Abstract
Background: The transition from student to professional nurse is often challenging, marked by stress, role confusion, and limited confidence in clinical practice. This study addresses a critical gap in research by exploring the readiness of Omani nursing graduates for professional practice, focusing on their knowledge, clinical competencies, and factors influencing their transition. Methodology: A descriptive cross-sectional study was conducted across multiple healthcare institutions in Oman, targeting recent nursing graduates and participants in internship programs. Data were collected using the 2023 Casey-Fink Graduate Nurse Experience Survey, a validated tool with a Cronbach's alpha of 0.890. Statistical analyses, including descriptive statistics, ANOVA, and independent t-tests, were performed using SPSS Version 23 to evaluate participants' perceived readiness and competencies. Results: The study included 194 novice nurses, with 86% from the Oman College of Health Sciences. The mean overall knowledge score was 3.56/4, highlighting high perceived competency. However, significant gaps were identified in areas such as initiating IV therapy (M=2.23), administering blood products (M=1.78), and managing violent patients (M=1.80). Confidence in clinical tasks like EKG interpretation and rapid response initiation was also limited. Participants in structured programs, such as internships and enhancement initiatives, reported slightly higher readiness scores, though differences were not statistically significant (p>0.05). Stress emerged as a pervasive challenge, with 46.9% strongly agreeing that work-induced stress impacted their performance. Conclusions: This study reveals substantial variability in the readiness of Omani novice nurses, emphasizing the need for enhanced clinical training, mentorship, and targeted interventions to address competency gaps. The findings provide valuable insights for nursing educators, internship coordinators, and policymakers in refining curricula and support programs to improve graduate preparedness for clinical practice.
Keywords
Nursing Education, Readiness for Practice, Novice Nurses, Clinical Competency, Transition to Practice, Competence
1. Introduction
The healthcare system in Oman has significantly evolved over recent decades, a transformation that has been mirrored globally due to the increased demand for a skilled national nursing workforce. This demand is part of a larger narrative of a global shortage of nurses and the challenges faced by nursing schools in preparing graduates to deliver safe, effective, and compassionate care. Worldwide, novice nurses often enter the workforce with limited practice and confidence, hindering their ability to navigate the complexities of high-acuity patient care
| [1] | Duchscher, J. B. (2008). A process of becoming: The stages of new nursing graduate professional role transition. The Journal of Continuing Education in Nursing, 39(10), 441–450. https://doi.org/10.3928/00220124-20081001-03 |
[1]
.
Nursing education is vital in equipping graduates for competent practice amidst dynamic healthcare advancements. However, bridging the gap between theory and practice remains a significant challenge
| [2] | Casey, K., Fink, R., Jaynes, C., Campbell, L., Cook, P., & Wilson, V. (2011). Readiness for practice: the senior practicum experience. The Journal of Nursing Education, 50(11), 646–652. https://doi.org/10.3928/01484834-20110817-03 |
| [3] | Pandya B, Ruhi U and Patterson L (2023) Preparing the future workforce for 2030: the role of higher education institutions. Frontiers in Education. 8: 1295249. https://doi.org/10.3389/feduc.2023.1295249 |
[2, 3]
. While readiness for practice lacks a unified definition, it is widely accepted as possessing the essential knowledge and skills for safe, independent nursing practice upon graduation
| [4] | Romyn, D. M., Linton, N., Giblin, C., Hendrickson, B., Limacher, L. H., Murray, C., Nordstrom, P., Thauberger, G., Vosburgh, D., Vye-Rogers, L., Weidner, A., & Zimmel, C. M. (2009). Successful transition of the new graduate nurse. International Journal of Nursing Education Scholarship, 6. https://doi.org/10.2202/1548-923X.1802 |
| [5] | Missen, K., McKenna, L., & Beauchamp, A. (2015). Work readiness of nursing graduates: current perspectives of graduate nurse program coordinators. Contemporary Nurse, 51(1), 27–38. https://doi.org/10.1080/10376178.2015.1095054 |
[4, 5]
.
Transitioning from student to professional nurse is often marked by stress, role confusion, and reality shock
| [6] | Casey, K., Fink, R., Krugman, M., & Propst, J. (2004). The graduate nurse experience. The Journal of Nursing Administration, 34(6), 303Y311. https://doi.org/10.1097/00005110-200406000-00010 |
| [7] | Catton, H. (2020). Global challenges in health and health care for nurses and midwives everywhere. International Nursing Review, 67(1), 4–6. |
| [8] | Sandler, M. (2018). Why are new graduate nurses leaving the profession in their first year of practice and how does this impact on ED nurse staffing? A rapid review of current literature and recommended reading. Canadian Journal of Emergency Nursing, 41(1), 23-24. |
[6-8]
. Newly graduated nurses must independently apply their knowledge and skills in real and critical patient care situations, highlighting the need for robust preparation during nursing education. Despite efforts to enhance clinical training, novice nurses often report gaps in areas such as pharmacology, pathophysiology, leadership, and electronic health record management
.
While existing studies highlight the importance of enhanced clinical training and mentorship
, there is a significant gap in research examining the readiness of Omani nursing graduates for clinical practice. This study seeks to fill this gap by exploring the perceptions of novice nurses regarding their preparedness for clinical roles and identifying factors that support or hinder their transition. The findings aim to provide valuable insights for nursing schools, internship program coordinators, and healthcare policymakers in Oman.
Novice nurses frequently experience stress, role adjustment challenges, and reality shock during their early employment
11]. Limited exposure to acutely ill patients during training can exacerbate this shock and contribute to early turnover
| [12] | Beecroft, P., Kunzman, L., Taylor, S., Devenis, E., & Guzek, F. (2004). Bridging the gap between school and workplace. Journal of Nursing Administration, 34(7/8), 338-345. |
| [13] | Candela, L., & Bowles, C. (2008). Recent RN graduate perceptions of educational preparation. Nursing Education Perspectives, 29, 266-277. |
[12, 13]
. Internship programs have proven effective in facilitating smoother transitions, improving patient care outcomes, and enhancing job satisfaction
| [14] | Goode, C. J., & Williams, C. A. (2004). Post-baccalaureate nurse residency program. The Journal of Nursing Administration, 34(2), 71–77. https://doi.org/10.1097/00005110-200402000-00004 |
| [15] | Goode, C. J., Lynn, M. R., Krsek, C., & Bednash, G. D. (2009). Nurse residency programs: an essential requirement for nursing. Nursing Economics, 27(3), 142–148. |
| [16] | National Council of State Boards of Nursing. (2009). The impact of transition experience on practice of newly licensed registered nurses. Retrieved from http://www.ncsbn.org |
| [17] | Al Hajri, A., Al Battashi, M. (2023). New nurses’ transition to practice experience after completion of the enhancement training program in the Sultanate of Oman. Journal of Nursing Education and Practice, 13(10), 36-44. https://doi.org/10.5430/jnep.v13n10p36 |
[14-17]
.
Hickey (2009)
highlights the critical responsibility of nursing schools in addressing knowledge and practice gaps to prepare graduates for safe care delivery. Frameworks such as Benner et al.'s (2010)
| [19] | Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Educating nurses: A call for radical transformation. San Francisco, CA: Jossey-Bass. |
[19]
call for radical transformation emphasizes the importance of equipping novice nurses with confidence and practical skills to thrive in clinical environments. This study builds on prior research by focusing on the perceptions of Omani nursing graduates about their readiness for practice, addressing a significant knowledge gap in the Sultanate of Oman.
This study explores the perceptions of Omani nursing graduates participating in internship programs regarding their knowledge and clinical competencies in delivering safe patient care. The objectives of this study were to assess the perceived knowledge and clinical competency levels of newly graduated Omani nurses, to examine variations in perceived clinical competencies among new Omani graduate nurses across different healthcare settings, and to identify specific areas of clinical practice where newly graduated Omani nurses feel least prepared.
This study sought to answer the following research questions: What is the perceived knowledge and clinical competency level among new Omani graduate nurses? How do perceived competencies vary across different clinical settings? In which areas of clinical practice do new Omani graduates feel least prepared?
This study provides critical insights into the challenges faced by novice nurses in Oman, addressing knowledge, skills, and practice gaps to enhance nursing education and healthcare delivery. Its findings can guide curriculum revisions, professional development programs, and mentorship initiatives to better prepare graduates for clinical roles.
The results of this study can significantly contribute to improving patient care, reducing nurse turnover, and fostering a sustainable workforce by creating supportive environments for novice nurses. Policymakers and educators can use this study to develop strategies for resource allocation, professional training, and curriculum enhancement, ensuring that nursing graduates meet the demands of modern healthcare. The urgency and importance of this research cannot be overstated.
This research also provides a solid foundation for future studies and comparative analyses in diverse cultural and healthcare contexts. By supporting innovative educational practices and workforce development strategies, this study's findings can inspire further exploration of the topic and contribute to the ongoing improvement of nursing education and healthcare delivery.
The literature review explores relevant research on the transition from nursing education to professional practice, focusing on work readiness, challenges, and strategies to facilitate new graduates’ integration into clinical roles. Using six databases, including PubMed and CINAHL®, and keywords such as "transition," "work readiness," and "nursing education," the review spans studies from Oman and neighboring regions.
Nursing education in Oman began in 1970 with a two-year program by the American Missionary Association. Over the decades, it evolved into multiple institutes, specialized training centers like the Oman Specialized Nursing Institute, and programs at institutions such as Sultan Qaboos University and the University of Nizwa. This growth reflects Oman’s commitment to developing a skilled nursing workforce to meet healthcare needs. However, studies highlight the persistent challenges faced by novice nurses during the transition to practice.
Transition-to-practice studies in Oman reveal that enhancement training programs improve new nurses’ confidence in patient care, communication, and task prioritization, though personal and work-related stressors remain significant. Al Hajri and Al Battashi (2023)
| [17] | Al Hajri, A., Al Battashi, M. (2023). New nurses’ transition to practice experience after completion of the enhancement training program in the Sultanate of Oman. Journal of Nursing Education and Practice, 13(10), 36-44. https://doi.org/10.5430/jnep.v13n10p36 |
[17]
surveyed 313 new nurses using the Casey-Fink Graduate Nurse Experience Survey, finding confidence in clinical skills (
M=3.11,
SD=0.59) and communication with patients (
M=3.19,
SD=0.65), yet moderate dissatisfaction with management-related aspects like time off (
M=2.41,
SD=1.31). Similarly, Al-Rawajfah et al. (2023)
| [20] | Al-Rawajfah, O. M., AlBashayreh, A., Sabei, S. D. A., Al-Maqbali, M., & Yahyaei, A. A. (2023). Role transition from education to practice and its impact on the career futures of Omani nurses. Nurse Education in Practice, 68, 103594. https://doi.org/10.1016/j.nepr.2023.103594 |
[20]
assessed 405 nurses and identified factors such as age and orientation duration significantly influencing transition experiences (
β=-0.007,
p=.018). The study emphasized the need for national strategies to support graduates.
Regional studies support these findings. In Egypt, Akeel and Kabeel (2023)
| [21] | Akeel, A., Kabeel, A. (2023). Nursing Interns' Orientation Program: A Predictor of Improving Nursing Interns' Knowledge About Professional Nursing Practice. Egyptian Journal of Nursing & Health Sciences. 4(2). https://doi.org/10.21608/ejnhs.2023.339486 |
[21]
demonstrated significant knowledge improvements (96%) among interns after orientation programs (
p<0.0001). In Jordan, Al-Yatim et al. (2023)
| [22] | Al-Yatim, S., Al-Ola, L., Al-Yateem, N. (2023). Enhancing Nursing Graduate Readiness for Practice through Leadership Competence: A Correlational Study. Jordan Medical Journal. 57(4). https://doi.org/10.35516/jmj.v57i3.1680 |
[22]
found moderate readiness among new graduates (
M=3.58,
SD=0.8), with leadership competencies correlating with readiness for practice (
p=0.02). However, gaps remain in decision-making and stress management under pressure.
In the UAE, AlMekkawi and El Khalil (2022)
| [23] | AlMekkawi, M., El Khalil, R. (2022). Undergraduate Nursing Students' Readiness to Practice: Views of the Senior Students in the United Arab Emirates. Nurse Educator. 47 (4), E86–E90. |
[23]
identified low confidence among nursing students in specific procedures and managing multiple patients, with limited perceived benefits from simulations (
M=2.70,
SD=0.93). Students called for increased clinical placements and diverse experiences to boost readiness. Similarly, Robinson (2019)
highlighted alignment between educators’ and leaders’ expectations of new graduates’ competencies, suggesting a need for enhanced preparation in critical thinking and leadership.
Broader studies, such as Missen et al. (2016)
| [25] | Missen, K., McKenna, L., Beauchamp, A., & Larkins, J. (2016). Qualified nurses’ rate new nursing graduates as lacking skills in key clinical areas. Journal of Clinical Nursing, 25(15–16), 2134-2143. https://doi.org/10.1111/jocn.13316 |
[25]
and Dwyer and Revell (2016)
, emphasize the gap between knowledge and practical application, with new nurses feeling unprepared for tasks like medication administration. Emotional intelligence (EI) and psychological capital (PsyCap) also influence readiness. Mashigo (2014)
identified EI factors like optimism and emotional management as predictors of job competence (
r=-.28,
p=.00). Caballero et al. (2011)
| [28] | Caballero, C., Walker, A., & Fuller-Tyszkiewicz, M. (2011). The Work Readiness Scale (WRS): Developing a measure to assess work readiness in college graduates. Journal of Teaching and Learning for Graduate Employability, 2(2), 41-54. |
[28]
developed a Work Readiness Scale (WRS) that underscores attributes such as personal qualities and organizational skills essential for workforce integration.
Overall, the literature underscores the importance of targeted interventions, including orientation programs and emotional development, to address new nurses’ challenges and enhance their readiness for clinical practice. Further research on self-assessed clinical competence and structured support strategies is essential to ensure successful transitions into professional roles.
2. Methodology
2.1. Study Area
The study was conducted across multiple institutions and healthcare facilities in Oman, targeting recent graduates from Sultan Qaboos University, the University of Nizwa, the University of Buraimi, and the Oman College of Health Sciences. Additionally, data were collected from 13 Ministry of Health hospitals that hosted trainees in internship and enhancement programs. These included three tertiary hospitals in Muscat—Al-Nahdha Hospital, Khoula Hospital, and Royal Hospital—and ten secondary hospitals located in various governorates: Bosher Renal Dialysis Unit, Al-Buraimi Hospital, Khasab Hospital, Ibra Hospital, Sohar Hospital, Rustaq Hospital, Sur Hospital, Nizwa Hospital, Ibri Hospital, and Sultan Qaboos Hospital in Salalah. The diverse settings ensured a representative sample of novice nurses across the Sultanate of Oman.
2.2. Study Design
A descriptive cross-sectional design was employed to assess the knowledge and clinical competency levels of novice Omani nurses in delivering safe patient care. The data collection period, from August to September 2024, was strategically chosen to align with the graduation timeline of the 2024 academic year cohort.
2.3. Sample Size Determination
Based on sample size calculations, a target of 255 participants was identified as adequate for the study. However, 194 participants ultimately completed the survey, achieving an approximate response rate of 86%.
2.4. Sampling Technique
Convenience sampling was utilized to recruit participants, focusing on novice nurses who met the following criteria: recently graduated (within the past 12 months) from Sultan Qaboos University, the University of Nizwa, the University of Buraimi, or the Oman College of Health Sciences; had completed or were actively participating in a formal internship or orientation program; and had commenced their professional careers in Ministry of Health hospitals across Oman.
2.5. Ethical Approval
Ethical approval was obtained from the Institutional Review Board (IRB) at the Ministry of Health's Center for Studies and Research. Participation in the study was voluntary, and informed consent was secured from all participants prior to data collection. The collected data were securely stored in a password-protected computer to avoid unauthorized access.
2.6. Data Collection Instrument
The study utilized the 2023 version of the Casey-Fink Graduate Nurse Experience Survey, a validated self-report questionnaire developed by Casey and Fink (Casey et al., 2004). This tool is widely used to evaluate the experiences of newly registered nurses and assess the effectiveness of nursing residency programs. The instrument demonstrated a high level of reliability, with a calculated Cronbach’s alpha of 0.890, indicating strong internal consistency. The survey assesses eight key factors: Role Confidence, Manage Patient Care, Support, Role Satisfaction, Stress/Burnout, Resilience, Organizational Commitment, and Preceptorship. It includes four sections: demographic variables, Role Transition Experience (covering the eight sub-scales rated on a 4-point Likert scale), Preceptorship (7 items on a 4-point Likert scale), and Learning Needs Assessment of Skills (rated on a 3-point confidence scale). This comprehensive tool provides valuable insights into novice nurses' readiness and professional growth.
2.7. Method of Data Collection
After securing ethical approval, the researchers distributed a link to the Casey-Fink Graduate Nurse Experience Survey through email and social media platforms. The link was shared with Ministry of Health enhancement coordinators, nursing students in internship programs, and newly graduated nurses. Participants were given two weeks to respond, with a reminder sent midway to maximize participation. The self-administered survey ensured convenience and accessibility for respondents, contributing to the high response rate.
2.8. Data Analysis
Statistical analyses were performed using SPSS Version 23 to ensure an accurate and reliable interpretation of the data. Descriptive statistics, including mean, standard deviation, frequencies, and percentages, were utilized to characterize the study sample and assess the perceived levels of clinical competency among novice nurses.
To examine differences in perceived competencies among graduates from various nursing schools in the Sultanate of Oman, a one-way Analysis of Variance (ANOVA) test was applied. Additionally, an independent sample t-test was conducted to compare the mean scores of knowledge and practical skills between groups of novice nurses, providing insights into variations across different academic and professional contexts. This robust analytical approach ensured a comprehensive evaluation of clinical competency perceptions, facilitating meaningful comparisons and enhancing the study's credibility.
3. Results
3.1 Demographic Characteristics of Participants
This study included 194 novice Omani nurses and recent graduates, achieving a robust response rate of 86%. The majority of participants (78.9%) identified as female, with males comprising 21% of the sample. In terms of educational background, a substantial proportion (78.4%, n =152) graduated from the Oman College of Health Sciences, followed by 10.8% from the University of Buraimi, 6.7% from Sultan Qaboos University, and 4.1% from the University of Nizwa.
Academic performance among participants was notable, with 81.4% reporting a GPA of 2.75 to 3.9. Specifically, 25.3% had GPAs between 3.3 and 3.74, 23.7% reported GPAs ranging from 2.3 to 2.74, 6.7% indicated GPAs from 2.0 to 2.29, and 2.6% achieved outstanding GPAs between 3.74 and 4.0.
Regarding professional roles, the majority of participants (64%) were recent graduates, while 33% were engaged in internship programs. A smaller segment, representing 11.9%, was enrolled in the enhancement program. These findings provide valuable insights into the demographic and educational profiles of novice nurses in Oman, underscoring the diversity and readiness of this cohort to meet the demands of their emerging professional roles (
Table 1).
Table 1. Demographic Characteristics of Participants (N=194).
Variable | Category | N | % | Mean | SD |
Gender | Male | 41 | 21.1 | 1.79 | .409 |
Female | 153 | 78.9 |
Schools of Nursing Attended | Sultan Qaboos University | 13 | 6.7 | 3.61 | .852 |
University of Nizwa | 8 | 4.1 |
University of Buraimi | 21 | 10.8 |
Oman College of Health Sciences | 152 | 78.4 |
Latest GPA | 2 - 2.29 | 13 | 6.7 | 2.93 | .928 |
2.3 - 2.74 | 46 | 23.7 |
2.75 - 3.29 | 81 | 81.4 |
3.3 - 3.74 | 49 | 25.3 |
3.75 - 4 | 5 | 2.6 |
Current Status | Newly Graduated | 64 | 64 | 2.22 | .915 |
Internship | 23 | 33 |
During Enhancement Program | 107 | 11.9 |
3.2. Perceived Knowledge and Clinical Competency
The participants in this study demonstrated a relatively high overall knowledge score, with a mean of 3.56 (out of a maximum of 4). However, a detailed analysis identified areas of concern. Item 28 states,
“I consistently feel high levels of stress while at work,” recorded a lower mean score of 2.9 (
SD = 1.2), with 46.9% of participants strongly agreeing. Similarly, item 30, addressing the impact of personal life stress on work performance, had a mean score of 2.78 (
SD = 1.2), with 50.5% strongly agreeing and only 11% strongly disagreeing. These findings highlight the pervasive influence of stress on the participants’ professional and personal lives, warranting targeted interventions to enhance workplace well-being (
Table 2).
Table 2. Perceived knowledge and clinical competency N=194.
| Items | Mean | SD |
1. | I am confident prioritizing patient care needs. | 3.84 | .630 |
2. | I feel confident delegating tasks to others. | 3.58 | .914 |
5. | I feel confident using best evidence when making clinical decisions. | 3.71 | .783 |
6. | I feel confident communicating a plan of care with patients, families, and caregivers. | 3.80 | .670 |
7. | I have confidence in my clinical decision-making skills. | 3.76 | .733 |
8. | I can accurately recognize changes in my patient's condition. | 3.78 | .694 |
9. | I can complete my patient care assignment on time. | 3.82 | .644 |
10 | I feel confident managing my patient workload. | 3.78 | .711 |
11. | I can organize my time effectively to complete my patient care tasks. | 3.81 | .657 |
12. | I can prioritize competing tasks during my shift. | 3.84 | .636 |
19. | I am satisfied with the clinical practice area I am working in currently. | 3.74 | .779 |
23. | I am satisfied with my current role in nursing. | 3.81 | .657 |
27. | I consistently feel overwhelmed by my workload. | 3.12 | 1.092 |
28. | I consistently feel high levels of stress while at work. | 2.90 | 1.150 |
29. | I feel exhausted at the end of my shift. | 3.29 | 1.082 |
30. | I am experiencing stress in my personal life that is affecting my work. | 2.78 | 1.193 |
31. | I feel overwhelmed by the patient acuity in my clinical practice area. | 3.03 | 1.119 |
| Overall mean score | 3.56 | |
3.3. Perceptions of Readiness for Professional Nursing Practice
In the domain of clinical problem-solving, mean scores were comparable across the three groups studied. Newly graduated nurses achieved a mean score of 3.63 (SD = 0.77), internship participants scored 3.64 (SD = 0.48), and those in the enhancement program recorded a slightly higher mean of 3.74 (SD = 0.46). Statistical analysis revealed no significant differences among the groups (r = 0.728, p = 0.484), suggesting uniform competence in this area regardless of group affiliation.
Regarding engagement in learning activities, the findings similarly showed no statistically significant differences across the groups (r = 1.304, p = 0.274). The mean scores were 3.70 (SD = 0.80) for newly graduated participants, 3.90 (SD = 0.30) for internship participants, and 3.82 (SD = 0.47) for those in the enhancement program. These results suggest consistent engagement in learning activities across all groups, reflecting a commitment to ongoing professional development.
Finally, practice readiness scores indicated minor group variations but did not reach statistical significance (
r = 2.337,
p = 0.099). The enhancement program participants had the highest mean readiness score (
M = 3.90,
SD = 0.46), followed closely by internship participants (
M = 3.87,
SD = 0.46), with newly graduated nurses scoring slightly lower (
M = 3.70,
SD = 0.80). While these trends suggest a positive impact of structured programs like internships and enhancement initiatives on readiness for practice, the lack of statistically significant differences underscores the need for further exploration to better understand and address potential gaps (
Table 3).
3.4. Correlation Analysis of Clinical Settings and Work Readiness
The results also indicated no significant correlation between the various clinical experience areas and the novice nurses' clinical problem-solving average score, learning activities average, and practice readiness in any of the wards (
p>.005) (
Table 4).
Table 3. Perceptions of Readiness for Professional Nursing Practice N=194.
Variables | Clinical Status | Mean | SD | F | P-value |
Clinical Problem-Solving | Newly graduate | 3.633 | .7682 | 0.728 | 0.484 |
In internship program | 3.638 | .4837 |
Started enhancement program | 3.735 | .4567 |
Learning Activities | Newly graduate | 3.700 | .7952 | 1.304 | 0.274 |
In internship program | 3.896 | .3007 |
Started enhancement program | 3.824 | .4772 |
Practice Readiness | Newly graduate | 3.703 | .8053 | 2.337 | 0.099 |
In internship program | 3.870 | .4577 |
Started enhancement program | 3.904 | .4564 |
Table 4. Correlation Analysis of Clinical Settings and Work Readiness N=194.
Clinical Settings | Clinical Problem-Solving | Learning Activities | Practice Readiness |
R-value | P-value | R-value | P-value | R-value | P-value |
Adult Medical/Surgical Ward | .009 | .899 | .007 | .921 | -.076 | .290 |
Emergency Department | .127 | .078 | .021 | .775 | -.008 | .915 |
Oncology department | .042 | .562 | .036 | .616 | -.008 | .917 |
Adult ICU | .052 | .470 | .033 | .652 | .032 | .663 |
Pediatric ICU | .135 | .060 | .095 | .187 | .057 | .433 |
Burn Unit | .131 | .068 | .052 | .475 | .029 | .691 |
Labor & Delivery | -.030 | .674 | .082 | .258 | -.076 | .294 |
Pediatric Medical/Surgical Ward | .058 | .422 | .092 | .204 | .012 | .871 |
NICU/ Newborn | .040 | .583 | .044 | .542 | .025 | .728 |
Orthopedic Ward | .106 | .141 | .040 | .580 | -.024 | .737 |
Neurology department | .028 | .701 | -.020 | .785 | -.019 | .790 |
Renal Medical Unit | .064 | .373 | .029 | .693 | .018 | .802 |
3.5. Confidence Level in Clinical Practice
The survey results reveal that newly graduated Omani nurses feel least prepared in several critical clinical practice areas. Participants reported particularly low confidence in initiating intravenous (IV) therapy (M = 2.23, SD = 0.955), administering blood products (M = 1.78, SD = 0.917), and performing nasogastric tube care (M = 2.73, SD = 0.512). Significant differences were observed among groups in these areas, with p-values of 0.005, 0.002, and 0.02, respectively.
In addition, the respondents expressed inadequate readiness in delivering handover reports (M = 2.33, SD = 0.736), interpreting electrocardiogram (EKG) or telemetry readings (M = 2.38, SD = 0.845), and initiating rapid response calls (M = 2.06, SD = 1.006). Other critical concerns included suicide risk screening (M = 1.63, SD = 0.968) and managing violent patients or their families (M = 1.80, SD = 0.929). These areas also demonstrated statistically significant differences (p < 0.05).
4. Discussion
This study aimed to explore the perceptions of novice Omani nurses regarding their readiness for clinical practice, focusing on their perceived knowledge, clinical competencies, and confidence in specific areas of practice. The findings provide critical insights into new nursing graduates' challenges in Oman, revealing strengths and areas for improvement in their clinical preparedness. This discussion will highlight the key findings, contextualize them within existing literature, and suggest strategies to address identified gaps.
4.1. Knowledge and Clinical Competency
The results indicated a high level of perceived knowledge among Omani novice nurses, with a mean score of 3.56 out of 4, suggesting that most participants felt they possessed the knowledge required for practice. This finding aligns with previous studies emphasizing the importance of a solid educational foundation in nursing
| [17] | Al Hajri, A., Al Battashi, M. (2023). New nurses’ transition to practice experience after completion of the enhancement training program in the Sultanate of Oman. Journal of Nursing Education and Practice, 13(10), 36-44. https://doi.org/10.5430/jnep.v13n10p36 |
[17]
. However, these findings also highlight the nuanced nature of perceived readiness, where general knowledge confidence does not necessarily equate to proficiency in specific clinical tasks. This study identified significant gaps in confidence and preparedness in areas such as intravenous (IV) therapy, blood product administration, and nasogastric tube care. These specific deficits raise concerns about how well nursing curricula in Oman address practical skill acquisition and reinforce the application of theoretical knowledge in real-world settings. These findings echo the work of Missen et al. (2016)
| [25] | Missen, K., McKenna, L., Beauchamp, A., & Larkins, J. (2016). Qualified nurses’ rate new nursing graduates as lacking skills in key clinical areas. Journal of Clinical Nursing, 25(15–16), 2134-2143. https://doi.org/10.1111/jocn.13316 |
[25]
, who noted that new nurses often struggle to apply this knowledge in clinical practice despite a robust knowledge background. Thus, bridging the gap between academic preparation and clinical readiness remains a critical area for improvement.
4.2. Stress and its Impact on Readiness for Practice
Another significant finding from this study was the pervasive influence of stress on participants' readiness for practice. Nearly half of the respondents reported high stress levels at work, and the majority felt that personal life stressors impacted their job performance. This reflects the "reality shock" that novice nurses often experience as they transition from student to professional roles
. High stress levels can impair clinical decision-making, job satisfaction, and retention
| [15] | Goode, C. J., Lynn, M. R., Krsek, C., & Bednash, G. D. (2009). Nurse residency programs: an essential requirement for nursing. Nursing Economics, 27(3), 142–148. |
[15]
, reinforcing the importance of developing effective strategies to manage stress during the transition period. In Oman, these stressors may be compounded by unique challenges, such as navigating new healthcare systems, managing patient care expectations in understaffed settings, and balancing professional and familial responsibilities. The interplay of these factors underscores the importance of culturally sensitive interventions that address both personal and workplace stressors. By tailoring strategies to these specific challenges, healthcare institutions can foster a more supportive environment for novice nurses.
4.3. Engagement in Learning Activities and Program Participation
The study also assessed participants' engagement in learning activities, with no significant differences across the three groups (new graduates, internship participants, and enhancement program participants). Despite minor variations, the findings suggest a uniform commitment to continued professional development across all cohorts, which is crucial in the context of evolving healthcare needs. This finding indicates that novice nurses in Oman value professional growth and recognize the importance of continuous learning in advancing their careers. Notably, the enhancement and internship program participants reported slightly higher practice readiness scores, which underscores the potential value of structured support systems such as internships and enhancement programs in bridging the gap between knowledge and clinical application. These findings highlight the effectiveness of structured learning pathways in building confidence and skills, suggesting that greater investment in such programs could yield significant benefits for nurses and healthcare organizations. This finding supports the literature suggesting that well-organized orientation and mentorship programs can enhance new nurses' competencies and confidence in clinical practice
| [15] | Goode, C. J., Lynn, M. R., Krsek, C., & Bednash, G. D. (2009). Nurse residency programs: an essential requirement for nursing. Nursing Economics, 27(3), 142–148. |
[15,
.
4.4. Clinical Competence and Confidence in Critical Skills
One of the most striking findings from this study was the significant lack of confidence among new nurses in performing critical clinical tasks such as IV therapy, administering blood products, and interpreting EKGs. The findings are consistent with earlier studies in Oman and the broader region, which found that novice nurses often feel inadequately prepared for high-stakes tasks despite their academic training
| [20] | Al-Rawajfah, O. M., AlBashayreh, A., Sabei, S. D. A., Al-Maqbali, M., & Yahyaei, A. A. (2023). Role transition from education to practice and its impact on the career futures of Omani nurses. Nurse Education in Practice, 68, 103594. https://doi.org/10.1016/j.nepr.2023.103594 |
[20,
. The low confidence in performing complex procedures raises patient safety concerns and reflects systemic challenges within nursing education, such as limited access to advanced clinical rotations or inadequate exposure to high-pressure scenarios during training. The relatively low confidence levels in performing complex procedures are concerning, as they suggest that existing educational programs may not adequately address the practical skills required in real-world clinical environments. This gap in readiness could be attributed to limited clinical exposure during nursing education, which is a persistent issue highlighted in the literature
. As a result, nursing programs must prioritize immersive, hands-on training experiences and incorporate advanced simulation technologies to better prepare students for high-stakes clinical tasks.
4.5. Implications for Nursing Education and Practice
The study’s findings suggest several important implications for nursing education and practice in Oman. First, there is a clear need for enhanced clinical training, particularly in high-risk areas such as IV therapy, blood product administration, and critical decision-making skills. While knowledge may be well covered in academic settings, more hands-on experience in clinical environments is essential to ensure that nurses are equipped to handle the complexities of patient care. This may involve revising existing curricula to allocate more time to clinical placements, developing competency-based assessments, and integrating real-world scenarios into teaching methodologies. Incorporating more simulation-based learning and offering extended clinical placements may help address these gaps
| [23] | AlMekkawi, M., El Khalil, R. (2022). Undergraduate Nursing Students' Readiness to Practice: Views of the Senior Students in the United Arab Emirates. Nurse Educator. 47 (4), E86–E90. |
[23]
.
Second, the role of mentorship and structured internship programs should be expanded. These programs have been shown to improve the confidence and competence of new nurses
, and the positive impact of these programs was evident in this study, where participants in internship and enhancement programs reported higher readiness scores. Targeted mentorship programs, particularly those involving senior nurses who understand local challenges, can provide the guidance, feedback, and emotional support needed to ease the transition into professional practice. Developing targeted mentorship initiatives, with experienced nurses providing guidance and support during the early months of training, could help alleviate some of the stress and uncertainty experienced by novice nurses.
Finally, the high stress levels reported by participants underscore the importance of supporting new nurses’ mental health and well-being. Integrating stress management techniques into nursing curricula and offering ongoing support throughout the transition period could help mitigate the adverse effects of stress on clinical performance and job satisfaction. Thus, to promote resilience and improve job satisfaction among novice nurses, we suggest implementing workplace wellness programs, regular mental health check-ins, and peer support networks. These strategies would not only benefit individual nurses but also contribute to the sustainability of the nursing workforce.
4.6. Limitations and Future Research Directions
While this study provides valuable insights into the perceptions of Omani nursing graduates, it is essential to acknowledge its limitations. The self-reported nature of the survey may have introduced biases, as participants may have overestimated their competencies or underreported areas of weakness. Additionally, the study's cross-sectional design limits the ability to draw causal conclusions. Future research could explore the longitudinal effects of internship and enhancement programs on nurses' long-term job satisfaction, retention, and clinical competence.
Further research is needed to explore the factors contributing to the observed differences in confidence and competence in specific clinical tasks. For example, examining the impact of clinical placements, training duration, and mentorship quality could provide more detailed insights into how nursing education programs can be improved to prepare graduates for practice better.
5. Conclusions
This study highlights the readiness of novice Omani nurses for clinical practice, revealing a strong foundation in knowledge and commitment to lifelong learning. However, gaps in clinical competence, particularly in high-stakes tasks like IV therapy and blood product administration, were evident. The findings underscore the need for enhanced clinical training, structured mentorship, and stress management initiatives to support the transition from education to practice. Addressing these areas can better prepare future nurses to deliver safe and effective care in Oman’s evolving healthcare system.
To enhance clinical readiness, nursing education programs should increase hands-on training in critical areas, expand mentorship opportunities, and integrate stress management into curricula. Educational institutions and healthcare providers must collaborate more closely to ensure nursing programs align with real-world clinical demands. Offering structured support systems such as internships and conducting regular competency assessments during the first year of practice will further enhance nurses' clinical competence and confidence.
Abbreviations
IV | Intravenous |
EKG | Electrocardiogram |
ICU | Intensive Care Unit |
NICU | Neonate Intensive Care Unit |
Author Contributions
Mohammed Khalfan Ambusaidi: Conceptualization, Data curation, Formal Analysis, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing
Abeer Nasser Al Jahdami: Conceptualization, Data curation, Formal Analysis, Methodology, Project administration, Resources, Software, Validation, Visualization, Writing – original draft, Writing – review & editing
Siham Said Al Rashdi: Conceptualization, Data curation, Formal Analysis, Methodology, Project administration, Resources, Software, Validation, Visualization, Writing – original draft, Writing – review & editing
Alya Juma Rashid Al Mashaykhi: Conceptualization, Data curation, Formal Analysis, Methodology, Project administration, Resources, Software, Validation, Visualization, Writing – original draft, Writing – review & editing
Conflicts of Interest
The authors declare no conflicts of interest.
References
| [1] |
Duchscher, J. B. (2008). A process of becoming: The stages of new nursing graduate professional role transition. The Journal of Continuing Education in Nursing, 39(10), 441–450.
https://doi.org/10.3928/00220124-20081001-03
|
| [2] |
Casey, K., Fink, R., Jaynes, C., Campbell, L., Cook, P., & Wilson, V. (2011). Readiness for practice: the senior practicum experience. The Journal of Nursing Education, 50(11), 646–652.
https://doi.org/10.3928/01484834-20110817-03
|
| [3] |
Pandya B, Ruhi U and Patterson L (2023) Preparing the future workforce for 2030: the role of higher education institutions. Frontiers in Education. 8: 1295249.
https://doi.org/10.3389/feduc.2023.1295249
|
| [4] |
Romyn, D. M., Linton, N., Giblin, C., Hendrickson, B., Limacher, L. H., Murray, C., Nordstrom, P., Thauberger, G., Vosburgh, D., Vye-Rogers, L., Weidner, A., & Zimmel, C. M. (2009). Successful transition of the new graduate nurse. International Journal of Nursing Education Scholarship, 6.
https://doi.org/10.2202/1548-923X.1802
|
| [5] |
Missen, K., McKenna, L., & Beauchamp, A. (2015). Work readiness of nursing graduates: current perspectives of graduate nurse program coordinators. Contemporary Nurse, 51(1), 27–38.
https://doi.org/10.1080/10376178.2015.1095054
|
| [6] |
Casey, K., Fink, R., Krugman, M., & Propst, J. (2004). The graduate nurse experience. The Journal of Nursing Administration, 34(6), 303Y311.
https://doi.org/10.1097/00005110-200406000-00010
|
| [7] |
Catton, H. (2020). Global challenges in health and health care for nurses and midwives everywhere. International Nursing Review, 67(1), 4–6.
|
| [8] |
Sandler, M. (2018). Why are new graduate nurses leaving the profession in their first year of practice and how does this impact on ED nurse staffing? A rapid review of current literature and recommended reading. Canadian Journal of Emergency Nursing, 41(1), 23-24.
|
| [9] |
Berkow, S., Virkstis, K., Stewart, J., & Conway, L. (2008). Assessing new graduate nurse performance. JONA: The Journal of Nursing Administration, 38(11), 468-474.
https://doi.org/10.1097/01.NNA.0000339477.50219.06
|
| [10] |
Chappy, S., Jambunathan, J., & Marnocha, S. (2010). Evidence-based curricular strategies to enhance BSN graduates' transition into practice. Nurse Educator, 35(1), 20–24.
https://doi.org/10.1097/NNE.0b013e3181c42120
|
| [11] |
Fink, R., Krugman, M., Casey, K., & Goode, C. (2008). The graduate nurse experience: qualitative residency program outcomes. The Journal of Nursing Administration, 38(7-8), 341–348.
https://doi.org/10.1097/01.NNA.0000323943.82016.48
|
| [12] |
Beecroft, P., Kunzman, L., Taylor, S., Devenis, E., & Guzek, F. (2004). Bridging the gap between school and workplace. Journal of Nursing Administration, 34(7/8), 338-345.
|
| [13] |
Candela, L., & Bowles, C. (2008). Recent RN graduate perceptions of educational preparation. Nursing Education Perspectives, 29, 266-277.
|
| [14] |
Goode, C. J., & Williams, C. A. (2004). Post-baccalaureate nurse residency program. The Journal of Nursing Administration, 34(2), 71–77.
https://doi.org/10.1097/00005110-200402000-00004
|
| [15] |
Goode, C. J., Lynn, M. R., Krsek, C., & Bednash, G. D. (2009). Nurse residency programs: an essential requirement for nursing. Nursing Economics, 27(3), 142–148.
|
| [16] |
National Council of State Boards of Nursing. (2009). The impact of transition experience on practice of newly licensed registered nurses. Retrieved from
http://www.ncsbn.org
|
| [17] |
Al Hajri, A., Al Battashi, M. (2023). New nurses’ transition to practice experience after completion of the enhancement training program in the Sultanate of Oman. Journal of Nursing Education and Practice, 13(10), 36-44.
https://doi.org/10.5430/jnep.v13n10p36
|
| [18] |
Hickey M. T. (2009). Preceptor perceptions of new graduate nurse readiness for practice. Journal for Nurses in Staff Development (JNSD) 25(1), 35–41.
https://doi.org/10.1097/NND.0b013e318194b5bb
|
| [19] |
Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Educating nurses: A call for radical transformation. San Francisco, CA: Jossey-Bass.
|
| [20] |
Al-Rawajfah, O. M., AlBashayreh, A., Sabei, S. D. A., Al-Maqbali, M., & Yahyaei, A. A. (2023). Role transition from education to practice and its impact on the career futures of Omani nurses. Nurse Education in Practice, 68, 103594.
https://doi.org/10.1016/j.nepr.2023.103594
|
| [21] |
Akeel, A., Kabeel, A. (2023). Nursing Interns' Orientation Program: A Predictor of Improving Nursing Interns' Knowledge About Professional Nursing Practice. Egyptian Journal of Nursing & Health Sciences. 4(2).
https://doi.org/10.21608/ejnhs.2023.339486
|
| [22] |
Al-Yatim, S., Al-Ola, L., Al-Yateem, N. (2023). Enhancing Nursing Graduate Readiness for Practice through Leadership Competence: A Correlational Study. Jordan Medical Journal. 57(4).
https://doi.org/10.35516/jmj.v57i3.1680
|
| [23] |
AlMekkawi, M., El Khalil, R. (2022). Undergraduate Nursing Students' Readiness to Practice: Views of the Senior Students in the United Arab Emirates. Nurse Educator. 47 (4), E86–E90.
|
| [24] |
Robinson, D. (2019). Nursing educators' and nursing leaders' views on practice readiness in novice nurses (Doctoral dissertation). Walden University.
https://scholarworks.waldenu.edu/dissertations/7332/
|
| [25] |
Missen, K., McKenna, L., Beauchamp, A., & Larkins, J. (2016). Qualified nurses’ rate new nursing graduates as lacking skills in key clinical areas. Journal of Clinical Nursing, 25(15–16), 2134-2143.
https://doi.org/10.1111/jocn.13316
|
| [26] |
Dwyer, P. A., & Hunter Revell, S. M. (2016). Multilevel influences on new graduate nurse transition. Journal for Nurses in Professional Development, 32(3), 112–121.
https://doi.org/10.1097/NND.0000000000000265
|
| [27] |
Mashigo, A. (2019). Factors influencing work readiness of graduates: an exploratory study (Dissertation). Stellenbosch University.
https://scholar.sun.ac.za/items/801883b3-f728-48ba-8ea3-e362a8cc2541
|
| [28] |
Caballero, C., Walker, A., & Fuller-Tyszkiewicz, M. (2011). The Work Readiness Scale (WRS): Developing a measure to assess work readiness in college graduates. Journal of Teaching and Learning for Graduate Employability, 2(2), 41-54.
|
Cite This Article
-
APA Style
Ambusaidi, M. K., Jahdami, A. N. A., Rashdi, S. S. A., Mashaykhi, A. J. R. A. (2024). Novice Omani Nurses' Readiness for Practice: Challenges and Insights from a National Study. American Journal of Nursing Science, 13(6), 132-141. https://doi.org/10.11648/j.ajns.20241306.13
Copy
|
Download
ACS Style
Ambusaidi, M. K.; Jahdami, A. N. A.; Rashdi, S. S. A.; Mashaykhi, A. J. R. A. Novice Omani Nurses' Readiness for Practice: Challenges and Insights from a National Study. Am. J. Nurs. Sci. 2024, 13(6), 132-141. doi: 10.11648/j.ajns.20241306.13
Copy
|
Download
AMA Style
Ambusaidi MK, Jahdami ANA, Rashdi SSA, Mashaykhi AJRA. Novice Omani Nurses' Readiness for Practice: Challenges and Insights from a National Study. Am J Nurs Sci. 2024;13(6):132-141. doi: 10.11648/j.ajns.20241306.13
Copy
|
Download
-
@article{10.11648/j.ajns.20241306.13,
author = {Mohammed Khalfan Ambusaidi and Abeer Nasser Al Jahdami and Siham Said Al Rashdi and Alya Juma Rashid Al Mashaykhi},
title = {Novice Omani Nurses' Readiness for Practice: Challenges and Insights from a National Study
},
journal = {American Journal of Nursing Science},
volume = {13},
number = {6},
pages = {132-141},
doi = {10.11648/j.ajns.20241306.13},
url = {https://doi.org/10.11648/j.ajns.20241306.13},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajns.20241306.13},
abstract = {Background: The transition from student to professional nurse is often challenging, marked by stress, role confusion, and limited confidence in clinical practice. This study addresses a critical gap in research by exploring the readiness of Omani nursing graduates for professional practice, focusing on their knowledge, clinical competencies, and factors influencing their transition. Methodology: A descriptive cross-sectional study was conducted across multiple healthcare institutions in Oman, targeting recent nursing graduates and participants in internship programs. Data were collected using the 2023 Casey-Fink Graduate Nurse Experience Survey, a validated tool with a Cronbach's alpha of 0.890. Statistical analyses, including descriptive statistics, ANOVA, and independent t-tests, were performed using SPSS Version 23 to evaluate participants' perceived readiness and competencies. Results: The study included 194 novice nurses, with 86% from the Oman College of Health Sciences. The mean overall knowledge score was 3.56/4, highlighting high perceived competency. However, significant gaps were identified in areas such as initiating IV therapy (M=2.23), administering blood products (M=1.78), and managing violent patients (M=1.80). Confidence in clinical tasks like EKG interpretation and rapid response initiation was also limited. Participants in structured programs, such as internships and enhancement initiatives, reported slightly higher readiness scores, though differences were not statistically significant (p>0.05). Stress emerged as a pervasive challenge, with 46.9% strongly agreeing that work-induced stress impacted their performance. Conclusions: This study reveals substantial variability in the readiness of Omani novice nurses, emphasizing the need for enhanced clinical training, mentorship, and targeted interventions to address competency gaps. The findings provide valuable insights for nursing educators, internship coordinators, and policymakers in refining curricula and support programs to improve graduate preparedness for clinical practice.
},
year = {2024}
}
Copy
|
Download
-
TY - JOUR
T1 - Novice Omani Nurses' Readiness for Practice: Challenges and Insights from a National Study
AU - Mohammed Khalfan Ambusaidi
AU - Abeer Nasser Al Jahdami
AU - Siham Said Al Rashdi
AU - Alya Juma Rashid Al Mashaykhi
Y1 - 2024/12/27
PY - 2024
N1 - https://doi.org/10.11648/j.ajns.20241306.13
DO - 10.11648/j.ajns.20241306.13
T2 - American Journal of Nursing Science
JF - American Journal of Nursing Science
JO - American Journal of Nursing Science
SP - 132
EP - 141
PB - Science Publishing Group
SN - 2328-5753
UR - https://doi.org/10.11648/j.ajns.20241306.13
AB - Background: The transition from student to professional nurse is often challenging, marked by stress, role confusion, and limited confidence in clinical practice. This study addresses a critical gap in research by exploring the readiness of Omani nursing graduates for professional practice, focusing on their knowledge, clinical competencies, and factors influencing their transition. Methodology: A descriptive cross-sectional study was conducted across multiple healthcare institutions in Oman, targeting recent nursing graduates and participants in internship programs. Data were collected using the 2023 Casey-Fink Graduate Nurse Experience Survey, a validated tool with a Cronbach's alpha of 0.890. Statistical analyses, including descriptive statistics, ANOVA, and independent t-tests, were performed using SPSS Version 23 to evaluate participants' perceived readiness and competencies. Results: The study included 194 novice nurses, with 86% from the Oman College of Health Sciences. The mean overall knowledge score was 3.56/4, highlighting high perceived competency. However, significant gaps were identified in areas such as initiating IV therapy (M=2.23), administering blood products (M=1.78), and managing violent patients (M=1.80). Confidence in clinical tasks like EKG interpretation and rapid response initiation was also limited. Participants in structured programs, such as internships and enhancement initiatives, reported slightly higher readiness scores, though differences were not statistically significant (p>0.05). Stress emerged as a pervasive challenge, with 46.9% strongly agreeing that work-induced stress impacted their performance. Conclusions: This study reveals substantial variability in the readiness of Omani novice nurses, emphasizing the need for enhanced clinical training, mentorship, and targeted interventions to address competency gaps. The findings provide valuable insights for nursing educators, internship coordinators, and policymakers in refining curricula and support programs to improve graduate preparedness for clinical practice.
VL - 13
IS - 6
ER -
Copy
|
Download
,
Abeer Nasser Al Jahdami
Share This Article
Twitter
Linked In
Facebook
