Evaluating clinical competence during nursing education: A comprehensive integrative literature review

Abstract

This paper explored concepts, definitions and theoretical perspectives evaluating clinical competence during nursing education. The questions were: (i) How is clinical competence evaluated? and (ii) What is evaluated? An integrative review of 19 original research articles from 2009 to 2013 was performed. Results showed that evaluation tools were used in 14, observations in 2 and reflecting writing in 3 studies. The students participated in all but one evaluation alone or together with peers, faculty members or preceptors. Three themes were found: (i) professional practice with a caring perspective; (ii) clinical skills and reflective practice; and (iii) cognitive, affective and psychomotor skills both with a nursing perspective. This review shows an emphasis on structured methods with a risk reducing nursing to tasks and skills why combinations with qualitative evaluations are recommended. A holistic view of competence dominated and in designing evaluations, explicit perspectives and operationalized definitions of clinical competence became evident.

The impact of Early Warning Score and Rapid Response Systems on nurses’ competence: An integrative literature review and synthesis

“…Benner () described that nurses’ competence includes aspects regarding social interactions. The contextual dimension, such as the clinical practice context, is a part of and affects nurses’ competence (Lejonqvist et al., , ; Meretoja et al., ). The EWS and the presence of the RRS were found, in our review, to support nurses in their clinical practice.…”

“…Cowan, Norman, and Coopamah () argue for a holistic conception of competence, including knowledge, performance, skills, values and attitudes; they also argue that nursing requires a complex combination of these factors and that competence becomes visible in divergent clinical contexts. The importance of the contextual dimension of the concept of competence is also highlighted by Meretoja, Isoaho, and Leino‐Kilpi () and Lejonqvist, Eriksson, and Meretoja (, ). They argue that competence is the capacity to integrate knowledge and skills in performance, with attitudes and values that mature and improve in the specific context of clinical practice.…”

Clusters of competence: Relationship between self‐reported professional competence and achievement on a national examination among graduating nursing students

“…To contribute to a global future workforce of nurses with professional competence in providing safe and high‐quality care, it is important to measure and evaluate nursing students’ progress and achievements towards educational goals and requirements. Structured methods including different evaluation tools are common in evaluations of nursing students’ clinical competence (Lejonqvist, Eriksson, & Meretoja, ). However, validity and reliability in assessments of competence may vary and pre‐existing expectations from mentors, in addition to their shared understanding of educational goals, are present in this assessment process (Burden, Topping, & O´Halloran, ).…”

Conceptualizing and determining core clinical competencies in nursing students: a qualitative study

“…Clinical competency in nursing education is a complex and ambiguous concept (Lejonqvist et al 2016). Although clinical competency is used as a specific criterion in nursing education for assessing the clinical performance of Bachelor of Nursing students, there is no comprehensive and appropriate definition (Lejonqvist et al 2016;Tiarnida & Erikson 2018).…”

“…Clinical competency in nursing education is a complex and ambiguous concept (Lejonqvist et al 2016). Although clinical competency is used as a specific criterion in nursing education for assessing the clinical performance of Bachelor of Nursing students, there is no comprehensive and appropriate definition (Lejonqvist et al 2016;Tiarnida & Erikson 2018). In nursing, clinical competence is mainly defined by the application of knowledge in decision-making, psychomotor skills and interpersonal communication that nurses expect from their roles (Bifftu et al 2016;Notarnicola et al 2016).…”