Learning-by-Concordance to Support the Transition-to-Practice process of New Graduate Nurses in Critical Care: A Descriptive Interpretative Study

This study aimed to describe the appreciation and experience of newly graduated nurses (NGNs) in critical care with using a synchronous Learning-by-Concordance (LbC) activity to support the development of clinical reasoning (CR). NGNs working in critical care units may face challenges applying CR. Therefore, educational strategies are needed to address their learning needs, particularly those that foster CR in uncertain or ambiguous contexts, which are frequently encountered in critical care settings. A descriptive interpretative design was used. A convenience sample of NGNs was recruited. A 60-90-minute period was allocated to the learning activity, which was facilitated by a nursing expert in critical care. Following the LbC activity, semi-structured group interviews were conducted. Data were analyzed using the interpretive description approach. The analysis of the verbatim transcription of the group interviews with 7 NGNs highlighted the following themes: expert and peer directed learning, increased confidence in developing CR to facilitate the transition-to-practice process and positive appreciation of the LbC activity. Participants positively evaluated the authenticity of the situations, the perceived benefit of conducting the learning activity with peers in person and the opportunity to reflect on various clinical practice situations. However, differing results emerged regarding the clarity and comprehensibility of the instructions, as well as the alignment of the vignette content with NGNs' level of practice. Critical care transition-to-practice programs should incorporate LbC activities. Longitudinal studies are needed to document how LbC supports the development of CR among NGNs in critical care settings.