Date of Award


Document Type

Restricted Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Cheryl Leuning


The Tiered Skills Acquisition Model (TSAM) is an effective method for structuring the clinical unit orientation for new nurses. Based on Dr. Benner's novice to expert stages of clinical competence, the orientee gradually assumes increased role responsibilities based on advancing through tiers of skills from simple interventions to more complex interventions. The preceptor serves as a professional role model, evaluator of skills, and teacher of concepts. TSAM has increased new nurses' confidence, comfort, and role satisfaction during orientation. TSAM has also demonstrated a reduction in overall length of orientation and decreased the cost of orientation.

AUGSBURG_DNP_2017_Joswiak.m4v (131091 kB)
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