Transition Readiness and Transition Shock Among Newly Graduated Nurses: A Systematic Review and Meta-Analysis of Quantitative Studies (2015–2026)

The transition from nursing education to clinical practice is a critical period for newly graduated nurses and is often associated with transition shock, reduced confidence, and difficulty adapting to professional responsibilities. Inadequate transition readiness may affect job satisfaction, retention, and the quality of patient care. Understanding readiness levels and the factors influencing early professional adaptation is important for developing effective transition-to-practice programs. This study aimed to systematically review and synthesise quantitative evidence on transition readiness and transition shock among newly graduated nurses and to perform a meta-analysis of comparable transition shock data. A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines. Electronic database searching was performed in PubMed/MEDLINE for studies published between January 2015 and February 2026, with additional records identified through manual reference screening. Studies were included if they involved newly graduated nurses, reported quantitative outcomes related to transition readiness, transition shock, confidence, competence, or early practice adaptation, and used validated measurement tools. Review articles, qualitative-only studies, and studies without relevant outcomes were excluded. Risk of bias was assessed using predefined criteria. Meta-analysis was performed for studies reporting comparable transition shock scores, and values were standardized using the percentage of maximum possible (POMP) method with a random-effects model. A total of 452 records were identified, of which 392 were screened after duplicate removal. Thirty-eight full-text articles were assessed, and nine primary quantitative/mixed-method studies with extractable quantitative outcomes met the inclusion criteria for the systematic review. Most studies were conducted in hospital settings and evaluated newly graduated nurses during the early professional transition period. Common outcomes included transition shock, readiness for practice, confidence, coping ability, and job satisfaction. Risk of bias was moderate in most studies due to cross-sectional designs and reliance on self-reported measures. Two studies provided comparable transition shock scores and were included in the meta-analysis. The pooled standardised transition shock level was moderate, with high heterogeneity across studies, indicating variability in workplace environments, support systems, and measurement approaches. Newly graduated nurses commonly experience moderate transition shock and only moderate readiness for independent clinical practice during the early professional period. Structured transition programs, mentorship, and organizational support appear to improve readiness and reduce stress. Strengthening transition-to-practice strategies may enhance professional competence, retention, and patient safety; further longitudinal and multicentre studies using standardised instruments are recommended.