The Journal of Continuing Education in Nursing

Original Article 

Preceptors' Subjective Competency Ratings in Acute Care Hospitals in Taiwan

Su-Ru Chen, PhD, RN; Hsiao-Ting Chiu, PhD; Li-Min Lin, MSN, RN; Pi-Chu Lin, EdD, RN

Abstract

Background:

This study focused on developing a Subjective Competency Scale (SCS) in acute care hospitals and identified factors that affect preceptors' competency to precept new graduate nurses (NGNs).

Method:

This study was conducted in two stages that included collecting information on preceptor training courses and conducting a cross-sectional questionnaire survey. A total of 350 preceptors completed the survey in 2011. The validity and reliability of the SCS were determined.

Results:

An SCS was developed using 22 items and five factors: teaching/assessment skills, interpersonal/communication skills, confidence/self-assurance, problem-solving/stress-coping skills, and self-reflection. These explained 69.73% of the variance. Cronbach's alpha for these five factors of scale ranged from .715 to .889. Preceptors' subjective competency was correlated positively with age, years as a nurse, years as a preceptor, willingness to be a preceptor, and self-rated relationship with NGNs (p < .001).

Conclusion:

The SCS exhibited high validity and reliability; therefore, it can be used for future preceptors' subjective competency assessment and evaluation. [J Contin Educ Nurs. 2019;50(2):69–78.]

Abstract

Background:

This study focused on developing a Subjective Competency Scale (SCS) in acute care hospitals and identified factors that affect preceptors' competency to precept new graduate nurses (NGNs).

Method:

This study was conducted in two stages that included collecting information on preceptor training courses and conducting a cross-sectional questionnaire survey. A total of 350 preceptors completed the survey in 2011. The validity and reliability of the SCS were determined.

Results:

An SCS was developed using 22 items and five factors: teaching/assessment skills, interpersonal/communication skills, confidence/self-assurance, problem-solving/stress-coping skills, and self-reflection. These explained 69.73% of the variance. Cronbach's alpha for these five factors of scale ranged from .715 to .889. Preceptors' subjective competency was correlated positively with age, years as a nurse, years as a preceptor, willingness to be a preceptor, and self-rated relationship with NGNs (p < .001).

Conclusion:

The SCS exhibited high validity and reliability; therefore, it can be used for future preceptors' subjective competency assessment and evaluation. [J Contin Educ Nurs. 2019;50(2):69–78.]

Preparing the new nursing workforce to be competent in patient care is a huge challenge for most nurse educators in acute care hospitals. To meet this challenge, hospitals have implemented preceptorship training programs to help clinical preceptors acquire knowledge and skills in guiding and coaching new graduate nurses (NGNs). Although preceptorship training programs have been widely implemented in many hospitals throughout Taiwan and used in nursing education, most training courses were not designed according to the needs of preceptors (Chang, Lin, Chen, Kang, & Chang, 2015). In addition, few preceptors have received adequate or formal training (Alspach, 2008; Elmers, 2010). Consequently, most preceptors feel emotional distress and dissatisfaction with their jobs during their preceptorship because they need to supervise, teach, and mentor NGNs who are likely to have little experience and few skills (Chen, Duh, Feng, & Huang, 2011; Omansky, 2010). Thus, preceptor training is an important task for hospital nursing educators worldwide.

Previous studies mainly focused on the roles and selection of preceptors (Elmers, 2010; Licqurish & Seibold, 2008) or on teaching strategies and techniques used by preceptors (Carlson, Wann-Hansson, & Pilhammar, 2009). Research specifically focused on preceptors' self-rated competency tools or Subjective Competency Scale (SCS) development in acute care hospitals is lacking. In addition, in Taiwan, the required qualifications for nurses to be a preceptor include having ≥3 years of working experience and having been certified at the N2 level of the clinical ladder system (nurses who have completed N2 clinical professional ability training and passed N2 promotion requirements). However, preceptor competency measures in precepting NGNs are lacking. Thus, this study primarily examined preceptors' subjective competency ratings in clinical instruction and guidance of NGNs during the orientation period. Understanding how preceptors self-rated their competency will enable nurse educators to be more aware of preceptors' limitations and to develop effective training programs for enhancement. Therefore, the aims of this study were to develop and test the psychometric properties of an SCS, to investigate the level of competency rated by preceptors in acute care hospitals, and to identify factors that affect preceptors' competency to precept NGNs. Results of this study will provide new and valuable information for nurse educators in hospital settings to improve preceptor training and selection.

Background

During the past 2 decades, a shortage of nurses and high turnover of NGNs have provided a variety of challenges for nursing educators and leaders. Consequently, hospitals have increased the number of NGNs to retain sufficient numbers of nurses to ensure patient safety. By doing this, hospitals not only have increased their human resource costs but also have required additional preceptors to guide the next generation of NGNs (Lee, Tzeng, Lin, & Yeh, 2009). Alspach (2008) collected experiences of critical care nurses in terms of the preparation and support afforded to preceptors, and results indicated nurses had not been effectively prepared to work as preceptors for the diverse variety of nurse orientees. In addition, only 24% of preceptors reported that their training was adequate. Trainees also perceived this to be a problem (Yonge & Myrick, 2004). Without proper training, preceptors might not be competent in their multiple tasks and will not interact effectively with NGNs. Tsai et al. (2014) used focus groups to explore views of preceptors and NGNs on the training needs of nurse preceptors. A nurse preceptor-centered training program also was developed based on an assessment of needs, and results showed the training program enhanced preceptors' clinical teaching behaviors and had a positive influence on NGNs (Lee, Lin, Tseng, Tsai, & Lee-Hsieh, 2017).

Baxter (2010) defined a preceptor as a person who has adequate experience, knowledge, skills, and competence to teach beginners to practice independently. Although competency is a multifaceted concept and has specific requirements for preceptors, several studies recognized some important elements of preceptor competency. For example, Baltimore (2004) pointed out that an effective preceptor must demonstrate competency in socialization, skill-building techniques, facilitation of critical thinking, and assignment management. In another study, Bengtsson and Carlson (2015) found that vital components for preceptor preparation were teaching and learning strategies, reflective and critical reasoning, communication models, the preceptor's role, and the preceptorship. A well-structured program based on the needs of preceptors could be successful in terms of increasing preceptors' perceived competence (Carlson & Bengtsson, 2015). Walker and Grosjean (2010) conducted a literature review on preceptors in health disciplines and generated four themes: knowledge and experience, personal characteristics, teaching skills, and interpersonal skills. Although preceptors often emphasize clinical patient care skills, they also need to demonstrate competence in interpersonal communication skills with patients, family members, and other disciplines. Myers et al. (2010) also noted that a good relationship with NGNs and provision of frequent feedback were important preceptor characteristics.

Although successful preceptorship programs should ensure a positive learning experience for NGNs, the preceptor–NGN relationship can be a source of stress and potentially cause preceptor burnout (Santucci, 2004). In addition, meeting NGNs' expectations is not always an easy task for many preceptors. The preceptor is recognized as a key person for enhancing NGN learning and professional development to effectively retain NGNs, reduce turnover costs, and improve the quality of patient care (Lee et al., 2009). If preceptors and NGNs have a good relationship, errors and personal costs can be reduced, and staff retention and job satisfaction can be improved (Lee et al., 2009). Thus, effective strategies that can strengthen preceptors' competency and the preceptor–NGN relationship are crucial for the future success of preceptorship programs.

Method

Study Design and Participants

This study was conducted in two stages that included collecting information on preceptor training courses currently in use and developing a cross-sectional questionnaire. In stage 1, information on training courses used in current preceptor training programs was collected from four medical centers and four district teaching hospitals in the greater Taipei region to generate items for the SCS, in the belief that the course content used in some hospitals would reveal one source from which to frame a preceptor SCS. Based on a content analysis, two research team members drafted a preliminary instrument of 39 items. Questions were designed using a 4-point Likert-type scale, with 4 = strongly agree and 1 = strongly disagree; a fifth option of not applicable also was available. One open-ended question regarding suggestions for courses used for future preceptor training programs was included to enrich the content of the SCS.

In stage 2, the contents of the SCS were assessed by a panel of seven experts (three deputy directors of nursing who were responsible for clinical nursing education, two directors of nursing, and two faculty members in nursing administration) to establish the content validity. These experts rated the importance, essentiality, and wording of each item of the SCS. The content validity index (CVI) of items included was set to ≥ 0.80 to indicate the percentage of agreement among experts. After that, two items with a CVI of < 0.8 and four items related to salary and bonus were deleted as suggested by the experts. The CVI for the total SCS scale was 0.93. The experts also accepted the format of the questions. Consequently, the final SCS was reduced from 39 items to 33 items. Five preceptors from one study hospital then were asked to assess the SCS for clarity, simplicity, suitability, time needed for completion, and any required changes. However, no changes were made. The mean total time to complete the SCS was approximately 25 to 30 minutes.

A questionnaire survey was conducted to test the psychometric properties of the 33-item SCS. Preceptors from eight acute care hospitals in the greater Taipei region were invited to participate in the survey using the established content validity of the SCS. Eligible preceptors were those who were currently employed as full-time RNs and had served as a preceptor for at least one NGN for a 3-month orientation period during the previous 12 months. The instrument was tested for validity and reliability on the high-volume general medical–surgical units but not on other specialized areas that might have other influencing variables, such as outpatient departments or operating rooms. The SCS was distributed to 411 preceptors. Ultimately, 350 questionnaires were valid after subtracting two invalid questionnaires due to preceptors being at the N1 level in the clinical ladder system. Thus, the effective response rate was 85.2%.

Figure 1 shows the complete processes for scale development and psychometric property testing of the SCS. The psychometric properties of the SCS, including the construct validity and internal consistency reliability, were evaluated and are described in depth in the following section.

Flowchart showing the psychometric evaluation of the subjective competency scale.

Figure 1.

Flowchart showing the psychometric evaluation of the subjective competency scale.

Demographics of the participants also were included in the SCS. The demographic data collected were age, clinical professional ability classification (called the clinical ladder, with ranks of N1 to N4), highest educational level, years of experience as an RN, years of experience as a preceptor, prior preceptor training (yes/no), voluntarily working as a preceptor (yes/no), currently pursuing higher education (yes/no), and willingness to be a preceptor (range, 1 to 10 points). A question pertaining to relationships with NGNs also was included in the SCS.

Construct Validity

A principal component factor analysis (exploratory) with varimax rotation was used to extract an orthogonal factor structure underlying the competency scores. A Scree test was used to determine which factors were to be retained with eigenvalues of > 1. Items loaded primarily at ≥ 0.5 were included in each factor. The Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy was 0.922, demonstrating the high level of appropriateness of the factor analysis. Bartlett's test of sphericity also was statistically significant (χ2 = 4738.105, p < .001). However, based on scholars' suggestions, factors that contained two or fewer items were deleted during the process of the factor analysis (Hair, Black, Babin, Anderson, & Tatham, 2006). In addition, three items that failed to meet a minimum criterion of no cross-loading of ≥ .3 were eliminated. Consequently, the final version of the SCS had 22 items and consisted of five distinct factors: teaching/assessment skills (five items), interpersonal/communication skills (six items), confidence/self-assurance (five items), problem-solving/stress-coping skills (three items), and self-reflection (three items). These five factors explained 69.73% of the variance. The complete procedures of the principle component factor analysis are shown in Table 1.

Item and Varimax-Rotated Factor Loadings for the Five Factors of the Preceptor Competency Scale (N = 350)

Table 1:

Item and Varimax-Rotated Factor Loadings for the Five Factors of the Preceptor Competency Scale (N = 350)

Reliability Testing

The internal consistency of Cronbach's alpha was .94 for the total SCS with 22 items, and values were .889 for teaching/assessment skills, .882 for interpersonal/communication skills, .870 for confidence/self-assurance, .837 for problem-solving/stress-coping skills, and .715 for self-reflection. The 2-week test–retest reliability with 30 preceptors from one study hospital in Taipei was confirmed and showed substantial reliability (r = 0.885, p < .05). Nurses who participated in the test–retest reliability survey were excluded from the final analysis.

Data Collection Procedures

The researchers contacted the director of nursing at each hospital to obtain names of potential preceptors and to set schedules for distributing the questionnaires. Questionnaires were distributed to preceptors between September 15 and November 30, 2011, in a quiet, private meeting room in each unit. All surveys were administered directly to preceptors by one of the researchers or research assistants. Any discussion of subjective bias during the data collection period was made if necessary.

Ethical Considerations

Approval was received from the institutional ethics committee of the primary investigators' university and from each study hospital. Before administering the questionnaire, researchers spoke directly to preceptors about the research aims, processes, the pros and cons of the study, and data management. Preceptors also were told that their participation was voluntary, and all information would remain confidential and anonymous at all times. All data were coded numerically and were accessible only to research team members. A small monetary gift of New Taiwan $150 ($5 U.S.) was given to each participant upon completion of the questionnaire.

Data Analysis

SPSS® version 19.0 software was used for data analysis. Independent t tests and one-way analysis of variance (ANOVA) were used to compare differences in demographic variables and scores of competencies. Pearson correlation was used to examine correlations among the study variables. The level of significance was set at p = .05.

Results

Preceptor Characteristics

All of the preceptors were women. The average age of the preceptors was 33.2 years (SD = 4.8, range 24.5 to 48 years). Preceptors had worked as an RN for an average of 11.3 years (SD = 4.8, range = 2.42 to 25.42 years), and participants' experience as a preceptor ranged from 8 months to 23 years (SD = 3.5, mean = 4.5 years). The average score for participants' willingness to be a preceptor was 6.5 (SD = 1.9, range = 0 to 10). The average score for participants' self-rated relationship with NGNs was 7.3 (SD = 1.3, range = 4 to 10), indicating a medium-level relationship. Among preceptors who had received training, the mean number of training hours was 12.3 (SD = 10.2, range = 0 to 96 hours). The majority of preceptors had a university degree or higher (n = 240, 68.6%) and worked in medical–surgical wards (n = 170, 48.6%). Most preceptors were not currently pursuing higher professional education (n = 280, 80%) and were not voluntarily working as a preceptor (n = 265, 76%). The majority of preceptors (n = 287, 82%) had received preceptor training provided by the hospitals before their preceptor assignment (Table 2).

Characteristics of the Preceptors (N = 350)

Table 2:

Characteristics of the Preceptors (N = 350)

Comparison of Mean Competency Scores by Preceptor Characteristics

The mean total competency score was 2.96 (SD = 0.33), indicating medium competency. On the subscales, mean scores were 3.04 (SD = 0.38) for teaching skills, 3.07 (SD = 0.36) for interpersonal and communication skills, 2.77 (SD = 0.50) for self-assurance, 2.85 (SD = 0.45) for problem-solving skills, and 3.05 (SD = 0.37) for self-reflection.

To analyze the data, preceptor characteristics were dichotomized, except for the variable of N levels of competency on the clinical ladder. As shown in Table 3, preceptors who were older than 30 years and had more than 5 years of experience as a nurse and as a preceptor, were at the N4 level of the clinical ladder, and were volunteer preceptors had a higher mean competency score than those who were not; largest mean difference was noted for volunteer preceptors. These variables also demonstrated statistically significant differences (p < .01). In addition, preceptors who had a university degree, worked in intensive care units, were currently pursuing higher education, and had received no preceptor training before being assigned to be a preceptor also had higher mean competency scores. However, these differences were not statistically significant (p > .05).

Comparisons of Mean Competency Scores by Preceptor Characteristics (N = 350)

Table 3:

Comparisons of Mean Competency Scores by Preceptor Characteristics (N = 350)

Correlation of Self-Rated Competency Scores, Relationship With NGNs, and Demographic Variables

Table 4 shows that preceptors' subjective competency ratings were positively correlated with age, years as a nurse, years as a preceptor, willingness to be a preceptor, and self-rated relationship with NGNs (p < .001). Of these variables, the willingness to be a preceptor was shown to have the highest correlation with overall competency (p = .001). This result demonstrated that the greater the willingness to accept the preceptor role, the greater the preceptor competence. In addition, a moderate correlation was found between the willingness to be a preceptor and the self-rated relationship with NGNs (r = 0.361, p < .001). Again, this finding demonstrated that the greater the willingness to accept the preceptor role, the better the relationship between preceptors and NGNs.

Correlation of Scores on Overall Subjective Competency Ratings and Self-Rated Relationship in New Graduate Nurses, and Significant Characteristics of Preceptors (N = 350)

Table 4:

Correlation of Scores on Overall Subjective Competency Ratings and Self-Rated Relationship in New Graduate Nurses, and Significant Characteristics of Preceptors (N = 350)

Discussion

The SCS, with five factors and 22 items, demonstrated acceptable psychometric properties to assess the competency of preceptors in acute care hospitals. The fact that no SCS was identified in Taiwan or in the current literature indicates that this SCS can serve as the first instrument to evaluate how preceptors self-assess their competency levels in mentoring NGNs during the orientation period. Previous research also has described some important aspects of competency for preceptors; those findings are consistent with observations made in the current study. In regard to competency of teaching/assessment skills, Shannon et al. (2006) reported that enjoyment of teaching was the most influential factor in the decision to be a preceptor in northwestern South Australia. Carlson et al. (2009) applied an ethnographic approach and highlighted that because teaching is a continuous process of precepting, preceptors require a diversity of teaching skills, such as listening, lecturing, and questioning, to enhance nursing student learning. Chen et al. (2011) conducted a qualitative phenomenological study and identified four strategies in preceptor teaching: rehearsing before practice, reflecting on learning experiences, providing practice opportunities, and adopting different evaluation methods. In summary, teaching presents a role model for NGNs to learn how to be an experienced nurse. Thus, it seems logical to conclude that preceptors require teaching skills to enhance NGNs' learning outcomes.

Interpersonal/communication skills also were identified as an essential competency for preceptors. Although the one-to-one relationship is most commonly used in the preceptorship model in nursing, it might not be feasible under current health care conditions such as the shortage of nurses and budget constraints (Luhanga, Billay, Grundy, Myrick, & Yonge, 2010). In addition, being a preceptor consumes much time and energy, and preceptors have their own patient caseloads. Omansky (2010) conducted an integrative review and concluded there is considerable stress and responsibility associated with precepting or mentoring. In addition, nurse preceptors experience role ambiguity, conflicts, and overload. Therefore, staffing levels need to be adjusted to take into account the time and effort that preceptors put into precepting NGNs so they can manage work-related stress. Licqurish and Seibold (2008), using a grounded theory methodology, found that interpersonal relationships are one of the required characteristics for preceptors in Australia. Walker and Grosjean (2010) reported that interpersonal skills were recognized as a core competency for health care discipline preceptors. Paton (2010) reported that a good relationship between preceptors and students will increase their social interactions and also promote preceptor teaching and student learning. In the current study, only a medium self-rated overall relationship with NGNs by preceptors was noted. Thus, effective strategies to strengthen the relationship between preceptors and NGNs are needed to accomplish preceptorship goals.

This study also revealed that confidence and self-assurance were other characteristics required by preceptors. The preceptor is the most influential role model for NGNs seeking to become experts in clinical practice; thus, a preceptor must demonstrate confidence and self-assurance, and make effective clinical decisions during the preceptorship. Walker and Grosjean (2010) found dietetic students were more likely to seek preceptors who demonstrated confidence in themselves. Assemi, Corelli, and Ambrose (2011) reported that trained pharmacy preceptors showed more confidence in their ability to enhance their students' critical thinking and problem-solving skills than those without training. Hence, training to increase preceptors' confidence and self-assurance should be provided to help them function more effectively.

This analysis also revealed problem-solving and stress-coping skills are important attributes for preceptors. During the orientation period, NGNs often acquire knowledge and skills by watching preceptors handle uncertain situations or resolve patient care problems. Therefore, problem solving requires preceptors to think and act critically (Brunt, 2005). Baltimore (2004) found that facilitating critical thinking is also a characteristic of effective preceptors. Thus, training to promote critical thinking in preceptors is important to enable them to face today's challenges and issues of nursing practice. Nevertheless, because precepting NGNs can be stressful, Hautala, Saylor, and O'Leary-Kelley (2007) suggested having an educator available during the preceptorship is needed to assist preceptors in effectively resolving problems and reducing emotional distress.

The final factor identified in this study was self-reflection. Wallman, Lindblad, Gustavsson, and Ring (2009) described reflection as a vital part of the reasoning process, and preceptors with reflective skills were able to assist pharmacy students develop reflective abilities. Bulman, Lathlean, and Gobbi (2011) conducted a philosophical study and concluded that self-reflection drives self-improvement and provides an opportunity for students and teachers to think critically about their practice and bring new ideas for innovation. However, Jones, Hanson, and Longacre (2004) found that 24% of medical students felt uncomfortable with critiquing their preceptors. Because one of the questions asked in the current study was, “I can accept any criticism from NGNs,” it is suggested researchers incorporate this perspective into future preceptor training programs and evaluations to minimize its impacts.

Results of the SCS also revealed that preceptors rated their overall competency as medium. This finding may have been due to the fact that each preceptor in this study received only an average of 12 hours of training. This short period of time might be inadequate preceptors to acquire an adequate level of competence. However, Sandau, Cheng, Pan, Gaillard, and Hammer (2011) did not support this finding; they reported that preceptors who completed 8 hours of workshop training had a significantly higher level of confidence compared with those who did not participate in the workshop. The difference in these findings may have been due to the fact that confidence is only one of the factors in the SCS. Different training programs will result in various study outcomes. Thus, this finding might indicate a need for additional training for preceptors to become competent in precepting NGNs and also a need to reexamine the current preceptor training courses in Taiwanese hospitals.

Results of this study revealed the willingness to be a preceptor was only of medium importance (6.5 of 10 points) and also was correlated with preceptors' overall competency. Phillips (2006) stated that because the roles of preceptors are complex in health care, preceptors must be willing to help people and work with orientees to increase their job satisfaction, retention, and socialization. This requires preceptors who are willing to work with NGNs to ensure that orientation programs are successful. In addition, this study found that older preceptors had more experience and higher levels of competency than younger preceptors. This finding was supported by Shannon et al. (2006), who found that experienced preceptors tended to have less than 5 years or more than 15 years of working experience. Although competency acquisition is a developing process, these criteria can be used as an assessment tool to find the best candidates for preceptor training.

Limitations and Recommendations

This study has several limitations. First, given that the survey was limited to 350 preceptors from eight acute care hospitals in northern Taiwan, the results might not be representative of all preceptors in Taiwan. Future research that expands data collection to hospitals in different regions is recommended. Second, preceptors in outpatient departments, central supply rooms, operating rooms, emergency departments, delivery rooms, baby rooms, and nursing homes were excluded from this study, thus the results could not represent all preceptors' status. It is recommended that future research include preceptors in all areas of the hospital. Third, only preceptors were surveyed in this study, suggesting that future research might also survey NGNs to compare differences in the level of competency between preceptors and NGNs. Fourth, the questionnaire was subjective and consisted of only 22 items with five factors of competency, meaning that some important attributes of competency might have been overlooked in the SCS. Therefore, further research, especially with other ethnic groups, is recommended to enhance the range of its clinical usefulness and effectiveness. Finally, the SCS, as a self-reported questionnaire, allows responses that lie on an objective-subjective continuum and also has responses for which recall bias may have occurred. Thus, more studies using other data sources, such as NGN turnover, and sensitive patient care outcomes, such as falls, pressure sores, and urinary tract infections, are suggested.

Relevance to Clinical Practice

Nurse educators can use these five competency domains to develop a tailored training program to better prepare and increase preceptors' competency in guiding and coaching NGNs to function independently early in the orientation period. In addition, this study helped set forth criteria for selecting preceptors, such as seniority as well as years of nursing and preceptor experience, which also might be recommended when inviting nurses to be prospective preceptors.

Conclusion

Competent preceptors can help NGNs obtain knowledge and skills required for patient care during the orientation period. The five factors extracted from the SCS—teaching/assessment skills, interpersonal/communication skills, confidence and self-assurance, problem-solving and stress-coping skills, and self-reflection—can be used to assess preceptors' subjective competency levels and strengthen their roles through awareness of deficiencies. The personal characteristics of preceptors, such as years as a nurse and willingness to be a preceptor, were positively correlated with preceptors' subjective competency.

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Item and Varimax-Rotated Factor Loadings for the Five Factors of the Preceptor Competency Scale (N = 350)

ItemFactor 1Factor 2Factor 3Factor 4Factor 5





Teaching/Assessment SkillsInterpersonal/Communication SkillsConfidence/Self-AssuranceProblem-Solving/Stress-Coping SkillsSelf-Reflection
1.I already have the clinical care skills to mentor new graduate nurses.0.771
2.During clinical teaching, I can clearly express and prioritize learning requirements for new graduate nurses correctly.0.744
3.I have the teaching ability to educate new graduate nurses.0.736
4.I have the knowledge and evidence-based theory to educate and coach new graduate nurses.0.690
5.I know how to assess the learning needs of new graduate nurses.0.654
6.I can assist new graduate nurses in maintaining good relationships with other health care providers.0.778
7.I can maintain a good relationship with new graduate nurses.0.749
8.I will praise new graduate nurses for their effort during the orientation period.0.707
9.I can promote new graduate nurses' professional growth.0.621
10.I can create and provide a positive learning environment for new graduate nurses.0.609
11.I can have productive communication with new graduate nurses.0.556
12.Being a preceptor, I feel confident.0.727
13.I feel self-fulfillment as a preceptor.0.716
14.I love being with new graduate nurses.0.703
15.I love teaching.0.670
16.Overall, I feel confident about my teaching competency.0.585
17.My problem-solving skills are excellent.0.829
18.My problem-solving knowledge is excellent.0.784
19.My stress-coping skills are very good.0.755
20.I can accept being questioned and criticized by new graduate nurses.0.710
21.I will engage in self-reflection while with new graduate nurses.0.700
22.I will encourage new graduate nurses to engage in critical thinking.0.637

Characteristics of the Preceptors (N = 350)

Variablen (%)Mean (SD)Range
Age (years)33.2 (4.8)24.5 to 48
Years of experience as a nurse11.3 (4.8)2.42 to 25.42
Years of experience as a preceptor4.5 (3.5)0.67 to 23
Score for willingness to be a preceptor (total = 10 points)6.5 (1.9)0 to 10
Score for the relationship with new graduate nurses (total = 10 points)7.3 (1.3)4 to 10
Hours of preceptor training12.3 (10.2)0 to 96
Gender
  Female350 (100)
Level of competency on the clinical ladder
  N2146 (41.7)
  N3126 (36)
  N478 (22.3)
Highest educational level
  Below junior college110 (31.4)
  University and above240 (68.6)
Work unit
  Medical/surgical ward170 (48.6)
  Medical/surgical ICU101 (28.9)
  Obstetric and pediatric unit46 (13.1)
  Pediatric ICU21 (6)
  Mixed unit12 (3.4)
Currently pursuing higher education
  Yes70 (20)
  No280 (80)
Voluntarily work as a preceptor
  Yes84 (24)
  No265 (76)
Had received preceptor training before their preceptor assignment
  Yes287 (82)
  No63 (18)

Comparisons of Mean Competency Scores by Preceptor Characteristics (N = 350)

VariablenMean (SD) Total Competency Scoreat/Fp
Age (years)−3.998.001*
  ≤309563.09 (6.57)
  >3023966.08 (7.53)
Level of education−1.522.129
  ≤Junior college10664.32 (7.25)
  ≥University23165.63 (7.39)
Years as RN
  ≤52661.77 (5.76)−2.575.01*
  >531065.57 (7.34)
Years as a preceptor−4.558.00*
  ≤521864.17 (6.76)
  >510268.09 (7.96)
Level on the clinical ladder15.104.00*
  N213963.01 (7.01)(N4>N3>N2)
  N312065.70 (7.62)
  N47868.42 (7.91)
Work unit0.699.485
  ICU11865.60 (7.42)
  Ward21965.01 (7.33)
Currently pursuing higher education1.246.214
  Yes6966.20 (7.82)
  No26864.97 (7.23)
Volunteer preceptor5.515.00*
  Yes8469.20 (7.95)
  No25263.89 (6.67)
Had received preceptor training before their preceptor assignment0.059.953
  Yes27865.21 (7.15)
  No5965.27 (8.32)

Correlation of Scores on Overall Subjective Competency Ratings and Self-Rated Relationship in New Graduate Nurses, and Significant Characteristics of Preceptors (N = 350)

Variable123456
1 Age (years)1
2 Years as a nurse.937** (.00)1
3 Years as a preceptor.591** (.00).634** (.00)1
4 Willingness to be a preceptor.122* (.024).145** (.007).182** (.001)1
5 Self-rated relationship with new graduate nurses.063 (.248).073 (.173).081 (.142).361** (.00)1
6 Overall competency.180** (.001).191** (.00)0.243** (.00).509** (.00).258** (.00)1
Authors

Dr. Chen is Associate Professor, Post-Baccalaureate Program in Nursing, and Dr. Lin is Professor, Master Program in Long-Term Care, College of Nursing, Taipei Medical University, Taipei; Ms. Lin is Clinical Nurse, Department of Nursing, Shin Kong Wu Ho-Su Memorial Hospital, Taipei; and Dr. Chiu is Assistant Professor, Department of Information Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.

The authors have disclosed no potential conflicts of interest, financial or otherwise.

Address correspondence to Pi-Chu Lin, EdD, RN, Professor, Master Program in Long-Term Care, College of Nursing, Taipei Medical University, 250 Wuxing St., Taipei, Taiwan, 110; e-mail: pclin@tmu.edu.tw.

Received: January 31, 2018
Accepted: September 06, 2018

10.3928/00220124-20190115-06

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