Contents lists available at ScienceDirect Nurse Education Today journal homepage: www.elsevier.com/locate/nedt Transition support for new graduate nurses to rural and remote practice: A scoping review Pauline Calleja a,b,c, ⁎ , Barbara Adonteng-Kissi a,b , Bernadine Romero a,d a School of Nursing and Midwifery, Griffith University, 61 University Drive, Logan, QLD 4114, Australia b Menzies Health Institute Queensland, Griffith University, 170 Kessels Road, Nathan, QLD 4111, Australia c Retrieval Services Queensland, Aeromedical Retrieval and Disaster Management Branch, Queensland Health, Level 7, 33 Charlotte Street, Brisbane, Queensland 4000, Australia d Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland 4215, Australia ARTICLE INFO Keywords: Rural health personnel Nursing education New graduate nurses Nursing staff Health resources ABSTRACT Background: New graduate nurses undertaking transition to practice encounter enormous challenges in their first year, and this is expounded in rural and remote locations. In rural and remote settings where geographical isolation and inadequate resources impact health care delivery, there is a perceived shortage of support systems to assist new graduate nurses to transition smoothly, with reported negative effects for all staff and on re- cruitment and retention. Objectives: To investigate what transition support was reported for new graduate nurses to function effectively in rural and remote settings. Design: A study protocol was developed using principles for scoping reviews that have been developed over the past fifteen years. Data sources: CINAHL, Medline, Proquest, Embase, Informit, PubMed, and Science Direct were systematically searched according to a predetermined search strategy. Review methods: Search terms included New Graduate AND Rural OR Remote AND Education. Studies were selected according to an inclusion and exclusion criteria. Three reviewers were involved in independent screening of articles. The degree of agreement for an article to be included was based on a Kappa score calcu- lation for inter-rater reliability. Results: Of the 662 articles searched, 13 met the inclusion criteria and their findings synthesised to form this review. Three overarching themes (and a number of subthemes) were identified within the context of rural and remote nursing workforce development, and included: new graduates' support needs, multifaceted support strategies and recruitment and retention strategies. Conclusions: Challenges faced by new graduate nurses when transitioning to practice are exacerbated in most rural and remote settings due to resourcing, lack of structured support programs, lack of training for support staff to mentor and give feedback and this impacts on recruitment and retention as well. Structured, well supported transition programs that provide flexible support are urgently required in these settings. 1. Introduction Globally, there is a historic challenge in the recruitment and re- tention of staff in the health sector, especially among nursing workforce (WHO, 2010). In rural and remote regions these challenges are sig- nificantly more difficult compared to metropolitan areas, often due to resources disparity between rural-remote and metropolitan areas (Ashley et al., 2018; Lasala, 2017). For New Graduate Nurses (NGNs) undertaking transition in rural and remote settings, it is imperative that efforts are made to aid them transition smoothly due to the lower levels of support available for providing health care in these locations. Al- though there have been some structures in place, the many problems NGNs face in the transition process in the last decade are complex and interwoven. This paper presents a scoping review of what transition support is reported in the literature for NGNs undertaking their first year of practice in rural and remote settings. https://doi.org/10.1016/j.nedt.2019.01.022 Received 12 July 2018; Received in revised form 25 November 2018; Accepted 28 January 2019 ⁎ Corresponding author at: School of Nursing and Midwifery, Griffith University, 61 University Drive, Logan, 4114, QLD, Australia. E-mail address: p.calleja@griffith.edu.au (P. Calleja). Nurse Education Today 76 (2019) 8–20 0260-6917/ Crown Copyright © 2019 Published by Elsevier Ltd. All rights reserved. T