The Effect of Nursing Residency Program on the Clinical Competency of Novice Nurses Working in the ICU & NICU from the Viewpoint of Head Nurses

Main Article Content

Azita Monshizadeh Khadijeh Nasiriani Mahsa Khodayarian Hosein Shakerfar


Background: The ultimate goal of nursing is to ensure the recovery and health of patients through providing high quality care. However, novice nurses who are working in clinical settings need help and are not aware of the system's expectations. In this study, we investigated the effect of a nursing residency program on the clinical competence of novice nurses working in the intensive care units of Yazd governmental hospitals from the viewpoint of head nurses.

Methods: In this interventional study, the clinical competence of 31 novice nurses was studied. The participants were randomly assigned into two groups of experimental and control. The nursing residency program consisted of 20 hours of training, support, and counseling in eight months for the experimental group. Data gathering tool in this study was a clinical competence questionnaire for novice nurses. The head nurses filled out the questionnaires before, immediately after, and three months after the training course. Data were then analyzed by SPSS (version 22) and running independent t-test, and repeated analysis of variance.

Results: according to the viewpoint of the head nurses, The clinical competence scores of novice nurses working in the ICUs & NICU, were (150.15 ± 23.1), (174.35 ± 2.75), and (168.3 ± 32.45) for the experimental group and (134.75 ± 24.75), (116.05 ± 29.7), and (146.3 ± 22) for the control group before, immediately after, and three months after the intervention, respectively. The difference between mean scores of two groups was not significant before the intervention and three months later, although of the mean scores of two groups differed significantly before the intervention and immediately after the intervention. With respect to clinical competence scores, the different between two groups was significant in three stages.

Conclusion: The results on the efficacy of nursing residency program in improving the clinical competence of novice nurses working in the ICUs & NICU were positive from the viewpoint of heads nurses. Accordingly, we propose execution of programs related to all issues over which nurses need to upgrade their clinical competencies and for the novice nurses of other parts of the hospital.

Keywords: Clinical competence, Novice nurse, Nursing residency program, Head nurses

Article Details

How to Cite
Monshizadeh, A., Nasiriani, K., Khodayarian, M., & Shakerfar, H. (2019, July 29). The Effect of Nursing Residency Program on the Clinical Competency of Novice Nurses Working in the ICU & NICU from the Viewpoint of Head Nurses. World Journal of Peri and Neonatology, 28-36. Retrieved from
Original Articles


1. Jafari Golestan N, Vanaki Z, Memarian R. Organizing “nursing mentors committee”: an effective strategy for improving novice nurses’clinical competency. Iranian J Med Edu 2008; 7(218): 237-47. [In Persian].
2. Goode CJ, Lynn MR, Krsek C, Bednash GD. Nurse residency programs: An essential requirement for nursing. Nurs Econ 2009; 27(3): 142-7.
3. Childress SB, Gorder D. Oncology nurse internships: a foundation and future for oncology nursing practice? Oncol Nurs Forum 2012; 39(4): 341-4.
4. Ravani pour M, Vanaki Z, Afsar L, Azemian A. The standards of professionalism in nursing: the nursing instructors’ experiences. Evidence Based Care 2014; 4(1): 27-40. [In Persian].
5. Hasandoost F, Ghanbari Khanghah A, Salamikohan K, Kazemnezhad E, Norouzi N. Prioritization of general clinical competence indicators from nurses’ view employed in emergency wards. J Holist Nurs Midwifery 2015, 25(4): 53-63. [In Persian].
6. Karimi-Moonaghi H, Gazerani A, Vaghee S, Gholami H, Salehmoghaddam AR, Gharibnavaz R. Relation between spiritual intelligence and clinical competency of nurses in Iran. Iran J Nurs Midwifery Res 2015; 20(6): 665-9.
7. Watson R, Stimpson A, Topping A, Porock D. Clinical competence assessment in nursing: a systematic review of the literature. J Adv Nurs 2002; 39(5): 421-31.
8. Yanhua C, Watson R. A review of clinical competence assessment in nursing. Nurse Educ
Today 2011; 31(8): 832-6.
9. Garside JR, Nhemachena JZ. A concept analysis of competence and its transition in nursing. Nurse Educ Today 2013; 33(5): 541-5.
10. Smith SA. Nurse competence: a concept analysis. Int J Nurs Knowl 2012; 23(3): 172-82.
11. Mahreini M, Moatary M, Akaberian S, Mirzaie K. Determining nurses' clinical competence in hospitals of Bushehr University of Medical Sciences by self-assessment method. Iran South Med J 2008, 11(1): 69-75.
12. Tilley S. Competency in nursing: a concept analysis. J Contin Educ Nurs 2008; 39(2): 58-64.
13. Tiwari A, Lai P. Nursing competence: too elusive to be assessed? International Conference on Assessment for Learning in Higher Education 2015; 9(1): 24-9.
14. Nesami M, Rafiee F, Parvizi S, Esmaeili R. Concept analysis of competency in nursing: Qualitative research. J Mazandaran Univ Med Sci 2008, 18(67): 35-42. [In Persian].
15. Mahdavisaeb F, Ruhani M, Hanifi N, Kamali K. Comparison of critical care nurses' clinical competency using self-assessment method and assessment by head nurses, Zanjan 2014. Preventive Care in Nursing and Midwifery Journal 2016; 6(1): 72-82. [In Persian].
16. Nobahar M. New nurses' clinical learning experience in the critical coronary care units (CCCU). J Nur Edu 2014; 3(2): 12-26.
[In Persian].
17. McKnight HM. New graduate nurse residency model. [Thesis]. Minneapolis, MN: Walden University; 2013.
18. Kim YS, Park KY. The mediating effect of professionalism in the relationship between clinical competence and field adaptation in newly graduated nurses. J Korean Acad Nurs Adm 2013; 19(4): 536-43.
19. Bull R, Shearer T, Phillips M, Fallon A. Supporting graduate nurse transition: collaboration between practice and university. J Contin Educ Nurs 2015; 46(9): 409-15.
20. Edwards D, Hawker C, Carrier J, Rees C. A systematic review of the effectiveness of strategies and interventions to improve the transition from student to newly qualified nurse. Int J Nurs Stud 2015; 52(7): 1254-68.
21. Hollinger-Smith L, Murphy MP. Implementing a residency program for the acute care nurse practitioner. Medsurg Nurs 1998; 7(1): 28-33, 36-8.
22. Bricker DJ, Pardee CJ. Nurse Experts Jump‐Start Clinical Simulation in Rehabilitation Nursing: Supporting New Graduate Transition to Competence. Nurs Educ Perspect 2011; 32(1): 34-6.
23. Baramee J, Blegen MA. New graduate perception of clinical competence: testing a causal model. Int J Nurs Stud 2003; 40(4): 389-99.
24. Klein CJ, Fowles ER. An investigation of nursing competence and the competency outcomes performance assessment curricular approach: senior students' self-reported perceptions. J Prof Nurs 2009; 25(2): 109-21.
25. Ouellette PS, Blount K. Team-Based Learning in a Graduate Nurse Residency Program. J Contin Educ Nurs 2015; 46(12): 572-6.
26. McClure E, Black L. The role of the clinical preceptor: an integrative literature review. J Nurs Educ 2013; 52(6): 335-41.
27. Missen K, McKenna L, Beauchamp A. Satisfaction of newly graduated nurses enrolled in transition‐to‐practice programmes in their first year of employment: a systematic review. J Adv Nurs 2014; 70(11): 2419-33.
28. Ghasemi E, Janani L, Dehghan Nayeri N, Negarandeh R. Psychometric properties of Persian version of the Competency Inventory for Registered Nurse (CIRN). Iran J Nurs 2014; 27(87): 1-13. [In Persian].
29. Trepanier S, Early S, Ulrich B, Cherry B. New graduate nurse residency program: A cost-benefit analysis based on turnover and contract labor usage. Nurs Econ 2012; 30(4): 207-14.
30. Verret G, Lin V. Easing the transition: an innovative generational approach to peer mentoring for new graduate nurses. J Pediatr Nurs 2016; 31(6): 745-56.
31. Wilgis M, McConnell J. Concept mapping: An educational strategy to improve graduate nurses’ critical thinking skills during a hospital orientation program. J Contin Educ Nurs 2008; 39(3): 119-26.
32. Rush KL, Adamack M, Gordon J, Lilly M, Janke R. Best practices of formal new graduate nurse transition programs: an integrative review. Int J Nurs Stud 2013; 50(3): 345-56.
33. Beyea SC, Slattery MJ, von Reyn LJ. Outcomes of a simulation-based nurse residency program. Clinical Simulation in Nursing 2010; 6(5): e169-e75.
34. Baldwin KM, Black DL, Normand LK, Bonds P, Townley M. Integrating Retired Registered Nurses Into a New Graduate Orientation Program. Clin Nurse Spec 2016; 30(5):