Our lives are spent interacting with technology and the inundation of data and information that results. We are continually influenced and impacted, both personally and professionally, by advances in technology and their implementation. All care providers, including nurses, need to demonstrate competence in their roles, with competence defined as "an ability acquired through experience and learning."1(p.1) Informatics is a core part of nursing practice. Today's nurses, no matter the role or setting, must be both competent and ethical in the use of devices, information systems, data management, and technology-mediated interaction.
This issue of JBI Evidence Synthesis presents a scoping review by Kleib and colleagues2 examining and mapping nursing informatics (NI) competencies literature that included 52 papers. Their comprehensive review of the current literature illustrated myriad, disparate competencies across the globe. They recommended further research to build consensus on core domains of NI competency. Their review is both timely and essential to the NI community because a synthesis of NI competencies was last conducted in 2012.3
Role-based competencies
Role-based competencies are needed for various roles. However, rudimentary computer skills, such as creating electronic documents or using email, are universal and not specific to health care. Initially, these basic skills were included among competencies because the technology was new; however, they should no longer be considered informatics, nor nursing-specific. We contend that they should be removed from informatics and nursing competencies in general.
Additionally, there are clinical care computer and informatics competencies that are not specific to nursing. Clinicians providing direct patient care have many shared competencies such as documentation, information, and knowledge management. This requires competence and ethical use of devices, information systems, data management, and technology-mediated interactions.4 Other professionals essential to the delivery of health services, such as data scientists, chief information officers, or executives, also have significant overlap in informatics competencies.
The challenge with role-based competencies is the resulting plethora of competencies, many of which overlap with other health professions. The informatics specialist role is not specific to nursing; rather, roles such as analyst, usability tester, security, or data manager should have competencies developed at a high level for the specific role. Competencies should be general and then applied based on role. For example, within an electronic health record, varying terminologies are used; nursing terminologists should understand nursing terminologies and their use by the nursing profession.
Current state of the industry
Lists of competencies are used throughout education and certification processes to measure and evaluate skills and knowledge. Recognizing and accommodating skills and knowledge specific to unique disciplines created an overabundance of competencies. The lack of a single trusted source of accepted interdisciplinary or nursing-specific competencies is apparent, and many different organizations have NI competencies according to this review.2 Yet, other pertinent, non-nursing competencies are available. Efforts such as the American Medical Informatics Association Board white paper5 acknowledge the interdisciplinary nature of informatics competencies and support the core scientific discipline of informatics; this approach could prevent formation of competing and confusing silos. What remains is for each discipline to concentrate on specific competencies surrounding the data, information, knowledge, and wisdom6 for their domain.
Recommendations for the future
Organized, recognized competencies are urgently needed as more countries move into the health care technological age. Providers must be competent in skills required to form the data, information, and knowledge needed to influence evidence-based practice.
Kleib and colleagues2 discouraged more lists, but an explicit direction forward is imperative. Goncalves and colleague's3 literature review recommended performing studies to link theoretical concepts with practical, real environments. An empirical study (as opposed to consensus-based) should be performed to consolidate and determine needed competencies. Once complete, competencies should be organized into an overarching multidisciplinary framework7 for core competencies and then organized by relevancy, such as health care worker type (nurse), role, level of expertise, or setting. The framework should include common domains such as basic information technology literacy; health information management; digital communication; ethical, legal, or regulatory requirements; and data privacy and security. The level of competencies within the framework should start with some level of abstraction applied across new technologies and then be discrete and measurable. Competencies must also stand the test of time, as specific technology-based competencies risk rapid outdating.
There needs to be one source for determination of informatics competencies, across health care but who should it be? We don't have the answer. The goal for all informaticists is to practice wisely. This requires a confirmed, competent ability to retrieve data, as well as store, search, and retrieve quality information in order to obtain and use the knowledge required to perform research and practice optimal evidence-based care.
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