Quantifying and Remediating the New Graduate Nurse Resident Academic-Practice Gap Using Online Patient Simulation

Background: There is an ever-widening academic-practice gap. Less than one third of new graduates demonstrate entry-level competencies required for practice. Hospitals expend many resources to create nurse residency programs to remediate this gap. Online interactive case simulation is effective to increase competencies and decrease the length of orientation and rate of turnover. The aims of this pilot research study were to quantify the academic-practice gap and to strengthen areas of development for competent and safe clinical practice through use of an online patient simulation program. Method: A pretest-posttest quasi-experimental study using an online patient simulation program was implemented in a convenience sample of nurse residents over 16 months. Results: Twenty-nine residents completed more than 3,400 patient simulations. Improvement in pretest and posttest metrics included 100% of nurse residents committing a sentinel error event decreased to 20.7%, 766 medication errors decreased to 160, and failed-to-rescue an average of 81% of the time decreased to 23%. Conclusion: Interactive online patient simulation programs provide a powerful learning methodology in which learners improve patient safety and reduce failures to rescue.