Description and Meaning of Clinical Competency: Perceptions of Nurse Managers and Baccalaureate Nurse Faculty

Purpose: Clinical competency is a significant concept for nursing as it relates directly to the quality of patient care that nurses provide in the healthcare setting. Despite the vital nature of this concept, there is no widely accepted understanding of the term between the academic and clinical groups in nursing, in the literature. Consequently, there is a continuous struggle to set standards to measure clinical competency in undergraduate nursing students. This imprecise understanding of clinical competency widens the gap between education and practice. When acute care nurse managers and prelicensure baccalaureate nursing faculty share expectations of what constitutes clinical competency in nursing students, that gap may be bridged.

The focus of this interpretive description study was to describe and gain an understanding of the concept of clinical competency from the perspective of acute care nurse managers and baccalaureate nurse faculty.

Methods: A purposive sample was recruited through the snowballing method. Participants included eight acute care nurse managers and nine prelicensure baccalaureate nurse faculty from Southeastern Pennsylvania. Data were collected through semi-structured interviews with the participants, and analyzed through a constant comparative analysis until the data reached saturation.

Results: Four themes emerged from the data of this interpretive description study when acute care managers and baccalaureate nurse faculty described the meaning of clinical competency and what expectations managers have of the new graduate nurse in regards to clinical competency. The themes are applying metacognitive judgment, getting the big picture, providing safe care, and developing professional nursing behaviors. Transitions Theory is presented as a theoretical framework supporting the findings of this study, as student nurses transitioning to the role of the new graduate nurse in the acute care setting. The application of the four themes described in this study to the Transitions Theory assists in further understanding the meaning of clinical competency in nursing.

Conclusion: Implications of this study from the perspective of nursing science and research offered for the first time a shared view of the concept of clinical competency from the perception of the managers in practice and the faculty educating undergraduate nursing students in the clinical area. Implications for nursing education included providing faculty a means to structure the clinical experience so that students may be better prepared to practice in the acute care setting as a new graduate nurse. In nursing practice, the benefits for the managers are an understanding of the level of clinical competency and preparation of the new graduate nurse, which enables them to further support their transition to clinical practice. Future research may include a tool for the objective measurement of clinical competency.