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. 2024 Aug 20;11(8):e70012. doi: 10.1002/nop2.70012

Students' core competence performance during fundamental nursing practicum: A cross‐sectional survey with importance–performance analysis

Yu‐Hsuan Chang 1,✉, Shiow‐Ching Shun 2, Pao‐Chen Lin 1
PMCID: PMC11336056  PMID: 39165079

Abstract

Aim

Limited available studies compare the core competence performance of students undertaking their practicum at different level‐of‐care practicum sites. This study aimed to (1) compare the gaps between the perception of importance for competence and the perceived performance of nursing students at practicum sites involving different level‐of‐care and (2) identify low competencies that must be prioritized for improvement at different sites during the fundamental nursing practicum.

Design

Cross‐sectional design.

Methods

A total of 659 students who had passed their fundamental nursing practicum within 1 month from six nursing colleges in Taiwan were recruited. The students completed the 25‐item Core Competence in Fundamental Nursing Practicum Scale, wherein both the importance and performance level of each item are indicated. One‐way analysis of variance along with the Scheffe post hoc test and importance–performance analysis were used to explore the gaps between the perception of importance for competence and the perceived performance and to identify weak competencies that must be prioritized for improvement, respectively.

Results

Compared with nursing students practicing in district hospitals (predominantly caring for chronically ill patients), nursing students practicing in medical centres (predominantly caring for patients with severe and critical conditions) had larger gaps in total scores and the application of nursing processes. Students in medical centres also had larger gaps in professional attitude than their counterparts in long‐term care facilities. Importance–performance analysis identified a common shortfall in communication skills among nursing students for all level‐of‐care practicum sites. Students at long‐term facilities had the highest number of weak competencies that required improvement. The results of this study can guide instructors in designing curricular activities focused on the weaker core competencies of the students at a practicum site for each level of care.

Patient or Public Contribution

No patient or public contributions.

Keywords: clinical practicum, core competence, importance–performance analysis, nursing student

1. INTRODUCTION

Fundamental nursing practicum, which is the first time that nursing students engage in professional practice, enables them to gain professional knowledge and skills in a real clinical setting (Hwang et al., 2021). In Taiwan, students must pass the fundamental nursing practicum before starting the nursing practicum in medical or surgical units. The fundamental nursing practicum sites for nursing students include medical centres, regional hospitals, district hospitals and long‐term care facilities. Students are commonly randomly assigned to one of the levels of practical sites. The implementation of the National Health Insurance program in 1995 has resulted in the improvement of Taiwan's medical referral system and hierarchical medical system (Yan et al., 2019). The hospitals in Taiwan are ranked based on the number of patient‐beds, severity of illness and function (Shie et al., 2011). Medical centres, which occupy the apex of this hierarchy, are responsible for education and research and for the treatment of patients with acute or complex conditions (Yan et al., 2019). Subsequent tiers in the hierarchy are occupied by regional and district hospitals, which primarily focus on managing chronic and general illnesses and treating chronically ill patients, respectively (Shie et al., 2011). Except for the level of the acute hierarchical medical system, long‐term care facilities admit patients afflicted with chronic illnesses, multiple comorbidities and functional deficits who cannot care for themselves independently (Lam et al., 2018). Consequently, during their fundamental nursing practicum, nursing students might take care of patients with different levels of disease severity and complications, depending on the different level‐of‐care practicum sites.

Students at different clinical practicum sites not only encounter patients with different levels of disease severity but also receive different levels of training content and supervision (Fuentes‐Pumarola et al., 2016; Yan et al., 2019). The clinical learning environment, including the pedagogical atmosphere and training content, is associated with nursing students' performance in core competencies and achievements during the clinical practicum (Visiers‐Jiménez et al., 2021). Compared with students who undertake their fundamental practicum at lower levels of care facilities, those undertaking their practicum at medical centres deal with more complicated care situations. Thus, we hypothesized that, compared with the other students, those who undertake their fundamental practicum at medical centres have a lower perceived core competence performance regarding patient care.

Although there were few studies that compared the competence performance or experience of students between different level‐of‐care practicum sites (Fuentes‐Pumarola et al., 2016; Hsieh & Hsu, 2013; Skaalvik et al., 2011), these studies either did not focus on fundamental nursing practicum (Hsieh & Hsu, 2013) or provided only a general assessment of the outcomes of the practicum (Fuentes‐Pumarola et al., 2016; Skaalvik et al., 2011), and they did not consider the core competence performance of the students.

2. BACKGROUND

A fundamental nursing practicum provides nursing students with an initial opportunity to integrate their professional knowledge, attitudes and skills into their clinical practice for application in the clinical settings (Fuentes‐Pumarola et al., 2016). The core competencies that students should possess during their fundamental nursing practicum include communication, application of nursing process, basic biomedical science, nursing skills and ability to perform a care process and professional attitude (Chang et al., 2022). When students possess insufficient professional knowledge and skills, they encounter difficulties in ensuring the safety of patients and care quality in a rapidly dynamic health‐care environment (van de Mortel et al., 2021; Visiers‐Jiménez et al., 2021). Therefore, the core competence of students must be assessed to determine whether they can meet the requirements of their fundamental nursing practicum (Chang et al., 2022). The findings of such an assessment can help instructors adjust or design the nursing curriculum to address the low competencies of the students.

Patients are admitted into different clinical facilitates in this hierarchical medical system that provides distinct levels‐of‐care based on the severity of their illness (Yan et al., 2019). In general, medical centres admit patients with more critical and unstable conditions than do other clinical placements (e.g. regional hospitals, district hospitals and long‐term care facilities). In Taiwan, junior college nursing students are usually distributed to clinical practicum sites, which involve different levels of care when they engage in their clinical practicum. Results of a previous study indicated that students who undertook their practicum at medical centres and regional hospitals had higher competence scores in basic biomedical science than did those who undertook theirs at district hospitals (Hsieh & Hsu, 2013); however, the students in medical centres also experienced adverse events more frequently (García‐Gámez et al., 2020) and perceived higher stress because of the high turnover of staff and patients in critical care placement (Skaalvik et al., 2011). Other studies have demonstrated that students who undertook their practicum at long‐term care facilities reported more negative experiences, including an insufficient pedagogical atmosphere, acquiring less professional knowledge and skills and unsatisfactory supervision, than did those who undertook theirs at hospitals (Fuentes‐Pumarola et al., 2016; Skaalvik et al., 2011). This was attributed to the monotonous and repetitive care routine and the limited number of nursing staff who can be approached at long‐term care facilities, which affected the outcomes of clinical training (Fuentes‐Pumarola et al., 2016; Skaalvik et al., 2011). Thus, as students are allocated to different level‐of‐care clinical sites to complete their clinical practicum, they encounter different challenges and hence develop different corresponding competencies. Consequently, distinguishing different students' insufficient competencies and understanding what skills and knowledge they need to learn is crucial.

Outcome‐based education, which is a student‐centered approach to curriculum design and teaching that emphasizes what students should know, understand and demonstrate (Tan et al., 2018), is more effective than conventional nursing education for cultivating students' core competence (Hsu & Hsieh, 2013; Lee et al., 2019). A systematic review of four studies indicated that including a clinical practicum in the outcome‐based education approach can effectively improve students' core competencies and skills performance, such as communication skills and performing a care process (Tan et al., 2018). In this approach, the learning effectiveness of practicum curricula is evaluated based on the students' own self‐assessment of whether they have reached their expected learning goals or outcomes (Lee et al., 2019) rather than the instructors' perspective (Chang et al., 2022). However, modifying a given curriculum or practicum to help students improve all competencies they might be lacking based on their self‐evaluation or outcomes is challenging.

An importance–performance analysis (IPA) is a useful approach for addressing these challenges because it can help instructors identify students' perceived low competencies and then prioritize them for improvement (McLeay et al., 2017). IPA was first applied in the field of marketing research to explore the importance and performance of products on the basis of consumer perceptions and then help companies prioritize product attributes for improvement (Martilla & James, 1977). In education research, IPA can enable instructors to assess the gaps between students' recognized importance of competence and their perceived performance (Lin et al., 2021) and thus dedicate more attention to narrowing such gaps (Martilla & James, 1977). In the field of nursing education, IPA has been extensively used to evaluate the learning effectiveness of students (Sembiring et al., 2017) and to assess the effectiveness of a nursing intervention (Lee et al., 2021). The IPA method requires students to respond to several items related to importance and performance scores; these scores reflect the degree of students' perception of the importance of competence and their perceived performance.

The aim of the present study was to (1) compare the gaps between the perception of importance for competence and the perceived performance of nursing students at practicum sites involving different level‐of‐care and (2) identify low competencies that must be prioritized for improvement at different sites during the fundamental nursing practicum. The results may aid instructors in designing curricula or developing teaching strategies that help improve certain competencies of nursing students, thereby allowing them to acquire sufficient core competence in managing patients at different levels of care.

3. METHODS

3.1. Participants and setting

This cross‐sectional study applied purposive sampling to recruit students from nursing junior colleges, which comprise a 5‐year program (associate degree) in southern Taiwan, to participate in this study. Students who passed their fundamental nursing practicum within 1 month were included. In general, nursing students can undertake the fundamental nursing practicum after passing their lecture of the fundamental nursing course. Students who had undertaken the fundamental nursing practicum or fundamental nursing course more than twice were excluded because they had many confounders, such as a complicated learning environment or learning disturbance diseases that would interfere with the study results. The study was conducted in participants' own classroom settings, which they were familiar with and convenient for their questionnaires to fill out.

3.2. Procedure

The authors were connected with stakeholders in several nursing colleges in southern Taiwan who can assist in screening for eligible participants. The participants were approached during their self‐learning classes or class meetings by members of our research team or research assistants, who did not know and were not responsible for the grades of the eligible students, thus avoiding the risk of social desirability response bias. Students were informed of the research purpose and were asked to fill out a questionnaire independently once to understand their perceived importance and performance of core competence during the practicum. Participants completed a questionnaire independently, which was then handed over to the research assistants to confirm its completeness.

3.3. Instrument

3.3.1. Core Competence in Fundamental Nursing Practicum Scale

The Core Competence in Fundamental Nursing Practicum Scale (CCFNPS) was used in this study to assess the level of satisfaction with students' perceived performance of core competence. The CCFNPS is a 25‐item questionnaire that was originally developed by Chang et al. (2022) to explore the core competencies of nursing students engaging in a fundamental nursing practicum. Thus, these competencies are those that the students need to develop during their fundamental nursing practicum. The CCFNPS was evaluated through rigorous psychometric testing using exploratory factor analysis and confirmatory factor analysis, which revealed extremely satisfactory validity (total variance = 70.15%, comparative fit index = 0.97, and root mean square error of approximation = 0.07) and reliability (Cronbach's alpha = 0.94). The CCFNPS comprises five domains: communication (three items), application of nursing process (six items), basic biomedical science (four items), nursing skills and ability to perform a care process (seven items), and professional attitude (five items). Each item is scored on a 5‐point Likert scale, with scores of 1, 2, 3, 4, and 5 corresponding to ‘very dissatisfied,’ ‘dissatisfied,’ ‘neutral,’ ‘satisfied,’ and ‘very satisfied,’ respectively; higher scores indicate greater self‐perceived core competence performance during the practicum (Chang et al., 2022).

In the present study, we retained the original scoring for the dimension of level of satisfaction with core competence performance. An additional dimension (namely, the level of importance of core competence) was incorporated after permission was obtained from the authors of the CCFNPS. This new dimension measured the degree to which participants perceived various competencies as important for their fundamental nursing practicum. Each item was scored on a 5‐point Likert scale. Higher scores on this dimension indicate a stronger perception of the importance of each competency. Therefore, the participants were required to answer the same items corresponding to the two dimensions—level of importance and level of satisfaction with 25‐item of core competence. The gaps between students' perceived importance of competence and the perceived performance could be evaluated by subtracting the importance score from the satisfaction score (Lin et al., 2021). In this study, the Cronbach alpha values for the CCFNPS were 0.97 and 0.95 for level of importance and level of satisfaction with core competence, respectively.

3.3.2. Participants' background information

The participants' background information was collected using a self‐report questionnaire, which collected the students' sex and college, in addition to information about the medical institution where their practicum was conducted.

3.4. Data analysis

SPSS version 24.0 (IBM, Corp. Released 2016. IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corp.) was used for data analysis. The participants' demographic information and their CCFNPS scores are presented as percentages, means, and standard deviations (SDs). A one‐way analysis of variance (ANOVA) was conducted to compare the mean scores of the gaps between the importance of competence and perceived performance of participants at different practicum sites involving different level‐of‐care, and the Scheffe test was used to execute post hoc testing.

An IPA was used to assess the perceptions of the importance of core competence and perceived performance scores of the participants. The average importance and performance scores for each item were drafted into an IPA matrix (Martilla & James, 1977). The participants' perceived performance was selected as the X‐axis, and their expected importance of competence was selected as the Y‐axis. Thus, four quadrants of priority were created, namely ‘keep up the good work,’ ‘concentrate here,’ ‘low priority,’ and ‘possible overkill,’ which corresponded to high performance and importance, low performance and high importance, low performance and importance, and high performance and low importance, respectively (Markazi‐Moghaddam et al., 2019; Martilla & James, 1977). Such a mapping process enables the prioritization of certain teaching strategies on the basis of students' perception of importance for competence and perceived performance. In the present study, the core competencies mapped in the second quadrant—‘concentrate here’—were the competencies for improvement that instructors should pay more attention to solving as a top priority, indicating that the participants recognized these competencies were important but the performance still needed improvement.

3.5. Ethical considerations

This study was approved by the human research ethics committee of a university in southern Taiwan (Registration number: NCKU HREC‐E‐105–039). All students understood the study purpose and process before participating in the study and filling out the informed consent form. The researchers were not the instructors of the enrolled students. The students were also informed that their grades and learning rights would not be affected by their participation in or opting out of this study. All the collected data were anonymized.

4. RESULTS

4.1. Participants' characteristics

A total of 699 students were fundamentally approached, of whom 30 did not satisfy the inclusion criteria and 10 had missing questionnaire responses. Consequently, a total of 659 participants (52 male and 607 female students) from six nursing colleges in southern Taiwan were included in this study. The response rate was 94.3% (Table 1). The participants were distributed among four practicum sites involving different level‐of‐care. Specifically, 21.9% (n = 144), 50.0% (n = 330), 9.9% (n = 65), and 18.2% (n = 120) of the participants undertook their practicum at medical centres, regional hospitals, district hospitals, and long‐term care facilities, respectively.

TABLE 1.

Demographic characteristics of participants and information on practicum sites (N = 659).

Variable n %
Gender
Men 52 7.9
Women 607 92.1
College
College 1 89 13.5
College 2 44 6.7
College 3 108 16.4
College 4 88 13.4
College 5 191 28.9
College 6 139 21.1
Level‐of‐care of practicum sites
Medical center 144 21.9
Regional hospital 330 50.0
District hospital 65 9.9
Long‐term care facility 120 18.2
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4.2. Perception of importance for core competence and the perceived performance during the fundamental nursing practicum

Regarding the between‐group differences in the gaps between the perception of importance core competence and the perceived performance scores, participants who undertook their practicum at medical centres exhibited more significant gaps in total score (F = 2.89, p = 0.035) and in the domain of application of the nursing process (F = 4.77, p = 0.003) than did those who undertook their practicum at district hospitals. Participants who undertook their practicum at medical centres exhibited more significant gaps in the domain of professional attitude than did those who undertook their practicum at long‐term care facilities (F = 2.96, p = 0.032; Table 2).

TABLE 2.

Between‐group differences in gaps between the perception of importance for competence and the perceived performance among students at different practicum sites involving different level‐of‐care.

Variable Medical centrea (n = 144) Regional hospitalb (n = 330) District hospitalc (n = 65) Long‐term care facilityd (n = 120) F p Post hoc
Mean SD Mean SD Mean SD Mean SD
Total score of gaps between the importance of competence and perceived performance −26.44 13.11 −24.05 16.00 −20.48 14.55 −22.52 14.01 2.89 0.035 a > c
Communication −3.51 2.04 −3.17 2.43 −2.86 2.21 −3.16 2.25 1.36 0.255
Application of nursing process −9.19 4.78 −8.35 5.16 −6.63 4.38 −7.62 4.84 4.77 0.003 a > c
Basic biomedical science −3.52 2.57 −3.51 3.04 −2.91 2.86 −3.79 3.10 1.28 0.281
Nursing skills and ability to perform a care process −5.93 4.14 −5.35 4.57 −4.38 4.40 −4.92 3.49 2.21 0.086
Professional attitude −4.29 3.07 −3.66 3.61 −3.69 3.66 −3.03 3.15 2.96 0.032 a > d
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Note: a, b, c, and d represent medical centre, regional hospital, district hospital, and long‐term care facility, respectively.

Abbreviation: SD, standard deviation.

Figure 1 illustrates the IPA results regarding the perception of importance for competence and the perceived performance scores derived for the participants at the four practicum sites involving different level‐of‐care. The results revealed that the participants who undertook their practicum at medical centres had weaker competencies in items Q1 (‘ability to use communication skills to communicate with patients’) and Q6 (‘ability to observe the nonverbal needs of patients’) of the CCFNPS; these items belong to the communication domain. The participants who undertook their practicum at regional hospitals had weaker competencies in items Q1 and Q18 (‘ability to instruct patients on medication use’), which belong to the domain of basic biomedical science. For the students who were allotted to the district hospital, items Q6 and Q18 were the low competencies that required improvement. Finally, the participants who undertook their practicum at long‐term care facilities had weaker competencies in items Q1 and Q6 (which both belong to the communication domain) and items Q15 (‘ability to understand reasons for prescribing specific medications for patients’), Q16 (‘ability to understand the side effects of medications used by patients’) and Q18, which belong to the domain of basic biomedical science. Hence, for these participants, emphasis should be placed on improving the core competencies in these items.

FIGURE 1.

FIGURE 1

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The perception of importance for competence and the perceived performance of nursing students engaged in practicum sites with different level‐of‐care during their fundamental nursing practicum. (a) Students undertaking their practicum at medical centres (n = 144); (b) students undertaking their practicum at regional hospitals (n = 330); (c) students undertaking their practicum at district hospitals (n = 65); and (d) students undertaking their practicum at long‐term care facilities (n = 120).

5. DISCUSSION

This study included a large sample of students from six nursing colleges and incorporated the IPA method—a novel statistical method—into the CCFNPS for analysis. Participants who undertook their practicum at medical centres had larger gaps between the perception of importance for competence and the perceived performance in the total score and in the domain of application of the nursing process compared with those who undertook their practicum at district hospitals. Moreover, students at medical centres had larger gaps in the domain of professional attitude compared with those who undertook their practicum at long‐term care facilities. The IPA results indicated that the participants who undertook their practicum at long‐term facilities had the highest number of weak core competencies that required prioritization for improvement. The participants at all practicum sites generally had lower performance scores in the communication domain.

Our analysis indicated that the improvement of communication skills should be prioritized among all the participants at all four practicum sites. This may explain the nonsignificant between‐group differences in the gaps between the perception of importance and the perceived performance in communication at all sites. These results are similar to many previous studies (Cannity et al., 2021; Chang et al., 2022; Shafakhah et al., 2015), which have reported that students demonstrated poor communication skills while interacting with patients in clinical settings; this can partly influence the nursing process and care. However, students' communication skills can be improved once they reach the senior semester or practicum (Shafakhah et al., 2015). Accordingly, communication skills should be incorporated into nursing curricula or even augment more communication skill training courses to help nursing students obtain the requisite experience before engaging in their fundamental nursing practicum (Taghizadeh et al., 2018). Additionally, instructors can apply multiple teaching strategies, such as objective structured clinical examinations or simulations, to create realistic scenarios to allow students to train in appropriate communication and dialogue according to different clinical care situations (Chang et al., 2022) and to improve their confidence when interacting with patients (Cannity et al., 2021).

According to our assessment of the between‐group differences in the gaps between the perception of importance for competence and the perceived performance, participants who undertook their practicum at medical centres had the greatest gaps compared to those who undertook their practicum at other sites. These results indicate that students at medical centres may experience a more pronounced reality shock, a phenomenon where the practical realities of clinical settings differ from theoretical knowledge, potentially hindering the development of their professional self‐concept (Kim, 2020). Medical centres typically have higher turnover rates of hospitalized patients with relatively critical conditions (Yan et al., 2019). Although students undertaking their fundamental nursing practicum are often allocated to a single patient, they are expected to provide appropriate nursing care with a professional attitude towards the patient (Kerr et al., 2020). However, previous study have indicated that students undertaking their practicum at medical centres can develop improved nursing skills and care procedures than those undertaking their practicum at long‐term care facilities because they are presented with more opportunities to apply their nursing training during their practicum (Fuentes‐Pumarola et al., 2016). Therefore, we recommended that instructors simulate critical realistic scenarios to enhance the core competence of their students before they undertake their practicum at medical centres; such simulations can reduce the students' reality shock during their practicum and can help them develop valuable professional nursing skills during their senior practicum or future nursing careers (Şentürk Erenel et al., 2021).

The participants who undertook their practicum at long‐term care facilities did not show greater gaps between the perception of importance for competence and the perceived performance than did those who undertook their practicum at other sites. However, according to their self‐reports, these participants had the highest number of weak core competencies (Q1, Q6, Q15, Q16, and Q18, belonging to the domains of communication and basic biomedical science) that required prioritization for improvement. These findings are similar to those of previous studies that have demonstrated that students practicing at long‐term care facilities experienced fewer professional challenges than did those practicing in other settings (Fuentes‐Pumarola et al., 2016; Skaalvik et al., 2011). Students undertaking their practicum at long‐term care facilities are presented with more practical opportunities to communicate and interact with residents and conduct activities for them. However, in Taiwan, residents often communicate in Taiwanese rather than in Mandarin, which is in contrast to the communication language used by young people. Therefore, the language barrier might be a reason for the limited development of communication skills for interacting with the residents (Q1). To address this language problem, we recommended the provision of elective vernacular language courses in the first or second year of nursing education. Regarding the low competence in basic biomedical science, which is involved in medicine use and education (Q15, Q16, and Q18), nursing students are not trained in geriatric nursing before engaging in fundamental nursing practicum. Therefore, when practicing at long‐term care facilities that are predominated by older adults with multiple chronic conditions (Birtwell et al., 2022), students cannot link the background of the older adults' chronic conditions and prescribed medicine; they also experience difficulty in identifying the older adults' nonverbal needs (Q6). Accordingly, we recommended that instructors use teaching strategies such as case‐report discussion and bedside teaching or educate students in geriatric physical and psychological care before they undertake their practicum; this can help students integrate their knowledge of basic biomedical science and communication skills into the care of older residents at long‐term care facilities (Ghasemi et al., 2020).

Our findings are likely to be representative given the study's large sample, which was drawn from six nursing junior colleges—representing two‐thirds of such colleges in southern Taiwan—and accounting for approximately 12.63% of nursing students in the same academic year across Taiwan. The insights garnered may reflect the broader landscape of core competence performance among nursing students during their fundamental practicum. Besides, our comprehensive explanation for our study resulted in a smooth recruiting process, causing a high response rate from participants. However, this study has some limitations. First, the sample sizes of the different groups were different; nevertheless, all groups exhibited equal variance before the ANOVA test was performed (p = 0.095). This also indicates that fewer students undertake their practicum at district hospitals in Taiwan. Second, the talent and learning efficiency might have differences among the students recruited from the six nursing colleges, and the included students were not averagely distributed among the four practicum sites. Therefore, the sample at each site might have comprised students from only four or five colleges. Similarly, students at different practicum sites were evaluated by different supervisors and mentors, which might have affected the results. Third, our approach of purposive sampling, which is a form of nonprobability sampling, targeted students who met inclusion criteria. Finally, we evaluated only the students' self‐perception of their core competence performance; future studies should include the instructors' evaluation and compare the two perspectives.

6. CONCLUSIONS

According to the between‐group differences in the gaps between the perception of importance for competence and the perceived performance, participants who undertook their fundamental nursing practicum at medical centres had a greater total score of gaps than did those who undertook their practicum at district hospitals. The IPA results for individual practicum sites revealed that participants who undertook their practicum at long‐term care facilities had the most insufficiently weak competencies that should be prioritized for improvement. The participants generally underperformed in communication skills across all practicum sites. The results of this study can guide instructors in designing curricular activities focused on the weaker core competencies of the students at a practicum site for each level of care.

6.1. Relevance to clinical practice

This study highlights the disparities in perceived importance and performance of competencies at different level‐of‐care practicum sites for students engaging in fundamental nursing practicum. The findings underscore a critical need for nursing instructors to provide more comprehensive support and training to promote students' core competence towards clinical practicum, particularly those practicing in medical centres, to strengthen their confidence and practical nursing abilities. Furthermore, the study identifies a common shortfall in communication skills among nursing students, regardless of their practicum site. Therefore, integrating verbal and nonverbal communication training into the fundamental nursing practicum is crucial.

AUTHOR CONTRIBUTIONS

YHC has contributed to conception, study design, collection, data analysis and interpretation, manuscript writing, editing, and review. SCS has contributed to conception, data interpretation, manuscript editing, and review. PCL has contributed to collection, data analysis, and review. All Authors have read and approved the final manuscript.

FUNDING INFORMATION

This research was supported by the National Science and Technology Council, Taiwan (Grant number: MOST 105‐2314‐B‐439‐001).

CONFLICT OF INTEREST STATEMENT

The authors have disclosed no potential conflicts of interest, financial or otherwise.

STATISTICS

The statistics were checked prior to submission by an expert statistician who working in professional statistics company (Estat, email: service@estat.com.tw).

ACKNOWLEDGEMENTS

We gratefully acknowledge the support of the students who participated in this study and the stakeholders who assisted to recruit the participants.

Chang, Y.‐H. , Shun, S.‐C. , & Lin, P.‐C. (2024). Students' core competence performance during fundamental nursing practicum: A cross‐sectional survey with importance–performance analysis. Nursing Open, 11, e70012. 10.1002/nop2.70012

DATA AVAILABILITY STATEMENT

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

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

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

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