Assessing the wound care competence of undergraduate nursing students: An integrative review.
Abstract
Aim
To examine current methods used to assess wound-care competence in undergraduate nursing programs and to identify key gaps and opportunities for improvement.
Background
Wound-care competence is fundamental to safe nursing practice, yet its assessment in undergraduate education remains inconsistent. Despite a range of tools and approaches, there is limited consensus on what constitutes wound-care competence or how it should be evaluated. Understanding existing assessment practices, including the validity and reliability of assessment instruments, is crucial for informing the development of robust and developmentally appropriate competence assessments.
Design
Integrative literature review.
Methods
Whittemore and Knafl's five-stage framework guided the review. PubMed, CINAHL and Web of Science were searched for peer-reviewed studies published in English between 2014 and 2026. Methodological quality was appraised using the JBI checklists, the Mixed Methods Appraisal Tool and the Quality Appraisal tool for Validity Studies. Data were extracted and thematically synthesised in alignment with the review aims.
Results
Ten studies met the inclusion criteria. Three themes were identified: (1) assessment instruments and approaches, (2) design and development considerations and (3) validation and psychometric rigour. Structured methods, such as simulation and Objective Structured Clinical Examinations, predominated, with a growing emphasis on formative feedback and clinical authenticity. However, limited year-level alignment, inconsistent validation, assessor variability and limited reporting of calibration strategies highlighted challenges in achieving consistent competence assessment.
Conclusions
Standardised, psychometrically sound instruments that capture both technical and values-based wound-care competence are needed. Co-designed, developmentally scaffolded tools integrating skills, reasoning and professional values offer a pathway to more consistent and meaningful assessment in nursing education.