Abstract
Introduction
To make sure that nursing students are capable of providing high-quality care and are adequately prepared for the workforce, it is imperative to evaluate the professional abilities of undergraduate nurses.
Objectives
This study aims to assess the core professional competencies among undergraduate nursing students and evaluate the mean differences between professional competencies with student's demographic characteristics.
Materials and Methods
A descriptive, cross-sectional comparative design was used. A total of 150 nursing students were recruited using the convenient sampling method. Data were collected using the Nurse Professional Competence Scale (NPCS)—short version 35 items. Data were collected conveniently through an online form that was filled and submitted through a Google survey link that was started from February 8, 2024, to September 21, 2024. Descriptive statistics were used to describe the demographics of participants. Pearson correlation, t-test, and ANOVA were used.
Results
The overall average competencies of nursing students were 80.8 ± 10.7 indicating high competency scores among nursing students. At .05 significant level (two-tailed), the correlation was significant between marital status (r = −.170, p = .037). Independent t-test results showed that there were no significant differences between age (t = 0.357, p = .35), marital status (t = 2.11, p = .411), and their previous taking of nursing courses (t = 3.25, p = .22). On the other hand, ANOVA indicated that age has a significant effect on overall professional competencies since higher age has an obvious effect on nursing competencies (F = 10.8, df = 2; p = .001).
Conclusion
The findings of this study can help educators and curriculum designers create programs that fill up the theoretical-clinical gaps, making graduates more capable of handling the demands of healthcare settings. Furthermore, to produce well-rounded, capable, and self-assured nursing professionals who can effectively contribute to patient care in Jordan, our findings highlight the necessity of enhancing clinical training, curriculum development, mentorship, and support system, conducting a professional development workshop, and collaborating with healthcare institutions.
Keywords
Background
Nowadays, guaranteeing the optimum safety and quality of nursing care is a crucial step in the global healthcare system (Cho et al., 2020). According to Cantwell et al. (2021), newly graduated registered nurses are acknowledged as a vital professional category that affects the health of future populations. Therefore, new graduates were regarded as a major focus of nursing research because of the substantial educational requirements necessary to close the knowledge gap between nursing theories and practices (Akhu-Zaheya et al., 2018).
According to the World Health Organization (WHO), the complexity of healthcare, the growing need for safe and high-quality practices, new instructional tools, and the disconnect between theory and clinical practice provide problems for nurses in the 21st century (WHO, 2023). Transition shock and clinical preparation are concerns raised by the challenges faced by recently graduating nurses (Purabdollah et al., 2023). Not paying attention to these competencies will result in a theory-practice gap, burnout, a decrease in satisfaction, and even job abandonment (Hökkä et al., 2020).
Nursing competencies are defined as a collection of abilities, behaviors, and knowledge required to carry out tasks, roles, or obligations successfully in clinical practice (Mrayyan et al., 2023). However, nursing skills, in the meantime, are key indicators of performance and a standard measure of the capacity to do nursing duties at a professional level (Alhamory et al., 2024). Identifying these competencies will improve patient experiences, reduce costs, ensure health outcomes and professional development, improve the quality of care needs, increase patient satisfaction, and increase job security (Chen et al., 2023). The assessment of professional competencies among Jordanian undergraduate nursing students must take into consideration demographic variables that could affect competency development (Masa'deh et al., 2023). Prior research has demonstrated that variables including sex, age, and clinical experience may have different effects on nursing students’ performance in both theoretical and practical abilities. For instance, a study by Curtis et al. (2023) revealed that older nursing students frequently have higher clinical proficiency, perhaps as a result of their maturity and past life experiences, while studies on gender have emphasized disparities in patient care strategies and communication abilities (Jang et al., 2019).
Literature Review
Several studies articulated a broad perspective on competence as a virtue in addition to knowledge (Alkhelaiwi et al., 2024; Suliman et al., 2023). Broad characteristics of competence include the ability to do an action under different circumstances and deliver the intended outcomes (Alkhelaiwi et al., 2024). It is further achieved by sound aptitudes, competencies, dispositions, and moral principles in conjunction with moral conduct and the efficient provision of high-quality services. Evaluating nursing students’ competency to get them ready for future work and professional duties is a part of the nurse preceptor's job description (Hussein et al., 2023). Few studies were conducted to evaluate and assess professional nursing competencies among undergraduate nursing students due to different challenges such as conflict-related obligations, work stress, overload, and unclear evaluation documentation (Lejonqvist & Kajander-Unkuri, 2022).
The provision of safe, high-quality patient care depends heavily on nursing competency, yet there is still a lack of knowledge regarding the competency levels of Jordanian undergraduate nursing students. Students frequently struggle to integrate their theoretical knowledge into actual healthcare settings throughout the transition from nursing school to clinical practice (Allari et al., 2022; Masa'deh et al., 2023). It is critical to assess nursing students’ professional competencies before they enter into healthcare institutions, given the growing complexity of healthcare needs and the critical role nurses play in patient outcomes. The competency levels of Jordanian undergraduate nursing students are investigated in this study, taking into account several demographic variables that could affect their clinical readiness. It is crucial to evaluate these competencies to pinpoint nursing education's advantages and disadvantages and make sure that graduates fulfill the necessary professional requirements. This study must be carried out to offer evidence-based insights that can guide the creation of curricula, improvements to clinical training, and changes to nursing education policies. To provide future nurses with the knowledge and self-assurance they need to provide efficient and superior patient care, this study's practical goal is to make recommendations for enhancing nursing education and training programs.
Materials and Methods
Design
A descriptive, cross-sectional design was used.
Settings and Sampling
Data were collected from 150 Jordanian nursing students. The target population of the current study was Jordanian nursing students from different levels in their study years, whereas the accessible population was Jordanian nursing students who agreed to participate in this study. The inclusion criteria were Jordanian nursing students who have at least one experience in clinical practice with direct contact with patients. Note that these students should be at least in their 2nd year level of study taking into consideration that the clinical experience was measured as that semester is 16 weeks with 1 credit hour (clinical) = 4 direct contact hours (192 hours for each clinical course).
Exclusion criteria were other Jordanian students and those who did not accept to participate in the study. Data were collected through an online form that was filled and submitted through a Google survey link that was started from February 8, 2024, to September 21, 2024.
The study was conducted in different Jordanian nursing faculties including governmental and private universities. Using the G*power, the minimum required sample size is 135 participants with a confidence level of 0.95, and a p-value of .05 (Faul et al., 2009). However, the total sample size in the current study was 150 participants.
Instruments
This study utilized a questionnaire composed of socioeconomic background information about nurses including sex, marital status, year level if they had taken nursing courses previously, age, and clinical experiences. The second part of the questionnaire was the Nurse Professional Competence Scale (NPCS)—a short version of 35 items. The NPSC was developed by Nilsson et al. (2014) to assess nursing students’ competencies composed of 35 items distributed in six domains of competencies, namely the nursing care domain with five items; value-based nursing care domain with five items; medical and technical care domain with six items; care pedagogics domain with five items; documentation and administration of nursing care domain with eight items; and development, leadership, and organization of nursing care domain with six items. Each of the 35 items included a scale with four possible responses to indicate the self-reported competencies, 1 = extremely low degree, 2 = fairly low degree, 3 = indicates a fairly high degree, and 4 = indicates a very high degree. The previously determined score of 1 to 4 is now a score of 1 to 100 following the NPC Scale Handbook. The greater score reflects higher competency skills. According to Nilsson et al. (2018), it was reported that the 35-item NPC Scale has α coefficients that were all within the range of .71 and .86, indicating that the quantity of items was satisfactory. Besides, another study using the NPC scale reported that value-based nursing care and care pedagogics had an α value of .89, nursing care, documentation and administration of nursing care, and medical and technical care had an α value of .87, while the item of development, leadership, and organization of nursing care had an α value of .84 (Halabi et al., 2023).
Nilsson et al. (2014) developed and validated the NPCS based on international nursing competency frameworks, ensuring that it aligns with key professional nursing competencies.
The NPCS has been tested using exploratory and confirmatory factor analysis, confirming its ability to measure distinct competency areas reliably, it demonstrates high internal consistency, with Cronbach's alpha values typically above .90, indicating strong reliability across different competency dimensions. Also, the NPCS has been translated and adapted for use in different countries, maintaining strong psychometric properties across various nursing populations (Duka et al., 2023; Finnbakk et al., 2015; Jalali et al., 2024).
The questionnaire was translated into Arabic by a team of multilingual specialists, who then translated it back into English until the Arabic and English versions were compatible.
Ethical Considerations
Ethical approval to conduct the study was granted by the Ethics Committees of Scientific Research and Ethics of Research at the Faculty of Nursing/Irbid National University (#: 005/2023) of the researchers’ university. There were no known risks from participating in the study. Anonymity and confidentiality were maintained. An information sheet was provided to each participant describing the purpose of the study, confirming the privacy, anonymity, and confidentiality of participants, the voluntary nature of their participation, and providing instructions on how to rate each domain of competencies. Informed consent was implied by completing and returning the survey via Google form.
Data Collection Procedures
Potential volunteers received the questionnaire along with a letter of information following the study's ethical approval. Individuals were invited to participate in the study by completing the questionnaire and sending it back via their email. The first author coded the questionnaires upon receiving them, typed them into the computer program, and kept them safely at the researcher's office.
Statistical Analysis
Descriptive statistics were used to characterize the data, the Shapiro test was used to determine if the data were normal, and inferential statistics were used to analyze the data using IBM's SPSS Statistics 25.0 for Windows (SPSS) at p = .05 of statistical significance was established. The competence domains were given mean scores; the greater the score, the greater the perceived competence. For nonparametric variables that were not normally distributed, the median score and interquartile were utilized (Shapiro test, W = 0.9588; p = .0001). These comprised the NPC Scale data, self-reported health, and demographic backgrounds. Where applicable, the Mann–Whitney U-test and the Kruskal–Wallis test were used.
Results
Characteristics of the Participants
The mean age of the participants was (M = 23.3, SD = 4.29) ranging from 18 to 30 years. Most of the participants were single (n = 114, 76.0%). About one-third of students were in their third year of study (n = 48, 32.0%). Most participants reported that they did not take nursing courses previously (n = 80, 53.3%). The nurses’ demographic characteristics are presented in full in Table 1.
Demographic Characteristics of the Participants (N = 150).
Note. F = frequency; % = percentage; M = mean; SD = standard deviation.
Professional Competencies of Nursing Students
The overall average competencies of nursing students were 80.8 ± 10.7 indicating higher competency scores among nursing students. However, nursing students have a higher average score in value-based nursing care of 87.5 ± 0.91, followed by documentation and administration of nursing care competency that have an average of 83.2 ± 1.25. The least competency mastered by nursing students was medical and technical care and care pedagogics with an average of 77.1 ± 0.91. The professional competencies of nursing students are provided in Table 2.
Descriptive Statistics of Professional Competencies of Nursing Students (n = 150).
Note. M = mean; SD = standard deviation.
Correlations of the Overall Professional Competencies of Nursing Students and Demographics
Pearson-product moment correlation was used since the data were normally distributed. At .05 significant level (two-tailed), the correlation was significant between marital status (r = −.170, p = .037) and the overall professional competencies of nursing students showing a weak negative correlation. On the other hand, at a .001 significant level (two-tailed), the results showed a positive weak correlation between age (r = .200, p = .014) and the overall nursing professional competencies. Besides, a positive moderate correlation was shown between taking nursing courses previously (r = .258, p = .001). Correlations were provided in Table 3.
Correlation Matrix of the Overall Professional Competencies and Sample Characteristics (n = 150).
Note. *Correlation is significant at .05 level (two-tailed), **correlation is significant at .01 level.
Significant Differences in the Overall Professional Competencies of Nursing Students
An independent sample t-test was used to assess the mean differences between the overall professional competencies of nursing students and their characteristics including sex, marital status, and their previous taking on any nursing courses. The results showed that there were no significant differences between age (t = 0.357, p = .35), marital status (t = 2.11, p = .411), and their previous taking of nursing courses (t = 3.25, p = .22). On the other hand, ANOVA indicated that age has a significant effect on overall professional competencies since higher age has an obvious effect on nursing competencies (F = 10.8, df = 2; p = .001). Similarly, ANOVA indicated a significant difference between clinical experience and year level; which indicated that the higher clinical experience that also associated with the progress in year level of nursing students higher professional competencies (F = 64.5, df = 2; p = .001), and (F = 24.5, df = 3; p = .001). For more details, please refer to Table 4.
Significant Differences in the Overall Mean Scores of Professional Competencies Among Nursing Students Based on Their Characteristics (n = 150).
*Correlation is significant at 0.05 level (2-tailed).
Discussions
This study highlights the professional competencies of Jordanian nursing students that focus on the skills, knowledge, and behaviors essential to delivering safe and effective patient care upon entering the workforce. Clinical care, value-based nursing care, medical and technical care, care pedagogics, documentation and administration, and development of leadership abilities. These competencies also encompass communication, critical thinking, cultural sensitivity, ethical practice, and professionalism.
The results of the current study indicated a high competency averaged score in all competencies; this finding was consistent with a study performed by Suliman et al. (2023) who reported a high level of competencies in all six domains. Besides, another Swedish study conducted by Gardulf et al. (2016) reported high nurse professional competencies as perceived by students, especially in patient-related skills. This result could be related to the utilization of a competency-based education curriculum in the clinical practice area.
Additionally, this study reported a higher competency level in the value-based nursing care domain, followed by documentation and administration of nursing care competency. These results were in the same line as a Jordanian study performed by Suliman et al. (2023) who reported that value-based nursing care with the highest average score. Another recent study performed by Zaitoun (2024) stated that value-based nursing care competency was the highest domain compared with other competencies. On the other hand, the current study reported the lowest score in medical and technical care and care pedagogics. This result was inconsistent with a study performed by Suliman et al. (2023) and Zaitoun (2024) who reported a least averaged score in leadership and administration skills due to the difficult application of this competency in the three-year nursing program. In the current study, it is also a great challenge to develop a complex task for nursing students in medical and technical care due to the lack of accountability of nursing students to apply such skills without a clinical instructor who is responsible for their training of his/her students. Besides, there is no designated clinical course on care pedagogics. So, it is strongly recommended to encourage nursing schools in Jordan, as well as in other developing countries, to introduce a clinical course in care pedagogics to improve high quality of patient care. This is a crucial implication to bridge the authorial-practice gap between theoretical knowledge learned in the classroom and practical skills needed in clinical settings.
Besides, it was noted that administrative staff self-efficacy and emotional intelligence are positively correlated with the professional competencies of nursing students. This finding was consistent with a study performed by Sarani et al. (2020) who provided an implication that can aid in the hiring, training, counseling, and retention of administrative staff to enhance the occupational performance of medical sciences universities.
The results of this study showed a weak negative correlation between marital status and overall professional competencies. This finding was consistent with a study reported by Shibiru et al. (2023) who found a correlation between professional competencies between nurses and their marital status. This result could be explained by time constraints and responsibilities that limit their abilities to maintain their professional competencies. Furthermore, the pressures of nursing school combined with marital duties may raise stress levels, which could affect learning new skills and academic performance. Their capacity to participate completely in learning activities may be impacted by this mental burden.
Besides, a positive moderate correlation was shown between taking nursing courses previously with the overall professional competencies of nursing students. This finding was consistent with a study performed by Ruzafa-Martinez et al. (2021) who reported that in their study, there were 76.3% of participants attended more than 75% of the nursing class hours as nursing courses showed a moderate positive correlation with the overall evidenced-based practices competency scores. Taking previous courses in nursing helps nursing students retain their knowledge, develop skills, and be exposed to diverse coursework could help their confidence and clinical judgment in the practice areas.
Furthermore, the current study showed a significant mean difference between clinical experience and competency level of nursing students. This result contradicts the finding of a study performed by Abbaspour et al. (2021) who reported that clinical competency was not significantly reflected by the participant's length of clinical experience years. The author believed that organizational and environmental factors may have an impact on the clinical competencies of nurses, as well as educational establishments, programs for retraining, in-service instruction, oversight, and management, as well as an effective system of training. However, the findings of this study need additional research, a comprehensive perspective on this matter, and thorough planning can enhance the clinical competency of nurses and improve the standard of assistance to the patients.
An important point to mention is that the health system has made disaster risk management a top priority as the frequency and intensity of disasters have increased. At every level of healthcare, nurses are crucial to disaster risk management, and they need to be prepared and equipped with the skills necessary to respond to emergencies. Hence, it is important to focus on nurse's competency in disaster cases. These findings were consistent with a study performed by Soltani Goki et al. (2023) who mentioned that nurses’ high level of competency in disaster risk management, but indicated gaps in their core competencies. The study results recommend authorities provide various training courses related to disaster risk management for all nurses.
Implications for Clinical, Education, and Research Practice
Assessing undergraduate nursing student's professional competencies has several implications that include the ability to enhance patient care quality. Besides, drawing attention to competency gaps, the nursing curriculum can be more open to incorporating evidence-based practices, which will prepare students to carry out clinical interventions supported by research in Jordanian healthcare settings. This study highlights the importance of understanding nursing students’ competency levels for effective training programs, mentorship initiatives, and competency-based assessments. It also emphasizes the need for curriculum enhancements, faculty development programs, and further research into factors influencing nursing competency, such as cultural, institutional, and policy-related variables, to inform evidence-based improvements in nursing education and practice.
Strengths and Limitations
The current study introduces several strong points that highlight the current educational outcomes that promise a future of qualified nurses serving patient care. Besides, highlighting the advantages and disadvantages of student training, the results can assist in guiding curriculum modifications and enable educational institutions to implement evidence-based enhancements. However, it is important to recognize the various limitations of this study. First, because the cross-sectional design only offers a momentary view of nursing students’ competencies, it precludes the development of cause-and-effect correlations. To evaluate the evolution of competency over time, longitudinal research would be required. Second, because the study used self-reported surveys, students may have overestimated or underestimated their skills, which could lead to response bias. Because perceptions and actual performance don’t always match, self-assessment techniques can also produce stronger but perhaps erroneous connections between variables. Third, because the convenience sample method may not be typical of all Jordanian undergraduate nursing students, the results cannot be applied broadly. Furthermore, the comparatively small sample size lowers statistical power, which can make it more difficult to find meaningful relationships or differences. To increase the validity of the results, future research should take into account bigger, more varied sample sizes and include objective competency evaluations, including clinical examinations.
Conclusion
The results point out specific competencies that need development including documentation and administration skills and development and leadership abilities. However, nursing care and value-based nursing care showed a high average score in the competency levels.
Future research on Jordanian nursing students’ professional competencies should consider longitudinal designs, educational interventions, and qualitative perspectives. It should also consider external factors like healthcare system demands and cultural influences. Comparing universities and international benchmarks could improve nursing curricula. Understanding the relationship between nursing competencies and patient outcomes could strengthen the connection between education and quality of care.
Footnotes
Acknowledgments
The authors want to thank all nursing students who participated in this study.
Author Contributions
AA-A: conception and design of the study, data curation; SBH: methodology, data analysis, and writing the original draft; EAA: data curation, editing, and discussion.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Ethical Approval
The Committees of Scientific Research at the School of Nursing/Irbid National University have approved the study (#: 005/2023).
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
