Leadership support is essential in helping new graduate nurses transition into practice and be successful in their new roles. Nurse residency programs are a key strategy for providing this support. However, one question that sometimes arises is how involved direct leaders, such as managers, should be in residency sessions.
Nurse residency programs were created to help bridge the gap between school and real-world experience. They are designed to provide new graduate nurses with structured support as they navigate this transition. A key component of these programs is to create an environment where residents feel comfortable learning, reflecting, and growing alongside their peers.
The Value of Peer-Centered Learning
Evidence shows residency programs are most effective when they are peer-focused. This means that residents often help lead discussions, and the group primarily consists of individuals in the same group. This structure helps promote psychological safety, allowing individuals to speak openly about concerns and challenges that they are facing.
When direct leaders are present, sessions may feel more evaluative for the new graduate nurse. This perception can lead residents to hold back, limiting open discussion and honest reflection. Research supports this, finding that student groups without faculty present reported stronger group dynamics, improved learning processes, and higher individual participation (Hoffman, Wilkinson, Xu, & Wiecha, 2014).
Peer-centered environments allow new nurses to:
- Think out loud without fear or judgment
- Share both positive and challenging experiences
- Help to build confidence through reflection
The AACN Practice Transition Accreditation Program standards recommend that educational experiences be separated from performance evaluations, reinforcing the importance of maintaining a safe, non-evaluative learning space for new nurses.
Psychological Safety and Program Outcomes
It has been found that residency programs are most impactful when they foster psychological safety. Dr. Amy Edmondson states, “Psychological safety describes the individuals’ perceptions about the consequences of interpersonal risk in their work environment” (Sherman, 2024). When present, new nurses can process their experiences more easily, normalize common challenges to know that they are not alone, and can help them develop their professional identity.
Research and best practice guidelines consistently show that residency sessions are more effective when direct leaders are not routinely present. Their absence supports open communication and reduces fear of judgment or embarrassment (Dong, Altshuler, et al., 2025). When sessions are more leader-driven, residents may feel less comfortable sharing ideas or concerns.
Leadership Role
While the presence of direct leaders in residency sessions may not be the most effective, leadership involvement remains critical in supporting the new nurse. Leaders play an important role by engaging with the individual at key times, such as during orientation, when they hit milestones, and completing individual check-ins outside of residency sessions. At these times, leaders can help reinforce real-world practice and what is being talked about in residency, provide individualized support, and help new nurses navigate specific challenges on the unit.
The goal in supporting these new nurses is to provide structured support, while also offering them autonomy. Residency sessions should prioritize peer connection and a sense of psychological safety, allowing participants to talk about their feelings and real-life experiences, while leaders also remain actively engaged outside the sessions, providing support and guidance to the individual.
Amanda Bruscher, MSN, RN
Iowa Online Nurse Residency Program Coordinator
amanda-bruscher@uiowa.edu
References:
CCNE standards for accreditation of entry-to-practice ... AACN Nursing. (2021). https://www.aacnnursing.org/Portals/42/CCNE/PDF/CCNE-Entry-to-Practice-Residency-Standards-2021.pdf
Dong C, Altshuler L, Ban N, Wong LY, Mohammed FEA, Tang CT and Kachur E (2025) Psychological safety in health professions education: insights and strategies from a global community of practice. Front. Med. 11:1508992. doi: 10.3389/fmed.2024.1508992
Hoffman, M., Wilkinson, J. E., Xu, J., & Wiecha, J. (2014). The perceived effects of faculty presence vs. absence on small-group learning and group dynamics: a quasi-experimental study. BMC medical education, 14, 258. https://doi.org/10.1186/s12909-014-0258-1
Pinkerton, B. (2025, June 3). Breaking the silence: Why nurse peer groups matter now more than ever. nurse.org. https://nurse.org/news/peer-support-groups-nurse-well-being-community/
Sherman, R. O. (2024, September 16). Creating psychological safety for staff. Emerging Nurse Leader. https://emergingrnleader.com/creating-psychological-safety-for-staff/