Evaluating the effect of preceptorship programs on clinical competence and self-confidence among newly graduated nurses in Saudi Arabia: a quasi-experimental study

Abstract

Abstract Background The transition from nursing student to registered nurse is a recognized period of vulnerability characterized by stress, role ambiguity, and reduced self-confidence, with implications for patient safety, job satisfaction, and early attrition. Structured preceptorship programs pair novice nurses with experienced preceptors to support this transition, although evidence varies by setting, program design, and outcome measurement. This study examined changes in self-assessed clinical competence and confidence in clinical skills during and after a structured preceptorship program among newly graduated nurses at Prince Mohammad Bin Nasser Hospital, Saudi Arabia. Methods A quasi-experimental one-group pretest–posttest design with one-month follow-up was used and reported in accordance with the STROBE statement. A census sample of 43 newly graduated registered nurses at Prince Mohammad Bin Nasser Hospital, Jazan, completed the Revised Casey-Fink Graduate Nurse Experience Survey 2023 at baseline (T1), immediately post-program (T2), and one-month follow-up (T3). Self-assessed clinical competence was operationalized as a study-specific composite of the Role Confidence and Manage Patient Care subscales. Internal consistency (Cronbach’s α), Shapiro–Wilk normality tests, Spearman correlations, Friedman tests, and Bonferroni-corrected Wilcoxon signed-rank post-hoc tests were conducted. Effect sizes were summarized as Kendall’s W, Wilcoxon r, and descriptive pooled-SD Cohen’s d. Results The seven baseline-assessed domains differed across time (all Friedman χ²(2) > 62, p < .001; Kendall’s W = 0.73–0.91), with higher scores at T2 and T3. Self-assessed clinical competence scores rose from M = 1.98 (T1) to 3.83 (T3), confidence in clinical skills from M = 1.36 to 2.87, and reverse-scored stress and burnout from M = 1.89 to 3.67 (higher scores indicate lower reported stress and burnout). Descriptive pooled-SD Cohen’s d values for T1–T3 ranged from 4.05 to 7.31; these are within-cohort differences, not estimates of intervention efficacy. Baseline role-transition scores were strongly intercorrelated (ρ = 0.90–0.98). In exploratory analyses, change in self-assessed clinical competence correlated with change in support and teamwork, job satisfaction, resilience and coping, and organizational commitment (ρ = 0.88–0.94); no corresponding association was detected for confidence in clinical skills. Conclusions Higher self-reported scores were observed during program participation and at one-month follow-up. The absence of a concurrent comparison group prevents causal attribution to the program, and the small, single-site sample limits precision and generalizability. Controlled, multi-site studies with longer follow-up and objective competence measures are recommended. Trial registration Not applicable; this study evaluated a hospital-based educational preceptorship program for newly graduated nurses and was not a registered clinical trial.

The authors' abstract, as published at the source. BMC Nursing, 2026 · DOI ↗