Assessing competency in nursing: a comparison of nurses prepared through degree and diploma programmes

AIMS AND OBJECTIVES: The present study aimed to investigate the competencies of qualifiers from three-year degree and three-year diploma courses in England at one, two and three years after qualification. BACKGROUND: The provision of three-year preregistration nursing degrees in the UK has increased in recent years and in many colleges degrees are offered alongside the existing three-year diploma courses. Yet little is known about the relationship between these different education programmes and the competence of qualifiers. METHODS: A cross-sectional survey design was employed to make comparisons of both self-reported and line-manager-rated competencies of graduate and diplomate nurses who had qualified up to three years previously. INSTRUMENTS: A revised version of the Nursing Competencies Questionnaire was used to measure both overall competence and also eight specific nursing competencies. A shortened version of this scale was also used to assess internal consistency across measures. Two additional competencies, research awareness and policy awareness, were also measured. RESULTS: Structural equation modelling found very little difference in the overall competence and specific competencies of graduates and diplomates. Where differences were found in the self-report data, diplomates scored more highly than graduates in the constructs of planning and social participation; however, these differences became non-significant when background variables were controlled for. LIMITATIONS: The findings are interpreted with caution due to the size of differences, the size of some of the samples of respondents and the developmental stage of the instrument used. CONCLUSIONS: It does not appear that graduates and diplomates in England differ in their level of competence to any great extent as measured by the Nursing Competencies Questionnaire. Areas of further work are discussed in the light of the findings. RELEVANCE TO CLINICAL PRACTICE: While this may alleviate concerns about clinical disparities between the two groups, it raises questions about the proposed benefits to nursing of three-year preregistration degrees in terms of quality of care during the first three years of qualification.