title: A systematic review of the effectiveness of strategies and interventions to improve the transition from student to newly qualified nurse.
abstract: BACKGROUND
  The transition from student to newly qualified nurse can be stressful for many newly qualified nurses who feel inadequately prepared. A variety of support strategies to improve the transition process have been reported across the international literature but the effectiveness of such strategies is unknown.
  
  
  OBJECTIVE
  To determine the effectiveness of the main strategies used to support newly qualified nurses during the transition into the clinical workplace and, where identified, evaluate the impact of these on individual and organisational outcomes.
  
  
  METHODS
  Systematic review.
  
  
  METHODS
  A search of electronic databases to identify published studies (CINAHL, MEDLINE, British Nursing Index, Cochrane Library, EMBASE, PsychLit, PsychINFO, PsychARTICLES, Web Of Science, EBM Reviews, BioMed, TRIP, ERIC, SCOPUS (January 2000-April 2011) was conducted. Relevant journals were hand-searched and reference lists from retrieved studies were reviewed to identify any further studies. The search was restricted to English language papers. The key words used were words that described new graduate nurses and support strategies (e.g. internship, residency, orientation programmes).
  
  
  METHODS
  The inclusion criteria were quantitative studies that investigated the effectiveness of support strategies for newly qualified graduate nurses. Studies that involved students in their final year of graduate study were excluded (for example extern programmes). Extraction of data was undertaken independently by two reviewers. A further two reviewers assessed the methodological quality against agreed criteria.
  
  
  RESULTS
  A total of 8199 studies were identified from the database search and 30 met the inclusion criteria for the review. The evidence suggests that transition interventions/strategies do lead to improvements in confidence and competence, job satisfaction, critical thinking and reductions in stress and anxiety for the newly qualified nurse.
  
  
  CONCLUSIONS
  This systematic review demonstrates the beneficial effects of transitional support strategies for newly qualified nurses from the perspective of the new nurse and their employer. The overall impact of support strategies appears positive, irrespective of the type of support provided. This may suggest that it is the organisations' focus on new graduate nurses that is important, rather than simply leaving them to acclimatise to their new role themselves. Future research should involve well designed randomised controlled trials with larger sample sizes, using more objective and reliable outcome measures.
authors.affiliation: The Wales Centre for Evidence-Based Care, a Collaborating Centre of the Joanna Briggs Institute, School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Eastgate House (4th Floor), 40-43 Newport Road, Cardiff CF24 0AB, United Kingdom. Electronic address: edwardsdj@cardiff.ac.uk.
authors.forename: Deborah
authors.initials: D
authors.lastname: Edwards
authors.affiliation: The Wales Centre for Evidence-Based Care, a Collaborating Centre of the Joanna Briggs Institute, School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Eastgate House (4th Floor), 40-43 Newport Road, Cardiff CF24 0AB, United Kingdom.
authors.forename: Clare
authors.initials: C
authors.lastname: Hawker
authors.affiliation: The Wales Centre for Evidence-Based Care, a Collaborating Centre of the Joanna Briggs Institute, School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Eastgate House (4th Floor), 40-43 Newport Road, Cardiff CF24 0AB, United Kingdom.
authors.forename: Judith
authors.initials: J
authors.lastname: Carrier
authors.affiliation: The Wales Centre for Evidence-Based Care, a Collaborating Centre of the Joanna Briggs Institute, School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Eastgate House (4th Floor), 40-43 Newport Road, Cardiff CF24 0AB, United Kingdom.
authors.forename: Colin
authors.initials: C
authors.lastname: Rees
mesh_terms: D019049:Developed Countries; D008611:Mentors; D009740:Nursing Staff; D010563:Personnel Turnover; D011231:Preceptorship; D013338:Students, Nursing
keywords: Internship; Mentorship; New graduate nurses; Orientation; Preceptorship; Residency; Simulation; Transition