Journal of Korean Academy of Nursing

Research Paper

Transforming nursing education to enhance integrated nursing competency: a Delphi-based methodological study on symptom-based clinical reasoning: Jeung-Im Kim, Soyoung Yu, Jin-Hee Park, Ju-Eun Song, Eunjung Ryu, JuHee Lee, YeoJin Im; J Korean Acad Nurs 2026;56(1):39-50. Published online February 5, 2026; DOI: https://doi.org/10.4040/jkan.25151

Abstract PDF ePub: Purpose
This study aimed to address the shift toward competency-based education and the planned 2028 “Integrated Nursing” National Licensing Examination (NLE), this study aimed to establish structural alignment among NLE domains, the seven integrated nursing competencies (INCs), and curriculum goals, with a particular focus on implementing symptom-based clinical reasoning (SBCR).
Methods
This Delphi-based methodological study included seven content experts for content validity index (CVI) assessment and 24 nursing education experts who participated in a consensus workshop. The item-level CVI and the scale-level CVI/average were calculated to confirm the linkage between INCs and NLE domains. In addition, qualitative analysis of workshop materials and meeting records was conducted to derive 10 integrated learning topics and to develop an SBCR educational model for the key symptom of headache, grounded in Miller’s Clinical Competence Pyramid (levels 2–4).
Results
The analysis confirmed the validity of integrating the INCs within the overall curriculum structure. The resulting framework delineates staged learning objectives and core clinical questions designed to systematically enhance clinical reasoning, promote safe nursing practice, and support professional reflection within a unified curriculum.
Conclusion
This study provides a practical foundation for nursing curriculum redesign by facilitating a transition from fragmented, subject-based instruction to a holistic, patient-centered SBCR model. This approach aligns with the requirements of the integrated NLE and is expected to contribute to meaningful improvements in actual clinical competency.

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Original Articles

Development of Objectives in Nursing Clinical Education based on the Nursing Core Competencies: Miwon Kim; Journal of Korean Academy of Nursing 2006;36(2):389-402. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2006.36.2.389

Abstract PDF

Purpose

The purpose of this study was to set up a Nursing Core Competencies required for staff nurses and to set up Objectives for Nursing Clinical Education based on the Nursing Core Competencies. The objectives in this study are to be achieved ultimately through clinical practice because it is a common avenue of work and the basic objective regardless of the education system and curriculum.

Method

A nursing Core Competencies were established by literature review and verified by 15 experts. Nursing Clinical Education Objectives were established by literature review and analysis, and a survey for validity using a five point Likert scale was given to 257 nursing professors, 503 head-nurses, 509 staff nurses who had less than 3 years clinical experience in 34 general hospitals and 738 senior student nurses from 81 nursing colleges.

Result

Nine nursing core competencies were set up. In addition 39 Objectives for each of the nursing clinical core competencies were set up.

Conclusion

In conclusion, this study will contribute to professional nursing education to provide comprehensive nursing care by applying knowledge to nursing practice to achieve the Nursing Core Competency as a professional nurse.

Citations

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Outcomes-based Curriculum Development and Student Evaluation in Nursing Education: Hesook Suzie Kim; J Korean Acad Nurs 2012;42(7):917-927. Published online December 12, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.7.917

Abstract PDF

Abstract Purpose

A curriculum development model is presented to examine the processes necessary to develop new programs or evaluate existing programs within the philosophy of outcomes-based education in nursing, especially in the context of accreditation. The philosophy of outcomes-based education is to produce individuals who can demonstrate the evidence of competencies in designated areas of education. For nursing education, this means competencies in performing the role of professional nursing as defined by the profession and social needs at the beginning level upon completing a nursing program.

Methods

A curriculum development model has been developed analytically based on the literature and experiences.

Results

A 10-step process framework incorporating the tenets of outcomes-based nursing education is illustrated.

Conclusion

This curriculum development framework can be applied in developing new educational programs in nursing or to evaluate and revise existing programs in anticipation of the accreditation process that is moving with a full force in such countries as Korea.

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