Differences in Knowledge Base at First Registered Nurse Employment Following Introduction of a Focused, High-Fidelity Simulation in a Baccalaureate Program

New graduate registered nurses (NGRNs), armed with a degree and having passed the licensure exam, regularly have difficulty in transitioning to registered nurse practice. This phenomenon has been a part of the professional community for decades. Central to the problem of knowledge gaps at hire is the debate on what competencies are required of the new graduate and what challenges the new graduate faces. In a qualitative study of NGRNs, commonalities of their experiences were elicited. Problematic communication with physicians, concern over their ability to supervise unlicensed personnel, and the impact of horizontal violence from experienced nurses were all part of the transition process.1 Competence in the clinical setting has been found to be positively correlated with empowerment; empowerment includes such factors as courage, autonomy and innovativeness.2 Organizational factors have a direct impact on empowerment. Academic preparation is key to communication skills and the ability to prioritize.