Developing regulatory readiness: A co-designed transition program and logic model for first-line nurse managers

Abstract

Background: Nurses transitioning into first-line nurse manager (FLNM) roles often receive unclear expectations, limited support, and inadequate preparation. These gaps raise concerns about regulatory readiness, as leadership competence underpins workforce stability and care quality. Experience-based co-design (EBCD) engages stakeholders to create relevant, context-sensitive programs. Purpose: To co-design a comprehensive educational program that supports novice FLNMs by addressing both technical competencies and emotional preparedness based on stakeholder input and contextual realities in two divisions of a highly specialized tertiary hospital. Methods: This study implemented a co-design process using the EBCD approach guided by the Medical Research Council Framework for complex interventions. Data collection included nonparticipant observation, seven focus groups, and two semi-structured interviews. Insights informed a persona archetype and journey map, which were the central tools used in four co-design workshops. Participants collaboratively identified priorities, which directly informed the content and structure of the intervention. Results: Participants in Stages 2 and 3 of the EBCD process included FLNMs (n = 26), nursing directors (n = 5), chief nursing officers (n = 2), and bedside nurses (n = 25). The co-design process generated a structured program comprising an onboarding phase and a multicomponent module-based curriculum. Validation workshops confirmed relevance, adaptability, and alignment with organizational and regulatory standards. A phased implementation plan and evaluation based on the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) Framework were endorsed to guide sustainability and scalability. Conclusion: Integrating EBCD with the Medical Research Council Framework produced a feasible, contextually grounded intervention. The program enhances regulatory readiness by combining technical, emotional, and relational preparation, offering a transferable model for leadership development. This study provides a replicable framework for transition programs to support novice FLNMs and strengthen workforce capacity in alignment with regulatory standards.