Development and Implementation of a Standardized Competency-Based Educational Framework for Home Health Aides: A Quasi-Experimental Study
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Background: Home health aides provide essential support in home-based care, but conventional training often emphasizes completion of instructional hours rather than demonstrable caregiving competence. This study evaluated whether a structured competency-based educational framework could improve aide knowledge, practical skills, and overall performance. Objective: To assess the effect of a four-week competency-based training program on knowledge, skill performance, and supervisor-rated performance among certified home health aides. Methods: A quasi-experimental one-group pre-test and post-test study was conducted among 50 certified home health aides working in a Medicare-certified home health agency in the United States. The intervention included theoretical sessions, demonstrations, hands-on practice, group discussion, and case-based scenarios. Outcomes included knowledge score, practical skill performance score, overall performance rating, and competency-domain scores. Results: Knowledge scores increased from 62.40 ± 8.50 to 82.70 ± 6.20, with a mean gain of 20.30 points and a descriptive standardized mean difference of 2.73. Skill performance improved from 58.90 ± 9.10 to 80.50 ± 7.40, and overall performance increased from 60.20 ± 7.80 to 84.10 ± 6.00. Infection control showed the largest competency-domain improvement, increasing from 55.0% to 85.0%. Conclusion: The competency-based educational framework was associated with substantial improvement in home health aide knowledge, practical skills, and observed performance, supporting further controlled evaluation in larger home healthcare settings
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