Strengthen academic–practice partnerships.
For decades, stakeholders in nursing practice have expressed concerns about the readiness of new graduate nurses to meet the demands of bedside care. Rather than dwelling on this challenge, a constructive approach begins with recognizing the unrealistic expectation of a fully practice-ready new graduate nurse.
Using the Del Bueno Performance-Based Development System, Kavanagh and Sharpnack analyzed aggregate data collected from 2016 to 2020. The findings revealed that only 14% of recently graduated RNs met acceptable assessment standards; 29% struggled to recognize urgent patient conditions or changes in status; and 57% demonstrated areas for growth in managing patient care. Specifically, they struggled to select appropriate nursing interventions, effectively communicate critical information to the healthcare team, and provide well-reasoned justifications for their clinical decisions.
A significant gap exists between employer expectations of new nurses and the academic preparation of prelicensure nursing programs. Misalignment in competency assessment contributes to this disconnect—new graduates frequently are evaluated at a competent level when, according to Benner’s model of skill acquisition, they’re still at the novice stage.
Nurse preceptor: Six emerging domains
New nurses and clinical judgment
Experience remains the defining factor in determining a new nurse’s readiness for practice, but real-time clinical exposure with actual patients is critically insufficient in prelicensure education. The curricula continue to follow a generalist approach, but clinical practice has become increasingly specialized. As a result, new graduates frequently enter complex specialty areas without adequate academic preparation tailored to these fields.
The lack of a universally accepted definition of competence complicates new nurse assessment. Academia primarily measures competency through cognitive learning, with test scores serving as a proxy for preparedness. In contrast, clinical practice evaluates psychomotor skills and workflow efficiency. Although the American Association of Colleges of Nursing defines competency as “an observable ability of a health professional, integrating multiple components such as knowledge, skills, values, and attitudes,” no standardized validated tool exists for nursing schools to assess competency effectively. This gap persists despite the delineation of core competencies in the 2021 The Essentials: Core Competencies for Professional Nursing Education.
Call to action
Academia acknowledges the importance of integrating clinical partners into curriculum development, but true collaboration remains rare. Strengthening academic–practice partnerships requires various strategies, such as granting academic appointments to practice leaders and encouraging faculty participation in unit practice councils.
Sustaining these partnerships necessitates collaboration and financial investment. The implementation of dedicated education units (DEUs) and nurse residency programs can enhance learning outcomes and clinical competence, improve staff retention, and support professional development. With structured oversight, incentives for preceptors, and robust program evaluation, DEUs can offer significant, mutually beneficial advantages for nursing schools and clinical partners.
Some state boards of nursing have established specific requirements for clinical hours and types of experiences, but others have no mandated minimum. A national initiative to standardize clinical hour requirements for prelicensure programs and improve the quality of clinical instruction would provide students with more meaningful, real-time patient interactions.
The shift toward competency-based education holds significant promise for improving the practice readiness of new nurses. We must acknowledge that although new graduates may not enter the workforce fully practice-ready, they’re adaptable and strive to provide safe care.
Fidelindo Lim, an American Nurse Journal editorial board member, is a clinical associate professor in the Rory Meyer College of Nursing at New York University in New York City.
American Nurse Journal. 2025; 20(6). Doi: 10.51256/ANJ062560
References
American Association of Colleges of Nursing. The Essentials: Core Competencies for Professional Nursing Education. 2021. aacnnursing.org/Portals/0/PDFs/Publications/Essentials-2021.pdf
Kavanagh, J. M., Sharpnack, P. A. (2021, January 31). Crisis in competency: A defining moment in nursing education. The Online Journal of Issues in Nursing. https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_electronic_sources.html
Marcellus L, Jantzen D, Humble R, Sawchuck D, Gordon C. Characteristics and processes of the dedicated education unit practice education model for undergraduate nursing students. A scoping review. JBI Evid Synth. 2021;19(11):2993-3032. doi:10.11124/JBIES-20-00462
Van Camp J, Chappy S. The effectiveness of nursing residency programs on retention: A systematic review. AORN J. 2017;106(2):128-44. doi:10.1016/j.aorn.2017.06.003
