Competence-leveled Assessments: A How-To Guide for BOC Approved Providers

The upcoming 2026 BOC Approved Provider Standard requires that every continuing education (CE) activity goes beyond knowledge assessment (II. Assessment 6. Learning Assessment, Essential Element A: Assessment). While knowledge checks remain appropriate, BOC Approved Providers must now also include at least one competence-level objective and a related competence-level assessment.

This change ensures learners don’t just know more; they can demonstrate how they’ll apply that knowledge to improve patient care using best practices.

Step 1: Connect Objectives and Assessments

Competence-level assessments must align with your stated learning objectives. When objectives involve applying skills, making judgements or demonstrating actions in a scenario, assessments should require learners to demonstrate their ability to apply or explain those actions, decisions, or processes in a way that reflects practice.

Step 2: Administer a Competence-level Assessment

Examples of competence-level assessments you can build into your CE activity include:

• Reflection Question (most common and easiest): Ask how participants will implement a concrete change in their practice.
• Case Studies/Scenarios: Present a realistic patient case that requires decision-making.
• Simulations/Role Play: Offer a controlled setting for demonstrating competence-level skills.
• Performance Checklists: Use peer or facilitator observation to evaluate specific steps.
• Applied Projects: Require participants to develop a plan, tool or intervention for their setting.

Step 3: Provide Feedback (Required by BOC Approved Provider Standard)

Feedback on competence assessments is not optional, it has been and remains a required component. Unlike right/wrong quizzes, competence-level assessments are often reflective and individualized. Feedback helps learners recognize strengths, address gaps and build confidence in applying new skills.

Ways to provide meaningful feedback:

• Theme Reports: Summarize learner responses and share themes back with the group.
• Discussion Boards: Open a discussion using the competence-level reflection question to allow dialogue between learners and faculty.
• Commitment Reminders: Provide a reminder to learners of their commitment to change practice by sending them their reflection after the course and asking for updates or reflection.
• Faculty Commentary: Have a facilitator review the responses (or themes from the responses) and provide a commentary highlighting promising strategies, common pitfalls or practical insights.
• Peer Accountability: Pair learners to follow up with each other and share experiences on feasibility, challenges, opportunities, success, etc.
• Resource Lists: After reviewing response, provide a resource list aligned with the most common implementation ideas.
• Success Stories: Invite participants to share implementation outcomes.

Step 4: Manage Low-Effort Responses

Some learners may submit minimal or no effort. While this doesn’t “fail” them, it does mean they lose out on deeper learning. For you as a CE provider, these responses can indicate disengagement and highlight opportunities to strengthen activity design, prompts or follow-up.

Decide whether your assessment will be formative (growth-focused) or summative (evaluative) and communicate that clearly.

Final Takeaway

Competence-level assessments are more than a compliance requirement. They help learners translate new knowledge into action, improving both professional growth and patient care. As a BOC Approved Provider, start small: add a reflection question to your next course, provide feedback and build from there.