Benner P. From novice to expert.New York: Addison-Wesley; 1984

Blömeke S, Gustafsson J-E, Shavelson RJ. Beyond dichotomies: competence viewed as a continuum. Z Psychol Z Angew Psychol. 2015; 223:3-13

Connell C, Jones E, Haslam M, Firestone J, Pope G, Thompson C. Mental health nursing identity: a critical analysis of the UK's Nursing and Midwifery Council's pre-registration syllabus change and subsequent move towards genericism. Ment Health Rev (Brighton). 2022; 27:(4)472-483

Dreyfus S, Dreyfus H. A five stage model of the mental activities involved in directed skill acquisition.Berkeley (CA): University of California; 1980

Francis G, O'Brien M. Teaching clinical skills in pre-registration nurse education: value and methods. Br J Nurs. 2019; 28:(7)452-456

Gonzalez L, Kardong-Edgren S. Deliberate practice for mastery learning in nursing. Clin Simul Nurs. 2017; 13:(1)10-14

In praise of professional judgment. 2020. https// (accessed 4 December 2023)

Nursing and Midwifery Council. Standards for pre-registration nursing education. 2010. https// (accessed 4 December 2023)

Nursing and Midwifery Council. Future nurse: Standards of proficiency for registered nurses. 2018. https// (accessed 4 December 2023)

Vernon R, Chiarella M, Papps E, Lark A. Assuring competence or ensuring performance. Collegian. 2019; 26:(3)399-406

Warrender D, Connell C, Jones E Mental health deserves better: Resisting the dilution of specialist pre-registration mental health nurse education in the United Kingdom. Int J Ment Health Nurs. 2023a;

Warrender D, Ramsay M, Hurley J. Mental health nurse education: a contemporary view in the debate between generic and specialist approaches. Ment Health Pract. 2023b; 26:(5)20-25

Competency versus proficiency: trying to develop an understanding of these terms in the context of practice learning

11 January 2024
Volume 33 · Issue 1


The language of nurse education in the UK has shifted from ‘competency’ to ‘proficiency’ since 2018. The shift in language has been poorly articulated leaving individual higher education institutions, practice supervisors and assessors to interpret what these terms mean in relation to assessing student nurses. There appeared to be some confusion regarding the interpretation of the term proficiency among those who engaged in an exchange on the topic via Twitter. Students may focus on the procedure-based checklists within the standards. The relationship between proficiency and implementing a person-centred approach to care remains unclear.

Judging by an exchange of views on Twitter (since renamed as X) in late 2022, it seems that there is both debate and confusion regarding the language of educational standards for the preparation of nurses in the UK. There appears to have been a change in language from ‘competence’ to ‘proficiency’, which may have implications when assessing student nurses in practice. This prompted the authors of this article to try to unpick some of the salient issues regarding the terms competence and proficiency. We are not promising any hard and fast solutions, rather we seek to provoke further debate and dialogue.

According to the Collins online dictionary, ‘competence is the ability to do something well or effectively’, but according to the same source, ‘if you are proficient in something, you can do it well’, which might lead us to assume that these terms are interchangeable.

Other definitions suggest that ‘proficiency’ implies higher levels of skills and experience. For example, ‘great skills, ability and experience’ (Cambridge Dictionary online) or ‘the ability to do something well because of training and practice’ (Oxford Learner's Dictionary). So why does this terminology matter in a nurse education context?

Register now to continue reading

Thank you for visiting British Journal of Nursing and reading some of our peer-reviewed resources for nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • Unlimited access to the latest news, blogs and video content