Research Activities, February 2011: Patient Safety and Quality: Nurses with higher education levels rate themselves as having more clinical expertise and are sought out for their guidance

Patient Safety and Quality
Nurses with higher education levels rate themselves as having more clinical expertise and are sought out for their guidance

Debate continues about the impact of education and experience on a nurse's clinical expertise. A survey of registered nurses (RNs) working in hospitals in Pennsylvania reveals that more highly educated nurses rate themselves as having greater nursing expertise than less educated nurses. What's more, how nurses rate their expertise correlates with how often they are selected as mentors or instructors or are consulted by other nurses for their clinical judgment. Nurses practicing in hospitals with a higher proportion of nurses with a bachelor's of science in nursing (B.S.N.) were more likely to report higher levels of expertise than nurses in hospitals with few such nurses.

The researchers examined survey responses of 8,611 RNs from a 1999 survey of acute care staff working in 182 acute care hospitals. Nurses were asked to rate their level of expertise as beginner, competent, proficient, advanced, or expert. They were also asked how often they were selected as a preceptor or consulted by other nurses for clinical judgment. Nurses were also asked to rate their hospital environment on a variety of measures.

Among the survey respondents, the average nursing experience was 13.2 years. More than a third (38 percent) held a B.S.N. degree. Most nurses (58 percent) gave themselves a rating of proficient, 20 percent rated themselves as competent, and 16 percent as expert. These levels of expertise were found to correlate with how frequently they were selected as a preceptor or asked for their clinical judgment. Nurses with a master's degree in nursing reported having the highest level of expertise, followed by nurses with a B.S.N. degree and those with associated nursing degrees. Nurses practicing in hospitals with a higher proportion of B.S.N. nurses were more likely to report higher levels of expertise. If this proportion of B.S.N.-prepared nurses increased from 25 to 65 percent, the probability of an average nurse in an average hospital reporting being an expert increased from .10 to .16. The study was supported in part by the Agency for Healthcare Research and Quality (HS17551).

See "Understanding clinical expertise: Nurse education, experience, and the hospital context," by Matthew D. McHugh, Ph.D., and Eileen T. Lake, Ph.D., in Research in Nursing & Health 33, pp. 276-287, 2010.
Research Activities, February 2011: Patient Safety and Quality: Nurses with higher education levels rate themselves as having more clinical expertise and are sought out for their guidance