University of Oulu

Kati Immonen, Ashlee Oikarainen, Marco Tomietto, Maria Kääriäinen, Anna-Maria Tuomikoski, Boris Miha Kaučič, Bojana Filej, Olga Riklikiene, M. Flores Vizcaya-Moreno, Rosa M. Perez-Cañaveras, Paul De Raeve, Kristina Mikkonen, Assessment of nursing students’ competence in clinical practice: A systematic review of reviews, International Journal of Nursing Studies, Volume 100, 2019, 103414, ISSN 0020-7489,

Assessment of nursing students´ competence in clinical practice : a systematic review of reviews

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Author: Immonen, Kati1; Oikarainen, Ashlee1; Tomietto, Marco1;
Organizations: 1Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
2The Finnish Centre for Evidence‐Based Health Care: A Joanna Briggs Institute Centre of Excellence, Helsinki, Finland
3College of Nursing in Celje, Slovenia
4Faculty of Nursing, Lithuanian University of Health Sciences, Kaunas, Lithuania
5Nursing Department, Clinical Nursing Research Group, University of Alicante, Spain
6European Federation of Nurses Associations, Belgium
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
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Language: English
Published: Elsevier, 2019
Publish Date: 2019-10-30


Background: The assessment of nursing students’ nursing competence is a matter of concern worldwide and the complexity of assessing students’ clinical competence has challenged educators for decades. It has been recognized that there is inconsistency among assessment methods and tools between countries and institutions.

Objective: To identify the current best evidence on the assessment of nursing students’ competence in clinical practice.

Design: Systematic review of reviews.

Data sources: The electronic databases CINAHL, PubMed, Eric, Medic and the JBI Database of Systematic Reviews and Implementation Reports were searched in autumn 2018.

Review methods: Two researchers independently assessed the eligibility of the studies by title, abstract and full-text, and then assessed the methodological quality of the included studies. Analysis of study findings was conducted using the thematic synthesis approach.

Results: Six reviews were included following critical appraisal. Assessment tools used to assess students’ nursing competence commonly focus on the domains of professional attributes, ethical practices, communication and interpersonal relationships, nursing processes, critical thinking and reason. Clinical learning environments and mentoring provide important support structures and guide the learning of students. The availability of assessment tools and criteria along with providing individualized feedback and time for reflection strengthen the objectivity and reliability of assessment.

Conclusions: There continues to be a need to develop consistent and systematic approaches in assessment, and to use reliable and valid instruments in assessment. Mentors find assessment of students’ competence to be particularly challenging and emphasize the importance of clear assessment criteria, support from nurse educators and further education on assessment. Further development in feedback practices and providing students with opportunities for reflection are important in supporting the continuous learning process of students.

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Series: International journal of nursing studies
ISSN: 0020-7489
ISSN-E: 1873-491X
ISSN-L: 0020-7489
Volume: 100
Article number: 103414
DOI: 10.1016/j.ijnurstu.2019.103414
Type of Publication: A2 Review article in a scientific journal
Field of Science: 316 Nursing
Funding: We would like to acknowledge European Commission, Erasmus+, KA2: Strategic partnership for providing funding for the project Quality mentorship for developing competent nursing students (QualMent).
Copyright information: © 2019 Elsevier Ltd. All rights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license