Clinical ladders: do they reflect levels of competence?

Staff nurses positioned within two discrete clinical ladder levels were surveyed for their responses to two components of clinical competence: job performance and problem-solving tactics. Although findings suggest that clinical ladders do not seem to provide clear delineation of competence levels, several interventions with staff nurses may increase clinical ladder viability: 1) opportunity to practice and utilize mixed and integrative problem-solving styles, 2) challenging work experiences, and 3) opportunity to mentor and be mentored.