1. Redesigned Nurse Residency Program & Nurse Residency Program Study

2. Program Redesign Elements
Cohort hiring of new RN graduates (12/year) Program curriculum/content Onboarding-Month 4 -NEO & Centralized Nsg.Orientation -Introduction to GHS Nurse Residency Program Content: Conscious Leadership Spiritual Care/Reflective Practice Intro to PPC/Quality Improvement/ Medical Library Services Commitment to Excellence Casey-Fink Survey -Phase II Competency-based Orientation (clinical focus) Weekly meetings to coincide with clinical education class day and service line/unit training and experiences

3. Program Redesign Elements
Program curriculum/content Month Once a month meeting -Curriculum: leadership skills, professional role, patient safety, communication, nurse-physician relationship -”Tales from the Bedside” -Surveys: Casey-Fink: 6 month & 12 month Critical Thinking Tool: 12 month

4. Program Redesign Elements
- Continue to be a one-year long program - Proposed program will pilot for 1 year

5. Impact of Redesigned Competency Based Graduate Nurse Residency Program on Critical Thinking and Experience of New Graduate RNs during their First Year of Transition into Practice

6. Research Investigators
Trudy Ackard MSN RN Nursing Residency Coordinator Susan Bethel MS RN NE-BC Manager of Nursing Scholarship & Research

7. Research Questions
What is the difference in level of critical thinking of new graduates who participate in the nurse residency program as measured throughout the one year program?
What is the level of readiness as perceived by the nurse managers related to the new graduates’ clinical and non clinical skills ?

8. Research Questions
Is there a relationship with characteristics of new RNs ( education, age, clinical track) related to the perceptions of their clinical competence?
How are characteristics of new RNs related to their performance in terms of critical thinking and clinical competence as measured by assessors { clinical advisors and educators} ?

9. Methodology Evaluation study/ descriptive/ comparative
Eligible: new graduates hired – grouped into cohorts [ study: Sept ‘14 – Feb ’15]
Target sample = 100 { at least 3 cohorts}
Residency -competency based model
curriculum & content focused on 6 nursing competency domains

10. Measurement
Partnered with Healthcare Advisory Board/ Nurse Executive Center
Critical Thinking Diagnostic Tool
Self assessment by new grad at one year
Assessors evaluate new 3mo, & 1 yr.
Problem Recognition, Clinical Decision Making, Prioritization, Clinical Implementation & Reflection
Learning module for assessor ( inter rater reliability)
Nurse Readiness for Practice Tool
Nurse Manager completes at one year
Casey Fink Graduate Nurse Experience Survey©
Self assessment by new graduate at start of program, 6 months and one year
Frequently used tool – validity established and reliability of

11. Summary
Gain knowledge of how new graduates are progressing in the residency program
Assess for specific competencies in which new graduates are excelling and areas when improvement needed
Provide insight and awareness of how to assess critical thinking and competence of new graduates
Gain multiple perspectives- new graduate, their preceptor, educator & manager
Expect the results to support the design of the residency program
Aggregated results ( w/o identifiers) will be available as feedback to our Nursing Faculty

12. Future Implications
How does a nurse residency program/ competency based program affect patient outcomes, safety and satisfaction?
What is the expected level of critical thinking for a new graduate nurse after one year of practice?