ArticleBMC medical education2026
Skill-based competencies, not traits, are associated with design thinking-aligned teaching behaviours in nursing education: a cross-sectional survey.
Article in BMC medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHealthcare systems' growing complexity has driven the adoption of design thinking (DT) pedagogies to cultivate creativity, collaboration, and adaptive expertise among nursing graduates. Faculty teaching behaviours play a critical role in how DT curricula are enacted, yet it remains unclear whether skill-based DT competencies or trait-based dispositions are more strongly associated with DT-aligned teaching behaviours. This study examined their relative and indirect associations among interdisciplinary faculty involved in DT-integrated nursing education in Taiwan.
methodsA cross-sectional survey was conducted with 95 faculty members from 12 Taiwanese institutions offering DT-integrated nursing courses. Measures included the 14-item Creative Teaching Behaviours Scale (CTBS) as a proxy for DT-aligned teaching behaviours, the 18-item Creative Synthesis Inventory-Taiwan version (CSI-TW) for skill-based DT competencies, and the 9-item Design Thinking Traits Questionnaire-Taiwan version (DTTQ-TW) for trait-based DT dispositions. Analyses included exploratory group comparisons, hierarchical multiple regression, and mediation analysis, controlling for demographic characteristics and DT-related teaching experience.
resultsFaculty with higher CTBS scores demonstrated significantly higher levels of both skill-based and trait-based DT competencies at the descriptive level. Hierarchical regression analysis showed that skill-based DT competencies (β = 0.429, p < 0.05) and DT teaching experience (β = 0.379, p < 0.05) were independently associated with DT-aligned teaching behaviours, explaining 27.2% of the variance. Trait-based DT dispositions did not contribute additional explanatory value once skills were taken into account (ΔR² = 0.001, p = 0.784). Mediation analysis further suggested an indirect association, whereby trait-based DT competencies were related to teaching behaviours through skill-based competencies, with no detectable direct association.
conclusionsWithin this cross-sectional sample, DT-aligned teaching behaviours were more closely associated with skill-based DT competencies and accumulated teaching experience than with trait-based dispositions. The findings are consistent with a distal-proximal interpretation derived from social cognitive theory and suggest that faculty development initiatives should prioritise sustained, hands-on training in DT process skills and authentic teaching practice opportunities rather than trait-based selection.
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