Nursing and Health Sciences (2010), 12, 147–154

Research Article

Competence assessment of nursing graduates of

Jordanian universities nhs_507 147..154

Reema Safadi, rn, phd,1 Malak Jaradeh, rn, phd,2 Amal Bandak, rn, phd2 and
Erika Froelicher, rn, ma, mph, phd3
1
Department of Maternal and Child Health Nursing, Faculty of Nursing, University of Jordan, 2Department of Maternal
and Child Health Nursing, Faculty of Nursing, Applied Science University, Amman, Jordan and 3University of California
San Francisco, San Francisco, California, USA

Abstract This cross-sectional survey assessed the level of competence of nursing graduates of Jordanian universities
(2001–2004 cohorts) in relation to the type of university, sex, hospital type, and working area. A convenience
sample (n = 258) of full-time nurses (6 months–4 years’ experience) was selected from public, private, and
teaching hospitals. A specifically designed tool with a rating scale of 1–5 was used to evaluate the nurses’
competence in five nursing competencies (management, professionalism, problem-solving, nursing process,
and knowledge of basic skills). The findings showed a satisfactory competency level with no significant
differences related to the type of university or sex. General ward nurses scored significantly better than those
in intensive care units in relation to management, professionalism, and nursing process, while the teaching
hospital nurses showed significantly better performance in professionalism and management skills than did
the nurses in the other two sectors. We recommend that nurse recruitment policies should consider individual
competencies rather than innate characteristics in their selection of employees.

Key words competence assessment, competence skills, Jordan, Jordanian universities, nursing graduates.

INTRODUCTION The evaluation of clinical nursing practice can be under-

taken by comparing the level of competence against prede-
Present-day health services are highly complex and high-
termined standards of practice (Kaiser & Rudolph, 2003).
quality care is mandatory. Nursing competence is vital to
Bircumshaw (1989) suggested using quantitative and quali-
provide such care. Competence in nursing practice and edu-
tative approaches to measure competence and advocated the
cation has been the concern of the Joint Commission on
development of an integrated approach that incorporates
Accreditation of Healthcare Organizations (JCAHO) and
a measurement of performance (Bartlett et al., 2000). The
other educational accreditation bodies, generating apprehen-
JCAHO in the USA, the International Council of Nurses
sion and concern among health practitioners and educators in
(ICN), the Nursing and Midwifery Council (NMC) in the
relation to meeting the standards set by these organizations.
UK, and the National League for Nursing are the main agen-
Competence has been defined in a number of ways. Most
cies concerned with developing and monitoring the standards
importantly, definitions include the requirements of essential
of health care. Each has a board of professionals for licensure
cognitive, psychomotor, and affective skills and the enhance-
purposes and for setting standards of minimal competence
ment of skills acquisition through formal knowledge and
for nurses. The American Nurses’ Association undertakes the
clinical experience. Decision-making and critical thinking are
responsibility and commitment of securing the public’s safety
integral parts of the process (Robb et al., 2002). Competence
through social policy, standards, scope of nursing practice,
is the concept used to determine whether or not a nurse is
and the ethical code of practice statements (Rowell, 2003).
fulfilling the required standards for safe practice. It also is
In Jordan, the first baccalaureate nursing program (Bach-
defined as the personal skills that are developed through
elor of Science or BSc) was established at the public Univer-
professional education and training and includes observable
sity of Jordan in 1972 with international consultants to
behaviors that occur in professional practice and unobserv-
develop the nursing curriculum. The rapid growth and
able attributes, capacities, dispositions, attitudes, and values
demand for more nurses led to the establishment of more
(Tzeng & Ketefian, 2003).
public and private universities offering BSc nursing pro-
grams, totalling six public and eight private universities today.
Being the pioneers in nursing education, public universities
Correspondence address: Reema Safadi, Faculty of Nursing, University of Jordan,
Amman 11942, Jordan. Email: [email protected] continuously have provided academic leadership for philoso-
Received 2 September 2009; accepted 26 October 2009 phy of education and curriculum development and testing

© 2010 The Authors doi: 10.1111/j.1442-2018.2009.00507.x

Journal Compilation © 2010 Blackwell Publishing Asia Pty Ltd.
148 R. Safadi et al.

and have helped the private sector in designing its programs. Unlike in the West, where competence evaluation is well
The exchange of faculty members between the public and studied, the examination of competence remains an impor-
private sectors resulted in a uniformity of curricula across tant issue in Jordan and the region. The results of this study
Jordan. might be of relevance to countries starting their nursing pro-
Although the curricula are the same, there are differences grams, licensing exams, program accreditation, and quality
in the admission criteria and tuition fees between the two control evaluations.
sectors. The public universities’ admission process is highly This study specifically aims to answer the following ques-
competitive, based on students’ high school grades; whereas, tions:
this is more flexible and more lenient in private universities, 1 Is there a significant difference in the level of competence
which allow the admission of lower academic ranking that can be attributed to the graduating university (public
students. versus private universities)?
There are three reasons for conducting this study. The first 2 Is there a significant difference in the level of competence
is the increasing number of nursing graduates from the dif- between male and female nurses?
ferent universities in the absence of a central regulating and 3 Is there a significant difference in the level of competence
monitoring body, until the establishment of the Jordanian between nurses working in general wards and nurses working
Nursing Council (JNC) in 2002. in intensive care units (ICUs)?
The second reason is the recent interest of Jordanian men 4 Is there a significant difference in the level of competence
in nursing, which has added to the competition and has led to among nurses working in the different types of hospitals
more men being admitted into private universities due to the (public, private, and teaching hospitals)?
limited number of places in public universities. An enroll-
ment level of male students of 65% (out of 6106) in these
Literature review
programs (Ahmad & Alasad, 2007) has provided a rich
supply of manpower for the health-care industry locally, Several international studies have evaluated nursing students
regionally, and internationally. Knowledge about whether or and newly qualified nurses for their level of competence
not there is a difference in the competence level attributed to (Bartlett et al., 2000; Redfern et al., 2002; Watson, 2002).
the university of graduation or sex would inform decision- Although the aims and methods of these studies differed, the
makers in nursing education in evaluating their program’s overall goals were to assess if educational and health-care
outcomes and enable nursing directors in practice settings organizations are preparing their students to satisfy the needs
to employ nurses based on the level of competence of the of health-care consumers.
graduates of these educational programs. This is especially Studies of clinical performance have investigated nurses’
important when there is more than one type of educational competencies in various aspects of practice, encompassing
program and a maldistribution of nursing graduates accord- safety, knowledge, skills, affect, motivation, leadership,
ing to sex: an abundance of male nurses and a shortage of interpersonal relations/communication, professional devel-
female nurses. opment (Dunn et al., 2000; Cowan et al., 2005), professional-
The third reason is the increase in population and the ism, and nurse practice laws (Liu et al., 2007; Son et al., 2007).
emphasis on the provision of cost-effective, high-quality The authors of these studies agreed on the complexity of the
health-care services in the last three decades, coupled with concept and suggested the need to develop a holistic defini-
the greater sophistication of patients about health issues, tion (Cowan et al., 2005). The findings of Dunn et al. (2000)
which requires scientific evidence about the competency of suggested 20 competency standards for specialized critical
graduates of different universities. We hope that this study care, grouped into six domains of nursing. Liu et al. (2007)
will provide such evidence. developed a tool to measure the clinical practice competen-
As a result of the existing dual educational system, we cies of Chinese nurses. No studies were found that investi-
evaluated the level of competence of Jordanian nurses gradu- gated competencies in relation to the area of work, the
ating from various institutions via the health-care service graduating university, and the type of hospital. Meretoja et al.
providers’ perspectives. To date, it is not known how the (2004) described 593 Finnish registered nurses’ self-assessed
graduates of this dual system perform once they are in the level of competence on 19 units (wards, emergency rooms,
workplace and in which setting they would have better outpatient clinics, ICUs, and operating rooms). The nurses
competence. working in the operating rooms and emergency/outpatient
The aims of this study were to: (i) examine the competence unit were significantly more competent in managing situa-
levels of nurses; and (ii) provide information to education tions (P < 0.05) than the ward nurses. Conversely, the ward
programs, service sectors, and policy-makers about gradu- nurses had higher competence levels in the helping role and
ates’ level of competence and curriculum effectiveness. The ensuring quality.
results would help in the future evaluation of programs as
these graduates have been in work settings for only 1–4 years.
METHODS
To our knowledge, our hospitals do not offer intensive train-
ing courses, as is common in institutions in the USA and UK,
Design
suggesting that the knowledge gained at university and infor-
mal colleagueship are what new graduates depend on for A cross-sectional design, using a survey technique, was
their early practice. employed to answer the study’s questions.

© 2010 The Authors

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Competence assessment of nurses 149

Sampling and data collection alism (seven items), problem-solving (five items), nursing
process (eight items), and knowledge of basic nursing prin-
A convenience sample was used, consisting of nursing gradu-
ciples (four items). The nursing supervisors were asked to
ates (n = 258) who were cohorts of 2001–2004, from four
rate their nurses’ competence on a scale of 1–5, where
public and two private universities, and who were working
1 = “low competence” and 5 = “excellent competence”.
full-time (6 months–4 years) in public, private, and teaching
For the face validity of the questionnaire, five nurse aca-
hospitals.The areas of work included medical, surgical, mater-
demics and two nursing directors were consulted to classify
nity, and pediatrics (general wards), and coronary care,
the items. Some items required rewording to match the com-
intermediate, neonatal ICUs, and emergency rooms (ICUs).
monly used hospital criteria for nurses’ appraisal. Items were
Graduates of all public and private universities (north,
reworded for two reasons: (i) to rephrase the variously stated
middle, and south) of Jordan were represented. A conve-
evaluation statements of the participating hospitals into one
nience sample of one public hospital, the largest hospital in
statement that combined the meaning of this criterion; and
Amman, eight private hospitals in Amman, and one teaching
(ii) to simplify the wording for easier completion by the
hospital in the north were selected to represent practice in
supervisors. A pilot test (n = 50) was carried out to evaluate
Jordanian hospitals. Although the private hospitals are in
the questionnaire and the item consistency for the scale was
excess, they constitute a similar number of beds when com-
calculated (Cronbach’s a = 0.97).
pared with the public and teaching hospitals. Hospitals in
In Jordan, where there is a severe nursing shortage and an
Amman were over-sampled because most university gradu-
overload of work, expecting the supervisors to participate in
ates are employed in the capital. The north was represented
an inter-rater reliability exercise is not feasible. Placing this
by the largest teaching hospital in that area. No hospital from
additional responsibility on the supervisors most likely would
the south was chosen due to the limited funds for travel. The
have resulted in them being unable to participate.
selected hospitals included urban and rural settings.
Institutional review board approval was obtained from the
research committee of Alzaytoonah Private University and Data management and analysis
each hospital. Approval for data collection was obtained
The Statistical Package for Social Sciences Version 14 was
from the nursing administrators and supervisors. A total of
used (SPSS, Chicago, IL, USA). Summary descriptive statis-
310 questionnaires was distributed to 10 hospitals, with a
tics, the Student’s t-test, and analysis of variance (anova)
return rate of 83% (n = 258). After giving full information
were used to provide the demographic details of the sample
about the evaluation questionnaire to the involved supervi-
and to test for differences in competence levels by the uni-
sors in the various hospital settings, they were asked to com-
versity type, sex, number of years of practice, working area,
plete the forms by evaluating eligible nurses in their work
and hospital type.
area. The supervisors were able to decline participation. A
willingness to evaluate was implied by answering the ques-
tionnaire. The nursing supervisors obtained consent from the RESULTS
nurses. The researchers planned to evaluate the nurses differ-
ently from the usual hospital appraisal because each hospital Sample characteristics
had its own criteria and timing for doing so. A uniformly
The sample represented 258 nursing graduates (2001–2004
designed tool that measured the competence of all nurses
cohorts) of six BSc programs in nursing. Of these, 75.6% were
was designed to ensure equivalence of measurement across
men and 72.9% were graduates of private universities. The
all hospitals.
number of male nurses exceeded that of the female nurses
in both the public (71%) and private universities (89.9%). No
private university graduates worked in the teaching hospital,
Measurement
while 79.7% worked in private hospitals. Over half (57.1%)
A specifically designed tool was used to measure nurses’ level of the graduates from the public universities were working in
of competence. The tool was intended to use statements that private hospitals, 17.4% in a public hospital, and 25.5% in the
were similar to the currently used hospitals’ evaluation tools. teaching hospital.
Thus, the researchers ensured simplicity, cultural adaptation Figure 1 shows that a higher proportion of the sample was
of the tool, as well as the cooperation of supervisors. The general ward nurses and that an equal number of graduates
researchers included a selection of competence skills items from the public and private universities worked in ICUs
that reflected a high importance to nursing practice across all (38.4% and 39.1%, respectively) and general wards (61.6%
nursing work areas. and 60.9%, respectively). Figure 2 depicts the type of
A two-part questionnaire was developed for this study: working areas (general wards versus ICUs) by the type of
a demographic data section (six items) and a competence hospital (public, private, and teaching).
assessment scale (27 items) (see Appendix I). The questions The graduates of the public and private universities had
reflected the universal standards of care found in the litera- similar above-average mean scores in the five competencies.
ture; that is, those of the ANA, NMC, and ICN. The com- The highest mean scores of the graduates from the public
petence assessment questions contained basic concepts (4.04 ⫾ 0.57) and private (4.15 ⫾ 0.63) universities were for
inherent in nursing education programs and of practicing management. The lowest mean score of the graduates of
nurses’ competencies: management (three items), profession- public universities was in knowledge of basic sciences

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150 R. Safadi et al.

(3.75 ⫾ 0.80), whereas the lowest mean score for the gradu- nursing process (3.78 ⫾ 0.71) and knowledge of basic prin-
ates from private universities was in the nursing process ciples (3.78 ⫾ 0.81); for women, the lowest mean score was in
(3.84 ⫾ 0.77). None of the type of university comparisons was knowledge of basic principles (3.79 ⫾ 0.84). None of the sex
statistically significant. comparisons was statistically significant.
Table 2 shows above-average mean scores for all compe- All the comparisons of nurses’ level of competencies by
tencies for men (4.06 ⫾ 0.61) and women (4.11 ⫾ 0.52), with general wards or ICUs showed higher mean scores for
the highest scores for both men and women in management general wards; they were significantly higher in manage-
(Table 1). The lowest mean scores for men were in the ment (t = -3.20, P < 0.001), professionalism (t = -3.68,
P < 0.001), and the nursing process (t = -2.10, P = 0.04). The
general ward nurses showed an overall significantly better
performance than the ICU nurses (t = -2.59, P < 0.01)
(Table 3).
An anova was used to test the difference in the level of
competence between the nurses working in the three types of
hospitals. The scores for management (F = 4.79, P = 0.01) and
professionalism (F = 4.02, P = 0.02) were significantly better
for the nurses working in the teaching hospital, compared
to the nurses in the private and public hospitals (Scheffe’s
post-hoc test) (Table 4).
The number of years of experience since graduation
(ⱕ 4 years) in relation to the level of competence was evalu-
ated and was not found to be significantly different in any
Figure 1. Distribution of students by the type of university and competency skills.
work area. ( ), graduated from public university; ( ), graduated
from private university.
DISCUSSION
The competence assessment of nurses in this study represents
graduates from all parts of Jordan including urban and rural
areas. Men and private hospitals are over-represented in our
sample as a reflection of the larger proportion of men enter-
ing nursing education programs. The JNC (2003) indicated
that, of 6007 registered nurses in the taskforce, there were
3829 female nurses (63.7%) and 2178 male nurses (36.3%).
It is estimated that the ratio of men to women has increased
in the last few years due to men’s greater interest in nursing
sciences. As the salaries of nurses are extremely low, more
men tend to seek employment in the private sector because
of higher pay and because they are the predominant provider
Figure 2. Distribution of nurses by the type of hospital and work for their own family. This differs from countries that have
area. ( ), intensive care units; ( ), general wards. relatively few men in the nursing profession, such as the

Table 1. Level of competence in the five nursing competency skills by type of university

Type of
Competency university N Mean SD t P-value

Management Public 186 4.04 0.57 -1.40 0.16

Private 69 4.15 0.63
Professionalism Public 186 3.98 0.64 -0.74 0.46
Private 69 4.05 0.69
Problem-solving Public 186 3.82 0.75 -1.01 0.31
Private 69 3.92 0.77
Nursing process Public 186 3.76 0.69 -0.76 0.44
Private 69 3.84 0.77
Knowledge of basic principles Public 186 3.75 0.80 -1.01 0.31
Private 69 3.87 0.86
Overall performance Public 186 3.86 0.64 -0.98 0.33
Private 69 3.95 0.71

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Competence assessment of nurses 151

Table 2. Level of competence in the five nursing competency skills by sex

Competency Sex N Mean SD t P-value

Management Male 195 4.06 0.61 -0.62 0.57

Female 63 4.11 0.52
Professionalism Male 195 3.98 0.67 -1.15 0.27
Female 63 4.08 0.59
Problem-solving Male 195 3.82 0.77 -1.17 0.26
Female 63 3.95 0.72
Nursing process Male 195 3.78 0.71 -0.41 0.68
Female 63 3.82 0.69
Knowledge of basic principles Male 195 3.78 0.81 -0.04 0.97
Female 63 3.79 0.84
Overall performance Male 195 3.87 0.64 -0.73 0.47
Female 63 3.94 0.71

Table 3. Level of competence in the five nursing competency skills by work area

Competency Setting N Mean SD t P-value

Management ICUs 99 3.93 0.56 -3.22 0.002*

General wards 158 4.17 0.59
Professionalism ICUs 99 3.82 0.63 -3.68 0.000*
General wards 158 4.12 0.64
Problem-solving ICUs 99 3.74 0.75 -1.87 0.063
General wards 158 3.92 0.75
Nursing process ICUs 99 3.67 0.74 -2.10 0.040*
General wards 158 3.86 0.68
Knowledge of basic principles ICUs 99 3.68 0.85 -1.58 0.120
General wards 158 3.85 0.79
Overall performance ICUs 99 3.75 0.66 -2.59 0.010*
General wards 158 3.96 0.64

*P ⱕ 0.05. ICUs, intensive care units.

Table 4. Level of competence in the five nursing competency skills by hospital type

Competency Hospital N Mean SD F P-value

Management Private 161 4.03 0.55 4.79 0.01*

Public 46 4.01 0.75
Teaching 49 4.31 0.48
Professionalism Private 161 3.95 0.61 4.02 0.02*
Public 46 3.95 0.82
Teaching 49 4.24 0.56
Nursing process Private 161 3.76 0.69 0.42 0.65
Public 46 3.86 0.83
Teaching 49 3.81 0.66
Problem-solving Private 161 3.83 0.69 0.14 0.87
Public 46 3.85 0.97
Teaching 49 3.90 0.73
Knowledge of basic principles Private 161 3.73 0.80 1.00 0.37
Public 46 3.88 0.94
Teaching 49 3.85 0.74
Overall performance Private 161 3.85 0.63 1.23 0.29
Public 46 3.90 0.83
Teaching 49 4.00 0.58

*P ⱕ 0.05.

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152 R. Safadi et al.

USA, where a recent national survey showed that the pro- ture. This result may be attributed to the graduates’ short
portion of men who enrolled in baccalaureate nursing pro- period of experience (4 years); thus, they have not yet
grams in 2002 was 9.6% (Girard, 2003). achieved the required higher competencies needed for prac-
Like most studies, our study had some limitations. First, we tice in the ICU setting. Another possible explanation for
used a non-probability convenience sample, which limits the these differences in competence is related to the supervisors’
generalizability of our findings. Future studies can improve higher expectations of the nurses choosing to work in ICUs,
on this through stratified random sampling. Second, our tool, putting them at a disadvantage from the beginning of their
which had strong face validity, needs to be validated for psy- career. Copnell (2008) suggested that working with critically
chometric properties. Moreover, an evaluation by the super- ill patients requires that nurses be highly knowledgeable.
visors as the sole assessment measure of staff competence Luotola et al. (2003) found that values and attitudes, tacit
might be prone to subjectivity and bias; most likely, any bias professional skills, and intuition were perceived to be impor-
would be in the direction of the null. Despite these limita- tant qualifying requirements for nurses working in ICUs.
tions, our study yielded important findings about nurses’ Furthermore, Saastamoinen (2007) indicated that the func-
competencies in relation to their graduating university, dif- tions of nurses working in ICUs necessitate holistic patient
ferent hospital sectors, clinical settings, sex, and number of care that requires special comprehensive competencies, pro-
years of experience. fessional skills, and expertise in order to offer this higher
The five salient findings from this study are that: (i) the level of competence. According to Benner’s stages of nursing
assessment of competencies in all areas were satisfactory on expertise, a proficient nurse must have 3–5 years of experi-
a scale of 1–5; (ii) the graduates from the public and private ence to provide care in terms of “wholes”, rather than in
university programs were similarly competent; (iii) the male “parts” (Berman et al., 2008), and to demonstrate intuition
and female nurses were equally competent; (iv) the nurses and decision-making ability is even more complex (King &
who worked on general wards rated higher in management, Clark, 2002). Atkinson and Tawse (2007) referred to the
professionalism, and nursing process competencies than did importance of specialized education in promoting hematol-
the nurses who worked in ICUs; and (v) the nurses working ogy nurses’ levels of knowledge and confidence; this input
in the teaching hospital had significantly higher competencies had enabled nurses to reach a level that experience alone
in management and professionalism than did those working could not have achieved.
in private and public hospitals. The possible explanations for In light of the above explanations, the burden of heavy
the above results are discussed. workloads, and the lack of continuing education opportun-
Despite the differences in the level of entry to nursing, we ities, the deficiency of professional development is an
found that nursing graduates of the public and private uni- expected outcome for Jordanian nurses. In this study, the
versities have comparable competencies in all areas. This is a nurses who worked on general wards rated significantly
reflection of the similarities in the educational programs, phi- higher in overall competence and, more specifically, in man-
losophies and curricula. Although the private universities agement, professionalism, and the nursing process than did
were established later than the public universities and have the nurses working in ICUs. The higher competencies of the
less stringent rules for accepting students, the Ministry of general ward nurses in these three abilities might have been
Higher Education places greater emphasis on applying strict achieved through the experiential learning gained on general
accreditation standards on these new programs. wards, with larger numbers of patients, higher patient–nurse
In this study, the similarities of competence between male ratios, the variety of case-mix, and closer personal contact
and female nurses counteract Hathaway’s (1990) findings. with patients and their family. Moreover, the nurses working
As rated by nursing faculty members and administrators, on general wards utilize the nursing process in their care
Hathaway indicated that a “typical male nurse” was statisti- plans and are given more responsibilities and management
cally significantly different from a “typical female nurse”. tasks than the nurses in ICUs.
Men were better than women in professional development, The higher competence levels in management and profes-
but had a lower competence level in their knowledge base sionalism of the nurses working in the teaching hospital
and patient communication. From the current study, it seems might be related to the expectation of them to serve as role
that, regardless of sex, new graduates continue to apply what models for students and to be able to manage the working
they learned in their baccalaureate programs accurately and conditions between students and staff members.Additionally,
abide by the hospital’s policies and procedures; therefore, teaching hospitals are more selective in recruiting nurses and,
they do not demonstrate individual clinical innovations or thus, reflect higher competence after employment.
creativity. As beginners, this is a safe approach in a country
where seniority and following the hierarchical order are
CONCLUSION
valued more than creativity and innovation. For nurses, it is
important to gain the basic knowledge as beginners and to The current study is the first in Jordan in which hospital
develop gradually to the next stage of professional develop- supervisors assessed the level of competence of nursing
ment, which is consistent with Benner’s model of novice to graduates from Jordanian universities. The competence
expert in nursing (Benner, 2001). assessment showed that, regardless of the type of university,
The general ward nurses’ better rating than ICU nurses in sex, number of years of experience, work area, and type of
overall performance, professionalism, management, and the hospital, Jordanian nurses’ performance was judged as satis-
nursing process is contrary to what is reported in the litera- factory. No significant differences in the overall level of

© 2010 The Authors

Journal Compilation © 2010 Blackwell Publishing Asia Pty Ltd.
Competence assessment of nurses 153

competence existed between public and private university Cowan DT, Norman I, Coopamah VP. Competence in nursing prac-
graduates, male and female nurses, or between the three tice: a controversial concept – A focused review of literature. Nurse
types of hospital. However, nurses working on general wards Educ. Today 2005; 25: 335–362.
showed a significantly better overall performance and in Dunn SV, Lawson D, Robertson S et al. The development of com-
petency standards for specialist critical care nurses. J. Adv. Nurs.
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These findings are consistent with Jordanian health-care ceptions regarding men in nursing (doctoral dissertation). Los
institutions’ lack of support for new graduates at entry into Angeles: University of Southern California, 1990.
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154 R. Safadi et al.

APPENDIX I

Competency evaluation questionnaire

Evaluation
No. Statement Excellent Very good Good Acceptable Weak

1 Personal appearance and appropriateness to profession (professionalism)

2 Commitment to working hours (management)
3 Communication with patients and their family (nursing process)
4 Communication with physicians and health team members (nursing process)
5 Communication with hospital administration staff (human resources and
finance personnel, etc.) (management)
6 Communication with nursing colleagues (nursing process)
7 Commitment to hospital rules and regulations (professionalism)
8 Commitment to the profession’s ethical guidelines (professionalism)
9 Conceptual knowledge of nursing (familiarity with the sciences and theoretical
concepts of nursing) (knowledge of basic principles)
10 Implementing nursing skills safely (nursing process)
11 Keeping up-to-date with the latest in the nursing profession (knowledge of
basic principles)
12 Participation in scientific research and utilization of its results
(professionalism)
13 Knowledge of the nursing process steps (knowledge of basic principles)
14 Ability to implement the nursing process steps (nursing process)
15 Ability to evaluate patients’ needs (physical, psychological, social, and
spiritual) (problem-solving)
16 Ability to diagnose patients’ nursing problems (problem-solving)
17 Providing nursing care according to priorities (problem-solving)
18 Implementing nursing responsibilities based on appropriate scientific
justification (problem-solving)
19 Managing critical nursing cases appropriately (problem-solving)
20 Using time efficiently (management)
21 Initiating new ideas related to the profession’s development (knowledge of
basic principles)
22 Having administrative abilities and accountability (professionalism)
23 Showing enthusiasm in carrying out nursing responsibilities (professionalism)
24 Applying hospital policies and procedures appropriately (professionalism)
25 Maintaining patient safety (nursing process)
26 Documenting nursing activities (nursing process)
27 Communicating nursing activities orally (nursing process)

The instrument was designed and distributed to the participants in Arabic. This is a translated copy. The terms in parentheses are the
competency labels.

© 2010 The Authors

Journal Compilation © 2010 Blackwell Publishing Asia Pty Ltd.
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