Transition to Practice: The Use of Virtual Clinical Replacement During the COVID-19 Pandemic and Its Impact on New Graduate Nurse Readiness

Abstract

AIMThis study investigated graduate nurse readiness for practice after receiving virtual clinical replacement experiences during the COVID-19 pandemic.BACKGROUNDThe pandemic led to the closure of clinical sites for many undergraduate nursing students. Nurse educators replaced the hospital setting with virtual clinical replacement experiences, potentially affecting readiness for practice in graduate nurses.METHODThe Casey-Fink Graduate Nurse Experience Survey was used to collect data in the areas of demographics, comfort level with skills, work environment stress, job satisfaction, role transition, and the impact of the virtual clinical experience on transition to practice. Descriptive statistics and independent t-tests were used for analysis.RESULTSThe virtual clinical replacement experience was statistically significant with greater confidence in providing for patient safety, stronger professional communication/leadership skills, and recognized support in the workplace.CONCLUSIONThe use of virtual clinical replacement experiences had a positive impact on new graduate nurses’ transition to practice.

Associations Between the COVID-19 Pandemic and New Nurses’ Transition to Practice Outcomes: A Multi-site, Longitudinal Study

“…Conversely, the patient safety score had a greater increase from baseline to 12 months in the pre–COVID-19 cohort and higher overall scores at baseline and 12 months. The reductions in patient safety align with findings in the literature related to reduced clinical site experiences and reduced in-classroom learning opportunities during the COVID-19 pandemic ( Bultas & L’Ecuyer, 2022 ; Ulmen et al, 2022 ). Commitment scores decreased from baseline to 12 months, with a greater decline reported in the COVID-19 cohort.…”

“…This period, known as TTP, has been extensively studied in research conducted prior to the pandemic ( Aldosari et al, 2021 ; Chappell & Richards, 2015 ; Dwyer & Hunter Revell, 2016 ; Goode et al, 2018 ; Mellor et al, 2017 ; Tyndall et al, 2018 ; Warren et al, 2018 ). Additionally, research on the impact of the COVID-19 pandemic on TTP is now emerging ( Alsalamah et al, 2022 ; Bultas & L’Ecuyer, 2022 ; Crismon et al, 2021 ; Healy et al, 2022 ; Powers et al, 2022 ; Smith et al, 2021 ; Ulmen et al, 2022 ).…”

“…A handful of studies have examined the impact of the COVID-19 pandemic on TTP. The pandemic caused many nursing students to lose hospital-based clinical experiences and hands-on knowledge application opportunities ( Crismon et al, 2021 ; Powers et al, 2022 ; Ulmen et al, 2022 ). One organization found that 67.5% of new nurses had fewer clinical practice experiences that their pre-pandemic counterparts, resulting in the nurses feeling overwhelmed, concerned for lack of efficiency, afraid of making mistakes after their orientation, and deficient in hands-on skills resulting from a lack of significant practice repetition ( Smith et al, 2021 ).…”

“…Emerging evidence suggests that the COVID-19 pandemic has impacted many facets of the healthcare system, nursing education, and the nursing workforce ( Alexander et al, 2021 ; Bultas & L’Ecuyer, 2022 ; Crismon et al, 2021 ; Smith et al, 2021 ), including close to 400,000 new nurses who passed the nursing licensing examination and became eligible to transition to practice (TTP) from nursing schools in the midst of the pandemic ( National Council of State Boards of Nursing [NCSBN], 2023 ). During the pandemic, new nurses who were transitioning reported experiencing changes in their clinical and academic preparation resulting from reduced clinical site experiences and the quick switch from in-person to online learning ( Alsalamah et al, 2022 ; Bultas & L’Ecuyer, 2022 ; Powers et al, 2022 ; Ulmen et al, 2022 ). Furthermore, the pandemic caused interruptions to many hospitals’ TTP programs, which negatively impacted new nurses ( Crismon et al, 2021 ; Bultas & L’Ecuyer, 2022 ; Smith et al, 2021 ).…”

Managing the Current Workforce

“…The impact of floating and taking any assignment (before or during the COVID-19 pandemic) could contribute to these comparatively lower scores. 16,28 Ulmen et al 32 found that NGNs who transitioned into practice during the pandemic wanted the following: (1) extended time and more opportunities to practice unit-specific skills, (2) an available and consistent preceptor, and (3) assignments that gradually increase patient ratios.…”