employee competence and performancebased assessment a college of american pathologists qprobes study of larboratory personnel in 522 institutions objective to survey employee competence assessment practices in departments of pathology and laboratory medicine and provide suggestions for improvementdesign a 3part study consisting of a questionnaire about current competence assessment practices an evaluation of compliance with stated competence assessment practices using personnel records of 30 employees and a written appraisal of competence of 5 specimenprocessing staff members per institutionsetting a total of 522 institutions participating in the college of american pathologists 1996 qprobes programmain outcome measures institutional competence assessment practices compliance of each institution with their own practices and determination of competence of specimenprocessing personnelresults of the participating institutions 898 had a written competence plan and 981 reported reviewing employee competence at least yearly general competence was reviewed by direct observations 875 review of test or quality control results 774 review of instrument preventive maintenance 600 written testing 522 andor other methods 208 in 86 of institutions employees who failed competence assessment were not allowed to continue their usual work on review of records of 14 029 employees for adherence to the laboratorys general competence plan adherence was 897 for direct observations 858 for review of quality control and test results 780 for review of instrument records and 740 for written testing employee failure rate ranged from 09 to 64 depending on the competence evaluated adherence to an institutions plan was 904 for new employees 931 for computer skills 958 for laboratory safety and 921 for continuing education when a written competence assessment was given to 2853 specimenprocessing staff members 900 responded satisfactorilyconclusions opportunities for improvement in employee competence assessment are numerous and we provide several specific suggestions