Why don't all nurse practitioners precept? A comparative study.

Abstract

Preceptors are integral in nurse practitioner (NP) education. A shortage of willing preceptors limits graduations from NP programs. However, little is known about why NPs decide not to precept. To identify the factors significantly associated with NPs' status as currently, previously, or never precepting, using the Integrated Behavioral Model as the conceptual framework. This was a cross-sectional, comparative, descriptive study of NPs using survey methodology. Our survey was based on published surveys with items added and adapted to reflect our framework. Subscales included personal factors, primary determinants of intent to precept, and external factors. We mailed recruitment postcards, with an online survey link, to all NPs in Arkansas. Data were analyzed using bivariate and stepwise multinomial logistic regression for each subscale. We obtained 261 responses. Participants who had previously and/or never precepted differed from current preceptors on multiple variables on bivariate analysis. Predictive personal factors included experience and hours worked per week. Predictive primary determinants included knowing NPs that precept, support for precepting, recognition of preceptors, and clinical expertise. Predictive external factors included space, liability, having a "gatekeeper," NP program, importance of precepting, and number of requests. Different factors predict NPs who currently, previously, and have never precepted. However, frequency of requests predicted both nonprecepting groups. Various supports in the clinical setting and program factors predicted one or other nonprecepting group. Strategies should be developed to ensure all potential preceptors are recruited, increase support for precepting, and ensure educational programs meet preceptors' needs.