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Structured Reflective Practice: Professional Identity Formation and Workforce Outcomes in Prelicensure Nurse Externs
Elise Turnbach1, Beth Ann White
1Author Affiliations: Penn Presbyterian Medical Center, Philadelphia, Pennsylvania (Dr Turnbach); Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, McVeytown, Pennsylvania (Dr White).
Nurse Educator
|August 13, 2026
Summary
Structured reflective practice improved nursing professional identity (PIN) in nurse externs (NEs), leading to higher RN conversion rates. This intervention supports PIN development and has workforce implications.
Area of Science:
- Nursing Education
- Professional Identity Development
- Quality Improvement in Healthcare
Background:
- Professional identity in nursing (PIN) is crucial for registered nurse (RN) outcomes.
- PIN development begins during prelicensure education.
- Inconsistent RN conversion rates were observed in a nurse extern (NE) program lacking targeted PIN interventions.
Purpose of the Study:
- To implement structured reflective practice within a nurse extern program.
- To assess the impact of reflective practice on the professional identity of NEs.
- To evaluate the effect of the intervention on RN conversion rates.
Main Methods:
- A quality improvement project was conducted.
- Structured reflective practice was integrated into the NE program.
- The Nursing Professional Values Scale-Three was used to measure PIN pre- and post-intervention.
Main Results:
- 14 out of 17 NE participants showed increased Nursing Professional Values Scale-Three scores.
- 94.1% (16/17) of NEs transitioned to patient care technician roles.
- 12 NEs were hired as full-time RNs, with others verbally committed to future RN positions.
Conclusions:
- Structured reflective practice may foster professional identity growth in prelicensure NEs.
- This pedagogical approach shows potential workforce implications for nursing.
- Integrating reflective practice can enhance the development and retention of nursing talent.
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