The newly released Essentials identify expected competencies of graduates of prelicensure and advanced practice programs.1 Students develop these competencies as they progress through their nursing program: few competencies are mastered with 1 learning activity. Most need to be practiced over time to build expertise and self-confidence and to gain the ability to apply them with varying patient populations and in different clinical situations. Although definitions vary, in general, competencies refer to observable abilities of the student or health care provider. Competencies usually require the integration of knowledge, skills, and values, but some competencies do not include all of the domains of learning. What is important is that competencies are observable, and their performance can be assessed.

Assessment is collecting information about what students know and can do.2 Think about the purpose of assessment as assessment for learning, not evaluation of learning that determines whether the objectives or outcomes were met. Assessment for learning emphasizes formative evaluation and providing feedback to students to guide further learning and improve performance. It includes student self-assessment and students knowing when to seek help.3 At some point in a course and in the program, the purpose of assessment shifts to determine whether competencies were achieved and to make decisions about readiness for practice. This is a different goal for assessment because, in this case, the teacher is ensuring achievement of competencies. Here are a few principles and insights that might be helpful as you plan your assessment of competencies.

Be clear about the competencies to be assessed. What knowledge is essential? Are there related skills to be performed and values and attitudes to be demonstrated during performance? The assessment methods, for example, a case analysis, a short paper, interviewing a patient, an objective structured clinical examination (OSCE), an e-portfolio, a test, and others, are selected or developed purposely to provide information to determine whether students are progressing toward achieving the competencies or can perform them. The ability to systematically obtain a complete and accurate history requires knowledge about the patient's condition and data to collect, which can be measured with test items or a quiz. However, other aspects of that competency require applying this knowledge in different clinical situations, interviewing skills, communicating effectively with the patient during the history, and demonstrating caring and respect, among others. Observing performance in a simulation, an OSCE, or clinical practice could be used for assessing this competency and also may be effective in evaluating students' communication and teamwork, clinical judgment, and procedural skills, among others. Assessment methods typically provide data for multiple competencies.

Think about a program of assessment rather than how you will evaluate students in your course, clinical practicum, or simulation. Assessment planned across the curriculum ensures that competencies are evaluated over time as students progress in their development and that your assessment is capturing improved depth of learning and proficiency. Observation (with a rating form) might be used to assess students' ability to perform a health history in a skills laboratory in a beginning course. Later in the curriculum, assessment of this skill might be integrated in a complex simulation where the patient's condition is not readily apparent, and students need to recognize cues and relevant history to guide their collection of data. By mapping your assessment across the curriculum, you also can identify competencies that are not being adequately assessed.

Using multiple assessment methods broadens the data collected for making judgments about students' performance and compensates for any limitations in an individual method. With multiple strategies, you also can collect both quantitative and qualitative data in combination.

When assessing end-of-course or end-of-program competencies and readiness to progress (high-stakes decisions), tools for rating performance need to be appropriate for the competencies being assessed, valid, and reliable; evaluators need to be trained; and best practice is to use more than 1 evaluator (who does not know the student whose performance is being rated), among other guidelines. We may need to better prepare faculty and tighten our processes in some schools to ensure more reliable assessments. We need some new performance-based assessments, which are mapped to specific competencies. Nurse educators are up to the challenge.

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