What is a Substantially Equivalent Competency (SEC) assessment
Under the Health Professionals Act (HPA) legislation in Alberta, the College and Association of Registered Nurses of Alberta (CARNA) may require Internationally Educated Nurses (IENs) to have a Substantially Equivalent Competency (SEC) assessment completed. SEC assessment is a means of maintaining the standards of practice between IENs and Canadian educated nurses through the professional regulator (CARNA).
An SEC Assessment is an evaluation that uses a variety of strategies to assess the IEN's professional knowledge, skills, attributes, values, and judgment. The different strategies (described below) draw out whether the IEN currently possesses the CARNA Entry to Practice competencies www.nurses.ab.ca (click on Competency Profile for Registered Nurses on the CARNA site) to fulfill the roles and responsibilities of the expected RN scope of practice in the Canadian health care system. The SEC Assessment will also identify where competency strengths, gaps or areas requiring growth exist. The SEC assessment is used to determine if IENs are prepared to provide safe, ethical and competent nursing care according to Canadian RN scope of practice expectations. The assessment includes the complexities of nursing practice (holistic care) and Primary Health Care principles and approaches. The SEC assessment provides IENs the opportunity to demonstrate their capacity for Canadian RN scope of practice in a way that complements the evidence provided in the paper documentation provided to CARNA.
An IEN may be referred by CARNA for an assessment in any (or all) of the following areas:
- General Nursing
- Maternal Newborn Health Nursing
- Child Health Nursing
- Mental Health Nursing
A "Complete" SEC assessment takes 4.5 days and comprehensively assesses knowledge and practice in general medical-surgical-community health, maternal-newborn health, child health, and mental health nursing. A "General" SEC assessment takes 2 days and assesses knowledge and practice in a variety of settings (medical-surgical-community health, as well as some focused (specialty) health. A "Focus" SEC assessment takes 1-3 days and assesses knowledge specific to Maternal-Newborn Health, Child Health, and/or Mental Health.
To have a SEC assessment completed, you must first:
- have an e-mailed referral or letter referral from CARNA indicating the need for an assessment and which type of SEC assessment(s).
- have met CARNA approved English language requirements
- review the IEN Assessment Centre Candidate Consent for Disclosure of Personal Information to consent to share your identifiable SEC assessment results with CARNA and consent to non-identifiable SEC assessment results to be used for research and statistical purposes. This consent is to be reviewed in advance, and then signed by you at the IEN Assessment Centre where your signature will be witnessed by the Centre front office staff prior to starting your SEC assessment.
- review the IEN Assessment Centre Candidate Confidentiality Agreement to consent to confidentiality of the SEC assessment content. This agreement is to be reviewed in advance, and then signed by you at the IEN Assessment Centre where your signature will be witnessed by the Centre front office staff prior to starting your SEC assessment.
- review the IEN Assessment Centre Candidate Consent for Audio and/or Visual Recording to agree to possible audio and/or visual recording of all or parts of the SEC assessment components. This consent form is also to be reviewed in advance, and then signed by you at the IEN Assessment Centre where your signature will be witnessed by the Centre front office staff.
The SEC assessment uses the following five strategies developed at Mount Royal University to evaluate the entry-to-practice competencies of registered nurses:
- Written Multiple Choice and Short Answer Exams
- Clinical Judgment Assessment
- A modified Triple Jump Assessment
- A modified Objective Structured Clinical Examination (OSCE)
- IEN Candidate Self-Assessment
The written exams include both paper and pencil multiple choice and short answer questions that will test the general and focused (specialty) nursing theoretical knowledge required of professional nurses in Canada.
- The General multiple choice and short answer exam is seven (7) hours with a break between the two halves.
- Each focused (specialty) exam is three and a half (3.5) hours.
Clinical Judgment Assessment
The Clinical Judgment Assessment is an interview style assessment that evaluates your ability to make sound clinical judgments in situations that are complex and have no "simple" answers. These clinical judgment situations will assess the ability of the candidate to think deliberately and critically through a nursing situation, apply essential and relevant knowledge, consider possibilities and options and take reasoned, reflective and insightful decisions and actions.
The following resource may help you to prepare for this portion of the SEC assessment. Please note that the clinical judgment structure in the example scenarios on this website are not necessarily exactly like the clinical judgment scenarios during the SEC assessment as they vary from one to the next. These are examples only of clinical judgment types of interviews.
Modified Triple Jump Assessment
Problem solving and critical thinking skills are tested using an assessment interview called the Triple Jump. In a triple jump assessment, there are 3 themes: identify client issues/problems, select relevant interventions, and provide evaluation strategies. In the interview, candidates will be 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
- develop an intervention/management plan
The process will assess knowledge, problem-solving, critical thinking, organizational, client assessment and self-evaluation skills, as well as self-directed learning abilities.
This website includes an on-line introduction to a Triple Jump Self Assessment interview that may help you prepare for this portion of the SEC assessment. This resource provides the opportunity to test yourself on selected portions of the assessment in preparation for a "modified" version of a Triple Jump assessment that will be conducted during your SEC assessment. The structure of this preparation example is not exactly the same as the actual modified Triple Jump assessments that are conducted during SEC assessments. However, this example may assist you in your preparation studies. Please note that in the actual modified triple jump SEC assessment component, you will not be provided with resources or research time to look up the answers.
Modified Objective Structured Clinical Examination (OSCE)
This one to three day assessment is conducted in a lab setting, where a candidate will role play the nurse in response to client/family health situations and demonstrate his or her abilities to apply knowledge by holistically caring for this client/family. The client may be a simulation mannequin or a person playing the client role. The OSCE is used to assess the following knowledge and skills:
- nurse-client interactions and relationships
- critical thinking and clinical judgment skills
- health assessment frameworks and nursing skills
- ethical decision making skills
- pharmacology and pathophysiology
- rapidly changing patient situations
- delivery of nursing interventions and evaluation.
Self-assessment of CARNA’s Nursing Practice Standards
Candidates will have the opportunity to provide a self-assessment by using the CARNA Nursing Practice Standards to analyze their past nursing practice and offer specific individualized examples from his/her country(ies) of origin/practice. This analysis of one's own practice will help the assessor to assess the candidate's insight regarding their areas of strength and areas requiring growth.
CARNA's Nursing Practice Standards can be found at www.nurses.ab.ca
The Assessor, the Analysis, and the Report
During the SEC assessment, the assessor observes for required key performance indicators of knowledge, skills, values, and attributes expected in the Entry-to-Practice competencies. The assessor observes for accuracy, completeness, quality, frequency, depth, independence, and consistency in performance. The assessor looks for patterns in IEN performance, looks at the "whole picture", not isolated elements.
At no time during the SEC assessment is the assessor able to discuss or give the IEN feedback on his/her performance. All decisions and feedback to the IEN is given by the regulator (CARNA) following receipt of the SEC assessment report.
After the assessment is complete, the assessor uses all the assessment tool criteria and descriptors to analyze the IEN's performance according to the competency expectations. Assessors make determinations on each of the Entry-to-Practice competencies as to whether the IEN "met", "high partially met", "low partially met", or "did not meet" the competency based on performance on all the tools. The analysis is then written into a rich summary report that offers the substantiating evidence for the determinations, including examples of patterns of performance that support the determinations.
SEC Assessment Results
The SEC assessment report is then sent to the regulator (CARNA) to assist with their decision making on how to proceed with the application for registration. You can expect to hear from CARNA in 3-5 weeks after your assessment. The regulator reviews the report as part of the IEN's application, along with the documentation provided by the IEN to determine if the IEN is:
- eligible for a temporary practice permit, and to write the Canadian Registered Nurse Examination (CRNE)
- suitable for bridging courses for registered nursing in Canada
- in need of further assessment of the IEN (if a Complete SEC assessment was not performed)
- ineligible for licensure at this time, due to the extent of the areas requiring growth in nursing knowledge and/or practice.
What You Can Do to Prepare for Your SEC Assessment:
- Become familiar with the assessment strategies information on this website so that you know what to expect in a similar SEC assessment.Work through the sample Clinical Judgment Scenarios and Triple Jump scenario links on this website for study purposes (remembering that the actual Modified Triple Jump assessment will not involve references or leaving the room).
- Refer to CARNA www.nurses.ab.ca (under Resources) to review the “CARNA Entry to Practice Competencies” and “CARNA Nursing Practice Standards” to help yourself understand the scope of RN practice in Canada and to help with your analysis of your own nursing practice.
- Review Primary Health Care (PHC) in relation to the principles and expected nursing approaches.
- Refer to Canadian Nurses Association (CNA) to review the “CNA Code of Ethics document”.
- Review current nursing textbook(s) (published within past 5 years), that cover the knowledge, practices, and procedures of medical-surgical-community nursing practice.
- If you are referred for a focused (specialty) assessment, you would also benefit from reviewing a current textbook in maternal-newborn health, child health, and/or mental health nursing.
- Access a Canadian Registered Nurses Exam (CRNE) preparatory book to review expected knowledge.
- An “optional” OSCE preparation resource is the Nursing Picture Dictionary Tutorial at www.englishforhealth.com to familiarize yourself with Canadian health care equipment and supplies that you could be exposed to in your OSCE assessments.
- If applicable, place yourself into as many English language situations as possible to improve your English speaking, listening, reading, and writing skills.
It may be helpful to recognize that many IENs who have been through the SEC assessment view the process not only as an assessment, but as a "learning tool", a way of exploring the scope of practice expected of an RN working in Canada.