The effects of nursing preceptorship on new nurses' competence, professional socialization, job satisfaction and retention: A systematic review

"How Can We Do Better?": A Case Study of a Pre-Implementation Analysis of a Residency Program for New Graduate Nurses in Canada

BackgroundUp to 33% of newly graduated nurses leave the profession within the first two years. This high turnover rate can burden care teams, negatively impacting the quality of care provided. To alleviate this problem, transition programs are offered to new nurses; however, they vary considerably in type and duration. Despite this heterogeneity, many researchers conclude that transition programs have a positive overall effect on new nurses' competencies, self-confidence, satisfaction, stress, and retention, especially when they are longer than six months and have an explicit framework and structure, such as residency programs.PurposeTo conduct a pre-implementation analysis of a residency program in the Canadian context.MethodsUsing a case study methodology, two sequential steps were performed to model the already implemented transition program and its components that needed to be upgraded to a residency program. Data were collected through 1) document analysis (n = 1,601) with selected interviews of stakeholders (n = 5) and 2) a survey with new graduate nurses (n = 29) and preceptors (n = 11).ResultsA preliminary logic model of the program was developed, depicting the structure of the proposed activities in terms of organizational orientation, unit integration, autonomous practice, and additional support measures. The operationalization of some program components was variable and sometimes missing, thereby affecting its quality.ConclusionThis study showed how transition programs already implemented in clinical settings can be enhanced into residency programs by conducting a pre-implementation analysis. This can positively impact the transition of newly graduated nurses, including their retention.

The cultural difference between empowerment and job satisfaction among nurses: An umbrella review

AIM

To synthesize and analyze the relationship between empowerment and job satisfaction among nurses in the cultural context using an umbrella review.

BACKGROUND

Empowerment improves individual autonomy, rights, and responsibilities, allowing employees to feel more control and accountability in their work and improving job satisfaction. Cultural differences also influence perceptions of power and responsibility, affecting empowerment, acceptance, and job satisfaction. Although some systematic reviews explored the relationship between empowerment and job satisfaction among nurses, the results were inconsistent, especially because of cultural contexts. Umbrella review can integrate and analyze the gap and provide final evidence.

METHODS

An umbrella review was conducted using the JBI guidelines. Seven academic databases were searched, and papers were published from database inception until June 2024. Inclusion criteria were the systematic review related to the relationship between empowerment and job satisfaction among nurses.

RESULTS

A total of five systematic reviews, including 67 single studies, were included. Empowerment is positively correlated with job satisfaction. Cultural differences may influence the levels of empowerment provided to nurses and the relationship between cultural differences and various forms of empowerment related to job satisfaction among nurses. Although the relationship between structural empowerment and job satisfaction does not show significant differences in cultural differences, psychological empowerment reveals weakness to moderate correlations, especially in Western contexts.

CONCLUSION

Enhancing psychological empowerment can improve job satisfaction, especially in Western cultures. Managers should consider cultural background to provide suitable empowerment, improve job satisfaction, potentially increase commitment and effectiveness, and reduce turnover.

REGISTRATION

This umbrella review has been registered in PROSPERO (CRD42024580679).

Content and Effect of Introduction Programmes to Increase Retention and Decrease Turnover of Newly Graduated Nurses in Hospitals: Umbrella Review

AIM

The aim of this study is to combine and compare results from systematic reviews reporting the content and effect of programmes for the introduction of newly graduated nurses employed in hospital settings on increasing retention and decreasing turnover.

DESIGN

An umbrella review.

METHODS

The electronic databases of PubMed/MEDLINE, CINAHL and PhycInfo were searched in January 2023 for eligible systematic reviews. The search string consisted of keywords extracted from the PICOS inclusion criteria. The AMSTAR 2 instrument was used for critical appraisal of the methodological quality of the eligible systematic reviews. The process and results of the review were presented using a narrative description of the data.

RESULTS

Five systematic reviews, reporting 84 intervention studies evaluating nine types of introduction programmes from 2001 to 2018, were included in the umbrella review. All nine programme types were executed by nurses in a preceptor or mentor role and the content was directed towards training of the preceptor/mentor and introduction of the newly graduated nurses. The nine programmes showed overall positive effects on retention and turnover.

CONCLUSIONS

Mentorship and Preceptorship were the most frequently evaluated programmes in the included intervention studies of the five reviews. However, the lack of transparency of the reviews and the bias of the intervention studies within the reviews, made it difficult to conclude specific effects of the content of the nine programmes.

REGISTRATION

The protocol for the umbrella review is registered with Open Science Framework (https://OSF.IO/DXYS4).

IMPACT

A weak introduction to hospital employment of newly graduated nurses may decrease retention and increase turnover. Structured and personal introduction by a mentor can have an effect on the newly graduated nurses' intentions to stay in their hospital care position.

REPORTING METHOD

AMSTAR 2.

PATIENT OR PUBLIC CONTRIBUTION

None.

Interventions to enhance the core competencies of clinical nursing preceptors: A systematic review

Aim This systematic review aimed to identify intervention studies on core competencies of clinical nursing preceptors, evaluate their quality using quantitative indicators, and summarize the effectiveness of the intervention programs and limitations of included studies.

DESIGN

This review was reported in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 checklist.

DATA SOURCES

Between May 1, 2024 and May 30, 2024, we searched PubMed, Web of Science, CINAHL, Medline, EMBASE and ProQuest (Health & Medical Collection) to get relevant literature published between January 2010 and May 2024. The main search concepts were core competence; preceptor; intervention; nurse. References in all eligible literature were also searched to prevent omissions.

REVIEW METHODS

Articles were screened and then evaluated by two researchers independently. The narrative table was used to summarize the characteristics of the included studies and the details of interventions. The modified Educational Interventions Critical Appraisal Tool was used to evaluate the quality of studies; the Kirkpatrick Model was used to assess the interventions. The content analysis method was used to synthesize data.

RESULTS

A total of 27 articles were included in this review. Six studies were rated as high quality. The remaining 21 studies were all rated as moderate quality and no studies were rated as low quality. Eight studies achieved the Kirkpatrick level 1, all the studies achieved the Kirkpatrick level 2, six studies achieved the Kirkpatrick level 3, Only one study achieved the Kirkpatrick level 4.

CONCLUSIONS

Interventions that covered key content themes, used face-to-face training method, and had shorter intervals may be more effective. Future studies could be improved by involving more representative samples, developing interventions based on theories, evaluating the long-term effects of the interventions. This review provided implications for developing more effective and sustainable educational programs for clinical nursing preceptors.

The effect of a 10-week field-oriented transition programme for new graduate registered nurses in critical care

BACKGROUND

The turnover rate of new graduate registered nurses in critical care is high as they have trouble adapting to the field. Various transition programmes are being applied, but the effectiveness thereof remains controversial.

AIM

This study examined the effects of a 10-week field-oriented training programme for new graduate registered nurses in critical care setting using the Kirkpatrick model.

STUDY DESIGN

This study used a one-group, repeated-measures design. A total of 71 new graduate registered nurses at a tertiary hospital in South Korea completed a 10-week field-oriented transition programme between March 2020 and June 2021. The programme consisted of a two-week ward-based modular orientation grounded in the concept of distributed practice model and eight-week individualized preceptorship. Using the Kirkpatrick model, the measures included the Job Satisfaction Scale, Clinical Knowledge Evaluation, Clinical Competencies, Professionalism Inventory, Organizational Commitment Questionnaire and short-term turnover rate, and data were collected four times: pre-education, after each education and at 3-month follow-up.

RESULTS

The ward-based modular orientation significantly improved clinical competencies (p < .001) and professionalism (p = .02). When preceptorship was applied, clinical knowledge (p < .001) and competencies (p < .001) significantly improved; in contrast, job satisfaction (p = .009) and organizational commitment (p < .001) were significantly reduced. Three months after the end of education, clinical knowledge (p < .001) and competencies (p < .001) increased compared with immediately after the programme, but organizational commitment (p = .013) decreased significantly. The turnover rate at 6 months after employment was estimated to be 15.5%.

CONCLUSIONS

The findings indicate that a field-oriented transition programme with sufficient practice opportunities in clinical sites and customized field training results in improved clinical knowledge and competencies in new graduate nurses.

RELEVANCE TO CLINICAL PRACTICE

A transitional programme for new graduate nurses needs to include additional components such as socialization within organization in order to improve job satisfaction and organizational commitment.

Reigniting the Passion for Medical-Surgical Nursing: Unveiling Its Crucial Role in Health Care

The declining interest among newly licensed nurses in medical-surgical nursing, compared to other specialties, poses a challenge to healthcare systems as they navigate staffing shortages and experienced nurse turnover in this important area. While the factors influencing specialty preferences remain unclear, nursing professional development practitioners play a vital role in bridging the gap between newly licensed nurses' interests and the essential needs of health care, fostering a stronger alignment and support for this foundational specialty.

Guiding novice nurses through resuscitations in the intensive care units: A qualitative descriptive study

BACKGROUND

Resuscitation in the ICU represents a critical juncture where both junior and experienced nurses are expected to respond effectively. As junior nurses may lack the clinical expertise to contribute optimally in a resuscitation, senior nurses may then be required to guide them while managing the intricacies of a resuscitation. Understanding such clinical teaching experiences is essential to strengthening the intra-professional nursing response to resuscitations.

AIM

The aim of this study was to explore junior and senior nurses' experience of guiding and being guided during resuscitations in the ICUs.

STUDY DESIGN

A qualitative descriptive study was conducted in four ICUs of a tertiary hospital. Ten ICU nurses who have experience with guiding junior nurses or being guided during resuscitations were recruited and interviewed using semi-structured interviews. Interviews were transcribed verbatim and thematically analysed.

RESULTS

Three main themes emerged from the data. First, "Under siege from all sides" highlights the limitations and challenges faced by junior nurses, as observed by senior nurses. Particularly, competency gaps in executing resuscitative procedures resulted in them being under-performing team members during resuscitations. Second, "Acts of guiding" depicted how senior nurses guided junior nurses through passive observation or active participation, with either approach facilitating the junior nurse into the functional roles of a resuscitation. Lastly, "Shouldering guiding responsibilities" espoused the moral quagmire that senior nurses experience when they must manage the complexity of a resuscitation while simultaneously guiding the junior nurse.

CONCLUSIONS

This study provides insights on the intra-professional experiences of nurses guiding and being guided during ICU resuscitations. Findings illuminate the need for leadership and clinical teaching capability building among senior nurses to create opportunistic learning during resuscitations for junior nurses.

RELEVANCE TO CLINICAL PRACTICE

More support is required for junior and senior nurses as they mount an attempt to revive the patient during resuscitations.

Interventions to enhance the core competencies of clinical nursing preceptors: a protocol for a systematic review

INTRODUCTION

Clinical nursing preceptors (CNPs) teach nursing skills to students in real medical scenarios and develop their professionalism. The adequacy of CNPs' teaching competencies affects the effectiveness of student learning, so it is crucial to seek the best evidence for teaching competency interventions. This report describes a protocol for a systematic review to identify and analyse interventions to enhance the teaching competencies of CNPs. The aims of this systematic review are to (1) summarise the characteristics, quality, effectiveness and limitations of existing intervention programmes that support or train CNPs in teaching competencies; and (2) identify knowledge gaps related to teaching competencies interventions for CNPs, thereby supporting future research on constructing and improving preceptor intervention programmes.

METHODS AND ANALYSIS

This protocol follows Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) Protocols 2015 checklist. We will report this systematic review following the updated PRISMA 2020 checklist. Between 1 May 2024 and 30 May 2024, we will search PubMed, Web of Science, CINAHL, MEDLINE, EMBASE and ProQuest (Health & Medical Collection). The intervention studies that focus on enhancing and supporting the core competencies of CNPs will be included. The two researchers will conduct the study screening, data extraction and quality appraisal independently. Disagreements will be addressed by discussion or the involvement of a third researcher. We will evaluate the quality of the included studies using the modified Educational Interventions Critical Appraisal Tool. Furthermore, we will label the training programme levels using Kirkpatrick's Four Levels of Training Evaluation Model.

ETHICS AND DISSEMINATION

Ethical approval is not applicable to this study. We will share the findings from the study at national and/or international conferences and in a peer-reviewed journal in the field of nurse education.

Effect of authentic leadership on work readiness: the mediating role of nurses' agility

BACKGROUND

The dynamic and demanding nature of healthcare environments necessitates that nurses not only possess clinical proficiency but also exhibit high levels of work readiness to adapt swiftly to changes. Authentic leadership has been recognized as a critical factor influencing various organizational outcomes.

AIM

Investigating the mediating role of nurses' agility in the relation between authentic leadership and nurses' work readiness.

DESIGN AND METHOD

A correlational analytical research design was utilized following STROBE guidelines, and data were collected from 249 nurses at a hospital affiliated with Beni-Suef University, Egypt. Instruments included authentic leadership Questionnaire, work readiness scale, and workforce agility scale. Data was collected from the beginning of March to the end of April 2024.

RESULTS

The findings indicate that authentic leadership was notably strong regarding morality/ethics dimension (mean score: 15.81), and nurses demonstrated relatively high agility levels, particularly in proactivity (mean score: 29.16). Organizational acumen scored highest in work readiness dimensions (mean score: 53.94). Nurses' overall scores for study variables ranged from 72 to 80% of the maximum, with agility scoring highest (mean score: 85.77). Significant positive correlations were found between variables, especially between nurses' agility and authentic leadership (r = 0.362).

CONCLUSION

Path analysis reveals nurses' agility as a paramount mediator between authentic leadership and nurses' work readiness, indicating its vital role in transmitting the positive effects of authentic leadership. Practical implications include establishing authentic leadership programs that foster nurses' agility especially proactive behaviors. That in turn improve nurses' readiness for various work responsibilities.

Preceptor's experience in supervising undergraduate nursing students in mental health: A qualitative study

Preceptorship is considered an essential component in undergraduate nursing student's clinical placement, especially those in speciality units such as mental health. During the preceptorship relationship students are granted the opportunity to work alongside experienced nurses in the ward observing their interactions with patients and other professionals. In addition, students are able to build clinical confidence and competence. There is currently a gap in the literature around the preceptorship experience in the mental health clinical environment which warrants further exploration. The aim of this study was to explore the experiences of Registered Nurses precepting undergraduate nursing students during mental health clinical placements. A qualitative, exploratory approach was performed. A total of eight registered nurses working in an acute in-patient mental health unit in a large regional hospital, were recruited and interviewed using a semi-structured interview technique. Thematic analysis was utilised to analyse the data resulting in the development of four overarching themes; (1) Time consuming and additional workload, (2) creating a safe environment, (3) providing and receiving feedback and (4) precepting is not a choice, it is an expectation. The results highlighted that preceptoring students was considered to be an extra workload that required significant time and effort. Preceptors also expressed concerns about student safety, emphasised the importance of feedback and acknowledged preceptorship as an expectation of registered nurses working in mental health. These findings underscore the necessity for further research to delve deeper into the experience of preceptors in mental health settings.

To precept or not to precept: Perspectives from nurse practitioners

BACKGROUND

Nurse practitioner (NP) preceptors are crucial to clinical education. Recent increases in the required direct patient care hours for NP students may worsen the current preceptor shortage. However, most studies of preceptorship only include NPs who are current preceptors and are therefore missing vital information from nonpreceptors. It is imperative to understand facilitators and barriers to preceptorship from the perspective of NPs who have stopped being or have never been preceptors.

PURPOSE

The purpose of this study was to understand the factors influencing NPs' decisions whether to precept.

METHODOLOGY

This was a descriptive, phenomenological study. Semistructured interviews were recorded in Zoom, transcribed verbatim, deidentified, and analyzed using thematic analysis.

RESULTS

Sixty NPs participated in the study: 23 current preceptors, 22 previous preceptors, and 15 who had never been preceptors. Facilitators to preceptorship included institutional support of preceptorship, positive student characteristics, clear expectations from the educational facility, and incentives. Barriers to preceptorship included time constraints, specialty, negative student characteristics, no institutional support, and being uncomfortable in the clinical role.

CONCLUSIONS

Preceptors and nonpreceptors shared similar themes-positive student characteristics and clear expectations as facilitators to preceptorship, and time as a barrier. However, other themes were unique to one preceptorship group. This provides new evidence for practice and research.

IMPLICATIONS

Nurse practitioner programs can facilitate preceptorship by ensuring that students are well prepared and providing clear expectations. Strategies should be developed to manage the time burden of preceptorship. In addition, support for preceptorship by health care organizations and systems should be studied.

Socialized to care: Nursing student experiences with faculty, preceptors, and patients

Effective socialization of nurses has led to positive outcomes for both hospitals and nurses, including higher retention and greater job satisfaction. The importance of faculty, preceptors, and patients in the socialization of nursing students has been documented extensively in the literature. The research presented in this article examines data from qualitative, longitudinal interview transcripts of 15 students as they progressed through a 2-year nursing program to determine how these three types of influence socialize nursing students, and at which points in their education. Using multiple perspective qualitative longitudinal interviews, I interviewed participants every semester of nursing school about their experiences. From the data, these three parties have an impact at different points in their socialization, starting with faculty who socialize students to nursing school by helping them think like nurses. Next, preceptors can be barriers or facilitators of learning by demonstrating how to act like nurses and providing insight about how and why nurses may act the way that they do. Finally, patients help students put everything together by applying classroom lessons to clinical settings. The research concludes with implications for research, practice, and policy.

Registered nurses' cultural orientation competence for culturally and linguistically diverse nurses in the hospital setting: A cross-sectional study

AIMS

To explore registered nurses' cultural orientation competence profiles for providing culturally and linguistically diverse (CALD) nurses with orientation in the hospital setting, and to identify which factors are associated with cultural orientation competence profiles.

DESIGN

A descriptive, explorative cross-sectional study.

METHODS

Data were collected from December 2020 to January 2021 using the Preceptors' Orientation Competence Instrument (POCI) and Preceptors' Cultural Orientation Competence Instrument (POCCI). A total of 844 registered nurses from one university hospital district in Finland participated, reflecting a response rate of 10%. A K-means cluster algorithm was employed to identify different cultural orientation competence profiles.

RESULTS

The cluster analysis identified three cultural orientation competence profiles (A, B and C). Nurses in Profile A evaluated their cultural orientation competence the highest, with members of profiles B and C demonstrating the second highest and lowest, respectively, cultural orientation competence scores. Several factors were associated with cultural orientation competence profiles, namely, orientation education and student mentoring education, support from managers and colleagues, motivation, willingness to act as a preceptor, time to provide orientation, sufficient clinical and theoretical nursing skills and current work title.

CONCLUSION

Cultural diversity and acceptance of it can be enhanced by building accepting culture towards new incomers and offering continuing education to improve the cultural competence of staff, which can further benefit patient care of CALD patients. Orientation practices can be improved by rewarding staff and building collaborative teamwork culture.

IMPLICATIONS FOR PROFESSION AND/OR PATIENT CARE

Organizations can strengthen nurses' cultural orientation competence; for example, by providing adequate orientation education and allocating more time to the orientation process.

REPORTING METHOD

The STROBE criteria were used to report the results of the observations critically.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Effectiveness appraisal of interventions to increase retention of newly qualified nurses implemented in the final year of pre-registration programmes: A literature review

AIM

To understand the effectiveness of interventions to increase retention of early career nurses, implemented during the pre-registration programme.

BACKGROUND

Retention of nurses is an issue of global concern. The transition period spanning the final year of pre-registration nurse education programmes and the first year of qualified practice is a point of high risk for attrition from the profession.

DESIGN

A systematic review without meta-analysis and a thematic synthesis of wider literature, reported using SWiM and ENTREQ guidelines.

METHODS

A convergent segregated approach was used to capture qualitative and quantitative study designs. A systematic review of quantitative papers reporting intervention and retention data and scoping review of a wider body of literature related to interventions supporting transition to qualified practice were conducted. Searches used Medline and CINAHL databases in October 2021. Data extracted from wider literature were inductively collated into themes relating to the intervention type and synthesised.

RESULTS

Six papers were included in the systematic review and 27 papers were included in the scoping review. Interventions included internships, externships, clinical immersion programmes, capstone projects, preceptorships and psychological wellbeing programmes. There was a lack of consensus about the benefits of implementing interventions during the final year of pre-registration programmes, but some evidence that interventions incorporating preceptors, expose students to the clinical environment and involve academic/clinical collaboration, report positive outcomes related to transition to qualified practice, which potentially has an impact on motivation to stay in the profession.

CONCLUSION

Greater understanding of interventions supporting student nurses to reduce likelihood of leaving once qualified has been achieved. There is some evidence these interventions lead to increases in retention, but this is limited by the quality of the reporting and the scarcity of data. Consideration should be given to maximizing students' exposure to clinical practice and the benefits that interventions with alternative approaches such as psychological wellbeing programmes may bring. This review has potential to influence effective implementation of interventions to increase retention of early career nurses if clinical practice and academic settings review proposed or actual interventions to maximise added value. REPORTING METHOD: the manuscript has been written in adherence with the EQUATOR guidelines following the SWiM reporting guidelines for the systematic review and the ENTREQ guidelines for the scoping review.

Content Analysis of Feedback Journals for New Nurses From Preceptor Nurses Using Text Network Analysis

This study aimed to identify keywords, core topic areas, and subthemes by analyzing feedback journals written by preceptor nurses to new nurses during the preceptorship period and to derive implications through word clustering. A total of 143 preceptor nurses' feedback journals for new nurses from March 2020 to January 2021 were converted into a database using Microsoft Office Excel. Text network analysis was performed using the NetMiner 4.4.3 program. After data preprocessing, simple frequency, degree centrality, closeness centrality, betweenness centrality, and community modularity were analyzed. In the feedback journals, the most central words were "study," "medication," "practice," "nursing," "method," "need," and "effort," whereas frustration, "new nurses" had low centrality. Five subthemes were derived: (1) learning necessity to strengthen new nurses' competency, (2) independence of new nurses, (3) emphasis on accuracy in nursing skills, (4) difficulties in understanding the nursing tasks expected of new nurses, and (5) basic competency of new nurses. The results of this study highlighted the experiences of new nurses and allowed for an assessment of journal feedback content provided by preceptor nurses. As such, the study provides basic data to develop a standardized education and competency empowerment program for preceptor nurses.

Reimagining the Preceptor Role

Preceptors are responsible for departmental specific orientation and shaping the development of the new graduate in the early weeks and months of their nursing career. Turnover of direct care nurses has increased at an alarming rate since the start of the pandemic and new graduate nurses continue to be in high demand, but the diminishing number of qualified preceptors presents a challenge. Innovative approaches are needed to make way for increasing the pace of hiring and onboarding new graduates. A group orientation approach was identified as an opportunity to redesign orientation for newly licensed registered nurses in an employer-based transition to practice nurse residency programs. Findings from the first cohort suggest that leaders, preceptors, direct care nurses, and new graduate orientees were satisfied with a group orientation model. Preparing novice nurses to enter practice requires organizational commitment and resources. Group orientation may be a useful approach to foster new graduate nurses' transition to practice and advance the preceptor role.

Effectiveness of transition programs on new graduate nurses' clinical competence, job satisfaction and perceptions of support: A mixed-methods study

AIM

To assess the effectiveness of two graduate nurse programs on new graduate nurses' overall competence at 3, 6, 9 and 12 months. Secondary aims were to assess new nurses' job satisfaction at 12 months and explore their experiences of support.

BACKGROUND

Most clinical settings have implemented transition programs to help new nurses to adapt to their new environments and expand their competences. To this day, very few studies have assessed the effectiveness of these programs.

DESIGN

Longitudinal mixed-methods study.

METHODS

The study was conducted at two teaching hospitals in Australia. New nurses were recruited during orientation. Data were collected at baseline (T0; n = 88), 3 (T1; n = 29), 6 (T2; n = 15), 9 (T3; n = 11) and 12 months (T4; n = 9). At each time point, the questionnaire included demographic and the Nurse Competence Scale. At T4, the questionnaire also included the Nurse Satisfaction Scale. Semi-structured interviews were conducted from T1 to T4. This study conforms to the STROBE guidelines.

RESULTS

Competence increased significantly at T1, with participants stating that they learned by "getting out" of student mode. At T2, despite no significant difference in competence, participants expressed they were more confident and in control, because they felt supported. Again, at T3, there was no significant increase in competence. Finally, at T4, competence increased significantly, with participants acknowledging that they still had a lot to learn.

CONCLUSION

This study supports that 12-month transition programs are necessary for NGNs to expand their competence. One major factor influencing NGNs during their first year was how well they felt supported and encouraged to seek help when they needed it.

RELEVANCE

There is a need to understand how new NGNs enrolled in transition programs expand their competences. Their professional development depends on a supportive environment where NGNs feel confident in asking questions or for help.

The role of motivation in the intention of nurse clinical instructors to persevere in their role: A cross-sectional study

AIM

To examine factors related to clinical instructors' motivation to persevere in their role, such as motivation, benefits and support.

BACKGROUND

Clinical nursing education is mainly based on acquiring hands-on training provided by clinical instructors in various health environments. In recent years the number of nursing students in Israel has increased, resulting in a shortage of clinical instructors. One of the reasons is that many clinical instructors do not persevere in their role for long.

DESIGN

A quantitative cross-sectional study.

METHODS

Participants included 176 licensed clinical instructors. Data were collected between January 2020 and March 2020 using an online questionnaire. The questionnaire included five parts: personal details, job benefits, perceived support, motivation for serving as a clinical instructor (autonomous motivation, controlled motivation and amotivation) and the intention to persevere as a clinical instructor.

RESULTS

Findings showed clinical instructors' intention to persevere in their role was positively associated with the overall score for motivation, perceived support and job benefits and negatively associated with amotivation (defined as a state where people do not intend to perform a particular behavior or do not know why they are performing it). Two mediation models analyses indicated that autonomous motivation fully mediates the relationship between support and the intention to persevere as a clinical instructor and that amotivation partially mediates the relationship between job benefits and the intention to persevere as a clinical instructor. The findings also demonstrated a correlation between the nature of the benefits preferred by clinical instructors and their motivation to persevere in their role.

CONCLUSIONS

Motivation plays an important role in the intentions of clinical instructors to persevere in their role. Providing clinical instructors with support from various resources and adjusting the benefits offered according to their needs may also raise their motivation to persevere in their role. Moreover, health managers and educators should pay attention to and follow the professional training and guidance processes of new and existing clinical instructors to establish and strengthen their internal motivation so that they continue willingly in their positions.

New graduate registered nurses' professional competence and the impact of preceptors' education intervention: a quasi-experimental longitudinal intervention study

AIMS AND OBJECTIVES

The aim of this quasi-experimental longitudinal intervention study was to investigate new graduate nurses' professional competence development after preceptors' participation in an education intervention.

BACKGROUND

New graduate registered nurses are expected to be competent in many areas of nursing. Expectations that are sometimes unrealistic may cause a sense of inadequacy and stress, and this may in turn prevent them from fully deploying their competencies. Competence development is related to practice environment, occupational commitment, empowerment, and work experience. Orientation or transition programs have been designed to ensure new graduate nurses' competence, and preceptors and preceptorship could also have significant influence on their competence development.

DESIGN

A quasi-experimental longitudinal intervention study.

METHODS

The data was collected from October 2015 to November 2017. Participating wards were randomized into intervention and control groups. The intervention group preceptors had an eight-hour education intervention that focused on new employees' orientation, particularly from new graduates' point of view. Wards in the control group continued to precept as before. The Nurse Competence Scale was used for new graduates' self-assessment at baseline and at three-month and nine-month follow-up. This study is reported in accordance with the TREND Statement Checklist.

RESULTS

The education intervention aimed at preceptors did not have impact on the intervention group NGRNs' competence development. There were no statistically significant differences between the groups and effect size remained small.

CONCLUSIONS

The preceptors' education intervention was not effective enough to develop new graduates' professional competence so that it would have differed from that of the graduates receiving conventional orientation at the university hospital. This study confirmed that competence development is a complex and multidimensional phenomenon and organizations should invest in new graduate registered nurses' competence development during their early career. Preceptors' education and development of preceptorship and transition programs are an important part of overall competence development in complex health care environments.

TRIAL REGISTRATION

Retrospectively registered.

Assessing Professional Competencies Among Undergraduate Nurses: An Exploratory Study

AIM

The study aimed to identify nursing students' professional competencies and examine which factors of the clinical learning environment affect these competencies.

BACKGROUND

Professional competencies are vital for the quality and safety of nursing practice. The learning environment is important for the development of professional competencies.

METHOD

Data were collected from 178 nursing students using the Clinical Learning Environment and Supervision Scale and the Nursing Professional Competencies Scale-Short Form.

RESULTS

The highest competency was achieved in value-based nursing care; the lowest competency was achieved in development, leadership, and organization of nursing. Factors such as positive pedagogical atmosphere, nursing care on the ward, and good supervisory relationship affected learning and, in turn, improved professional competencies.

CONCLUSION

The results establish a link between the clinical environment and reported professional competencies, leading to a call for more focused coverage of these factors in the academic curricula.

The experiences of new graduate nurses working in a pediatric setting: A qualitative systematic review

OBJECTIVE

To synthesize the literature regarding the experiences of new graduate nurses working in a pediatric setting.

BACKGROUND

The transition experiences of new graduate nurses can be stressful and challenging. Pediatric settings may cause additional stress due to the unique nature of children's nursing and its' environment.

INCLUSION CRITERIA

Qualitative studies of any design and qualitative components of mixed method studies that explored the experiences of new graduate nurses in a pediatric setting were included in this review: neonatal intensive care units and special care nurseries were excluded.

METHODS

The JBI meta-aggregation approach for synthesizing qualitative data was followed. Databases searched were CINAHL, MEDLINE (Ovid), APA PsycInfo, Scopus, PubMed Central, ERIC, and ProQuest Dissertations and Theses. Studies published between January 2000 and January 2022 inclusive were considered.

RESULTS

2229 records were screened, and nine studies selected. From the nine studies 203 findings were included, resulting in 19 categories and five synthesized findings. The synthesized findings related to support, developing identity and role transition, working conditions and environment, fear and uncertainty, and career and goal planning.

CONCLUSIONS

New graduates in a pediatric setting required support that took account of their development needs with consistent preceptorship. Being considered part of a team and the support of other team members were important in developing identity as a new graduate nurse in a pediatric setting. Working conditions for the new graduate needed to be safe, and new graduates also felt fearful and uncertain when it came to their new accountability and responsibilities.

Interpersonal and communication skills development in general nursing preceptorship education and training programmes: A scoping review

AIM

The aim of this systematic scoping review is to examine and synthesise the available literature on developing interpersonal and communication skills in general nursing preceptorship education programmes.

BACKGROUND

Highly developed interpersonal and communication skills are an essential component of nursing preceptorship. Preceptors are integral in facilitating, guiding, and developing positive interpersonal relationships between the nursing student (the preceptee), the qualified nurse (the preceptor), and patients. They also have a responsibility to foster and develop preceptees' interpersonal and communication skills and assess and deem preceptees as competent in such skills. Furthermore, preceptors require effective interpersonal and communication skills to carry out key responsibilities of their role, including creating a safe clinical learning environment, teaching, and providing effective feedback.

DESIGN

A scoping review was conducted using the methodological framework of Arksey and O'Malley. The PRISMA Extension for Scoping Reviews guided the reporting.

METHODS

Five electronic databases were searched for relevant articles in consultation with a librarian, supplemented by hand-searching and internet searches for grey literature. A total of 19,431 potentially relevant articles published between Jan 2000 and August 2021 were retrieved from the initial search, and an additional six articles were obtained from the supplemental search. A total of 146 articles were independently reviewed by two researchers, resulting in 24 articles eligible for inclusion in the review.

RESULTS

Several themes were identified in the literature that influenced the development of interpersonal and communication skills in preceptorship education and training programmes, including design and development of programmes, key learning outcomes, pedagogical approaches of preceptorship education and training programmes and interpersonal & communication skills development in preceptorship education and training programmes. Conclusions This review highlighted that research on developing interpersonal and communication skills amongst preceptors is mainly absent from the literature. Further research to address these knowledge gaps is warranted. The results from this review can be used to inform future curriculum design and development of nursing preceptorship education and training programmes.

Practice readiness of new graduate nurses and factors influencing practice readiness: A scoping review of reviews

BACKGROUND

For many years there has been concern that new graduate nurses may not have been adequately prepared for the workplace, often framed in terms of whether they are work ready or practice ready and able to deal with the 'reality shock' of transitioning from student to clinician. This has prompted significant research to investigate the practice readiness of new graduate nurses.

OBJECTIVES

Identify what is known about the practice readiness of new graduate nurses upon commencement of employment, how practice readiness changes over their first year of employment and explore the factors which influence practice readiness.

DESIGN

Scoping review of existing reviews guided by the framework developed by Arksey and O'Malley, with search results based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement.

METHODS

MEDLINE, CINAHL, PsycINFO, Scopus and Web of Science were searched to identify literature reviews synthesising evidence about new graduate nurses, work readiness, practice readiness, competency and transition to practice. New graduate nurses were defined as nurses who were working in any clinical setting as a nurse within their first year of employment after graduation. Database searching was supplemented with snowball searching and limited to English language papers published between 2011 and 2020. Full-text copies of included reviews were imported into an NVivo (Version 12) database to facilitate analysis and synthesis of findings.

RESULTS

Forty-five reviews were included. The findings indicate that transition is influenced by a wide range of intrapersonal, interpersonal and organisational factors, many of which are beyond the control of new graduate nurses. The findings also suggest that, overall, there are no major concerns about the practice readiness of new graduate nurses consistently supported by strong evidence. However, there is evidence to suggest that they 'lack confidence' during the first few months of employment.

CONCLUSIONS

The 'receptivity' of the clinical environment to new graduate nurses appears to be a critical influence on their experience of transitioning from student to clinician and can also influence their readiness for the role of a registered nurse. Rather than focusing on the question of whether new graduate nurses are adequately prepared for the workplace, it may be time to shift the question to whether the workplace is ready to support new graduate nurses. The findings suggest two research priorities for advancing our understanding of workplace support for new graduate nurses.

A comparative study of the opinions, experiences and individual innovativeness characteristics of operating room nurses on robotic surgery

AIM

To compare and evaluate operating room nurses' opinions about robotic surgery with their individual innovativeness metric scores. The aim was also to identify the experiences, adaptation processes and influencing factors of operating room nurses working in robotic surgery rooms in Turkey.

DESIGN

This was a comparative descriptive study.

METHODS

The sample included 114 operating room nurses working in 12 institutions that performed robotic surgery in Turkey. Data were collected between January 2018 and September 2019 using the Demographic Characteristics of Nurses and Robotic Surgery Evaluation Form and the Individual Innovativeness Scale, and were analysed using a quantitative statistical approach (independent samples t-test, one-way analysis of variance and Kruskal-Wallis H test). The data obtained from the Robotic Surgery Evaluation section, which consisted of open-ended and closed-ended questions, were analysed with appropriate steps. In particular, answers to open-ended questions were grouped and coded according to their content.

RESULTS

Operating room nurses held positive opinions about robotic surgery. Only 35.8% of the nurses had received training before joining the robotic team, while 55.2% had individually searched for information. Operating room nurses with robotic surgery experience had significantly higher (p < .001) individual innovativeness scores. Over 85% of nurses who received training adapted to robotic surgery in 3 months or less, while nurses with higher individual innovativeness scores adapted in a statistically significantly (p < .05) shorter period. Training, teamwork, and practical experience were mentioned as facilitating factors; inadequate training and technical problems were reported as obstructing factors.

CONCLUSION

Operating room nurses hold positive opinions about robotic surgery; nurses with robotic surgery experience have higher levels of individual innovativeness; and nurses who have received training are significantly better adapted.

IMPACT

What problem did the study address? This study addresses the need for a better understanding of operating room nurses' opinions and experiences about robotic surgery and the influencing factors of adapting to it. This study also offers an evaluation and comparison of the nurses' individual innovativeness characteristics and the correlation with their adaptation processes to the new role. What were the main findings? The main findings show a correlation between specific education/training and nurses' adaptation to the new role of robotic surgery, the individual innovativeness characteristics metric of nurses with or without robotic surgery experience and the time frame of their adaptation. Where and on whom will the research have an impact? This research traces the profile of current operating room nurses working in the robotic surgery field and the factors influencing their experience. These findings and conclusions have a much broader impact than in Turkey alone. The findings raise awareness of the importance of educating and preparing operating room nurses before introducing them to the new roles and responsibilities inherent to robotic surgery.

Effectiveness of a standard clinical training program in new graduate nurses' competencies in Vietnam: A quasi-experimental longitudinal study with a difference-in-differences design

OBJECTIVE

This study aimed to estimate the effectiveness of a standard clinical training program for new graduate nurses in Vietnam.

METHODS

A quasi-experimental longitudinal study with a difference-in-differences design was conducted. A total of 280 new graduate nurses completed a self-administered questionnaire. The intervention group consisted of 206 respondents (those having participated in standard clinical training) and the control group (those that did not receive training) of 74. Differences in mean increases in competency scores between the intervention and control groups were estimated. The effect size of the intervention was estimated by calculating Cohen's d. A generalized linear model was employed to identify the factors associated with mean increases.

RESULTS

The mean increase in total competency scores (range: 0-6 points) in the intervention group was 0.73 points greater than in the control group with an intermediate effect size (Cohen's d = 0.53; 95% CI 0.26 to 0.80). A greater reduction in standard deviation of total competency scores in the intervention group was confirmed. Participation in standard clinical training produced a positive association with a mean increase in total competency score without significance (β = 0.04, P = 0.321). Provincial hospitals as clinical training venues had a significantly positive association (β = 0.11, P = 0.007) with the mean increase in total competency scores. Competency at pre-clinical training was negatively (β = -0.75, P < 0.001) associated with the mean increase.

CONCLUSION

Findings implied that the standard clinical training program could contribute to both increasing and standardizing new graduate nurses' competencies in Vietnam. Further studies are needed to more precisely examine the attribution of standard clinical training to better increase new graduate nurses' competencies.

Nurses' perception of individual and organizational changes caused by a novel clinical training system for new graduate nurses: A qualitative research using photovoice

BACKGROUND

Clinical training for new graduate nurses has a positive impact on their clinical competence; however, there is limited evidence on the impact of this training at the organizational level and on the processes that mediate these impacts.

OBJECTIVES

To identify the individual and organizational impacts of a clinical training system and the mechanism that produces them by exploring nurses' perceptions of the changes in health facilities after the introduction of a standardized clinical training system in Vietnam.

DESIGN

Qualitative research using an ethnographic approach; photovoice was used to obtain insights into nurses' perceptions.

SETTING

Health facilities of four provinces and one city in Vietnam participated in the Project for Strengthening of the Clinical Training System for New Graduate Nurses.

PARTICIPANTS

New graduate nurses, preceptors, and managers who engaged in the clinical training program.

METHODS

Qualitative data, including photographs, were collected through photovoice sessions and inductively analyzed using thematic analysis.

RESULTS

Sixteen photovoice sessions were conducted with 94 nurses from 22 hospitals. Three themes emerged: "acquiring competency" as an individual change, "fostering mutual learning culture" as an organizational change, and "improved quality of care and nurse empowerment" as the impact. The clinical training system was found to enhance diverse competencies of new graduate nurses, preceptors, and nurse managers, while facilitating collaboration among different professions, departments, and organizations and cultivating a better learning environment. Organizational changes were initiated with the hospital director's support. These changes were interactively related and produced the impact.

CONCLUSIONS

The novel clinical training system for new graduate nurses could strengthen nurses' competencies and facilitate organizational changes to actualize a positive impact on nursing care and nurses' status. These findings could facilitate the design of an effective training program to stimulate organizational learning to produce better health outcome.

Quality improvement project: An online discussion forum for the support of nurse preceptors orienting newly hired nurses

Preceptorship in nursing is a complex responsibility that is often performed without any formal preparation. In nursing literature, there is consensus that nurse preceptors should be better supported and receive education regarding this role. There is however scarcity of evaluative evidence on educational strategies for preceptors of newly hired nurses transitioning to a new role. A structured online discussion forum (ODF) was developed and implemented to provide support and continuing education to a group of nurse preceptors (N = 25) in an accessible and low-cost manner; it was evaluated for the depth of knowledge co-construction. The results of this quality improvement (QI) project reveal that with sustained online and offline support and a structured learning activity, an ODF can encourage deep learning. Nurse preceptors who took part in this ODF reported feeling supported in their role of preceptor and desired to continue their participation.

Preceptorship as part of the recruitment and retention strategy for nurses? A qualitative interview study

AIM

To explore aspects that are important for the integration of preceptorship and processes for recruitment and retention of nurses.

BACKGROUND

The shortage of nurses is a global concern that has a major impact on health care systems around the world. However, earlier research has not considered whether preceptorship of nursing students can be an integral part of recruitment and retention of nurses.

METHOD

A descriptive design with a qualitative approach was used. Semi-structured interviews were conducted with ten preceptors and six ward managers in different health care specialties in Sweden.

RESULTS

Three aspects were found central for integrating preceptorship with recruitment and retention: perceptions of preceptorship, the organisation of preceptorship and the way preceptorship operates in relation to recruitment and retention strategies.

CONCLUSION

The findings suggest that preceptorship and recruitment strategies could both benefit from being integrated.

IMPLICATIONS FOR NURSING MANAGEMENT

It is central for nursing managers to develop organisational practices that enable the integration of preceptorship with recruitment and retention of nurses. This could increase the quality of both preceptorship and the work environment in general.

Interpersonal and communication skills development in nursing preceptorship education and training programmes: a scoping review protocol

The preceptorship model is an education-focused model for teaching and learning within a clinical environment in nursing. It formulates a professional educational relationship between a staff nurse (preceptor) and student nurse and is based on the provision of providing patient care. Preceptorship is widely acknowledged in the literature as a positive pedagogical approach in clinical nursing education in terms of knowledge and skill acquisition, confidence, and professional socialisation of undergraduate nursing students. However, the literature also widely reports negative interpersonal experiences within this professional educational relationship resulting in negative educational experiences and in some cases, negative patient experiences. Therefore, the authors set out to examine what teaching strategies are being implemented by nurse educators to encourage the development of interpersonal and communication skills in facilitating positive interpersonal relationships between the preceptor, nursing student and patient. This paper outlines the protocol for an exploratory scoping review that aims to systematically and comprehensively map out the available published and unpublished literature on the teaching strategies to develop interpersonal and communication skills in preceptorship education and training programmes. To conduct a systematic and comprehensive scoping review, the review will be guided by the Joanna Briggs Institute and Arksey & O' Malley (2005) six-stage iterative framework, as well as PRISMA-ScR framework guidelines, to ensure the quality of the methodological and reporting approaches to the review. It is anticipated that the results of the scoping review will inform nurse educators on the current educational practices for developing interpersonal and communication skills in preceptorship education and training programmes and identify any educational practices that are worthy of further consideration for future research.

Communication Skills and Transformational Leadership Style of First-Line Nurse Managers in Relation to Job Satisfaction of Nurses and Moderators of This Relationship

The job satisfaction of nurses is reflected in almost all organizational outputs of medical facilities. First-line nurse managers (FLNMs), who are directly related to subordinate nurses, have a great influence on this satisfaction. The aim of our paper is to examine the connection between communication skills and the transformation style of FLNMs management with the job satisfaction of nurses and to verify the influence of three moderators on the strength of this relationship. The chosen moderators-the practice of managing FLNMs, the degree of control (span of control) and psychosocial work-follow from theoretical studies. The moderating effect of the variable management practice is also significant from the point of view of Slovak legislation. The sample consisted of 132 FLNMs from five university hospitals in Slovakia. Data collection took place in the form of a questionnaire. All data were processed using the SPSS 24 software package. A series of regression analyzes were used to identify the proposed hypotheses. ANOVA analysis was used to analyze multiple dependencies. We worked at a 5% level of significance. The findings point to the strong direct effects of communication skills and the transformational leadership style of FLNMs on nurses' job satisfaction. Moderation effects are mild, but significant in the case of management and span of control practices. The lower values of both variables reinforce the positive relationships among the two predictors and the job satisfaction of nurses. The third moderator, psychosocial work factors, also have a significant moderating effect, which is negative, and the higher value of this moderator mitigates both positive direct effects.

Interpersonal and communication skills development in nursing preceptorship education and training programmes: a scoping review protocol

The preceptorship model is an education-focused model for teaching and learning within a clinical environment in nursing. It formulates a professional educational relationship between a staff nurse (preceptor) and student nurse and is based on the provision of providing patient care. Preceptorship is widely acknowledged in the literature as a positive pedagogical approach in clinical nursing education in terms of knowledge and skill acquisition, confidence, and professional socialisation of undergraduate nursing students. However, the literature also widely reports negative interpersonal experiences within this professional educational relationship resulting in negative educational experiences and in some cases, negative patient experiences. Therefore, the authors set out to examine what teaching strategies are being implemented by nurse educators to encourage the development of interpersonal and communication skills in facilitating positive interpersonal relationships between the preceptor, nursing student and patient. This paper outlines the protocol for an exploratory scoping review that aims to systematically and comprehensively map out the available published and unpublished literature on the teaching strategies to develop interpersonal and communication skills in preceptorship education and training programmes. To conduct a systematic and comprehensive scoping review, the review will be guided by the Joanna Briggs Institute and Arksey & O' Malley (2005) six-stage iterative framework, as well as PRISMA-ScR framework guidelines, to ensure the quality of the methodological and reporting approaches to the review. It is anticipated that the results of the scoping review will inform nurse educators on the current educational practices for developing interpersonal and communication skills in preceptorship education and training programmes and identify any educational practices that are worthy of further consideration for future research.

Approaches used to enhance transition and retention for newly qualified nurses (NQNS): A rapid evidence assessment

AIM

To undertake a rapid evidence assessment of approaches used to enhance nurse transition and retention for newly qualified nurses and to evaluate the strength of the evidence for specific approaches to nurse transition and retention.

DESIGN

A rapid evidence assessment was undertaken. Electronic databases were searched, and the full texts of relevant papers were retrieved. Studies were appraised using relevant Critical Appraisal Skills Programme and Mixed Methods Assessment Tools and a single descriptor of quality: high; medium; or low was assigned to each output. Given the disparity in methods, the lack of randomised trials, results could not be combined; therefore, a descriptive approach was used to synthesise and present the data.

DATA SOURCES

The search was undertaken using: specific database searching; and secondary searching of relevant websites. Electronic databases (CINAHL complete, Academic search premier, Open Grey, ERIC* (Education), Web of Science-Social Science Citation Index and PubMed) were searched during February 2018.

RESULTS

Orientation and creating supportive environments were frequently reported as being effective in enhancing transition across a range of studies. A range of methods: quasi-experimental, survey and qualitative were used. Generally, the quality of most studies was poor.

CONCLUSIONS

Despite decades of research into the experiences of newly qualified nurses and development of schemes and frameworks to support them during this period, there is little substantive or robust evidence in terms of impact on retention. Further research into the longer-term retention of newly qualified nurses is recommended. Longitudinal studies would be beneficial in assessing the efficacy of approaches to enhancing retention.

Taking charge of your preceptorship: Strategies to optimize orientation

ABSTRACT

Despite plans and processes designed to create a seamless transition from orientation to practice for new RNs, nurses may still struggle with this process. With a focus on preceptorship, this article discusses the transition process for newly licensed nurses during onboarding and nursing orientation. It identifies challenges and communication strategies to enhance the learning experience throughout preceptorship.

Preceptorship of Student Nurses in Ghana: A Descriptive Phenomenology Study

Background

Preceptorship plays an integral part in the clinical training of nursing and midwifery students, especially in high-income countries where it is a well-accepted concept. However, in Ghana, most nurses and midwives do not view preceptorship as part of their role.

Aim

The aim of this study was to explore the lived experiences of preceptorship of student nurses and the challenges confronting the preceptorship role.

Methods

A descriptive phenomenological study was conducted with 22 purposively selected preceptors aged 34 to 56 years from five clinical placement sites in the Cape Coast Metropolis in the Central Region of Ghana. Most of the participants had been preceptors for two to 18 years. In-depth interviews were conducted with the aid of a semistructured interview guide and analysed by qualitative thematic analysis inspired by Braun and Clarke's description of the method.

Results

The essence of the phenomenon has been captured in three main themes: (1) being excited about the role as it offered opportunities to learn and build relationship with students. (2) Encountering challenges including student's unwillingness to learn, absenteeism, and disrespect and also lack of interest of staff to assist students, time constraints, workload, burnout, parallel schedules of preceptors, and large student numbers, and (3) the need for effective collaboration between educational institutions and hospitals.

Conclusions

Though preceptors were excited about precepting student nurses, the challenges associated with it are multidimensional which requires effective collaboration between educational institutions and clinical placement sites.

Newly qualified nurses' transition from learning to doing: A scoping review

OBJECTIVES

To identify newly qualified nurses' experiences during transition to professional practice, and explore their and other key stakeholders' perceptions of nursing transition programmes.

DESIGN

Scoping review using the Arksey and O'Malley framework.

METHODS

Several electronic databases were searched for relevant articles, which were supplemented by hand-searching and internet searches for grey literature. 1823 potentially relevant articles published between 1974 and 2019 were retrieved from the initial search, and an additional ten articles were obtained from the supplemental search. Each article was independently reviewed, leaving 60 articles eligible for inclusion in the review.

FINDINGS

Two overarching themes emerged: 1) the transition experience; 2) the perceived benefits of nursing transition programmes. Evidence that nursing transition programmes positively impact the transition experience is inconclusive. Some studies suggest a positive impact on newly qualified nurses' competency, level of confidence and attrition rates; others reported no impact. There was a general consensus that newly qualified nurses still encounter difficulties when transitioning into professional practice. Most articles found were quantitative in nature, focusing on measurable outcomes of nursing transition programmes. Few investigated the experiences and perceptions of newly qualified nurses, preceptors, and managers regarding the transition to professional practice.

CONCLUSIONS

Literature mapping suggests that newly qualified nurses frequently struggle to successfully complete the transition into professional practice, and that this transition is complex and multifaceted. There is limited evidence to justify the widespread implementation of nursing transition programmes. Additional research focusing on experiences and perceptions of newly qualified nurses and their transitory process is warranted. Tweetable abstract: Are newly qualified nurses receiving sufficient transition support (e.g. #nursing residency programs or #preceptorship)? #Nurse #Nurses #nursing_intern.

Nurses' experiences on the road during transition into community care: An exploratory descriptive qualitative study in Singapore

Healthcare systems are evolving to meet the demands of an ageing population whereby the provision of health care services in the community has increased to alleviate the burden faced by acute care health facilities. As the result, the number of community nurses are expected to increase in order to meet the demand. Several studies have identified the unique challenges faced by the growing responsibilities of community nurses. However, fewer studies focused on the experiences of nurses transitioning to become community nurses as they rise to meet the unique challenges of working in the community. This study aimed to explore the experiences of nurses' transitions into community care while gaining insight into the transition process. The study adopted the exploratory qualitative approach. Data collection was performed through semi-structured interviews with 14 community nurses in Singapore. Interview sessions were digitally recorded and transcribed into verbatim, and the thematic analysis approach was used for data analysis. Three major themes and nine subthemes were developed from the data of 14 interviews. The three major themes are: 'Changes in Dynamics in a Nurse-Patient Relationship', 'To Live Up to Expectations', and 'Negotiating the Landscape in the Community'. New community nurses are experiencing stress and struggling to adapt with performing nursing care in uncontrolled environments. Additionally, higher expectations have been set on them even when they are still in transition. It is important to provide support for nurses, including in-service talks, courses and formal orientation programs. The study findings highlighted the importance of adequately preparing new community nurses and provided insights on developing a customised formal orientation program. This study also contributed to the limited body of knowledge with respect to nurses' transition experiences into community care.

A survey of clinical competence of new nurses working in emergency department in Iran: A descriptive, cross-sectional study

Aims

This article reports on a study investigating the self‐assessed clinical competence of new nurses working in emergency departments.

Design

A quantitative approach using descriptive cross‐sectional survey design was employed.

Methods

The clinical competency of the participants was assessed using the Competency Inventory for Registered Nurse questionnaire, which contains the seven dimensions of clinical care, leadership, interpersonal relations, legal/ethical, professional development, teaching/coaching and critical thinking/research aptitude. Data from 115 new nurses employed in emergency departments of nine selected university hospitals in the northwest of Iran were collected by the Competency Inventory for Registered Nurse (CIRN) from December 2018–May 2019 and analysed.

Results

The mean clinical competency for the total scale was 155.7 (SD 32.9), indicating a moderate competency. The most highly self‐rated competency was legal/ethical practice, and the least rated was critical thinking–research aptitude.

Facilitating and hindering experiences to the development of humanistic caring in the academic and clinical settings: an interpretive phenomenological study with nursing students and nurses

Objectives This paper reports on nursing students' and nurses' lived experiences mediating their development of humanistic caring. Methods Using interpretive phenomenology, 26 participants were individually interviewed. A five-stage phenomenological analysis based on Benner's (Benner, P. (1994). Interpretive phenomenology: Embodiment, caring, and ethics in health and illness. Thousand Oaks, CA: SAGE) method occurred simultaneously. Results The analysis highlighted that the development of humanistic caring is affected by role models and counterexamples, environments in which humanistic caring is exalted or trivialized, communication-related courses, patient storytelling, and work overload. Conclusions It might be valuable to raise the awareness of nurse educators about their opportunity in shaping the development of students' humanistic caring.

Validation of the PHNs precepting experiential learning causal model for preceptors of novice public health nurses in Japan

Aims

The purpose of this study was to analyse the relationship among public health nurse (PHN) precepting experiential learning (PHN-PEL) and the outcomes.

Background

The government supported PHNs' systematic career development and precepting learners.

Design

A nationwide questionnaire survey was conducted for PHNs who precepted novice PHNs in governmental units from 2012 to 2015.

Methods

"PHN Precepting Experiential Learning Scale," "Professional Development for Public Health Nurses" and "Awareness of Responsibility for Organization" were examined through structural equation modelling.

Results

Usable responses were 378 (43.5%). Significant relationships were as follows: "Role Performance of Fostering Novice PHN" related to "Self-development as a PHN" (β = 0.72, p < .001); "Role Performance of Fostering Novice PHN" related to "Sharing to Foster Novice PHN" (β = 0.52, p < .001) and "Sharing to Foster Novice PHN" related to "Improving Career Development Environment" (β = 0.69, p < .001). "Role Performance of Fostering Novice PHN" and "Self-development as a PHN" related to "Professional Development for Public Health Nurse" (β = 0.31, p < .001; β = 0.29, p < .001). Moreover, "Improving Career Development Environment" related to "Awareness of Responsibility for Organization" (β = 0.33, p < .001).

Reflections on setting up a nursing preceptorship programme

It is now common practice for preceptorship programmes to be offered to newly qualified nurses within the NHS. The Nursing and Midwifery Council expects newly qualified nurses to be given protected time for learning in their first year of qualified practice and to access support from a preceptor. This article discusses a preceptorship programme that has been implemented in a large integrated NHS Trust in north-west London and shares reflections and learning to date, which can benefit others wanting to roll out a similar programme in the UK.

A university/healthcare institution mentorship programme: Improving transition to practice for students

AIM

This study describes the impact of a university-based mentorship programme that is designed to prepare nursing students for the transition to practice during their last year of classes.

BACKGROUND

Research shows that mentorship is an effective strategy for facilitating the transition to clinical practice. However, there is a lack of programmes that provide mentorship prior to the students' graduation from nursing school.

METHODS

A mixed qualitative and quantitative approach was chosen to describe nursing students' perceptions. Mentees and mentors were invited to complete a survey or participate in an interview (September-November 2018).

RESULTS

Nine participants were interviewed and 22 completed the survey. Four themes were found. Students were as follows: Feeling unsure and looking for answers from clinicians and wanted to Learn about practical real-life situations. Their experiences allowed them to Normalize the entry to practice and become more prepared and capable to address pragmatic issues.

CONCLUSIONS

By bridging the academic and clinical environments, this mentorship programme helped mentees address their concerns and facilitated an easier transition to the workplace after graduation.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers can advocate for mentorship programmes by partnering with educational institutions. This support can also be continued as new graduates transition into their careers.

Improving Retention of Home Health Nurses: Fostering Outcome Sustainability Through an Innovative Orientation and Mentorship Program

Home healthcare plays an increasingly vital role in contemporary postacute healthcare. Staffing instability and lack of perceived organizational support is a stimulus for nursing attrition from the organization with far-reaching impact on staff morale, patient care, agency budgets, and relationships with other healthcare settings. The purpose of this article is to describe a redesign of an agency's nursing orientation and the development of a mentorship program for newly hired home healthcare nurses within a large Midwestern integrated health system. During this time frame, 154 nurses completed the newly designed orientation program and, of those, 91 participated in the mentorship program. In this article, we evaluate 1-year new-hire nursing retention rates over a 4-year period, examine new-hire job satisfaction and perceptions of preceptors and mentors during their first year, and discuss issues of outcome sustainability. Agency-wide turnover rates for all home healthcare nurses decreased from 15.4% in 2016 to 10.1% in 2018, demonstrating the associated impact of these initiatives on staffing stabilization.

On the difficulty of finding one's place: A qualitative study of new nurses' processes of growth in the workplace

AIMS AND OBJECTIVE

To explore new nurses' processes of growth in the workplace in order to understand the challenges they face.

BACKGROUND

Quantitative and qualitative research to date has not adequately explored the complex ways in which initial work experiences may shape new nurses' very high quit rate and, consequently, impact the long-term nursing shortage in Taiwan.

DESIGN/METHODS

We conducted in-depth interviews with new nurses to explore their professional development, including the challenges they faced, and their feelings about staying or quitting. Twenty newly registered nurses who had worked in a hospital setting full-time for a year or less in two southern Taiwan medical centres were interviewed. Data were collected from March-November 2016. EQUATOR guidelines were followed, using the COREQ checklist.

RESULTS

Interview transcripts were analysed and coded; three stages of growth were discovered: Feeling disillusioned and shocked, Gaining experiential knowledge and Making a place for oneself. Most nurses (n = 18/20) went through these three stages within 9 months and continued to work in nursing at follow-up 2 years later.

CONCLUSIONS

Job continuity was contingent upon new nurses' enduring a painful process of adjustment in the first two stages when new nurses were unsure of themselves and their interactions with preceptors were wrought with social tensions. New nurse development and retention efforts should make explicit the possibility of these tensions and how to deal with them.

RELEVANCE TO CLINICAL PRACTICE

A better understanding of new nurses' growth processes and adjustment pains can help refocus professional development and retention efforts towards how new nurses can succeed in finding a place for themselves.

Factors influencing the practice of new graduate nurses: A focused ethnography of acute care settings

AIM

To explore the influence of an acute care setting on competency deployment of new graduate nurses (NGNs) from a competency-based undergraduate programme.

BACKGROUND

In the last 15 years, nursing education has shifted to competency-based education (CBE). Few studies have focused on how NGNs from these reformed programmes use the competencies they have developed. To be paradigmatically coherent with the nature of a competence, studies should also examine how context influences nursing practice and competency deployment.

DESIGN

A focused ethnography of three acute care units from one academic hospital in Canada.

METHODS

Purposive and snowball sampling strategies were used to recruit 19 participants: NGNs (n = 4), nurse preceptors (n = 2), clinical nurse specialists (n = 9) and nurse managers (n = 4). Data were collected through individual interviews, focus groups, observation and documentation. Data were analysed according to Roper and Shapira (Ethnography in nursing research. Thousand Oaks, CA: Sage Publications, 2000) ethnographic nursing analysis framework.

RESULTS

Organisational and individual factors were identified as influencing NGNs' competency deployment. Organisational factors are orientation, stability, workload and the scientific culture of the unit. Personal factors have been linked to groups of professionals: for NGNs, personality and clinical placements during their initial education; for nurses working with NGNs, to be role models, to promote integration and to denounce bullying; and for other health professionals, to recognise nursing expertise.

CONCLUSION

One way to smooth the transition from academic to clinical settings for NGNs is by offering transition or orientation programmes that will provide them with stability and a reduced workload, allowing them to progressively deploy their competencies.

RELEVANCE TO CLINICAL PRACTICE

Organisational and individual factors influence how new graduate nurses deploy their competencies. Clinical educators and nurse managers can help new nurses by acting on these factors. This study conforms to the COREQ Research Reporting Guidelines for qualitative studies.