New graduate nurses' transition to practice: A longitudinal quantitative analysis of factors that impact workplace...

The transition from a student to a professional nurse is challenging; these challenges are well-documented, namely, imposter syndrome, anxiety, and perceived incompetence. Internationally programs have been established to support new graduate nurses during initial employment. However, very little quantitative data is available that differentiates the composite factors that impact graduate progression during their first year of employment. Exploration of factors associated with new graduate nurses' progress is warranted.

This study explored associations of individual demographic factors and organisational provisions with the development of workplace performance of new graduate nurses across their first nine months of practice.

A longitudinal quantitative evaluation design analysed new graduate nurse workplace performance at one, three and nine months. Performance, based on practice standards, was analysed in relation to demographic data and education programs across two health services from 2021 to 2024. A linear mixed model was used to examine association of individual factors and organisational contingencies with performance trajectories over time.

Data from 521 new graduate nurses were sampled, generating 1142 performance appraisals across the three timepoints. Mean scores increased significantly from 74.05 (95% CI: 72.51-75.39) at month 1 to 94.88 (95% CI: 93.45-96.31) at month 9, representing a 28% improvement (p < 0.001). Comprehensive nursing practice showed the largest improvement over time. Previous employment in healthcare only (M = 84.02, 95% CI: 82.51-85.52), non-healthcare (M = 84.68, 95% CI: 83.27-86.11), or both sectors (M = 82.64, 95% CI: 81.64-84.24) showed no statistically significant differences in performance trajectories (p = 0.198). Programs with integrated postgraduate education (baseline Total Score M = 83.89, 95% CI: 82.34-85.44) demonstrated statistically significantly improvement trajectories across all domains compared to standard programs (base line Total Score M = 82.27, 95% CI: 80.95-83.55, all p < 0.005).

New graduate nurses experience consistent and significant competency growth during their first nine months of practice. This highlights the critical role of structured transition-to-practice programs, particularly those that integrate feedback and clinical coaching in fostering and shaping early professional development. Program design matters, differences in transition-to-practice graduate program structure influenced the rate of development over time, highlighting the importance of supportive transition programs that partnered with higher education provider to continue to foster professional growth.