A synthesis of the literature on "competence" as it applies to perioperative nursing.

Perioperative competence is an eclectic concept that has been difficult to define and even more difficult to measure. Competence has been described in relation to standards of practice with little emphasis placed on its interpersonal aspects. This article presents a synthesis of the literature focused on perioperative nurse competence. Although specialized knowledge in the form of technical proficiency is important, it is no longer the only indicator of perioperative competence. The findings in this synthesis attest to the increased awareness and emphasis given to human factors--recognition that teamwork, communication, coordination, and leadership also affect human performance. Based on these findings, the next important step would be to develop and test these categories of competence empirically.