This study will pilot a Comprehensive Transition Programme (CTP) to support nurses who move into first-line nurse manager (FLNM) roles at Clínica Universidad de Navarra. The transition to frontline management can be challenging and is linked to uncertainty, workload stress, and role ambiguity. The CTP was co-designed with clinical nurses, FLNMs, nursing directors and chief nursing officers using experience-based co-design methods so that its content fits the organisation's practice model and priorities.
The programme combines classroom training, online learning, mentorship, and structured reflective practice. Participants complete brief assessments before and after the programme. The primary focus is to see whether leadership practices improve; we will also examine feasibility and acceptability to inform future refinement.
This pilot uses a simple pre-post design with data collected at baseline and immediately after the programme. Findings will be used to optimise the CTP and to guide broader implementation in the health system.
(Eligibility, outcomes, dates and intervention components are detailed in their specific sections of this record.)
Clinical nurses with responsibility roles at Clínica Universidad de Navarra (CUN) but not yet formally appointed as supervisors.
First-Line Nurse Managers (FLNMs) with less than five years of managerial experience in the CUN.
FLNMs with more than five years of managerial experience acquired mainly in other institutions but recently appointed as first-line managers at the CUN.
Ability to understand and provide informed consent.
Nurses with more than five years of continuous experience as FLNMs at the CUN.
Nurses in middle or executive management roles (e.g., area directors, chief nursing officers).
Clinical nurses without any responsibility or leadership role.
Inability or unwillingness to provide informed consent.
Single group
Comprehensive Transition Programme (CTP)
BehavioralA co-designed, multicomponent educational programme delivered over three months to support nurses transitioning into first-line management roles. The programme integrates classroom training modules, online learning, mentorship by senior nurse managers, and structured reflective practice.
Change in leadership practices (Leadership Practices Inventory, LPI)
Leadership behaviours will be assessed using the Leadership Practices Inventory (LPI), a validated 30-item questionnaire covering five domains: Model the Way, Inspire a Shared Vision, Challenge the Process, Enable Others to Act, and Encourage the Heart. Scores range from 10 to 100 per domain, with higher scores indicating more frequent leadership behaviours. Mean change between baseline and post-intervention will be analysed.
Quality of reflective narratives
Reflective narratives written by participants will be assessed using an evaluation tool adapted from the Nursing Professional Practice Model (NPPM-CUN). The tool evaluates three core managerial competencies-respect, intentional presence, and knowing the team-together with reflective capacity. Each item is rated on a 4-point scale (1 = not demonstrated, 4 = fully demonstrated). Mean scores and changes between baseline and post-intervention will be analysed, complemented with thematic analysis of narrative content.
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Clinica Universidad de Navarra, Universidad de Navarra
Lead sponsor
University of Navarra
Sponsor institution
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