Abstract
Newly graduated nurses (NGNs) face disproportionately high turnover rates compared to experienced nurses, with estimates ranging from 18% to 43% globally1. This persistent challenge has prompted increased attention to transition-to-practice programs, which aim to support NGNs during their critical first year of work3. Research has identified key facilitators and barriers to successful transition through thematic analysis; however, their recommendations lacked direct input from NGNs themselves, highlighting a gap in participatory approaches3. Understanding the transition experience from NGNs and mentors is essential to design effective, responsive supports5. The urgency of this issue has been amplified by the global nursing shortage, which has left health systems struggling to retain and support their workforce4.
This research explores the use of Experience-Based Co-Design (EBCD) to identify challenges that NGNs experience in transition to practice, and to co-design solutions with NGNs and mentors, aiming to create more inclusive, effective, and sustainable solutions to support NGNs in complex, evolving practice environments. NGNs were recruited from across Ontario, Canada. Two additional groups participated as mentors: nurse educators and administrators who were recruited through targeted emails sent to specific groups within the association’s member database. Participants who responded to the expression of interest were selected semi-randomly to ensure that there was diversity of race, gender, ethnicity and geographic location within the province of Ontario. Nine NGNs and 11 mentors were individually led through semi-structured interviews during the discovery phase of the project. The interview transcripts were analyzed using a structured text analytics workflow designed to extract meaningful themes supporting a deeper understanding of challenges and opportunities for improvement.
Emerging themes related to transition to practice from the interviews included emotional and professional challenges; time management and prioritization; support systems and mentorship; workplace culture and team dynamics; clinical confidence and skill acquisition; systemic barriers and staffing pressures; financial stress and employment barriers; and orientation and NGG program effectiveness.
This presentation will outline the EBCD methodology as a tool that can be used for process improvement outside of direct care and highlight participants-identified themes and next steps.
Notes
Presenter notes available in attached slide deck. To see the notes in Adobe Acrobat, go to Tools > Comment or look at your Layers Panel. If the notes were saved as comments or layers, you can toggle them visible.
References:
1. Bae, S.-H. (2022). Noneconomic and economic impacts of nurse turnover in hospitals: A systematic review. International Nursing Review, 69(3), 392–404. https://doi.org/10.1111/inr.12769
2. Charette, M., Robitaille, A., Bouchard, J., Quesnel, É., Ledoux, I., & Caty, M.-È. (2025). “How Can We Do Better?”: A Case Study of a Pre-Implementation Analysis of a Residency Program for New Graduate Nurses in Canada. The Canadian Journal of Nursing Research, 57(3), 390–405. https://doi.org/10.1177/08445621251336503
3. Hallaran, A. J., Edge, D. S., Almost, J., & Tregunno, D. (2023). New Nurses’ Perceptions on Transition to Practice: A Thematic Analysis. Canadian Journal of Nursing Research, 55(1), 126–136. https://doi.org/10.1177/08445621221074872
4. Halverson, K. L., Lalonde, M., Duchscher, J., Xin, S., Currie, C., & Raynak, A. (2025). Optimizing Academic-Practice Partnerships to Promote Transition to Nursing Practice. Canadian Journal of Nursing Research, 08445621251366583. https://doi.org/10.1177/08445621251366583
5. Hussein, R., Everett, B., Ramjan, L. M., Hu, W., & Salamonson, Y. (2017). New graduate nurses’ experiences in a clinical specialty: a follow up study of newcomer perceptions of transitional support. BMC Nursing, 16(1), 42. https://doi.org/10.1186/s12912-017-0236-0
Sigma Membership
Non-member
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Transition to Practice or Onboarding, Workforce, Mentoring and Coaching, Novice Nurses, Transitional Programs, Clinical Competence
Recommended Citation
Hoffarth, Morgan; Mihan, Robert; Naik, Shanoja; Wimalarathna, Hasitha; and Grinspun, Doris, "Co-Designing Success: Supporting New RNs in Their Transition to Practice" (2026). International Nursing Research Congress (INRC). 110.
https://www.sigmarepository.org/inrc/2026/presentations_2026/110
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-08-03
Co-Designing Success: Supporting New RNs in Their Transition to Practice
Toronto, Ontario, Canada
Newly graduated nurses (NGNs) face disproportionately high turnover rates compared to experienced nurses, with estimates ranging from 18% to 43% globally1. This persistent challenge has prompted increased attention to transition-to-practice programs, which aim to support NGNs during their critical first year of work3. Research has identified key facilitators and barriers to successful transition through thematic analysis; however, their recommendations lacked direct input from NGNs themselves, highlighting a gap in participatory approaches3. Understanding the transition experience from NGNs and mentors is essential to design effective, responsive supports5. The urgency of this issue has been amplified by the global nursing shortage, which has left health systems struggling to retain and support their workforce4.
This research explores the use of Experience-Based Co-Design (EBCD) to identify challenges that NGNs experience in transition to practice, and to co-design solutions with NGNs and mentors, aiming to create more inclusive, effective, and sustainable solutions to support NGNs in complex, evolving practice environments. NGNs were recruited from across Ontario, Canada. Two additional groups participated as mentors: nurse educators and administrators who were recruited through targeted emails sent to specific groups within the association’s member database. Participants who responded to the expression of interest were selected semi-randomly to ensure that there was diversity of race, gender, ethnicity and geographic location within the province of Ontario. Nine NGNs and 11 mentors were individually led through semi-structured interviews during the discovery phase of the project. The interview transcripts were analyzed using a structured text analytics workflow designed to extract meaningful themes supporting a deeper understanding of challenges and opportunities for improvement.
Emerging themes related to transition to practice from the interviews included emotional and professional challenges; time management and prioritization; support systems and mentorship; workplace culture and team dynamics; clinical confidence and skill acquisition; systemic barriers and staffing pressures; financial stress and employment barriers; and orientation and NGG program effectiveness.
This presentation will outline the EBCD methodology as a tool that can be used for process improvement outside of direct care and highlight participants-identified themes and next steps.
Description
Newly graduated nurses face high turnover rates, worsened by COVID-19 and workforce shortages. Using Experience-Based Co-Design (EBCD), this study engaged NGNs, educators, and administrators to identify transition challenges and co-create solutions. Interviews revealed themes such as emotional strain, mentorship, workplace culture, and systemic barriers. EBCD shows promise for improving transition processes, with next steps focused on collaborative solution design.