BackgroundThe clinical ladder system categorizes the degree of nursing professionalism and rewards and is an important human resource tool for managing nursing.AimWe developed a model to evaluate nursing professionalism, which determines the clinical ladder system levels, and verified its validity.MethodsData were collected using a clinical competence tool developed in this study, and existing methods such as the nursing professionalism evaluation tool, peer reviews, and face-to-face interviews to evaluate promotions and verify the presented content in a medical institution. Reliability and convergent and discriminant validity of the clinical competence evaluation tool were verified using SmartPLS software. The validity of the model for evaluating overall nursing professionalism was also analyzed.ResultsClinical competence was determined by five dimensions of nursing practice: scientific, technical, ethical, aesthetic, and existential. The structural model explained 66% of the variance. Clinical competence scales, peer reviews, and face-to-face interviews directly determined nursing professionalism levels.ConclusionsThe evaluation system can be used for evaluating nurses’ professionalism in actual medical institutions from a nursing practice perspective.Implications for nursing managementA conceptual framework for establishing a human resources management system for nurses and a tool for evaluating nursing professionalism at medical institutions is provided.