There’s often a disconnect between what nurses see in their first nursing role and what they practiced in nursing school. Many nursing students report facing challenges in gaining practical, real-world experience in nursing school, and often feel unprepared for the challenges they face in the field, such as medication administration, heavy workloads, night shifts, complex procedures, and balancing the care of multiple patients with complex needs. This is one factor driving one in five newly registered nurses to leave their first nursing role within the first year .

This disconnect is also one of three focus areas for the American Nurses Foundation Reimagining Nursing Initiative. Through $14 million in grant funding distributed to pilot programs in 21 states over three years, the initiative is focused on testing and accelerating bold, nurse-led ideas. Here, we share how they are supporting the success of the next generation of nurses, through the Reimagining Nursing Initiative.

A deeper focus on the integration of education and practice can better prepare nursing students for their first jobs and create a smoother path between nursing school and the real world of healthcare practice. Because this transition can be rocky, these four nursing education initiatives offer actionable ways to approach training nurses so that they feel confident and supported, starting on their first shift and continuing throughout their nursing career.

“An investment in today’s nursing students is an investment in the future of healthcare,” said Lynda Benton, Senior Director, Global Community Impact Strategic Initiatives Johnson & Johnson Nursing. “The programs funded by the American Nurses Foundation lay the foundation for more graduates to begin a thriving career in nursing.”

It’s simply a reality of the educational process – new graduates bring varying degrees of knowledge, expertise, and experience to the field.

But competency-based models — where curriculum is based on learning outcomes, and students are given clear goals and a well-designed course of study in order to demonstrate mastery and competency in their specialty — presents an exciting future for nursing education.

Ten nursing schools across the country will pivot to a competency-based education system to better prepare and elevate nursing students for practice in a complex healthcare system through a pilot guided by the American Association for Colleges of Nursing (AACN).

There is no single definition of competency-based education, but it’s often characterized as building curriculum around what students know and can do, versus by course structure.

The new core competencies approved by the AACN include ten domain areas and eight key concepts, which overlap and integrate to provide a holistic educational model. The pilot will provide financial and technical support for ten nursing schools to test the new competency-based model, with the goal of identifying key learnings and strategies to share with all schools of nursing.

The decision to move toward competency-based approach to nursing education has “sparked a new era of innovation that will require fresh approaches to teaching, student assessment, clinical learning, and engagement with our partners in practice,” says Dr. Deborah Trautman, AACN president and CEO, and “is critical to reimagining the role of nursing for the future of health care delivery.”

Modern healthcare is highly complex and dynamic. Nursing students and graduates need an opportunity to practice caring for multiple complex patients in an environment that is safe and low-risk – but also realistic.

Innovation in immersive virtual reality holds the solution.

Building on a University of Minnesota-led effort this pilot will expand the use of immersive virtual reality simulation (IVRS) learning alongside precepted clinical experiences at the University of Michigan, Purdue University, and two additional “Big 10” schools. Virtual reality in nursing schools encourages innovation in education, pushes the boundaries of testing new methods, and eases the burden of understaffed administrators, teachers, and other nursing educators.

“Without radical change in clinical education, the revolving door of new nurses entering and quickly leaving the profession will continue,” says Cynthia Sherraden Bradley, assistant professor and director of simulation at University of Minnesota. “It’s past time to reimagine how we prepare nurses to meet the needs of the future.”

Many nurses leave the field too soon because they start their career with limited experience in the clinical specialty in which they are hired.

In response, Chamberlain University is taking a proactive approach to combatting this trend, and the subsequent shortage of specialty nurses, through its Practice-Ready, Specialty-Focused™ model, a 16-module online course that complements existing curriculum with specialty-focused education and clinical experiences.

The pilot program hopes to demonstrate that nurses are more likely to thrive in their first role when they can assess the best “fit” for their initial practice area and receive specialty-focused training in that area.

In partnership with the Association of periOperative Registered Nurses (AORN), this model will help nursing students determine which specialty they’re drawn to and then better prepare them for practice. Future employers will be invited to participate by providing eight-week specialty clinical experiences for students, helping to prevent new nurses from leaving the profession prematurely.

The program is being piloted at five Chamberlain campuses and three clinical partners, with an initial focus on perioperative nursing. Chamberlain University plans to add post-acute care and home health to this pilot program, and will publish a publicly available playbook enabling other schools of nursing to replicate the approach when the pilot ends in 2025.
“Practice Ready. Specialty Focused.™ provides nursing students the opportunity to begin the journey of finding where they feel a sense of belonging,” says Karen Cox, Chamberlain University president. “They can leverage their strengths and passions to provide the best patient care while lessening the potential for burnout and first-year turnover rates.”

“Failure to rescue” is a common struggle for first-year nursing graduates. These are the critical points in patient care where quick decisions are needed, and decisive nursing intervention can determine whether a patient survives.

It is incredibly challenging to replicate these situations in an academic environment, but the Ohio State College of Nursing and College of Engineering seek to change that through the implementation of extended reality (XR), artificial intelligence (AI), and machine learning (ML) technology throughout their core curriculum.

Using technology to simulate increasingly difficult situations allows nursing students to gain experience and competence with no risk to patient care. As a result, students gain critical, real-world experience in performing high-acuity procedures, reducing early discouragement and burnout. The RN Initiative funding will be used to support the “Disrupting Nursing Education with XR, AI and ML” program, which will culminate in a 2025 impact report and resources to scale the technology within the nursing profession.

“We seek to explore the hybrid nature of digital and physical life that develops from the immersive digital ecosystem. We imagine nursing education as a place where students can learn in the physical world, the digital world, or a hybrid of the two with people from across the globe,” said Michal Ackerman, PhD, RN, FCCM, FNAP, FAANP, FAAN, professor of clinical nursing and director of the Center of Healthcare Innovation and Leadership at Ohio State College of Nursing.

Along with the six other pilot programs funded by the Reimagining Nursing Initiative, these four practice-ready nurse graduate programs are uniquely designed to solve specific nursing obstacles, elevate the profession, and enable nurses with the tools, testing and data to transform patient care and healthcare delivery.

You can learn more about the best-in-class pilot programs that are moving nursing forward across the country here, and you can find out how Johnson & Johnson Nursing is supporting organizations and working to diversify the nursing workforce and strengthening readiness to practice here. To get articles like this in your inbox, subscribe to Notes on Nursing, our monthly e-newsletter.