Workforce retention
Practice the conversations that shape whether nurses and physicians stay
Last updated: October 2026
Nurse managers, charge nurses, medical directors and new graduate nurses practice by voice with AI characters, from the experienced nurse who's quietly looking elsewhere to the on-call physician who doesn't want to come in. Each conversation is scored against your leadership model or escalation policy, with the participant's own words under every score. ClinicalSim does not predict or reduce turnover. It shows how these conversations go and gives people practice before the real one.
Why these conversations
As more documentation and administrative work moves to software, more of each clinician's day is the work only a person can do, and much of that is talking: to patients, to families, to colleagues, and to the people they manage. Two groups come up again and again in the retention research: frontline managers and nurses in their first year.
Managers first. In a 2025 survey of US nurses, 41% of frontline nurses who were likely to leave said they don't feel valued by their leaders, a reason second only to looking for a better job (McKinsey, Nursing Pulse Survey, 2025). Among 2,813 Mayo Clinic physicians and scientists who rated their supervisor's leadership on a 12 to 60 scale, each one-point gain went with a 3.3% lower likelihood of burnout and a 9% higher likelihood of satisfaction (Shanafelt et al., Mayo Clinic Proceedings, 2015). Most of what those ratings measure happens in conversation: explaining a change, asking for ideas, giving feedback, recognizing good work, talking about someone's career.
Then the first year. 22.7% of newly hired RNs leave within twelve months, at $60,090 per departure (NSI Nursing Solutions, 2026 National Health Care Retention and RN Staffing Report). Across more than 10,000 new graduate RNs assessed from 2011 to 2020, the share meeting entry-level competency expectations fell from 23% to 9% (Kavanagh and Sharpnack, OJIN, 2021).
What managers practice
The AI character plays a member of staff, and the manager gets to have the conversation once before it counts.
A stay conversation with a strong nurse who's looking elsewhere
Ask what keeps them and what would make them leave, recognize specific work, and commit only to a follow-up the manager can keep.
A safety concern raised mid-shift
Hear an unsafe-assignment concern without defending the staffing grid, decide on a next step, and tell the nurse when they'll hear back.
A preceptor who's hard on new nurses
Name the behavior and its effect on new hires without labels, and keep an experienced colleague on the unit.
A change staff won't like
State the change and the reason early, take the reaction, and say what input is still open.
A physician who's pulling back
For medical directors and section chiefs: check in on the person before negotiating the schedule.
What new nurses practice
For nurse residency programs and new graduate cohorts. The AI character plays the physician, the family member, the colleague or the oncoming nurse.
The overnight call to a physician who doesn't want to come in
Give an SBAR with an explicit recommendation, then use CUS language and the two-challenge rule if the concern isn't heard.
Calling the rapid response team
Act on a calling criterion that's been met when a busy colleague says to wait.
A handoff with a pending result
Name the result, the value that changes the plan and who calls whom, then ask for a read-back.
Delegating to an experienced colleague who pushes back
Hold the request, or reprioritize it out loud, without apologizing it away.
A family question the nurse can't answer yet
Say honestly what the nurse knows, don't speculate, and tell the family who will answer and when.
What a health system gets
Participants get feedback they can use on the next attempt, while programs review agreed individual or cohort views.
Your standard, scored as written
Send the leadership model, escalation policy or handoff tool you already teach. The report scores each element a case gave the participant a chance to show.
The words behind every score
Each rating quotes what the manager or nurse said, so an educator can review the conversation without listening to every recording.
Reporting rules set before anyone practices
Results can be named or anonymous, by unit or cohort. Manager and new nurse results stay out of performance reviews.
A study plan if you want to test retention
If you want to know whether practice relates to retention, we'll help design a comparison against a unit or cohort using your own retention and survey data. That's a study, not a product outcome.
The frameworks behind the score
Each case names the published framework or institution-defined standard used for feedback. The report shows strengths and areas for practice, with the participant's own words behind each score.
Your own leadership model, escalation policy or handoff tool
YoursSend the competency model, policy or tool you already teach. We score it as written.
SBI and Pendleton: Feedback conversations
Center for Creative Leadership; Pendleton and colleaguesSBI ties feedback to a situation, a behavior and its impact. Pendleton's rules ask the person to say what went well and what to change before the observer adds their view.
SBAR: Structured communication
Agency for Healthcare Research and Quality, TeamSTEPPSSituation, background, assessment, and recommendation structure a concise clinical escalation or handoff.
TeamSTEPPS: Teamwork and communication competencies
Agency for Healthcare Research and Quality and the US Department of DefenseThe rubric scores communication, team leadership, situation monitoring, and mutual support when the case gives one speaker a chance to show them. Its tools include CUS, the two-challenge rule, check-back and DESC.
I-PASS: Handoff communication
I-PASS Study Group and Agency for Healthcare Research and QualityIllness severity, patient summary, action list, situation awareness and contingency planning, and synthesis by the receiver structure a handoff.
Teach-back
Agency for Healthcare Research and QualityThe listener explains the information back in their own words, so the speaker can check what landed and correct what didn't.
How scoring against a framework works, including the scope rule
Frequently asked questions
Does ClinicalSim reduce turnover?
No study shows that communication training, ours or anyone else's, reduces nurse or physician turnover. ClinicalSim measures how specific conversations go and gives people repeated practice. If you want to test a link to retention, we'll help you set up a comparison with your own data.
Who plays the staff member, physician or family member?
An AI character that the participant talks to by voice. Our clinical team writes each case, including how the character reacts when the conversation goes well or badly.
Can we score against our own leadership model?
Yes. Send the model or the competency language. The report scores the elements a case gave the manager a chance to show and quotes the words behind each score.
Can manager and new nurse results stay out of performance reviews?
Yes, and they should. Output is formative. The institution sets access before anyone practices, including anonymous participant IDs, and labor agreements govern what leadership can see.
Does this fit our nurse residency program?
It can be one part of a residency's communication curriculum, scored against your escalation policy or TeamSTEPPS. ClinicalSim is not affiliated with ANCC or Vizient, and practice scores don't establish accreditation compliance.