Article Perceived Managerial Competence of First-Line Nurse Managers: A Comparative Analysis Among Public Hospitals Joko Gunawan, BNS, PhD 1 , Yupin Aungsuroch, PhD, RN 1 , Mary L. Fisher, PhD, RN 2,4 , Anna M. McDaniel, PhD, RN, FAAN 2 , and Colleen Marzilli, PhD, DNP, MBA, RN-BC, CCM, PHNA-BC, CNE, NEA-BC 3 Abstract Knowing the perceptions of first-line nurse managers (FLNMs) regarding their managerial competence is an important step to resolve disparities between their perceived competence and the competencies required for them to effectively function in their roles. Yet, evidence examining managerial competence of FLNMs among public hospitals in Indonesia is sparse. To fill this gap, we conducted a cross-sectional study aimed to identify managerial competence of FLNMs according to hospital type and ownership. This study was conducted from January to May 2018 and included a convenience sample of 233 FLNMs selected from 13 public hospitals. We used the Indonesian-First-Line Nurse Managers Managerial Competence Scale (I-FLNMMCS) to measure managerial competence. Descriptive statistics, Kruskal–Wallis, and Dunn’s Pairwise were used for data analysis. Findings showed a significant difference in managerial competence according to the hospital type (p < .05). The FLNMs with a Diploma III, those relatively older, in their position for 7 or more years, and with managerial training in Type A hospitals (larger hospitals) had the highest managerial competence. The FLNMs with a bachelor’s degree, those relatively younger, with less training, and those in their position for 3 to 4 years in Type B and C hospitals (smaller hospitals) had less managerial competence. A significant difference was also found in managerial competence according to hospital ownership (p <.05). Public hospitals owned by the Ministry of Health of Indonesia had the highest competence among the others. This study is useful for guiding future policy work for human resource development in public hospitals. Keywords nurse administrators, leadership, Indonesia, cross-sectional study, ownership, public hospitals First-line nurse managers (FLNMs) roles have become highly complex and challenging due to the nonlinear, dynamic, and unpredictable nature of the health care system today (Baxter & Warshawsky, 2014; Lipsitz, 2012). A decentralization process has transformed their roles from direct nursing care to 24-hour accountability for staffing, budgeting, and human resource management in the unit (Baxter & Warshawsky, 2014; Skytt et al., 2007). Unlike the top or middle line managers, the FLNMs are key stakeholders that provide leadership with direct contact to first-line employees and responsible for overseeing first-level nursing practice. Thus, the FLNMs certainly require managerial competence as a critical component in an organization, especially in a hospital. Managerial competence is defined in two approaches within the literature. Based on the UK approach, managerial competence is described as the ability to per- form activities within an occupation (Fletcher, 1997), while the US approach defines managerial competence as the behavioral and underlying characteristics of an individual to perform in a superior way (McClelland & Boyatzis, 1982; Spencer & Spencer, 2008). In Indonesia, managerial competence refers to FLNMs’ behavior that 1 Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand 2 College of Nursing, University of Florida 3 School of Nursing, The University of Texas at Tyler 4 Indiana University School of Nursing, Indianapolis, USA Corresponding Authors: Yupin Aungsuroch and Joko Gunawan, Faculty of Nursing, Chulalongkorn University, Borommaratchachonnani Srisataphat, Building, Rama 1 Road, Pathumwan, Bangkok 10330, Thailand. Email: yaungsuroch@gmail.com and jokogunawan2015@gmail.com Policy, Politics, & Nursing Practice 0(0) 1–13 ! The Author(s) 2020 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/1527154420926616 journals.sagepub.com/home/ppn