NURS3006 - Transition to Practice Assessment Answer

Part 1

The qualitative analytical study by Brown, 2019 was titled "Graduate Nurses' Perception of the Effect of Simulation on Reducing the Theory-Practice Gap." The study was carried out on the conceptual background of cognitive constructivism to elaborate on the theory-practice gap during the transitional process between student nurses and graduate nurses. The abstract background of cognitive constructivism suggests that the nurses develop an understanding and comprehensively apply the knowledge gained in their learning stage efficiently in their future clinical practices. The research was structured to subsequently justify the three primary research objectives- to understand the ideology of nurses regarding the skill of applying the concepts and knowledge gained in the clinical settings, to receive nurses' suggestions to implement strategies in the pre-clinical training, and lastly to evaluate the effect of simulation in enhancing the quality of care delivered within the clinical settings. Along with centralized research, query to evaluate the benefits of simulation in the pre-clinical training for the graduate nurses transitioning to the clinical practices (Brown, 2019). 

Methodology

The research design applied by Brown, 2019 was the qualitative exploratory design, which enables the researcher to conduct definitive explanatory research. The experimental design of the qualitative analysis is a prominent strategy to overcome research gaps and explores the specific aspects of the research based on the research questions. The study focuses on drawing nurses' perspectives to understand the issue of the theory-practice gap with a clear and in-depth understanding. Semi-structured interviews comprising open-ended questions were used to extract broader perspectives regarding the research questions. Interviews with open-ended questions are a reliable source of detailed and in-depth information, especially in the case of studies focusing on perspectives and ideologies. Before beginning the research, Ethical approval for the study was received from Walden University and written consent from the participants before indulging the participants in the study interviews (Brown, 2019).

Data Collection and Analysis

The participants (13 graduate nurses) involved in the study were selected based on the inclusivity criteria determined by the researchers. The eligibility criteria of the research excluded a significant portion of the nurses as the research was limited to the nurses fluent in English who graduated during the past five years. The restriction of participation presents a probability of information bias, which can hamper the credibility of the research outcomes. The data collection for the research was achieved by recording the interviews, and manual transcription of the audio recordings was completed by employing software (Excel). The utilization of computational software for data management reduces the chances of data mishandling and simplifies the procedure of transcript preparation. However, the extensive process of converting audio recordings to transcripts has a higher potential for misinterpretation of information. The qualitative analysis of the data in the research was performed by the use of a modified version of Stevick-Coalazzi-Keen's technique. The researcher used extensive triangulation, peer-reviewing, and thematic categorization to analyze the research data significantly. The integration of extensive data analysis techniques ensured that the research outcomes were relevant and the validity of the research outcomes to the graduate nurses (Brown, 2019). 

Results

The research outcomes were subsequently categorized into four themes with twelve subthemes. The thematic research outcomes were listed as adaptability during the transition period, strategies for clinical practice, application of knowledge into practice, and effect of the simulation in handling clinical challenges. The study effectively addressed the challenges based on the insights and perspectives of graduate nurses during the transition phase. The research also suggested future modifications in the nursing curriculum to efficiently prepare the nurses to handle the transition challenges in clinical practice. 

Part 2

Graf et al., 2020 conducted a critical analysis of different transition models, which successfully elaborate on the phases of transition experienced by a graduate nurse while taking charge of clinical practices. Transition is an indispensable part of nursing and is referred to as the process of moving from the level of student nurse to a clinical practitioner. A graduate nurse experiences several challenges during the transition period due to the lack of understanding of applying the knowledge gained in the nursing curriculum efficiently in clinical practices. Transition models assist graduate nurses in achieving an absolute understanding of the clinical implications of their role as a nurse, along with the opportunity of forming relevant strategies to adapt to everyday clinical nursing practices (Graf et al., 2020).

To understand the concept of transition models, a comparative evaluation of the Benner's and Bridges Transition models can be significantly carried out. Both the transition models are built on the framework of describing the transition phases and the importance of adaptability of the nurses in clinical practices. Bridges model of transition in nursing supports the healthcare organizations and the nurse to establish a consistent and evolving working environment. Similar to the principle framework of the Bridges transition model, Benner's transition model also allows the nurses to efficiently achieve all the stages of development to be capable of delivering quality care within the healthcare settings (Graf et al., 2020). Both the transition models in nursing comprise distinctive stages, which define the levels of development a graduate nurse must achieve before resuming their clinical practice to prevent any discrepancy or compromise in the quality of care the graduate nurses deliver (Graf et al.), 2020).

The concept of the Bridges model of transitioning proposes that graduate nurses must justify the stages of transitioning entirely and then begin the clinical practices (Miner, 2019). The model comprises three standard phases of transitioning- finishing the present scenario (Ending), screening through the emotions and overcoming the previous experiences (Letting Go), and lastly, preparing for new experiences (New Beginning). These stages of the Bridges model imply that graduate nurses should not resume their role as clinical nurses with existing or previous knowledge and experience dominant perspective (Graf et al., 2020). Graduate nurses need to attain the skill of overcoming emotions of previous experience and retain the primary learning objectives for future considerations. The Bridges model of transitioning suggests that resuming new experiences under the influence of previous experiences can impact the quality of care provided by the nurses (Miner, 2019). 

Benner’s model of transitioning is a conceptualized plan based on the Dreyfus phases of transitioning and transition shock theory (Graf et al., 2020). The standard framework of Benner's model suggests that a graduate nurse develops competence within the healthcare setting by fulfilling five stages (Sam et al., 2020). Benner's transitioning model includes student nurses as the first step of the transitioning model. According to Benner's transition model, the transition process implies that graduate nurses develop expertise and gather knowledge while providing care in healthcare settings. As per Benner's model, the five stages of transitioning comprise novice, advanced beginner, competent, proficient, and expert (Graf et al., 2020). The fulfillment of the stages of transitioning in Benner’s model inculcates competence, acquiring necessary skills, experiences, clinical procedures and education, and the application of knowledge in practical clinical settings; in the graduate nurses during their course of gaining expertise (Sam et al., 2020). 

Both models of transitioning in nursing practice reflect applying knowledge into clinical practice to deliver quality patient-centric care. The significant difference in the ideological framework of the models presents the different perspectives of transitioning for graduate nurses. Benner's model of transitioning suggests that graduate nurses to achieve a neutral perspective prior to the beginning of their clinical role. However, in Benner's model, the graduate nurses are included as part of the transitioning process, which implies that- to gain adequate expertise in clinical settings equivalent contribution of the knowledge possessed by the graduate nurses (Sam et al., 2020). Another variation of concept between both the models is that the Bridges transition model is applied after a student nurse graduates (Miner, 2019), while the Benner's model of transitioning begins from the learning stage of the graduate nurses. The skill acquiring aspect of the Benner's transitioning model suggests the consistent flow of knowledge maintained by the graduate nurses. In case of Bridges model of transitioning the nurses are required to overcome past experiences and begin afresh. Both the transition models have significant effects on the graduate nurses' transition and explain the importance of the process to ensure enhanced clinical practices (Graf et al., 2020). 

Reference 

Brown, J. E. (2019). Graduate nurses’ perception of the effect of simulation on reducing the theory-practice gap.  Sage Open Nursing,  5. https://doi.org/10.1177%2F2377960819896963

Graf, A. C., Jacob, E., Twigg, D., & Nattabi, B. (2020). Contemporary nursing graduates’ transition to practice: A critical review of transition models.  Journal of Clinical Nursing,  29 (15-16), 3097-3107. https://doi.org/10.1111/jocn.15234

Miner, L. A. (2019). Transition to nursing academia: A positive experience.  The Journal of Continuing Education in Nursing ,  50 (8), 349-354. https://doi.org/10.3928/00220124-20190717-05

Sam, G., Leong, T. M., & Aini, A. (2020). Competence-based frameworks in nursing–a concept analysis.  Journal of Applied Learning and Teaching ,  3 (1), 90-97. https://journals.sfu.ca/jalt/index.php/jalt/article/download/183/153/667

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