AIM: To analyse graduating nursing students' self-assessed competence level in Europe at graduation, at the beginning of nursing career. DESIGN: An international cross-sectional evaluative design. METHODS: Data were collected in February 2018-July 2019 from graduating nursing students in 10 European countries. Competence was assessed with a validated instrument, the Nurse Competence Scale (NCS). The sample comprised 3,490 students (response rate 45%), and data were analysed statistically. RESULTS: In all countries, graduating nursing students assessed their competence as good (range 50.0-69.1; VAS 0-100), albeit with statistically significant differences between countries. The assessments were highest in Iceland and lowest in Lithuania. Older students, those with working experience in health care, satisfied with their current degree programme, with excellent or good study achievements, graduating to 1st study choice and having a nursing career plan for future assessed their competence higher.

Department of Biostatistics University of Turku Turku Finland

Department of Fundamentals of Nursing Lisbon School of Nursing Lisbon Portugal

Department of Medical Sciences University of Udine Udine Italy

Department of nursing Jessenius Faculty of Medicine in Martin Comenius University in Bratislava Bratislava Slovakia

Department of Nursing Palacký University Olomouc Czech Republic

Department of Nursing science University of Turku Turku Finland

Department of Public Health Azienda Provinciale per i Servizi Sanitari Trento Italy

Diaconia University of Applied Sciences Helsinki Finland

Faculty of Medicine Institute of Health Sciences Vilnus University Vilnus Lithuania

Faculty of Nursing Universitat Internacional de Catalunya Barcelona Spain

Faculty of Nursing University of Iceland Reykjavík Iceland

Fundación San Juan de Dios Centro de CC de la Salud San Rafael Universidad Antonio de Nebrija Madrid Spain

Institute for Health and Nursing Science Martin Luther University Halle Wittenberg Halle Germany

School of Health Sciences University of Aveiro Aveiro Portugal

School of Nursing Psychotherapy and community Health Dublin City University Dublin Ireland

Turku University Hospital Turku Finland

Zobrazit více v PubMed

Aiken, L. H. , Sloane, D. , Griffiths, P. , Rafferty, A. M. , Bruyneel, L. , McHugh, M. , Maier, C. B. , Moreno‐Casbas, T. , Ball, J. E. , Ausserhofer, D. , & Sermeus, W. (2017). Nursing skill mix in European hospitals: Cross‐sectional study of the association with mortality, patient ratings and quality of care. BMJ Quality & Safety, 26(7), 559–568. 10.1136/bmjqs-2016-005567 PubMed DOI PMC

ALLEA, All European Academies . (2017, March 24). The European code of conduct for research integrity. Revised edition [Internet document]. Retrieved from https://allea.org/code‐of‐conduct/

AlmaLaurea . (2019). 2019 reports on the profile and occupational condition of graduates in Italy [Internet document]. Retrieved from https://www.almalaurea.it/sites/almalaurea.it/files/comunicati/2019/2019_almalaurea_report.pdf

American Nurses Association [ANA] . (2015). Nursing: scope and standards of practice. [EPub] (3rd ed.) Silver Spring, MD. Retrieved from https://www.iupuc.edu/health‐sciences/files/Nursing‐ScopeStandards‐3E.pdf

ANMC, Australian Nursing & Midwifery Council . (2016, June 1). Registered nurse standards for practice [Web page]. Retrieved from https://www.nursingmidwiferyboard.gov.au/Codes‐Guidelines‐Statements/Professional‐standards/registered‐nurse‐standards‐for‐practice.aspx

Ball, J. , Rafferty, A. M. , & Philippou, J. (2019). England. In Rafferty A. M., Busse R., Zander‐Jentsch B., Sermeus W., & Bruyneel L. (Eds.), Strengthening health systems through nursing: Evidence from 14 European countries (pp. 17–29). : WHO Regional office for Europe. PubMed

Blackman, I. , Hall, M. , & Darmawan, I. G. N. (2007). Undergraduate nurse variables that predict academic achievement and clinical competence in nursing. International Education Journal, 8(2), 222–236.

Blazun, H. , Kokol, P. , & Vosner, J. (2015). Research literature production on nursing competences from 1981 till 2012: A bibliometric snapshot. Nurse Education Today, 35, 673–679. 10.1016/j.nedt.2015.01.002 PubMed DOI

Boniol, M. , McIsaac, M. , Xu, L. , Wuliji, T. , Diallo, K. , & Campbell, J. (2019). Gender equity in the health workforce: Analysis of 104 countries (No. WHO/HIS/HWF/Gender/WP1/2019.1). World Health Organization. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/311314/WHO‐HIS‐HWF‐Gender‐WP1‐2019.1‐eng.pdf?sequence=1&isAllowed=y&te=1&nl=in‐her%20words&emc=edit_gn_20200312

Buchan, J. , O’May, F. , & Dussault, G. (2013). Nursing workforce policy and the economic crisis: A global overview. Journal of Nursing Scholarship, 45(3), 298–307. 10.1111/jnu.12028 PubMed DOI

CNA, Canadian Nurses Association . (2015, November). Framework for the practice of registered nurses in Canada [EPub] (2nd ed.). Retrieved from https://www.cna‐aiic.ca/~/media/cna/page‐content/pdf‐en/framework‐for‐the‐pracice‐of‐registered‐nurses‐in‐canada.pdf?la=en

Crisp, N. , Brownie, S. , & Refsum, C. (2018). (2018, November 18th) Nursing and Midwifery: The key to the rapid and cost‐effective expansion of high‐quality universal health coverage. World Innovation Summit for Health. Retrieved from https://www.icn.ch/sites/default/files/inline‐files/IMPJ6078‐WISH‐2018‐Nursing‐181026‐1.pdf

Drennan, V. M. , & Ross, F. (2019). Global nurse shortages—the facts, the impact and action for change. British Medical Bulletin, 130(1), 25–37. 10.1093/bmb/ldz014 PubMed DOI

EC, European Commission . (2005, September 30). Directive 2005/36/EC. Retrieved from https://eur‐lex.europa.eu/legal‐content/EN/TXT/PDF/?uri=CELEX:32005L0036&from=EN

EC, European Commission . (2013, December 28). Directive 2013/55/EU. Retrieved from http://eur‐lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2013:354:0132:0170:en:PDF

EC, European Commission . (2016a, April 27). Regulation (EU) 2016/679 [Regulation]. Retrieved from http://data.europa.eu/eli/reg/2016/679/2016‐05‐04

EC, European Commission . (2016b, June 16th). Supporting public health in Europe. Retrieved from https://europa.eu/european‐union/topics/health_en

EC, European Commission . (2019). Ranking – the most mobile professions. Statistics – Professionals moving abroad (establishment). Regulated professions database. Retrieved from https://ec.europa.eu/growth/tools‐databases/regprof/index.cfm?action=stat_ranking&b_services=true

EC, European Commission . (2020). Forces shaping and challenging the resilience of the health work force. Retrieved from https://ec.europa.eu/health/workforce/overview_en

England, K. , & Azzopardi‐Muscat, N. (2017). Demographic trends and public health in Europe. The European Journal of Public Health, 27(suppl_4), 9–13. 10.1093/eurpub/ckx159 PubMed DOI

Ensio, A. , Lammintakanen, J. , Härkönen, M. , & Kinnunen, J. (2019). Finland. In Rafferty A. M., Busse R., Zander‐Jentsch B., Sermeus W., & Bruyneel L. (Eds.), Strengthening health systems through nursing: Evidence from 14 European countries (pp. 31–39). : WHO Regional office for Europe. PubMed

Eurostat . (2019, December 3). Healthcare personnel statistics ‐ nursing and caring professionals [Internet document]. Retrieved from https://ec.europa.eu/eurostat/statistics‐explained/index.php?title=Healthcare_personnel_statistics_‐_nursing_and_caring_professionals&oldid=355980#Healthcare_personnel_.E2.80.94_nursing_professionals

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. 10.1111/jan.13183 PubMed DOI

Forsman, H. , Jansson, I. , Leksell, J. , Lepp, M. , Sundin Andersson, C. , Engström, M. , & Nilsson, J. (2020). Clusters of competence: Relationship between self‐reported professional competence and achievement on a national examination among graduating nursing students. Journal of Advanced Nursing, 76(1), 199–208. 10.1111/jan.14222 PubMed DOI PMC

Gardulf, A. , Florin, J. , Carlsson, M. , Leksell, J. , Lepp, M. , Lindholm, C. , Nordström, G. , Theander, K. , Wilde‐Larsson, B. , & Nilsson, J. (2019). The Nurse Professional Competence (NPC) Scale: A tool that can be used in national and international assessments of nursing education programmes. Nordic Journal of Nursing Research, 39(3), 137–142. 10.1177/2057158518824530 DOI

Gardulf, A. , Nilsson, J. , Florin, J. , Leksell, J. , Lepp, M. , Lindholm, C. , Nordström, G. , Theander, K. , Wilde‐Larsson, B. , Carlsson, M. , & Johansson, E. (2016). The Nurse Professional Competence (NPC) Scale: Self‐reported competence among nursing students on the point of graduation. Nurse Education Today, 36(1), 165–171. 10.1016/j.nedt.2015.09.013 PubMed DOI

Glasgow, M. E. S. , Dreher, H. M. , & Schreiber, J. (2019). Standardized testing in nursing education: Preparing students for NCLEX‐RN® and practice. Journal of Professional Nursing, 35(6), 440–446. 10.1016/j.profnurs.2019.04.012 PubMed DOI

Haavisto, E. , Hupli, M. , Hahtela, N. , Heikkilä, A. , Huovila, P. , Moisio, E.‐L. , Yli‐Koivisto, L. , & Talman, K. (2019). Structure and content of a new entrance exam to select undergraduate nursing students. International Journal of Nursing Education Scholarship, 16(1), 1–16. 10.1515/ijnes-2018-0008 PubMed DOI

Halter, M. , Boiko, O. , Pelone, F. , Beighton, C. , Harris, R. , Gale, J. , Gourlay, S. , & Drennan, V. (2017). The determinants and consequences of adult nursing staff turnover: A systematic review of systematic reviews. BMC Health Services Research, 17(1), 824. 10.1186/s12913-017-2707-0 PubMed DOI PMC

Harris, P. A. , Taylor, R. , Minor, B. L. , Elliott, V. , Fernandez, M. , O’Neal, L. , McLeod, L. , Delacqua, G. , Delacqua, F. , Kirby, J. , Duda, S. N. , & REDCap Consortium . (2019). The REDCap consortium: Building an international community of software partners. Journal of Biomedical Informatics, 95, 103208. 10.1016/j.jbi.2019.103208 PubMed DOI PMC

Harris, P. A. , Taylor, R. , Thielke, R. , Payne, J. , Gonzalez, N. , & Conde, J. G. (2009). Research electronic data capture (REDCap) – A metadata‐driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics, 42(2), 377–381. 10.1016/j.jbi.2008.08.010 PubMed DOI PMC

Heinen, M. M. , van Achterberg, T. , Schwendimann, R. , Zander, B. , Matthews, A. , Kózka, M. , Ensio, A. , Sjetne, I. S. , Casbas, T. M. , Ball, J. , & Schoonhoven, L. (2013). Nurses’ intention to leave their profession: A cross sectional observational study in 10 European countries. International Journal of Nursing Studies, 50(2), 174–184. 10.1016/j.ijnurstu.2012.09.019 PubMed DOI

Humar, L. , & Sansoni, J. (2017). Bologna process and basic nursing education in 21 European countries. Annali Di Igiene, Medicina Preventiva E Di Comunità, 29, 561–571. 10.7416/ai.2017.2185 PubMed DOI

ICN, International Council of Nurses . (2020, April 16). Guidelines on advanced practice nursing 2020 [EPub]. Retrieved from https://www.icn.ch/system/files/documents/2020‐04/ICN_APN%20Report_EN_WEB.pdf

Immonen, K. , Oikarainen, A. , Tomietto, M. , Kääriäinen, M. , Tuomikoski, A.‐M. , Kaučič, B. M. , Filej, B. , Riklikiene, O. , Flores Vizcaya‐Moreno, M. , Perez‐Cañaveras, R. M. , De Raeve, P. , & Mikkonen, K. (2019). Assessment of nursing students´ competence in clinical practice: A systematic review of reviews. International Journal of Nursing Studies, 100, 103414. 10.1016/j.ijnurstu.2019.103414 PubMed DOI

JAHWF, Joint Action Health Workforce Planning and Forecasting . (2016, May). Future skills and competences of the health workforce in Europe. Joint Action on Health Workforce Planning and Forecasting. [POLICYBRIEF 3: HEALTH CARE SERVICES–MAY 2016] Retrieved from http://portal.healthworkforce.eu/wp‐content/uploads/2016/06/JAHWF_WP6_D062‐HS‐briefing‐3‐Health‐care‐services‐Final‐May‐2016.pdf

Kajander‐Unkuri, S. , Leino‐Kilpi, H. , Katajisto, J. , Meretoja, R. , Räisänen, A. , Saarikoski, M. , Salminen, L. , & Suhonen, R. (2016). Congruence between graduating nursing students’ self‐assessments and mentors’ assessments of students’ nurse competence. Collegian: The Australian Journal of Nursing Practice, Scholarship & Research, 23(3), 303–312. 10.1016/j.colegn.2015.06.002 DOI

Kajander‐Unkuri, S. , Meretoja, R. , Katajisto, J. , Leino‐Kilpi, H. , & Suikkala, A. (2020). Students’ self‐assessed competence levels during nursing education continuum – A cross‐sectional survey. International Journal of Nursing Education Scholarship, 17(1), 1–12. 10.1515/ijnes-2019-0050 PubMed DOI

Kajander‐Unkuri, S. , Meretoja, R. , Katajisto, J. , Saarikoski, M. , Salminen, L. , Suhonen, R. , & Leino‐Kilpi, H. (2014). Self‐assessed level of competence of graduating nursing students and factors related to it. Nurse Education Today, 34(5), 795–801. 10.1016/j.nedt.2013.08.009 PubMed DOI

Kaunonen, M. , Gobbi, M. , Meier, K. , Østergaard, B. , Nielsen, D. S. , Kollak, I. , Hollos, S. , Donohoe, A. , Marchetti, A. , Stievano, A. , Demskyte, J. , Sammut, R. , Cassar, M. , Kaaijk, M. M. , Pajni, M. , Paen, L. , Icart Isern, T. , Barriball, L. , & McCready, I. (2018). Tuning educational structures in Europe: Guidelines and reference points for the design and delivery of degree programmes in nursing. In Gobbi M., & Kaunonen M. (Eds.), Tuning educational structures in Europe. University of Groningen.

Kiekkas, P. , Michalopoulos, E. , Igoumenidis, M. , Michalopoulos, A. , & Stefanopoulos, N. (2019). Factors associated with self‐reported competence of graduating nursing students. Collegian: the Australian Journal of Nursing Practice, Scholarship & Research, 26, 267–272. 10.1016/j.colegn.2018.08.004 DOI

Kim, J. H. , & Shin, H. S. (2020). Effects of self‐reflection‐focused career course on career search efficacy, career maturity and career adaptability in nursing students: A mixed methods study. Journal of Professional Nursing, 36(5), 395–403. 10.1016/j.profnurs.2020.03.003 PubMed DOI

Lahtinen, P. , Leino‐Kilpi, H. , & Salminen, L. (2014). Nursing education in the European higher education area – Variations in implementation. Nurse Education Today, 34(6), 1040–1047. 10.1016/j.nedt.2013.09.011 PubMed DOI

Lima, S. , Newall, F. , Kinney, S. , Jordan, H. L. , & Hamilton, B. (2014). How competent are they? Graduate nurses self‐assessment of competence at the start of their careers. Collegian: The Australian Journal of Nursing Practice, Scholarship and Research, 21(4), 353–358. 10.1016/j.colegn.2013.09.001 PubMed DOI

Maier, C. B. (2019). Nurse prescribing of medicines in 13 European countries. Human Resources for Health, 17(1), 95. 10.1186/s12960-019-0429-6 PubMed DOI PMC

Maier, C. B. , & Aiken, L. H. (2016). Task shifting from physicians to nurses in primary care in 39 countries: A cross‐country comparative study. European Journal of Public Health, 26(6), 927–934. 10.1093/eurpub/ckw098 PubMed DOI

Maneesriwongul, W. , & Dixon, J. K. (2004). Instrument translation process: A methods review. Journal of Advanced Nursing, 48(2), 175–186. 10.1111/j.1365-2648.2004.03185.x PubMed DOI

Marcinowicz, L. , Andersson, E. K. , Bohman, D. M. , Hjelm, M. , Skarbalienė, A. , Shpakou, A. , Kalinowska, P. , & Jamiolkowski, J. (2019). Nursing students’ perception of the professional nurse's role in four European countries. International Nursing Review, 66(2), 250–258. 10.1111/inr.12494 PubMed DOI

Mastrillo, A. (2019). Corsi Di Laurea Delle Professioni Sanitarie. Dati sull’accesso ai corsi e programmazione posti nell’ A.A. 2018–19 [Internet document, in Italian]. Retrieved from https://fli.it/wp‐content/uploads/2019/01/Mastrillo‐Report‐2018.pdf

Meretoja, R. , Isoaho, H. , & Leino‐Kilpi, H. (2004). Nurse Competence Scale: Development and psychometric testing. Journal of Advanced Nursing, 47(2), 124–133. 10.1111/j.1365-2648.2004.03071.x PubMed DOI

Meretoja, R. , Leino‐Kilpi, H. , & Kaira, A.‐M. (2004). Comparison of nurse competence in different hospital work environments. Journal of Nursing Management, 12(5), 329–336. 10.1111/j.1365-2834.2004.00422.x PubMed DOI

Meretoja, R. , Numminen, O. , Isoaho, H. , & Leino‐Kilpi, H. (2015). Nurse competence between three generational nurse cohorts: A cross‐sectional study. International Journal of Nursing Practice, 21(4), 350–358. 10.1111/ijn.12297 PubMed DOI

Ministerio de Ciencia, Innovación y Universidades . (2019). Número de estudiantes matriculados en Grado (1º y 2º Ciclo) [Web page, in Spanish]. Retrieved from https://www.ciencia.gob.es/portal/site/MICINN/menuitem.7eeac5cd345b4f34f09dfd1001432ea0/?vgnextoid=0930dd449de8b610VgnVCM1000001d04140aRCRD

Nilsson, J. , Carlsson, M. , Johansson, E. , Egmar, A.‐C. , Florin, J. , Leksell, J. , Lindholm, C. , Nordström, G. , Theander, K. , Larsson, B. , Lepp, M. , & Gardulf, A. (2014). Nursing in a globalized world: Nursing students with international study experience report higher competence at graduation. Nordic Journal of Nursing Research, 34(4), 848–858. 10.4236/ojn.2014.412090 DOI

Nilsson, J. , Mischo‐Kelling, M. , Thiekoetter, A. , Deufert, D. , Mendes, A. C. , Fernandes, A. , Kirchhoff, J. W. , & Lepp, M. (2019). Nurse professional competence (NPC) assessed among newly graduated nurses in higher educational institutions in Europe. Nordic Journal of Nursing Research, 39(3), 159–167. 10.1177/2057158519845321 DOI

NMBI, Nursing and Midwifery Board of Ireland . (2015, October 31). Scope of nursing and midwifery practice framework 2015. Retrieved from https://www.nmbi.ie/nmbi/media/NMBI/Publications/Scope‐of‐Nursing‐Midwifery‐Practice‐Framework.pdf?ext=.pdf

NMBI, Nursing and Midwifery Board of Ireland . (2018). Pre‐Registration Honours Degree Programmes 2018. Nursing/ Midwifery A career for you [Internet document]. Nursing and Midwifery Board of Ireland. Retrieved from https://www.nmbi.ie/NMBI/media/NMBI/WebversionNMACFY2020.pdf?ext=.pdf

NMC, Nursing and Midwifery Council . (2014). Standards for competence for registered nurses. Retrieved from https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc‐standards‐for‐competence‐for‐registered‐nurses.pdf

Notarnicola, I. , Stievano, A. , Pulimeno, A. , Iacorossi, L. , Petrizzo, A. , Gambalunga, F. , … Lancia, L. (2018). Evaluation of the perception of clinical competencies by nursing students in the different clinical settings: An observational study. Annali Di Igiene: Medicina Preventiva E Di Comunità, 30(3), 200–210. 10.7416/ai.2018.2211 PubMed DOI

Numminen, O. , Laine, T. , Isoaho, H. , Hupli, M. , Leino‐Kilpi, M. , & Meretoja, R. (2014). Do educational outcomes correspond with the requirements of nursing practice: Educators’ and managers’ assessments of novice nurses’ professional competence. Scandinavian Journal of Caring Science, 28(4), 812–821. 10.1111/scs.12115 PubMed DOI PMC

Numminen, O. , Meretoja, R. , Isoaho, H. , & Leino‐Kilpi, M. (2013). Professional competence of practicing nurses. Journal of Clinical Nursing, 22(9–10), 1411–1423. 10.1111/j.1365-2702.2012.04334.x PubMed DOI

OECD . (2020). Nursing graduates (indicator) [Web page]. Retrieved from https://data.oecd.org/healthres/nursing‐graduates.htm#indicator‐chart

OECD/EU . (2018). Health at a Glance: Europe 2018: State of Health in the EU Cycle. OECD Publishing. Retrieved from https://ec.europa.eu/health/sites/health/files/state/docs/2018_healthatglance_rep_en.pdf

PORDATA . (2020a). New entrants in higher education in the area of health: Total, by area of education and training and sex [Web page]. Retrieved from https://www.pordata.pt/en/Portugal/New+entrants+in+higher+education+in+the+area+of+health+total++by+area+of+education+and+training+and+sex‐803‐6621

PORDATA . (2020b). Graduates in year, in higher education in the area of health: Total, by area of education and training and sex [Web page]. Retrieved from https://www.pordata.pt/en/Portugal/Graduates+in+year++in+higher+education+in+the+area+of+health+total++by+area+of+education+and+training+and+sex‐804‐6688

Rafferty, A. M. , Busse, R. , Zander‐Jentsch, B. , Sermeus, W. , & Bruyneel, L. (Eds.) (2019). Strengthening health systems through nursing: Evidence from 14 European countries [EPub]. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/326183/9789289051743‐eng.pdf?sequence=1&isAllowed=y PubMed

Randall, S. , Crawford, T. , Currie, J. , River, J. , & Betihavas, V. (2017). Impact of community based nurse‐led clinics on patient outcomes, patient satisfaction, patient access and cost effectiveness: A systematic review. International Journal of Nursing Studies, 73, 24–33. 10.1016/j.ijnurstu.2017.05.008 PubMed DOI

Riklikienė, O. , Starkienė, L. , & Macijauskienė, J. (2019). Lithuania. In Rafferty A. M., Busse R., Zander‐Jentsch B., Sermeus W., & Bruyneel L. (Eds.), Strengthening health systems through nursing: Evidence from 14 European countries (pp. 73–84). : WHO Regional office for Europe. PubMed

Rizany, I. , Hariyati, R. T. S. , & Handayani, H. (2018). Factors that affect the development of nurses’ competencies: A systematic review. Enfermería Clínica, 28(Suppl 1), 154–157. 10.1016/S1130-8621(18)30057-3 DOI

Salamonson, Y. , Everett, B. , Cooper, M. , Lombardo, L. , Weaver, R. , & Davidson, P. M. (2014). Nursing as first choice predicts nursing program completion. Nurse Education Today, 34(1), 127–131. 10.1016/j.nedt.2012.10.009 PubMed DOI

Scheffler, R. M. , & Arnold, D. R. (2019). Projecting shortages and surpluses of doctors and nurses in the OECD: What looms ahead. Health Economics, Policy and Law, 14(2), 274–290. 10.1017/S174413311700055X PubMed DOI

Slovak Centre of Scientific and Technical Information . (2019). Štatistická ročenka ‐ vysoké školy [Internet document, in Slovak]. Retrieved from https://www.cvtisr.sk/cvti‐sr‐vedecka‐kniznica/informacie‐o‐skolstve/statistiky/statisticka‐rocenka‐publikacia/statisticka‐rocenka‐vysoke‐skoly.html?page_id=9596

Smatana, M. , Pažitný, P. , Kandilaki, D. , Laktišová, M. , Sedláková, D. , Palušková, M. , … Spranger, A. (2016). Slovakia: Health system review. Health Systems in Transition, 18(6), 107–120. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/330213/HiT‐18‐6‐2016‐eng.pdf?sequence=7&isAllowed=y PubMed

Smith, M. R. (2018). Student perspectives on satisfaction with learning in bachelor of nursing programs in Australia: A constructivist grounded theory study. PhD thesis, School of Nursing & Midwifery, Griffith University. Retrieved from http://hdl.handle.net/10072/381377

Squires, A. , Aiken, L. H. , van den Heede, K. , Sermeus, W. , Bruyneel, L. , Lindqvist, R. , … Matthews, A. (2013). A systematic survey instrument translation process for multi‐country, comparative health workforce studies. International Journal of Nursing Studies, 50(2), 264–273. 10.1016/j.ijnurstu.2012.02.015 PubMed DOI PMC

Statistics Iceland . (2020a). Nemendur eftir skólastigi, tegund náms, námsbraut og kyni 1997–2018 [Internet document, in Icelandic]. Retrieved from https://px.hagstofa.is/pxis/pxweb/is/Samfelag/Samfelag__skolamal__4_haskolastig__0_hsNemendur/SKO04105b.px

Statistics Iceland . (2020b). Brautskráningar á háskólastigi og doktorsstigi eftir námsbraut, prófgráðu og kyni 1995–2018 [Internet document, in Icelandic]. Retrieved from https://px.hagstofa.is/pxis/pxweb/is/Samfelag/Samfelag__skolamal__4_haskolastig__1_hsProf/SKO04205c.px

Taylor, I. , Bing‐Jonsson, P. , Wangensteen, S. , Finnbakk, E. , Sandvik, L. , McCormack, B. , & Fagerström, L. (2020). The self‐assessment of clinical competence and the need for further training: A cross‐sectional survey of advanced practice nursing students. Journal of Clinical Nursing, 29(4), 545–555. 10.1111/jocn.15095 PubMed DOI

ten Hoeve, Y. , Castelein, S. , Jansen, W. , Jansen, G. , & Roodbol, P. (2016). Predicting factors of positive orientation and attitudes towards nursing: A quantitative cross‐sectional study. Nurse Education Today, 40, 111–117. 10.1016/j.nedt.2016.02.019 PubMed DOI

Theander, K. , Wilde‐Larsson, B. , Carlsson, M. , Florin, J. , Gardulf, A. , Johansson, E. , Lindholm, C. , Nordström, G. , & Nilsson, J. (2016). Adjusting to future demands in healthcare: Curriculum changes and nursing students' self‐reported professional competence. Nurse Education Today, 37(2), 178–183. 10.1016/j.nedt.2015.11.012 PubMed DOI

Theisen, J. L. , & Sandau, K. E. (2013). Competency of new graduate nurses: A review of their weaknesses and strategies for success. The Journal of Continuing Education in Nursing, 44(9), 406–414. 10.3928/00220124-20130617-38 PubMed DOI

UN, United Nations . (2020). Standard country or area codes for statistical use (M49). Retrieved from https://unstats.un.org/unsd/methodology/m49/

Vipunen ‐ Education statistics Finland . (2019). Students and degrees [Web page]. Retrieved from https://vipunen.fi/en‐gb/

Wangensteen, S. , Finnbakk, E. , Adolfsson, A. , Kristjansdottir, G. , Roodbol, P. , Ward, H. , & Fagerström, L. (2018). Postgraduate nurses' self‐assessment of clinical competence and need for further training. A European cross‐sectional survey. Nurse Education Today, 62, 101–106. 10.1016/j.nedt.2017.12.020 PubMed DOI

WHO, World Health Organization . (2020a). State of the world's nursing 2020: Investing in education, jobs and leadership. Author.

WHO, World Health Organization . (2020b, January 13th). The 13 biggest threats to global health, according to WHO [Internet document]. Retrieved from https://www.who.int/news‐room/photo‐story/photo‐story‐detail/urgent‐health‐challenges‐for‐the‐next‐decade?utm_source=STAT+Newsletters&utm_campaign=1931cb646b‐MR_COPY_02&utm_medium=email&utm_term=0_8cab1d7961‐1931cb646b‐150708293

WHO, World Health Organization . (2020c). Data and statistics [Internet document]. Retrieved from http://www.euro.who.int/en/health‐topics/Health‐systems/nursing‐and‐midwifery/data‐and‐statistics

WMA, World Medical Association (2013, October). WMA Declaration of Helsinki – Ethical principles for medical research involving human subjects [Internet document]. Retrieved from https://www.wma.net/policies‐post/wma‐declaration

Yilmaz, A. A. , Ilce, A. , Cicek, S. C. , Yuzden, G. E. , & Yigit, U. (2016). The effect of a career activity on the students' perception of the nursing profession and their career plan: A single‐group experimental study. Nurse Education Today, 39, 176–180. 10.1016/j.nedt.2016.02.001 PubMed DOI

Železnik, D. , Kokol, P. , & Vošner, H. B. (2017). Adapting nurse competence to future patient needs using Checkland's Soft Systems Methodology. Nurse Education Today, 48, 106–110. 10.1016/j.nedt.2016.09.015 PubMed DOI

A successful nursing education promotes newly graduated nurses' job satisfaction one year after graduation: a cross-sectional multi-country study

Self-assessed competence of final-year nursing students

Nursing students' self-directed learning abilities and related factors at graduation: A multi-country cross-sectional study

Graduating Nursing Students' Empowerment and Related Factors: Comparative Study in Six European Countries