaberson in the early 2000s, the CTQS evaluates dimensions of clinical teaching including role modeling, knowledge transmission, feedback quality, student empowerment, and development of critical thinking. The scale is used in nursing and health professions education to provide educators with feedback on their teaching performance, identify professional development needs, and inform program quality assurance.
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When to use it
The CTQS is used primarily in nursing education, though it applies across health professions. It is administered: (1) at the end of clinical placements to evaluate individual clinical educators; (2) across multiple students and rotations to develop an educator's performance profile; (3) before and after clinical teaching skill development programs to assess training effectiveness; (4) for annual educator evaluations or credentialing in clinical teaching; and (5) in program-level quality assurance to identify patterns and guide institutional clinical education improvement.
Strengths & limitations
- Targeted feedback for educators: subscale scores pinpoint specific teaching competencies (feedback, role modeling, empowerment) enabling educators to focus development efforts.
- Student-centered perspective: captures what learners directly experience, providing authentic input often not visible to program directors or administrators.
- Practical relevance: items focus on observable, changeable teaching behaviors rather than personality traits, making feedback actionable.
- Validation across contexts: validated in hospital, community, and specialty clinical settings, suggesting generalizability.
- Support for professional development: CTQS scores can initiate coaching conversations, structure peer observations, and document growth in teaching competence.
- Student bias factors: student ratings may be influenced by their prior experiences, personality fit with the educator, grading expectations, and social desirability. Low scores may reflect student anxiety rather than educator quality.
- Limited scope of teaching: CTQS assesses relational and feedback aspects of clinical teaching but does not capture classroom instruction, curriculum design, or assessment validity—important teaching components outside direct supervision.
- Reverse causality ambiguity: if student competence and confidence improve, they may rate their educator more favorably—creating uncertainty about whether CTQS reflects teaching quality or student outcomes.
- Aggregation challenges: aggregating scores across multiple students is useful for program evaluation but may obscure variation. A given educator might be excellent with senior students but less effective with novices.
Frequently asked
Can low CTQS scores mean students were poorly placed with a educator?
Possibly, but not necessarily. Low CTQS scores could reflect the educator's teaching effectiveness, but also the student's adjustment difficulties, prior expectations, or learning style mismatch. Before concluding the educator is ineffective, consider whether the student's low ratings on CLES+T, confidence measures, or clinical competence are also low (suggesting environment issues) or isolated to this educator's ratings (suggesting personality fit or unrealistic expectations).
Should I show the CTQS results to educators immediately or aggregate them across students first?
Aggregate across all students on that educator's placement rotation (typically 3–6 students per rotation) before sharing results. This avoids biasing scores toward any one student's perspective and provides a more stable estimate of teaching quality. Aggregate at least two rotations (≥6 students total) before making any development plans.
What if an educator's CTQS scores differ widely across students on the same placement?
Wide variability might reflect genuine student differences in learning needs, prior experience, or personality–educator fit. It could also indicate the educator's consistency is low (effective with some students, less so with others). Qualitative follow-up interviews with high and low raters, plus peer observation, can clarify whether variability is student-driven or educator-driven.
Can CTQS be used for clinical educators in non-nursing professions?
The CTQS was developed for nursing but is applicable to other health professions (medicine, pharmacy, allied health) with minimal adaptation. Items should be reviewed for specialty-specific language, but the core teaching competencies (feedback, role modeling, empowerment) are universal across healthcare education.
Sources
- Ohrling, K. & Hallberg, I. R. (2001). The meaning of precepting: Nurse preceptors' lived experience of precept education. J Adv Nurs 33(1): 96–103. link ↗
- Gaberson, K. B., Schroeder, S. G., & Aplin, M. C. (2003). Evaluating clinical teaching: A tool for nurse educators. Nurse Educ Pract 3(1): 48–56. link ↗
How to cite this page
ScholarGate. (2026, June 3). Clinical Teaching Quality Scale. ScholarGate. https://scholargate.app/en/health-education/clinical-teaching-quality-scale
Which method?
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