Clinical competence: starship enterprise or straitjacket?

Clinical competence assessment has been a feature of nurse education in the United Kingdom for about 20 years but has really moved to centre-stage since the nurse education reforms of 1999. Clinical competence is a controversial issue and there are problems with assessment and the relationship between the practical and educational aspects of nurse education programmes. The present paper explores the origins of clinical competence assessment, presents some of the problems associated with the adoption of clinical competence in nurse education and reviews some literature in this area. In so doing the paper refers to two research studies commissioned in the United Kingdom into the educational preparation of nurses in which the measurement of clinical competence has been an issue. This paper is based on the Winifred Raphael Memorial Lecture delivered by the author on behalf of the Royal College of Nursing Research Society at the Royal College of Nursing Congress in Harrogate, England on 23 May 2001. The views expressed are those of the author and not necessarily, those of the Royal College of Nursing or the Royal College of Nursing Research Society.