From Knowledge to Practice: Understanding Competency Challenges in Nursing

Abstract

Nursing competency is a fundamental determinant of safe, effective, and high-quality healthcare delivery; however, a persistent gap remains between theoretical knowledge and its application in clinical practice. This review examines contemporary challenges affecting nursing competency development and the factors influencing knowledge translation into professional practice. Evidence indicates that nursing competency is a multidimensional construct encompassing clinical knowledge, technical skills, critical thinking, communication, leadership, professional judgment, and technological proficiency. Key challenges include limited clinical learning opportunities, inconsistent competency assessment, workforce shortages, organizational constraints, and the increasing complexity of healthcare systems. The findings highlight competency-based education, simulation-based learning, mentorship, quality and safety initiatives, and continuing professional development as important strategies for strengthening practice readiness. Emerging technologies, including digital health systems, telehealth, and artificial intelligence, are also reshaping competency expectations and creating new educational requirements. Competency development should therefore be understood as a dynamic, lifelong process requiring continuous learning, adaptation, and institutional support. Bridging the knowledge-practice gap requires coordinated efforts among educational institutions, healthcare organizations, professional bodies, and policymakers to foster supportive clinical environments and prepare resilient, adaptable, and practice-ready nurses capable of delivering safe, evidence-based, patient-centered care across increasingly complex healthcare environments.