RESEARCH IN BRIEF
A comparison of preceptor and preceptee’s perceptions of how the preceptor’s role is operationalized Robyn Fox
RN, RM, Aged Care Cert., Grad Cert Management, Grad Cert HRM, DNE, BEd Studies, M Nursing Leadership
Nursing Director of Education, Royal Brisbane and Women’s Hospital, Herston, Queensland, Australia
Amanda Henderson
RN, RM, ICU Cert, BSc, Grad Dip Nurs (Ed), MSc Soc, PhD
Nursing Director of Education, Princess Alexandra Hospital, Woolloogabba, Queensland, Australia
Kristina Malko-Nyhan
RN, PhD
Education Consultant, Queensland, Australia
Submitted for publication: 22 October 2004 Accepted for publication: 24 June 2005
Introduction
Method
Supporting the transition of new graduates into the workplace is a major consideration for the retention and recruitment of new staff (McNamara 2000). Effective preceptoring is identified as contributing to the integration and transition of staff into the workplace (Usher et al. 1999, Andrews & Chilton 2000). While preceptoring is recognized as a positive experience, it is associated with high levels of burnout (Grealish & Carroll 1998). When preceptorship is provided, it is important to consider whether the preceptor believes they are supporting the preceptee and whether this support is deemed appropriate by the preceptee. If preceptors do not feel they are able to provide effective support, or the preceptee feels unsupported than this can lead to frustration by both parties. Furthermore, if preceptees do not perceive they are being adequately supported then this does not justify the efforts that organizations and staff are making to develop preceptor roles.
Registered Nurses in either a preceptor or preceptee role were requested to complete a survey at two to three months and again at six to nine months after the preceptor/preceptee relationship was initiated. Fifty-nine Registered Nurses taking on the role of preceptoring new staff (preceptors) were sent the survey at two to three months and six to nine months. On both occasions, the response rate was only 24% (14/59). See Tables 1 and 2 for summaries of responses. Fiftynine new Registered Nurses who were assigned preceptors when they commenced employment (preceptees) were sent the survey at two to three months and six to nine months. Thirty-three completed an evaluation form (response rate 56%) at two to three months after commencement of the programme and 17 completed the form (response rate 29%) after six to nine months. See Tables 3 and 4 for summaries of responses.
Results Aim To compare preceptor and preceptee’s perception about the effectiveness of how the preceptor role was undertaken at two time periods during the relationship.
Correspondence: Dr Amanda Henderson, Nursing Director (Education), Nursing Practice Development Unit, Princess Alexandra Hospital, Woolloongabba 4102, Queensland, Australia. Telephone: 617 3240 2780, E-mail:
[email protected] 2006 Blackwell Publishing Ltd
Preceptor’s responses Overall, preceptors provided broadly positive responses regarding their role at both two to three months after commencement of the relationship, and also at six to nine months after commencement, however there were also areas of concern identified. At both points of data collection, preceptors reported that other staff were supportive of their preceptor role, with 100% of respondents at two to three months and at six to nine months stating that other staff were 361
Research in brief Table 1 Preceptor responses two to three months after commencement of the relationship
Statement Other staff have been supportive of my role as a preceptor My expectation of being a preceptor was met when I began undertaking the role I have not experienced difficulties in fulfilling my preceptor role I have been able to fulfil my preceptor role expectations I have been able to realize my goals as a preceptor Factors that affected my ability to achieve my preceptor role and achieve my goals were beyond my control
Strongly agree
Agree
Disagree
Strongly disagree
0 1 0 0 0 2
14 7 4 7 6 4
0 2 6 4 4 2
0 0 1 0 1 0
(0) (10) (0) (0) (0) (25)
(100) (70) (36Æ4) (63Æ6) (54Æ5) (50)
(0) (20) (54Æ5) (36Æ4) (36Æ4) (25)
(0) (0) (9Æ1) (0) (9Æ1) (0)
Values are presented as n (%). Variations in numbers are because of some respondents not completing each question.
Table 2 Preceptor responses six to nine months after commencement of the relationship
Statement Other staff have been supportive of my role as a preceptor My expectation of being a preceptor was met when I began undertaking the role I have not experienced difficulties in fulfilling my preceptor role I have been able to fulfil my preceptor role expectations I have been able to realize my goals as a preceptor Factors that affected my ability to achieve my preceptor role and achieve my goals were beyond my control
Strongly agree
Agree
Disagree
Strongly disagree
1 (7Æ7) 2 (15Æ4)
12 (92Æ3) 8 (61Æ5)
0 (0) 3 (23Æ1)
0 (0) 0 (0)
1 2 0 1
4 8 11 9
5 1 1 0
(41Æ7) (8Æ3) (8Æ3) (0)
2 1 0 0
(8Æ3) (16Æ7) (0) (10)
(33Æ3) (66Æ7) (91Æ7) (90)
(16Æ7) (8Æ3) (0) (0)
Values are presented as n (%). Variations in numbers are because of some respondents not completing each question.
Table 3 Preceptee responses two to three months after commencement of the relationship
Statement My learning needs were/are being met The unit resources provided were relevant and available to me Other resource people were helpful and supportive The transition support programme has helped me to apply knowledge to practise in this new setting My preceptor was approachable and available My preceptor met with me on a regular basis to provide feedback and to discuss any issues I had My line manager was supportive during my transition to this new setting I felt welcome in the ward/unit/facility when I first started
Strongly agree
Agree
Disagree
Strongly disagree
12 15 18 10
18 17 14 14
2 1 1 2
1 0 0 1
(36Æ4) (45Æ5) (54Æ5) (37)
(54Æ5) (51Æ5) (42Æ5) (51Æ9)
(6Æ1) (3) (3) (7Æ4)
(3) (0) (0) (3Æ7)
15 (45Æ5) 11 (35Æ5)
15 (45Æ5) 12 (38Æ7)
3 (9) 7 (22Æ6)
0 (0) 1 (3Æ2)
21 (63Æ6) 23 (71Æ9)
10 (30Æ3) 9 (28Æ1)
2 (6Æ1) 0 (0)
0 (0) 0 (0)
Values are presented as n (%). Variations in numbers are because of some respondents not completing each question.
supportive of their role. Over half the respondents reported having experienced difficulties in fulfilling the role of preceptor [63Æ6% (7/11) at two to three months (Table 1), and 58Æ4% (7/12) at six to nine months after commencement of the relationship (Table 2)]. In terms of role expectations, the data displayed in Tables 1 and 2 show that approximately 362
20% of preceptors disagreed with the statement that ‘…expectations of being a preceptor were met when I began undertaking the role’ at both points of data collection, with 20% (2/10) disagreeing at two to three months and 23Æ1% (3/13) at six to nine months. Fulfillment of preceptor role expectations did improve, however, between the two periods
2006 Blackwell Publishing Ltd, Journal of Clinical Nursing, 15, 361–364
Research in brief Table 4 Preceptee responses six to nine months after commencement of the relationship
Statement The expectations I had of preceptor support were met My learning needs were identified with preceptor support My preceptor has assisted me to meet my learning needs The staff of the unit were helpful and supportive in assisting me to address my learning needs Other resource people were helpful and supportive in assisting me to address my learning needs My preceptor was approachable and available My preceptor was able to address my concerns and learning needs, or find someone who could My preceptor met with me on a regular basis to provide feedback and to discuss any issues I had My line manager has been supportive throughout my transition programme I did not experience any difficulties entering the work unit I believe that improvements to my transition support could have been made
Strongly agree
Agree
Disagree
Strongly disagree
6 5 7 13
6 9 6 3
5 0 2 1
0 3 2 0
(35Æ3) (29Æ4) (41Æ1) (76Æ5)
(35Æ3) (52Æ9) (35Æ3) (17Æ6)
(29Æ4) (0) (11Æ8) (5Æ9)
(0) (17Æ6) (11Æ8) (0)
8 (47Æ1)
9 (52Æ9)
0 (0)
0 (0)
9 (52Æ9) 12 (70Æ6)
6 (35Æ3) 5 (29Æ4)
1 (5Æ9) 0 (0)
1 (5Æ9) 0 (0)
5 (29Æ4)
8 (47Æ1)
1 (5Æ9)
3 (17Æ6)
7 (41Æ1) 5 (29Æ4) 4 (23Æ5)
8 (47Æ1) 8 (47Æ1) 8 (47Æ1)
2 (11Æ8) 3 (17Æ6) 5 (29Æ4)
0 (0) 1 (5Æ9) 0 (0)
Values are presented as n (%). Variations in numbers are because of some respondents not completing each question.
of data collection. This is shown clearly with 63Æ6% (7/11) of respondents agreeing that they had been able to fulfil their preceptor role expectations at two to three months (Table 1), and 83Æ4% (10/12) of respondents at six to nine months (Table 2). Comparison using t-test analysis of the collective responses about the preceptor role, across the two time periods, found a statistically significant change, P ¼ <0Æ001.
Preceptee’s responses Similarly to preceptors, the experiences of preceptees were generally positive within the areas addressed in data collection. At two to three months after commencement of the relationship, preceptees reported that staff were supportive and helpful as is shown in Table 3 – including other resource people (97%; 32/33), their line manager (93Æ9%; 31/33) and the ward generally (100%; 32/32). As shown in Table 4, this supportive environment was also reported after six to nine months – including the staff of the unit (94Æ1%; 16/17), other resource people (100%; 17/17) and their line manager (88Æ2%; 15/17). At both points of data collection, respondents mostly agreed that the preceptor met with them on a regular basis [74Æ2%; 23/31 at two to three months (Table 3) and 76Æ5%; 13/17 at six to nine months (Table 4)]. Of concern, however, is the 24% (8/33) that disagreed with the statement ‘my preceptor met with me on a regular basis to provide feedback and to discuss issues’. t-test analysis between the two time periods revealed a statistically significant result, indicating improvement at the six to nine month period for the following questions: My preceptor was
approachable and available (P ¼ 0Æ018); My preceptor met with me on a regular basis to provide feedback and to discuss any issues I had (P ¼ <0Æ01). While the questionnaire completed at six to nine months asked similar questions, some other questions were added to elicit more detail. Once again the questions about general support were answered favourably (over 90%), yet other questions framed in more directive terms received considerable negative feedback. In response to ‘I did not experience any difficulties entering the work unit’ 23% (4/17) of respondents answered that they disagreed. Of particular interest, is the 70% (12/17) who responded that they believed improvements could be made to the support.
Comparison of preceptor and preceptee’s responses While preceptees acknowledged that their preceptors were available to meet regularly and provide feedback (74Æ2%; 23/31), preceptors reported that they were unable to fulfil their role 63Æ6% (7/11) of the time at the two to three months stage. This discrepancy seemed to revert at six to nine months when preceptees reported preceptor availability to meet regularly and provide feedback at 76Æ5% (13/17) yet preceptors believed that they were able to fulfil their role 83Æ4%.
Discussion Of particular interest in this report, is the finding that the same numbers of preceptors stated that they did not meet their expectations and that they experienced difficulties at six
2006 Blackwell Publishing Ltd, Journal of Clinical Nursing, 15, 361–364
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Research in brief
to nine months, while conversely they stated that they were better able to fulfil their designated roles. This suggests that preceptors were becoming more realistic about their expectations in the role and more experience and lessening demands facilitated a greater fulfillment of roles within existing limitations. Analysis of differences in staff perceptions of support is also warranted given the initial incongruencies in preceptor and preceptee’s responses. Findings indicate that overall the preceptees were more satisfied about the availability and contribution of the preceptor than the preceptors were during their transition to the ward. There was, however, greater congruence at six to nine months. This greater congruence at the six to nine months period could be resultant on a number of factors, namely, preceptors and preceptees may both have become more knowledgeable and more realistic about what could be achieved with increased time in the organization. It would be useful to trial the preceptor model more broadly to get more statistically robust results, or alternatively to evaluate some qualitative data.
Conclusion The responses provided by both preceptors and preceptees suggest that the provision of preceptors have assisted in the transition of new staff. Preceptors reported attainment of their
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role expectations, with difficulties decreasing between the two points of data collection. Preceptees reported high levels of staff support and involvement from both the preceptor and other staff. From an organizational perspective, this relative congruence reached over a period of time is important as it suggests that experienced staff acting as preceptors and new staff as preceptees are in agreement on what constitutes their roles and responsibilities and that both can acknowledge equally when this support is present and when it is not forthcoming. While these results provide a reasonable snapshot, further investigations into role expectations would be beneficial in establishing congruence from the outset.
References Andrews M & Chilton F (2000) Student and mentor perceptions of mentoring effectiveness. Nurse Education Today 20, 555–562. Grealish L & Carroll G (1998) Beyond preceptorship and supervision: a third clinical teaching model emerges for Australian nursing education. Australian Journal of Advanced Nursing 15, 3–11. McNamara A (2000) Mind the gap: transitions in nursing education and care delivery systems. Nursing Administration Quarterly 25, 39–50. Usher K, Nolan CA, Reser P, Owens J & Tollefson J (1999) An exploration of the preceptor role: preceptor’s perceptions of benefits, rewards, supports and commitment to the preceptor role. Journal of Advanced Nursing 29, 506–514.
2006 Blackwell Publishing Ltd, Journal of Clinical Nursing, 15, 361–364
