Date of Completion


Embargo Period



nurse practitioner, role transition, instrument development, factor analysis

Major Advisor

Regina Cusson

Associate Advisor

Cheryl Beck

Associate Advisor

Stephen Walsh

Field of Study



Doctor of Philosophy

Open Access

Open Access


Nurse practitioners (NPs) are formidable members of the health care system providing high quality, cost-effective care. Their transition into practice is often fraught with unexpected challenges. In support of this dissertation, a series of three studies was conducted to improve the process of NP role transition by increasing our knowledge and understanding of the defining constructs and the development and validation of the NP role transition scale (NPRTS). The NPRTS is a self-report survey designed to measure NP’s perceptions of role transition experiences during the first year of practice. Two individual studies supported the development and evolution of the NPRTS through factor analyses and reliability assessments. In a third study, a qualitative analysis including a subset of neonatal NPs was conducted to further our understanding of role transition constructs and support the revisions of the NPRTS. Two samples comprised of 182 and 427 NPs representing a variety of specialties and practice settings participated in the scale development studies. Multiple factor analyses provided empirical support for the existence of the resulting three factor eighteen indicator model. Internal consistency for the final three factors was high. A qualitative analysis of 70 neonatal NPs revealed four themes that described the reattainment of expert status during role transition: 1) First impressions: Am I prepared? 2) The transition, 3) Making it as a real NNP, and 4) The helpers and hinderers. The resulting NPRTS model is inferred as a valid and reliable measure of the constructs of NP role transition including: 1) confidence, comfort, and competence in the role; 2) collegial relationships; and 3) understanding of the role by clients. Implications for practice include the implementation of the NPRTS as a beginning model for NP role transition discussions and as a means to assess transition progress in the clinical setting. Continued research is warranted to progress the understanding of NP role transition and for the refinement and validation of the NPRTS.