What Shapes Clinical Competence in Intensive Care Nurses? A Hierarchical Regression Analysis

Area of Science:

• Nursing Science
• Healthcare Professional Development
• Clinical Competence Assessment

Background:

• Clinical competence is crucial for safe and high-quality intensive care unit (ICU) nursing.
• The traditional assumption that professional experience is the primary driver of competence requires re-evaluation in modern ICUs.
• It remains unclear whether accumulated experience or structured training/certification primarily shapes ICU nurse competence.

Purpose of the Study:

• To determine the clinical competence levels of ICU nurses.
• To analyze the influence of sociodemographic factors, professional experience, ICU experience, certification, and ICU training on clinical competence.
• To employ hierarchical regression analysis to identify key determinants of clinical competence.

Main Methods:

• A descriptive, cross-sectional study design was utilized.
• Data were collected via a self-administered online questionnaire using Google Forms.
• The Intensive and Critical Care Nursing Competence Scale (ICCNCS) assessed competence (knowledge, skills, attitudes, values), with scores categorized as poor, fair, good, or excellent.

Main Results:

• A total of 253 ICU nurses from 36 hospitals in Türkiye participated.
• The mean ICCNCS score was 441.58 (±51.66), falling into the excellent competence category, with 51.4% of nurses achieving excellent competence.
• While age, gender, and total nursing experience explained 29.3% of competence variance, education and certification significantly increased explanatory power to 33.7% (p < 0.001).

Conclusions:

• Clinical competence among ICU nurses is not solely attributable to experience.
• The findings challenge the experience-competence assumption of Benner's Novice-to-Expert model.
• Education-driven competence development, including structured ICU training and certification, is supported for contemporary ICU nursing.