This section explains how the knowledge, skills and abilities that meet the performance standards of Canadian nursing practice are tested using the competence assessment.
Assessment Methods used during the Competence Assessment
The competence assessment consists of written examinations containing multiple choice and short answer questions, oral examinations (clinical judgement and triple jump assessments) and modified objective structured clinical examinations (OSCEs). OSCEs are conducted in a lab setting where the nurse demonstrates his or her abilities to care for a patient. The nurse also needs to complete a self-assessment tool.
The majority of the 34 competencies are tested using three or more assessment techniques.
The written examinations include multiple choice and short answer questions that test the general and focused (specialty) nursing knowledge required of professional nurses in Canada. These are paper-based examinations. The candidate is supplied with all necessary materials to complete the examinations (e.g., calculator, pencils, scrap paper).
Clinical Judgment Assessment
The Clinical Judgment Assessment is an interview style assessment that evaluates the nurse’s ability to make sound clinical judgments in complex situations that have no "simple" answers. It tests the nurse’s ability to purposefully and critically through a clinical nursing situation; apply essential and relevant knowledge; consider options; and make reasoned, reflective and insightful decisions about nursing actions. Each clinical judgment consists of a brief case scenario, followed by several questions which are answered verbally.
Triple Jump Assessment
The Triple Jump assessment is another oral examination that further tests the nurse’s problem solving and critical thinking skills. In the interview, the candidate is presented with a brief client situation and asked to: generate a problem list/hypotheses about the client’s situation, identify and collect relevant data about the client/family, revise his/her problem list based on the data collected, develop an intervention/management plan, and self-evaluate his/her performance.
This process tests the nurse’s knowledge, problem-solving, critical thinking, organizational, client assessment and self-evaluation skills, as well as self-directed learning abilities. The website listed below may help to prepare for this portion of the competence assessment. The structure of this preparation example is not exactly the same as the actual Triple Jump assessments that are conducted during the competence assessment. Please note that in the actual triple jump assessment, the candidate will not be provided with resources or research time to look up the answers. However, this example may assist in the nurse’s preparation studies.
Modified Objective Structured Clinical Examination (OSCE)
The OSCE is conducted in a simulated clinical setting, where the candidate role plays the nurse in response to client/family health situations and demonstrates the ability to apply the nursing knowledge while holistically caring for a client/family. The client will be a person playing the client role. The OSCE is used to test the following knowledge and skills: nurse-client communication and relationships, critical thinking and clinical judgment skills, health assessment and nursing skills, ethical decision making skills, pharmacology and pathophysiology, planning and intervening based on health status, and rapidly changing client situations.
All equipment and supplies for the OSCE is provided for the candidate. It is recommended that the clothing worn be comfortable and appropriate for bedside nursing practice. Although it is not necessary, some candidates do prefer to wear a nursing uniform to the OSCE.
Self-assessment: Entry-Level Competencies of the Registered Nurse
The nurse must complete a self-assessment by using the Self Assessment Tool to analyze the nurse’s past nursing practice in comparison to the role of the nurse in Canada. This analysis of the nurse’s own practice is used to assess the nurse’s insight regarding the nurse’s areas of strength and areas requiring growth. This tool is completed and passed in before the start of the other parts of the competence assessment.
Time to Complete Competence Assessment
The candidate will be given a set amount of time to complete each part of the competence assessment, as well as ample time for meals and breaks. Candidates must take at least thirty minutes for a meal break mid-day for each day of the competence assessment. If a candidate completes a portion of the assessment early, he or she may be able to begin another part of the competence assessment. At times the schedule for the competence assessment may need to be changed. No extra time will be given to candidates. If candidates are late, this time will be taken off the time allotted for the competence assessment.