Successful completion of a competence assessment programme enables an individual nurse to demonstrate his or her ability to meet the Nursing Council of New Zealand (“Council”)’s competencies for his or her scope of practice. Overseas nurses may be required to complete a programme before registration in New Zealand. New Zealand nurses returning to practice after a period of five years or more are now required to complete an approved competence assessment programme before a practising certificate may be issued. Competence assessment programmes may be offered by an accredited health care service provider or jointly between an accredited health care service provider and a tertiary provider with a Council-approved programme leading to registration as a nurse.

Competence Assessment Programmes

1. Competence assessment programmes may be provided by a District Health Board (“DHB”) or non-DHB health care service provider alone or may be a collaborative arrangement between a service provider and a tertiary education institution with a nursing department.
2. The Council will be responsible for accrediting competence assessment programmes against the requirements set out in the Standards for competence assessment programme (Appendix 1), the Standards for clinical placement providers (Appendix 2), and the requirements for registration of overseas nurses (see below).
3. The programme outline document should include detail on the following:
   • Content - scope of practice, safety to practise, (including an update of nursing skills and current practice), legislation and guidelines for nursing practice, Treaty of Waitangi and cultural safety, and a period of supervised clinical experience to allow demonstration of the competencies for the registered nurse scope of practice or enrolled nurse scope of practice.
   •  Length - relevant theory and supervised nursing practice must be of sufficient length to enable the nurse to demonstrate the competencies for the registered nurse scope of practice or the enrolled nurse scope of practice.
   • Provision of resources
   • Teaching and learning strategies
   • Evaluation of outcomes
   • Quality management
4. A student may complete a competence assessment at any point in the programme. This should comprise an assessment of knowledge and assessment of clinical practice in simulated and real clinical environments.
5. Overseas registered nurses or enrolled nurses seeking entry to the programme requires written notification from the Council of the requirement to complete a competence assessment programme before registration.
6. Applicants requiring a competence assessment programme and who have English as a second language must:
   1. Meet English language requirements laid down in the Council’s registration policy for overseas nurses prior to entry to the competence assessment programme. Specifically, applicants from a country where English is not the first or native language will need to provide evidence, obtained within the past two years from the date of assessment for registration, of their ability to speak and write in English.
      Approved English language assessments are:
      • academic International English Language Testing System (“IELTS”) with a score of at least 7.0 in reading, listening, writing and speaking respectively
      • occupational English Test (“OET”) with a B band in each section
   2. Demonstrate their ability to communicate effectively for the purpose of practising within their scope of practice.

Accreditation process

Competence assessment programmes are considered in relation to the competence programme standards and existing accreditation/audit status of the applying institution. Evidence of quality processes may be obtained from previous Council audit reports when a tertiary educational institution is the programme provider.

The health care service provider or tertiary provider with a Council-approved programme leading to registration as a nurse notifies the Council of its intention to submit a programme for accreditation with an approximate date.

1. The appropriate checklist and standards are forwarded to the programme provider.
2. The programme provider submits to the Council the necessary documentation and completed accreditation checklist and agreed with payment.
3. Submitted documentation is considered in relation to the standards (Appendix 1) and the existing accreditation/audit status of the applying institution. Quality processes may be obtained from previous Council audit reports when a tertiary educational institution is the programme provider.
4. A desk audit of the programme may be followed by a site visit.
5. A recommendation report is prepared for Council.
6. Council makes decisions and any subsequent requirements.
7. A letter is sent notifying the provider of the Council’s decision.

Audit Process

1. Where the programme is a collaborative arrangement, the competence assessment programme audit is integrated into the Council’s audit cycle for educational institutions with nursing programmes, i.e. similar processes are audited for undergraduate programmes.
2. Where a service provider alone offers a competence assessment programme, the programme should be audited separately as required by the Council.

Competence Assessment Programme Standards

These standards relate to programmes that seek to assess the ability of an overseas nurse seeking registration, or New Zealand nurses who are returning to practice, to demonstrate the competencies for their scope of practice under the Health Practitioners Competence Assurance Act 2003 (“the Act”).

The standards relate to each of the following five areas:

• programme content
• provision of resources
• teaching and learning processes
• evaluation of outcomes
• quality management.

Programme Content

Standard one

Each programme will have a programme outline that includes theory and related practice experience to enable students to demonstrate their ability to meet the Nursing Council Competencies for their scope of practice.

Criteria

1. The content is specific to New Zealand and includes:
   • the Treaty of Waitangi
   • cultural safety
   • legislation impacting the practice of nurses in New Zealand
   • an update of nursing skills and current practice.
2. Appropriate clinical placements enable the student to demonstrate all the competencies for the registered nurse or enrolled nurse scopes of practice.
3. Appropriate placements are:
   • all DHB’s
   • non-DHB placements that have been approved by the Council and meet the standards for non-DHB clinical placement providers. These may include private surgical hospitals, aged care and primary health settings.

Provision of resources

Standard two

The facilities and resources are available to support the achievement of the expected outcomes of the programme.

Criteria

1. Teaching and learning resources are adequate to achieve course outcomes and purposes:
   • nurses have access to relevant library resources (this may be by electronic access)
   • practice suite for simulation learning where appropriate
   • computer facilities are available.
2. Clinical practice experience placements (as per clause 1.3) are assessed as meeting the standards for clinical placements and are negotiated for each student.
3. Lecturers/educators are available to give support to students, as and when required, in the practice setting.
4. The curriculum vitae of the programme co-ordinator or the person who certifies the applicant as being competent for registration is forwarded to the Council.

Teaching and learning processes

Standard three

Student performance is assessed relative to the attainment of expected learning outcomes and nursing practice.

Criteria

1. The assessment process determines whether applicants have achieved the standard of nursing competence for registration.
2. The student is supervised by a registered nurse (“preceptor”) with a minimum of three years of experience who has completed preceptor or assessment training.
3. Students are assessed against the Council’s competencies for their scope of practice by the programme co-ordinator in association with the preceptor at the conclusion of the clinical experience.
4. Criteria used for assessment are made available to students who receive individual feedback and the opportunity for self-assessment.
5. Appeal mechanisms are made explicit to students.

Legislative and Council requirements

Standard four

The programme complies with legislated requirements and Nursing Council policy and guidelines.

Criteria

1. Overseas nursing students have completed the application for registration process with the Council and have received a decision letter outlining the requirements to be met.
2. The student must provide evidence of proficiency in the English language via one of the English Language tests approved by the Council when English is his or her second language.
   • Approved English language assessments are:
     • Academic International English Language Testing System (“IELTS”) with a score of at least 7.0 in reading, listening, writing and speaking respectively
     • Occupational English Test (“OET”) with a B band in each section
3. Students who are not able to demonstrate their ability to meet the competencies following a period of time in practice not exceeding 12 weeks should be referred back to Council.
4. All registered nurses implementing the curriculum and assessing students in competence programmes must be appropriately qualified within the registered nurse scope of practice with preceptor or assessment preparation.
5. At the time of appointment registered nurses lecturing in competence programmes hold registration under the Act and a current practising certificate.

Quality management

Standard five

The programme provider plans and implements continuous quality improvement and demonstrates achievement of the following components of quality management.

Programme evaluation

Criteria

1. Policies, guidelines, and strategies for learning and teaching are developed, implemented and continually reviewed.
2. A supportive environment that is conducive to effective learning and teaching is provided.

Staff Selection, Appraisal, and Development

Criteria

1. There are clearly defined policies in place for staff selection, appraisal and development.

Assessment and moderation

Criteria

1. There are identified systems for providing students with fair and regular feedback on progress.
2. The assessment for the programme includes a final assessment of the student’s ability to meet the competencies for his or her scope of practice.
3. There is a clear link between the assessment procedures and the stated objectives and learning outcomes.

Standards for clinical placement providers

Standard one

• The placement provider commits itself to provide a high-quality clinical experience and appropriate learning opportunities.
• The provider has a best practice/quality assurance statement for student placements including preceptor arrangements and the role of staff and students.
• The provider values and supports a learning environment.
• The provider has a staff development programme (in-service, journal club, study leave provisions).
• The provider offers a range of learning opportunities, i.e. there is an opportunity to assess and provide nursing interventions for a variety of clients and an opportunity to work with professionals from other disciplines.
• Placements are evaluated by students and preceptors at the completion of the placement.
• Placement evaluations are used by the provider to improve the quality of the placement.

Standard two

2. The placement provider has the administrative procedures in place to organise a quality education experience.

• The placement provider specifies a named clinical placement coordinator who is a registered nurse.
• Pre-placement information is available. The student is orientated to the facility on his or her first day.
• There is a student manual available containing information on orientation, assessment processes and complaints procedures.
• Students will have access to resources such as relevant books, journals and equipment.

Standard three

3. The student is allocated an appropriate workload and is able to demonstrate the competencies and management skills required for clinical practice.

• The student participates in the placement on a supernumerary basis.
• The student develops learning goals at the beginning of the placement.
• The registered nurse student has an opportunity to demonstrate all the competencies when managing nursing care for clients with complex needs.
• The enrolled nurse student has an opportunity to demonstrate the competencies when providing nursing care for clients with stable and predictable needs.

Standard four

4. The student is allocated a preceptor with appropriate skills and qualifications.

• The preceptor is a registered nurse with a minimum of 3 years experience.
• The preceptor will have completed a preceptor’s/assessor’s programme.
• The preceptor/programme coordinator is responsible for the assessment of the student.
• The preceptor is supported by the clinical placement coordinator and the programme coordinator.
• The preceptor has recognised clinical skills in the area of practice.
• The preceptor provides one-to-one supervision of the nurse.
• The preceptor provides feedback to the student.

Standard five

5. Assessment is completed using appropriate assessment procedures

• The student, preceptor, and programme coordinator complete a formative assessment at the beginning of the placement and the student then establishes learning goals.
• The student receives timely, balanced, independent, and specific feedback.
• The student is encouraged to assess their own performance and refine learning goals.
• The student is assessed against the Council’s competencies for their scope of practice by the programme co-ordinator in association with the preceptor at the conclusion of the clinical experience.