An Observational Cross-Sectional Analysis of the Correlation between Clinical Competencies and Clinical Reasoning among Italian Registered Nurses

Abstract

Ability, knowledge, aptitude, and skill are the terms identified in the literature as the attributes of the concept of clinical competence. This implies that in order to act competently in their own context, the nurse must be able to make decisions which mainly depend on the ability to put clinical reasoning into practice. However, the evaluation of clinical reasoning in the various clinical-care activities of nursing competence is a necessary operation to prevent routine attitudes. From the perspective of an assessment of nursing competences, the aim of this study is to validate the relationship between the degree of competence recognized in a specific clinical setting and the amount of clinical reasoning executed by nurses. The study design was a cross-sectional observational design, following the guidelines of the Strengthening Reporting of Observational Studies in Epidemiology (STROBE) of observational studies. Both the Italian Nurse Competence Scale and the Nurse Clinical Reasoning Scale were used. The data was collected between 25 January and 5 March 2022. Four hundred twenty-four clinical nurses participated by completing and returning the questionnaires. The instruments underwent assessment to ensure internal consistency and test–retest reliability. Their validity was tested with the validity of known content, construct, and groups. This is supported by statistically significant correlations between the different variables examined and the scores of the different dimensions of the Italian Nurse Competence Scale and the Italian Nurse Clinical Reasoning Scale. The data collected showed an excellent average level of competencies and clinical reasoning, M = range of 72.24 and 63.93, respectively. In addition, we observed satisfactory scores across all dimensions of I-NCS (significance range: 0.000–0.014) and I-NCRS (significance range: 0.000–0.004). The understanding and development of clinical reasoning has also brought out new aspects that require further research. This study provides a fresh perspective on the correlation between clinical competences and clinical reasoning, representing a novel attempt to analyze their relationship.