title: Empirical evolution of a framework that supports the development of nursing competence.
abstract: OBJECTIVE
  The aim of this study was to refine a framework for developing competence, for graduate nurses new to paediatric nursing in a transition programme.
  
  
  BACKGROUND
  A competent healthcare workforce is essential to ensuring quality care. There are strong professional and societal expectations that nurses will be competent. Despite the importance of the topic, the most effective means through which competence develops remains elusive.
  
  
  METHODS
  A qualitative explanatory method was applied as part of a mixed methods design.
  
  
  METHODS
  Twenty-one graduate nurses taking part in a 12-month transition programme participated in semi-structured interviews between October and November 2013. Interviews were informed by data analysed during a preceding quantitative phase. Participants were provided with their quantitative results and a preliminary model for development of competence and asked to explain why their competence had developed as it had.
  
  
  RESULTS
  The findings from the interviews, considered in combination with the preliminary model and quantitative results, enabled conceptualization of a Framework for Developing Competence. Key elements include: the individual in the team, identification and interpretation of standards, asking questions, guidance and engaging in endeavours, all taking place in a particular context.
  
  
  CONCLUSIONS
  Much time and resources are directed at supporting the development of nursing competence, with little evidence as to the most effective means. This study led to conceptualization of a theory thought to underpin the development of nursing competence, particularly in a paediatric setting for graduate nurses. Future research should be directed at investigating the framework in other settings.
authors.affiliation: The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.|The University of Melbourne, Parkville, Victoria, Australia.|Murdoch Children's Research Institute Melbourne, Parkville, Victoria, Australia.
authors.forename: Sally
authors.initials: S
authors.lastname: Lima
authors.affiliation: The University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Helen L
authors.initials: HL
authors.lastname: Jordan
authors.affiliation: The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.|The University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Sharon
authors.initials: S
authors.lastname: Kinney
authors.affiliation: The University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Bridget
authors.initials: B
authors.lastname: Hamilton
authors.affiliation: The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.|The University of Melbourne, Parkville, Victoria, Australia.|Murdoch Children's Research Institute Melbourne, Parkville, Victoria, Australia.
authors.forename: Fiona
authors.initials: F
authors.lastname: Newall
mesh_terms: D001315:Australia; D002983:Clinical Competence / Q000592:standards*; D004509:Education, Nursing, Continuing / Q000379:methods; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D064701:Pediatric Nurse Practitioners / Q000592:standards*; D010371:Pediatric Nursing / Q000592:standards; D057184:Practice Patterns, Nurses' / Q000592:standards
keywords: asking questions; clinical competence; new graduate nurses; professional competence; professional development; programme development; programme evaluation; staff development; teamwork; transitional programmes