Completing Substantially Equivalent Competency Assessment: Barriers and Facilitators for Internationally Educated Nurses

Challenges to licensing and employment for internationally educated nurses (lENs) are reported to include immigration, language fluency, costs and anxiety related to competency assessment, and content of nursing education. IENs account for over 10% of the registered nurse (RN) workforce in Alberta, Canada, and 8.2% of the Canadian workforce. IENs with insufficient documentation for a determination of their eligibility for RN licensure in Alberta are referred for Substantially Equivalent Competency (SEC) assessment to determine their ability to provide safe, ethical, and competent nursing care. Between 2006 and 2013, approximately 75% of all IENs applying for RN licensure were referred for SEC assessment. Only 74% of this group completed their assessment; 26% did not follow up for SEC assessment. The study presented here explored the barriers as well as the facilitators that influenced the IENs throughout the assessment process. The results of the study will assist stakeholders in developing strategies that help IENs prepare for and complete competency-based assessments in an effective, informed, and timely manner.