The Competency Based Objective

What is a Competency Based Objective?

A Competency Based Objective (CBO) is a skill or set of skills and applied knowledge that is integrated into patient care by the student. There are approximately 100 different CBOs, and each CBO is linked to what is expected of a student upon graduation and entry to practice. The student’s performance of a CBO is evaluated by the preceptor, and in turn signed off at a level of competency (see defined levels below).

CBO Requirements:

The CBO Tracker document lists all CBOs for completion during the clinical training part of the program, and is broken down into adult, pediatric and neonatal age group requirements. Shaded areas of this document indicate CBOs that are required for sign off. Students are encouraged to achieve the highest level of competency for all CBOs, however some of these may not have sufficient clinical opportunity to practice and attain the highest level 3. The minimum required level of sign off is indicated for each CBO. Failure to complete required CBOs may result in additional clinical hours and/or clinical simulation.

Some CBOs can be signed off in a variety of clinical rotations, while others can only be signed off in a specific area. A CBO can be required for sign off within neonatal, pediatric or adult patient populations, or any combination of these. For example, Pulse Oximetry is a CBO that must be signed off within neonatal, pediatric and adult patient populations. Anesthetic Gas Machine Check can only be signed off in the OR rotation.

Students will have access to a list of recommended CBOs for each rotation, although this list is not exclusive, in that other CBOs may be signed off in the rotation as well if given the opportunity. If a student does not get sufficient exposure during a rotation to some recommended CBOs, they may have opportunity in other clinical rotations as well. Students should make effective use of all possible clinical opportunities to practice and have CBOs signed off. Preceptors should assist students in seeking these clinical opportunities.

When is a CBO signed off?

After having sufficient opportunity to practice a CBO, the student can request the preceptor to have a CBOs performance evaluated and signed off. If the preceptor signs off the CBO at a level lower than what is required, further attempts will be required to attain the minimum competency. Feedback and discussion between the preceptor and student is always encouraged regardless of the level of competency attained.

How are CBOs signed off?

CBOs will be signed off on the student’s portable electronic device (iTouch/iPhone) or on line, and students can assist the preceptors with this electronic sign off process. Through the course of clinical training and after completing the mandatory amount of clinical training hours, NAIT faculty will ensure all required CBOs have been signed off appropriately by preceptors. Students will have access to the procedural guideline for a CBO and a preceptor may request to review this with the student at anytime. Each CBO has an assessment record for sign off attached.

Levels of competency when signing off a CBO:

Students are expected to practice CBOs under supervision and direction from their preceptor, and are always encouraged to achieve the highest level of competency possible. Performance of a CBO can be evaluated at one of the following competency levels:

Level 1: Required assistance and direct supervision while performing this procedure/task

Level 2: Performed this procedure/task AT LEAST ONCE to a satisfactory level, without assistancebut MAY REQUIRE DIRECT SUPERVISION performing this task in normal situations

Level 3: Performed this procedure/task A NUMBER OF TIMES to a satisfactory level, without assistance and NO LONGER REUIRES DIRECT SUPERVISION performing this task in normal situations

Instructions for signing off a CBO:

  1. Student discusses with preceptor CBOs that were supervised and evaluated, and appropriate for signing off.
  2. Student will access Comptracker by hand held device, or on line to submit one or more CBO(s) to the preceptor for approval and sign off.
  3. Preceptor accesses Comptracker either by hand held device or on line, and reviews procedural guideline if necessary to ensure steps have been performed correctly.
  4. Preceptor assigns a level of sign off (1, 2 or 3), and may enter comments on areas performed well or requiring improvement.
  5. Preceptor provides a signature verifying the competency level attained, and submits it to Comptracker.

2014 Grads Competency Based Objective (CBO) Tracker

Level indicates minimum level of competency/ Dark shades indicate required CBOs

A=AdultN=Neonatal P=Pediatric

CBO / Level / Patient Population
2. Communication
2.1 Interdisciplinary Rnd / 3 / A / N / P
2.2 Shift Report / 3 / A / N / P
4. Health and Safety
4.1 Prep for Procedure / 3 / A / N / P
4.2 Vent Clean /Check / 3 / A / N / P
4.3 Quality Control BGA / A / N / P
8. Patient Assessment
8.1 Pt Assess and Plan / 3 / A / N / P
8.2 Retrieve Chart Info / 3 / A / N / P
8.3 Non Invasive BP / 3 / A / N / P
8.4 CXR Interpretation / 3 / A / N / P
8.5 Home O2 Assess / 3 / A / N / P
9. Pharmacology
9.1 MDI/SVN Vent / 3 / A / N / P
9.2 MDI / 3 / A / N / P
9.3 DPI / 3 / A / N / P
9.4 SVN / 3 / A / N / P
9.5 O2 Therapy / 3 / A / N / P
9.6 O2 Titration / 3 / A / N / P
9.7 HF Heated Humidity / 3 / A / N / P
9.8 HF Cold Neb / 3 / A / N / P
10. Bronchopulmonary Hygiene
10.1 Sputum Coll/ Induct / 2 / A / N / P
10.2 NP Suction / 2 / A / N / P
10.3 Suction/ Instill ETT / 3 / A / N / P
10.4 Suction Instill Trach / 3 / A / N / P
10.5 Suction Laryngect / 3 / A / N / P
10.6Reposition patient / 3 / A / N / P
10.7 Incentive Spirom / 3 / A / N / P
11. Airway Management
11.1 NPA / 2 / A / N / P
11.2 OPA / 3 / A / N / P
11.3 Self Infl Bag/Mask / 2 / A / N / P
11.4 Flow Inf Bag/Mask / 2 / A / N / P
11.5 Self Inf Bag/ AA / 3 / A / N / P
11.6 Flow Inf Bag/ AA / 2 / A / N / P
11.7 TP Resuscitator / 2 / A / N / P
11.8 Intubation / 2 / A / N / P
11.9 Intubation Assist / 2 / A / N / P
11.10 Re secure ETT / 2 / A / N / P
11.11 Adv/ Retract ETT / 2 / A / N / P
11.12 Cuff/ CASS Mgmt / 3 / A / N / P
11.13 Extubation / 2 / A / N / P
11.14 Trach Assist / 1 / A / N / P
11.15 Trach Care / 3 / A / N / P
11.16 Trach Change / 2 / A / N / P
11.17 Decannulation / 2 / A / N / P
11.18 Stoma Care / 2 / A / N / P
11.19 Wean Trach / 2 / A
11.20 Speaking Valve / 2 / A / N / P
11.21 LMA / 2 / A / N / P
CBO / Level / Patient Population
12. Anesthesia
12.1 AGM Checkout / 2 / A / N / P
12.2 Anesthetic Admin / 1 / A / N / P
12.3 Assist Emergence / 1 / A / N / P
12.4 Vasc Press Monitor / 2 / A / N / P
12.5 Malig Hyperthermia / 1 / A / N / P
12.6 Proc. Sedation / 2 / A / N / P
13. Invasive Vascular Procedures
13.1 Art Line (Standard) / 3 / A / N / P
13.2 Art Line (Vamp) / 3 / A / N / P
13.3 Arterial Puncture / 2 / A / 7 / N / P
13.4 Capillary Puncture / 2 / A / N / P
13.5 BG Analysis / 3 / A / N / P
13.6 BG Interpretation / 3 / A / N / P
14. Ventilation Management
14.1 NIV Initiate / 3 / A / N / P
14.2 NIV Optimize / 3 / A / N / P
14.3 NIV Wean / 3 / A / N / P
14.4 MV Initiate / 3 / A / N / P
14.5 MV Monitor / 3 / A / N / P
14.6 MV Optimize / 3 / A / N / P
14.7 MV Interpret WF / 3 / A / N / P
14.8 MV Wean / 3 / A / N / P
14.9Advanced Modes / 1 / A / N / P
14.10 Recruitment / 1 / A / N / P
14.11 Internal Transport / 2 / A / N / P
16. Cardiac Diagnostics
16.1 ECG: 12 Lead / 2 / A / N / P
16.2 ECG: 5 Lead / 2 / A / N / P
16.3 Interp Hemo Data / 2 / A / N / P
17. Pulmonary Diagnostics and Investigations
17.1 Pulse Oximetry / 3 / A / N / P
17.2 Exertional Oximetry / 3 / A / N / P
17.3 Peak Flow / 3 / A / N / P
17.4 Spirometry / 2 / A / N / P
17.5 He Dilution / 2 / A / N / P
17.6 N2 Washout / 2 / A / N / P
17.7 VTG / 2 / A / N / P
17.8 Single Breath Diff / 2 / A / N / P
17.9 RAW / 2 / A / N / P
17.10 BronchAssist / 2 / A / N / P
17.11 Transcutaneous / 2 / A / N / P
17.12 ETCO2 / 3 / A / N / P
17.13 Sleep Diagnostics / 1 / A / N / P
18. Adjunct Therapy
18.1 Surfactant / 2 / A / N / P
18.2 Radiant Warmer / 2 / A / N / P
18.3 Heliox / 1 / A / N / P
18.4 NO / 1 / A / N / P
18.5 Portable Liquid O2 / 3 / A / N / P