A review of clinical competence assessment in nursing

Aims: To investigate trends in the evaluation of clinical competence in nursing students and newly qualified nurses over the last 10 years. Design: A literature review following PRISMA guidelines. Methods: The following databases were searched: Cochrane, Medline and CINAHL using the terms competenc*, nurs*and assess*, evaluat*, measure*, from January 2001-March 2010. Strict inclusion and exclusion criteria were applied. Results: Twenty three papers were included and these mainly considered the following topics: instrument development and testing; approaches to testing competence; assessment and related factors. A holistic concept of competence is gaining popularity, and consensus around definitions is emerging. Some methods and instruments to measure competence are under systematic development and testing for reliability and validity with large samples and rigorous statistical method. Wider national and international cooperation is evident in competence-based assessment. Conclusions: Competence-based education is evident, but this does not mean that issues related to competence definition have been resolved. Larger and more international cooperation is required to reach common agreement and validity in competence-based education and assessment.