Nurse Education, Practice, Quality and Retention - Transition to Practice Program - Metropolitan State University of Denver (MSU Denver), in partnership with Denver Health, proposes the LEARN: Learn and Earn Apprenticeship into Registered Nursing Pathway (LEARN Pilot) through the Nurse Education, Practice, Quality, and Retention—Transition to Practice Program (NEPQR-TPP). The project will strengthen the nursing workforce and expand access to care in medically underserved and rural communities by creating an innovative, competency-based, earn-while-you-learn pathway that supports frontline healthcare workers in becoming Bachelor of Science in Nursing (BSN)-prepared registered nurses. Colorado faces a significant nursing workforce shortage, while Denver Health, Colorado’s primary safety-net health system, experiences substantial vacancy rates among early-career registered nurses. The LEARN Pilot addresses these challenges by recruiting and supporting incumbent healthcare workers, including Certified Nursing Assistants (CNAs), Emergency Medical Technicians (EMTs), Medical Assistants (MAs), and other unlicensed assistive personnel currently employed within the health system. Participants will remain employed while progressing through prerequisite coursework and a CCNE-accredited BSN program, reducing financial barriers that often limit career advancement for working adults. During the four-year project period, the LEARN Pilot will support sixteen trainees through a structured apprenticeship pathway that combines competency-based education, simulation-enhanced learning, academic advising, mentoring, tuition assistance, and community-based clinical training. Participants will receive direct support through tuition assistance, academic tutoring, supplemental instruction, peer mentoring, individualized advising, and subsistence support to improve retention, progression, and successful program completion. The project directly aligns with all four NEPQR-TPP objectives by: (1) expanding nursing workforce pathways through competency-based curriculum and career advancement opportunities; (2) strengthening academic-practice partnerships and increasing training opportunities in community-based, medically underserved, and rural settings; (3) providing faculty and preceptor development and support; and (4) expanding experiential learning through simulation-based technology and innovative clinical education. Clinical training will occur across a continuum of care that includes acute care, community health centers, school-based health centers, mobile health units, and a rural critical access practice site. Participants will complete more than 100 additional clinical hours beyond traditional nursing program requirements in nontraditional and community-based settings serving medically underserved and rural populations. The project will enhance experiential learning through acquisition and implementation of high-fidelity simulation equipment, virtual reality simulation technology, maternal-child simulation resources, and competency-based simulation curricula aligned with International Nursing Association for Clinical Simulation and Learning (INACSL) standards. Simulation experiences will focus on chronic disease management, maternal and infant wellness, behavioral health, therapeutic communication, de-escalation, social determinants of health, and interprofessional team-based care. Expected outcomes include increased recruitment and retention of incumbent healthcare workers into nursing education pathways, successful progression through prerequisite and nursing coursework, enhanced clinical competency and transition-to-practice readiness, strengthened faculty and preceptor capacity, and increased employment of graduates in medically underserved and rural communities. Project findings and apprenticeship strategies will be disseminated throughout Colorado’s nursing workforce network to support sustainability, replication, and broader implementation of effective nursing workforce development models.
