New graduate nurses' clinical competence: A mixed methods systematic review

Area of Science:

• Nursing Education
• Clinical Competence Assessment
• Healthcare Professional Development

Background:

• New graduate nurses face challenges transitioning to clinical practice.
• Assessing clinical competence is crucial for ensuring patient safety and effective healthcare delivery.
• Existing literature lacks a comprehensive synthesis of competence assessment for newly graduated nurses.

Purpose of the Study:

• To systematically review and synthesize empirical evidence on the assessment of new graduate nurses' clinical competence.
• To identify and evaluate methods used for assessing clinical competence in early-career nurses.
• To provide insights for improving nurse transition programs and support.

Main Methods:

• A mixed methods systematic review was conducted.
• Searches included CINAHL, MEDLINE, Embase, PsycINFO, and Web of Science databases (2010-2019).
• Included empirical studies with detailed methods and results, focusing on competence assessment in clinical settings for nurses within 24 months of graduation.

Main Results:

• 42 papers were included: 31 quantitative, 7 qualitative, and 4 mixed methods.
• New graduate nurses were generally assessed as having good or adequate clinical competence.
• Longitudinal data showed competence increased significantly in the first 6 months, but inconsistently between 6-12 months.

Conclusions:

• A wide array of quantitative tools exist for measuring clinical competence, necessitating a review of their scientific rigor.
• Findings suggest that while competence is generally adequate, the expected increase may not always materialize, indicating a need for enhanced support during the transition period.
• This review identified effective quantitative and qualitative assessment methods and provides evidence to inform the design of improved transition programs for nurses.