Authors (including presenting author) :
Li KY (1), Chow TC (1), Terry Yau (1)
Affiliation :
(1) Central Nursing Division, Queen Elizabeth Hospital
Introduction :
Generation Z (Gen Z), born between 1997 and 2013, exhibits distinct characteristics that differentiate it from previous generations, including a strong preference for technology, self-directed learning, and an emphasis on work-life balance. Given that many fresh graduate registered nurses (FGRNs) in KCC - “KCCian”, belong to this cohort, current learning approaches may not adequately meet their needs. The COVID-19 pandemic has further complicated this landscape, transforming traditional nursing education and exacerbating existing challenges, such as diminished hands-on practicum opportunities and skill gaps among new nurses.
As the population of KCCian is now predominantly Gen Z, the existing preceptorship program may produce even poorer outcomes than those observed before the pandemic. Recognizing these challenges as opportunities for innovation, the Professional Development & Research (PD&R) team in the Central Nursing Division (CND), Queen Elizabeth Hospital (QEH) proactively redesigned the KCCian preceptorship program in 2022.
This paper conducts a comprehensive review of the effectiveness of the revamped preceptorship program over three years, emphasizing its impact on the competence and transition of KCCians into clinical practice, along with their retention and job satisfaction.
Objectives :
This review aims to:
1. illustrate the key components of the revamped KCCian program that address the characteristics and learning preferences of Gen Z nurses
2. assess the effectiveness of these components in enhancing the competence of KCCian, in basic nursing skills.
3. evaluate the program's impact on the attrition rate of KCCians, particularly in the context of their transition to clinical practice.
4. analyze job satisfaction levels among KCCians as a measure of program effectiveness.
Methodology :
The revamped KCCian preceptorship program was developed using a mixed-methods approach to address the learning preferences and challenges faced by Generation Z nurses.
1. Needs Assessment
A comprehensive needs assessment, including focus groups and surveys of KCCian, identified preferred learning styles and clinical skill gaps exacerbated by the COVID-19 pandemic.
2. Program Design
The program incorporates blended learning formats with engaging online content, utilizing multimedia elements to enhance interaction. It features adaptive learning pathways that combine theoretical knowledge with practical application through interactive scenario-based training workshops.
3. Implementation
Key components include:
- Technology Integration:
Fully utilize the function of micro-learning to facilitate collaboration and continuous self-directed online learning.
- Practical Skill Enhancement:
Real-world frontline problem-solving is emphasized through high-fidelity simulations and scenario-based learning.
- Tailored Individual Support:
Individualized coaching sessions and supportive check-ins create a safe environment for KCCian engagement and adaptation.
- Collaborative Learning:
Peer and Cell group activities, pre-rotation preparatory workshops, incident sharing, and bedside mentorship foster a supportive atmosphere among FGRNs.
4. Evaluation
- Immediate Course Evaluation
- Diverse assessments, including performance evaluations via log book, and nursing skills competency checklists
- Job Satisfaction assessment by 10 points-Likert Scale
- Comparison of KCCian attrition rate from 2022 to 2024
Result & Outcome :
The evaluation of the revamped KCCian preceptorship program employed a multifaceted approach to ascertain its effectiveness and participant satisfaction. Feedback from 442 First Graduate Registered Nurses (FGRNs) at Queen Elizabeth Hospital (QEH) who engaged in the program between 2022 and 2024 indicated high levels of satisfaction, with data collected upon completion of their first year.
The majority of participants expressed that the program was well-organized (96.8% agreement), with clarity of information (96.3% agreement), and communicated prerequisites effectively (95.9% agreement). Participants reported that the program was executed smoothly (96.7% agreement) and that its content was practical and relevant for their transition into new roles (96.2% agreement). The depth and breadth of theoretical content were positively received, with 95.9% and 96.3% of participants agreeing that the material was sufficiently comprehensive and broad, respectively. The flexibility of e-learning was appreciated by 96.5% of participants, highlighting the program’s effectiveness in meeting diverse learning needs. Supportive check-ins received commendable feedback, with 99% of participants indicating that these sessions were tailored to their needs. Psychological support was affirmed with a 99% agreement, while 98.2% of KCCians reported experiencing stress relief following these check-ins.
The program's effectiveness was also evaluated based on basic nursing standards. Prior to the program's revamp, FGRNs typically required approximately six months to complete their assessments by preceptors. Post-implementation data indicated a significant reduction in this timeframe, decreasing from 5.25 months in 2022 to 3.58 months in 2024, demonstrating the program’s efficiency in enhancing the readiness of KCCians for clinical practice.
Job satisfaction among KCCians was measured using a 10-point Likert scale from 2022 to 2024, yielding mean scores of 7.05, 7.20, and 7.18, respectively. Although there was a slight dip in 2024, overall satisfaction levels remained stable.
Additionally, the attrition rate among KCCians showed a noteworthy decline, decreasing from 30% in 2022 to 4.05% in 2024 (as of the first 6-month of post-employment). This significant reduction suggests that enhanced support mechanisms and integration processes have positively influenced the retention of newly graduated nurses, indicating the sustainable impact of the interventions implemented during this period.
In summary, the revamped KCCian preceptorship program has demonstrated effectiveness in enhancing competence, job satisfaction, and retention among FGRNs. Future assessments could explore long-term impacts and adaptations of the program to further align with the evolving needs of Gen Z KCCians.
