ArticleBMC nursing2026
The importance of Continuing Professional Development of clinical competence in municipal healthcare: a cross-sectional study of workplace-based training.
Article in BMC nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHealthcare personnel face increasing demands on their clinical competence due to shifting responsibilities, growing task complexity, and ongoing policy changes. In response, structured workplace-based training programmes have become a central component of lifelong learning and Continuing Professional Development. This study was conducted at the start of the Clinical Observation Competence in the Municipal Health Service programme, a national initiative in Norway designed to strengthen clinical observation and decision-making skills among healthcare personnel.
methodsA cross-sectional design was used, involving 811 healthcare personnel from six municipalities. Participants included registered nurses, assistant nurses, and assistants. Clinical competence was assessed using the validated Ms. Olsen test, which measures knowledge across three domains: Acute Help, Nursing Measures, and Involving Physician. Statistical analyses included ANOVA and multiple linear regression to examine group differences and predictors.
resultsRegistered nurses scored significantly higher than assistant nurses and assistants across all domains, with the strongest performance in Acute Help. Assistant nurses outperformed assistants in Acute Help and Involving Physician, but no significant difference was found in Nursing Measures. All groups showed lower scores in Nursing Measures, indicating a critical gap. Professional role was the strongest predictor of competence, while position size had a more modest effect. Work experience was positively associated with competence in the domain Acute Help, while age was not a significant factor. Healthcare personnel working in home care services scored higher than those in nursing homes.
conclusionThe study reveals a clear professional hierarchy in clinical competence and highlights specific gaps, particularly in Nursing Measures. The unexpected finding that home care personnel outperformed those in nursing homes may suggests a shift in competence patterns. These results underscore the importance of structured, workplace-based training programmes to address competence gaps and support professional development in municipal healthcare.
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