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The transition from nursing student to RN was viewed as both a challenge and an opportunity by nurse leaders, even before the coronavirus disease 2019 (COVID-19) pandemic. Health care organizations implement nurse residency programs (NRPs) in an attempt to minimize the gap between academia and practice. Some health care organizations are also looking at opportunities to address this challenge by strengthening academic-practice partnerships and developing student externship programs. This article shares a single hospital's outcomes, comparing new graduate nurses in an NRP who completed a student externship program during nursing school with those who did not.
Literature Review
The most recently reported first-year turnover rate was 23.8% (NSI, 2024). Work environment, support systems, and satisfaction are widely known factors that affect the intention of new graduate nurses (NGNs) to leave the organization (Lyu et al., 2024; Shinners et al., 2021). The increased dependency on NGNs as a primary source of staffing means remedies such as academic-practice bridge programs, NRPs, and student externship programs must be effectively implemented to strengthen the workforce pipeline (Africa & Grimley, 2024).
Academic-practice bridge programs create formal relationships between schools of nursing and health care organizations to improve student and staff satisfaction, enhance student performance, and increase the school of nursing's capacity to admit more students (Trepanier et al., 2017). The NGNs who participated in an academic-practice bridge program while in nursing school have shown higher retention of employment compared with those who did not (Trepanier et al., 2017).
Student externship programs, primarily implemented and managed by health care organizations (White et al., 2019b), provide immersive experiences for nursing students as an augmentation to their clinical practicum to experience real-world operations and nursing practice (Ruth-Sahd, 2022; Ruth-Sahd et al., 2010). Although the nursing clinical practicum serves as the primary method by which nursing students learn to apply foundational nursing skills and competencies, there is a tremendous variation in clinical practicum hours (Liu et al., 2022). Clinical simulation in lieu of clinical practicum hours in prelicensure nursing education also added complexity in ensuring that nursing students receive the necessary exposure and quality experience in a clinical environment (Hayden et al., 2014). Nursing...