1127 - Perioperative Fellowship: Attract and Retain Experienced Nurses to the Operating Room

Learning Outcome: Eighty percent (80%) of learners will report increased knowledge of effective strategies to transition experienced nurses into the operating room through a structured perioperative fellowship model.

Overview/Abstract: The ongoing shortage of perioperative nurses continues to strain surgical departments nationwide, prompting healthcare organizations to reimagine recruitment and onboarding strategies. Traditional orientation models often fall short in equipping nurses transitioning from other specialties with the foundational skills required for safe, efficient practice in the operating room. This presentation introduces a comprehensive perioperative nursing fellowship designed specifically to transition experienced nurses into the OR through a structured, immersive educational model.
Developed by Mayo Clinic Arizona, the 16-week fellowship integrates the AORN Periop 101: A Core Curriculum, Simulation, Virtual Reality (VR), Hands-on Demonstrations, and Surgical specialty rotations. This multi-modal approach provides a robust learning experience that builds confidence and competence in scrubbing and circulating roles. The fellowship also includes eligibility for the Certified Foundational Perioperative Nurse (CFPN) exam upon program completion, reinforcing professional growth and retention.
This presentation will explore the implementation of a perioperative fellowship, including recruitment strategies, curriculum content, technology integration, evaluation tools, lessons learned, and key considerations for replicating the model to meet workforce needs in various perioperative settings. Attendees will leave with actionable strategies to build or refine transition pathways that empower experienced nurses to enter and thrive in the operating room.

Description of Current State: The perioperative nursing workforce is facing a critical shortage, compounded by an aging workforce, high turnover, and a limited number of nurses entering the operating room (OR) specialty (Xie et al., 2024). Despite the growing demand for surgical services, many experienced nurses from medical-surgical, critical care, or other nursing specialties encounter barriers when attempting to transition into perioperative roles. These barriers include lack of formal OR exposure during nursing education, absence of structured onboarding programs, and the steep learning curve of scrub and circulate responsibilities in a high-risk environment.
Traditional orientation models sometimes fail to provide dedicated time, structure, and educational framework necessary to support experienced nurses new to the operating room. Without formalized transition-to-practice pathways, the perioperative nursing pipeline may become insufficient to meet current and future demand. There is a need for strategic programs that not only attract experienced nurses into surgical services but also prepare and retain them through high-quality, competency-based education. Creating these transition programs is vital to sustaining the surgical nursing workforce and ensuring quality patient outcomes in increasingly complex surgical environments.

Description of Desired/Achievable State: In the desired future state, perioperative nursing departments will implement structured transition-to-practice fellowships that effectively attract, train, and retain experienced nurses seeking to enter the operating room. These programs will be intentionally designed to close the practice-readiness gap by integrating evidence-based curricula such as AORN’s Periop 101, immersive specialty rotations, simulation-based skill acquisition, and innovative technologies like virtual reality.
Participants attending this session will be taught practical steps to develop or enhance their own perioperative nurse transition programs including recruitment strategies, curriculum structure, certification pathways, and understand how these components work together to promote confidence, clinical competence, and long-term retention of experienced nurses.

Audience Engagement: To promote an interactive and impactful learning experience, this session will incorporate multiple engagement strategies throughout the presentation. Attendees will participate in live polling questions to assess baseline knowledge and perceptions about transitioning experienced nurses into the operating room. These polls will be used at key intervals to prompt reflection, compare peer perspectives, and guide discussions related to perioperative nurse onboarding, nursing retention, and the challenges of transitioning experienced nurses into the operating room.
The session will conclude with an open Question & Answer period to further re-engage participants and explore specific questions or considerations related to replicating the program. These interactive methods are intended to sustain participant attention and reinforce key learning objectives through real-time dialogue and shared insights from their experience.

Additional Information: This session offers a timely and practical solution to one of the most pressing challenges facing perioperative services today: the shortage of skilled operating room nurses and the lack of structured transition programs for experienced RNs. The presentation is grounded in a successfully implemented perioperative fellowship model developed by Mayo Clinic Arizona, combining academic-practice collaboration, innovative teaching strategies, and certification alignment.
The fellowship has demonstrated success in improving recruitment, competency development, and retention outcomes, making this presentation highly relevant to perioperative educators, nurse managers, and clinical leaders. The session will be led by the nurse educator and fellowship coordinator with extensive experience in perioperative workforce development, surgical services training, and simulation-based learning.
This presentation is suitable for attendees at all experience levels (from emerging nurse educators to seasoned perioperative directors) interested in creating or refining their own perioperative RN onboarding programs. The content will include practical implementation strategies, outcomes data, and interactive opportunities for knowledge exchange.
Speaker Requirements:
• Podium with microphone
• Slide projection with audio-visual support
• Ability to run live polling (e.g., through Slido, Poll Everywhere, or conference-provided platform)
Please consider this session as a high-impact, solution-focused contribution that addresses workforce stability in the operating room while aligning with AORN’s mission to advance perioperative nursing through innovation, education, and excellence in patient care.

Content/Topics: 1. Introduction to the Workforce Challenge
o National shortage of perioperative nurses
o Gaps in traditional orientation programs for experienced RNs
2. Overview of the Perioperative Nursing Fellowship
o Purpose and goals of the program
o Target audience: experienced RNs from med-surg, critical care, and other specialties
o Fellowship structure: duration, cohorts, eligibility, and schedule
3. Curriculum Framework and Core Components
o Integration of AORN’s Periop 101: A Core Curriculum
o Surgical Procedure Presentations
o Hands-on skills training: gowning, gloving, draping, documentation etc.
4. Immersive Clinical Training and Specialty Rotations
o Structured scrub and circulate roles
o Rotations in different surgical specialties (e.g., cardiovascular, ortho, neuro, transplant)
o Additional Clinical Rotations (Preop/PACU, CSPD)
o Preceptorship and team-based learning environments
5. Innovative Educational Strategies
o Virtual reality (VR) instrumentation and surgical procedures
o Technology’s role in improving engagement and skill development
6. Certification and Professional Growth
o CFPN certification eligibility upon completion
o CNOR pathway after two years in the OR
o Promoting professional identity and retention (AORN Membership)
7. Evaluation, Outcomes, and Program Impact
o Assessment methods: written exams, skills validation, preceptor feedback
o End of program survey: learner satisfaction
o Organizational benefits
8. Lessons Learned and Implementation Recommendations
o Key considerations for launching a fellowship
o Common barriers and solutions
o Importance of institutional support and dedicated educators/preceptors
9. Conclusion and Call to Action
o The role of fellowships in building the OR workforce
o Empowering experienced nurses to enter perioperative practice
10. Audience Engagement and Q&A
• Live polling questions
• Open Q&A session

References: • Association of periOperative Registered Nurses. (2022). AORN Position Statement on Orientation of the Registered Nurse and Surgical Technologist to the Perioperative Setting. https://www.aorn.org/docs/default-source/guidelines-resources/position-statements/education/posstat-orientation-0908.pdf?sfvrsn=543ead4e_4
• Association of periOperative Registered Nurses. (n.d.). Recruit & Retain Perioperative Nurses Amid A Nursing Shortage. Retrieved May 17, 2025, from https://www.aorn.org/docs/default-source/aorndocuments/toolkits/recruitment-and-retention/20-00372_recruit_and_retain_ebook.pdf?sfvrsn=c8e1895c_2
• Dellasega, C., Gabbay, R., Durdock, K., & Martinez-King, N. (2009). An exploratory study of the orientation needs of experienced nurses. Journal of Continuing Education in Nursing, 40(7), 311–316. https://doi.org/10.3928/00220124-20090623-04
• Fraone, J. P. (2024, May 2). From Expert to Novice: The Importance of Educators and Preceptors. https://www.aorn.org/article/from-expert-to-novice
• Russell, M. B., Koch, M., & Holecek, N. (2020, November 17). OR Orientation Hybrid Program Streamlines Transition into Practice. https://www.ormanager.com/orientation-hybrid-program-streamlines-transition-practice/
• Toomey, L. (2023, October 5). Transitioning From Expert to Novice. https://www.aorn.org/article/transitioning-from-expert-to-novice
• Xie, A., Duff, J., & Munday, J. (2024). Perioperative nursing shortages: An integrative review of their impact, causal factors, and mitigation strategies. Journal of Nursing Management, 2024(1). https://doi.org/10.1155/2024/2983251