• evaluation research;
  • management;
  • nursing competencies’;
  • professional development;
  • surgical nursing

meretoja r. & koponen l. (2012) A systematic model to compare nurses’ optimal and actual competencies in the clinical setting. Journal of Advanced Nursing 68(2), 414–422.


Aim.  This paper is a report of a study to develop a model to compare nurses’ optimal and actual competencies in the clinical setting.

Background.  Although future challenge is to focus the developmental and educational targets in health care, limited information is available on methods for how to predict optimal competencies.

Method.  A multidisciplinary group of 24 experts on perioperative care were recruited to this study. They anticipated the effects of future challenges on perioperative care and specified the level of optimal competencies by using the Nurse Competence Scale before and after group discussions. The expert group consensus discussions were held to achieve the highest possible agreement on the overall level of optimal competencies. Registered Nurses (n = 87) and their nurse managers from five different units conducted assessments of the actual level of nurse competence with the Nurse Competence Scale instrument. Data were collected in 2006–2007.

Results.  Group consensus discussions solidified experts’ anticipations about the optimal competence level. This optimal competence level was significantly higher than the nurses’ self-reported actual or nurse managers’ assessed level of actual competence. The study revealed some competence items that were seen as key challenges for future education of professional nursing practice.

Conclusion.  It is important that the multidisciplinary experts in a particular care context develop a share understanding of the future competency requirements of patient care. Combining optimal competence profiles to systematic competence assessments contribute to targeted continual learning and educational interventions.