Demystifying the

Competency Conundrum
Facilitated by:
Sylvia McKee, MN, RN, BC
Coordinator, Clinical Staff Development & Education
VA Salt Lake City Health Care System

Developing a highly visible,

tightly linked competency
assessment program is key
to organizational success.
 Topics to Cover
 Why Competency Assessment?
 Establishing a Competency Program
 Initial and On-going Competency
Assessment Process
 Validating Competency
 Results of Competency Assessment
 COMPETENCY FACTS

SECRET INGREDIENTS
YIELD MAGIC POTIONS
 Why Competency Assessment?
 Competent Staff = Quality Care

 JCAHO Requirement
 NEW Competence Assessment – HR.3.10
Competence to perform job responsibilities
is assessed, demonstrated and
maintained.
 Competence vs. Competency
 Competence:
An individual’s capacity
to perform his or her
job functions.
 Professional Competence
★ The ability to function
effectively in the tasks
considered essential within a
given profession.
 Competency:
An individual’s actual
performance in a
particular situation.
 The ability to integrate
knowledge and skill to
perform a task under the
varied circumstances of
the real world.
 Competency

Actual performance is the gold

standard for demonstration of
competency.
 Competency vs. Training
 Train – to instruct so as to make proficient or
qualified
 Training – the process or experience of being
trained
 Competency – an individual’s actual performance
in a particular situation

The ability to integrate knowledge and skill to

perform a task under the varied circumstances of
the real world.
Components of Competence
COMPETENCE
Performance
Appraisal/Evaluation
Continuing
Education & Training
Orientation
Effectiveness assessed
Job through performance
Description improvement activities
License, Certificate
Additional Considerations
Patient satisfaction feedback
Incident reports
Peer Review
Physician feedback
Skills Checks
Preceptor/mentor teaching
 Program Components
 Backbone to a high-quality assessment
program
 Policy
 Process
 Reporting Mechanism
How Will I Know It When I See It?
 Initial Competency
Assessment
 Ongoing
Competency
Assessment
 Initial Competency Assessment
 Education  References
 Certification  Previous competence
assessments and
 Experience performance evals
 Knowledge Testing  Direct observation
 Self-assessment  Preceptor evaluation
 Interviews (PBI)  Formal peer review
 In-service or CE  Narrative/anecdotal
attendance comments
Ongoing Competency Assessment

 JCAHO requirement - AGAIN!!

 New HR.2.30 Ongoing education,
including in-services, training, and other
activities, maintains and improves
competence.

 Limited (job specific)

 PROCESS/TOOLS

EXPANDING YOUR
REPERTOIRE OF
TRICKS
Competency Assessment Process

 Performance tests consists of evaluation

entries embedded within a checklist

 A performance standard is used to compare

actual performance against in order to
determine competency.
Competency Assessment Tools
 A performance checklist is used to
determine presence of performance

 Demonstration of knowledge does not

equal demonstration of competence.
Competency Assessment Tools
 Learner centered: performance
criteria stated in terms of what the
learner has to demonstrate for the
behavior to be considered competent.
 Writing Competency Statements
 EssentialCharacteristics of A Competency
Statement
 Describes a general category of behavior or
performance
 Describes staff behavior
 Describes behavior that is observable and measurable
 Includes no conditions imposed on performance
 Is validated by practitioners in the designated role and
setting
Writing Competency Statements –
Initial Assessment Examples

Handouts – Orientation Competency

Skills Checklists
Dialysis
Physical Science Technician – Research
Research Nurse BSN and/or Coordinator
Writing Competency Statements –
Annual Assessment Examples

 Operating Room
 Research Nurse
 Writing Performance Criteria
 Essential Characteristics of Performance Criteria
 Describe employee behavior
 Describe behavior that is observable and measurable
 Limited to a single behavior
 Include sufficient description of the behavior
 Include desired conditions imposed on performance
 Include a performance standard
 Include only essential aspects of performance
Writing Performance Criteria –
Initial Assessment Examples

Handouts – Orientation Competency

Skills Checklists
Dialysis
Physical Science Technician – Research
Research Nurse BSN and/or Coordinator.
Writing Performance Criteria –
Annual Assessment Examples

 Operating Room
 Research Nurse
 VALIDATING
COMPETENCY

READING THE STARS

 Validating Initial Competency

 Requirements of position
 Develop skills checklist
 Develop measurable performance criteria
★ Performance standard to compare actual performance against
 Determine method of assessment to be used
 Provide training if required
 Assess
 Validating On-going Competency
 Selectcompetencies (high-risk, low volume,
problem prone)
 Develop measurable performance criteria
★Performance checklist
★Performance standard to compare actual performance against
 Determine method of assessment to be used
 Assign appropriate person to perform assessment
 Provide training if required
 Assess
 Validating Competency
Key Activities
Remediate if necessary, then reassess
Assign accountability for follow-up
 REPORTING
RESULTS/LINK

TO EDUCATION

PEERING INTO THE

CRYSTAL BALL
 Reporting Results/
Link to Education
 Annual report
 Why report findings?
 What you will report
 To whom you will report
 How will the report be used?
 Competency assessment =
snapshot

 Performance appraisal =
videotape
 Competency Assessment

 “Is this staff member able to do his/her

assigned job?”
 Answer: found in comparing employee’s
performance against a set of criteria
 Completed during orientation
 Ongoing to determine if competency
maintained
 Performance Evaluation
 “Is this staff member doing his/her assigned
job?”
 Answer: found in comparing daily
performance against set of expectations
 Compiled and summarized annual basis
 Used to monitor the quality of care/service
QUESTIONS ?
THANK YOU