The Nursing and Midwifery Council’s (2008a) Standards to Support Learning and Assessment in Practice have been strengthened, with an expectation that mentors develop their knowledge and skills beyond registration to enable credible decisions about the competence of students. As a result, there are a number of conflicts for students and mentors to negotiate, not least in maintaining a fair and transparent assessment process. This review identifies different interpretations of competence and competence assessment. Competence assessment should be given greater credibility when student learning is set in a context of care involving patient experience and evaluated by reflexive and inclusive mentors.