Clinical competence assessment in nursing: a systematic review of the literature

Background. The assessment of clinical competence has returned to centre stage of nurse education. However, there is little evidence to support the use of clinical competence and a wide variety of methods for its use. Research question. The present study was designed to investigate the evidence for the use of clinical competence assessment in nursing. Design. A review using systematic methods of literature pertaining to clinical competence in nursing was conducted using defined dates, databases and search terms. Results. There is still considerable confusion about the definition of clinical competence and most of the methods in use to define or measure competence have not been developed systematically and issues of reliability and validity have barely been addressed. Conclusion. The assessment of clinical competence remains almost universally accepted in the nurse education literature as a laudable pursuit yet there are aspects of it that remain at odds with the higher education of nurses.