How Prepared Are New Nurse Graduates for Practice Today? Clinical Judgement Skills Identified as a Primary Gap in Practice Readiness According to Wolters Kluwer Report

Wolters Kluwer Report Examines the Widening Gap Between Education and Practice Magnified in a Post COVID-19 Reality

Wolters Kluwer, Health released a report that provides a retrospective snapshot of the perceived strengths and weaknesses of nurse graduates signaling a lack in clinical judgement skills as a primary gap in their readiness for practice. “Closing the Nursing Education-Practice Readiness Gap” reveals that nurse graduates today are not fully prepared for clinical practice and presents opportunities to rethink what practice-ready nursing looks like. The findings are based on the latest Wolters Kluwer New Nurse Readiness Survey conducted in early 2020 as COVID-19 was beginning to spread globally. This is the third survey since 2012 to assess perceptions of new nurses’ clinical preparedness from the perspective of nursing faculty, hiring managers in practice, and new nurse graduates themselves.

“Technology is increasingly a factor in student preparedness as innovations in evidence-based learning platforms and personalized, adaptive technology combined with simulation solutions are helping to drive the development of clinical judgement.”

According to the 2020 survey, today’s nurse graduates are no more confident to practice than those in 2012. Only 20% of new nurses surveyed reported being very strong in their general knowledge of nursing, while 66% of practicing nurse respondents believe today’s nurse graduates are less prepared to enter practice than those graduating five to ten years ago. The findings also show that students’ lack of confidence is an indicator of their preparedness for the realities of practice in today’s complex healthcare system.

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Evidence shows that the gaps in nursing education and practice for new graduates can be attributed to ineffective communication, the complexity of the clinical environment, lack of knowledge about patient care, and lack of experience working in teams. As COVID-19 has put further emphasis on ensuring that nurses are better prepared for practice, the report calls for a foundational change of stronger collaboration among educators and practicing nurses to co-develop programs to close the gaps and help ease new nurses into practice more efficiently while building a culture of learning that will allow them to practice with increased confidence.

“Our survey calls attention to real learning opportunities for nurses in both academic and practice settings to look at nurse preparedness in a new way and to advance a ‘practice makes ready’ approach that will build critical thinking skills and ensure that nurses entering the rapidly evolving and complex healthcare system are competent and confident,” said Julie Stegman, vice president, Nursing Segment, Health Learning, Research and Practice, Wolters Kluwer. “Technology is increasingly a factor in student preparedness as innovations in evidence-based learning platforms and personalized, adaptive technology combined with simulation solutions are helping to drive the development of clinical judgement.”

Access to better technology ranked highest across the board as a key factor for nurse graduates today being more prepared. 76% of student respondents agree that incorporating technology into their learning helps to better prepare them for their nursing career. For example, with fewer available clinical learning sites, faculty and nursing students are turning to simulation, including virtual simulation, for realistic case-based patient scenarios presented in a safe environment to build clinical judgement skills. Digital and AI-powered tools within online learning platforms offer advantages with personalized learning techniques to improve student pass rates on the National Council Licensure Examination (NCLEX), to gain exposure to tools used in practice, such as Lippincott Advisor and electronic health records (EHRs), and to increase the use of course content that reinforces clinical reasoning.

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Survey methodology

Wolters Kluwer New Nurse Readiness Survey was conducted in January and February 2020, comprised faculty, program directors and deans on the education side, and nurse managers, nurse educators, and directors of nursing on the practice side. Following surveys conducted in 2012 and 2016, this survey was designed to measure how perceptions among the respondents may have changed over time. In total, 572 valid responses were collected with 316 respondents (55%) in education settings and 256 respondents (45%) in practice settings.