Nurse Education, Practice, Quality and Retention - Transition to Practice Program - The Transition-to-Practice through Academic-Practice Partnership, Student Training, Experiential Preparation, and Simulation (TAPP-STEPS) will increase the supply of a high-quality nursing workforce for rural and medically vulnerable communities in North Carolina. The project addresses nursing shortages, uneven access to rural and community-based clinical education, limited preparation for primary and community-based care, and the academic-to-practice transition gap. Over four years, TAPP-STEPS will recruit, retain, and support 40 undergraduate prelicensure nursing students (10 annually) through the Carolina STEP-IN (Supporting the Transition of Experienced Personnel Into Nursing) Rural Ready Scholar Pathway. Recruitment prioritizes students with prior healthcare experience and rural backgrounds, connections, or commitment to medically vulnerable populations. Scholars will receive financial assistance, academic and peer support, structured mentoring, remediation, rural career coaching, and travel support for approved learning. Each scholar will complete a sequenced, three-course, 3-credit, pass/fail experiential elective series modeled on established UNC SON experiential-learning courses. The series will provide at least 100 additional hours beyond standard nursing clinical rotations: 50 hours of rural hospital micro-immersions, 30 hours of supervised mobile, community, and prevention-focused learning, and 20 hours of standardized patient, human simulation, and telehealth-enabled preparation. Scholars who secure rural summer externship may enroll in an optional 1-credit course. TAPP-STEPS will strengthen student-centered competency-based education through instruction, assessment, feedback, remediation, and progression focused on clinical judgment and safe practice. The UNC SON-UNC Health Rural Transition-to-Practice Partnership will expand rural and community training opportunities, engage preceptors, and strengthen externship-to-capstone-to-employment pathways. Structured educator development will support coaching, debriefing, competency assessment, remediation, and learner handoff. High-fidelity maternal and pediatric simulation, standardized patients, and telehealth will support measurable competencies, interprofessional care, and reusable resources benefiting scholars and the broader prelicensure student population. Existing institutional systems will monitor recruitment, retention, scholar support, elective completion, experiential hours, direct-versus-simulation balance, competency progression, partner engagement, pathway completion, and graduate employment and retention at six- and 12- months. Expected outcomes include 40 scholars completing the required sequence and 100 additional hours; increased rural training capacity; stronger educator and preceptor capability; improved clinical judgment and rural practice readiness; expanded workforce transition pathways; and a sustainable, replicable academic-practice model.
