New Graduate Nurse Clinical Competencies

Purpose: Processes have been implemented to assist graduate nurses with the transition from student to staff nurse. They include individualized precepted orientation and mentoring. However, there continues to be a need for further enhancement of critical thinking skills and confidence levels of the newly graduated staff nurse. The purposes of this study were to:

• Evaluate the participants’ critical thinking skills and confidence at the beginning and conclusion of the simulation.
• Determine the effect of medium and high fidelity simulation on the transition from student nurse role to staff nurse role.

Method:  The Nursing Education Simulation Framework provided the theoretical framework for this quasi-experimental repeated measures study designed to measure the effect of medium and high fidelity on the critical thinking skills and self confidence of graduate nurses in a Nurse Residency Program. The Health Sciences Reasoning Test and The Performance Based Development System were used to measure critical thinking pre and post simulation. The Casey Fink Graduate Nurse Experience Survey was used to assess the graduate nurse’s perception of skill development and support. A 2 1/2 hour medium fidelity simulation was introduced during the first month of employment with high fidelity simulation during the second month of employment. The graduate nurses were scheduled for group and individual sessions of high fidelity simulation. The participant’s ability to respond to a specific patient event was assessed during the individual sessions. The post-tests were administered 5 months after the final high fidelity simulation.

Results: Descriptive statistics and repeat measures ANOVA were used to analyze the data. The significance level of p<0.05 was established. Results have shown improvement in critical thinking and confidence levels.

Conclusions: Simulation provides an additional method to facilitate the transition of the graduate nurse. Findings, conclusions, and implications will be presented at the conference.