Appendix a Competency Assessment Schedule Title: Competency Assessment

Appendix a Competency Assessment Schedule Title: Competency Assessment

Lab Name / Title: Competency Assessment
Site:

Competency Assessment Examples

Author: OmarDualeh / Document Number: / Per30-03
Effective (or Post) Date: / 25-August 2010
Review History / Date of last review: / NA
Reviewed by: / Heidi Hanes
SMILE Comments: This document is provided as an example only. It must be revised to accurately reflect your lab’s specific processes and/or specific protocol requirements. Users are directed to countercheck facts when considering their use in other applications. If you have any questions contact SMILE.

Title: Competency Assessment

1.COMPETENCY ASSESSMENT SCHEDULE

Competency assessment is an ongoing process that occurs throughout the year. Assessment activities may be scheduled to coincide with other review processes. The following schedule is a tool for organizing assessment activities. It is not intended as a rigid schedule.

Lab Location: / Department: / Year:

Date Completed

Month

/ Job Assignment (Training Module) /

DO

/ RR / TP / WT

DO – Direct Observation RR – Record Review TP – Test Performance WT – Written Test

SEMIANNUAL ASSESSMENTS:

Employee / Job Assignment / Month Due

Direct Observation Title: Competency Assessment

2.DIRECT OBSERVATION CHECKLIST

Employee Name: / Job Assignment:

Acceptable?

Step Observed: / YES / NO / N/A

3.Employee Signature: ______Date: ______

Observer Signature: ______Date: ______

Supervisor Assessment:

Employee demonstrates competency

Minor deviations reviewed. Employee demonstrates competency. (Document corrective actions below).

Remedial training required. Employee can not perform test until retraining is complete. Review employee’s previous work to see if patient results were affected.

Supervisor/Designee: ______Date: ______

Minor Deviations:

Step # / Comment / Employee Initial

Record Review Title: Competency Assessment

4.RECORD REVIEW CHECKLIST

Employee Name: / Job Assignment:

Acceptable?

Records Reviewed: / ID or Date / YES / NO / N/A

5.Employee Signature: ______Date: ______

Reviewer Signature: ______Date: ______

Supervisor Assessment:

Employee demonstrates competency

Minor deviations reviewed. Employee demonstrates competency. (Document corrective actions below).

Remedial training required. Employee can not perform test until retraining is complete. Review employee’s previous work to see if patient results were affected.

Supervisor/Designee: ______Date: ______

Minor Deviations:

Step # / Comment / Employee Initial

Test Performance Title: Competency Assessment

6.TEST PERFORMANCE ASSESSMENT

Employee Name: / Job Assignment:

This assessment tool applies only to those individuals who are directly involved in the testing process. Test performance may be assessed using either a proficiency test challenge or reanalysis of previously analyzed or blind specimens. At least one representative analyte should be tested from each job assignment or training module. It is not necessary to assess all analytes for a particular job assignment.

PROFICIENCY TEST:

This employee successfully analyzed the following analytes from this training module on the following external or internal proficiency test survey:

Analyte(s) tested: Date tested:

Proficiency test ID:

REPEAT ANALYSIS OR BLIND TESTING:

Analyte(s) tested:Date tested:

Sample ID:Result Obtained:Acceptable Range: ______

______

______

______

______

7.Employee Signature: ______Date: ______

Supervisor Assessment:

Employee demonstrates competency

Minor deviations reviewed. Employee demonstrates competency. (Document corrective actions below).

Remedial training required. Employee can not perform test until retraining is complete. Review employee’s previous work to see if patient results were affected.

Supervisor/Designee: ______Date: ______

Minor Deviations:

Step # / Comment / Employee Initial

Written Test/Problem-solving Title: Competency Assessment

8.COMPETENCY ASSESSMENT QUIZ

Employee Name: / Job Assignment:
  1. Question #1.
  1. Question #2.
  1. Question #3.
  1. Question #4.
  1. Question #5.
  1. Question #6.
  1. Question #7.
  1. Question #8.
  1. Question #9.
  1. Question #10.

9.Employee Signature: ______Date: ______

Supervisor Assessment:

Employee demonstrates competency

Unacceptable answers reviewed. Employee demonstrates competency. (Document corrected answers below).

Remedial training required. Employee can not perform test until retraining is complete. Review employee’s previous work to see if patient results were affected.

Supervisor/Designee: ______Date: ______

Incorrect answers:

Step # / Comment / Employee Initial
SOP ID:
SOP version # / Page 1 of 7
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