Competence to expertise in nursing practice.

Background: A shift from a content-focused curriculum to a competency-based curriculum has occurred in nursing education. Competency-based education (CBE) is highly debated within higher education despite the need for competency. Competency-based education (CBE) is a form of education that takes a curriculum from a focus on an actual role or analysis perspective to an individual student's progress based on their demonstrated performance of aspects of the role. While debate exists regarding the pros and cons of CBE, theories of expertise exist to understand competency via the worldview of expert performance. Researchers and educational scholars are delving into the role of knowledge, particularly clinical knowledge, in developing and enhancing expertise and the practice of experts. In addition, CBE focuses on individual students' development and skill performance into experts. Many competency frameworks prioritize applying clinical knowledge, skills, and abilities as the building blocks of professional expertise. However, these models often overlook the capability of a nurse to handle unforeseen challenges effectively in practice as an expert.Aim and Design: This discussion piece is dedicated to exploring the ongoing debates and developments in the conceptualization of expertise. It also serves to underscore the urgent and crucial need for a paradigm shift in our approach to competency-based education (CBE) in nursing. The discussion will delve into various cognitive perspectives on expertise, particularly how accumulated knowledge is conceptualized in expert development and practice models and the implications for understanding competence through expert performance. This piece will also provide critical implications for understanding competence through expert performance, such as the conceptualizations of knowledge. Finally, this discussion will highlight the significant impact of competence as expertise within CBE, emphasizing the weight and importance of competency as expertise in nursing education.Findings and Conclusion: Literature has found that expertise in nursing practice is a result of a developmental pathway involving appropriate training and substantial practice. We propose that an integrated understanding of expertise could lead to a more comprehensive set of expert nursing practice competencies. This integration of educational concepts and situated knowledge into competency and expertise understanding requires a shift in learning environments where future experts are educated.