The TTPL Study

The 10-year longitudinal study of the transition to and through professional life of Nurses.

The demand for registered nursing professionals has never been greater. A rapidly aging population with more complex health issues, health inequities, increased need to address the social determinants of health (SDOH), poor health outcomes, mental and behavioral health issues, a shift in the healthcare paradigm, and the COVID-19 pandemic have stretched the healthcare system to the breaking point.

The nationwide nursing shortage persists in part due to high turnover, transition to practice shock, incompatible personal and professional fit, and decreased retention rates for newly graduate nurses.

The COVID-19 pandemic only exacerbated the nursing shortage as many nurses exit or contemplate leaving the profession. Additionally, it is imperative that the nursing workforce reflects the diversity of communities to ensure culturally competent equitable nursing care is delivered.

In this 10-year longitudinal study, tekMountain endeavors to understand why—by uncovering the challenges and opportunities faced by an individual nurse along his or her transition to and through professional life (TTPL), and by making the individual the primary stakeholder.

The study will examine
six critical components
of an individual’s journey through
his or her
nursing education and
professional life:

Self Discovery

Self Discovery

What does the student know about him or herself? How do they see themselves today and in the future?

Professional Discovery

Progessional Discovery

What is their desired professional path? How have their clinical and academic experiences influenced their decisions?

Gap Analysis

Gap Analysis

What are the gaps in their skills and knowledge as it relates to their desired?

Gap Closure

Gap Closure

What steps will they take to close those skills - and knowledge-gaps to complete their education and improve their transition to professional life?

Transition Analysis

Transition Analysis

What does the student know about him or herself? How do they see themselves today and in the future?

Steady State Analysis

Steady State Analysis

What conditions promote long-term retention, or turnover, after the new graduate nurse has reached a professional steady state? What influences the professional to stay and grow at one healthcare facility, or to seek out new opportunities at a different facility?

By identifying and addressing issues
and opportunities in these six stages,
we hypothesize that:

  1. The industry will have nursing professionals more prepared to transition through their professional journey.
  2. The study data and results can be used to create a system that identifies a mutually beneficial FIT between the individual nurse professional and the healthcare system thereby reducing turnover and increasing nurse retention.
  3. By better understanding variables contributing to turnover and retention, academia and industry will partner creating a stronger workforce of new graduate nurses to positively impact quality healthcare outcomes.

Governance, guidance and leadership at the highest levels.

The TTPL Study will be led by a cross section of recognized industry leaders representing the Healthcare, Higher Education, and Nurse Professional verticals including: Nursing Education, Leadership, Workforce, Human Resources and Finance.

In partnership with the University of Kansas School of Nursing, the TTPL Study Research Team will be comprised of three areas of expertise—Academic, Practice, and Data Science. This team will have representation from nursing education, academic research, nursing practice, and data analytics. Dr. Amy Garcia, in collaboration with Dr. Nelda Godfrey, who will act as the Principal Investigator.

Dr. Nelda Godfrey is the Associate Dean of Innovative Partnerships and Practice at the University of Kansas School of Nursing. A scholar in the area of professional identity in nursing, Dr. Godfrey serves as chair of the International Society for Professional Identity in Nursing. Widely published in innovation and leadership, she is a fellow in the American Academy of Nursing and a fellow in the NLN Academy for Nursing Education.

Dr. Amy Garcia serves as Associate Clinical Professor at the University of Kansas School of Nursing. Dr. Garcia’s expertise includes health policy and informatics; her research is focused on the value of nursing. She previously served as the Chief Nurse/Chief Programs Officer for the American Nurses Association, the Chief Executive Officer for the National Association of School Nurses, and as a Director & Chief Nursing Officer for Cerner Corporation.

Brief Descriptor of the Literature Review:
CastleBranch has commissioned independent academic research to better understand the journey of nurses from nursing school to and through professional life. More specifically, CastleBranch sought to identify, quantify, and understand the forces and factors that correlate to the professional movement of nurses. The literature review, executed by the University of Kansas School of Nursing, produced a summary of the existing academic literature that touched on:

  • The rates for nurse turnover and attrition.
  • The factors specific to the nurse that might correlate with turnover and attrition.
  • The factors specific to the nurse’s education that might correlate with turnover and attrition.
  • The factors specific to the nurse’s professional experience or work context that might correlate with turnover and attrition.
  • The factors specific to decision to return to school.

Liturature review observations and gaps.

Nurses don’t always practice where society needs nurses.
Nurses sometimes move from job to job seeking something closer to their needs and dreams. Schools struggle to provide clinical experiences that open new doors for students. Employers struggle to hire and retain nurses in certain jobs. Communities struggle to recruit nurses to live and work in rural and underserved areas. We need evidence on how to help nurses achieve an optimal fit.

Nurses are individuals.
Nurses’ needs and aspirations do change during different ages and stages of life. How to plan for/with the addition of a family or a change in health status is not well addressed in the literature.

Research is limited by the data that is available.
Each stakeholder brings a different lens and disparate data. Nurses focus on patients. Nursing schools focus on how to best educate nursing students. Employers focus on hiring and retaining employees. Associations focus on the needs of their members. Regulators focus on public

Although researchers try to bridge the gaps, the data is fragmented.
For example, nursing schools are largely unable to follow graduates into the workplace beyond the first year or two. This makes it difficult to demonstrate outcomes beyond NCLEX pass rates.

Integrated datasets following a nurse across the continuum of his or her career are sorely needed.
It is time-consuming and expensive to integrated disparate data. This contributes to a lack of generalizable, longitudinal research. Nurses, schools, employers, and communities need answers.