Background Japanese nurses may not be adequately trained to perform physical assessments compared to nurses overseas due to differences in accessibility to education; currently, research investigating this discrepancy is limited. This study investigated the current performance levels of Japanese community nurses in physical assessments and compared their performance to that of nurses overseas. Methods In this cross‐sectional study, we examined the practical application of physical assessments conducted by nurses at a Japanese community hospital. We used a questionnaire based on one used in a similar prior study conducted overseas. The results were also compared with the overseas data. A chi‐squared test and analysis of variance were used to analyze the variables in each question. Results We distributed the questionnaires to 171 nurses working in the hospital. The return rate was 97.6% (167 out of 171). There was no significant difference in the methods used to perform a physical assessment based on the number of years of experience. Compared to nurses overseas, Japanese community hospital nurses differed in one area of assessment: A physical assessment of the chest was more likely conducted via auscultation rather than inspection. Conclusions When Japanese community hospital nurses performed a physical assessment of patients, auscultation was more frequently implemented than inspection. This approach contrasts with nurses overseas, who were more likely to use inspection when performing physical assessment. Japanese community nurses should improve their skills related to inspection, as inspection is an important process in the recognition of early stages of emergency.

The clinical ladder is an essential tool for nursing education, enabling nurses to ascend from novice to expert. The learning content for nurses can depend on their clinical situations. The aging of societies has changed the demand for nurses at community hospitals because of the multimorbidity of older patients. At the same time, the gap in nursing education between urban and rural hospitals is wide, as rural hospitals often lack the application of the clinical ladder. This study investigates the effectiveness of using the clinical ladder in a rural Japanese community hospital using the clinical ladder scale and interviews. Through its application, we found that both novice nurses and nursing educators came to recognize the effectiveness and importance of the ladder. However, unfamiliarity with assessments, working conditions, and Japanese culture inhibited the smooth application of the ladder. For the effective application of the clinical ladder, continual training on assessments and the ladder’s effectiveness in clinical situations, along with consideration of educational background, should be enhanced through the monitoring of the clinical ladder.

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Background and PurposeThe Japanese Nurse Association (JNA) has established the JNA ladder to assess competency in various clinical nursing settings in Japan. This study developed and tested a specific Japanese community hospital’s Nurse Competency Scale (the Unnan ladder).MethodsUsing the Delphi method, the contents of the Unnan ladder were identified and validated in a four-step approach. A 28-nurse panel approved 66 items; 112 community nurses assessed the content, construct concurrent validity, and internal consistency of the Unnan ladder competency scale.ResultsThe Unnan ladder data were normally distributed. Higher scores on it correlated with higher scores on the Nurse Competency Scale. The Unnan ladder categories showed good internal consistency.ConclusionsThis ladder’s application may lead to improved nursing skills and better patient care.