The Extent of Cross-Training Exposure and Relationship With Job Satisfaction and Perceived Clinical Competency Among Nurses In Multidisciplinary Units of an Independent Public Health Care Institution in the Northern Mariana Islands, USA

Hospitals in remote settings often lacked sufficient qualified personnel and faced complex patient cases that prompted adoption of cross-training. This study determined the extent of cross-training exposure and its relationship with job satisfaction and perceived clinical competence among nurses in multidisciplinary units of an independent public healthcare institution in the Northern Mariana Islands, USA. A total enumeration of 68 registered nurses who had completed at least one institutionally recognized cross-training program participated. Data were collected via a validated self-administered Likert-scale questionnaire and analyzed using descriptive statistics and Spearman’s rank-order correlations. Results showed that Frequency (M = 4.16, SD = 0.57) and Breadth (M = 4.14, SD = 0.64) were the predominant cross-training dimensions. Nurses reported high job satisfaction (M = 4.09, SD = 0.73) and very high self-assessed clinical competence (M = 4.24, SD = 0.71). Significant positive associations were observed between Breadth and job satisfaction (rho = 0.272, p = 0.025) and between Breadth and perceived competence (rho = 0.241, p = 0.048). Training Frequency correlated most strongly with perceived competence (rho = 0.329, p = 0.006). Training duration did not show significant relationships with either job satisfaction or perceived competence. The findings suggested that repeated exposure across diverse clinical areas, rather than longer single-duration training, was more strongly associated with improved self-perceived competence and higher job satisfaction. Recommendations included prioritizing frequent, multi-unit cross-training and regular refresher sessions, implementing competency-based training plans, and incorporating supervised hands-on practice to sustain clinical expertise and staff motivation in remote healthcare settings.