1. Competence and Evidence Jackie Wales Royal Hospital for Sick Children

2. What does it mean to be competent? ‘Ability to perform a technique or procedure to the required standard consistently with minimal or no supervision’

3. IBMS Certificate of Competence Professional attitude Skills Knowledge Precedent now set at registration

4. FIT TO PRACTICE Knowledge Understanding Evidence based Reflective Practice Problem solving and decision making Technical skills Professional code Ethics Attitudes

5. The bigger picture Learning Outcomes (What do I want staff to know, do and understand?) Learning & teaching strategy (What methods will best help staff achieve the learning outcomes?) Assessment criteria (How will I know if the member of staff has achieved the learning outcomes) Assessment strategy (What method(s) of assessment is best suited to staff demonstrating the learning outcomes?)

6. Basic aims of assessment Assess the performance of staff in relation to the aims and outcomes of a particular learning activity Act as an integral part of the teaching and learning process Serve as feedback to staff regarding his/her progress

7. Cardinal Criteria Validity – extent to which a test measures what it is designed to measure Reliability – similar results when used on separate occasions with different assessors Discrimination - distinguishes clearly between those who have reached the standard and those who have not Practicality/usability – consider resource constraints

8. Feedback Meaningful Appropriate Specific to the assessment Timely Simple

9. Approaches to Competency and Assessment Task based/behaviourist – associated with achieving a specific standard Generic approach – broad cluster of abilities with underlying attributes. Difficult to assess Integrated/holistic – Links the above taking into account attitude, knowledge and skills

10. Evidence – Cognitive competencies Questions – Written or oral – integral part of learning Assessment discussion Testimony of others – witness statements, can be linked to direct observation Projects/case studies

11. Professional judgement Assessing competencies has to bring in own professional judgement Knowledge and experience

12. The Yorkhill Experience Departmental training manual based on learning outcomes Initial set of questions aimed at students/trainees Use of National Occupational Standards in the design of competency records Development of assessment methods

13. Skills RequiredKnowledge and Understanding Start up procedure and daily running QC Principle of analyser Load reagents and screening cells, including appropriate diamed cards What action to take in event of QC failure Load samples and request desired tests from menu Location of relevant SOP/COSHH material Recognise alarms and carry out minor troubleshooting remedies Sample suitability e.g. unable to process clotted samples. Situations where manual group and antibody screen is required Replenish reagent, empty waste and carry out routine maintenance Transmission of results to host computer Shut down procedureAuthorisation/printing of results (see learning outcome Use of Telepath Computer System) Level of responsibility and authority: Training must be carried out by a qualified member of staff with experience of this analyzer. OVERVIEW: On completion of training, trainee must be able to operate analyzer, carry out QC procedures and perform routine maintenance.

14. Staff Signature Witness Signature Date Operational Theoretical Troubleshooting Record of Completion

15. The Learning Process Awareness & Understanding Practise & Feedback Consolidation of Learning Don’t Know, can’t do Do know, Can’t do Do know, can do Can do intuitively Can do expertly

16. National Occupational Standards? Based on outcomes, or the measurement of outcomes against national predefined standards. Statements of practice that will ultimately provide a basis for the development of assessment of competency Each standard aims to capture the decision making process, the knowledge required and the judgement applied

17. Member of Staff/Trainee DepartmentHaematologySection: Specimen reception TaskReceive specimens for processing – Receipt of all types of specimen including correct identification and appropriateness of sample Key CompetenciesDateTrainee Signature Trainers Signature Trainee/Trainers Comments Check specimen for correct container, damage, suitability for processing and reason for referral Differentiate between those specimens which can be processed and those that need referral elsewhere Take appropriate action to deal with leakage, spillage, breakage or other contingency Check labelling of specimen for complete details and match to request documentation Take appropriate action to deal with inadequate or incomplete labelling Record date and time of specimen arrival at point of reception Identify high risk and those with hazard warning labels Identify urgent samples and notify relevant staff

18. Knowledge and Understanding DateTrainee SignatureTrainers Signature Comments Local procedures for specimen receipt and distribution The importance of identifying referral reason, test required and suitability for processing How to differentiate between those specimens which can be processed and those which need referral elsewhere Local procedures for handling, storage and disposal of specimens The importance of correct identification including uniques individual, specimen and laboratory numbers

19. Record of Competency Competency Assessment Date Completed Trainee Signature Trainers Signature Trainee/Trainers Comments

20. TasksDocument Numbers to be completed ABO & Rhesus blood group HAE-CR- B001 HAE-TLO- B001 Antibody Screen HAE-CR- B002 Antibody Identification HAE-CR- B003 HAE-TL0- B003 Selection of Blood components HAE-CR- B004 HAE-TLO- B004 HAE-TLO- B008 HAE-TLO- B009 HAE-TLO- B010 HAE-TLO- B011 Detect and Monitor Antibody Status in Pregnancy HAE-CR- B005 HAE-TLO- B002 HAE-TLO- B005 Investigate Feto-maternal haemorrhage HAE-CR- B006 Investigation of transfusion reaction HAE-CR- B007 HAE-TLO- B006 Blood and blood product stock entry and dereservation procedures HAE-TLO- B007 Bone marrow harvest HAE-TLO- B012 Good Manufacturing Practice Attended presentation and completed competency assessment Certificate issued

21. Completion of records – Standard phrases Experienced member of staff trained in procedure prior to development of learning outcome. Training completed prior to establishment of competency records Assessments are available for staff to complete for CPD records – competency is assessed primarily by observation, examination audits and participation in External Quality Assurance schemes

22. Q-Pulse - Training module Create a training event in Q-Pulse Add attendees to event Complete above records electronically Attach completed records to individual records

23. Q-Pulse – Staff module Open individual staff record Produce a hard copy of training history Review options e.g. PDP or Competency review

24. Have we gone too far? HPC Code of conduct, performance and ethics HPC Standards of Proficiency HPC Standards for CPD CPA Standards MHRA IBMS Standards for Pre and Post registration training - due for release early 2009

25. Skills for Health – National Occupational Standards IBMS Specialist portfolios based on National Occupational Standards Knowledge and Skills Framework

26. Quality Improvement Scotland Standards (3a.2) – Competency based training and assessment systems are in place and training records are maintained Safe, Accurate and Effective Modernising Scientific Careers