Degree Name

PhD (Doctor of Philosophy)



Date of Award


Committee Chair or Co-Chairs

Sally S. Blowers

Committee Members

Joel J. Hillhouse, Patricia Vanhook, Tamera Pearson


Every new nursing graduate is challenged to successfully transition from student to professional nurse. The stress involved in that transition can manifest itself as performance anxiety, a type of anxiety occurring when someone is the focus of attention and is fearful of interactions or of being humiliated or embarrassed. It occurs only in specific situations. The new graduate's performance is the focus of attention and evaluation. Further, the need to interact with other professionals, patients, and families can create anxiety about performance. No studies have examined performance anxiety in graduate nurses.

Use of cognitive behavioral therapy, progressive muscle relaxation, and reflective journaling has demonstrated reduction of performance anxiety in musicians and actors. There have been no studies evaluating these interventions in new graduate nurses or in combination to reduce performance anxiety in any population.

Peplau's theory of interpersonal relations suggests that relationships play a significant role in mediating anxiety. Because most graduate nurses work with a registered nurse preceptor, it is likely that relationships with preceptors and the level of perceived support from those preceptors could influence the success of transition as well as new graduates' anxiety.

Using a quasi-experimental, mixed method design, the sample was drawn from 2 classes of new graduates participating in a 6-month nurse residency program. Participants self-administered instruments measuring performance anxiety, preceptor relationships, and perceptions of preceptor social support, and were asked to journal weekly. Open-ended questions indicated their feelings about the intervention and its usefulness.

This study verified the presence and level of performance anxiety in the sample. Results revealed a decrease in performance anxiety in both treatment and control groups but no significant influence of preceptor relationship or perceived preceptor support. Analysis of qualitative data revealed that the majority of participants were not engaged in the intervention and did not value it.

Performance anxiety did not appear to negatively impact new graduate transition. No additional insight was gained about the preceptor and newgraduate relationship because the majority of participants' interactions remained at the initial level identified in Peplau's theory.

Document Type

Dissertation - unrestricted


Copyright by the authors.