Perceived competences by graduated nurses before and during COVID-19 restrictions: A repeated cross-sectional study from 2019 to 2022.

Aims: To explore the differences, if any, in the competences perceived by newly graduated nurses who attended their education before and during the COrona VIrus Disease 19 (COVID-19) restrictions. Background: Nursing education has undergone significant changes because of the COVID-19 restrictions. However, to date the perceived competences at the point of graduation have not been investigated over the restrictions years compared with the pre-restrictions era. Design: A repeated cross-sectional study followed by a pseudo-panel analysis. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used. Data on individual, nursing programme and perceived competences with Nurse Competence Scale (NCS) were collected and analysed by also using a pseudo-panel approach. Methods: Two universities were involved. Those eligible were nursing students who graduated: (1) in 2020 (=323) as the first post-COVID-19 group, who were studying in the 3rd year at the onset of the restrictions; (2) in 2021 (=250) as the second post-COVID-19 graduated group, who were in the 2nd year at the restrictions onset; and (3) in 2022 (=247) as the third post-COVID-19 group, attending the 1st year of nursing education at the onset of the restrictions. Data were compared with those who graduated in 2019 (=336, pre-COVID-19 group). Results: The overall NCS score was higher in the pre-COVID-19 group (68 out of 100, 95 % Confidence of Interval [IC] 66.4–69.5), lower in the first post-COVID-19 graduates (62.9, 95 % CI 60–65.8), higher in the second (66.6, 95 % CI 63.6–69.4) and lower again in the third post-COVID-19 group (63.8, 95 % CI 60.9–66.5). A sinusoidal pattern also emerged for the frequency of use of the competences from the pre-COVID-19 (2.3 out of 3) and the first group (2.1) and increased between the second and the third group (from 2.1 to 2.3) (p< 0.001). These sinusoidal trends are also evident in the pseudo-panel analysis. Conclusions: A different degree of perceived competences at the point of graduation emerged, with higher competences in the pre-restrictions group, lower in the first post-COVID-19 generation, higher again in the second and third group. However, all scores were over 60 points out of 100, thus indicating sufficient competences. The frequency of use of such competences slightly changed over the years with limited practical