Nurse Competence Scale (NCS)

The Nurse Competence Scale (NCS) was developed to assess nurses’ generic competence in different phases of their careers and in a variety of clinical settings. It was developed to overcome competence instruments’ shortcomings in early 2000s, i.e. their lack of a strong theoretical background and rigorous psychometric testing.

The 73-item NCS is a structured questionnaire and comprises seven competence categories. The level of competence is measured with a visual analogue scale (VAS 0-100) and the frequency of the use of competencies with a four-point scale.

The NCS is currently widely used internationally. The scale has been translated into 20 languages and have been used over 30 countries. It has been used for competence level assessments, investigating associated individual and organisational variables and studying the effects of educational interventions. Development and testing was conducted as part of the doctoral thesis of docent Riitta Meretoja. Further research has been done in a long-lasting cooperation with Professor Helena Leino-Kilpi.

See the summary of the development and psychometrics of NCS:

Flinkman M, Leino-Kilpi H, Numminen O, Jeon Y, Kuokkanen L, Meretoja R. 2017. Nurse Competence Scale: a systematic and psychometric review. Journal of Advanced Nursing 73(5), 1035-1050.

Nurse Competence Scale is currently in use in PROCOMPnurse and COMPEUnurse Research Projects.

Selected publications

Meretoja, Riitta. 2003. Nurse competence scale. Annales Universitatis Turkuensis, D579, University of Turku,  Turku, Finland

Meretoja R & Leino-Kilpi H. 2001.  Instruments for Evaluating the Nurse Competence. JONA 31 (7/8), 346?352.

Meretoja R, Eriksson E & Leino-Kilpi H. 2002. Indicators for competence nursing practice. Journal of Nursing  Management 10 (2), 95-102.

Meretoja R & Leino-Kilpi H. 2003. Comparison of competence assessments made by nurse managers and  practising nurses. Journal of Nursing Management 11, 404-409.

Meretoja R, Isoaho H & Leino-Kilpi H. 2004. Nurse Competence Scale: development and psychometric testing.  Journal of Advanced Nursing 47(2), 124-133.

Meretoja R, Leino-Kilpi H & Kaira A-M. 2004. Comparison of nurse competence in different hospital work  enviroments. Journal of Nursing Management 12, 329-336.

Kajander-Unkuri S. Nurse Competence of Graduating Nursing Students. Doctoral Thesis. University of Turku 2014, D1158

From education to work-life project

In this part,  nurse competence, its development and the organizational and individual workhealth factors connected were studied. Target group was especially nurses in the beginning of their career.

Study was done in three phases.
Nurses’ competence in worklife was analyzed in the first phase 2010-2012.
Nurses’ competence development during education was analyzed in the second phase 2010-2012.
In the third phase, the competence of nurses in the beginning of their career and the factors contributing to the workhealth in a long-term study were studied.

See the HUS’s site and the publications by Meretoja.

This part was funded by The Finnish Work Environment Fund.

Currently, the postdoctural study of PhD Mervi Flinkman is continuing in this field.

Principal Investigator

Riitta Meretoja Director of nursing research and science, Hospital District of Helsinki and

​Research team

Riitta Meretoja, RN, PhD, Professor, Director of nursing research and science, Hospital District of Helsinki and Uusimaa; Docent, Department of Nursing Science, University of Turku
Olivia Numminen, RN, PhD, Researcher,
Helena Leino-Kilpi, RN, PhD, Professor, Department of Nursing Science, University of Turku
Liisa Kuokkanen, RN, PhD,
Satu Kajander-Unkuri, RN, PhD, Teacher of Medicine, Savonia University of Applied Sciences, Department of Nursing Science, University of Turku
Mervi Flinkman, RN, PhD, Postdoc Researcher, Department of Nursing Science, University of Turku
Jeon Yunsuk, RN, Doctoral candidate, Clinical researcher, Hospital District of Helsinki and Uusimaa; Department of Nursing Science, University of Turku