Purpose
This study aimed to clarify the concept of nursing competence in coping with clinical deterioration by employing Rodgers’ evolutionary concept analysis, which reflects both sociocultural and temporal dimensions. Methods: A six-step concept analysis was conducted following Rodgers’ methodology. A systematic literature review was performed using PubMed, Embase, CINAHL, and Google Scholar, yielding 35 relevant studies published between 2000 and 2025. Data extraction followed the Joanna Briggs Institute template, and quality was appraised using the STROBE checklist. Results: Four key attributes of nursing competence were identified: technical skills in patient monitoring, situational awareness and clinical intuition, decision-making regarding escalation of care, and communication and teamwork to ensure timely intervention. Antecedents included formal education, clinical experience, and institutional support. Consequences encompassed enhanced patient safety, increased nurse confidence, and greater professional autonomy. The concept was demonstrated to be dynamic and influenced by healthcare policies, such as the implementation of rapid response systems. Conclusion: Nursing competence in managing clinical deterioration is a multidimensional and evolving concept that is essential for patient safety. Clarification of this concept can inform the development of assessment tools and simulation-based education. Further research should explore its application across diverse healthcare contexts and address challenges related to escalation of care.

Purpose
This scoping review aimed to comprehensively examine environmental and individual factors contributing to clinical practice stress among nursing students in South Korea and to provide evidence-based recommendations for improving the clinical education environment. Methods: A scoping review was conducted following Arksey and O’Malley’s five-stage framework and the PRISMA-ScR guidelines. Relevant studies published between January 2016 and March 2025 were identified through searches of domestic databases (KCI, RISS) and international databases (PubMed, CINAHL) using predefined keywords. A total of 18 studies met the inclusion criteria. Data were extracted using a standardized template and categorized by study characteristics, methodological features, and stress-related variables. Results: Most included studies were conducted after 2022 and involved students from multiple institutions. Environmental stressors identified included poor clinical setting quality, lack of instructor support, interpersonal challenges, limited educational infrastructure, and disruptions caused by new infectious diseases. At the individual-level, resilience, coping strategies, and emotional regulation were the most frequently studied variables. Among these, resilience was consistently reported as a protective factor against stress, while incivility emerged as the most prominent environmental stressor. Multiple regression models indicated that stress-related factors explained between 18.0% and 75.6% of the variance in outcomes. Conclusion: Clinical practice stress in nursing students results from a dynamic interaction between environmental and individual factors. Nursing education programs should incorporate resilience-enhancing interventions, strengthen collaboration with clinical sites, and adopt flexible educational methods, such as simulation-based training, particularly during periods of restricted clinical access.