New Graduate Professional APPRENTICESHIP

From Novice to Competent Team Member!

Successful recruitment and retention of the new graduate is key to filling RN vacancies. But new nurses are not prepared for the complex patients and hospital culture that awaits them at graduation. 


New graduates across the country are struggling to connect the dots from theory to practice.

   The academic-practice gap in nursing is well documented.

   Academe is criticized for producing nurses insufficiently prepared to fully participate in patient care.

   Practice settings are criticized for having unrealistic expectations of new graduates. 

                                                                                                                                                                    (Huston et al., 2018)

Registered nursing has been recognized by the Department of Labor as an occupation where structured, on-the-job apprenticeships could improve the quality of nurse skills and services provided.   

Our New Graduate Professional Apprenticeship combines structured on-the-job learning with related, supportive web-based instruction.  Integrated seminar-based and work-based learning opportunities will help the new nurse launch a successful career.

COS brought together respected educators, clinical practice experts and health policy experts to address strategies that would retain and develop the new graduate while addressing the new graduate’s job expectations. 

The result is a unique, 12-month long, New Graduate Professional Apprenticeship Program (NGPAP) whose structure and content is based in current research and extensive experience in nursing.  

State-of-the-art, cloud-based technology is leveraged to deliver course material, achieve critical task competence, enhance critical thinking skills, and support and coach the new graduate throughout the first year of practice. 

Education and support is also provided to the care team who work with the new graduate so that they may participate in the new graduate’s transition to practice. Through this involvement, bonds are forged between the new graduate and their unit and hospital, resulting in higher levels of satisfaction, competence and confidence which lead to increased new graduate retention.



For the New Graduate

  · Support for transition from novice to competent, professional nurse

  · Improve confidence and competence

  · Ease transition from classroom to bedside 

 For the Hospital

  · Improve patient outcomes

  · Improve staff resiliency and satisfaction

  · Improve RN recruitment and retention

  · Decrease overtime and bonus pay

  · Decrease contract labor

The NGPAP prepares the New Graduate to:

1. Demonstrate effective decision-making skills.

2. Function as a partner with professional colleagues in the patient care team.

3. Incorporate research and evidence into practice.

4. Provide clinical leadership in improving patient care.

5. Formulate an individual plan for continued learning and professional development.

NGPAP History

The COS NGPAP is based on recommendations and evidence gathered over 10 years by the Institute of Medicine, the Joint Commission, National Council of State Boards of Nursing and the Robert Wood Johnson Foundation.  

Guided by the 2015 report, Assessing Progress on the IOM Report The Future of Nursing, and the work of the Action Coalitions, NGPAP qualities and course content are designed to achieve maximum benefit for the patient, the staff and the hospital.  

NGPAP courses include:

    1. Clinical Courses

    2. Culture Transition Courses

    3. Leadership Development Courses

Critical Thinking content,  scenarios and evaluation are threaded throughout the program.

Innovative Blended Learning System

 All COS Programs are delivered on a web-based platform provided by Brightspace, an industry-leading, learning management system.   

The NGPAP is a unique experience that occurs both online and onsite.  This innovative approach is referred to as Blended Learning.   

To learn about how the NGPAP is delivered and by whom,  click on the button below.


Clinical Competency

1. Clinical Competence Course

    (Knowledge Evaluation / Validation / Learning)

         · General Patient Care

         · Medication & Pain Management 

         · Lymph & Immune System 

         · GU & Reproductive Systems

         · Gastrointestinal System 

         · Musculoskeletal System 

         · Nervous System 

         · Endocrine System 

         · Integumentary System 

         · Cardiovascular System 

         · Respiratory System 

         · Behavioral Health

         · Critical Thinking: Thinking Like a Nurse

2. Clinical Skill Validation

Key skills, identified from the Clinical Competence Course and from hospital and unit needs, are used to create Clinical Skill Validation. 

The Preceptor checks off the new graduate skills anywhere there is an internet with Chrome browser, including at the bedside, using COS Bedside Skill Sign-Off. 

Skill validation progress can be viewed any time on Dashboards to support early intervention for problem solving and opportunities to praise and encourage wins.

Culture Transition

1. Workplace Culture Toolbox

         · Integrity & Ethics

         · Health Policy & Regulatory Frameworks

         · Healthcare Business & Finance

         · Role Transition & Self Care

         · Workplace Acclimation & Organization

         · Change Management

         · Communication 

         · Patient Education 

         · Case Management & Care Management

         · Quality & Culture of Safety 

2. Culture Competency Validation

Competency Validation includes a Casey-Fink Survey self-assessment at Program start and at 6-month and 12-month points. 

Self-assessment topics include:

         · Confidence & Competence

         · Mastery of the Job

         · Ability to Organize & Prioritize

         · Satisfaction & Engagement

Leadership /Patient Ownership

1. Leadership Development

         · Teamwork & Leadership Skills    

         · Evidence-based Practice & Research

         · Career Path Development

2. Leadership Competency Validation

A Clinical Leadership/Quality Improvement Project is completed during the last 6 months of the Program. It is a capstone-like project designed to examine and put into practice a quality improvement idea for patient care, unit environment or team processes.  It encourages the new graduate to take ownership of their patients and contribute to their team and unit.

The Clinical Leadership / Quality Improvement Project supports development of critical thinking and clinical reasoning skills.  It provides a framework for exploration and continuous, lifelong learning.  

The excitement of finding and sharing an improvement for patient care or for the quality of life for colleagues on your own unit can be the impetus for a life of contribution in nursing. 



Designed to support competency-based learning, NGPAP dashboards are available online for review at any time. These actionable learning analytics, support maximum productivity for the new graduate and healthcare team.

New graduate progress and outcomes available for review include:

  • Confidence
  • Competence
  • Mastery of the Job
  • Ability to Organize and Prioritize
  • Satisfaction
  • Engagement
  • Bedside Leadership
  • Course Progress
  • Competency Completion

COS works with the hospital to provide hospital data to trend program impact.

 1.     Organization Data

  • Recruitment
  • Turnover
  • Overtime
  • Bonus Pay
  • Contract Labor

2.     Clinical outcomes