The effects of a prelicensure extern program and nurse residency program on new graduate outcomes and retention.

Organizations are looking to new graduate nurses to fill expected staffing shortages over the next decade. Creative and effective onboarding programs will determine the success or failure of these graduates as they transition from student to professional nurse. This longitudinal quantitative study with repeated measures used the Casey-Fink Graduate Nurse Experience Survey to investigate the effects of offering a prelicensure extern program and postlicensure residency program on new graduate nurses and organizational outcomes versus a residency program alone. Compared with the nurse residency program alone, the combination of extern program and nurse residency program improved neither the transition factors most important to new nurse graduates during their first year of practice nor a measure important to organizations, retention rates. The additional cost of providing an extern program should be closely evaluated when making financially responsible decisions.