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Registered Nurse CCA

The CCA is an opportunity for you to demonstrate how your knowledge and practice matches what is expected of registered nurses to deliver safe and competent care. All registered nurses must demonstrate that they can meet the entry-level competencies.

  • CCA components

    The assessment is made up these components:

    • Written diagnostic exam
    • Clinical Judgment Scenarios (CJS)
    • Chart review and development of a nursing care plan
    • Objective Structured Clinical Examination (OSCE)
    • Self-assessment
  • Preparing for the assessment

    The CCA looks at entry-level competencies; it does not look at expert levels of nursing practice.

    Even if you have practiced in a highly specialized area, your knowledge and practice is being compared to entry-level competencies. You will likely need to refresh your entry-level knowledge before you take the CCA.

  • Assessment areas

    You may be asked to complete assessments in any or all of the following areas:

    • Ambulatory care
    • Community health
    • Emergency care
    • Geriatrics
    • Medical
    • Mental health
    • Obstetrics
    • Palliative care
    • Pediatric and adolescent health
    • Surgical

How to apply

Authorized Prescriber CCA

The Authorized Prescriber (AP) Clinical Competence Assessment (CCA) provides nurses the opportunity to demonstrate their prescribing knowledge, skills and judgement in practice. It is an examination used to assess an individual’s practice for gaps in their ability to meet the Competencies for Nursing Authorized Prescribers in Manitoba.

CCA components

The assessment is made up these components:

  • A written diagnostic exam 
  • Objective-Structured Clinical Examinations (OSCE)

Additional information is available on this site and on the College of Registered Nurses and College of Registered Psychiatric Nurses websites:


  • Authorized prescriber reproductive health, sexually transmitted infections and blood-borne pathogens clinical competence assessment 

    You will be assessed for competencies grouped under the following headings:

    • Assessment and Diagnosis of Client Health/Illness Status
    • Pharmacotherapeutics and Other Therapeutic Interventions in Client Care
    • Professional Responsibilities and Accountabilities
  • Authorized prescriber diabetes health clinical competence assessment

    You will be assessed for competencies grouped under the following headings:

    • Assessment and Diagnosis of Client Health/Illness Status
    • Pharmacotherapeutics and Other Therapeutic Interventions in Client Care
    • Professional Responsibilities and Accountabilities

Exam details


The RN Clinical Competency Assessment Exams and the AP Clinical Competency Assessment Exam are computer-based written examinations.

You will find them online within the University of Manitoba Learning Management System which is called UM Learn (also called Brightspace or D2L).

Exams are written at home, in a quiet private space. If you do not have a quiet private space in your home, you may choose a different location. However, you must be alone at all times while writing your exam(s).

Exams are monitored and recorded using a webcam and a program called Respondus Monitor, which will note any abnormal movements or talking. Also remember the contents of all exams are confidential and therefore nobody else can see your computer screen while you are writing.

In your exam room you may have:

  • Calculator
  • Clear bottle of water
  • Pencils
  • Scrap paper (one sheet)

To pass the written exam you must achieve a minimum score of 65%.

Technical requirements

You will require:

  • Laptop or desktop computer
  • Web camera (internal or external)
  • Reliable broadband internet connection
  • Windows 10, 8, 7 or Mac os x 10.12 or higher

If you do not have a computer with these specifications, you may borrow a laptop from the College of Nursing with Respondus Monitor already loaded. You may pick up the laptop the day prior to your exam(s) and return it the day following completion. A $100 refundable deposit is required.

Practice exam

You will be provided with a UM Learn username and password three days prior to testing during which you may practice taking your exam(s).

This is your opportunity to test whether you can download the Respondus Monitor program and that your webcam is working etc. As well, it provides you an opportunity to walk through the steps of showing your ID, preparing your space, and launching the exam.

The practice exam consists of five questions. These are not graded and you may take the exam as many times as you wish.


The OSCEs are performance assessments used to evaluate a candidate’s skills and ability to critically think in a variety of situations.

The OSCEs will be offered in- person or virtually, depending on the candidate’s preference. When booking assessments, candidates will have the choice.

Candidates will complete a total of four stations conducted in a simulated clinical practice setting, where they play the role of a registered nurse (AP) and interact with a standardized patient.

For OSCEs conducted virtually, the candidate will be moved through four “Zoom room” simulated practice setting stations. Each room will have a CCA assessor and a standardized patient in it.

In-person and virtual OSCE stations will follow identical procedures. At the start of each station, the candidate will receive a brief written statement describing the presenting clinical situation, instructions, and the total time allotted for the station.

Candidates should demonstrate how they would manage each presenting case as they would in a real-life practice setting. There are no hidden surprises or tricks. More details are found below.


CCA assessors will oversee the OSCEs; they will observe and take notes but will not interact with candidates during the encounters.


Candidates should be dressed in professional attire, appropriate for a clinical environment.


The assessment center is equipped with camera/video equipment that will record both in-person and virtual OSCEs and be used to review the OSCEs for quality assurance purposes by the CCA assessment team.


If you are engaging in virtual OSCE’s, Zoom links and instructions will be sent to you a week in advance of the assessment day.



If you are engaging in an in-person OSCE, please report to Helen Glass Centre for Nursing, Room 424 no later than 0845 on your scheduled day. See appendix A at the end of this guide for more information.


Electronic devices must be turned off prior to storing personal belongings within the center.

Total time allotted includes:

  • Reading the presenting clinical situation and candidate instructions
  • Client encounter/ completion of tasks
  • Responding to assessor’s questions, if any
  • Presenting clinical situation and candidate instructions

Candidates will receive a written scenario, which will include information about the client, setting and instructions about tasks they are expected to complete.

Patient encounter/completion of tasks

Candidates will interact with the standardized patient/manikin and complete the required tasks described in the candidate instructions.

Standardized patients are proficient at replicating signs and symptoms in a reliable and consistent manner. Candidates should interact with the standardized patient/manikin as they would with an actual client in a real- life setting.

Assessor questions

Following completion of tasks, the assessor will ask oral questions. Candidates will be assessed on:

  • Health history and data collection
  • Responsibility and accountability
  • Communication
  • Implementation of care strategies
  • Collaboration

For the Authorized Prescriber Diabetes Health Clinical Competence Assessment, you will also be assessed on:

  • Use of diabetes specific knowledge, skill and judgment
  • Analysis and interpretation of findings
  • Prescribing drugs and devices
  • Prioritization
  • Ethical safety/advocacy
  • Ordering screening and diagnostic tests
  • Evaluation and monitoring of care
  • Legal responsibilities

For the authorized prescriber reproductive health, sexually transmitted infections and blood-borne pathogens clinical competence assessment, you will also be assessed on:

  • Use of STBBI specific knowledge, skill and judgment
  • Analysis and interpretation of findings
  • Prescribing drugs and devices
  • Prioritization
  • Ethical safety/advocacy
  • Ordering screening and diagnostic tests
  • Evaluation and monitoring of care
  • Legal responsibilities


Candidates will be moved to the next virtual station by the program assistant, or will walk to next OSCE room (if in person).


For more information, view the sample OSCE video.

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Exam day - AP Clinical Competency Assessment Exam

The AP CCA consists of:

  • A written diagnostic exam
  • Objective-Structured Clinical Examinations (OSCE)

This exam will be available to you from 1300 -2200 hours on your CCA day.

You will have one attempt at the exam. 

You have 2.5 hours allowed to complete the exam and you must write it in one continuous sitting, beginning the moment you launch the exam.

    Exam days - Clinical Competency Assessment Exams

    You can write the following exams in any order and at any time during the three days you have booked:

    1. Child health (multiple choice and short answer combination)
    2. General nursing (multiple choice)
    3. General nursing (short answer)
    4. Maternal/newborn (multiple choice and short answer combination)
    5. Mental health nursing (multiple choice and short answer combination)

    You will have one attempt at each exam. 

    You have 3.5 hours allowed to complete each of the five exams.

    Confidentiality and conduct

    Upon booking an AP CCA, candidates will be asked to read and sign a confidentiality agreement stating that they will not disseminate or reveal any content of the CCA. Breaches include, but are not limited to:

    • Comparing client and candidate responses with colleagues
    • Sharing exam content
    • Posting case information or exam questions online
    • Cheating or dishonest behaviors during the exams

    NOTE: Any breach in confidentiality of AP CCA material may lead to disciplinary and legal measures, including invalidating your results. CRNM or CRPNM will be notified of any breaches.

    After the exam

    Upon completion of the Written Diagnostic Exams & OSCEs, a report will be completed that entails the candidate’s ability to demonstrate meeting competencies for APs in Manitoba.

    Numerical scores are not assigned to the individual competencies; candidates will receive a Met or Not Met for each competency.

    The assessor will send the report to the CRNM or CRPNM for review. Within six weeks of completion of the CCA, the CRNM or CRPNM will provide the candidate with its decision and the candidate copy of the CCA report.

    Based on the outcome of the (AP)CCA, the College will inform the candidate of the necessary next steps. There are two possible outcomes.

    1. No gaps are identified. The candidate is eligible for approval of an AP notation for the applicable population.
    2. Gaps in AP competencies are identified in the CCA and must be addressed through remedial education. The candidate could be required to either:
    • Complete a course of instruction as identified by CRNM or CRPNM to address identified gaps prior to being eligible for the AP notation.


    • Complete a full authorized Prescriber Program as identified by CRNM or CRPNM to be eligible for the AP notation.


    Please review the information below, then complete and submit the online form.

    Fee payment instructions

    Step 1: Website

    Go to the following link to make your payment.

    Step 2: Select items to purchase

    Select the option for your exam.

    Select which method of payment you will use. Please note there is an extra $1.00 charge if using a Debit Card.

    Step 3: Candidate Information

    Enter the information for the candidate that will be taking the Clinical Competency Assessment (CCA). Please ensure you provide the same information as what was provided to CRNM or CRPNM.

    Step 3: Purchaser information

    Enter the information for the card holder that is making the payment. If this is the same information as Step 3, please select the “Same as above” option at the top of this section.

    Step 4: Submit and proceed to payment page

    Click the submit button and you will be taken to the payment page. You will be sent a confirmation email once this information has been submitted, but you will need to complete the payment page (Step 5) for your fee to be fully processed. Not completing Step 5 will result in an incomplete payment.

    Step 5: Payment page

    Enter the card details on this page and submit payment. You will receive another email confirming that your payment has been processed.

    Please be advised that replacement receipts are not provided by the CCA Centre. It is the responsibility of the candidate to ensure they keep their original receipt.

    Payment, cancellation and refund policy

    Payment can be made online using the link you will be emailed when you book your appointment. Payments can only be made online.

    Payment must be recieved at least two weeks prior to the CCA or your appointment will be cancelled.

    In the event you have to cancel, a non-refundable cancellation fee will be charged which must be paid in full prior re-booking your CCA.

    Cancellation fees are as follows:

    • First cancellation: $300
    • Second cancellation: $400
    • Late cancellation: $500 (if done less than two weeks before scheduled CCA)


    Additional resources

    Contact us

    For more information about the Clinical Competence Assessment, please contact:

    Kimberly Workum

    nurscomp@umanitoba.ca OR apnurscomp@umanitoba.ca

    College of Nursing
    Helen Glass Centre for Nursing
    89 Curry Place
    University of Manitoba (Fort Garry Campus) 
    Winnipeg, MB R3T 2N2 Canada