The assessment of nursing competence has become an inseparable part of nursing education over the last two decades. It comprises the assessment of the theoretical and practical competence, each worth 50% of the overall assessment. The two assessments must be passed if the candidate wants to register as a nurse. Clinical competence and theoretical competence are also assessed in the post-registration period. Competence, however, does not have a single definition in relation to the nursing profession. On its simplest level, the definition is as follows: competence is “a quality possessed by someone without specifying all that they can do in a given set of circumstances” (Watson et al., 2002). This section of the paper explains at which point and how an instructor assesses and diagnoses that the BSN students’ performance is below the adequate level of competence with reference to the profession of nursing.
Having reviewed a number of academic sources, it has turned out that the assessment and diagnostics of nursing students’ competencies is to be carried out before the BSN students are assigned to clinical practice settings as well as before advancing them further in educational programs (Luttrell et al., 1999; del Bueno, 1990). This recommendation is empirically-based and it is based on the belief that in order to proceed further (i.e. to take part in clinical practice), BSN students should demonstrate their knowledge, which is a part of overall nursing competence.
The assessment of nursing students’ knowledge can be done through assigning knowledge-based tests. Besides, BSN students’ undergraduate performance in non-practical setting, when the grades are lower than C, displays lack of theoretical knowledge and may be a predictor of students’ further practical performance below the level of competence. In any case, it is recommended that the student is observed during a significant period of time because short observations might “not be representative of the competence of the student, particularly as demonstration of competence may be impeded by a range of extraneous influences such as stage fright, local circumstances and resource deficiencies” (Watson et al., 2002). The next assessment of competence is on the practice level, when the BSN student’s practical nursing skills application is assessed through observation by a mentor/preceptor and an instructor.
Assessment of BSN students’ competence is thought problematic because there is a lack of rigor in tools and methods used during assessment (Watson et al., 2002). Two methods are generally used to assess nursing students’ competence. CPAs or Competency Performance Assessments are utilized to assess every class assignment that has a consequence for the student’s course grade, including papers, presentations, projects, and participation. CPEs or Competency Performance Evaluations are utilized in clinical situations to evaluate students’ clinical outcomes. The criteria for students’ assessment are based on course learning goals and rooted in the national occupational standards including requirements for competent nursing clinical practice established by the American Nurses Association as well as the American Association of Critical Care Nurses’ Standards for Nursing Care of the Critically Ill alongside their Education Standards for Critical Care Nursing (Redman et al., 1999).
In summary, assessment and diagnosis of nursing students competence is recommended to be done prior to the beginning of their clinical practice. It is based on long-term observation of students’ academic performance. On the practice level, the CPEs should be used during the period of the student’s practice. The teachers’ tools of assessment range from grade and performance analysis to knowledge-based tests to practical skills oriented evaluation tools. Assessment of a BSN student competence level is an inseparable part of nursing education and formation of qualified nursing workforce.