Journal List > J Korean Acad Nurs Adm > v.20(3) > 1051745

Park and Kim: Development of a Nursing Competence Measurement Scale according to Nurse's Clinical Ladder in General Wards



This methodological study was done to develop a Nursing Competency Measurement Scale based on the clinical ladders of nurses working in wards.


Thirty clinical experts and 501 ward nurses evaluated the content validity of the scale. A survey using the Nursing Competency Measurement Scale was conducted with 114 nurses to evaluate reliability and applicability of the instrument. Data were analyzed using SPSS/WIN 21.0.


A review of the literature identified 13 components of nursing competencies and 30 core nursing competencies based on each of the 4 grade clinical ladders. Cronbach's α coefficient for the total was .92. Cronbach's α reliabilities of each clinical ladder grade were .83 for Grade I, .84 for Grade II, .81 for Grade III, and .84 for Grade IV. The Content Validity Index (CVI) of the scale with 120 individual items was 0.976~1.000 for Grade I scale, 0.986~1.000 for Grade II scale, 0.984~1.000 for Grade III scale, and 0.992~1.000 for Grade IV scale. The expert group nurses' average degree of nursing competence measured using the scale was 3.38~3.75 out of 4.0.


Through this process, 120 final questions were confirmed to represent items of the Nursing Competency Measurement Scale based on clinical grade.

Figures and Tables

Table 1
Grade I (Beginner) Nursing Competency Performance Criteria

*Criterions are corrected.

Table 2
Grade II (Intermediate) Nursing Competency Performance

*Criterions are corrected.

Table 3
Grade III (Advanced) Nursing Competency Performance Criteria

*Criterions are corrected.

Table 4
Grade IV (Expert) Nursing Competency Performance Criteria

*Criterions are corrected.

Table 5
Nursing Performance among Expert (Grade IV) Group (N=114)


This manuscript is condensed form of the first author's doctoral thesis from The Catholic University of Korea.


1. Jang KS. A study on establishment of clinical career development model of nurses [dissertation]. Seoul: Yonsei University;2000.
2. Carryer J, Russell A, Budge C. Nurses' understandings of the Professional Development Recognition Programme. Nurs Prax N Z. 2007; 23(2):5–13.
3. Nelson JM, Cook PF. Evaluation of a career ladder program in an ambulatory care environment. Nurs Econ. 2008; 26(6):353–360.
4. Hsu N, Chen BTH, Lee LL, Chen CH, Lai CF. The comparison of nursing competence pre- and post implementing clinical ladder system. J Clin Nurs. 2005; 14(2):264–265.
5. Tørstad S, Bjørk IT. Nurse leaders' views on clinical ladder as a strategy in professional development. J Nurs Manag. 2007; 15(8):817–824.
6. Zimmer MJ. Rationale for a ladder for clinical advancement in nursing practice. J Nurs Adm. 1972; 2(6):18–24.
7. Benner P. From novice to expert. Am J Nurs. 1982; 82(3):402–407.
8. Kwon IG, Sung YH, Park KO, Yu OS, Kim MA. A study on the clinical ladder system model for hospital nurses. Clin Nurs Res. 2007; 13(1):7–23.
9. Drenkard K, Swartwout E. Effectiveness of a clinical ladder program. J Nurs Adm. 2005; 35(11):502–506.
10. Ward CW, Goodrich CA. A clinical advancement process revisited: A descriptive study. Medsurg Nurs. 2007; 16(3):169–173.
11. Lacey SR, Teasley SL, Henion JS, Cox KS, Bonura A, Brown J. Enhancing the work environment of staff nurses using targeted interventions of support. J Nurs Adm. 2008; 38(7-8):336–340.
12. Colavecchio R, Tescher B, Scalzi C. A clinical ladder for nursing practice. J Nurs Adm. 1974; 4(5):54–58.
13. Reid RT. Practitioner competency assessment and career ladders as a recruiting and retention tool. Respir Care Clin N Am. 2004; 10(2):173–195.
14. Sievers V, Stinson S. Excellence in forensic practice: A clinical ladder model for recruiting and retaining sexual assault nurse examiners (SANEs). J Emerg Nurs. 2002; 28(2):172–175.
15. Liu M, Kunaiktikul W, Senaratana W, Tonmukayakul O, Eriksen L. Development of competency inventory for registered nurses in the People's Republic of China: scale development. Int J Nurs Stud. 2007; 44(5):805–813.
16. Streeter BL. A clinical advancement program for registered nurses with an outpatient focus. Gastroenterol Nurs. 2007; 30(3):195–200.
17. Kang YS, Lee SJ, Kim IJ, Ahn KH. A measurement scale development of nursing competence for nurses working in general wards. J Korean Acad Nurs Adm. 2008; 14(3):219–228.
18. Shapiro MM. A career ladder based on Benner's model. An analysis of expected outcomes. J Nurs Adm. 1998; 28(3):13–19.
19. Carper B. Fundamental patterns of knowing in nursing. ANS Adv Nurs Sci. 1978; 1(1):13–23.
20. Park KO, Park SA, Park SH, Lee EH, Kim MA, Kang WH. Revision of performance appraisal tool and verification of reliability and validity. J Korean Clin Nurs Res. 2011; 17(1):70–80.
21. Park SH, Park KO, Park SA. A development of career ladder program for nurse in a hospital. J Korean Acad Nurs Adm. 2006; 12(4):624–632.
22. Riley JK, Rolband DH, James D, Norton HJ. Clinical ladder: Nurses' perceptions and satisfiers. J Nurs Adm. 2009; 39(4):182–188.
23. Jung SW. A survey on the recognition of RNs about the adoption of the clinical ladder system. Korean Nurse. 2005; 44(6):69–82.
24. Park KO, Yi M. Nurses' experience of career ladder programs in a general hospital. J Korean Acad Nurs. 2011; 41(5):581–592.
25. Kim H. Developing and verifying validity of a clinical ladder system for operating room nurses [dissertation]. Gwangju: Chonnam National University;2010.
26. Choi JS, Eun Y. A study on the clinical competence according to clinical ladder of operating room nurses. J Korean Acad Soc Nurs Educ. 2006; 12(1):60–69.
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