Number/percent of trainees competent to provide specific services upon completion of training

“Competence" refers to the trainee's ability to deliver a service according to a set standard, which may differ according to the training context. Thus, the program (or evaluator) must determine the standard that is appropriate for the context. Examples may include clinical guidelines or programmatic guidelines set at the national or international level. Training organizations use "competence" to refer to the acquisition of skills (although performing a skill often requires knowledge). "Upon completion of training" refers to the final assessment given as part of the training event.

This indicator is calculated as:

(# of trainees delivering services according to set standards / total # of trainees tested) x 100

Listing of trainees; pre-established operational definitions of criteria determining competency; assessment of each trainee against established standards for a number of service delivery or programmatic tasks, conducted by an expert observer

Competency tests as determined by the program (often in the form of a checklist administered by the trainers and/or external expert observer)

This indicator measures the technical competence of participants who have completed training in a specific skill set. The indicator reflects both the adequacy of the training and the ability of trainees to absorb the information.

Several training organizations working in reproductive health have made considerable efforts to standardize the items on the checklist for given program areas (e.g., family planning) as well as the interpretation of each item on the list (e.g., what constitutes satisfactory performance on that item).

However, at the field level, programs and evaluators may use inconsistent criteria to define competency. Some programs may expect a 100 percent grade before they judge the trainee competent in a battery of skills, whereas another organization may judge competency at the 50 percent grade level. In some cases, local standards for the delivery of family planning services may not exist, in which case evaluators can use international standards.

Assessing competency generally is more complex than the simple testing of knowledge. Whereas measuring knowledge is easier than measuring competency (i.e., the correct performance of skills), the latter is more likely to define the quality of care that providers give. Some potential measures of competency are client-exit interviews, observation, self-reporting (acknowledging the inherent bias), or provider-interviews using vignettes.

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