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BackgroundNurses’ clinical competence is vital to ensure safe and high quality care, and the continuous assessment of nurses’ clinical competence is of major concern. A validated instrument for the self-assessment of nurses’ clinical competence at different educational levels across specialties and countries is lacking. The aim of this study was to test the reliability and construct validity of the new Professional Nurse Self-Assessment Scale (ProffNurse SAS) questionnaire in long term and home care contexts in Norway. The questionnaire is based on the Nordic Advanced Practice Nursing model, in which the nurse-patient relationship is central.MethodsThe study has a cross-sectional survey design. A purposive sample of 357 registered nurses who worked in long term and home care contexts in two geographical regions encompassing eight municipalities and three counties was included. The respondents completed the 74-item ProffNurse SAS questionnaire and demographic background data was collected. Data collection was conducted in two phases: first region autumn 2011 and second region spring 2012.Exploratory factor analyses (EFA) were used to test the psychometric properties of the questionnaire and included the following steps: assessment of the factorality of the data, factor extraction by Principal Component Analysis (PCA), oblimin (oblique) factor rotation, and interpretation. Cronbach’s alpha was used to estimate the internal consistency.ResultsThe PCA revealed a six-component structure, reducing the number of items in the questionnaire from 74 to 51. Based on the content of the highest-loading items, the six components were named: Direct Clinical Practice, Professional Development, Ethical Decision-Making, Clinical Leadership, Cooperation and Consultation, and Critical Thinking. The Cronbach’s alpha values ranged from 0.940 (highest; Direct Clinical Practice) to 0.737 (lowest; Critical Thinking), leading to the estimation that the ProffNurse SAS is reliable.ConclusionsThe six components support the study’s theoretical framework. The ProffNurse SAS showed acceptable reliability and construct validity and may therefore be a promising instrument for the assessment of practicing nurses’ clinical competence. However, we recommend further psychometric testing in other countries and contexts and the inclusion of larger samples of nurses at various levels of education, particularly master’s level APNs.

Aims and objectives(a) To describe and analyse advanced practice nursing students' self‐assessment of their clinical competence and need for further training and (b) to analyse the possible predictive variables in their self‐assessment.BackgroundThe self‐assessment of clinical competence in nursing education is important for identifying professional development and educational needs to improve patient care.DesignA cross‐sectional survey following STROBE guidelines was used.MethodsNinety‐nine students from three universities/university colleges in Norway participated in the study, and data were collected using a revised version of the Professional Nurse Self‐Assessment Scale II. Descriptive, correlation and regression analyses were performed.ResultsThe students gave the highest self‐assessment ratings for their clinical competence in taking full responsibility and for their need for further training in medication effects and interactions. Although the students gave themselves low ratings for the use of electronic devices, they assessed their need for further training in this area as average. Clinical work experience as a registered nurse and previous higher education level were not significant predictors of clinical competence nor the need for further training.ConclusionThe findings indicate that self‐assessment is appropriate for students in advanced practice nursing programmes. This study implies that programmes in advanced practice nursing need to familiarise students with the possibilities of information technology. It questions the entry requirement that stipulates that prospective students must have several years of clinical work experience as registered nurses before entering advanced practice nursing programmes. These programmes need to communicate that competencies other than direct clinical practice are also needed for students' future roles.Relevance to clinical practiceThe study contributes to the exploration of how students self‐assess own clinical competence and need for further training in advanced practice nursing programmes. Further research should evaluate the development of clinical competence.

To meet demands, a clear need exists for the advanced clinical competence of nurses. There is also a clear need to reorganise health care services for older people, develop the leadership abilities of nurse managers and make workplaces more attractive.

Background In order to achieve a sustainable standard of advanced clinical competence for nurse practitioners leading to a credible role, it is important to investigate the development of clinical competence among nurse practitioner students. Aim The aim of the present study is to analyse the development of nurse practitioner students’ self-assessed clinical competence from the beginning of their education to after completion of their clinical studies. Design The study involved the application of a longitudinal survey design adhering to STROBE guidelines. Methods The participants consisted of 36 registered nurses from a nurse practitioner programme at a Norwegian university. The Professional Nurse Self-Assessment Scale II was used for data collection during the period August 2015 to May 2020. Results The students developed their clinical competence the most for direct clinical practice. Our findings are inconclusive in terms of whether the students developed clinical competence regarding consultation, coaching and guidance, and collaboration. However, they do indicate a lack of development in some aspects of clinical leadership. The students with the lowest level of clinical competence developed their clinical competence regarding direct clinical practice significantly more than the students with the highest level of clinical competence. The differences between students with high and low levels of clinical competence were levelled out during their education. Thus, the students as a whole became a more homogenous group after completion of their clinical studies. Previous work experience in primary healthcare was a statistically significant, yet minor, predictor of the development of clinical competence. Conclusion Our findings indicate that the students developed their clinical competence for direct clinical practice in accordance with the intended learning outcomes of the university’s Master’s programme and international standards for nurse practitioners. It is imperative that the clinical field supports nurse practitioners by facilitating extended work-task fits that are appropriate to their newly developed clinical competence. We refrain from concluding with a recommendation that prior clinical work experience should be an entry requirement for nurse practitioner programmes. However, we recommend an evaluation of the nurse practitioner education programme with the aim of investigating whether the curriculum meets the academic standards of clinical leadership expected in advanced level of nursing.

Nurses' clinical competence is crucial to ensure that elderly, frail patients in nursing homes are met with high-quality nursing care. Thus, this study aimed to disclose the essential meaning of registered nurses' experiences as related to their clinical competence when caring for elderly patients with complex health needs in nursing homes. Focus group interviews and a phenomenological hermeneutical analysis were conducted revealing that the nurses balanced between being and striving to be competent. The utterance “It's not for amateurs!” symbolized that if nurses are not clinically competent or hindered from acting competently, they may be at risk for moral distress.