Understanding the learning needs to enhance clinical competence of new professional nurses in public hospitals of South Africa: A qualitative study


clinical competence
learning needs
new professional nurses
operational managers
South Africa

How to Cite

Matlhaba, K. L., & Nkoane, N. L. (2022). Understanding the learning needs to enhance clinical competence of new professional nurses in public hospitals of South Africa: A qualitative study . Belitung Nursing Journal, 8(5), 414–421. https://doi.org/10.33546/bnj.2180
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Background: A competent nursing workforce plays an important role, as it will ensure effective management of the healthcare system by providing quality nursing care. However, from the literature, it is evident that the learning needs of new professional nurses are not well explored and documented.

Objective: The objective of this paper was to report identified learning needs of new professional nurses to enhance their clinical competence to ensure that they are able to provide excellent quality nursing care to patients with confidence.

Methods: A qualitative study design was used to understand the perceptions of operational managers regarding the learning needs of new professional nurses to enhance their clinical competence. The study was conducted at seven public hospitals in the three districts of the North West Province, South Africa, between September and November 2021. Data were analyzed thematic.

Results: Four themes emerged from data analysis: 1) Ethos and professional practice, 2) Management and leadership skills, 3) Assessment and observation skills, and 4) Documentation and record keeping.

Conclusion: This study provides valuable information regarding the learning needs of new professional nurses. Understanding these learning needs can provide insight into how to better transition student nurses to registered nurses so that they are able to adequately and safely take care of a diverse patient population and work successfully as new nurses.



Copyright (c) 2022 Kholofelo L. Matlhaba, Naomi L. Nkoane

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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Declaration of Conflicting Interest

The authors declare that they have no conflict of interest in this study.


The authors would like to acknowledge the participants of this study.

Authors’ Contributions

Both authors contributed to the study conceptualization, methodology, data collection, data analysis, writing, and manuscript editing and approved the final and submitted version of the article.

Data Availability

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.


Alanezi, F. Z. (2021). Nurses’ attitude towards patient advocacy in a single tertiary care hospital. Nursing Open. https://doi.org/10.1002/nop2.958

AlMarzooq, A. M. (2020). Emergency department nurses’ knowledge regarding triage. International Journal of Nursing, 7(2), 29-44. https://doi.org/10.15640/ijn.v7n2a5

Alsufyani, A. M., Aldawsari, A. A., Aljuaid, S. M., Almalki, K. E., & Alsufyani, Y. M. (2020). Quality of nursing care in Saudi Arabia: Are empathy, advocacy, and caring important attributes for nurses. Nurse Media Journal of Nursing, 10(3), 244-259. https://doi.org/10.14710/nmjn.v10i3.32210

Anton, N., Hornbeck, T., Modlin, S., Haque, M. M., Crites, M., & Yu, D. (2021). Identifying factors that nurses consider in the decision-making process related to patient care during the COVID-19 pandemic. PloS One, 16(7), e0254077. https://doi.org/10.1371/journal.pone.0254077

Aydogan, Y., & Ulupinar, S. (2020). Determining the learning needs of new graduated nurses working in inpatient care institutions. Nurse Education Today, 92, 104510. https://doi.org/10.1016/j.nedt.2020.104510

Benner, P. (2001). From novice to expert excellence and power in clinical nursing practice (Commemorative ed.). Upper Saddle River: Prentice Hall.

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative research in Psychology, 3(2), 77-101. https://doi.org/10.1191/1478088706qp063oa

Cambridge Dictionary. (2021). Cambridge dictionary. In https://dictionary.cambridge.org/us/dictionary/english/enhancement

Chua, W. L., Rahim, N. R. B. A., McKenna, L., Ho, J. T. Y., & Liaw, S. Y. (2022). Intraprofessional collaboration between enrolled and registered nurses in the care of clinically deteriorating ward patients: A qualitative study. Australian Critical Care, 35(1), 81-88. https://doi.org/10.1016/j.aucc.2021.01.009

Dalton, M., Harrison, J., Malin, A., & Leavey, C. (2018). Factors that influence nurses' assessment of patient acuity and response to acute deterioration. British Journal of Nursing, 27(4), 212-218. https://doi.org/10.12968/bjon.2018.27.4.212

Ernawati, E., & Bratajaya, C. N. A. (2021). Senior nurses’ perceptions of essential soft skills for novice nurses in a private hospital in Jakarta, Indonesia: A phenomenological study. Belitung Nursing Journal, 7(4), 320-328. https://doi.org/10.33546/bnj.1549

Goh, P. Q. L., Ser, T. F., Cooper, S., Cheng, L. J., & Liaw, S. Y. (2020). Nursing teamwork in general ward settings: A mixed‐methods exploratory study among enrolled and registered nurses. Journal of Clinical Nursing, 29(19-20), 3802-3811. https://doi.org/10.1111/jocn.15410

Hoskins, K., Grady, C., & Ulrich, C. M. (2018). Ethics education in nursing: Instruction for future generations of nurses. OJIN: The Online Journal of Issues in Nursing, 23(1), 1-4. https://doi.org/10.3912/OJIN.Vol23No01Man03

Ilkafah, I., Mei Tyas, A. P., & Haryanto, J. (2021). Factors related to implementation of nursing care ethical principles in Indonesia. Journal of Public Health Research, 10(2), jphr-2021. https://doi.org/10.4081%2Fjphr.2021.2211

International Council of Nurses (ICN). (2012). The ICN code of ethics for nurses. https://www.icn.ch/sites/default/files/inlinefiles/2012_ICN_Codeofethicsfornurses_%20eng.pdf

International Council of Nurses (ICN). (2019). Patient safety-ICN position. https://www.icn.ch/sites/default/files/inline-files/D05_Patient_Safety_0.pdf

Kaihlanen, A. M., Haavisto, E., Strandell‐Laine, C., & Salminen, L. (2018). Facilitating the transition from a nursing student to a registered nurse in the final clinical practicum: A scoping literature review. Scandinavian Journal of Caring Sciences, 32(2), 466-477. https://doi.org/10.1111/scs.12494

Kamil, H., Rachmah, R., & Wardani, E. (2018). What is the problem with nursing documentation? Perspective of Indonesian nurses. International Journal of Africa Nursing Sciences, 9, 111-114. https://doi.org/10.1016/j.ijans.2018.09.002

Kinnunen, U.-M., Kivekäs, E., Palojoki, S., & Saranto, K. (2020). Register-based research of adverse events revealing incomplete records threatening patient safety. Digital Personalized Health and Medicine. Proceedings of MIE 2020, 270, 771-775. http://dx.doi.org/10.3233/SHTI200265

Lengetti, E., Kronk, R., Ulmer, K. W., Wilf, K., Murphy, D., Rosanelli, M., & Taylor, A. (2018). An innovative approach to educating nurses to clinical competence: A randomized controlled trial. Nurse Education in Practice, 33, 159-163. https://doi.org/10.1016/j.nepr.2018.08.007

Major, D. (2019). Developing effective nurse leadership skills. Nursing Standard, 34(6), 61-66. https://doi.org/10.7748/ns.2019.e11247

Massey, D., Chaboyer, W., & Anderson, V. (2017). What factors influence ward nurses’ recognition of and response to patient deterioration? An integrative review of the literature. Nursing Open, 4(1), 6-23. https://doi.org/10.1002/nop2.53

Matlhaba, K. L., Pienaar, A. J., & Sehularo, L. A. (2021a). Professional nurses’ perceptions regarding clinical competence of community service nurses in North West province, South Africa. Health SA Gesondheid, 26, 1688. https://doi.org/10.4102%2Fhsag.v26i0.1688

Matlhaba, K. L., Pienaar, A. J., & Sehularo, L. A. (2021b). Validation of a clinical competence evaluation tool for community service nurses in North West province, South Africa. Health SA Gesondheid, 26, 1602. https://doi.org/10.4102%2Fhsag.v26i0.1602

Minister for Public Service and Administration. (2007). Occupation Specific Dispensation (OSD): Professional nurse. South Africa: Minister for Public Service and Administration, Republic of South Africa

Mutshatshi, T. E., Mothiba, T. M., Mamogobo, P. M., & Mbombi, M. O. (2018). Record-keeping: Challenges experienced by nurses in selected public hospitals. Curationis, 41(1), 1-6. https://dx.doi.org/10.4102/curationis.v41i1.1931

Nabizadeh-Gharghozar, Z., Alavi, N. M., & Ajorpaz, N. M. (2021). Clinical competence in nursing: A hybrid concept analysis. Nurse Education Today, 97, 104728. https://doi.org/10.1016/j.nedt.2020.104728

Price, S., & Reichert, C. (2017). The importance of continuing professional development to career satisfaction and patient care: Meeting the needs of novice to mid-to late-career nurses throughout their career span. Administrative Sciences, 7(2), 17. https://doi.org/10.3390/admsci7020017

Song, Y., & McCreary, L. L. (2020). New graduate nurses’ self-assessed competencies: An integrative review. Nurse Education in Practice, 45, 102801. https://doi.org/10.1016/j.nepr.2020.102801

South African Nursing Council (SANC). (2005). Code of ethics for nursing practitioners in South Africa. https://www.sanc.co.za/wp-content/uploads/2021/04/Code-of-Ethics-for-Nursing-in-South-Africa.pdf

Street Jr, R. L., Petrocelli, J. V., Amroze, A., Bergelt, C., Murphy, M., Wieting, J. M., & Mazor, K. M. (2020). How communication “failed” or “saved the day”: Counterfactual accounts of medical errors. Journal of Patient Experience, 7(6), 1247-1254. https://doi.org/10.1177%2F2374373520925270

Tasew, H., Mariye, T., & Teklay, G. (2019). Nursing documentation practice and associated factors among nurses in public hospitals, Tigray, Ethiopia. BMC Research Notes, 12(1), 1-6. https://doi.org/10.1186/s13104-019-4661-x

Tiwary, A., Rimal, A., Paudyal, B., Sigdel, K. R., & Basnyat, B. (2019). Poor communication by health care professionals may lead to life-threatening complications: Examples from two case reports. Wellcome Open Research, 4(7). https://doi.org/10.12688%2Fwellcomeopenres.15042.1

Tuinman, A., de Greef, M. H. G., Krijnen, W. P., Paans, W., & Roodbol, P. F. (2017). Accuracy of documentation in the nursing care plan in long-term institutional care. Geriatric Nursing, 38(6), 578-583. https://doi.org/10.1016/j.gerinurse.2017.04.007

Vaismoradi, M., Tella, S., A. Logan, P., Khakurel, J., & Vizcaya-Moreno, F. (2020). Nurses’ adherence to patient safety principles: A systematic review. International Journal of Environmental Research and Public Health, 17(6), 2028. https://doi.org/10.3390/ijerph17062028

van Rooyen, D. R. M., Jordan, P. J., ten Ham-Baloyi, W., & Caka, E. M. (2018). A comprehensive literature review of guidelines facilitating transition of newly graduated nurses to professional nurses. Nurse Education in Practice, 30, 35-41. https://doi.org/10.1016/j.nepr.2018.02.010

van Rossum, M., Leenen, J., Kingma, F., Breteler, M., van Hillegersberg, R., Ruurda, J., Kouwenhoven, E., van Det, M., Luyer, M., & Nieuwenhuijzen, G. (2021). Expectations of continuous vital signs monitoring for recognizing complications after esophagectomy: Interview study among nurses and surgeons. JMIR Perioperative Medicine, 4(1), e22387. https://doi.org/10.2196/22387

Willman, A., Bjuresäter, K., & Nilsson, J. (2021). Insufficiently supported in handling responsibility and demands: Findings from a qualitative study of newly graduated nurses. Journal of Clinical Nursing, 30(1-2), 83-92. https://doi.org/10.1111/jocn.15483

World Health Organization. (2020). World health statistics 2020: Monitoring health for the SDGs, sustainable development goals. Geneva: World Health Organization. https://apps.who.int/iris/handle/10665/332070

World Health Organization. (2021). Global action on patient safety. https://apps.who.int/gb/ebwha/pdf_files/EB148/B148_6-en.pdf