A concept analysis of competence and its transition in nursing

https://doi.org/10.1016/j.nedt.2011.12.007Get rights and content

Summary

Competence is one of the most commonly used words in nursing internationally, yet is a nebulous concept defined in diverse ways by different healthcare practitioners. The slippery nature of the concept often exists purely in the eye of the beholder however, the universal principles are deeply rooted in the measurement of the Registered Nurse's (RN) ability to perform effectively. Competence is a simpler thing to define when recognising where it does not exist in the form of incompetence. The aim of this paper is to present finding from a concept analysis that explored various facets of competence, particularly how it has been interpreted, applied and transformed over the years within nurse education in the United Kingdom. The analysis utilised a systematic review of contemporary evidence base based on theory construction by Walker and Avant (2005), a primary concern being to understand the underpinning conceptual principles that define the concept of competence and competency development and how these may be used to inform our understandings. The analysis identified how influential academics and professional bodies have attempted to provide definitions and concluded that it may be the existence of so many of these definitions, which has compounded the conundrum of what competence really is.

Introduction

The general public assumes the registered nurse (RN) to be competent in the execution of tasks and duties expected of the profession (Eraut, 1994). The term competence is a concept which is internationally applied in reference to professional people of all kinds, but especially so in relation to nursing practice. It is considered an essential ingredient when measuring a practitioner's ability to provide effective nursing care (Watson, 2002). Competence however, is generally regarded as an elusive entity when it comes to its actual meaning. Watson et al. (2002, p.422) argued that “competence is a somewhat nebulous concept which is defined in different ways by different people” and there is no universal definition of competence although the concept is integral to the principles of many nurse educational programmes (Milligan, 1998). Ambivalent definitions of what genuinely comprises of competence are not solely a challenge for nursing, but have significance for many other professional groups such as teachers, solicitors and doctors (Eraut, 1994, Epstein and Hundert, 2002).

The aim of this concept analysis was to examine and critically analyse the available evidence base surrounding competence, the focus being to identify any significant influences that inform professional understanding, which in turn would influence practical implementation within contemporary nursing practice.

Section snippets

Method

A concept analysis may be rationalised for the purpose of theory development, understanding and operationalising of certain terms of which a variety of models exist (Paley, 1996). One adaptation commonly used is Walker and Avant's (1988) systematic approach, it's objectives lay in identifying the concepts ‘defining attributes’, therefore advocates that the investigator follows eight steps so that the actual meanings of the concept may be explained. The eight steps include: selecting the

Nurse Education

In the United Kingdom (UK) the last two decades have seen all nurse education programmes transfer to Higher Education Institutes. Competence is firmly embedded in pre-registration nurse education which has led to it becoming a controversial issue, particularly when clinical competence and elements of the more formal educational preparation appeared to be in conflict because of the stereotypical norm and the general perception was that universities prefer scientific rather than professional

Discussion

The expectations and timing in the career of a competent practitioner may be quite varied from being fit to practice, to being fit for purpose to having attributes defined by Benner as that of the expert who has deep understandings, a vision of the possible options and has a well developed analytical ability (Benner, 1984). Is competence a prerequisite for the qualified practitioner which provides the platform for their transition to experienced practitioner or do we continue to measure the

Conclusion

Walker and Avant's (2005) strategy for concept analysis, in its adapted form, did achieve its original intention of giving structure to the concept analysis process, yet the concept chosen for analysis has led to more questions than conclusions, thus supporting Paley's (1996) argument that concept clarification can be an arbitrary and vacuous exercise. This concept analysis has identified how influential academics and professional bodies have attempted to provide context specific definitions of

Acknowledgments

Sincere thanks to Professor Peter Bradshaw for his guidance and support.

References (40)

  • Department of Health

    Knowledge and Skills Framework

    (2004)
  • S. Dreyfus et al.

    A Five Stage Model of the Mental Activities Involved in Direct Skill Acquisition

    (1980)
  • R.M. Epstein et al.

    Defining and assessing professional competence

    Journal of the American Medical Association

    (2002)
  • M. Eraut

    Developing Professional Knowledge and Competence

    (1994)
  • M. Eraut

    Concepts of competence

    Journal of Interprofessional Care

    (1998)
  • M. Fink

    Conducting Research Literature Reviews: From the Internet to Paper

    (2005)
  • A. Gonczi et al.

    The development of competency-based assessment strategies for the professions

  • H. Hand

    Promoting effective teaching and learning in the clinical setting

    Nursing Standard

    (2006)
  • P. Jarvis et al.

    The Theory and Practice of Learning

    (2003)
  • K. Manley et al.

    Paying Peter and Paul; reconciling concepts of expertise with competency for a clinical career structure

    Journal of Clinical Nursing

    (2000)
  • Cited by (0)

    View full text