Successful Role Transition Research Articles

Improving the evaluation of novice advanced practice nurse transition.

Novice advanced practice registered nurses (RNs) experience decreased self-confidence, anxiety, and identity confusion in their first year of practice, which leads to poor job satisfaction and turnover. Advanced practice RN fellowship programs, developed to bridge the gap from the RN to the advanced practice role, lack standardized measures for program evaluation. A large Midwestern pediatric hospital's advanced practice nurse fellowship program lacks a structured program evaluation. A quasi-experimental evidence-based improvement project was implemented to evaluate fellowship program outcomes for novice nurse practitioner transition and retention. All novice advanced practice RNs (APRNs) were enrolled in the site's 12-month APRN fellowship program. The transition experiences of enrollees who completed the fellowship program were assessed using the novice nurse practitioner role transition scale. In addition, role transition scores were compared for two subgroups: fellows in acute care and fellows in primary care roles. Fellowship participant retention 1 year after hire was measured. Postintervention data showed that most fellowship graduates had a positive transition experience as evidenced by at least a 4.33/6.0 mean total novice nurse practitioner role transition score. There was not a statistically significant difference between the transition scores of the acute care fellows and primary care fellows. The APRN fellowship program was effective in promoting a successful role transition from RN to novice APRN. Similar APRN fellowship programs may benefit from using this tool for program evaluation.

Role transition of higher education teachers due to disruptive technological change: Identity reconstruction for a better teacher-student relationship

This paper highlights the importance of higher education teachers’ professional identity in the field of management, especially when faced with crisis events or disruptive technology. By employing the Bridges transition framework, we comprehended the profound transformation brought about by the pandemic and suggested proactive measures to effectively address future obstacles that significantly affect teaching methods. Based on a PLS-SEM analysis performed to examine the outcomes of an online survey (N = 145), our study provides insights into the connections between changes in the teachers' identity, digital mastery, successful role transition, and the teacher-student relationship. Our results show that the loss of teaching identity has a direct negative impact on the digital mastery, the success of the transition of the teaching role, and the student-teacher relationship as well. We suggest that a transition process is successful if it is well-managed and supported during its psychological phases, places significant emphasis on the phenomenon of loss of identity and provides guidance towards defining the new identity.

Development and evaluation of a neonatal nurse practitioner mentoring workshop.

New graduate neonatal nurse practitioners (NNPs) need more than an orientation; they need mentoring to facilitate successful role transition and enhance job satisfaction. A gap exists in the literature about mentoring participant training and launching of successful programs for NNPs. This article provides an overview of the development and evaluation of a nurse practitioner (NP) mentoring workshop before the start of a formalized mentoring program. Workshop participants attended a half-day education event with an emphasis on mentoring program expectations, mentor and mentee roles, and effective communication. After the workshop, participants completed an electronic survey to evaluate satisfaction with the teaching and areas for improvement. From January 2022 through January 2023, newly hired NPs paired with experienced NP mentors participated in this structured workshop. Twenty-eight participants in two cohorts evaluated the workshop to identify meaningful aspects of the presentations and areas for improvement. Participants reported high levels of satisfaction with the interactive components of the 4-hr workshop. An interactive mentoring workshop helps participants establish realistic expectations and mutual goals. Further study is needed to identify time- and cost-efficient strategies in the preparation of effective mentoring participants to enhance the quality of mentoring programs.

Filipino Nurses’ Experiences in a Collaborative Advanced Practice Model: A Critical Incidents Study

The advanced practice nursing role has been found to be a potential solution in low and middle-income countries where access to primary care physicians is limited. In the Philippines, this advanced role has yet to be enacted, hindering the full potential of nurses as primary care providers. Hence, this study aimed to provide an in-depth analysis of nurses’ experiences within a collaborative advanced practice model for hypertension care in the Philippines. This qualitative study utilized a modified version of the Critical Incident Technique. Three participating nurses were asked to self-report the behaviors, interactions, and emotions that positively or negatively impacted their clinic experiences. Similarities in the data were iteratively labeled and classified until major themes emerged. Findings indicate that the overarching theme underpinning the nurses’ experiences in a collaborative advanced practice model was the significant role transition they underwent. While undergoing this transition, three distinct sub-themes of critical incidents emerged: 1) acquiring and maintaining competence, 2) establishing and strengthening collaboration, and 3) gaining and maintaining trust or respect. These insights on the successful role transition of advanced practice nurses in a primary care setting should be used by low- and middle-income countries when establishing their advanced practice nursing frameworks. Furthermore, training programs that prepare advanced practice nurses should also tailor their curricula and strategies on the relevant competencies to include collaboration skills towards building trust with patients and other healthcare providers.

The Structural Dimensions of “Double-Qualified” Teachers’ Work Role Transition Competence and Its Generation Mechanism

The competence to change work roles is a key factor for individuals in achieving a successful work role transition. In this study, we analyzed in-depth interview data of 31 “double-qualified” teachers and related teaching managers in higher education institutions using the grounded theory method and constructed a model of the structural dimensions of teachers’ work role transition competence and its generation mechanism. The model was also interpreted using work role transition theory, the Job Demand–Control–Support (JDCS) model, and employee learning theory. The research results show that the work role transition competence of teachers in higher education institutions is mainly composed of four dimensions: old role detachment, psychological adaptation, new role cognition, and resource reserve capacity; the four factors of work role demand (initiation factor), role breadth self-efficacy (internal contextual factor), social support (external contextual factor), and individual learning (direct factor) follow the theoretical logic of “demand–context–learning–competence” to influence the formation of work role transition competence. This study enriches and expands the theory of work role transition, which can help teachers in higher education institutions to effectively apply it in their work role transitions and can help higher education institutions to further improve the corresponding norms of human resource management practice.

Supporting Role Knowledge and Role Transition in Neonatal APRN Students.

Advanced practice registered nurses (APRNs) play a critical role in alleviating provider shortages and expanding access to health care services for medically underserved populations. To meet these shortages, the APRN workforce is growing faster than the average for all occupations. This creates a critical need for effective transitioning from the role of student to APRN provider. Unfortunately, transitioning to the APRN role is not seamless and role confusion or challenges in role exposition can contribute to job stress and even role exodus. A recent quality improvement project supported student understanding of APRN roles and anticipation of role transition challenges for neonatal students preparing for roles as nurse practitioner and clinical nurse specialist. This strategy has the potential to contribute to successful role transition of neonatal nurse practitioner and neonatal clinical nurse specialist students.

Participation in a nurse practitioner fellowship to instill greater confidence, job satisfaction, and increased job retention.

The Institute of Medicine's The Future of Nursing report recommended the extension of nurse practitioner (NP) fellowship programs to highlight and assess competencies after completion of licensure. The initiative, "Participation in a nurse practitioner fellowship to instill greater confidence, job satisfaction, and increased job retention as nurse practitioners promptly transition from novice to expert clinician," evaluated NP satisfaction between NPs who had not completed a fellowship versus NPs who had participated in a fellowship. Transition of an NP was evaluated through the Misener Nurse Practitioner Job Satisfaction Scale via 258 NPs through Emory Healthcare, MD Anderson, DNP discussion groups, and Show Me Your Stethoscope from social media. A series of independent t-tests were performed to determine statistical significance. The results of the analyses found that individuals who had participated in an NP fellowship had significantly higher scores on a sense of value for "what you do," monetary bonuses, and compensation for services outside of normal duties and obtained statistical significance. Owing to the positive trends of the surveys, continuation of NP fellowships is recommended for a successful NP role transition to develop clinical growth, retention, leadership skills, and ultimately an expert clinician.

Transition to Practice: Onboarding Components for Establishing and Sustaining Healthy Work Environments.

Transition to Practice: Onboarding Components for Establishing and Sustaining Healthy Work Environments.

Empowering the novice family nurse practitioner: Promoting readiness to practice through immersion in an innovative educational strategy.

The demand for primary care providers in the United States is on the rise with projected shortages by the year 2025. The number of primary care nurse practitioners (NPs) is expected to nearly double from 2013 to 2025 in an effort to respond to the growing demand for primary care services both regionally and nationally. Nurse practitioners are key to addressing the current and future shortage of health care providers, especially in primary care. However, novice NPs face a significant challenge when transitioning from the registered nurse role to the advanced practice role, which can affect job satisfaction and retention. The purpose of this project is to assess the implementation of a structured Clinical Transition Program (CTP) embedded within a family NP (FNP) educational program as a learning strategy to strengthen readiness to practice and promote successful role transition in the novice FNP graduate. The CTP includes primary care clinical placements as well as specialty clinical rotations and intentional clinical placements in varied settings, including those in rural and underserved areas. Participation in the program had a positive effect on perceived readiness to practice for students at graduation and 9 months after graduation. Nurse educators, armed with the knowledge of the importance of successful role transition for the new NP, must continue to develop, implement, and assess educational opportunities that promote and support readiness to practice within existing NP programs.

Factors that influence transition to advanced roles by RN to BSN nurses, in three selected hospitals of Central-Uganda

BackgroundDespite the global rise in the number of nurses upgrading from Registered Nursing (RN) to a Bachelor of Science in Nursing (BSN), studies have indicated that successful role transition is difficult once the nurses return to their previous workplaces. Guided by the Transitional Theory, this study investigates the factors that influence the transition from basic to advanced roles among RN to BSN nurses in Uganda, Africa.MethodsThis study employed a descriptive correlational design. Using convenience sampling, fifty-one (51) RN to BSN nurses completed the semi-structured questionnaires.ResultsAll the study participants (100%) described themselves as having transitioned from RN to BSN role. In bivariate linear regression, personal factors that were found to predict successful role transition included holding a managerial role, being aware and prepared for the role transition, and positive role transition experiences. Role transition motivators that predicted successful role transition included: job promotion, internal desire for self-development, and career development. One community factor – that is the support of doctors/physicians during the RN to BSN transition – predicted unsuccessful role transition. Societal factors deterring successful role transition included lack of support from other colleagues and the perception that BSN learning was not applicable to the RN clinical setting. In multivariate linear regression, only sub-scales of personal factors such as advanced skills mastery and positive personal experiences predicted successful role transition.ConclusionThe study suggests that personal factors influence successful role transition more than external factors.

Family nurse practitioner students' perceptions of readiness and transition into advanced practice.

Utilizing skills identified in previous research on successful role transition, this study evaluated the relationship between a strategically designed practicum course and the readiness for role transition to family nurse practitioner (FNP) in graduate nursing students. A mixed methods approach evaluated pre- and post-participation survey data for the FNP role preparedness in graduate nursing students in a strategically designed practicum course. The survey addressed 22 skills associated with readiness for role transitionand had three open-ended questions to collect narrative student perceptions. Mann-Whitney U tests revealed readiness for the FNP role increased from pre to post-participation in the course for 19 out of 22 skills with significant increases (P < 0.05) for one skill and marginally significant increases (P < 0.10) for three skills. Qualitative findings yielded an overall sense of readiness in students for novice FNP roles. A well-designed practicum course that reviews prior knowledge gained through the program and reinforces critical thinking, assessment, and decision-making skills facilitates role transition from registered nurse to novice FNP.

The effect of preparation strategies, qualification and professional background on clinical nurse educator confidence.

To describe how clinical nurse educators (CliNEs) in Vietnam are prepared for their role; to identify which preparation strategies assist development of confidence in clinical teaching; and to measure the effect of educational qualifications and professional background on perceived confidence levels. The quality of clinical teaching can directly affect the quality of the student learning experience. The role of the clinical educator is complex and dynamic and requires a period of adjustment for successful role transition to occur. Planned orientation and specific preparation programmes assist transition and reduce anxiety for new CliNEs. There is, however, a lack of clear evidence to identify the form this preparation should take or which strategies are likely to facilitate the development of role confidence. Descriptive survey study. Cross-sectional surveys were used to collect data from 334 CliNEs during January-March 2015. Eight preparation methods commonly used in Vietnam were identified. There was a small yet significant association between preparation and CliNEs' perceived confidence. Formal preparation methods, and postgraduate qualifications and years of clinical teaching experience were linked to increased confidence in clinical teaching. Conversely, informal mentorship was found to hinder confidence development. This study identifies several preparation strategies that significantly enhance clinical educator confidence and readiness for their complex role. These preparation strategies drawn from the Vietnamese context, provide important examples for the wider nursing community to consider.

A Cross-training Initiative Among Acute Care, Interventional Services: Development of a Pilot Program

Nurses have influenced and added value to radiology practice by incorporating assessment skills and evidence-based practice initiatives. An effective orientation program in a specialty practice such as radiology may be challenging in terms of meeting the learning needs of new employees. A learning needs assessment revealed that current educational content was sufficient, but nurses were not receiving education at the appropriate time, and consistent preceptorship was lacking. A nursing education specialist redesigned the orientation program by creating various teaching/learning methods, including independent self-study reading assignments, online modules, and scheduled monthly skills laboratories. A preceptor workgroup was established, and training was provided. Providing a solid orientation, especially for new graduates, that is consistent with values, behavioral expectations, and essential knowledge, allows for successful role transition, which in turn led to retention. In addition, staff participation in the redesign and implementation of the orientation program provided opportunities for engagement in the practice, which increased job satisfaction.

Caring for Pediatric Patients Requiring Cardiac Stress MRI: I Can't Run but I Can Be Medicated

Nurses have influenced and added value to radiology practice by incorporating assessment skills and evidence-based practice initiatives. An effective orientation program in a specialty practice such as radiology may be challenging in terms of meeting the learning needs of new employees. A learning needs assessment revealed that current educational content was sufficient, but nurses were not receiving education at the appropriate time, and consistent preceptorship was lacking. A nursing education specialist redesigned the orientation program by creating various teaching/learning methods, including independent self-study reading assignments, online modules, and scheduled monthly skills laboratories. A preceptor workgroup was established, and training was provided. Providing a solid orientation, especially for new graduates, that is consistent with values, behavioral expectations, and essential knowledge, allows for successful role transition, which in turn led to retention. In addition, staff participation in the redesign and implementation of the orientation program provided opportunities for engagement in the practice, which increased job satisfaction.

Radiology Nursing Specialty Orientation

Nurses have influenced and added value to radiology practice by incorporating assessment skills and evidence-based practice initiatives. An effective orientation program in a specialty practice such as radiology may be challenging in terms of meeting the learning needs of new employees. A learning needs assessment revealed that current educational content was sufficient, but nurses were not receiving education at the appropriate time, and consistent preceptorship was lacking. A nursing education specialist redesigned the orientation program by creating various teaching/learning methods, including independent self-study reading assignments, online modules, and scheduled monthly skills laboratories. A preceptor workgroup was established, and training was provided. Providing a solid orientation, especially for new graduates, that is consistent with values, behavioral expectations, and essential knowledge, allows for successful role transition, which in turn led to retention. In addition, staff participation in the redesign and implementation of the orientation program provided opportunities for engagement in the practice, which increased job satisfaction.

Graduate nurses’ experience of feedback, support and anxiety: a pilot study

Objective: The aims of this study were to investigate the association between feedback and anxiety, while also exploring the feedback and support experiences of graduate nurses. Design: This study used a mixed methods approach. Setting: Participants completed an online survey. Subjects: The study included 107 Australian graduate nurses. Main outcome measures: Anxiety and feedback. Results: Using bivariate regression a negative relationship was identified between feedback and anxiety. Further analysis using one-way analysis of variance revealed that participants who received regular and quality feedback and support reported the lowest anxiety. The second aim was assessed by reviewing participants’ subjective comments regarding their experiences as graduate nurses. Results revealed high variability in feedback and support experiences. The data gathered suggests graduate nurses experience anxiety during their transition from university to professional nursing. Conclusion: The provision of regular feedback and support was associated with reduced anxiety in graduate nurses. Thesepreliminary findings highlight the importance of regular and appropriate feedback and support to facilitate learning,successful role transition and improved patient outcomes.

Student Nurse Anesthetists’ Views on CRNA Role Transition

Purpose: Understanding student nurse anesthetists’ views on nurse anesthetist role transition.Design and Methods: Three focus groups were conducted with a total of 17 nurse anesthesia students. Nurse Anesthesia Programs in the Chicago area were contacted to elicit volunteers. Discussions were audiotaped and transcribed verbatim. Thematic analysis using constant comparison was completed within and across focus groups.Findings: Nurse Anesthesia students defined successful role transition from RN to CRNA as the ability to function independently with minimal backup or assistance while ensuring patient safety through a successful anesthetic. The following themes were identified as factors affecting SRNAs’ successful role transition: Preceptor, Mentoring, Reflection, Training Variety, and CRNA role modeling.Conclusions: Perceptions on what factors affect the role transition from RN to CRNA vary depending upon the level of training SRNAs have had in their anesthesia program. SRNAs nearing the end of their training have a firmer grasp on which factors affect their transition. This pilot study has allowed this researcher to examine the perceptions of SRNAs at different levels in their training and allowed for future changes in planning for a full study.

Using High-fidelity Simulation to Teach Acute Care Pediatric Nurse Practitioner Students

Acute care nurse practitioner students do not have the opportunity to practice independent clinical decision making in serious situations in student clinical rotations, and learning this skill is critical to successful role transition. High-fidelity simulation can provide an opportunity for practicing these skills. A pilot study comparing students' knowledge before and after participation in a high-fidelity simulation as compared with traditional learning is presented. The difference between the 2 modes of teaching was not statistically significant. However, these pediatric acute care nurse practitioner students reported satisfaction, enthusiasm, and enjoyment reflected through participation in a structured debriefing process.

Mentoring Relationships and the Levels of Role Conflict and Role Ambiguity Experienced by Novice Nursing Faculty

This study explored the effect of mentoring on the levels of role conflict and role ambiguity experienced by novice nursing faculty related to their transitions into academe using a descriptive, comparative design. It also measured the relationship between the quality of mentoring experiences of novice nursing faculty and their levels of role conflict and role ambiguity using a correlational design. P. Benner's (1984) novice to expert model was utilized as a framework for successful role transition. J. R. Rizzo, R. J. House, and S. I. Lirtzman's (1970) role conflict and role ambiguity scale was used to measure the levels of role conflict and role ambiguity experienced by novice nursing faculty. Results indicate that participants (n = 224) who were mentored have significantly lower levels of role conflict (M = 3.57) and role ambiguity (M = 3.02) than those who were not mentored (M = 4.62 and M = 3.90, respectively). Also significant, the higher the participants' reported levels of quality of mentoring experiences were, the lower their levels of role conflict and role ambiguity were. The results of this study indicate that mentoring eases the transition of novice nursing faculty from practice into academe by decreasing the degree of role ambiguity and role conflict that they experience.

Bridging the Gap: Clinical Practice Nursing and the Effect of Role Strain on Successful Role Transition and Intent to Stay in Academia

The shortage of registered nurses is inextricably linked to the shortage of nursing faculty which has resulted in the turning away of over 40,000 qualified students in 2010. One solution to the faculty shortage has been to recruit faculty from clinical practice. This often becomes problematic resulting in intent to leave academia within five years. Possible factors contributing to this action are role ambiguity and role strain. This study, therefore, examined role strain experienced by nursing faculty and the extent to which role strain predicted satisfaction with the role transition and intent to stay in academia. Findings revealed that role strain does exist among nursing faculty. Role ambiguity and self-assessed competency are significant predictors of role strain, and role strain is a significant predictor of satisfaction with the role transition and intent to stay. The study also looked at whether age, education, and experience affected role strain, and they were found to be poor predictors.