The big question: "How have the ways we think of competence changed?"

This month we ask  '"How have the ways we think of competence changed?"

The Oxford English Dictionary defines competence as “the ability to do something successfully or efficiently”. I would have been happy with this, 
if I hadn’t been so heavily involved in the training and education of our future biomedical scientists. I’ve been Head of Laboratories since 2014, but in 2004 I was appointed Departmental Training Manager, just six months after the introduction of the IBMS Certificate of Competence Portfolio as a route to registration with the Health and Care Professions Council (HCPC).

In my opinion, the advent of these forced us to look at what attributes are demanded from registrants by forcing them to submit evidence that their practice meets a minimum set of standards i.e. Standards of Proficiency.

Owing to the limited number of places in the laboratories, universities have a strict selection process that underpinned and changed my understanding of competence. The layout of all versions of the portfolio requires the student to demonstrate their developing knowledge, skills and understanding; however, the evidence required also demands that students demonstrate their professionalism. High academic marks are not enough; students must demonstrate professionalism i.e. communication skills, ability to work as a team, respecting confidentiality, equality and diversity in the workplace, organisational skills and overall practising to a professional code of conduct.

During my time as a biomedical scientist, it has been like night and day. Individuals could be in post for many years, or return to work after a significant absence, without ever having the tasks they performed assessed and recorded. Competence assessment was unheard of.

The evolution to the HCPC with Standards of Proficiency, followed by the introduction of portfolios and mandatory CPD, has brought requirements of registrants into sharp focus. High-impact improvements in skills, knowledge and scientists’ work is the outcome. Competence assessment emerged in the late 1990s. However, ISO 15189 accreditation has resulted in the need for structured training programmes to reflect skills and knowledge matrices, involving scheduled and recorded training with competence assessment and reassessment within justifiable, defined time frames. When independently assessed, the competences required for a given role and the overall competence of the individual must be evident.

Never before has the function of training managers and officers been so vital, necessitating that these are performed full time. Multifaceted knowledge, skills and experience combine to demonstrate job role competence. Departments that do not have dedicated training personnel will find it hard to build and maintain a system that supports staff to evidence competence. 

In recent years, competence has become more evidence-based, with a clearly defined set of standards to achieve or be demonstrated. It is led 
by documented evidence and reflective practice and must be available when competence is queried. This can become a “paper exercise” with the ability of the individual to complete paperwork being tested, rather than their ability at the task. We need evidence that competence exists. That should not be replaced with a bureaucratic process that measures ability to complete paperwork.

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