Objectives: To reveal nursing competence acquired by nursing students via role-playing (RP) exercises and define the learning points necessary for acquiring practical nursing skills.

Methods: Qualitative content analysis was performed using debriefing sheets (DSs) for adult nursing RP. There were 109 participants.

Results: The DSs of 69 individuals who met the selection criteria were used as base data, and 1179 data items were extracted. The results showed that the structure included 3 main themes, 8 subthemes, 31 categories, and 121 subcategories.

Conclusion: The results indicated that participants noticed the underlying elements that make up practical nursing skills, analyzed them using advance organizers based on previously learned knowledge, and applied the acquired practical nursing skills to newly proposed strategies for continuous self-management for adult patients with chronic disease and their families. One aspect of nursing competence, "ability to improve nursing quality," could not be extracted; the elucidation of this acquisition process is a task for future research.