You would need to reach out to your Brightspace Administrator or D2L Support (if you are an Approved Support Contact for your institution) to get an answer to the specific settings used on a live system.
In this forum I can tell you this:
Competencies/Learning Objectives are useful for having a specified set of goals that can be met through course activities (Quizzes, Assignments, Discussion participation, direct assessment using Rubrics, etc), particularly when those course activities are spread over multiple courses.
Awards are used for a more friendly feedback, quickly gauging completion in a group (or leaderboard), providing a printable certificate of completion, and I've seen them used a few times for exporting a list of completions to an external record (Useful when you can't download the Grades because they are updated throughout the course and those values would appear to be a failing grade until the course is actually concluded) because a user either has the Award or doesn't yet have it.
So it depends on how these clinical skills are being transferred/recorded. Both tools are good for tracking and displaying skill achievement.
I hope that's helpful.
MattLearning Administration Manager