Harmony Healthcare Blog

Core Competencies for Healthcare Clinicians

Posted by Pam Duchene on Tue, Nov 14, 2017

Edited by Kris Mastrangelo


Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency

Knowledge on Orange Puzzle on White Background..jpegThe healthcare environment is in a state of perpetual change and as such, the skills and capabilities of those working within the healthcare system require a continual assessment of competence.  Clinicians are responsible for ensuring that they consistently meet competencies associated with professional standards.  This means that those practicing within the healthcare environment need to adopt the habits of life-long learning and accept responsibility for developing competence for areas not included within their basic educational program. 

For clinicians, there are six core areas of competence 

  1. Clinical Knowledge
  2. Patient and Resident Care
  3. Professionalism
  4. Interpersonal Communication
  5. Clinically-Based Learning and Personal Improvement
  6. System-Based Practice and System Improvement 

Systems/organizations may hold identified and specific required competencies for clinical and non-clinical staff.  As an example, a competency on the 5/10 rule (when approaching another person, smile at 10 feet; greet at 5 feet) might be required for all employees within an organization.  In contrast, a competency on assessing a resident for orthostatic hypotension would be required for all clinicians monitoring blood pressure.  Although blood pressure monitoring is a standard component of nursing programs, methods of measuring blood pressure for orthostasis can vary, and clinical competence cannot be assumed. 

In identifying required competencies, the organization must determine which areas of competence for which the organization will require validation, the frequency of competence validation, and the system for documentation of competence validation.  It is imperative that the system in place be reviewed on an ongoing basis for applicability, necessity, and integrity.  

Core Competencies are identified and typically assessed during the introductory employment period.  Annual competencies are reviewed on an annual basis.  Many organizations use electronic learning management systems for the annual required competencies.  This enables a systematic approach to competence review and documentation.  Some clinical skills require an annual or more frequent review to assure maintenance of competence.  An example is the Clinical Laboratory Improvement Amendment (CLIA) waivered test of glucose monitoring devices.  Competence in use of the glucose monitoring device must be reassessed periodically (optimally, on an annual basis). 

Following is a guideline for consideration of competency requirements: 

  • Core Competencies: Established based on the role or job to be performed.  Performance reviewed and documented during the introductory period.  Examples:  Skill checklist for clinical staff; completion of competency post-tests for non-clinical/non-skill competencies.
  • Annual Required Knowledge: Inclusive of organizational competencies for performance and skills for which annual competence must be demonstrated.  Example:  Annual test of the meaning of RACE for fire emergencies; attendance at a skills day for clinical staff members during which BLS skills are demonstrated. 

The policy on competency determination should include the method for documentation of competence.  A sample competence documentation form is noted below: 

Competency for:


Competency Steps

Date Completed






































Printed Name:




Printed Name:


References:   List appropriate references for the competence in this section.




Harmony Healthcare International (HHI) is available to assist with any questions or concerns that you may have.  You can contact us by clicking here.  Looking to train your staff?  Join us in person at one of our our upcoming Competency/Certification Courses.  Click here to see the dates and locations. 


Holmboe, E. S. (2017). Practical guide to the evaluation of clinical competence. S. J. Durning, & R. E. Hawkins (Eds.). Elsevier. 

Lejonqvist, G. B., Eriksson, K., & Meretoja, R. (2016). Evidence of clinical competence by simulation, a hermeneutical observational study. Nurse education today38, 88-92. 

Tavares, W., & Eva, K. W. (2014). Impact of rating demands on rater-based assessments of clinical competence. Education for Primary Care25(6), 308-318. 

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