Substantially Equivalent Competency (SEC) Assessment

Clinical judgment scenarios are short, three minute, specific, written scenarios that a candidate reads and verbally responds to in the presence of an assessor.

The scenarios contain client data and/or information as well as instructions to guide the candidate’s response. Accordingly, the scenarios are administered in a one-on-one undisturbed situation between the assessor and the candidate.

No written work is required from the candidate, although they may take notes if they desire; the response time frame is not changed.     

Clinical judgment scenarios assess the candidate’s ability to think deliberately and critically through a nursing situation in a timely manner. There is an opportunity to apply essential and relevant knowledge, consider possibilities and options and make reasoned, reflective and insightful decisions and actions in a variety of situations. A rationale for responses should be given and considered.

For each scenario, a candidate is assessed on the correctness of the responses according to the criteria outlined in the scenario, as well as their ability to communicate relevant nursing knowledge and demonstrate critical thinking using the nursing process tools; e.g. assessments, interventions, goals, collaborative practice and evaluation.

The assessor records the verbal responses of the candidate using the detailed performance criteria provided for each clinical judgment scenario. These criteria are based on objective criteria and include the most common responses. A ‘1’ in parentheses beside the criteria indicates correct responses, and a ‘0’ in parentheses indicates incorrect responses. It is anticipated that the assessor document any additional candidate responses – right and wrong. 

Following each clinical scenario, the assessor rates the candidate’s overall performance based on the following rating scale labels and definitions. 

Unsatisfactory	No answer, wrong answer, or poor answer and/or explanation.
Marginal	Partially correct answer and/or explanation.
Competent	Applies relevant knowledge and demonstrates basic critical thinking.
Highly competent	Applies relevant knowledge and makes reasoned, reflective and insightful decisions.

 

It generally takes 30-45 minutes to administer the 12 clinical judgment scenarios assessment in each nursing specialty.

The Triple Jump is a one-on-one interaction between the candidate and the assessor. The candidate is presented with a case study. The candidate can assess, plan, implement and evaluate nursing practice related to the case situation. The process is individualized as the direction of the Triple Jump is based on the candidate’s initial assessment of the situation.

The assessor follows the instructions on the tool itself, recording the candidate’s responses and ideas right on the tool. The candidate is asked to keep notes for reference. Information is provided to the candidate when he/she asks for information. The candidate may ask for information in a variety of ways at different steps. The candidate may also ask a number of questions that are not provided in the data. Please make note of these and either make up information as you see fit or simply state that the information is not available. We are assessing the process and relevancy, not the specific details. What the candidate does with the data is as important as the data itself in the triple jump.

Throughout the assessment, there are several rating scales like the table below. The assessor circles the rating for each scale as you go through. The rating scales and notes from the assessor will be used to interpret the candidate’s ability to assess, plan, implement and evaluate nursing care. Keep notes on other things as they arise.

Unsatifactory	Inconsistently performed, and/or performance does not meet the standard, compromised client/nurse care and/or safety; improvement is needed
Marginal	Occasionally performance is to standard, and/or performance meets minimum standards and is safe; improvement is recommended
Competent	Often performance is to standard and is safe. Minimal improvement needed, if any.
Highly competent	Consistently meets and/or exceeds standards and is safe.

1. Provide the candidate with paper and pen so the candidate can take notes.
2. Write down the candidate’s problem list and interventions on the tool.
3. Answer only specific questions, not general ones.
4. Get any paper the candidate has written on back from him/her.

The assessor will provide you with paper and pen so you can make notes as you go through the Triple Jump task. The whole process takes about 45 minutes.

1. The assessor will read you a short scenario, following which you will identify problems or concerns related to the client that you will want to later address. 
2. Once you have identified your problem list, you will move on to the health history and physical assessment. The assessor will be holding the chart, and you will ask questions to gather more information about the client. Your questions must be specific to gain the information.
3. Once you have gathered as much information from the health history and physical assessment, you will identify new problems from the client. 
4. In the next section, you will identify the plan of care or interventions for the client. 
5. Next, you will identify resources to carry out the interventions or plan of care that had been identified in the previous section.
6. In dealing with your clients, you will have to identify communication strategies or approach to facilitate active involvement of the client. 
7. In the last section, you are tasked to evaluate the care you provided. You can modify or change the care as you see fit. 

A general SEC assessment Triple Jump exercise may include common health challenges in Canada e.g., diabetes mellitus, cardiovascular accident (stroke), COPD, CHF, community acquired pneumonia, hypertension, cancer, Alzheimer’s disease, arthritis, anxiety or mood disorders.