Nurse preceptors’ orientation competence and 360-degree assessment

Nurses’ orientation competence varies, and nurses' self-assessment alone does not provide a complete picture. A doctoral research by MSc (Health Sciences) Netta Pohjamies at the University of Oulu identified three distinct profiles of orientation competence. Nearly half of the nurses fell into a high-competence profile, just over 40% were at a medium level, and fewer than 10% scored at the lowest level. Furthermore, a 360-degree assessment—combining assessments from multiple sources—revealed that nurse preceptors assessed their own competence more critically than did the preceptees, peers, and nurse managers.

The study developed the Preceptors’ Orientation Competence Instrument (POCI). This new instrument makes nurses’ orientation competence visible, helping to pinpoint strengths and areas for development. Wellbeing counties and healthcare organizations can readily use this instrument to select, train, and develop preceptors, as well as to monitor the overall quality of the orientation process.

The assessment instrument covers seven areas of orientation competence: preceptor characteristics, goal-oriented new employee orientation, guiding a reflective orientation discussion, knowledge of work-unit practices, creating a supportive learning atmosphere, preceptor motivation, and giving developmental feedback.

"The POCI offers healthcare organizations a concrete way to assess and develop their preceptors' competence," Pohjamies says.

Multiple factors associated with orientation competence

Nurses who felt more supported in their role and were more eager to serve as preceptors rated their own orientation competence higher. Additionally, work motivation was linked to how nurses evaluated both their own competence and the skills of others.

"Orientation should not rely on a single nurse preceptor; it should be a shared effort across the entire workplace community. Ideally, the chosen nurse preceptor should have sufficient experience in nursing, proper training, and a genuine desire for the role," Pohjamies explains. "We also need to boost nurses' work motivation by providing an appreciative, inclusive, and supportive work environment," she adds.

Every year, thousands of nurses start in new units. High-quality orientation strengthens their ability to deliver safe, top-tier patient care. It also supports learning, professional growth, and integration into the team. Given current healthcare staffing shortages, high staff turnover, and the retirement of experienced staff, quality orientation is more vital than ever. Success requires competent preceptors and support from the entire work community.