Template

Competency Matrix & Skills Checklist

Interactive competency assessment template and printable skills checklist. Use this form to record role-specific competencies, assessment method and date, results, remediation plans, training resources, and next-assessment scheduling. Records are saved for auditing, re-credentialing, and workforce planning.

Interactive Tool

Competency Assessment & Skills Checklist

How to use this template

This interactive assessment captures one competency instance (one skill or procedure for one role). Use repeated submissions (one per skill/role pairing) to build your full competency matrix. Export or download submissions to assemble a printable matrix or import them into your LMS/HR system.

Suggested matrix column layout: Role | Skill / Procedure | Minimal Standard | Assessment Method | Assessment Date | Assessor | Result / Score | Remediation Plan | Next Due

Printable checklist: After saving assessments, filter by role or skill to create a printable checklist for supervisors. Consider exporting to CSV for bulk edits and reporting.

Quick tips:

  • Be specific when writing the minimal competency standard (observable actions and acceptable tolerances).
  • Use consistent assessment methods (direct observation, simulation, written test) so results are comparable.
  • Record remediation plans with target dates and assigned trainers.
e.g., Registered Nurse - ICU, Phlebotomist, Respiratory Therapist
Optional: department, unit or site
Short label for the competency, e.g., Central Line Dressing Change
Describe what 'meets standard' looks like in observable terms
Choose the method used for this assessment
YYYY-MM-DD or free text date
Person who performed the assessment
High-level outcome
Optional numeric score where 5 is highest
How often this competency should be re-assessed
Enter number of months between assessments (optional)
If assessor marked 'Does not meet' or 'Borderline', set yes and add a plan
Who will do what, with what resources, and by when
YYYY-MM-DD or free text
List courses, SOPs, checklists, mentors, or links to learning modules
Where supporting evidence (photos, checklists, test results) is stored
Date when the next assessment should occur
Name and title of supervisor verifying the assessment
Any contextual notes helpful for audit or re-training
Select to mark this record for inclusion in exported matrices
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