From Competence to Autonomy: A Developmental Model of Transition to Practice

Newly graduated nurses often meet competency standards yet struggle to function independently in clinical practice, suggesting that competence alone does not explain readiness for autonomous practice.

To propose a developmental model explaining the transition from competence to autonomy and its implications for nursing education and workforce transition.

Contemporary literature was integrated with grounded theory findings and prior conceptual work to develop a staged model of clinical transition.

The model describes 5 developmental phases supported by 3 interacting mechanisms: mediated clinical experience, professional identity formation, and developmental calibration. Ownership of practice represents the pivotal transition from externally guided performance to internally regulated clinical judgment and responsibility.

Transition to autonomy is developmental rather than time-dependent. The model provides a framework for designing clinical education, transition-to-practice programs, and workforce strategies that intentionally support autonomous professional practice.