Competency and Proficiency
These two terms are often used interchangeably, but it is important to clear about their definitions and the difference between them. Flip the cards to find out more:
Learning for professional development is designed to equip learners for their current or future role. This means they need to be competent in all the key areas of that role, and that this should be reflected in the learning outcomes of the programme
Standards
The competency areas for any role require an external reference which needs to identify the areas of expertise required and the level of proficiency needed in each area.
In the UK, there are two common sources of standards, Professional standards and National Occupational Standards
Professional standards
Many professions are governed by professional bodies that define competency standards for roles within that profession.Typically, they define competency frameworks that provide a list of the areas where professionals need to be competent. They often do not specify a level of proficiency necessary to be competent.
For example, take a look at the Generic Professional Capabilities Framework from the General Medical Council.
It covers nine broad domains, but does not cover the requirements of specific clinical specialties:
- Domain 1: Professional values and behaviours
- Domain 2: Professional skills
- Domain 3: Professional knowledge
- Domain 4: Capabilities in health promotion and illness prevention
- Domain 5: Capabilities in leadership and team working
- Domain 6: Capabilities in patient safety and quality improvement
- Domain 7: Capabilities in safeguarding vulnerable groups
- Domain 8: Capabilities in education and training
- Domain 9: Capabilities in research and scholarship
Similar frameworks exist for nursing, midwifery and the other clinical professions.
The Solicitors Regulation Authority provide a competence statement made up of three parts:
- The Statement of Solicitor Competence that sets out what solicitors need to be able to do to perform their role effectively;
- The Threshold Standard; and
- A Statement of Legal Knowledge, both of which show the standards for practising and using the title of solicitor
that defines the continuing competences that are required from all solicitors.
Read them here:
The threshold standard does start to define the level of proficiency required.
National Occupational Standards
For job roles not governed by a professional body or regulator, the UK Government has approved over 23,000 National Occupational Standards (NOS). They have been developed by Standard Setting Organisations (SSO) who consult with employers and other stakeholders across each of the UK nations: Scotland, Wales, Northern Ireland and England. T The NOS, which are set out in a common format, are approved on a four-nation basis and content is scrutinised by SQA Accreditation. Each NOS has a published date stating when it was approved, and the most current NOS are listed in a database. There is also an anticipated review date and this is used as a guide to when they require reviewing and feedback from stakeholders is taken to influence when this is commissioned.
NOS can be used for developing skills and knowledge by direct transfer into vocational and other qualifications, defining a framework for training programmes, creating measures of workplace competence and influencing job descriptions. They can also be used to inform the learning of professional development programmes in the area of the standard.
Consider the NOS entitled “Develop employees for your business”
This standard is for entrepreneurs who need to develop employees for their business. Helping people to improve their skills will allow your business to increase productivity, improve the quality of the service or products you offer and support the continuing development of your business. Developing your employees involves deciding on their development needs, planning and setting targets for development, and completing their training in-company or externally.
It states that you might do this if you need to make your business or social enterprise more productive, improve the quality of the product or service of your business or social enterprise, make changes to staff roles to develop and expand your business or social enterprise, or monitor employees’ progress. It defines 19 performance criteria and 23 required areas of knowledge and expertise
You can search for an appropriate NOS from the complete list here.
National Occupational Standards provide an insight into the areas where learners need to be competent, but will require adaptation before they can be used to specify learning outcomes.
The Novice to expert model of proficiency
One of the biggest challenges is defining the level of proficiency required for competency. An influential model is the Novice to Expert approach, first proposed by Dreyfus as a model of skill acquisition in 1980.
In 1984, Benner outlined an adaptation of the Dreyfus model of skill acquisition as applied to Nursing. Her model suggests a number of stages on the way to becoming a skilled practitioner. Benner describes these levels as being based upon three aspects of overall performance. Firstly, the paradigms shift from abstract rules to life experiences as the basis for behaviour. Secondly, a change in perception of situations, from a collection of disparate equal parts to a complete entity in which some parts have more relevance or importance than others. Thirdly, the move from “detached observer” to “involved performer”. Within this framework, there are five stages through which the learner will pass on their way to becoming an expert
Table 3: Six levels of the Performance Model (after Benner, [6]).
| Level | Designation | Description |
| 0 | Unskilled /Not Relevant | The individual is unable to perform this skill even under instruction or the skill is not required in this role |
| 1 | Novice | The individual has little or no experience in this aspect. Able to perform only under close instruction or guidance. |
| 2 | Learner | The individual has some experience in this aspect and is able to perform with minimal day-to-day supervision but still requires regular instruction or guidance as new situations arise. |
| 3 | Competent* | The individual performs in this aspect regularly and is able to work effectively, without supervision, on a day-to-day basis, but may need occasional instruction, guidance or support when confronted with unusual situations. |
| 4 | Proficient | Skilful in this aspect. The individual has a wealth of experience and functions with only managerial supervision. Is capable of demonstrating this aspect to others |
| 5 | Expert | Highly skilful in this aspect with several years experience. The individual has an intuitive grasp of the aspect and requires no supervision other than clinical governance. Acts as a mentor and innovator in this aspect. |
*Benner defines level 3 as competent. This use of the term refers to the level required for an individual to function autonomously in the role, and differs from the way we define it
The key to using this model effectively is that skilled performance is not simply a measure of outcome, or simplistic behaviour, but includes the way in which the individual processes information before acting and then in the way in which they act in order to achieve a desired outcome.
It may be argued that anybody of reasonable intelligence and ability could, given a set of detailed instructions, undertake a range of highly complex activities. Whilst this would achieve a desired output, it would not mean that they are an expert; rather that they are capable of following instructions which will produce an acceptable outcome, as long as nothing untoward occurs. This is the level of performance described by Level 1 – Novice. Here, performance is dictated by adherence to context-free rules when determining actions. Thus, the learner’s actions are guided to provide the achievement of a task. However, performance is also constrained by these same rules as no account is taken of the relative importance of different components within the situation
At level 5, the individual now performs as an expert. The learner has passed beyond the need for what Benner refers to as “analytic principle”. Now the clinician is able to adapt their actions outside of those prescribed in response to events. Rather than following a list of instructions or cognitively referring each situation to the archive of past experience for comparison, actions are now refined to such an extent that they are performed from an intuitive grasp of the current situation. At this level of performance, iterative descriptions become problematic due to the complexity of the processes involved. There are clear similarities with the threshold standard defined for solicitors.
While describing what constitutes expert performance in isolation may be difficult, recognising it is relatively simple, not from a single incident but over a period of observation. Benner states that “Expertise takes time to develop, and it is neither cost-effective nor practical to try to “teach’ it in formal educational programs.” The role of education and training therefore, is to provide the learner with the appropriate theoretical knowledge to enable them to maximise the learning available from each experience, thus allowing the development of their expertise.
A fundamental problem with the Benner model is that, across the board, an individual’s performance is not uniform in all aspects of their role. As the model is situational and experientially based, performance in disparate areas will necessarily be at different levels depending on the theoretical knowledge and previous experience of the individual. In order to address this, the authors have used the skill acquisition model of performance to relate not to the whole individual, as is the case in Benner’s work, but to selected facets of performance expertise against each competency item. Thus, a learner may be an expert in one competency item due to their level of experience and theoretical knowledge, whilst at the same time being a novice in a competency of which they have no experience or background knowledge.
In a development of the original Benner model, the author of this programme, together with John Howard, developed a version of the Novice to Expert model where a level of proficiency required for competence is specified for each area of competence.
Using this model, individuals with levels of proficiency in specific areas below that required for a current or future role are defined as having a specific professional development need.
Mapping proficiency to learning objectives
Educationalists like to use Bloom’s taxonomy for defining the level of educational programmes and the level of learning outcomes associated with them. In the field of adult professional learning, it makes more sense to link them to a competency area and define the target outcome level in terms of novice to expert.
As an example, Performance Criteria 3 from the Develop employees for your business NOS states that staff must be able to “identify and agree development needs for employees through appraisal or discussion”
This can be translated directly into a learning outcome:
By the end of the programme, learners should be able to identify and agree development needs for employees through appraisal or discussion.
However, this can be refined according to the required proficiency level for this activity:
| Learning outcome where the necessary proficiency level is Level 1: Novice: | By the end of the programme, learners should be able to identify and agree development needs for employees through appraisal or discussion under close instruction or guidance |
| Learning outcome where the necessary proficiency level is Level 2: Learner (as defined by Benner): | By the end of the programme, learners should be able to identify and agree development needs for employees through appraisal or discussion with minimal day-to-day supervision but will still require regular instruction or guidance as new situations arise. |
| Learning outcome where the necessary proficiency level is Level 3: Competent (as defined by Benner): | By the end of the programme, learners should be able to identify and agree development needs for employees through appraisal or discussion under close instruction or guidance effectively, without supervision, on a day-to-day basis. |
And so on…
Using this approach, by assessing each learner’s proficiency in each area, the areas where they require professional development can be identified. If the learning outcomes are mapped onto the same areas in terms of both area and outcome proficiency level, then they can be matched to programmes that will meet their needs and fill the gaps in their competency, either for their current or future role.
Further reading
Burke, A. E., Sklansky, D. J., Haftel, H. M., Mitchell, A., & Mann, K. J. (2024). Competency-based medical education and the education continuum: Establishing a framework for lifelong learning. Current Problems in Pediatric and Adolescent Health Care, 54(9), 101642. https://doi.org/10.1016/j.cppeds.2024.101642.
Batt A, Williams B, Rich J, Tavares W. A Six-Step Model for Developing Competency Frameworks in the Healthcare Professions. Front Med (Lausanne). 2021 Dec 14;8:789828. doi: 10.3389/fmed.2021.789828. PMID: 34970566; PMCID: PMC8713730.
Other references
Benner, P. (1984). From novice to expert, excellence and power in clinical nursing practice. Menlo Park, CA: Addison-Wesley Publishing Company.
Dreyfus S, Dreyfus H. A five stage model of the mental activities involved in directed skill acquisition. California University, Berkeley Operations Research Center [monograph on the Internet]; 1980.