title: Nurse Competence Scale: a systematic and psychometric review.
abstract: OBJECTIVE
  The aim of this study was to report a systematic and psychometric review.
  
  
  BACKGROUND
  The Nurse Competence Scale is currently the most widely used generic instrument to measure Registered Nurses' competence in different phases of their careers. Based on a decade of research, this review provides a summary of the existing evidence.
  
  
  METHODS
  A systematic literature review of research evidence and psychometric properties.
  
  
  METHODS
  Nine databases from 2004 - October 2015.
  
  
  METHODS
  We retrieved scientific publications in English and Finnish. Two researchers performed data selection and appraised the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments checklist.
  
  
  RESULTS
  A total of 30 studies reported in 43 publications were included. These consisted of over 11,000 competence assessments. Twenty studies were from Europe and 10 from outside Europe. In addition to experienced nurses, the Nurse Competence Scale has been used for the competence assessment of newly graduated nurses and nursing students, mainly in hospital settings. Length of work experience, age, higher education, permanent employment and participation in educational programmes correlated positively with competence. Variables including empowerment, commitment, practice environment, quality of care and critical thinking were also associated with higher competence. The Nurse Competence Scale has demonstrated good content validity and appropriate internal consistency.
  
  
  CONCLUSIONS
  The value of Nurse Competence Scale has been confirmed in determining relationships between background variables and competence. The instrument has been widely used with experienced and newly graduated nurses and their managers. Cross-cultural validation must be continued using rigorous methods.
authors.affiliation: Corporate Headquarters, Helsinki University Hospital, Finland.|Department of Nursing Science, University of Turku, Finland.
authors.forename: Mervi
authors.identifier: http://orcid.org/0000-0003-1570-9605
authors.initials: M
authors.lastname: Flinkman
authors.affiliation: Department of Nursing Science, University of Turku, Turku University Hospital, Finland.
authors.forename: Helena
authors.initials: H
authors.lastname: Leino-Kilpi
authors.affiliation: Corporate Headquarters, Helsinki University Hospital, Finland.|Department of Nursing Science, University of Turku, Finland.
authors.forename: Olivia
authors.initials: O
authors.lastname: Numminen
authors.affiliation: Corporate Headquarters, Helsinki University Hospital, Finland.|Department of Nursing Science, University of Turku, Finland.
authors.forename: Yunsuk
authors.initials: Y
authors.lastname: Jeon
authors.affiliation: Corporate Headquarters, Helsinki University Hospital, Finland.|Department of Nursing Science, University of Turku, Finland.
authors.forename: Liisa
authors.initials: L
authors.lastname: Kuokkanen
authors.affiliation: Corporate Headquarters, Helsinki University Hospital, Finland.|Department of Nursing Science, University of Turku, Finland.
authors.forename: Riitta
authors.initials: R
authors.lastname: Meretoja
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003431:Cross-Cultural Comparison; D006801:Humans; D009726:Nurses / Q000592:standards*; D011594:Psychometrics; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: Nurse Competence Scale; assessment; competence; instrument validation studies; instruments; nursing; nursing workforce; professional competence; psychometric testing; registered nurses; systematic review