Implementation of an Enculturation Toolkit for New Nurses During Unit Onboarding

Abstract

Objective: This quality improvement project targeted an enculturation gap among new nurses by assembling and piloting an Enculturation Toolkit.

Background: Enculturation of new nurses contributes to engagement, performance, sense of belonging, and retention. During the COVID-19 pandemic, orientation was shortened, virtual, and asynchronous, creating a gap in enculturation.

Methods: New nurses and their preceptors were surveyed at baseline, 2 to 3 months, and 4 to 5 months to measure engagement and enculturation using the Meaning and Joy in Work Questionnaire (MJWQ) and questions about the history and values of the organization.

Results: Initial MJWQ responses were high and sustained throughout the study period. Participants demonstrated increased knowledge of the organization's mission statement and logo. New nurses rated the toolkit activities favorably, with an average score of 4.6 out of 5.

Conclusions: An Enculturation Toolkit was effective in improving knowledge about the organization and sustaining engagement and belonging.

Figure 1

Concept model for drivers of engagement. This model is adapted from another model of engagement from Shanafelt and Noseworthy. In this model, Organizational culture, sense of community, and meaning in work comprise approximately half of the dimensions of engagement and those most malleable at the individual level. The other dimensions are subject to more rigid organizational structures: efficiency and resources, workload demands, lack of control, and work-life integration. From: Shanafelt TD & Noseworthy JH. Executive leadership and physician well-being: nine organizational strategies to promote engagement and reduce burnout. Mayo Clin Proc. 2017;92(1):129-146; used with permission of Mayo Foundation for Medical Education and Research, all rights reserved.

Figure 2

Engagement and enculturation survey results. MJWQ responses for preceptors (A) and new nurses (B) demonstrated high initial and sustained scores throughout. Although knowledge increased for the organizational logo (C) and mission statement (D), the changes were not significant (P values generated by McNemar test from baseline to 1 month posttraining). Knowledge of the organization's primary value (E) and the 8 values (F) were initially high and stayed high.