The association between creativity, creative components of personality, and innovation among Taiwanese nursing students

Journal Pre-proof The association between creativity, creative components of personality, and innovation among Taiwanese nursing students Hsing-Yuan Liu, Chia-Chen Chang, I-Teng Wang, Shu-Yuan Chao

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https://doi.org/10.1016/j.tsc.2020.100629

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Thinking Skills and Creativity

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Please cite this article as: Liu H-Yuan, Chang C-Chen, Wang I-Teng, Chao S-Yuan, The association between creativity, creative components of personality, and innovation among Taiwanese nursing students, Thinking Skills and Creativity (2020), doi: https://doi.org/10.1016/j.tsc.2020.100629

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The association between creativity, creative components of personality, and innovation among Taiwanese nursing students Short running title: creativity, creative components of personality, and innovation Hsing-Yuan Liu1, Chia-Chen Chang2, I-Teng Wang3, Shu-Yuan Chao 4 1

Associate Professor, Department of Nursing, Chang Gung University of Science and Technology,

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Chang Gung Memorial Hospital Institutional addresses: No.261, Wenhua 1st Rd., Guishan Dist.,

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Taoyuan City 33303, Taiwan R.O.C. Email addresses: [email protected] 2

Assistant professor, Department of senior citizen service business, St. John's University,

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Institutional addresses: 499, Sec. 4, Tam King Road,Tamsui District, New Taipei City, 25135 Taiwan, R.O.C. Email addresses: [email protected] 3

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Postdoctoral, Department of Nursing, Chang Gung University of Science and Technology,

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Institutional addresses: No.261, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33303, Taiwan R.O.C. Email addresses: [email protected]

Professor, Department of Nursing, Hungkuang University, Institutional addresses: No. 34, Chungchi

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Rd. Shalu District, Taichung City, 433 Taiwan, ROC. Email addresses: [email protected] Correspondence

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Shu-Yuan Chao, No. 34, Chungchi Rd.Shalu District, Taichung City, 433 Taiwan, ROC. Email addresses: [email protected]

HIGHLIGHTS  Taiwanese nursing students had high levels of innovation; creativity was moderate. 

The creative personality component of imagination was highest, curiosity lowest.

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Innovation was positively correlated with curiosity.

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Methods that increase students’ curiosity and innovation could improve creativity.

ABSTRACT The link between creativity, aspects of personality associated with creativity, and innovation are unclear with regards to nurses and nursing education. This cross-sectional, descriptive,

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correlational study explored levels of creativity, creativity personality, and innovation among

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nursing students, and the association between these variables. Senior-year nursing students (N = 98) at a university in Northern Taiwan participated in this study. All were enrolled in a capstone

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course for developing patentable healthcare-related products. Verbal and figural Torrance Tests of

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Creative Thinking (TTCT-V and TTCT-F, respectively) measured creativity; the Affective Components of Creativity Scale (ACCS) evaluated creative personality; innovation was the mean

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product creativity score from the capstone course. Pearson’s test with Bonferroni’s post-hoc adjustment examined correlations. Scores for innovation were moderately high (mean = 91.37, SD

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= 2.83). Mean scores on the TTCT-F and TTCT-V were 40.05 (SD = 21.21) and 18.08 (SD = 13.94), respectively; level of creativity was moderate on the TTCT (mean = 58.13, SD = 30.47). For components of creative personality, the highest score was imagination (mean = 4.75, SD = 0.71); challenge and adventure were similar (2.71, SD = 0.31 and 2.53, SD = 0.25, respectively);

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curiosity was lowest (1.76, SD = 0.23). Mean total score for the ACCS was 3.15 (SD = 0.33). Innovation was correlated with curiosity (p < .001). The was no significant association between creativity and creative personality. The positive relationship between innovation and curiosity suggests implementing methods aimed at increasing curiosity and innovation could improve nursing students’ abilities to create innovative products.

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Keywords: Nursing students, creative tendency, creative level, innovation performance, personality 1. INTRODUCTION Researchers suggest that in nursing, innovation also requires the component of creativity (Weng, Huang, & Lin, 2013) . Innovation improves health care quality and reduces health care costs (Liao, Chang, & Li, 2015; Tsou, Chi, Liao, & Chen, 2008) while it eases health care professionals’ stress

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and reduces burnout (Kung, Chen, & Hsu, 2011). Therefore, nursing professionals worldwide have

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been fostering nurses’ innovation and creativity (Weng et al., 2013). In the US, cross-disciplinary teaching of nursing students improved critical thinking and problem-solving skills and team-based

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collaboration fostered innovative prototypes designed to improve healthcare outcomes (Geist,

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Sanders, Harris, & Arce-Trigatti, 2019). Nursing programs in Taiwan have incorporated interdisciplinary teaching with instruction in techniques for creativity to stimulate divergent

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thinking abilities and enhance development of innovative healthcare products (Liu, Tsai, Wang, & Chen, 2019; Liu, Wang, Huang, Hsu, & Han, 2019a). A qualitative study in Iran found nurturing

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nurses creativity improved not only patient care but also increased nurses’ self-confidence (Isfahani, Hosseini, Khoshknab, Peyrov, & Khanke, 2015). In 2003, the Advisory Office of the Ministry of Education declared that the Taiwanese government foster creativity for students at all education levels (Liu & Wang, 2019). As a result,

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since 2006 technical institutes, vocational schools, and universities integrated capstone courses to stimulate creativity, innovation, and entrepreneurship (Liu, Wang, Huang, Hsu, & Han, 2019b). Incorporating this type of ‘design thinking’ has also been encouraged for nursing programs in the US to help nurses develop problem-solving skills aimed at improving quality of care (Beaird, Geist, & Lewis, 2018). Five nursing schools in Taiwan have incorporated capstone courses with

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the aim of helping students generate innovative patentable healthcare products to solve real-world healthcare problems (Liao et al., 2015; Liu, Wang, Hang, Hang, & Hsu, 2019). However, there is a gap in the literature as to whether there is a relationship between creativity and innovation. 1.1 Background Creativity has been shown to be vital in models of job performance (Pace & Brannick, 2010; Zhang

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& Bartol, 2010). Studies suggest both generation and implementation of ideas are essential (Janssen, 2000). Idea generation can be viewed as creativity, and idea implementation can be

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viewed as innovation (Mumford & Gustafson, 1988). Creativity has been described as a

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component of a person’s personality (Janssen, 2000), a process of psychological engagement in an activity (Sternberg & Lubart, 1999), and something that is novel and useful (Amabile, 1988;

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Drazin, Glynn, & Kazanjian, 1999). Creativity is also one of the building blocks of innovation (Dewett & Gruys, 2007). Innovation is considered to be a predictor of creativity in a work

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environment (Hülsheger & Salgado, 2009).

Kamplyis and Berki have stressed that creative thinking and innovation should be a

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fundamental part of education (Kampylis, Saariluoma, & Berki, 2011). In their view, “Creative thinking enables students to apply their imagination to generating ideas, questions and hypotheses, experimenting with alternatives and to evaluating their own and their peers’ ideas, final products

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and processes” (Kampylis, 2014). Although creativity and innovation are considered important core competencies for nursing students in Taiwan (Liu, Wang, Hang, et al., 2019), few studies have examined the interaction of creativity and innovation for nursing students as it relates to delivery of healthcare. Measures of nursing students’ creativity require valid assessment tools. Guilford hypothesized that an individual’s creativity results from the ability to use divergent thinking (Michael &

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Michael, 1969). Thus, creativity can be measured with the Torrance tests of creative thinking (Wu et al., 1999). The Torrance tests measure both verbal (TTCT-V) and figural (TTC T-F) creativity. They have been shown to be a valid assessment of creativity (Kim, 2008; Kim, 2017) and have been translated into more than 35 languages (Millar, 2002; Runco & Acar, 2012). Guilford suggested divergent thinking was comprised of fluency, flexibility, originality, and elaboration (Michael & Michael, 1969). Fluency is the ability to generate diverse ideas about a problem

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quickly, flexibility is the ability to generate diverse ideas to solve many problems, originality is the

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ability to generate novel ideas, and elaboration is the ability to expand on an idea (Kampylis et al., 2011; Kim, 2011, 2017). Scores on the TTCT can be used to indicate nursing students’ abilities to

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use strategies and processes to connect ideas and organize creative thoughts.

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Numerous studies have examined the correlation between personality and creativity (Dollinger, Burke, & Gump, 2007; Hoseinifar et al., 2011; Lee & Kemple, 2014; Saad, Cleveland,

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& Ho, 2015; Silvia, Kaufman, & Pretz, 2009). Openness to experience is a trait consistently and positively associated with creativity in students (Hoseinifar et al., 2011; Lee & Kemple, 2014).

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Silvia et al. suggested that there is close relationship between openness to experience and creativity-related variables, such as the divergent thinking skills of fluency and creativity (Silvia et al., 2009). Studies have also suggested a relationship between creativity and components of a creative personality (Kim, 2011; Wu et al., 1999). Williams claimed that creative individuals have

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high levels of curiosity, imagination, adventure, and challenge (Williams, 1980). One means of examining the relationship between an individual’s creative personality traits and creativity is the Creativity Assessment Packet (CAP) (Williams, 1980). Studies using the CAP have shown creative personality traits directly influence creativity (Hsiao & Tu, 2012; Prajogo & Ahmed, 2006; Simonton, 2000; Wang & Cheng, 2010; Wu, 2002; Xia, 2009) . In one study that compared

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students who received a creativity training intervention with a control group, the author found the students in the intervention group had higher levels of curiosity, creativity, and sensitivity than controls (Wu, 2002). Xia used the Affective Components of Creativity Scale (ACCS) to measure college student’s creative personality traits (Xia, 2009). Students had high levels of imagination and adventure. Male students perceived themselves as more curious than female students (Xia, 2009). The ACCS has also been used to evaluate Taiwanese nursing faculty’s perceived levels of

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creative personality traits (Liu, Wang, Hang, et al., 2019).

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Creativity is purported to be positively related to innovation (Kampylis, 2014; Simonton, 2000). However, most studies showing a positive correlation between creativity and innovation

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have been conducted with employees in industrial work environments or with college students

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(Hsiao & Tu, 2012; Prajogo & Ahmed, 2006; Simonton, 2000; Wu, Wang, & Huang, 2016; Wu, 2002). Although creative people are often innovators, not all creative people are necessarily

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innovative (Fadaee & Alzahrh, 2014). Studies have reported a positive relationship between an individual’s personality traits and innovation (Hsieh, Lin, Chung, Yang, & Chen, 2013; Wu, 2015),

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however how innovation is measured is often subjective. One way to assess innovation is to quantify the originality of a created product using the Consensual Assessment technique (Amabile, 1983). This technique assumes that assessment a more of experts has been shown to be is the best way to evaluate something a person has created. The Consensual Assessment Technique has been

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shown to be valid and reliable for use in higher education settings (Baer & McKool, 2009). 2. METHODOLOGY 2.1 Aim There is a lack of research regarding the relationship of creativity, creative components of personality and innovation in healthcare schools. Understanding these relationships could help

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educators develop learning atmospheres designed to stimulate students’ thinking skills. To address this gap, the current study analyzed measures of creativity, creative components of personality and innovation among Taiwanese nursing students enrolled in a capstone course. We explored the following research question: Is there a correlation between creativity, components of a creative personality and innovation? The possible relationships and interactions are shown in Figure 1.

2.2 Design

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Our study used a cross-sectional, descriptive, correlational design.

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[Figure 1 here]

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2.3 Participants

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Nursing students enrolled in a capstone course participated in this study; all students were from one university of technology in northern Taiwan. The first author described the study design and

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purpose to all students, and invited them to participate during the last week of the course. Packets containing a description of the study design and purpose, survey questionnaires and a consent form

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were distributed to 120 students. The first author explained that students who wanted to be participants would need to sign the consent form enclosed in the packet, fill out the questionnaires, and return the packets. To maintain the anonymity of the participants, a coding number was assigned to each packet. A total of 98 packets with signed consent were returned after the

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conclusion of the course, a response rate of 81.6%. The average age of the participants was 21.3 years (standard deviation (SD) = 0.47; almost all (98%) were female. G*Power 3.1.9.2 software (Faul, Erdfelder, Lang, & Buchner, 2007) was used to determine sample size required for observing the same effect of the instruments over time with an alpha-type error < .05 and power beta of 85%. The minimum sample size was 95.

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2.4 Capstone Course The capstone course was designed to help nursing students develop patentable healthcare-related products for clinical care applications. The 18-week course included lectures from seven nursing faculty and small group discussions with teams of 7-8 students. Material covered included patent searching, healthcare product development and needs assessment. Students received instruction in the use of creative thinking tools, such as brain storming to stimulate divergent and convergent

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thinking skills. Students were required to develop an innovative product, give a mid-term

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presentation, and present the final product at the end of the semester to the seven nursing faculty

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and their student-team. 2.5 Measurements

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The Torrance Tests of Creative Thinking (TTCT) (Wu et al., 2016) measured nursing students’ levels of creativity. We used a Chinese version of the TTCT to evaluate creativity (Hsiao & Tu,

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2012). The verbal test (TTCT-V) contains six activities; each activity begins with a picture and the student responds with a written description of the picture. Three subscales are used for scoring:

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fluency, the number of ideas related to the picture; originality, the uniqueness of the response; and flexibility, which is the variety of different ideas (Kim, 2017). The range for the subscales scores of fluency, flexibility, and originality are 0-50, 0-26, and 0-100, respectively; total scores range

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from 0-176.

The figural test (TTCT-F) is comprised of three activities: picture construction, picture

completion, and repeated figures of lines and circles. Four subscales score each activity on the TTCT-F: fluency, originality, and flexibility, as described for the TTCT-V, and elaboration, which involves rich imagery and abstraction (Kim, 2017). The range for the subscale scores of fluency, flexibility, originality, and elaboration are 0-57, 0-35, 0-114, and 0-171, respectively; total scores

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range from 0-377. Cronbach’s alpha coefficients for the subscales of the TTCT-F were between 0.79 and 0.98. In addition, we also measured total scores for TTCT-F and TTCT-V, as suggested by Okuda, Runco, and Berger (Okuda, Runco, & Berger, 1991). Cronbach’s alpha coefficients for total scores for the TTCT-F and TTCT-V and were 0.83 and 0.90, respectively, indicating satisfactory reliability. The Affective Components of Creativity Scale (ACCS) was used to assess components of

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participants’ personalities considered to be associated with creativity (Williams, 1980). The ACCS

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is a self-assessment instrument derived from the New Creative Affective Scale developed by Xia (Xia, 2009); the scale measures affective creativity traits: imagination, curiosity, adventure, and

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challenge. Statements are rated on a 4-point Likert scale; 1 = completely disagree to 4 = completely

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agree. Some questions are reverse scored. Higher scores indicate higher perceived levels of creativity. The reliability estimate for the ACCS is 0.92, and satisfactory validity was confirmed

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through factor analyses. Cronbach’s alpha coefficient was 0.78 for the total score and for subscales it ranged from .70 to .85, indicating satisfactory reliability. Table 1 shows examples of statements

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for each subscale of the ACCS.

Innovation was determined by the mean final grade for the 98 students at the end of the capstone course. Seven faculty who taught the course graded the students on attendance and

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participation (30 points), a mid-term report (30 points), and a team evaluation (10 points). Students also received a score for their final project, which included a presentation of their project to faculty and team members (10 points) and project creativity score (20 points), which is described below. Therefore, the maximum score for innovation was 100 points; 20% was their product creativity score.

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Product creativity was determined using the Consensual Assessment Technique (Baer & McKool, 2009). A diverse panel of experts each judge the product and provide a rating based on novelty and usefulness. Our panel was comprised of four judges, all with a Ph.D. in their area of expertise: two in nursing and two in industrial design. Judges had published studies on the development of healthcare products and were experienced in evaluating student-designed products. Two of the nurses were in practice as an RN, the other judges were college instructors. The judges

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never met to confer or discuss their ratings in any way. Novelty was determined by how the product

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compared to other similar products on the market and was scored by assessing three items: originality, overall impression, and uniqueness. Usefulness as a healthcare product was scored by

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rating two items: appropriateness (how likely the product would be used) and esthetics (visual

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appeal). Each item was scored low (0 point) to high (4 points); total scores range from 0 – 24 points. Cronbach’s alpha coefficient for internal consistency was .72 for novelty and .85 for

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usefulness. Inter-rater reliability was acceptable (ICCnovelty = .91, ICCusefulness = .87). Scores from the four judges were averaged to determine the project creativity score for each developed product.

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2.6 Data collection and analysis

Data were collected after nursing students completed the 18-week capstone course, in the fall of 2016. Anonymous survey data were collected from paper-and-pencil questionnaires, which

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included information about students age, gender, and their final capstone course grade. Data from the questionnaires were analyzed using SPSS version 20.0. Descriptive statistics, such as the mean (M) and standard deviation (SD) were used to describe participants’ characteristics, and scores for innovation, creativity, and creative personality traits. Pearson’s correlation coefficient was run to identify correlations between innovation, creativity, and creative personality traits. To reduce the

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likelihood of testing bias for 12 variables, a Bonferroni correction (= .05/12) was used, resulting in a required significance of p ≤ .004. 2.7 Ethical Considerations Approval was obtained from the Institutional Review Board of the hospital ethics committees prior to data collection. After the coded packets were returned, the director of the healthcare program

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checked for the presence of a signed consent form and removed it from the packet to ensure

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confidentiality of the students’ information. 3. RESULTS

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3.1 Nursing students’ levels of creativity, creative personality traits, and innovation Table 2 shows participants mean scores for creativity (TTCT), creative personality traits (ACCS),

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and innovation following completion of the capstone course. The mean total score for the TTCT

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was 58.13; mean total scores for the TTCT-V and TTCT-F were 18.08 and 40.05, respectively. The construct with the highest mean score on the TTCT-V was for fluency (M = 8.06; SD = 6.16);

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the lowest was flexibility (M = 4.91; SD = 2.43). The construct with the highest mean score on the TTCT-F was fluency (M = 17.17; SD = 8.63); the lowest was elaboration (M = 1.71; SD = 2.09). All scores for creativity were below the mid-point of the ranges, suggesting low levels of creativity. The mean total score for creative personality traits was 3.15 (SD = 0.33), suggesting students

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perceived themselves as moderately creative. Of the traits considered components of a creative personality, the mean score for imagination was highest (M = 4.75, SD = 0.71); curiosity was lowest (M = 1.76, SD = 0.23). The mean scores for innovation ranged between 83 and 96 out of a possible 100, indicating a medium-high level of innovation. A total of 48 students had scores greater than 91, indicating a high level of innovation. [Table 2 here]

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3.2 Correlations and associations of innovation, creativity, and creative personality traits Pearson’s product-moment correlations showed a positive low to moderate correlation between innovation and the creative personality trait of curiosity (r = 0.32, p < .001) (Table 3). Innovation was not correlated with any other personality traits or any figural or verbal constructs of the TTCT. [Table 3 here]

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4. DISCUSSION We determined the levels of creativity, creative personality traits, and innovation for Taiwanese

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nursing students following completion of a capstone course in developing creative healthcare

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products. There was a significant correlation between innovation and the creative personality trait

figural or verbal constructs of the TTCT.

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of curiosity. Levels of innovation were not correlated with any other personality traits or any

The correlation between innovation and curiosity has been demonstrated for engineering

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students (Hunter, Abraham, Hunter, Goldberg, & Eastwood, 2016) and in successful businesses and organizations (Mesquita, 2011). One explanation for the absence of an effect of creativity on

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innovation might be explained by the nursing students’ scores on the Torrance tests. All scores for creativity were below the mid-point of the ranges, suggesting low levels of creativity among participants. The model for the componential theory of creativity suggest creativity is a component

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required for an individual to produce products that are innovative (Amabile, 2012; Blauth, Mauer, & Brettel, 2014), which suggests the lack of a relationship between innovation and creativity for the nursing students in our study might be the result of low levels of creativity. A study on creativity among college students (Karpova, Marcketti, & Barker, 2011) and another among nursing students at Washburn University in the U. S. (University, 2014) reported higher scores on the creativity index than measured in our study. Our students’ scores were almost 50% lower for

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the TTCT and TTCT-F, and approximately 80% lower on the TTCT-V than the mean scores for the nursing students in the Washburn University study (University, 2014). Significantly lower participant scores could explain the lack of correlation with innovation as well as with creative personality traits. The Taiwanese nursing students’ lower scores for creativity might also be explained by cultural influences of Confucianism, which can act as blocks to creativity (Kim, 2009). Elements

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of Confucianism can negatively impact creativity, such as unconditional obedience, gender

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inequality, role expectations, and suppression of expression. Nursing faculty can improve student creativity by incorporating teaching methods sensitive to the needs of students (Duhamel, 2016).

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However, in Chinese cultures such as Taiwan, teaching creativity is often seen as optional, relative

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to other areas of education; the focus of education is on memorization of facts in order to pass national exams. Also, some teaching faculty are reluctant to be viewed as “creative” (Henriksen,

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Richardson, & Mehta, 2017). Chinese society is a collectivist, hierarchical culture; students are more likely to be followers, they are strongly influenced by what faculty believe is important (Saad

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et al., 2015; Tsai, Horng, Liu, Hu, & Chung, 2015). Therefore, in Taiwan, students taught by faculty who do not value the role of creativity in education may be less likely to exhibit creativity than students in Western cultures. We suggest the future studies examine relationships between Taiwanese faculty and student creativity.

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Although the highest component of creative personality was imagination, the only creative

personality trait associated with innovation was curiosity. Wu found that imagination was a key component of creativity and innovation (Wu et al., 2016), in contrast to a study by Liu and Liao and unlike our findings (Liu & Liao, 2019). However, the difference in findings may be explained by the environments of the participants. The creative component of curiosity was the lowest

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subscale score on the ACCS. One explanation may be that all nursing students in our study were female; two studies reported lower scores for female college students in Taiwan than males (Torrance, 1995; Xia, 2009). The ACCS is a self-assessment instrument, and the nursing students may have underestimated their creative personality traits, including curiosity. However, low scores for curiosity among females may also be a result of the role gender plays in Chinese culture; males

studies should include a larger sample of male nursing students.

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are encouraged to seek new information when faced with a challenge; females are not. Future

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Although curiosity is a key to enhancing creativity (Hardy III., Jay, Ness, & Mecca, 2017; Puccio et al., 2018), our results do not explain how this impacts innovation. There is no standard

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measure of innovation. A lack of a correlation between creativity and innovation could be due to

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our use of student capstone grades. The Consensual Assessment Technique, used to evaluate the student projects, is gaining more acceptance in higher education. It has been demonstrated to be

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gender-neutral, unlike many achievement or aptitude tests (Baer & McKool, 2009). However, the project creativity score represented only a fraction of the students’ capstone grade, suggesting that

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our measure of innovation, may have been insufficient. A recent study used a more qualitative approach for measuring innovation by applying text mining for structural analysis of student projects (Abuzir, 2018). A more sensitive assessment of innovation might be achieved by relying solely on scores for project creativity.

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The capstone course format may have impacted the findings. Although the course included

instruction in creative thinking techniques that have been shown to improve innovation (Ludwig, Nagel, & Lewis, 2017), we did not assess how well students understood or applied these concepts. Perhaps students did not learn how to apply creative thinking. The focus of these capstone courses in Taiwan is to improve students’ creativity in all areas of education, not just healthcare. Therefore,

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we suggest educators in Taiwan assess the effectiveness of instruction in creative thinking skills prior to evaluating the relationship of creativity and innovation. 4.1 Limitations The use of a cross-sectional design makes it difficult to determine causal relationships for creativity, creative personality traits, and innovation. Assessing students from one university limits

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the applicability of findings, the predominate inclusion of females’ limits the generalization of our findings. Finally, scores on the TTCT may not be an accurate reflection of the nursing students’

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creativity. Further studies should incorporate other quantitative measures of creativity as a

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validation of our findings. 5. CONCLUSION

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The findings contribute new information to previous studies on creativity, creative personality

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traits, and innovation. There was a low correlation between innovation and the creative personality trait of curiosity. There was a significant and positive association with innovation and curiosity.

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Design thinking in higher education has become increasingly important as the use of technology in healthcare has burgeoned (Beaird et al., 2018). The findings suggested a need for nursing to enhance and improve students’ creativity and innovation. Extending the course length to a year, and including a weekly lab might be warranted. Nursing educators who teach capstone courses are

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urged to implement learning experiences designed to improve student creativity and innovation.

Authorship statement All persons who meet authorship criteria are listed as authors, and all authors certify that they have participated sufficiently in the work to take public responsibility for the content, including participation in the concept, design, analysis, writing, or revision of the manuscript.

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Furthermore, each author certifies that this material or similar material has not been and will not be submitted to or published in any other publication before its appearance in the Thinking Skills and Creativity. All authors have agreed on the final version and meet at least one of the following criteria (recommended by the ICMJE*): Substantial contribution to conception and design, acquisition of data or analysis and interpretation of data, drafting the article or revising it critically for

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importance intellectual content.

Funding Statement

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This study was supported by both research grant from the Ministry of Science and Technology

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Taiwan R.O.C. (NMRPF3F0151).

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Acknowledgments

We greatly appreciate the support of all students of Chang Gung University of Science and

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Technology Institutional for their voluntary participation in this study.

References

Abuzir, Y. (2018). Innovative Model for Student Project Evaluation Based on Text Mining.

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International Journal of Research in Education and Science, 4(2), 409-419.

Amabile, T. M. (1983). The social psychology of creativity: A componential conceptualization. Journal of personality and social psychology, 45(2), 357.

Amabile, T. M. (1988). A model of creativity and innovation in organizations. Research in organizational behavior, 10(1), 123-167.

17

Amabile, T. M. (2012). Componential theory of creativity. Harvard Business School, 12(96), 110. Baer, J., & McKool, S. S. (2009). Assessing creativity using the consensual assessment technique. In Handbook of research on assessment technologies, methods, and applications in higher education (pp. 65-77): IGI Global. Beaird, G., Geist, M., & Lewis, E. J. (2018). Design thinking: Opportunities for application in

of

nursing education. Nurse Education Today, 64, 115-118.

ro

Blauth, M., Mauer, R., & Brettel, M. (2014). Fostering creativity in new product development through entrepreneurial decision making. Creativity and Innovation Management, 23(4), 495-

-p

509.

re

Dewett, T., & Gruys, M. L. (2007). Advancing the case for creativity through graduate business education. Thinking Skills and Creativity, 2(2), 85-95.

Journal, 19(2-3), 91-103.

lP

Dollinger, S. J., Burke, P. A., & Gump, N. W. (2007). Creativity and Values. Creativity Research

ur na

Drazin, R., Glynn, M. A., & Kazanjian, R. K. (1999). Multilevel Theorizing about Creativity in Organizations: A Sensemaking Perspective. The Academy of Management Review, 24(2), 286-307.

Duhamel, K. V. (2016). Bringing us back to our creative senses: Fostering creativity in graduate-

Jo

level nursing education: A literary review. Nurse Education Today, 45, 51-54.

Fadaee, A., & Alzahrh, H. O. A. (2014). Explaining the relationship between creativity, innovation and entrepreneurship. International Journal of Economy, Management and Social Sciences, 3(1), 1-4.

18

Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior research methods, 39(2), 175-191. Geist, M. J., Sanders, R., Harris, K., & Arce-Trigatti, A. (2019). Hitchcock-Cass C: Clinical immersion: An approach for fostering cross-disciplinary communication and innovation in nursing and engineering students. Nurse educator, 44(2), 69-73.

of

Hülsheger, U. R., & Salgado, J. F. (2009). Team-level predictors of innovation at work: a

ro

comprehensive meta-analysis spanning three decades of research. Journal of Applied Psychology, 94(5), 1128.

-p

Hardy III., Jay, H., Ness, A. M., & Mecca, J. (2017). Outside the box: Epistemic curiosity as a

re

predictor of creative problem solving and creative performance. Personality and Individual Differences, 104, 230-237.

lP

Henriksen, D., Richardson, C., & Mehta, R. (2017). Design thinking: A creative approach to educational problems of practice. Thinking Skills and Creativity, 26, 140-153.

ur na

Hoseinifar, J., Siedkalan, M. M., Zirak, S. R., Nowrozi, M., Shaker, A., Meamar, E., & Ghaderi, E. (2011). An investigation of the relation between creativity and five factors of personality in students. Procedia-Social and Behavioral Sciences, 30, 2037-2041. Hsiao, C. C., & Tu, C. H. (2012). The Inventory of Teachers’ Teaching for Creativity. Curriculum

Jo

& Instruction Quarterly, 15(2), 87-118.

Hsieh, T. H., Lin, Y. Y., Chung, R. G., Yang, W. H., & Chen, Y. J. (2013). The Impact of Creativity Personality Trait on Innovation Behavior: The Test of Mediating Effect of Well-being. Hsiuping Journal, 27, 61-77.

19

Hunter, J. A., Abraham, E. H., Hunter, A. G., Goldberg, L. C., & Eastwood, J. D. (2016). Personality and boredom proneness in the prediction of creativity and curiosity. Thinking Skills and Creativity, 22, 48-57. Isfahani, S. S., Hosseini, M. A., Khoshknab, M. F., Peyrov, H., & Khanke, H. R. (2015). Nurses’ creativity: advantage or disadvantage. Iranian Red Crescent Medical Journal, 17(2). Janssen, O. (2000). Job demands, perceptions of effort-reward fairness and innovative work

of

behaviour. Journal of Occupational and Organizational Psychology 73(3), 287-302.

ro

Kampylis, P. B. E. (2014). Nurturing creative thinking. International Academy of Education. Kampylis, P. G., Saariluoma, P., & Berki, E. (2011). Fostering creative thinking: What do primary

-p

teachers recommend? Hellenic Journal of Music. Education, and Culture, 2, 45-46.

re

Karpova, E., Marcketti, S. B., & Barker, J. (2011). The efficacy of teaching creativity: Assessment of student creative thinking before and after exercises. Clothing and Textiles Research

lP

Journal, 29(1), 52-66.

Kim, K. H. (2008). Meta-Analyses of the Relationship of Creative Achievement to Both IQ and

ur na

Divergent Thinking Test Scores. The Journal of Creative Behavior, 42(2), 106-130. Kim, K. H. (2009). Cultural influence on creativity: The relationship between Asian culture (Confucianism) and creativity among Korean educators. The Journal of Creative Behavior, 43(2), 73-93.

Jo

Kim, K. H. (2011). The Creativity Crisis: The Decrease in Creative Thinking Scores on the Torrance Tests of Creative Thinking. . Creativity Research Journal, 23(4), 285-295.

Kim, K. H. (2017). The Torrance Tests of Creative Thinking - Figural or Verbal. Which One Should We Use, 4(2), 302.

20

Kung, Y. S., Chen, H. C., & Hsu, C. C. (2011). Is creativity needed for helping profession? The influence of creativity on the relationship between burnout and stress among helping professionals. Creation journal, 2(2), 113-136. Lee, I. R., & Kemple, K. (2014). Preservice teachers' personality traits and engagement in creative activities as predictors of their support for children's creativity. Creativity Research Journal, 26(1), 82-94.

ro

critical ill patients. Journal of health and architecture, 2(1), 65-73.

of

Liao, S. C., Chang, W. C., & Li, C. P. (2015). The effectiveness of modified restraint glove in

Liu, C. M., & Liao, K. T. (2019). Using Localized Features for Analyzing College Students’

-p

Imagination. EURASIA Journal of Mathematics, Science and Technology Education, 15, 4.

re

Liu, H. Y., Tsai, H. M., Wang, I. T., & Chen, N. H. (2019). Predictors of self-perceived levels of creative teaching behaviors among nursing school faculty in Taiwan: A preliminary study.

lP

Journal of Professional Nursing (in press).

Liu, H. Y., & Wang, I. T. (2019). Creative teaching behaviors of health care school teachers in

ur na

Taiwan: mediating and moderating effects. BMC medical education, 19(1), 186. doi:https://doi.org/10.1186/s12909-019-1641-8 Liu, H. Y., Wang, I. T., Hang, H. M., Hang, D. H., & Hsu, D. Y. (2019). Self-efficacy of teaching for creativity for nursing faculty in Taiwan: A Preliminary Study. Nursing Education

Jo

Perspectives (in press).

Liu, H. Y., Wang, I. T., Huang, D. H., Hsu, D. Y., & Han, H. M. (2019a). Nurturing and enhancing creativity of nursing students in Taiwan: A quasi-experimental study. Journal of Creative Behavior(0), 1-20. doi:https://doi.org/10.1002/jocb.407

21

Liu, H. Y., Wang, I. T., Huang, D. H., Hsu, D. Y., & Han, H. M. (2019b). Nurturing and Enhancing Creativity of Nursing Students in Taiwan: A Quasi‐ Experimental Study. The Journal of Creative Behavior. Ludwig, P. M., Nagel, J. K., & Lewis, E. J. (2017). Student learning outcomes from a pilot medical innovations course with nursing, engineering, and biology undergraduate students. International journal of STEM education, 4(1), 33.

ro

Applications: Tools, Techniques and Applications: IGI Global.

of

Mesquita, A. (2011). Technology for Creativity and Innovation: Tools, Techniques and

Michael, J. J., & Michael, W. B. (1969). Book Reviews Intelligence, Creativity, and Their

-p

Educational Implications. . Educational and Psychological Measurement 29(4), 1013-1015.

re

Millar, G. W. (2002). The Torrance kids at mid-life: Selected case studies of creative behavior. Westport, CT, US.

lP

Mumford, M. D., & Gustafson, S. B. (1988). Creativity syndrome: Integration, application and innovation. Psychological Bulletin, 103(1), 2743.

ur na

Okuda, S. M., Runco, M. A., & Berger, D. E. (1991). Creativity and the finding and solving of real-world problems. Journal of Psychoeducational assessment, 9(1), 45-53. Pace, V. L., & Brannick, M. T. (2010). Improving prediction of work performance through frameof-reference consistency: Empirical evidence using openness to experience. International

Jo

Journal of Selection and Assessment, 18(2), 230-235.

Prajogo, D. I., & Ahmed, P. K. (2006). Relationships between innovation stimulus, innovation capacity, and innovation performance. R&D Management, 36(5), 499-515.

22

Puccio, G. J., Burnett, C., Acar, S., Yudess, J. A., Holinger, M., & Cabra, J. F. (2018). Creative problem solving in small groups: the effects of creativity training on idea generation, solution creativity, and leadership effectiveness. The Journal of Creative Behavior. Runco, M. A., & Acar, S. (2012). Divergent Thinking as an Indicator of Creative Potential. Creativity Research Journal, 24(1), 66-75. Saad, G., Cleveland, M., & Ho, L. (2015). Individualism–collectivism and the quantity versus

of

quality dimensions of individual and group creative performance. Journal of business

ro

research, 68(3), 578-586.

Silvia, P. J., Kaufman, J. C., & Pretz, J. E. (2009). Is creativity domain-specific? Latent class

-p

models of creative accomplishments and creative self-descriptions. Psychology of Aesthetics,

re

Creativity, and the Arts, 3(3), 139.

Simonton, D. K. (2000). Creativity: Cognitive, personal, developmental, and social aspects.

lP

American psychologist, 55(1), 151.

Sternberg, R. J., & Lubart, T. I. (1999). The concept of creativity: Prospects and paradigms. 3-15.

ur na

Torrance, E. P. (1995). Why fly? A philosophy of creativity. Norwood. In: NJ: Ablex publishing corporation.

Tsai, C. Y., Horng, J. S., Liu, C. H., Hu, D. C., & Chung, Y. C. (2015). Awakening student creativity: Empirical evidence in a learning environment context. Journal of hospitality,

Jo

leisure, sport & tourism education, 17, 28-38.

Tsou, Y. C., Chi, M. M., Liao, C. Y., & Chen, Y. C. (2008). The effectiveness of nursing innovation system in a medical center. Veterans General Nursing, 25(1), 44-52.

University, W. (2014). Strategic Analysis and Reporting Torrance Test of Creative Thinking Results. 2014-2015 Torrance Tests of Creative Thinking Results Summary.

23

Wang, A. C., & Cheng, B. S. (2010). When does benevolent leadership lead to creativity? The moderating role of creative role identity and job autonomy. Journal of organizational behavior, 31(1), 106-121. Weng, R. H., Huang, C. Y., & Lin, T. E. (2013). Exploring the cross-level impact of market orientation on nursing innovation in hospitals. Health Care Management Review, 38(2), 125136.

of

Williams, F. E. (1980). Creativity assessment packet : (CAP).

ro

Wu, C. T., Wang, P. C., & Huang, W. H. (2016). A Study on the Relationship among Creative Personality and Creative Behavior - Evidence from A University of Science and Technology.

-p

Management Information Computing, 5(2), 47-57.

re

Wu, J. J., Chen, F. Y., Guo, J. X., Lin, W. W., Liu, S. H., & Chen, Y. H. (1999). The directions manual of the Torrance Tests of Creative Thinking.

lP

Wu, M. H. (2002). The effect of Williams creative teaching method on the elementary school students’ creative cognition, sensitivity, and science academic performance. (Unpublished

ur na

master’s thesis).

Wu, T. Y. (2015). The Influence of Creative personality, Imagination and Innovation Performance －The Moderating of Voice Behavior. National Chung Hsing University. Xia, W. H. (2009). The research of attachment style and creativity among college students

Jo

(Unpublished master’s thesis).

Zhang, X., & Bartol, K. M. (2010). The influence of creative process engagement on employee creative performance and overall job performance: A curvilinear assessment. Journal of Applied Psychology, 95(5), 862-873.

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Figure 1 Possible relationships and interactions between creativity, creative personality traits, and innovation Creative personality traits  Imagination  Curiosity  Adventure  Challenge

Innovation

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Final score for Capstone Course (Includes Product Creativity Score

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Creativity (TTCT score) Verbal Figural Fluency Fluency Flexibility Flexibility Originality Originality Elaboration

Example statement (each statement is scored from 1 to 4)  In school, I like to try to guess the answer, even if the answer is not correct.  When I see a picture of a stranger, I like to try to guess what kind of person he/she is.  I will often guess first. Then check the answer and see if I am correct.  When working in a group, I like to do things the way they have been done in the past; I do not like to try alternate approaches. R  If I have enough time, I believe I can answer all the questions on an exam.  When I do my work, I like to gather a variety of information to improve my understanding of the topic.R  When faced with a difficult problem, I approach the solution one step at a time. R  If my supervisor at work asks me to do something, I do not speculate about the reasons behind the request.  When I do something incorrectly at work, I voluntarily admit my mistake. R  I think each question has only one possible answer.R  In my part-time job, I don’t want to try doing an assignment which no one else is capable of doing.R  I do not like to do tasks that I do not do well or have not done before. R

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Subscale Curiosity (CU)

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Table 1 Examples of statements used to generate subscale scores for the Affective Components of Creativity Scale (ACCS)

Imagination (IM)

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Adventure (AD)

Challenge (CH)

R indicates the statement is reverse scored. Table 2 Scores for nursing students (N = 98) for measures of creativity, creative personality traits, and innovation following completion of the capstone course Variable Mean SD Range 25

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TTCT total score (creativity) 58.13 30.47 12-160 TTCT-V Total score 18.08 13.94 2-75 Fluency 8.06 6.16 1-36 Flexibility 4.91 2.43 1-12 Originality 5.11 6.19 0-35 TTCT-F Total score 40.05 21.21 6-92 Fluency 17.17 8.63 3-42 Flexibility 9.74 3.90 2-18 Originality 11.42 8.83 0-38 Elaboration 1.71 2.09 0-11 ACCS (Creative personality traits) Total score 3.15 0.33 2.09-4.31 Traits Curiosity 1.76 0.23 1.17-2.25 Imagination 4.75 0.71 2.75-8.25 Adventure 2.53 0.25 1.73-3.18 Challenge 2.71 0.31 1.18-3.88 Innovation 91.37 2.83 83-96 Abbreviations: TTCT-F, Torrance Tests of Creative Thinking-Figural; TTCT-V, Torrance Tests of Creative Thinking-Verbal; ACCS, Affective Components of Creativity Scale; Innovation, determined by the mean grade following completion of the capstone course.

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Table 3 Pearson's correlation for scores of innovation, constructs of figural creativity (TTCT-F), verbal creativity (TTCT-V), and creative personality traits (ACCS) for nursing students (N =98) TTCT-F FL InnovationFL U E

Variable

1.00

EL A

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Innovation TTCT-F Fluency (FLU) Flexibilit y (FLE)

ORI

TTCT-V FLU FLE

-.03 1.00 -.01

.77*

1.0 0

*

.90

-.04

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Originalit y (ORI)

.86*

1.00

**

*

.47

Elaboration (ELA) .12 .42*

**

.43*

1.0 0

.47*

.09

1.00

.53*

.19

.84**

*

TTCT-V Fluency (FLU) Flexibilit y (FLE)

-.03

.40* .36

.04

.45* .45

*

*

**

**

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1.00

OR I

ACCS CU IM

AD

C H

Originalit y (ORI) ACCS Curiosity (CU) Imaginati on (IM) Adventur e (AD)

-.02

***

.32 .10 .23 *

.40* .40 *

.00 .03 .01

.46*

.13

.86**

.72** 1.0 0

-.07

-.09

-.08

-.13

.12

.01

.00

-.14

-.07

.18 .21

**

.06

-.10 .16

-.19

-.15

-.14

-.17

1.0 0 .58

1.00

**

.74 **

1.00 .60**

*

.17 .16 .13 .04 -.10 -.05 .72 .57** .73** 1. Challeng .29 ** .08 00 e (CH) Abbreviations: Innovation, defined as the final score at the conclusion of the capstone course. TTCT-F, Torrance Tests of Creative Thinking-Figural; TTCT-V, Torrance Tests of Creative Thinking-Verbal; ACCS, Affective Components of Creativity Scale; Significance of p = .004 determined by applying a Bonferroni correction. *p < .05; **p < .01; ***p < .001

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**

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