From Competence to Autonomy: A Developmental Model of Transition to Practice
Brent MacWilliams, Heather M. EnglundBackground:
Newly graduated nurses often meet competency standards yet struggle to function independently in clinical practice, suggesting that competence alone does not explain readiness for autonomous practice.
Purpose:
To propose a developmental model explaining the transition from competence to autonomy and its implications for nursing education and workforce transition.
Methods:
Contemporary literature was integrated with grounded theory findings and prior conceptual work to develop a staged model of clinical transition.
Results:
The model describes 5 developmental phases supported by 3 interacting mechanisms: mediated clinical experience, professional identity formation, and developmental calibration. Ownership of practice represents the pivotal transition from externally guided performance to internally regulated clinical judgment and responsibility.
Conclusion:
Transition to autonomy is developmental rather than time-dependent. The model provides a framework for designing clinical education, transition-to-practice programs, and workforce strategies that intentionally support autonomous professional practice.