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Updated: Apr 12, 2026

Using Learning Outcome Measures to assess Doctoral Nursing Education
Published on: June 21, 2010
The effects of a prelicensure extern program and nurse residency program on new graduate outcomes and retention
Laura Friday1, James S Zoller, Ann D Hollerbach
1Laura Friday, DHA, MSN, RN, is Executive Director of Medical/Surgical and Behavioral Services, Memorial Health University Medical Center, Savannah, Georgia. James S. Zoller, PhD, MHA, is Professor Chair, Department of Healthcare Leadership & Management, Medical University of South Carolina. Ann D. Hollerbach, PhD, RN, is Associate Professor, College of Nursing, Medical University of South Carolina. Katherine Jones, PharmD, is Medication Safety Pharmacist, Memorial Health University Medical Center, Savannah, Georgia. Greg Knofczynski, PhD, MS, is Associate Professor, Mathematics, Armstrong State University, Savannah, Georgia.
Abstract:
Organizations are looking to new graduate nurses to fill expected staffing shortages over the next decade. Creative and effective onboarding programs will determine the success or failure of these graduates as they transition from student to professional nurse. This longitudinal quantitative study with repeated measures used the Casey-Fink Graduate Nurse Experience Survey to investigate the effects of offering a prelicensure extern program and postlicensure residency program on new graduate nurses and organizational outcomes versus a residency program alone. Compared with the nurse residency program alone, the combination of extern program and nurse residency program improved neither the transition factors most important to new nurse graduates during their first year of practice nor a measure important to organizations, retention rates. The additional cost of providing an extern program should be closely evaluated when making financially responsible decisions.
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