Development of competence in the first year of graduate nursing practice: a longitudinal study.

Abstract

To determine the extent to which competence develops in the first year of nursing practice in a paediatric setting. Among all the literature related to nursing competence, there have been few studies that have used a standardized tool to determine the development of professional nursing competence in the first year of practice. A quantitative longitudinal design was applied as part of a mixed methods study. Forty seven nurses commencing a 12-month graduate nurse programme were invited to undertake a self-assessment of their level of competence at four time points; commencement, 3months, 6months and 12months, between January 2013-February 2014. The assessment was completed using the Nurse Competence Scale; a questionnaire with 73 items across seven domains of competence. Each item is scored along a visual analogue scale (0-100). Response rates varied from 100% at commencement to 68% at 12months. At commencement, the self-assessed level of overall competence was 41·4, 61·1 at 3months, 72·9 at 6months and 76·7 at 12months. Similar patterns were seen for each domain. Mixed effects model analysis for longitudinal data revealed gains in competence for each of the domains and overall, was statistically significant from commencement to 3months and 3months to 6months. While gains were made between 6-12months, the results were not statistically significant. Graduate nurses showed significant gains in competence in the first 6months of transition from nursing students to Registered Nurses.