Introduction

The transition from academic training to clinical practice represents a critical stage in the professional development of healthcare professionals. Newly recruited healthcare staff are required to adapt rapidly to demanding clinical environments, complex interpersonal relationships, evolving professional responsibilities, and high expectations regarding patient care and service quality. Difficulties during this transition period may negatively affect job performance, team integration, psychological well-being, and long-term workforce retention.1–3

Previous studies have shown that newly recruited healthcare professionals frequently experience challenges related to professional competence, workplace communication, role adaptation, and stress management.1,4 The early employment period is often characterized by uncertainty, increased workload, and difficulties in balancing professional expectations with personal coping resources.5 These challenges may contribute to occupational stress, reduced job satisfaction, burnout, and turnover intentions, ultimately affecting workforce stability and organizational performance.6

To facilitate successful transition, hospitals commonly implement orientation programs, pre-employment training, mentorship arrangements, and competency-based educational activities.7 Although these approaches play an important role in improving technical knowledge and clinical skills, they often focus primarily on professional training and institutional regulations. Comparatively less attention has been paid to interpersonal integration, emotional adjustment, role transition, and broader organizational support needs during the induction period.8

Recent evidence indicates that supportive organizational environments are associated with greater work engagement, lower turnover intention, and improved workforce stability among healthcare professionals.9,10 For newly recruited healthcare professionals, particularly newly qualified nurses, organizational-level support may help alleviate transition-related stress and facilitate adaptation to clinical practice.11 This issue is important not only for individual well-being and professional development but also for team functioning, workforce retention, and organizational stability.9,10 Despite increasing attention to transition support, several gaps remain. First, much of the existing evidence on transition and adaptation support has focused on newly graduated nurses, whereas multidisciplinary groups of newly recruited healthcare professionals have received comparatively limited attention.12,13 Second, conventional orientation programs generally emphasize institutional regulations and technical competence, whereas psychological adjustment, workplace communication, team integration, and organizational socialization receive comparatively limited attention.3,13 Third, although context-specific and needs-informed organizational interventions have been recommended, relatively few support programs have been evaluated using integrated quantitative and qualitative evidence.14 Evidence from Chinese hospital settings also remains limited.15

In Chinese tertiary hospitals, newly recruited healthcare professionals often enter demanding clinical environments characterized by large patient volumes, intensive workloads, hierarchical organizational structures, and the need for rapid coordination across multiple professional groups. These contextual conditions may increase transition-related stress and make it more difficult for newcomers to achieve role clarity, establish workplace relationships, and develop a sense of organizational belonging. Furthermore, differences in professional backgrounds, departmental practices, and supervisory arrangements may lead to variation in the support available during the early employment period. Therefore, organizational support programs in Chinese hospitals should extend beyond standardized orientation and technical training to address context-specific psychological, interpersonal, and socialization needs.15

To address these gaps, we conducted a mixed-methods intervention study in a tertiary hospital in Beijing. We identified occupational adaptation needs, developed a six-session group-based organizational support program, and preliminarily evaluated its feasibility, acceptability, and association with occupational adaptation outcomes.

Methods Study Design

This study employed a mixed-methods intervention design to explore occupational adaptation challenges among newly recruited healthcare professionals and to evaluate the feasibility of a structured organizational support program. Quantitative and qualitative data were collected concurrently and integrated during interpretation to provide a comprehensive understanding of occupational adaptation experiences and support needs.

Setting and Participants

The study was conducted at Beijing Chest Hospital, a tertiary teaching hospital in Beijing, China, between January and August 2024. Newly recruited healthcare professionals who had been employed at the hospital for less than 12 months were eligible for participation. Participants were recruited voluntarily through departmental recommendations and open invitations.

A total of 28 newly recruited healthcare professionals participated in the needs assessment phase. Based on the assessment findings, 10 participants with common occupational adaptation challenges participated in the group-based support program. The participant recruitment, intervention implementation, and evaluation process are illustrated in Figure 1.

Figure 1 Study flow of participant recruitment, intervention implementation, and evaluation. Flow diagram illustrating participant recruitment and selection, occupational adaptation needs assessment, development and implementation of the organizational support program, and post-intervention evaluation among newly recruited healthcare professionals in a tertiary hospital. The primary outcome was the change in the total occupational adaptation score.

Data Collection

First, a structured occupational adaptation questionnaire was developed specifically for this study based on a review of the literature, existing conceptual frameworks on occupational adaptation and organizational support, and expert consultation.16,17 The questionnaire evaluated four domains: professional skill adaptation, interpersonal interaction, team collaboration, and psychological stress adaptation. Each domain consisted of multiple items rated on a five-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree), with higher scores indicating better occupational adaptation.

Second, semi-structured interviews were conducted with newly recruited healthcare professionals and departmental supervisors to explore occupational adaptation experiences, perceived barriers, and expectations regarding organizational support.

Third, participant observation was conducted throughout the intervention period. Workplace interactions, adaptation processes, and responses to support activities were documented to supplement quantitative findings and interview data. The questionnaire was reviewed by experts in hospital management, medical education, and social work to ensure content relevance and clarity before administration.

Organizational Support Intervention

The group-based support program consisted of six structured sessions conducted over an eight-month period. Session topics included occupational role adaptation, workplace communication, stress management, team collaboration, professional identity development, and peer support. Each session incorporated facilitated discussion, experience sharing, problem-solving exercises, and reflective activities designed to promote workplace adaptation and organizational integration.

Outcome Measures

Occupational adaptation outcomes were evaluated across four domains: professional skill adaptation, interpersonal interaction, team collaboration, and psychological stress adaptation.

Quantitative outcomes included changes in occupational adaptation scores before and after the intervention. Qualitative outcomes included participants’ perceptions of adaptation challenges, perceived benefits of the intervention, satisfaction with support activities, and supervisors’ evaluations of workplace adaptation.

Data Analysis

We analyzed quantitative data using IBM SPSS Statistics version 27.0 (IBM Corp, Armonk, NY, USA). Descriptive statistics were used to summarize participant characteristics, occupational adaptation needs, and intervention outcomes. Continuous variables are presented as means and standard deviations, while categorical variables are presented as frequencies and percentages. Changes in occupational adaptation scores before and after the intervention were compared using paired-sample t-tests or Wilcoxon signed-rank tests as appropriate. Data distribution was assessed before inferential analysis. Paired-sample t-tests were used for approximately normally distributed paired data, whereas Wilcoxon signed-rank tests were used otherwise. A two-sided P value <0.05 was considered statistically significant. Effect sizes were calculated to estimate the magnitude of intervention effects. Given the small intervention sample and the absence of a control group, inferential analyses were considered exploratory, and the observed pre–post changes were interpreted as preliminary rather than as evidence of causal effectiveness.

Qualitative interview transcripts and observational records were analyzed using thematic analysis. Emerging themes were independently reviewed and categorized according to adaptation challenges, organizational support experiences, and perceived intervention effects.

Quantitative and qualitative findings were integrated during interpretation to provide a comprehensive evaluation of the intervention.

Ethical Considerations

Participation was voluntary, and informed consent was obtained from all participants before data collection. All collected information was anonymized prior to analysis to ensure confidentiality and privacy. This study was approved by the Institutional Review Board of Beijing Chest Hospital (Approval No. BJXK-2023-KY-31).

Results Participant Characteristics

A total of 28 newly recruited healthcare professionals participated in the occupational adaptation needs assessment. Their demographic and professional characteristics are summarized in Table 1. All participants had been employed at the hospital for less than six months and were in the early stage of transition from academic training to clinical practice.

Table 1 Demographic Characteristics of Study Participants (N = 28)

The majority of participants were female (75.0%) and younger than 25 years of age (71.4%). In terms of educational attainment, 46.4% held a bachelor’s degree, 28.6% held a master’s degree, and 3.6% held a doctoral degree. Nurses constituted the largest professional group (64.3%), followed by physicians (25.0%) and other healthcare professionals (10.7%).

Overall, the study population was characterized by a predominantly young, highly educated, and multidisciplinary workforce, providing an appropriate context for exploring occupational adaptation needs and evaluating organizational support strategies during the early employment period.

Occupational Adaptation Needs Assessment

Occupational adaptation needs were commonly reported by participants. Occupational adaptation needs were reported across multiple domains. All 28 participants reported a need for practical clinical skills training, 26 (92.9%) reported a need for psychological support and stress-management guidance, and 24 (85.7%) reported a need to improve workplace communication skills. As shown in Table 2, adaptation needs were observed across multiple domains, including professional skill development, psychological adjustment, interpersonal communication, and team integration.

Table 2 Occupational Adaptation Needs Identified Among Newly Recruited Healthcare Professionals (N = 28)

Professional skill adaptation emerged as the most frequently reported concern. All participants (100.0%) expressed a need for additional practical training and guidance to improve clinical competence. Difficulties were particularly evident in managing complex clinical situations, communicating effectively with patients and their families, and balancing work efficiency with quality of care.

Psychological adjustment was another important challenge. Fourteen participants (50.0%) reported experiencing work-related stress, while 13 (46.4%) described anxiety associated with overtime work and increasing job responsibilities. Furthermore, 26 participants (92.9%) indicated a need for psychological support and stress-management guidance during the transition to clinical practice.

Interpersonal interaction and team integration also represented important areas of need. Twenty-four participants (85.7%) expressed a desire to strengthen workplace communication skills, particularly when interacting with senior colleagues, supervisors, and multidisciplinary team members. Several participants also reported difficulties adapting to established team structures and organizational expectations.

Overall, these findings suggest that occupational adaptation among newly recruited healthcare professionals extends beyond professional skill acquisition and encompasses psychological, interpersonal, and organizational dimensions. These findings formed the conceptual basis for developing a structured organizational support program targeting psychological adaptation, interpersonal integration, teamwork, and professional transition.

Outcomes of the Group-Based Support Program

A structured six-session organizational support program was subsequently implemented to address the identified adaptation needs. The intervention emphasized peer interaction, facilitated reflection, workplace communication, and psychological support rather than technical skills training alone. Post-intervention changes in occupational adaptation are summarized in Table 3 and illustrated in Figure 2.

Table 3 Changes in Occupational Adaptation Scores Before and After the Structured Organizational Support Program (n = 10)

Figure 2 Occupational adaptation profiles before and after the group-based support program. Radar chart illustrating mean scores across four occupational adaptation domains among participants who completed the six-session support program (n = 10). Mean scores increased descriptively across all four domains following the intervention.

Following completion of the intervention, occupational adaptation scores improved across all four domains. The greatest improvements were observed in interpersonal interaction and team collaboration, followed by psychological stress adaptation. Mean interpersonal interaction scores increased from 9.2 to 12.8, while team collaboration scores increased from 8.8 to 12.3. Psychological stress adaptation also improved substantially, increasing from 9.1 to 12.1 following the intervention.

Improvements in professional skill adaptation were comparatively smaller (from 8.9 to 9.9), consistent with the intervention’s emphasis on organizational support rather than technical skills training. Nevertheless, participants reported greater confidence in communicating with colleagues, seeking workplace support, and adapting to departmental workflows.

Overall occupational adaptation scores increased from 36.1 at baseline to 46.9 following the intervention, representing an average improvement of 10.8 points.

Qualitative feedback further indicated that the group-based support program facilitated peer communication, strengthened team integration, and provided opportunities for participants to share adaptation experiences and coping strategies. These qualitative findings were consistent with the quantitative improvements observed in interpersonal interaction, team collaboration, and psychological adaptation, providing complementary evidence for the feasibility and perceived benefits of the organizational support program.

Participant and Supervisor Satisfaction

Participant satisfaction with the organizational support intervention was high (Table 4). Among the ten participants, six (60.0%) reported being very satisfied, three (30.0%) reported being satisfied, and one (10.0%) reported a neutral evaluation. No participants reported dissatisfaction.

Table 4 Participant and Supervisor Satisfaction with the Organizational Support Intervention

Supervisor feedback was similarly positive. Most supervisors reported improvements in workplace communication, team integration, and professional attitudes among participants. Overall, 83.3% of supervisors provided positive evaluations and considered the intervention beneficial for facilitating occupational adaptation among newly recruited healthcare professionals. These findings indicate good acceptability among participants and supervisors and provide preliminary support for the program’s implementation feasibility within the study hospital.

Discussion Principal Findings

This mixed-methods study investigated occupational adaptation among newly recruited healthcare professionals and preliminarily evaluated the feasibility and acceptability of a structured organizational support program in a tertiary hospital. Three principal findings emerged. First, occupational adaptation challenges were commonly reported by participants during the early employment period and extended beyond technical competence to include psychological adjustment, workplace communication, and team integration. Second, the structured organizational support program was associated with improvements across occupational adaptation domains and demonstrated high acceptability among both participants and supervisors. Third, the largest improvements were observed in interpersonal interaction, teamwork, and psychological adaptation, whereas improvements in professional skill adaptation were comparatively modest. Collectively, these findings suggest that newly recruited healthcare professionals may benefit from organizational support that complements, rather than replaces, conventional orientation and technical training.

The specific contribution of this study lies in its needs-informed, multidisciplinary, and mixed-methods approach. Unlike transition programs focusing primarily on newly graduated nurses or technical orientation, the present study included newly recruited healthcare professionals from different occupational backgrounds and used an initial needs assessment to inform the development of a structured group-based organizational support program. The integration of quantitative outcome assessment with qualitative feedback further provided a multidimensional understanding of both preliminary changes in occupational adaptation and participants’ experiences of the intervention.

Organizational Support Beyond Conventional Orientation

The needs assessment indicated that participants’ occupational adaptation needs extended beyond clinical competence.18 Although all participants reported a need for additional practical skills training, similarly high proportions also expressed unmet needs for psychological support (92.9%) and workplace communication (85.7%).2,4,19 These findings suggest that the challenges experienced during the transition to clinical practice are not limited to acquiring technical competence but also involve adapting to new professional roles, organizational expectations, and multidisciplinary working environments.

Most participants in the present study were recent graduates who had entered the workforce shortly after completing their academic education.4,20 While undergraduate and postgraduate training primarily emphasize professional knowledge and clinical skills, considerably less attention is devoted to preparing students for workplace integration, professional identity formation, and organizational adaptation.21,22 Previous studies have shown that the transition from student to healthcare professional is frequently accompanied by transition shock, characterized by uncertainty, emotional stress, role ambiguity, and reduced confidence during the early stage of employment.20,23 In parallel, professional identity is progressively developed through participation in authentic clinical practice, interactions with colleagues, and engagement with organizational culture rather than through classroom education alone.24 This dual transition may partly explain the similarly high demand for psychological support and practical skills training observed in the present study. In addition to acquiring clinical competence, newly recruited healthcare professionals must establish a professional identity, adapt to organizational culture, and integrate into multidisciplinary teams.

Beyond psychological adjustment, workplace communication and team integration also emerged as prominent support needs among newly recruited healthcare professionals in the present study. These findings may be explained by the process of organizational socialization, through which newly recruited staff gradually adapt to the expectations, culture, and interpersonal dynamics of a new workplace. Entering a hospital requires healthcare professionals not only to communicate effectively with patients but also to function within hierarchical clinical teams, collaborate across professional disciplines, understand informal workplace norms, and adapt to department-specific expectations while assuming increasing clinical responsibility. These competencies are largely developed through workplace participation rather than formal education.25 Previous studies have shown that successful organizational socialization facilitates professional identity development, strengthens organizational commitment, and promotes effective integration into multidisciplinary teams.18,26 The high prevalence of communication and team integration needs observed in our study therefore suggests that conventional orientation programs, which primarily emphasize institutional regulations and technical training, may not sufficiently prepare newly recruited healthcare professionals for the interpersonal and organizational demands encountered during the transition to clinical practice.26

Taken together, these findings suggest that occupational adaptation should be conceptualized as a process of organizational socialization and professional identity development rather than merely the acquisition of clinical competence. Structured organizational support therefore complements conventional orientation by addressing dimensions of workplace adaptation that are insufficiently covered by technical training alone.

Understanding the Observed Changes Following the Organizational Support Program

An important finding was that the magnitude of the observed changes varied across the dimensions of occupational adaptation. The largest improvements were observed in interpersonal interaction, team collaboration, and psychological adaptation, whereas gains in professional skill adaptation were comparatively modest. This pattern is consistent with both the objectives of the intervention and existing evidence on workplace learning.26,27 The program was designed to strengthen workplace adaptation through facilitated group discussion, peer interaction, reflective learning, and organizational support rather than through additional technical training. The observed pattern was therefore consistent with the program’s emphasis on interpersonal and psychosocial aspects of occupational adaptation.

The relatively limited improvement in professional skill adaptation is also consistent with the developmental process of clinical competence. Previous studies have demonstrated that clinical skills are primarily acquired through supervised practice, repeated patient encounters, and cumulative workplace experience, whereas confidence, communication, and professional judgement develop through participation in authentic clinical environments and interaction with colleagues.26,28 Improvements in professional competence generally require prolonged clinical exposure, repeated patient care experiences, and continuous supervision, processes that extend well beyond the duration of a structured organizational support program. In contrast, interpersonal confidence, communication, and workplace adaptation may respond more rapidly to structured opportunities for peer interaction, reflection, and organizational support.26,28 The differential improvements observed across occupational adaptation domains therefore suggest that organizational support complements conventional clinical education by addressing interpersonal, psychological, and organizational challenges that are not adequately addressed through technical training alone.

The qualitative findings provide contextual insight into participants’ experiences of the organizational support program. Participants consistently described greater confidence in communicating with colleagues, increased willingness to seek support when encountering difficulties, and a stronger sense of belonging within their departments following the intervention.29 These experiences are consistent with theories of social and workplace learning, which emphasize that professional adaptation occurs through observation, reflection, shared experiences, and participation in communities of practice rather than through individual learning alone.30 By creating structured opportunities for discussion and peer support, the program appeared to reduce uncertainty during organizational entry and facilitate integration into existing multidisciplinary teams.

The quantitative and qualitative findings suggest that the observed changes in occupational adaptation may be related primarily to greater organizational integration and professional confidence rather than to direct enhancement of clinical competence.31 This complementary role may explain why the greatest improvements occurred in interpersonal interaction, teamwork, and psychological adaptation, domains that are often insufficiently addressed during conventional orientation programs.

Policy and Risk-Management Implications for Healthcare Organizations

The present study provides practical implications for designing organizational support strategies for newly recruited healthcare professionals. Rather than treating occupational adaptation as a single orientation event, our findings suggest the potential value of a staged approach in which organizational support extends beyond pre-employment training and continues throughout the early transition period. The needs assessment indicated that adaptation challenges were present after participants entered routine clinical practice, particularly in relation to communication, team integration, and psychological adjustment.2,7,12 These findings suggest that effective transition programs may benefit from combining conventional technical training with structured organizational support that responds to the changing needs of newly recruited staff during their first months of employment.

A practical feature of the present program was its delivery within routine practice at the study hospital. Unlike resource-intensive educational interventions, the program was developed from a systematic needs assessment, delivered through six structured group sessions, and integrated into the hospital’s existing orientation system. The intervention relied primarily on facilitated peer discussion, reflective learning, and organizational support rather than additional educational infrastructure or protected clinical training time. This implementation strategy may facilitate integration into existing workforce development programs; however, its resource requirements and implementation feasibility require formal evaluation.2,8

Beyond improving individual adaptation, structured organizational support may also contribute to broader organizational outcomes. Previous studies have shown that successful transition support and organizational support are associated with stronger organizational commitment, higher job satisfaction, improved work engagement, and better workforce retention.1,31 Although these outcomes were not directly evaluated in the present study, the improvements observed in interpersonal interaction, teamwork, and psychological adaptation suggest that structured organizational support may facilitate successful transition into clinical practice and thereby contribute to longer-term workforce stability. Future multicentre controlled studies with longer follow-up are needed to determine whether the improvements observed in occupational adaptation can be sustained and translated into improved workforce retention, job satisfaction, and organizational commitment.1,6,31

From a healthcare policy and risk-management perspective, occupational maladaptation during the early employment period may represent an organizational workforce risk rather than solely an individual adjustment problem. Difficulties in psychological adjustment, workplace communication, and team integration may contribute to burnout, turnover intention, communication breakdowns, and workforce instability, with potential implications for service continuity and organizational performance. Hospitals may therefore consider incorporating structured needs assessment, early identification of adaptation difficulties, and staged organizational support into workforce development and staff-retention policies. Such an approach could enable healthcare organizations to identify emerging workforce risks and provide timely support before adaptation difficulties become persistent. However, because the present study did not directly evaluate turnover, patient safety, service quality, or long-term organizational outcomes, these policy and risk-management implications should be interpreted as preliminary and require confirmation in larger, controlled, multicentre studies.

Strengths and Limitations

This study has several strengths. First, the mixed-methods design enabled triangulation of quantitative and qualitative evidence, providing a more comprehensive understanding of occupational adaptation than either approach alone. Second, the organizational support program was developed through a systematic needs assessment and integrated into routine hospital orientation practice, supporting its practical delivery within the study hospital and its potential for further implementation evaluation.

Several limitations should also be acknowledged. First, the intervention evaluation included only 10 participants from a single tertiary hospital, limiting statistical power and the generalizability of the findings. The inferential results should therefore be considered exploratory. Second, the absence of a comparison group precludes causal attribution of the observed changes to the intervention. Third, this study was designed as a preliminary feasibility study, and follow-up was limited to the intervention period. Consequently, the long-term sustainability of the observed improvements remains uncertain. Future multicentre controlled studies with larger sample sizes and longer follow-up are warranted to evaluate the effectiveness of structured organizational support programs, evaluate their implementation in different healthcare settings, and determine whether the observed short-term improvements can be sustained over time.

Conclusion

Occupational adaptation among newly recruited healthcare professionals extends beyond technical competence to include psychological adjustment, workplace communication, and team integration. The needs-informed group-based organizational support program was well accepted, and preliminary improvements in occupational adaptation were observed following the program. Larger multicentre controlled studies are needed to assess its effectiveness, implementation feasibility, and generalizability before widespread implementation.

Data Sharing Statement

The datasets generated and/or analyzed during the current study are not publicly available due to institutional data governance and confidentiality policies. Requests for access to the data should be directed to Li Ma at [email protected] and will be considered upon reasonable request and subject to permission from Beijing Chest Hospital.

Ethics Approval and Consent to Participate

This study was approved by the Institutional Review Board of Beijing Chest Hospital (Approval No. BJXK-2023-KY-31). Participation was voluntary, and written informed consent was obtained from all participants prior to data collection. All data were anonymized before analysis to protect participant confidentiality and privacy. The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Funding

This study was supported by the Beijing Hospitals Authority Incubating Program (Grant No. PG2025023), the Research Project on the Current Status and Promotion Strategies of Multidisciplinary Diagnosis and Treatment Collaboration in Municipal Hospitals of the Beijing Hospitals Authority (Grant No. 2025YGZLYJ-01-02-2), and the Medical Social Work Capacity Development Program (Grant No. DYPY202311). The funding bodies had no role in study design, data collection, data analysis, interpretation of the data, manuscript preparation, or the decision to submit the manuscript for publication.

Disclosure

The authors declare that they have no competing interests.

References

1. Ojala H, Kuivila HM, Mikkonen K, Jarva E, Juntunen J. Factors associated with newly graduated nurses’ work engagement: systematic review of quantitative studies. J Adv Nurs. 2026;82(3):1947–13. doi:10.1111/jan.17069

2. Kenny A, Dickson-Swift V, McKenna L, et al. Interventions to support graduate nurse transition to practice and associated outcomes: a systematic review. Nurse Educ Today. 2021;100:104860. doi:10.1016/j.nedt.2021.104860

3. Kim H, Kim E, Noh J, Bang E, Tak SH. The effect of a 10-week field-oriented transition programme for new graduate registered nurses in critical care. Nurs Crit Care. 2025;30(2):e13298. doi:10.1111/nicc.13298

4. Kong LN, Yao Y, Chen SZ, Mi J. Levels of transition shock and associated factors among newly graduated nurses: a systematic review and meta-analysis. Nurse Educ Pract. 2026;94:104863. doi:10.1016/j.nepr.2026.104863

5. Woo T, Ho R, Tang A, Tam W. Global prevalence of burnout symptoms among nurses: a systematic review and meta-analysis. J Psychiatr Res. 2020;123:9–20. doi:10.1016/j.jpsychires.2019.12.015

6. de Vries N, Boone A, Godderis L, et al. The race to retain healthcare workers: a systematic review on factors that impact retention of nurses and physicians in hospitals. Inquiry. 2023;60:469580231159318. doi:10.1177/00469580231159318

7. Nijkamp N, Calleja P, Sahay A. Transition support arrangements to support new graduate & novice nurses entry into perioperative nursing: a scoping review. Heliyon. 2024;10(1):e23316. doi:10.1016/j.heliyon.2023.e23316

8. Ventimiglia G, Setti I, Maffoni M. Mentoring in hospital settings: a systematic review of guidance, care, and professional development. Healthcare. 2026;14(4):505. doi:10.3390/healthcare14040505

9. Galanis P, Moisoglou I, Papathanasiou IV, et al. Association between organizational support and turnover intention in nurses: a systematic review and meta-analysis. Healthcare (Basel). 2024;12(3):291. doi:10.3390/healthcare12030291

10. Zhu LL, Wang H-J, Xu Y-F, Ma S-T, Luo YY. The effect of work engagement and perceived organizational support on turnover intention among nurses: a meta-analysis based on the price–mueller model. J Nurs Manag. 2023;2023(1):3356620. doi:10.1155/2023/3356620

11. Holtz H, McQueen A, Weissinger G, et al. The impact of transitional shock on newer nurses in a contemporary healthcare environment. J Nurs Adm. 2024;54(9):507–513. doi:10.1097/nna.0000000000001468

12. McClure J, Gonzalez C, Elmir H, et al. Clinical education programs for new graduate nurses: a scoping review. BMC Nurs. 2026;25(1). doi:10.1186/s12912-026-04561-8

13. du Toit A, Leech R, Coetzee-Prinsloo I. Managing the support needs of newly graduated nurses in professional practice environments: a scoping review. Nurse Educ Pract. 2026;90:104663. doi:10.1016/j.nepr.2025.104663

14. Charette M, McKenna L, McGillion A, Burke S. Effectiveness of transition programs on new graduate nurses’ clinical competence, job satisfaction and perceptions of support: a mixed-methods study. J Clin Nurs. 2023;32(7–8):1354–1369. doi:10.1111/jocn.16317

15. Ying L, Fitzpatrick JM, Philippou J, Huang W, Rafferty AM. The organisational context of nursing practice in hospitals in China and its relationship with quality of care, and patient and nurse outcomes: a mixed-methods review. J Clin Nurs. 2021;30(1–2):3–27. doi:10.1111/jocn.15486

16. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101. doi:10.1191/1478088706qp063oa

17. Baharum H, Ismail A, McKenna L, Mohamed Z, Ibrahim R, Hassan NH. Success factors in adaptation of newly graduated nurses: a scoping review. BMC Nurs. 2023;22(1):125. doi:10.1186/s12912-023-01300-1

18. Cornett M, Palermo C, Ash S. Professional identity research in the health professions-a scoping review. Adv Health Sci Educ Theory Pract. 2023;28(2):589–642. doi:10.1007/s10459-022-10171-1

19. Narbona-Gálvez Á, García-Iglesias JJ, Ayuso-Murillo D, et al. Stress in novice nurses in new work environments: a systematic review. Front Public Health. 2024;12:1463751. doi:10.3389/fpubh.2024.1463751

20. Al-Tikriti S, Kennedy C, Abubakr K, Higgins M. Navigation of dual identities among health care professionals transitioning between clinical practice and research roles: scoping review protocol. JMIR Res Protoc. 2026;15:e76490. doi:10.2196/76490

21. Cruess RL, Cruess SR, Steinert Y. Amending miller’s pyramid to include professional identity formation. Acad Med. 2016;91(2):180–185. doi:10.1097/acm.0000000000000913

22. Cruess RL, Cruess SR, Boudreau JD, Snell L, Steinert Y. A schematic representation of the professional identity formation and socialization of medical students and residents: a guide for medical educators. Acad Med. 2015;90(6):718–725. doi:10.1097/acm.0000000000000700

23. Hallaran AJ, Edge DS, Almost J, Tregunno D. New nurses’ perceptions on transition to practice: a thematic analysis. Can J Nurs Res. 2023;55(1):126–136. doi:10.1177/08445621221074872

24. Duchscher JE. Transition shock: the initial stage of role adaptation for newly graduated registered nurses. J Adv Nurs. 2009;65(5):1103–1113. doi:10.1111/j.1365-2648.2008.04898.x

25. Polansky MN, Koch U, Rosu C, Artino AR, Thompson A. Which learning experiences support an interprofessional identity? A scoping review. Adv Health Sci Educ Theory Pract. 2023;28(3):911–937. doi:10.1007/s10459-022-10191-x

26. Verhees MJM, Landstra AM, Engbers R, Koksma JJ, Laan R. Exploring workplace-based learning in distributed healthcare settings: a qualitative study. BMC Med Educ. 2024;24(1):78. doi:10.1186/s12909-024-05053-6

27. Fuentes-Cimma J, Sluijsmans D, Riquelme A, et al. Designing feedback processes in the workplace-based learning of undergraduate health professions education: a scoping review. BMC Med Educ. 2024;24(1):440. doi:10.1186/s12909-024-05439-6

28. Rothwell C, Kehoe A, Farook SF, Illing J. Enablers and barriers to effective clinical supervision in the workplace: a rapid evidence review. BMJ Open. 2021;11(9):e052929. doi:10.1136/bmjopen-2021-052929

29. Cruess SR, Cruess RL, Steinert Y. Supporting the development of a professional identity: general principles. Med Teach. 2019;41(6):641–649. doi:10.1080/0142159x.2018.1536260

30. Zhang J, Shields L, Ma B, et al. The clinical learning environment, supervision and future intention to work as a nurse in nursing students: a cross-sectional and descriptive study. BMC Med Educ. 2022;22(1):548. doi:10.1186/s12909-022-03609-y

31. Brook J, Aitken L, Webb R, MacLaren J, Salmon D. Characteristics of successful interventions to reduce turnover and increase retention of early career nurses: a systematic review. Int J Nurs Stud. 2019;91:47–59. doi:10.1016/j.ijnurstu.2018.11.003