Background:  Newly graduated nurses often face complex acute care situations where structured support and simulation-based training can be valuable for building competence and confidence.

Aim: To examine the effect of structured simulation-based education on nurses' acute care competencies.

Method: A multiple-group pre- and post-test design was used with self-reported data collected through the PCAS scale from 12 simulation sessions at a regional hospital in Sweden. Forty-six of 57 participating nurses consented. Participants completed surveys before and after high-fidelity, interprofessional simulation based on the ProACT framework.

Results: The Wilcoxon signed-rank test and the paired samples t-test analyses showed significant improvements in overall care abilities (P < .001), with large effect sizes (Cohen's d) for total score (-1.21) and confidence (-1.38) and medium effects for communication (-0.56) and patient perspective (-0.36).

Conclusion: Structured simulation-based education may enhance acute care competencies in newly graduated nurses.

Background

Limited knowledge exists about the impact and value of transition programs for newly graduated nurses (NGNs) during participation. Gaining insight into this phase can help improve strategies that support NGNs’ learning, retention, and work satisfaction during the transition to professional practice.

Aim

The overall aim was to investigate the experienced value of a hospital-based one-year transition program for NGNs after four months of participation. Specific aims were (1) to create and evaluate a tool to capture NGNs perceived value of the transition program and (2) to apply the tool to explore associations between NGNs experienced value of the transition program and factors related to work preparedness, future career as a nurse, work environment, and work satisfaction.

Design

Exploratory cross-sectional survey study.

Setting and Participants

The study included 216 NGNs enrolled in a regional transition program across six hospitals in Sweden.

Methods

Data were collected using an online questionnaire with Likert-scale questions and analyzed by using the Kruskal–Wallis test. Prior to analysis, an exploratory factor analysis (EFA) of the nine Transition Program Variable (TPV) items was performed.

Results

The TPV scale demonstrated satisfactory psychometric properties, including high internal consistency and a one-factor structure. Higher perceived value of the transition program was associated with higher perceived practical and theoretical preparedness, higher reported clarity regarding work expectations, stronger reported employer support for professional development, and a higher intention to remain at the current hospital.

Conclusion

Higher perceived value of the transition program was associated with higher reported preparedness and retention intentions for newly graduated nurses. Further qualitative exploration is recommended to inform future program development.

Higher education is a formal requirement for most professions in Sweden, yet education alone is often considered insufficient for preparing students for working life. Mentoring, which integrates education and working life, has been identified as important for students’ learning, identity development, and transition to work and may be understood as a relational form of work-integrated learning. Despite this, limited research has examined how mentoring can be designed for interdisciplinary programs. This study investigates undergraduate HR students’ experiences of an extracurricular mentoring activity and how it contributed to their understanding of the educational content and the human resources (HR) profession. In doing so, it explores the learning potentialof mentoring in an interdisciplinary, nonprofessional education program. Written assignments from 79 students who participated in a mentoring activity in a Swedish HR program were analyzed using a thematic analysis approach.

The results showed that mentoring supported students’ understanding of the HR profession and encouraged reflection on course content, themselves, and their future professional roles. The activity was described as facilitating reciprocal knowledge exchange between mentees and mentors. At the same time, students experienced tensions between academic learning and practical application, with working life often perceived as a more authentic and practice-oriented source of knowledge than the learning and knowledge acquired in educational contexts. The study highlights mentoring as a means of supporting professional identity formation, bridging theory and practice, and strengthening learning in interdisciplinary higher education.

The transition process for newly graduated registered nurses (NGN) entering hospital work is critical in managing challenges like insecurity and stress, while also supporting role navigation, learning, job satisfaction and retention. This study aimed to explore NGNs’ perceptions and experiences during their first four months transitioning to hospital work. A cross-sectional survey with Likert-scale questions and two open-ended free text questions was conducted with NGNs enrolled in a regional transition program at five Swedish hospitals, gathering data from 216 nurses between September 2021 and September 2022. Descriptive statistics and qualitative content analysis were used to assess the data.

The findings revealed that 61% of NGNs felt well prepared by their undergraduate nursing education, and 85% enjoyed their profession as nurses. Most reported they were integrated into their teams, satisfied with their support, and understood their responsibilities. However, only 28% reported feeling fully recovered for work, and 44% expressed fear of making mistakes. Qualitative responses highlighted feelings of unpreparedness for the workload, pace and ward-specific routines, although opportunities for learning, building relationships and validating their skills were viewed positively. The transition experience was influenced by individual, social, and organisational factors. Ongoing improvement in transition processes requires shared responsibility between nurses, educational institutions and hospitals.

BACKGROUND: Transition programs for newly graduated nurses in hospital settings are reported to provide learning opportunities, strengthening confidence, workplace integration and skills, retention and job satisfaction. Still, our knowledge of long-term effects is scarce and few studies have used control groups.

OBJECTIVE: To explore the long-term impact of having attended a transition program on the nurses' experiences of the first years of practice. More specifically, ideology-infused psychological contract, ethical stress, perceived organizational support, job satisfaction, opportunities for learning, and intention to stay in the nursing profession, were explored as outcome variables.

METHODS: A questionnaire survey was carried out among registered nurses from November 2019 to January 2020, with a 54% response rate. The analysis was based on 149 nurses who had attended a transition program, and 72 who had not attended. The nurses had seniority between one and three years. Independent samples t-test were used to investigate differences between the groups.

RESULTS: The two groups showed small and non-significant differences in the outcome variables. However, regarding the frequency of ethical value conflicts induced by insufficient resources, as well as experiences of ethical value conflict distress, the group of nurses who had attended a transition program showed statistically significantly higher mean values, although the effect sizes were small.

CONCLUSION: Newly graduated nurses need more than transition programs and skills training to progress in their nursing role and develop competence, increase job satisfaction, and reduce stress. Achieving these goals requires a long-term supportive learning environment that is integrated into everyday work.

Transitioning from being an undergraduate nursing student to becoming a clinical nursing professionalis often depicted as a stimulating yet stressful and uncertain time (Duchscher & Windey, 2018; Reebalset al., 2022). Approaches such as encouraging and facilitating the development of networks, on-the-jobtraining, and mentoring have been suggested to support the development of professional capabilities among early career workers (Jackson et al., 2022). To facilitate learning and socialization processes when newly graduated nurses (NGNs) enter working life, transition programs are implemented in hospital settings (Kenny et al., 2021; Aldosari et al., 2020). These programs generally include a combination of components, such as ward-specific orientations, supervision with an experienced nurse, mentoring and training sessions (Rush et al., 2019; Eklund et al., 2021). Another activity applied in transition programs to address transitional issues for NGNs is process-oriented group supervision (POGS); reflection seminars with peers led by a supervisor. The aim of this activity is to provide a forum for the participants to identify, discuss, and reflect upon their daily work situations, dilemmas, and ethical issues, to support the NGNs' professional development (Carlson et al., 2020).

Work-Integrated Learning (WIL) in this study interpreted as to explore “different types of connections between work and learning” (Sunnemark et al., 2023). Reflection can be such a connective activity, as it has been described as learners processing their experiences (of work), by exploring their understanding of what they are doing and why they are doing it and impact on themselves and on others’ (Boud, 1999).This definition could be useful in the context of health care, where the professionals work on their own, in teams and with patients where their decisions and actions will have consequences on the care.

Clinical group supervision with NGNs has been reported to be an effective activity in the transition process by providing a supportive peer environment with time to vent and a sense of belonging while sharing and listen to others’ care situations (Mangone et al., 2005; Carlson et al., 2020) and gaining a deeper understanding of their profession as the seminars supported a translation of their situational experiences (Eklund et al., 2021), and supporting NGNs to develop expertise more rapidly within their working area (Brink et al., 2012). Benefits such as sharing of experiences whilst receiving feedback and support are reported, while challenges identified related to group processes (Tulleners et al., 2023), or to get time to participate (Carlson et al., 2020). In addition, studies from the WIL context have emphasized reflection on workplace activities as a practice to better prepare students for work (Sykes & Dean, 2013) and to connect experiences from different contexts and refine skills (Jackson, 2015).

However, studies from this field are predominantly retrospective interview studies focusing on nurses’ experiences. This study aims to contribute to this research field by exploring the learning progression over time in POGS as an activity in a transition program for early career nurses. More specifically, the study aims to identify what issues the NGNs addressed and how these issues are processed in POGS.

Purpose

While transition programs are widely used to facilitate newly graduated nurses transition to healthcare settings, knowledge about preconditions for implementing such programs in the hospital context is scarce. The purpose of this study was to explore program coordinators’ perspectives on implementing a transition program for newly graduated nurses.

Design/methodology/approach 

An explorative qualitative study using individual interviews. Total of 11 program coordinators at five acute care hospital administrations in a south-west region in Sweden. Data was subjected to thematic analysis, using NVivo software to promote coding.

Findings

The following two themes were identified from the analysis: Create a shared responsibility for introducing newly graduated nurses, and establish legitimacy of the program. The implementation process was found to be a matter of both educational content and anchoring work in the hospital organization. To clarify the what and why of implementing a transition program, where the nurses learning processes are prioritized, was foundational prerequisites for successful implementation.

Originality/value 

This paper illustrates that implementing transition programs in contemporary hospital care context is a valuable but complex process that involves conflicting priorities. A program that is well integrated in the organization, in which responsibilities between different levels and roles in the hospital organization, aims and expectations on the program are clarified, is important to achieve the intentions of effective transition to practice. Joint actions need to be taken by healthcare policymakers, hospitals and ward managers, and educational institutions to support the implementation of transition programs as a long-term strategy for nurses entering hospital care.

Purpose – The aim of this study was to identify and describe the collaborative and professional boundary challenges at a hospital ward from a bottom-up perspective.

Design/methodology/approach – The study was conducted as a bottom-up improvement project at a hospital ward in western Sweden. An insider action research (IAR) approach was used during the project. The theoretical framework for this project was based on the Cultural-Historical Activity Theory (CHAT). Data were collected between 2019 and 2021.

Findings – The findings showed that unclear professional boundaries and limited resources challenged and hindered interprofessional collaboration. The project group had to reorganize its daily work to adjust to the different disciplines’ legal responsibilities in relation to the patients’ recovery process. To safely discharge patients, the professionals needed to talk about each other’s professional responsibilities, professional boundaries and ethical codes.

Originality/value – The IAR project revealed that revising the daily team-round routine improved the status of assistant nurses and encouraged physicians to consider input from all professions during the patients’ recovery process. However, the new approach faced resistance from clinic leadership, who believed it could prolong patients’ stays in the ward. The findings underscore the challenges of modifying hierarchical structures and social orders within hospital settings.