Identification of statewide core competencies for new graduate nurses at the beginning of practice and after a 12-month nurse residency program

Aim

To inform the development of statewide core competencies for new graduate nurses at the beginning of their professional career and after completing a 12-month nurse residency program.

Background

Although studies have attempted to clarify the expected core competencies of new graduate nurses at the beginning of their professional career, results are mixed. Additionally, nurse residency program competency expectations vary.

Design

A retrospective cross-sectional study using a purposive sample of a national nurse residency program database.

Methods

Wilcoxon Signed Rank tests compared retrospective self-report data between January 1st 2017 and December 31st 2019, from 2916 acute care hospital new graduate nurses working in the state of Maryland, USA, to examine their perceptions of competency at hire and after completing a nationally standardized 12-month nurse residency program. The study used six domains from the Casey Fink Graduate Nurse Experience Survey© 2006 and the Vizient/AACN Nurse Residency Program™ Progression survey.

Results

New graduate nurses' self-report of competency increased from a mean score of 4.81 at the beginning of a nurse residency program to 6.67 after completion of 12-month nurse residency program (scale of 0–10). At the beginning of a nurse residendy program, new graduate nursesreported a low level of comfort in three of the six survey domains: communication and leadership, high-intensity skills and patient safety. At 12 months, new graduate nurses reported higher levels of comfort in all six survey domains, with statistically significant increases (Wilcoxon Signed Rank test, α =0.05).

Conclusions

Four domains for ongoing competency development were identified for the nurse residency program curriculum—communication and leadership, patient safety, complex patient assignments and end-of-life care—with the expectation that new graduate nurses achieve competency at program completion. New graduate nurses’ perceptions corroborated findings from a statewide study of academicians and practice leaders, thus helping to develop realistic core competencies for new graduate nurses entering the workforce and after completing a 12-month nurse residency program.