Empowering Medical Assistants in Providing Standardized Patient Care: A Competency Model Approach

Description of the work: Medical assistants are becoming an integral part of the healthcare team in the ambulatory care setting. Due to differences in state and organizational requirements, medical assistants arrive in a healthcare setting with different levels of training and expertise. To ensure medical assistants begin orientation in their work area with a predictable skill set, this large academic pediatric medical center identified four core competencies inclusive of 16 skills medical assistants would be trained to perform. This would ensure that receiving units would have consistent expectations allowing for this valued personnel resource to be floated or shared within ambulatory divisions and sites, if needed in the future. Once the core competencies were identified, the organization needed to level the current medical assistant staff to ensure all medical assistants in the organization, regardless of division or site, were trained and could competently perform all aspects of the identified core competencies.

Methodology: A medical assistant core competency task force comprised of ambulatory clinical nursing leaders and educators was formed consisting of nine members from five different divisions. The task force met to identify the core competencies and to discuss the plan for implementation and training for the current medical assistants. Eleven classes were scheduled allowing for return demonstration of all core competencies. The classes were four hours in duration and were taught by registered nurse champions who became content experts of the skills stations they were teaching. Each class allowed for up to twenty-four participants. Participants rotated through six different skill stations (electronic medical record documentation, blood pressure, weight, head circumference/length, temperature, and respiratory rate/pulse oximeter). In addition, age-specific care was integrated throughout the skill stations. Detailed instruction sheets were developed for the registered nurse champions to use at each skill station to promote standardization. Return demonstration was the verification method for each skill. Leveling of medical assistant performance was assigned based on a three-point Likert scale, where three indicated no coaching was required to perform the skill successfully. Remediation was provided for any medical assistant who struggled with a skill.

Analysis and results: 177 medical assistants from 48 specialty services attended the training. Thirty registered nurses, eight clinical leadership members, and seven education specialists participated as nurse champions for the activity. All 177 medical assistants were trained in the core competencies and were able to perform the core competencies at the conclusion of the training class or after remediation at the unit level. A pre-survey was completed by 172 medical assistants, and 168 completed the post-survey to evaluate the impact of the educational activity on confidence level. A 5-point confidence Likert scale was used during this evaluation as well as content questions to review pre- and post-knowledge of the content matter. Confidence increased in fourteen of the sixteen skills that were measured, and knowledge increased from 76% correct responses to 87% correct responses in the identified areas.