Evaluation of Nursing Competences in the Licensure Exam: an Italian Observational Study

Background: In recent years, the licensure exam in nursing has focused on the range of curricula and teaching methods used in international universities. ‘Tuning’ was the first document that sought to harmonise training purposes in terms of competences and learning outcomes in Europe. Nursing has 47 specific competences divided into 5 domains. Methods: A multicentric observational perspective study was conducted in four universities in the Lazio region for to describe which of 47 Tuning competences are evaluated during the licensure exam in Italian nursing degree courses, at what level of performance, in which clinical area and setting are contextualised, and what types of tests are used for their evaluation. The commissioners of the Professional Order of Rome – OPI – collected data via tests in the licensure exams for the academic years 2017–2019 using 2 grids, one for cognitive and one for psychomotor assessments. Results: The Tuning competences were requested 7522 times, 5130 for the cognitive trials and 2392 for the psychomotor trials. The most frequently requested competences were those associated with domain 2, and the level of performance most required in cognitive tests was autonomy of judgement (52.30%). In both tests, the most-investigated competences concerned the area of non-communicable diseases and the hospitalised adult patient. Conclusions: The competences assessed most often were associated with nursing practice and clinical decision-making. These areas coincided with those deemed essential for the first cycle of studies and are contextualised for the priority health problems of hospitalised adult patients. This indicates that nursing education still focuses on the preparation of nursing students for hospital settings. Moreover, there is still a high degree of discrepancy in the types of tests used in different schools. Their choices are influenced by the number of students and the structural resources available.