Part II- Designate, Develop, and Demonstrate

Nov. 28, 2023

Q: November’s article asked: “We just had a staff meeting and our manager told us that ‘Results from a recent survey of the department stated we need to have more competency for the staff and the work they do.’ Do you know how many competencies a department should have?”

After last month’s cliffhanger, this month we will address:

  1. How do you develop competency?
  2. How many competencies should a department need/have?

First, it is necessary to have a policy outlining how to do an assessment of what skills are vital for performance within the department. Next, decide what method they will use to assess staff competency. This will vary from department to department.
Skills might be a) how to brush/clean medical devices, b) how to operate an ultrasonic cleaner, or c) how to read a sterilizer record. What are the vital skills needed in your department? I believe this should be a combined effort with staff and management.

Experts agree there are three primary competency assessment methods.

  • Self-assessments: employee evaluates their own level of competency.
  • Manager assessments: manager evaluates the employee’s competency.
  • Assessment: employees are evaluated by more than one person (i.e., managers, preceptor, peers, and subordinates).

Next, how do you write and perform the competency assessment?

Based on an article published on this topic by OR nurse and educator Alice Speers, RN, this is the formula I used when I was in a leadership position. I would advise all to read Ms. Speers’ article.1 I have adapted and modified her teachings to meet my needs.

  1. Define the competencies you want to assess.
  2. Observe the employee and request feedback based on the competencies you wrote.
  3. Determine the employee’s expected competency level (score).
  4. Develop an action plan if a deficiency is determined. Did not achieve the desired score
  5. (outcome).
  6. Communicate the result.
  7. If there is a deficiency, then retrain and retest.

Based on your questions, the surveyor may believe your department needs more competency testing to show the staff performed properly, or perhaps they saw something incorrectly performed and that your manager could not show adequate training for that specific skill.
Second, how many competencies should a department need/have? I had 15 departmental competencies. Once completed, we started over again for all the staff. I believe each department is different, and leadership in concert with staff needs to devise what is important for their department. I do not believe in a fixed number for any department.

This process should be documented and saved to show anybody how you produced your set of competencies for your department. Also, it can change over time. Maybe you do not use Ethylene Oxide (EtO) anymore, but now use another form of low-temperature sterilization, replacing your EtO competency. Our work is ever changing, and so should our competencies (along with our knowledge).
In closing, consider the Chinese philosopher Lao Tzu, founder of Taoism, who said, “Give a man a fish and you feed him for a day. Teach him how to fish and you feed him for a lifetime.” Let’s revise it some. Teach a medical device reprocessing professional how to do something correctly with the why, and they will do it right for a lifetime.
If you recall “my C2” from Part I, I said certification is part of the answer. Ring in the new year with January’s issue to discover the last piece—why certification should be considered when developing competency for medical device reprocessing professionals.


  1. Speers, Alice T., RN. (2005). Centra Processing technician Internship – A Unique Learning Opportunity. AORN Journal. August 2005; Volume 82, Issue 2. 231-243.

Original photo courtesy Bayhealth SPD, HPN's 2021 SPD of the Year, with affects added by generative AI.
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