Nurse Education, Practice, Quality and Retention - Transition to Practice Program - The University of Tennessee at Chattanooga (UTC) College of Nursing proposes BRIDGE-RN -Bridging Rural workforce gaps through Immersive, Deliberate, Guided Entry into practice, a NEPQR-TPP project to strengthen the nursing workforce and expand access to care in Chattanooga, Hamilton County, and nine surrounding medically vulnerable counties in Southeast Tennessee. Partnering with the Chatt Foundation and UTC Mobile Moc, BRIDGE-RN addresses nursing shortages, important healthcare priorities, and the gap between new-graduate competence and employer expectations. The BRIDGE-RN program targets three integrated strategies. First, it expands and enhances the health professions pipeline by building formal, supported pathways for LPNs, EMTs, CNAs, paramedics, and other unlicensed personnel to enter and complete the BSN program, paired with targeted recruitment and holistic admissions. Competency-based curriculum redesign, grounded in gap-analysis work, will integrate health priorities such as chronic disease management, nutrition, and disease prevention. BRIDGE-RN expands community and clinical training partnerships in non-traditional, rural, and medically vulnerable settings, building on the existing Chatt Foundation foot care clinic, pursing a mobile foot clinic outreach model, and mobile health unit to extend care and clinical training into underserved communities, including housing-instable populations, senior centers, and those with limited access to care. The BRIDGE-RN project provides structured faculty and preceptor development, including trauma-informed care training and simulation technology instruction (VR/XR), to sustain high-quality clinical teaching as partnerships scale. A major aim of the BRIDGE-RN is the Traineeship Program. The program will award 15 annual traineeships to BSN/ABSN students, prioritizing those committed to serving rural/medically vulnerable populations. Trainees choose a Clinical/Experiential or Research/EBP path, complete a two-semester supplemental course linking didactic content to a health equity project, and log 100 enrichment hours spanning simulation, professional development, and mentored service. Trainees will be encouraged to committee to post-graduation employment at sites serving medically underserved areas. Recognizing that formal, structured mentoring is among the strongest evidence-based predictors of nursing student retention, BRIDGE-RN embeds a mentoring infrastructure addressing relationship development, psychosocial support, academic/clinical support, and role modeling. Every trainee is paired with a trained faculty and student mentor at admission, with defined touchpoints each semester rather than reactive support. A peer-to-peer mentoring network that will include a peer skills lab mentorship program, summer workshop series, and ongoing “lunch-and-learn” sessions extending support across all BSN students. A post-graduate engagement program sustains contact with recent graduates, offering continuing professional development and creating pathways into UTC's graduate program and future preceptor roles. Over the project period, an estimated 375 BSN/ABSN students, including all traineeship participants, will complete simulation-enhanced, practice-ready training. UTC's existing track record of placing 65% of BSN graduates into Chattanooga/Hamilton County nursing positions offers a strong foundation for extending workforce retention into the additional target counties. Formative and summative evaluation, guided by a rapid-cycle quality improvement framework, will track enrollment, progression, clinical competency, health equity project outcomes, graduate employment, and retention in medically underserved areas. Successful mentoring and traineeship models will be institutionalized into the standing BSN curriculum and disseminated through a mentoring and traineeship toolkit and conference presentations. These efforts will ensure sustainability and replicability beyond the grant period.
