The effects on novice clinical adjunct nursing faculty

According to the U.S. Bureau of Labor Statistics, the current national nursing shortage leaves many nursing roles—in acute care, long-term care, and community settings—unfilled. To prepare more future nurses, pre-licensure nursing programs require adequate faculty. Although ideal nursing faculty have received training in nursing education pedagogy, as of 2022, according to Smiley and colleagues, only 17.4% of the over 5 million RNs in the United States have at least a master’s degree in nursing. This statistic doesn’t consider the focus of those advanced degrees, which means even fewer RNs prepared to serve as effective educators for pre-licensure nursing students.

The lack of preparation in educational pedagogy common among adjunct clinical faculty, as stated by the American Association of Colleges of Nursing (AACN), means the onus for teaching them how to serve as effective educators lies with the educational institutions that employ them. Novice faculty require support and guidance

in implementing evidence-based methods for learner teaching, evaluating student learning, and ensuring students achieve course and program outcomes. AACN recommends mentorship as one approach to providing this guidance. Mentorship can help novice clinical adjunct faculty develop into competent clinical educators who make a positive impact on student learning.

The National League for Nursing (NLN) published a Mentoring Toolkit in 2022 to guide best practices for mentoring nursing faculty. According to NLN, best practice involves formal mentorship programs that provide mentor training, match mentors and mentees based on similar goals or interests, and provide ongoing support for all involved.

In addition to mentorship, structural empowerment serves to enhance faculty confidence and engagement. Kanter defines structural empowerment as the extent to which a person feels they have access to information, resources, and support to do their job. Mentorship programs aimed at providing novice faculty access to experienced faculty who can help them learn the culture of the institution as well as evidence-based techniques for educating adult learners in the clinical setting have the potential to enhance structural empowerment. Empowered clinical faculty can use their knowledge of clinical practice and educational pedagogy to help students develop critical thinking and clinical judgment skills. Empowered faculty also feel as though their work has an impact on the organization.

Learning more

To learn more about the relationship between mentorship and perceptions of structural empowerment, I conducted a descriptive, cross-sectional quantitative study. I targeted novice clinical adjunct faculty (taught no more than 3 years) teaching at pre-licensure RN programs, including diploma, associate, baccalaureate, and entry-level master’s degrees. I asked participants if they’d received formal mentorship (employer-assigned mentor), informal mentorship (finding their own mentor through professional or collegial relationships), or no mentorship. I received institutional review board approval through my institution.

I recruited participants (a convenience sample) via nursing education forums and email invitation. Participants anonymously completed an electronic version of Laschinger’s Conditions for Work Effectiveness Questionnaire – II (CWEQ – II). This validated questionnaire, used in several other studies focused on the nursing population, examines the domains of structural empowerment. Participants answered 21 questions, which were broken up into six subscales assessing access to opportunity, resources, information, support, formal power, and informal power. The scoring for each question ranged from 1 to 5, with 5 representing the strongest response.

Results

Of the 107 potential participants who completed (or partially completed) the survey between April 4, 2023, and May 14, 2023, 67 met all eligibility requirements and were included in the study. Participants resided in all areas of the country, ranged in age from 25 to over 65, and represented various ethnicities. Years of nursing experience ranged from less than 5 years to more than 25. Participants’ highest levels of nursing education included 14 bachelor’s degree, 44 master’s degree, and 8 doctoral degrees; one participant did not state their education level. With regard to mentorship, 36 received no mentorship into their adjunct clinical faculty role, 18 received informal mentorship, and 13 received formal mentorship.

I calculated mean, median, and standard deviation for each question as well as for each subscale. The informal power, formal power, and access to support subscales had the lowest average scores (2.74, 2.92, and 2.91, respectively); access to opportunity had the highest score (3.91). Total structural empowerment for all participants was moderate (M = 18.83, SD = 4.36). (See CWEQ – II descriptive statistics)

A Kruskal-Wallis H test showed that mentorship type had a relatively strong effect on participants’ perception of structural empowerment with a mean rank structural empowerment score of 24.5 for those who didn’t receive any mentorship, 41 for those who received informal mentorship, and 50.62 for those who received formal mentorship. Post hoc analysis showed significant differences between no mentorship and informal mentorship (p < .05) and between no mentorship and formal mentorship (p = .00). These findings suggest that participants who received any form of mentorship had higher perception levels of structural empowerment than those who didn’t; however, I found no statistically significant differences in perception of structural empowerment between those who received formal mentorship and those were received informal mentorship. (See Mentorship–structural empowerment connection.)

Implications for practice

A study by Valdez and colleagues shows that high levels of empowerment can decrease burnout and increase work satisfaction. Both of these outcomes have the potential to improve faculty retention levels, an important step in resolving the issue of insufficient faculty to train future nurses. Findings from this study support that contention.

This study showed significantly higher empowerment levels for adjunct clinical faculty who received mentoring. In addition, most participants (95.5%) intend to remain in nursing education. Of those, 22.4% plan to increase their roles as nurse educators. These findings, when viewed together, reflect positively on the role of mentorship in improving empowerment, work satisfaction, and the recruitment and retention of nursing faculty.

CWEQ-II subscale scores shed light on areas that require further improvement. For example, informal power received the lowest score (M = 2.74, SD = 1.03). According to Laschinger, informal power comes from social connections and communication among employees at all levels of an organization. Areas of interest in the informal power subscale include collaboration with the course coordinator on activities conducted with students and being sought out by the course coordinator for information pertaining to student progress. Clinical faculty can feel more empowered when they perceive their role as collaborative with course coordinators; however, the participants in this survey reported little collaboration occurring at this level.

The access to opportunity subscale, which investigates participants’ thoughts on the possibility of progression within the organization as well as the opportunity to increase knowledge and skills on the job, received the highest score (M = 3.91, SD = .68). Scores in this subsection as well as results showing that 22.4% of participants intend to increase their responsibilities as nurse educators provide evidence of participant job satisfaction.

Suggestions for future research

The topic of mentorship and empowerment of clinical adjunct faculty warrants further research. Although the NLN Mentoring Toolkit endorses a formal mentoring program as best practice, this study showed no significant difference in perception of structural empowerment between those who received formal mentoring and those who received informal mentoring. Increasing the size of the study might result in further significant findings.

In addition, future studies could examine how the type of mentorship received affects other areas related to work satisfaction and professional development. Researchers might also want to conduct a study with a longitudinal design in which clinical adjunct faculty complete the CWEQ-II questionnaire when they’re hired and again after a certain amount of time has passed.

Examination of the effects of being a mentor on empowerment deserves further study. Most studies focus on the mentee, rather than the mentor. Learning about the effects of participation on the mentor may provide additional insight to support the benefits to both parties.

Tiffani Natalini-Whitmore is an assistant professor of nursing at Concordia University Irvine in Irvine, California.

American Nurse Journal. 2025; 20(7). Doi: 10.51256/ANJ0725127

References

American Association of Colleges of Nursing. Nursing faculty shortage fact sheet. May 2024. aacnnursing.org/news-data/fact-sheets/nursing-faculty-shortage

Kanter RM. Men and Women of the Corporation. New York City, NY: Basic Books Inc; 1993.

Laschinger HKS. CWEQ – Conditions for Work Effectiveness: Questionnaire I and II. Western University. uwo.ca/fhs/hkl/cweq.html

National League for Nursing. NLN Mentoring Toolkit. March 2022. nln.org/education/teaching-resources/professional-development-programsteaching-resources/toolkits

Smiley RA, Allgeyer RL, Shobo Y, et al. The 2022 National Nursing Workforce Survey. J Nurs Regul. 2023;14(1 suppl 2):S1-90. doi:10.1016/S2155-8256(23)00047-9

Spreitzer GM. Psychological empowerment in the workplace: Dimensions, measurement, and validation. Acad Manag J. 1995;38(5): 442-65. doi: 10.2307/256865

U.S. Bureau of Labor Statistics. Occupational outlook handbook. Registered nurses. August 29, 2024. bls.gov/oohhealthcare/registered-nurses.htm

Valdez GF, Ramos-Cayaban AR, Mathews S, Doloolat ZA. Workplace empowerment, burnout, and job satisfaction among nursing faculty members: Testing Kanter’s theory. Nurs Palliat Care Int J. 2019;2(1):29-35. doi: 10.30881/npcij.00012