• The holistic approach to assessing competency happens through observation of total role performance

  • The care you deliver must be compassionate, confident and safe

  • Educators, preceptors and head nurses should discuss confirmation of clinical competence and help staff access HMC approved resources to update and maintain their knowledge and practice. 

  • Preceptors and other team members must work at elbow with you preceptees over a period of time in practice.  

  • Through this process, the team assesses preceptee competence using a holistic approach.  

  • Competence can be evidenced through communication, ethics, technical skills, cultural awareness, attitudes, knowledge, professional behaviors, clinical decision making, responding to changing patient needs, critical thinking etc.

  • A preceptor is ultimately accountable and professionally responsible for decisions made about others’ competence and fitness to practice.

  • A preceptor must not sign staff of as competent unless without evidence of competence 

  • Based on overall performance of the role in line with the scope of practice, job description and QCHP license.

  • There is no specific requirement for the order in which competencies are demonstrated.

  • Evidence of successful achievement of competence must be maintained in the professional portfolio.

  • Some elements of complex practice (eg ECMO, therapeutic cooling, stoma site marking) do not apply to every nurse or midwife within the specialty.

  • Where that is the case, that element of practice required to evidence competence must be marked as N/A in the competence assessment template.

  • Category 2 CPD can be claimed by critically reflecting on performance and achievement of competence (optional). 
Holistic approach to competence (Montgomery 2006) 

“What experienced clinicians possess…is an immense and well-sorted catalogue of clinical cases and the clinical judgement to know how to use it, and that store of knowledge is activated by seeing, touching and questioning the patient.

Such knowledge is varied and extensive enough so that the bottom-up rules of practice or maxims that the cases collectively embody are hedged and qualified, layered in memory with skepticism about their applicability to any particular patient.” (pp 34-35)

Competence and fitness to practice can be evidenced holistically through a range of activities. These include for example: 
  • Completion of CPD activities 
  • Application of new knowledge to practice 
  • International certification
  • Simulated practice (eg ILS)
  •  Engaging with research activities
  • Knowledge transfer through presentations 
  • Development of guidelines, protocols and policies
  • Contributions to peer reviewed publications 
  • Precepting and mentoring others 
  • Critical reflection.