Although the majority of literature about competence
in nursing education focuses on undergraduate education,
assuring increasing levels of competency across the
educational continuum is important. Education at the graduate level and beyond must be offered with increasing
competency as a goal.
Although education based on competency may be
agreed upon, determining which competencies are most
critical, at what level they should be demonstrated, and
how to teach them remains unclear. Evaluating cognitive,
affective, and psychomotor achievement of skills
and knowledge that increase in complexity throughout
a career is challenging.
Origin of the Concept of Competency
Competency is derived from the Middle French and
Latin word competens. To be competent is to be proper
or rightly pertinent, to have requisite or adequate ability
or qualities, to be legally qualified or adequate, or to have
the capacity to function or develop in a particular way
(Merriam-Webster Online, n.d.). The National Council
for State Boards of Nursing (NCSBN; 2005) defined
competency as “the application of knowledge and the
interpersonal, decision-making, and psychomotor skills
expected for the practice role, within the context of public
health” (p. 81). McMullan et al. (2003) distinguished
between competence and competency, stating that competence
is focused on the description of the action or behavior,
while competency is focused on the individual’s
behavior that underpins the competent performance.
These terms are frequently used interchangeably.
Beginning in the early 1980s, many boards of nursing
began to explore the issue of competencies for graduating
nurses in their states. Several states developed essential
competencies of nursing program graduates. Typically,
these competencies are specified by educational program
preparation (e.g., diploma, associate degree, and bachelor’s
degree). Most identify the knowledge, judgment,
skills, and professional values expected of graduates of
nursing programs.
Continued competency became a topic of intense
and frequent discussion among nurses nationally in the