Nationwide use, challenges, facilitators, and impact of preceptors in prelicensure clinical nursing education

Abstract

Background and objective: Preceptor-facilitated clinical nursing education prevalence information is dated. Information is most often limited to regional baccalaureate programs and provides sparse evidence of its education-related outcomes. The purpose of this study is to describe the nationwide use, structures, facilitators, and challenges of using preceptors in prelicensure clinical education; compare its use by program characteristics; and explore its impact on education-related outcomes.

Methods: In this cross-sectional comparative study, prelicensure programs in randomly selected jurisdictions in all four regions of the US were identified and official pass rates obtained.  Program administrators completed an online questionnaire about preceptor use, incentives used, challenges, facilitators, and perceived impact on program capacity.

Results: Preceptors were used in 73% of the 366 responding programs. Prevalence rates ranged from 25% to 87% by program type and from 64% to 86% by region. Programs’ NCLEX-RN^® pass rates and perceived impact on program capacity did not differ by use of preceptors. Most respondents indicated there was no impact although one-fifth perceived moderate to high impact. The top five challenges and facilitators to preceptor use were identified. Programs used a variety of preceptor incentives, ranging from 62% using informal recognition to 7% providing some type of financial compensation.

Conclusions: Most programs use preceptors with differences by program type and region. Designating resources to enhance preceptor orientation and preceptor-student-faculty communications may be useful, as well as identifying the challenges and facilitators. While a variety of preceptor incentives are available, few offer direct monetary compensation. Regional preceptor incentive data provide useful benchmarks. With high rates of use in some sectors and yet no demonstrable influence on pass rates, closer scrutiny of the quality of preceptor-facilitated educational experiences and associated outcomes are warranted.