Innovation in Clinical Course Delivery and Impact on Students' Clinical Decision-Making and Competence.

The purpose of this study was to explore the differences in clinical decision-making and clinical competence between two different cohorts of graduating baccalaureate nursing students from a traditional prelicensure program in the United States. A quasi-experimental design was used to compare students who had substituted their traditional medical-surgical clinical experiences with simulation (Cohort 1, n = 35) with students who had supplementary simulation in addition to their traditional clinical experiences (Cohort 2, n = 36). The findings demonstrated that when simulation was used as a supplement to traditional clinical experiences, participants performed better patient assessments.

Are rural and urban newly licensed nurses different? A longitudinal study of a nurse residency programme.

AIM: This study aimed to compare rural and urban nurse residency programme participants' personal and job characteristics and perceptions of decision-making, job satisfaction, job stress, nursing performance and organisational commitment over time. BACKGROUND: Nurse residency programmes are an evolving strategy to foster transition to practice for new nurses. However, there are limited data available for programme outcomes particularly for rural nurses. METHOD: A longitudinal design sampled 382 urban and 86 rural newly licensed hospital nurses during a 12-month nurse residency programme. Data were collected at the start of the programme, at 6 months and the end of the programme. RESULTS: At the end of the programme, rural nurses had significantly higher job satisfaction and lower job stress compared with urban nurses. Across all time-periods rural nurses had significantly lower levels of stress caused by the physical work environment and at the end of the programme had less stress related to staffing compared with urban nurses. Perceptions of their organisational commitment and competency to make decisions and perform role elements were similar. CONCLUSIONS: Differences in these outcomes may be result from unique characteristics of rural vs. urban nursing practice that need further exploration. IMPLICATIONS FOR NURSING MANAGEMENT: Providing a nurse residency programme in rural and urban hospitals can be a useful recruitment and retention strategy.

Organizational and Practice Outcomes of a Post-Baccalaureate Registered Nurse Residency Program.

A nurse residency for newly licensed registered nurses is best practice. A novel model for transitioning new nurses is a 1-year, postbaccalaureate residency that is rotation based with protected time for supervised clinical and didactic learning. After 10 years with this program, a summative evaluation found that retention rates for 1, 2, 3, and 5 years after program completion were 93%, 83%, 73%, and 82%, respectively, higher than similar programs in the literature.

Predictors of new graduate nurses' organizational commitment during a nurse residency program.

Retaining newly graduated nurses is critical for organizations because of the significant cost of turnover. Since commitment to an organization is associated with decreased turnover intent, understanding factors that influence new graduates' organizational commitment is important. In a sample of nurse residency program participants, predictors of organizational commitment over time were explored. Perceptions of the work environment, particularly job satisfaction and job stress, were found to be most influential.

Retaining the next generation of nurses: the Wisconsin nurse residency program provides a continuum of support.

Because of the high costs associated with new graduate nurse turnover, an academic-service partnership developed a nurse residency program that provides a comprehensive support system that spans 15 months. Now in its fourth year, involving more than 50 urban and rural hospitals of varying sizes and geographic locations, the program provides formalized preceptor training, monthly daylong educational sessions, and mentoring by clinical coaches. Key factors contributing to the success of this program are a dedicated, cohesive planning team of individuals who embrace a common agenda, stakeholder buy-in, appropriate allocation of resources, and clear articulation of measures of success, with associated data collection. Successful elements of the monthly educational sessions are the use of interactive teaching methods, inclusion of content tailored to the unique needs of the nurse residents, and storytelling to facilitate learning from practice. Finally, training to advance the skill development of preceptors, coaches, educators, and facilitators has provided organizations with enduring benefits.

Perceptions of professional practice and work environment of new graduates in a nurse residency program.

New nurses continue to face challenging work environments and high expectations for professional competence as they enter practice. Nurse residency programs are gaining prominence as a mechanism to ease new graduates' transition to practice. This study examined new graduates' perceptions of their professional practice competence and work environment throughout a yearlong nurse residency program. Employing a repeated measures design, data were collected at baseline, at 6 months, and at 12 months. Results showed that job satisfaction was significantly lowest at 6 months and highest at 12 months. Job stress was found to be lowest at 12 months and organizational commitment was highest at baseline. Of the variables related to professional practice, clinical decision-making was highest at 12 months and quality of nursing performance significantly increased at each measurement point. These data add to the growing evidence supporting the efficacy of nurse residency programs.

Clinical Focus Program: enhancing the transition of senior nursing students to independent practice.

The Clinical Focus Program was designed to prepare senior nursing students for the transition to practice in the hospital setting. Through a series of 1:1 precepted clinical experiences, the students developed a broad base of clinical competencies and self-confidence in their nursing skills. Hospitals experienced reduced costs related to orientation and recruitment of new graduate nurses. The program also was valuable in building a network of collegiality and scholarship between education and practice environments.