SimZones Approach to a Competency-Based Objective Structured Clinical Examination

Background:Competency-based education (CBE) can be achieved through purposeful structuring of experiential learning. Yet, there is scant guidance for nurse educators to operationalize this transition.Purpose:To describe a semester-long CBE simulation curriculum for third-year nursing students, using the SimZone (Zone 0-3) framework.Methods:Zone 0 ensured foundational knowledge. Objective Structured Clinical Examination (OSCE) Prep Lab 1 (Zone 1) and Prep Lab 2 (Zone 2) provided deliberate skill practice and small group simulation practice, respectively. Zone 3 was the summative OSCE.Results:Students' (n = 107) performance was assessed on patient safety, clinical judgment, assessment, and communication. Initially, 64% of students were deemed competent, increasing to 92% after additional practice and to 100% with further iteration. Students also reviewed their OSCE recordings and completed reflective writing.Conclusion:This approach may serve as a model for other nursing programs to implement competency-based curricula through leveled simulations and iterative learning.