Performance Based Development System (PBDS) Assessment Tips and Study Guide

Health Carousel Travel Nursing
April 27, 2022
Share this post

Many travel nursing agencies and healthcare facilities are now requiring performance based development system (PBDS) assessments, which is also called PBDS testing. Let’s review the basics of PBDS testing, why it’s necessary, and a PBDS study guide for critical care to help you pass your assessment with flying colors.


According to the company that developed and markets the test, the Performance Based Development System (PBDS) is a customized competency assessment process that evaluates hospital personnel’s ability to do the job. This test has gained a foothold in many large hospital systems throughout the country, and most travel nurses at some point in their career may encounter this test for consideration for a temporary nurse travel assignment.

The PBDS addresses clinician competency in three skill sets: critical thinking (problem recognition, risk management, priority setting), inter-personnel relations (team building, conflict resolution, customer satisfaction) and technical skills (safe, effective, efficient skills). Your responses as a travel registered nurse are evaluated against standards set forth by the Hospital.

Used effectively, the PBDS test is used to supplement orientation efforts in an area a new RN may be weak in; however, for a travel nurse, unsatisfactory completion of the test often results in termination of your temporary nurse travel assignment.

The test commences with a baseline assessment that consists of a number of exercises in one of four specialties: Medical Surgical (Tele Travel Nurses would use the Med/Surg portion), Critical Care, NICU, and OB. Some exercises may be administered with pen and paper, some are pictures, but the majority are video vignettes. Based on your observations from the clinical situations depicted in the video vignettes, judgments are made on what is the probable diagnosis and what actions you would take in that situation.

Why is it necessary?

Many healthcare facilities are beginning to require PBDS testing to evaluate clinician competency. It serves as a tool for hiring facilities to determine if you, as a travel nurse, are competent in the care you provide to patients. They also use PBDS testing to match your skills with the specific needs of the hiring unit, while ensuring you deliver quality care.

In addition, it ensures you would know the correct next steps to take if an emergency were to occur. Since you’re a travel nurse, PBDS testing also evaluates clinician competency in team-building and problem-solving skills. Team-building skills are especially important for travel nurses, as they consistently adapt to new environments and communicate with new team members.

The assessment determines clinician competency through a series of real world clinical situations. They often assess your ability to determine a priority nursing diagnosis using your critical thinking skills, clinical knowledge, and technical skills. The scenarios range from obtaining IV access and administering IV fluid to an acute myocardial infarction.


In the critical thinking exercises, various scenarios depicting common clinical situations and complications are presented. Assess the situation as if it was your own patient in that situation. What would you do? Nurses are asked to define the problem, offer a solution and its rationale, as well as prioritize its need for action. This means that the nurse is asked 4-5 questions based on the scenario just viewed in the video. These questions usually include critical thinking, probably medical diagnosis, initial nursing interventions and actions to be taken in response to clinical situations. 

Interpersonal skills are evaluated by presenting different situations in which a nurse must give a response. Using the example of starting statements, in one situation a physician says, “I don’t know why the administration of this hospital won’t hire any decent nurses when there are plenty of girls out there.”

Upon completion of the assessment, it is rated by comparing the employee’s answers to model answers that were developed and validated by nurses at the facility.

Here are some other potential “scenarios” that you might see as well as the medical diagnoses that you should be aware of:

What would you do if…

  • Family member cardiac arrests in a semi-private room?
  • You are scheduled for an annual evaluation today?
  • Dr. says you have to accompany your patient to a procedure that may last up to 90 minutes?
  • You have a code at the beginning of your shift and family members are still in the room?
  • You have a nursing student to work with you during your shift?
  • There will be a staff meeting in 1 hour?

Consider before responding to these scenarios what you must do, should do, and what you could do.

Be familiar with the following medical diagnoses and nursing actions to be taken for these situations including rationale:

  • CVA
  • Renal failure
  • Intracranial bleed or increased intracranial pressure
  • Chest pain/Acute MI
  • Pulmonary embolism
  • Pneumothorax
  • Digoxin toxicity
  • Ilieus
  • Thrombocytopenia
  • Bladder retention/pyelonephritis
  • Ketoacidosis and hyperglycemia
  • Pain control

Most importantly, don’t forget to include nursing actions that may seem obvious. An example would be a patient with a high digoxin level, exhibiting symptoms of toxicity. Your first action would be to hold the digoxin. Another example might be a patient, receiving IV heparin, who suddenly starts vomiting blood. You would shut off the heparin drip.

Is it specific to your specialty?

PBDS testing is divided into four clinical areas, which include medical-surgical, critical care, neonatal intensive care, and obstetrics. While one of the clinical areas may not be directly related to your speciality, you may be asked to complete an assessment similar to your area of expertise. For example, an emergency room nurse would most likely take the critical care assessment.


No! – The majority of our hospital clients DO NOT require PBDS testing. Health Carousel Travel Nursing has a strong reputation as a travel nurse staffing company for hiring clinically sound travel nurses. However, some of our hospital clients do require the testing.

If you’re interested in taking a performance based development system assessment, study beforehand. Practice critical thinking skills and actions you would take in different real world clinical situations. We offer a printable study guide to help you ace your exam.


Land your dream job faster when you travel with us. Get started with top local and national travel nurse jobs in On Demand


Land your dream job faster when you travel with us. Get started with top local and national travel nurse jobs in On Demand


Land your dream job faster when you travel with us. Get started with top local and national travel nurse jobs in On Demand

Get Started Now


Land your dream job faster when you travel with us. Get started with top local and national travel nurse jobs in On Demand

Find the Travel Job that’s Right for You

Interested in how the pay stacks up in other states not on this list? Our trusty Super Nurse sidekicks are standing by to answer any questions you have. Click below to get information on opportunities in other states!

Woman standing with suitcase looking out at the city