Developing an introductory training programme for newly employed nurses in the ambulance service through participatory action research

BACKGROUND: Newly employed nurses entering the ambulance service face clinical, organisational and cultural challenges. Although transition-related support needs have been described, less is known about how such knowledge can be translated into organisationally feasible introductory training programmes. AIM: To explore how organisational and pedagogical challenges in introductory training for newly employed nurses were identified, interpreted, negotiated and translated into a revised programme through participatory action research (PAR). METHODS: A qualitative PAR design was conducted between 2020 and 2024 in one Swedish ambulance service organisation. Newly employed nurses, clinical supervisors, the management group (total duration 2 h and 14 min) and the research group contributed at different phases and levels of participation. The primary analytic material comprised two video-recorded management group meetings, field notes, and researcher reflections. Previously analysed interview, focus group and questionnaire findings were integrated as experiential and evaluative material. Narrative process analysis reconstructed how identified challenges were interpreted, negotiated, and translated into programme interventions, and how these were reconsidered following implementation. RESULTS: Four interrelated challenges were consolidated: a theory-heavy programme structure, variation in supervision, limited leadership connection and role ambiguity. Organisational interpretation and negotiation translated these into three interconnected interventions: restructuring theory and practice, preparing selected clinical supervisors and integrating peer learning during clinical placement, with leadership connection and role clarification embedded across the programme. Reflection on implementation indicated that theory-practice integration, supervision, leadership and peer learning were interdependent and required continued organisational and pedagogical support. CONCLUSION: PAR provided a structured process for moving from empirical knowledge about professional transition to organisationally embedded and contextually feasible programme development. Supporting newly employed nurses requires alignment between programme design, supervision, leadership and workplace learning. REGISTRATION: Not registered.