Competency in Nursing: A Concept Analysis

Texas Christian University, Fort Worth, Texas 76129, USA.
The Journal of Continuing Education in Nursing (Impact Factor: 0.52). 03/2008; 39(2):58-64; quiz 65-6, 94. DOI: 10.3928/00220124-20080201-12
Source: PubMed


Competency is a topic of great interest to educators and administrators in practice disciplines, particularly health care disciplines such as nursing. This article focuses on the role of competency in nursing. Through a concept analysis process, various elements of competency were assessed. The defining attributes of competency are the application of skills in all domains for the practice role, instruction that focuses on specific outcomes or competencies, allowance for increasing levels of competency, accountability of the learner, practice-based learning, self-assessment, and individualized learning experiences. The learning environment for competency assurance involves the learner in assessment and accountability, provides practice-based learning opportunities, and individualizes learning experiences.

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Available from: Donna Scott Tilley, Oct 10, 2015
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    • "Some authors believe that professional expertise is expressed through a set of initiatives and skills, (Tai and Chung, 2008; Scott, 2008) which are developed and "
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    ABSTRACT: To know the national and international scientific publications which address the teaching of professional skills for undergraduate students of nursing. A systematic review of LILASC, BDENF, MEDLINE, and TESESENF databases, using the following keywords: professional skills, education and nursing. The following inclusion criteria were established for this review: full articles available online and free of charge, published from 2005 to October 2011, in Portuguese, English and Spanish, and focused on the study object. Eleven articles were selected, which were predominantly published in Brazilian (81.8%) and nursing journals (99.9%); most of them were original (63.6%), and addressed, as their objective, the subject 'professional skills': in constructing the political pedagogical project (54.5%) and as a tool to be developed in the students (45.5%). We expect that the subject identified in this study may contribute to the development of critical/reflexive thinking and attitudes in nursing.
    • "Nevertheless, it is worth noting the methodological difficulties in terms of designing competency assessment methods in nursing. These difficulties are derived from the conceptual frailty of many instruments and difficulties in defining competency attributes (Axley 2008; Scott 2008). Moreover, many competencies in health professions are subject to contextual and local determinants that make it difficult to extend them to other contexts of care (Epstein & Hundert 2002). "
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    ABSTRACT: This paper describes a literature review that identified common traits in advanced practice nursing that are specific to competency development worldwide. There is a lack of international agreement on the definition of advanced practice nursing and its core competencies. Despite the lack of consensus, there is an ongoing process worldwide to establish and outline the standards and competencies for advanced practice nursing roles. International agencies, such as the International Council of Nurses, have provided general definitions for advanced practice nursing. Additionally, a set of competency standards for this aim has been developed. A literature review and a directed search of institutional websites were performed to identify specific developments in advanced practice nursing competencies and standards of practice. To determine a competency map specific to international advanced practice nursing, key documents were analysed using a qualitative approach based on content analysis to identify common traits among documents and countries. The review process identified 119 relevant journal articles related to advanced practice nursing competencies. Additionally, 97 documents from grey literature that were related to advanced practice nursing competency mapping were identified. From the text analysis, 17 worldwide transversal competency domains emerged. Despite the variety of patterns in international advanced practice nursing development, essential competency domains can be found in most national frameworks for the role development of international advanced practice nursing. These 17 core competencies can be used to further develop instruments that assess the perceived competency of advanced practice nurses. The results of this review can help policy developers and researchers develop instruments to compare advanced practice nursing services in various contexts and to examine their association with related outcomes.
    International Nursing Review 11/2014; 61(4). DOI:10.1111/inr.12132
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    • "; Jungnickel, Kelley, Hammer, Haines, & Marlowe, 2009; Landon, Normand, Blumenthal , & Daley, 2003; Scott Tilley, 2008). Although numerous definitions exist, the term " competence " broadly refers to an individual's knowledge, skills, and attitudes related to a specified role (Harvey, 2012; Scott Tilley, 2008; Tamblyn, 1994; Wimmers, 2006). Competence may be assessed by evaluating knowledge, cognition , or performance, either by simulation or in the workplace (Miller, 1990). "
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    ABSTRACT: As part of ongoing efforts to improve quality of care through clinical education of our medical assisting staff, we developed a competency-based training and assessment program. At the time of program implementation, we assessed clinical skills of 111 certified medical assistants and found that 10% were unable to accurately measure blood pressure, 9% were unable to correctly perform an intradermal injection, and 48% were unable to correctly draw specified volumes into syringes. More than 10 years after program implementation, we continue to detect and remediate clinical skills in newly hired employees. This case study report describes the evolution of the program and assessment findings.
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Questions & Answers about this publication

  • Mary C R Wilson added an answer in Nurses:
    Is anyone familiar with Nurse autonomy measurement tools, and Nurse accountability measurement tools?

    Are there any suggestions to find autonomy and accountability measuring tools ?

    Mary C R Wilson

    Hello Zeinab

    There might be something relevant in the following - relating to autonomy:

    Wade, G. H. (1999). Professional nurse autonomy: concept analysis and application to nursing education. Journal of Advanced Nursing, 30(2), 310-318.

    Kramer, M., & Schmalenberg, C. E. (2003). Magnet hospital staff nurses describe clinical autonomy. Nursing Outlook, 51(1), 13-19.

    This paper is available to request from Claudia Schmalenberg's ResearchGate page, but if you search for this paper on Google Scholar, the fulltext is available if you click on Researchgate.

    Re accountability - the paper by Prof Emily Patterson and Robert Wears on ResearchGate might be applicable:

    Patterson, E. S., & Wears, R. L. (2010). Patient handoffs: standardized and reliable measurement tools remain elusive. Joint Commission Journal on Quality and Patient Safety, 36(2), 52-61.

    You might find something relevant in these papers:

    Veillard, J., Champagne, F., Klazinga, N., Kazandjian, V., Arah, O. A., & Guisset, A. L. (2005). A performance assessment framework for hospitals: the WHO regional office for Europe PATH project. International Journal for Quality in Health Care, 17(6), 487-496.

    Cowan, D. T., Jenifer, W. B. D., Norman, I. J., & Murrells, T. (2008). Measuring nursing competence: development of a self-assessment tool for general nurses across Europe. International Journal of Nursing Studies, 45(6), 902-913.

    There may be something that you could follow up from this review paper by Prof Donna Scott Tilley, on ResearchGate:

    Tilley, D. S. (2008). Competency in nursing: A concept analysis. Journal of Continuing Education in Nursing, 39(2), 58-64.

    Best wishes


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      ABSTRACT: Staff nurses describe control over nursing practice (C/NP) as a professional nursing function made up of a variety of activities and outcomes. Greater acclaim, status, and prestige for nursing in the organization are viewed as a result, not a precursor, of C/NP. Interviews with 279 staff nurses working in 14 magnet hospitals indicated that effective C/NP requires some kind of empowered, formal organizational structure, extends beyond clinical decision making at the patient care interface, and is the same as or highly similar to what the literature describes as professional autonomy. From constant comparative analysis of nurses' descriptions of C/NP activities, five ranked categories of this real-life event emerged. The basis for the categories and ranking was "who owned the problem, issue, and solution" and the "degree of effectiveness of control" as reflected in visibility, viability, and recognition of a formal structure allowing and encouraging nurses' control over practice. Hospital mergers and structural reorganization were reported to negatively affect the structure needed for effective C/NP. Almost 60% of these magnet hospital staff nurses stated and/or described little or no C/NP.
      Western Journal of Nursing Research 07/2003; 25(4):434-52. DOI:10.1177/0193945903025004008

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