The relationship between the levels of nurses' competence and the length of their clinical experience: a tentative model for nursing competence development

J Clin Nurs. 2013 May;22(9-10):1400-10. doi: 10.1111/j.1365-2702.2012.04239.x. Epub 2012 Sep 7.


Aims and objectives: To explore the relationship between the levels of nurses' competence and the length of their clinical experience, in order to provide a tentative model of the continuing competence of nurses.

Background: The professional development of employees has attracted great interest. This interest has led to the development of various models that illustrate how employees develop their competence throughout their careers. However, little is known of how nurses maintain and develop their competence throughout their career pathways.

Design: A cross-sectional design was used.

Methods: Using a survey method, five dimensions of self-assessed nursing competence and the length of the nurses' clinical practice were measured (n = 325). Each dimension of competence was plotted against the length of their clinical experience using locally weighted scatterplot smoothing. Then, the shapes of the plots were analysed by fractional polynomial regression analysis.

Results: Overall, the relationships between the levels of nursing competence and the length of clinical experience were illustrated by curves with a rapid increase in competence levels at the early stage of the nursing career and a slower increase later. These curves were modelled by either a logarithmic, square-root function or its reciprocal. The results supported the learning curve model.

Conclusions: The competence development of nurses may be characterised by two distinctive periods: a rapid growth period followed by stable periods. However, the modality of the growth may be different depending on which dimension of nursing competence is in focus.

Relevance to clinical practice: The level of nursing competence directly affects the quality of care provided to patients. The findings of the study enable healthcare organisations to take proactive approaches to enhance nurses' competence by identifying when and how to assist nurses.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Clinical Competence*
  • Cross-Sectional Studies
  • Education, Nursing
  • Educational Status
  • Humans
  • Models, Nursing*
  • Nursing Staff / standards*
  • Surveys and Questionnaires
  • Young Adult