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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 competencieswww.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, maternalnewborn 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

Written Exams
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.
Clinical Judgment Self Assessment

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 clients situation

identify and collect relevant data about the client/family

revise his/her problem list based on the data

develop an intervention/management plan

self-evaluate

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 CARNAs 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-toPractice 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.

SEC ASSESSMENT
What is a SEC assessment?
CARNA may request you to take a Substantially Equivalent Competency (SEC)
assessment. This is an evaluation designed to determine whether you currently
possess the required Entry to Practice competencies to fulfill the roles and
responsibilities expected of registered nurses in Alberta. It will also identify if any
competency gaps exist, and to what extent. If there are gaps, you will need to
take bridging education. If the gaps are too extensive, you may not be eligible to
practice in Alberta.
The SEC uses a variety of strategies to assess your professional knowledge, skills,
attributes, values and judgements, including:

multiple choice and short answer exams

interview-based case management situations

clinical lab role-play situations

self-assessment

Where are SEC assessments done?


You will need to take your SEC assessment at Kwantlen Polytechnic Universitys
IEN Assessment Centre in Langley, British Columbia. Though there is no fee for
the assessment, travel and accommodation costs will be your responsibility.

How long do SEC assessments take?


There are three types of SEC:
1. General: This takes 2 days and assesses general nursing knowledge and
skills for a variety of settings as well as some focused (specialty) health
areas.
2. Focused: This takes 1 to 1.5 days and assesses knowledge specific to the
required specialty.
3. Complete: This takes 5 days and covers all areas of knowledge and skill.

What am I assessed for?


An applicant may be referred by CARNA for an assessment in any combination of
the following areas:

General nursing

Maternal Newborn Health Nursing focus

Child Health Nursing focus

Mental Health Nursing focus

The different type of SEC assessments evaluate the following areas of nursing
knowledge and practice:

Generalist and/or specialty nursing knowledge and application

Anatomy, physiology and pathophysiology

Pharmacology and medication administration

Health history and health assessment knowledge and skills

Basic and advanced clinical skills, as well as use of current technology in


nursing practice

Clinical judgement, critical thinking, decision making and evidenceinformed practice

Knowledge of the Canadian healthcare system and current nursing


practices

Professional responsibility and accountability

Therapeutic communication practices

Cultural competencies

Ethical decision-making skills

Regulation of the profession

CARNA Nursing Practice Standards and CNA Code of Ethics for Registered
Nurses

Substantially Equivalent Competency (SEC) Assessment


The Saskatchewan Registered Nurses' Association (SRNA) may require
Internationally Educated Nurses (IENs) to complete a Substantially Equivalent
Competency (SEC) assessment. To complete a SEC, you must fill the following
requirements:

meet the SRNA's English language test requirement (pdf)

have a letter from the SRNA indicating the need for an assessment. You may
be required to have an assessment in the areas of:

o General Nursing
o Maternal Newborn Health Nursing
o Child Health Nursing
o Mental Health Nursing

Overview of the SEC Assessment

The SEC is a comprehensive assessment that uses the following four strategies to
evaluate the competencies of registered nurses:

Written Diagnostic Exam

Clinical Judgement Assessment

Triple Jump Assessment

Objective Structured Clinical Examination (OSCE)

Note: The SEC assessment strategies and tools were developed at Mount Royal
University in Calgary, Alberta.

Written Diagnostic Exam


The written diagnostic exam includes both paper and pencil multiple choice and
short answer questions that test general and focused (specialty) nursing 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) diagnostic exam is three and a half (3.5) hours

Clinical Judgement Assessment


The Clinical Judgement Assessment is an interview-style assessment that evaluates
your ability to make sound clinical judgements in situations that are complex and
have no "simple" answers. A clinical judgement situation 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:

Clinical Judgement Self Assessment*

Triple Jump Assessment


Problem solving and critical thinking skills are tested using an assessment interview
called the Triple Jump. 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

self-evaluate

The process will assess knowledge, problem-solving, critical thinking, organizational,


client assessment and self-evaluation skills, as well as self-directed learning abilities.
An online introduction to the Triple Jump Self Assessment* interview 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. It is not exactly
the same as the actual Triple Jump assessment but will still give you an idea of how
the interview will be conducted.

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
OSCE is used to assess the following knowledge and skills:

nurse-client interactions and relationships

critical thinking and clinical judgement skills

health assessment and nursing skills

ethical decision making skills

pharmacology and pathophysiology

rapidly changing patient situations

Self Assessment of the SRNA's Nursing


Practice Standards
SRNA nursing practice standards (pdf) candidates will have the opportunity to
provide a self-assessment of how they have met the professional standards during
nursing practice in their country of origin.

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 actual SEC assessment

work through the sample Clinical Judgment Scenarios and Triple Jump
scenario links on this website

refer to the SRNA to review the "SRNA Standards and Foundation


Competencies"

Refer to the Canadian Nurses Association (CNA) to review the "CNA Code of
Ethics document"

review current nursing textbook(s) (published within past five years), that
cover the knowledge, practices, and procedures of medical/surgical 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, review to familiarize yourself with Canadian health care equipment
and supplies that you could be exposed to in your OSCE assessments

SEC Assessment Results


Following your assessment, the results will be sent to the SRNA and you can expect
to hear from the SRNA in about three to five weeks. Please note that the nurse
consultant/assessors will not be discussing your performance with you during or after
your SEC assessment.
*Special thanks to the School of Nursing, Mount Royal University for the use of
these SEC assessment preparation exercises.

How?
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.
Written Examinations
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
nurses ability to make sound clinical judgments in complex situations that have no "simple"
answers. It tests the nurses 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 nurses
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 clients
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 nurses 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 nurses preparation
studies.
https://wwwacad.mtroyal.ca/healthcomm/ien/triplejump/
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: nurseclient 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 nurses past nursing practice in comparison to the role of the nurse in Canada. This

analysis of the nurses own practice is used to assess the nurses insight regarding the
nurses 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 w