Table 1 Comparison between the European Qualification Frame, QL based on Darmann-Finck. (2021), and qualification groups of the German Social Code

Level 1:

▪ Basic general knowledge,

▪ Basic skills required to carry out simple tasks,

▪ Work or study under direct supervision in a structured context

QL 1:

Employees without training, after four months of supervised work

unqualified nurses

Level 2:

▪ Basic factual knowledge of a field of work or study,

▪ Basic cognitive and practical skills required to use relevant information in order to carry out tasks and to solve routine problems using simple rules and tools,

▪ Work or study under supervision with some autonomy

▪ QL 2 (care): 2–6-month introductory nursing course (at least 150 h)^b and a total of at least one year of supervised work

▪ QL 2 (supervision and support): Caregivers with 160 h lessons and three weeks internship

Level3:

▪ Knowledge of facts, principles, processes, and general concepts in a field of work or study,

▪ A range of cognitive and practical skills required to accomplish tasks and solve problems by selecting and applying basic methods, tools, materials, and information,

Take responsibility for the completion of tasks in work or study; adapt own behavior to circumstances in solving problems

QL 3:

Nursing assistants with one or two years of training (according to state-specific training regulations)

semi-qualified nurses

Level 4:

▪ Factual and theoretical knowledge in broad contexts within a field of work or study,

▪ A range of cognitive and practical skills required to generate solutions to specific problems in a field of work or study,

▪ Exercise self-management within the guidelines of work or study contexts that are usually predictable but are subject to change; supervise the routine work of others, taking some responsibility for the evaluation and improvement of work or study activities

QL 4:

Nursing staff with at least three years of full-time vocational training

qualified nurses

Level 5:

▪ Comprehensive, specialized, factual, and theoretical knowledge within a field of work or study and an awareness of the boundaries of that knowledge

▪ A comprehensive range of cognitive and practical skills required to develop creative solutions to abstract problems

▪ Exercise management and supervision in contexts of work or study activities where there is unpredictable change; review and develop the performance of self and others

▪ QL 5 (specialist): Nursing staff with at least 160 hours^b of theoretical training (e.g., palliative care, geriatric psychiatry, wound management) following the state-specific training regulations and two years of work experience

▪ QL 5 (management): Nursing specialist with further training for management tasks (at least 460 h of theoretical instruction)

Level 6:

▪ Advanced knowledge of a field of work or study involving a critical understanding of theories and principles

▪ Advanced skills, demonstrating mastery and innovation, required to solve complex and unpredictable problems in a specialized field of work or study

▪ Manage complex technical or professional activities or projects, taking responsibility for decision-making in unpredictable work or study contexts; take responsibility for managing the professional development of individuals and groups

QL 6:

Nursing specialist with a Bachelor's degree (primary qualifying degree, management studies, or similar)