To develop the New Nurse Manager Fellowship curriculum, Atrium Health conducted a rigorous needs assessment of skills required by new nurse managers, referencing AONL and ANCC established models. Additionally, Atrium Health used feedback provided by the Nurse Manager Advisory Group to better understand the immediate needs of practicing nurse managers in the system. The needs assessment began by identifying the specific challenges facing new nurse managers, and then identifying the learning areas that aligned with each challenge.

The needs assessment was followed by a gap analysis of existing development resources to minimize duplication and overlap between the fellowship program and existing leadership trainings. The central aim of the gap analysis was to understand what support and training nurse managers needed to develop their managerial skillsets from a theoretical context to one of everyday application. An added goal of the gap analysis was to pinpoint resources that would avoid making new nurse managers feel like they were repeating a graduate school experience. The gap analysis enabled the fellowship to be designed in a way that was tailored explicitly to leadership development skills, focusing on the unique context of a nurse manager.

How Atrium Health developed their Fellowship curriculum using three main steps

Step I: Identify the distinct problem area and the desired outcome

Atrium Health Chief Nurse Executives (CNEs) identified new nurse managers as a key constituency in need of added support. They reached this conclusion after reviewing data from a variety of sources: retention rates for 1st year nurse managers, feedback from the Nurse Manager Advisory Group (an advisory council of nurse managers), as well as informal discussions with individual nurse managers. Feedback they received indicated that there was a need for a targeted, comprehensive, and standardized leadership development process to support new nurse managers.

Putting together all of this feedback, Atrium Health decided to create a professional development program specifically for nurse managers. The program had two main goals: 1) to assist new nurse managers in acquiring needed skills and confidence for their role and 2) to improve retention rates for 1st year nurse managers.

Step II: Conduct a needs assessment to pinpoint specific skills for reinforcement

Building off of feedback from the Nurse Manager Advisory Group and individual nurse managers, Atrium Health identified that many new nurse managers felt overwhelmed by their role from an operational standpoint (i.e. how do I manage a team effectively, provide effective feedback, create a budget, etc.) as well as from an engagement standpoint (i.e. how do I achieve sustainable work-life balance as a leader). They asked probing questions of nurse managers to identify specific skillsets that they felt required further reinforcement. Business acumen, such as budgeting and data analysis, creating a staffing schedule, and holding crucial conversations with staff were some of the leading areas identified for further development.

Step III: Use a gap analysis to identify existing resources

System Nursing cross-referenced the skills identified in the needs assessment with existing development resources at Atrium Health, including trainings already found in onboarding trainings and through the online resource portal. They worked with the system’s Learning and Development staff to determine whether there was any overlap between existing resources and the proposed curriculum. Throughout the process, Atrium Health sought to align each learning goal with the AONL Nurse Manager Competencies, the ANCC Transition to Practice Guidelines, as well as Atrium Health Strategic Priorities.

Implement this best practice at your own organization

When contemplating a curriculum re-design at your organization, be sure to:

• Identify both new skills for integration as well as any existing skill areas that require reinforcement.
• Ask staff members who have gone through your professional development programs for feedback and use these answers to complement any operational performance data that you are analyzing, such as patient outcomes or staff retention.
• Identify all existing development resources at your organization before designing a new curriculum.
• Determine whether you can repurpose any existing resources to address the results of your needs assessment before choosing to design and implement any new educational programing.

A stated goal during the design of the Fellowship was to only add trainings to the curriculum if the subject matter was not covered by any existing resources. Atrium Health’s gap analysis proved particularly useful in avoiding overlap between existing learning resources and the planned curriculum. Nursing Professional Development, which designed the curriculum, partnered with Atrium Health’s Learning & Development team to conduct this gap analysis. This partnership ensured that Nursing Professional Development was made aware of all existing resources and in some cases allowed the curriculum to build off trainings that new nurse managers had received during onboarding. See our example below of how you can use a gap analysis to isolate learning goals at your organization.

Model of how to use a gap analysis to develop nurse manager learning goals at your organization

1. After conducting a needs assessment at your organization to identify overarching areas/skillsets for improvement, isolate individual learning goals.

Overarching area for improvement:
Nurse managers need additional, standardized support for the annual budgeting process, focusing on the specific nuances of productivity standards and budgeting at the organization.

Identified learning goals:

• Nurse managers must understand their role within the annual budgeting process
• Nurse managers should feel comfortable with financial literacy and basic data analysis
• Nurse managers need to learn how to navigate online budgeting tools

2. Conduct a thorough audit of existing resources to determine if any already address the identified learning goals and can be repurposed or improved to meet the needs assessment findings.

Do any of our existing continuing education opportunities address the unique learning needs of new Nurse Managers regarding budgeting and data analysis…?

New leader onboarding: Addresses budgeting, but is not nursing-specific

Continuing professional development trainings: Addresses budgeting, but is not nursing-specific

Online resource portal for organization leaders: Resources available, but are not nursing-specific

3. Lastly, pinpoint whether any of the identified learning areas fall through a ‘gap’ in their collection of existing learning and development resources. Then, consider the best means to address that gap.

Some resources found that address how to help nurse managers implement a unit budget, but are not designed for novice nursing leaders: Include an in-person training around budgeting in the fellowship

Trainings during the 9-12 month fellowship are scheduled to precede or coincide with a nurse manager’s daily and seasonal responsibilities. Atrium Health finalizes annual budgets in the fall; as a result, new nurse managers receive the training ‘Tools for Budgeting & Organization’ in September during the budget season. Similarly, performance reviews are conducted in the fourth quarter; nurse managers receive training on conducting performance appraisals and delivering feedback in early fall.

The benefit of this alignment is that it enables the trainings to come right before or at the same time as the actual tasks for which the manager needs extra preparation. So when a manager has to sit-down and finalize an annual budget in early autumn, the knowledge and practice gained from the training in September will still be fresh in their minds. For tasks that take place all-year, such as nurse leader rounding, nurse managers will be able to bring the experiences they have already gained on-the-job to the fellowship and use the training to identify areas for improvement. As a result, the training is transformed from theory to actual practice, as nurse managers connect existing job experiences to the knowledge gained in-class.

Each training during the New Nurse Manager Fellowship is delivered by a subject matter expert instead of by Learning & Organizational Development staff. These experts volunteer to deliver the training as part of their job.

Atrium Health has found this practice to be beneficial for both new nurse managers and the divisions which are supplying the subject matter experts. The new nurse managers receive the benefit of learning skills from the most knowledgeable source and in the process gain a contact who can also serve as a point of contact when questions arise. The subject matter experts become acquainted with new leaders and are guaranteed a set time in which to fully explain operations knowledge, instead of having to schedule individual meetings with each new manager.

Key logistics

Each in-person training typically last three hours

Most of the trainings are conducted by 3-4 subject matter experts, either individually or as a panel

How are subject matter experts chosen?

Subject matter experts were identified by Nursing Professional Development through a variety of processes. At the Atrium Health Nurse Leader Summit, a cross-system meeting with leaders from multiple units, participants were asked to fill out an online evaluation form. This form asked whether the participant had been in-seat in their leadership role for more than 2 years; if they answered yes, then the evaluation directed them to a new page where the participant was asked whether they would be willing to volunteer their time as a subject matter expert and teach a training during the Fellowship.

Some subject matter experts were identified by Nursing Professional Development directly based on reputation and experience and asked to teach a training during the Fellowship. All subject matter experts were selected not only on their experience and willingness, but also on their ability to teach a training effectively. A number of subject matter experts were already teaching trainings on their area of expertise.

What is expected of subject matter experts before and during the training?

Before: Ahead of the training, subject matter experts work with program team to develop their materials. Ahead of the training, Nursing Professional Development sends the subject matter expert the AONL1 nurse competencies related to the training topic for them to peruse. These competencies typically help subject matter experts develop specific talking points for their presentation. Additionally, Nursing Professional Development will provide a projector and computer for any PowerPoint presentations.

If the subject matter experts are presenting as part of a panel or are building their presentation off of a preceding speaker, Nursing Professional Development will arrange Skype calls ahead of the training with the presenters. These presenters will then discuss how to best align their presentations and talking points with each other.

During: The trainings are designed to be largely conversational. Subject matter experts are expected to present on their topics, but to also integrate opportunities for questions and conversations. Activities such as icebreakers and practice exercises are also included within each session.

What motivates subject matter experts to volunteer their time for the Fellowship?

While the overall time commitment is fairly low (a few hours once every 9-12 months), subject matter experts are still volunteering their time and effort to teach a Fellowship training. Their primary motivation to participate is the strong understanding that when nurse managers understand organization processes and how to do their job well, it benefits the entire department. In particular, when nurse managers learn how to perform well as managers, it typically makes the jobs of the subject matter experts easier: fewer mistakes are made, fewer questions are asked, and a strong rapport between the nurse managers and the subject matter experts is established.

Incentivize participation in learning by aligning trainings with credit hours

All of the in-person sessions in the New Nurse Manager Fellowship count as credit hours for nurse continuing education requirements. As a result, nurse managers not only gain further knowledge, but they also can count their professional development activities towards certification as a nurse executive through ANCC or AONL.

At your institution, consider what requirements must be met in order to count a learning activity towards official licensure and continuing education credit hours. Doing so will help incentivize participation and drive engagement.

Examples of trainings led by subject matter experts at Atrium Health