Journal of Qualitative Research in Health Sciences

Journal of Qualitative Research in Health Sciences

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Policy Analysis of the Professional Competency of Clinical Nurses in Iran and its Comparison with the United States: A comparative policy analysis

Articles in Press

Document Type : Original Article

Authors

1 Student Research Committee, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran

2 Department of Medical and Surgical Nursing, School of Nursing and Midwifery, Fasa University of Medical Sciences, Fasa, Fars, Iran

3 School of Nursing and Midwifery, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran

4 Nursing Research Centre, Kerman University of Medical Sciences, Kerman, Iran

10.22062/jqrhs.2026.201994.1701

Abstract

Background: Professional competence is essential for nurses to provide safe and effective care. Comparing how this competence is acquired against international standards can reveal strengths and weaknesses in national policies and education. This study used the Walt and Gilson policy triangle model to compare the policies shaping professional competence for clinical nurses in Iran and the United States.
Methods: This study employed a qualitative comparative policy analysis framework. Data were collected through a triangulated approach: (1) a documentary review of relevant literature; (2) analysis of key Iranian national policy documents; and (3) six structured interviews with nurses experienced in both national and international competency examinations to capture practical insights. The Walt and Gilson model (actors, context, content, and process) was used as the framework for data analysis.
Results: Findings are organized around the four dimensions of the policy triangle: Actors: Clinical nurses, students, and faculty members. Context: Factors such as organizational dynamics, educational and evaluation systems, healthcare changes, and the need for cost-effective services. Content: Professional competency includes five domains: care management, scientific competence, individual management, patient-centeredness, and knowledge-seeking. Process: Professional qualification is primarily achieved through a standardized exam in both countries.
Conclusion: Iran's professional competency system is simpler than the U.S. model. Despite both using exams, implementation and incentives differ significantly, reducing nurse motivation in Iran. Reforms should align policies with international standards by improving evaluation methods and linking competency to career advancement.

Keywords

References
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Journal of Qualitative Research in Health Sciences

Articles in Press, Accepted Manuscript
Available Online from 22 August 2026
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  • Receive Date: 31 October 2025
  • Revise Date: 22 August 2026
  • Accept Date: 22 August 2026
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