Abstract
OBJECTIVE: This longitudinal study examined how preceptors' perceived difficulty and role performance in instructing newly graduated nurses impacted by restricted clinical practicum opportunities because of COVID-19 impact their mental health outcomes, including stressors, burnout, and turnover intention. METHODS: The study surveyed 426 preceptors responsible for newly graduated nurses across 39 hospitals during fiscal year 2022. Data were collected at three time points: June, September, and December 2022. The questionnaire assessed personal attributes, perceived instructional difficulty (PID) due to limited clinical practice, self-rated preceptor role performance, nursing job stressors, burnout, and intention to resign. Two-way ANOVA was conducted to analyze the effects of perceived difficulty (high/low) and role performance (high/low) on mental health indicators. RESULTS: Seventy-six preceptors (6 males, 70 females) completed all three surveys. In June 2022, preceptors reporting high perceived difficulty demonstrated significantly higher scores in role performance subscales, including "goal achievement and accident prevention" and "continuation of instruction with cooperation." Significant main effects of perceived difficulty and role performance were observed on stressors such as role conflict, physician conflict, and death-related stress, as well as on burnout dimensions such as emotional exhaustion and personal accomplishment. By December, significant interaction effects emerged for outcomes related to "intention to quit nursing" and "desire to change departments." CONCLUSIONS: Preceptors' PID and role performance significantly influence their stress, burnout, and turnover intentions. Those experiencing both high difficulty and high role performance experience increased psychological burdens. This underscores the importance of targeted mental health support for preceptors.