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Preceptor Practice

Initial Results of a National Association for Nursing Professional Development Study

Harper, Mary G. PhD, RN, NPD-BC; Ulrich, Beth EdD, RN, FACHE, FAONL, FAAN; Whiteside, Dawn MSN-Ed, RN, CNOR, NPD-BC, RNFA; Warren, Joan Insalaco PhD, RN, NPD-BC, NEA-BC, FAAN; MacDonald, Ryan PhD

Author Information
Journal for Nurses in Professional Development: 5/6 2021 - Volume 37 - Issue 3 - p 154-162
doi: 10.1097/NND.0000000000000748
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Nursing professional development (NPD) practitioners serve as partners for practice transitions supporting the “transition of nurses and other healthcare team members across learning and practice environments, roles, and professional stages” (Harper & Maloney, 2016, p. 17). Because preceptors are integral to successful transitions, NPD practitioners are responsible for ensuring that individuals are developed for this critical role (Schuelke & Barnason, 2017). Although preceptors are commonly used during transitions, little evidence exists to guide their development. The purpose of this study was to identify the roles and competencies essential to preceptor practice and to validate the seven roles of precepting delineated in the Ulrich Precepting Model (Ulrich, 2019).


Preceptors are foundational to clinical learning and socialization of healthcare workers who are new to the practice, the organization, or setting. No universally agreed-upon definition of preceptorship or comprehensive operational description of the preceptor process exists in the literature (Ward & McComb, 2017). Ulrich (2019) defines a preceptor as “an individual with demonstrated competence in a specific area who serves as a teacher/coach, leader/influencer, facilitator, evaluator, socialization agent, protector, and role model to develop and validate the competencies of another individual” (p. 1). In nursing, preceptors help students with prelicensure clinical experiences, new nurses transitioning from academia into professional practice, and experienced nurses transitioning from one organization to another, one specialty to another, or one role to another. Precepting is “an organized, evidence-based, outcome-driven approach to ensuring competent practice” (Ulrich, 2019, p. 1).

Empirical evidence supports the importance and benefits of preceptors in preparing new and experienced healthcare workers in their roles (Cotter & Dienemann, 2016; Edward et al., 2017; Irwin et al., 2018). Although the literature is replete with research studies about preceptor roles, responsibilities, and competencies (L'Ecuyer, Hyde, & Shatto, 2018; L'Ecuyer et al., 2020); qualifications (L'Ecuyer, Lancken, et al., 2018); selection criteria (Bohnarczyk & Cadmus, 2020; Cotter et al., 2018); preparation, support, and role challenges (Quek & Shorey, 2018; Schuelke & Barnason, 2017); and impact on the learner and organization outcomes (Piccinini et al., 2018; Quek et al., 2019), a comprehensive national practice analysis underpinned by a theoretical framework describing nursing preceptor roles and competencies is missing.

Although no nursing preceptor practice analysis has been found, DeAngelis and Wolcott (2019) conducted a job analysis to determine the roles and responsibilities of pharmacist preceptors. A task inventory survey was developed from feedback from pharmacy preceptors and consisted of 92 tasks, representing nine practice domains: planning/logistics, intrapersonal, interpersonal, clinical knowledge, assessment, leadership, professionalism, teaching, and communication. In a pilot study with 19 pharmacy preceptors, the domains of professionalism, communication, and interpersonal skills were deemed most relevant to practice. DeAngelis and Wolcott posit that job analysis provides a “novel” approach to gaining expert input into preceptor roles and responsibilities. However, even though DeAngelis and Wolcott support the use of job analysis methodology in describing the role of preceptors, they did not use a theoretical framework to support their processes.

In 2012, a model of precepting was developed by Ulrich based on existing knowledge and on the experiential knowledge of nurses who were experts in preceptor practice, the preparation of preceptors, and role transitions. Subsequent literature and practice supported the components of the model (Ulrich, 2012). The Ulrich Precepting Model, shown in Figure 1, is a framework that identifies seven roles of preceptors within the context of nursing and the broader healthcare system, which includes quality, safety, and evidence (Ulrich, 2019). These preceptor roles include teacher/coach, role model, leader/influencer, facilitator, socialization agent, evaluator, and protector.

Ulrich Precepting Model: roles and context of precepting. This figure is available in color online ( Copyright by Sigma Theta Tau International Honor Society of Nursing, 2019. Reprinted with permission.

The purposes of this 2020 Association for Nursing Professional Development (ANPD) National Preceptor Practice Study were to perform a national practice analysis to identify the roles, knowledge, and activities essential to preceptor practice and to use those data to validate the seven roles of precepting proposed by the Ulrich Precepting Model.



A nonexperimental, cross-sectional, descriptive study was conducted using the practice analysis method to identify the roles and competencies essential to preceptor practice. The study was qualified as exempt by The University of Texas Health Science Center at Houston Committee for the Protection of Human Subjects. Participation and completion of the survey implied the informed consent of the participants.

Sample and Recruitment

The sampling frame included all healthcare workers across the United States who functioned as preceptors for students, new-to-practice staff, or staff transitioning to new organizations, specialty areas, or roles. The inclusion criteria included currently working in the healthcare field and having precepted at least one individual in 2019.

A nonprobability snowball sampling technique was used to recruit participants. Communication to potential participants occurred through national professional organizations’ e-mail distribution lists and online sites, including social media. In addition, e-mail distribution lists from hospital systems and statewide and local organizations were used.


In an anonymous survey, participants were asked to rate the importance of preceptor competencies gleaned from the literature. Importance was defined as the perceived value of the task and was rated using a 5-point Likert-type scale in which 1 = no importance and 5 = very important. In addition, participants were asked to provide demographic information, such as their current position, specialty area of practice, work setting, preceptor preparation and experience, and so forth.

Data Analysis

Data were summarized using counts (Ns), percents, means, and standard deviations. Validity was assessed using principal components factor analysis. Component scores for validity and scale reliability were reported with Cronbach’s alphas. Scores were constructed by summing responses to Likert scale questions for each preceptor role, domain, and competency and dividing by the number of valid responses. Scores with more than 50% missing data were considered missing overall. Data attrition was handled by taking all available responses and reporting missing data for each measure. All analyses were conducted using SPSS 23.0, and statistical significance was set at p ≤ .05 level.



A total of 4,359 responses to the survey were received; 3,863 met the inclusion criterion of currently working in the healthcare field, and of those 3,863, 3,623 met the inclusion criterion of functioning as a preceptor in 2019. Listwise deletion was used to include as many responses as possible.

Participants in the study were from 47 states. Of the 3,555 participants indicating their current role, 2,341 (65.9%) were direct patient care registered nurses (RNs), 563 (15.8%) were NPD practitioners, 192 (5.4%) were unlicensed assistive personnel such as patient care technicians and surgical technicians, and 126 (3.5%) were advanced practice RNs. Of those participants who indicated their current work setting, 84.0% worked in acute care hospitals and 11.7% worked in ambulatory care. Participants represented a number of nursing specialties, with the largest representation from general medical and/or surgical nursing (21.4%), intensive care (18.0%), perioperative services (12.9%), progressive care (8.7%), emergency department (8.1%), and ambulatory care (7.9%).

The average age of participants was 43.4 years (range: 21–72). They have worked in their profession for an average of 17.7 years (range: 1–53), worked for their current employer for an average of 9.6 years (range: 0.5–47), and worked in their current position for an average of 8.7 years (range: 0.25–49). Detailed demographic information is shown in Table 1.

TABLE 1 - Sample Demographics
n %
Current position
 Registered nurse (direct patient care) 2,341 65.9
 Nursing professional development practitioner 563 15.8
 Nursing assistant/patient care technician–certified 108 3.0
 Advanced practice registered nurse: nurse practitioner 104 2.9
 Nurse manager 76 2.1
 Licensed practical/vocational nurse (LPN/LVN) 72 2.0
 Other 68 1.9
 Nurse executive (vice-president, director) 49 1.4
 Surgical technologist 33 0.9
 Nursing assistant/patient care technician (not certified) 22 0.6
 Advanced practice registered nurse: CNS 21 0.6
 Respiratory therapist 21 0.6
 Medical assistant–certified 20 0.6
 Academic nursing faculty 19 0.5
 Physician 17 0.5
 Radiology technician 9 0.3
 Physician’s assistant 6 0.2
 Physical therapist 3 0.1
 Pharmacist 2 0.1
 Advanced practice registered nurse: CRNA 1 0.0
Work setting
 Acute care hospital 2,621 84.0
 Ambulatory 366 11.7
 Specialty hospital 89 2.9
 Subacute/long-term care 21 0.7
 Other 19 0.6
 Academic 5 0.20
Work unit
 General medical and/or surgical unit (adult or pediatric) 663 21.4
 Intensive care unit (e.g., medical-surgical, pediatric, neonatal, respiratory, coronary) 559 18.0
 Perioperative services (e.g., operating room, post-anesthesia care unit) 400 12.9
 Progressive care (e.g., intermediate care, step-down unit, telemetry unit) 270 8.7
 Emergency department/trauma center 250 8.1
 Ambulatory care (e.g., outpatient clinic, outpatient surgery, school) 245 7.9
 Women’s health (e.g., obstetrics, labor and delivery, postpartum) 193 6.2
 Specialty patient care units—not critical care (e.g. orthopedics, neuro, burn) 165 5.3
 Nursing professional development/education department 96 3.1
 Administration 69 2.2
 Behavioral health 67 2.2
 Other 47 1.5
 Subacute/long-term care 38 1.2
 Radiology/imaging services 25 0.8
 Specialty service (e.g., occupational therapy, physical therapy, speech pathology) 13 0.4
 Pharmacy 1 0.0
Years of experience as a preceptor
 2 years or less 302 20.1
 >2 to≤ 5 years 305 20.3
 More than 5 years 895 59.6
Note. The total participants who answered the question were as follows: current position = 3,555, work setting = 3,121, work unit = 3,101, and years of experience as a preceptor = 1,502.

Preceptor Experience and Preparation

The study participants represented all levels of preceptor experience. Of those indicating their experience, 59.6% had over 5 years of experience, 20.3% had greater than 2 years but 5 or less years of experience, and 20.1% had 2 years of experience or less. Over 60% of the participants had precepted new-to-practice professionally licensed individuals (62.2%), experienced individuals who were new to the organization (61.4%), and employees who were new to a clinical setting/specialty but not new to the organization (60.9%). Additional experience with specific preceptee types is available in Table 2.

TABLE 2 - Duration of Precepted Time
Preceptee No. of Responses Yes % Mean Hours/Preceptee
New-to-practice, professionally licensed individual (e.g., new graduate registered nurses); does not include advanced practice nurses 3,385 2,107 62.2 162.7
Employee new to clinical setting/specialty but not new to the organization 3,318 2,022 60.9 109.1
Experienced individual new to both the specialty and the organization (but not newly licensed or new to practice) 3,163 1,070 33.8 105.0
New advanced practice registered nurse: nurse practitioner (e.g., APRN, CRNA) 3,054 95 3.1 95.5
Experienced individual, new to organization 3,238 1,987 61.4 86.0
Student 3,473 1,998 57.5 68.6
Newly licensed advanced practice registered nurse: clinical nurse specialist 3,059 75 2.5 62.9
Nonlicensed individual (e.g., surgical technicians, patient care technicians) 3,413 553 16.2 52.4
New administrator (e.g., manager, director, executive) 3,047 167 5.5 49.6
Note. No. of Responses = total participants who answered the question; Yes = total participants who said they had precepted the preceptee type indicated; % = % of participants who said they had precepted the preceptee type indicated; Mean Hours/Preceptee = the mean number of hours the participants reported precepting each preceptee.

Of the 3,066 study participants who answered the preceptor preparation questions, 84.2% indicated that they had some form of formal or informal preparation for the preceptor role. Of those who had preparation, 60.2% reported having one type of preparation, 26.0% reported having two types of preparation, and 8.8% reported three types. The remaining participants reported four or more types of preparation (see Table 3). The most frequently reported types of preparation included attending a facility-based workshop or class (59.0%), self-study (e.g., journal articles, books), and completing a facility-based online program (19.1%), as shown in Table 3.

TABLE 3 - Preceptor Preparation
n %
Preceptor preparation
 Any preparation 2581 84.2
 No formal preparation 485 15.8
No. of types of preparation reported
 1 1846 60.2
 2 797 26.0
 3 269 8.8
 4 97 3.2
 5 43 1.4
 6 11 0.4
 7 2 0.1
 8 1 0.0
Types of preparation for the preceptor role
 Attended a facility-based workshop/class 2139 59.0
 Self-study (e.g., journal articles, books) 717 19.8
 Completed a facility-based online program 692 19.1
 Attended one or more sessions at a conference outside my organization 250 6.9
 Attended a workshop outside my organization 239 6.6
 Other 149 4.1
 Completed a commercial/proprietary online program 140 3.9
Note. The total participants who answered the questions was 3,066.

Preceptor Roles and Domains

All seven preceptor roles in the Ulrich Precepting Model were validated, along with their associated domains and competencies. Cronbach’s alphas ranged from .927 to .972 for the roles and from .839 to .949 for the domains. The high Cronbach’s alphas suggest that there may be redundancies. The validity results for the roles and domains are shown in Table 4.

TABLE 4 - Preceptor Roles and Domains: Validity
No. of Items α α
Teacher/coach 46 .971
 Learning theories .878
 Teaching strategies .932
 Coaching .949
Leader/influencer 13 .927
 Leadership principles .875
 Professional considerations .877
Facilitator 14 .946
 Positive learning environment .933
 Preceptee competence .839
Evaluator 30 .972
 Effective communication .944
 Feedback .913
 Critical thinking .928
Socialization agent 17 .946
 Transition to practice .946
Protector 11 .938
 Safe learning environment .872
 Healthy work environment .909
Role model 9 .930
 Professionalism for preceptee  and self .912
 Preceptor competence .858
Note. α = Cronbach’s alpha.

Differences in Importance of Preceptor Roles

Differences in the perception of the importance of the individual preceptor roles based on the participants’ length of experience as a preceptor were found. Preceptors with over 5 years of experience rated the role model role (p = .001) and the leader/influencer role (p = .016) more important than did preceptors with more than 2 and 5 or less years of experience and preceptors with 2 years or less of experience. Preceptors with more than 2 and 5 or less years of experience rated the protector role as less important than did preceptors with 2 years or less of experience and preceptors with more than 5 years of experience (p = .037). Details on the rating of importance for all roles by preceptor experience are shown in Table 5. No differences in importance of roles by work units were found.

TABLE 5 - Importance Rating of Roles Based on Preceptor Experience
n Items Min–Max Mean SD p
Role model
 2 years or less 290 9 9–45 41.3 4.6 0.001**
 >2 to≤ 5 years 295 9 9–45 41.1 4.4
 More than 5 years 881 9 9–45 42.0 4.1
 2 years or less 294 13 13–65 58.8 6.6 0.016*
 >2 to≤ 5 years 298 13 13–65 58.6 6.2
 More than 5 years 889 13 13–65 59.6 5.6
 2 years or less 290 11 11–55 49.7 6 0.037*
 >2 to≤ 5 years 295 11 11–55 48.8 6.2
 More than 5 years 880 11 11–55 49.7 5.6
 2 years or less 296 46 46–230 207.0 20.6 0.060
 >2 to≤ 5 years 300 46 46–230 206.0 20.6
 More than 5 years 892 46 46–230 208.8 18.6
 2 years or less 289 30 30–150 136.1 15.1 0.079
 >2 to≤ 5 years 295 30 30–150 134.4 15.1
 More than 5 years 882 30 30–150 136.6 13.7
 2 years or less 292 14 14–70 63.2 7.1 0.238
 >2 to≤ 5 years 297 14 14–70 62.7 6.9
 More than 5 years 887 14 14–70 63.5 6.5
Socialization agent
 2 years or less 289 17 17–85 76.2 9.0 0.294
 >2 to≤ 5 years 295 17 17–85 75.3 9.0
 More than 5 years 880 17 17–85 76.1 8.5
Note. n = number of participants who responded; Items = number of items rated in the role; Min–Max = minimum mean rating–maximum mean rating; Mean = mean based on the potential rating of items in the role (1–5) and the number of items included in the role; SD = standard deviation.
*p ≤ .05.
**p ≤ .001.

Differences in Duration of Precepted Time

The amount of time preceptors precepted differed by the type of preceptee and clinical area. Participants were asked, on average, how many hours they spent precepting each type of preceptee. Initially, precepting times reported by all participants (e.g., RNs, advanced practice RNs, unlicensed technicians, respiratory therapists, etc.) were analyzed. They reported precepting new-to-practice, professionally licensed individuals the longest, with a mean of 162.7 hours each. The next highest precepting time reported was for precepting employees who were new to the clinical setting/specialty but not new to the organization (109.1 hours), followed by experienced individuals who were new to both the specialty and the organization (but not newly licensed or new to practice; 105.0 hours). Experienced individuals who were new to the organization required an average of 86.0 precepted hours (see Table 2).

Subsequent analysis of the precepting times reported by only direct care RNs who were preceptors illuminated differences from the data for all participants. For example, like all participants, direct care RNs reported the longest precepting time for new-to-practice, professionally licensed professionals, but the mean time reported was longer at 182.5 hours. In addition, direct care RNs reported longer mean times precepting employees who were new to the clinical setting but not new to the organization (125.0 vs. 109.1 hours), experienced individuals who were new to the specialty and to the organization (122.4 vs. 105.0 hours), experienced individuals who were new to the specialty but not the organization (109.3 vs. 101.3 hours), and experienced individuals who were new to the organization (99.1 vs. 86.0 hours). Direct care RNs reported shorter mean times precepting students (66.1 vs. 68.6 hours) and nonlicensed individuals (45.3 vs. 52.4 hours).

The duration of precepted time reported by direct care RNs also differed by clinical area. In general, the highest mean hours per preceptee were found in intensive care units (ICU), women’s services, and the emergency department; the lowest mean hours were in ambulatory care. Comparison data by preceptee type and clinical area are shown in Figure 2. For example, direct care RNs reported mean precepting times for experienced employees who were new to a specialty but not new to the organization as higher in perioperative areas (172.6 hours), ICUs (155.7 hours), and women’s services (134.5 hours) compared to ambulatory services (110.3 hours), the emergency department (144.6 hours), medical and surgical units (100.4 hours), progressive care units (79.2 hours), and specialty care units (70.8 hours).

Mean hours of precepting provided by direct care registered nurses by preceptee type and work. This figure is available in color online (


The purposes of this study were to perform a national practice analysis to identify the roles, knowledge, and activities essential to preceptor practice and to use that data to validate the seven roles of precepting proposed by the Ulrich Precepting Model (Ulrich, 2019). The seven preceptor roles, shown in Figure 1, were validated. These roles were subdivided into domains of knowledge and practice, which were used to group required competencies. The domains of each role and their associated competencies were also validated as shown in Table 4. Comparison of preceptor roles with the roles of the NPD practitioner (Harper & Maloney, 2016; Warren & Harper, 2017), as shown in Table 6, demonstrates several commonalities. Recognition of these commonalities led the ANPD Board of Directors to approve a position statement acknowledging preceptors as a common entry point into NPD practice, recognizing preceptor’s value, and supporting their practice (ANPD, 2020).

TABLE 6 - Comparison of NPD Practitioner and Preceptor Roles
NPD Practitioner Roles
(Harper & Maloney, 2016; Warren & Harper, 2017)
Preceptor Roles/Responsibilities
(Ulrich, 2019)
Learning facilitator Teacher/coach, facilitator
Change agent Leader/influencer
Mentor Role model
Leader Leader/influencer
Partner for practice transitions Socialization agent, protector
Champion for scientific inquiry Evaluator
Advocate for the NPD specialty n/a
Note. NPD = nursing professional development.

This study not only validated the seven roles identified by the Ulrich Precepting Model (Ulrich, 2019) but also demonstrated the complexities of precepting. As shown in the Ulrich Precepting Model (see Figure 1), precepting is multifactorial, and preceptors must be able to discern the role competencies needed for a given circumstance and move fluidly among the roles based on situational context and the unique needs of the preceptee.

This multifactorial complexity of the preceptor roles aligns with findings of other studies. For example, DeAngelis and Wolcott (2019) identified nine domains of pharmacist preceptor practice, each of which contained multiple associated tasks. In addition, L'Ecuyer, Hyde, and Shatto (2018) used course evaluation responses from 553 preceptors who attended 40 preceptor academies to identify 25 competencies, which the researchers categorized into knowledge, skills, and attitudes (KSA), along with two non-KSA competencies. These competencies were subsequently used, along with a review of the literature, to develop the Preceptor Self-Assessment Tool, which contains 64 unique items also divided into KSA and non-KSA competencies (L'Ecuyer et al., 2020).

In this study, 84.2% of preceptors reported having preparation for the preceptor role, though in a follow-up question, the reported preparation ranged from self-study to faculty-based workshops/classes. In spite of the complexity of the preceptor role, this study found that 15.8% of preceptors had no preparation for the role. This finding is more promising than that of Liu et al. (2019), who found that 83% of participants who attended preceptor workshops (n = 89) had previously precepted without any educational preparation. Furthermore, inconsistent preceptor education or a lack of trained preceptor availability are reported (Nash & Flowers, 2017; Senyk & Staffileno, 2017). Clearly, additional focus on preceptor development is needed.

This study found differences in the reported duration of precepting time by preceptee type and clinical area. The initial results show expected trends such as more precepting time reported for new-to-practice preceptees than for those with experience and for preceptees in ICUs as compared to areas of lower acuity. Subsequent analyses of the data may reveal additional relationships; however, additional research is needed to answer many of the questions generated by the results of this study.

Regulatory requirements and accreditation initiatives promote professional development of preceptors. Although some state boards of nursing require “orientation” of preceptors who work with students (L'Ecuyer, Lancken, et al., 2018), 11 states have no requirements for precepting. The Arizona State Board of Nursing (2018) states that precepting is within the experienced nursing professional’s scope of practice only pursuant to “specific education/training” (para. 1) for the preceptor role. In addition, both the American Nurses Credentialing Center’s (2020) and the Commission on Collegiate Nursing Education’s (2015) transition to practice accreditation criteria mandate professional development of preceptors.

Although regulatory and accreditation mandates are likely increasing the occurrence of initial preceptor role development, the findings of this study suggest the additional need for professional development after precepting for approximately 2 years. Benner (1984) posits that competent nurses perceive themselves as having achieved mastery. This perceived sense of mastery, as well as potentially forgetting what was learned in initial preceptor training, suggest the need for periodic education to maintain and enhance preceptor competence.


Although data attrition is a limitation of the results of this study, the volume of responses remaining gives adequate power to generalize to the population. In addition, all data are self-reported. The survey instrument, which was based on the literature, was developed by the research team and was designed to provide initial data on the topic. As such, some questions are broad in nature (e.g., how much time a preceptor spent precepting a specific type of preceptee). The responses to these broad questions provide indications of future research needs, but they cannot be generalized to broader populations. Finally, participants were not asked to specify if preparation for the preceptor role occurred prior to the initial preceptor experience.


As partners for practice transitions who are responsible for role development of both healthcare staff in transition and the preceptors who work with them, NPD practitioners are strategically positioned to impact organizational outcomes such as staff retention and quality of patient care by ensuring preceptors are intentionally prepared for their critical, complex role. This research serves as a call to action to ensure high-quality initial preceptor development that is based on evidence-based roles and competencies as well as ongoing preceptor “refreshers” to ensure that perceived significance of preceptors’ responsibilities does not wane. Additional research is needed to determine the prevalence of individuals who precept without prior education.

In addition, although this study indicates the amount of time preceptors precepted various individuals in different patient care settings, the study does not necessarily reflect the duration of the total preceptored experience for the preceptee. In practice, a preceptee may have more than one preceptor, either by design as the preceptee gains experience (Shinners et al., 2018) or out of necessity based on staff availability. Research is needed to determine the duration of the preceptored experience for each category of preceptee.

A report on the competencies and concomitant educational needs of preceptors identified in this study is forthcoming.


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