Patti, I have found in these situations (of clinical competency with pas/fail) that there is a lot of individual variances that can be observed and tolerated. Some actions may not be exactly as desired but assessing the basic question of whether the student is performing safely, achieving all the essential proficiencies, and has performed to a level that is at least satisfactory is what needs to be measured. Although my college uses a letter grade system for cliniucal, I prefer the pass/fail, as I do no want to pass along a student performing with a C- avearage to patients. Barry Westling