Association for Children of Alcoholics recently published core competencies using a structure with levels (Adger et al., 1999). The first of three levels of competency is presented as the minimum for all health care providers and includes basic knowledge and skills in identifying cases, assessing needs and services, expressing concern, and offering support and referral. Health professionals who choose this role are “not expected to solve, manage, or treat the problem by themselves.” However, they must “be able to collaborate with and refer to those who have the skill and expertise to provide these specialized services” (Adger et al., 1999, p. 1083). Competencies for persons at the next level include prevention, assessment, intervention, and coordination of care. At level three, long-term treatment is added to the list.
By not prescribing roles, this leveling schema has the advantage of allowing flexibility. Some health care professionals may need or be required to achieve competence at the advanced, specialized level based on the responsibilities of their roles and positions; others will choose to advance based on personal interest; and others may advance to fill local system gaps in services. The complexity of cases differentiates the need for varying levels of competence, defined in terms of amount of knowledge about the specified area (Auslisio et al., 2000).
The Oklahoma Principles, based on a multidisciplinary family violence conference of experts (Brandt, 1995, 1997), provide a detailed set of goals and objectives for three levels: Family Violence 101 includes core competencies to be mastered prior to graduating from a health professions school (e.g., medical school, nursing school, dental school). Family Violence 201 includes curricular principles for practicing primary care providers and for specialty-trained health professionals. Family Violence 301 includes curricular principles for scholars and leaders in family violence (expert clinicians, educators, researchers, curriculum architects, policy experts, and other experts in this field). The bulk of education for the 101 course or level is expected to take place during and within professional school, so that all graduating students can be assumed to have a stable foundation in the field. Education for the 201 level is expected to occur during postgraduate training (residency, advanced clinical work, or first-level graduate study) and is differentiated for primary care providers and specialty trainees, who would be expected to acquire more detailed expertise in more limited areas. Development of the 301 level expertise begins during fellowship or other advanced training and would continue as a dynamic, career-long process. These levels were formulated to guide curriculum development, program evaluation, career development, and policy formulation.
The American Association of Colleges of Nursing (1999) offers another scheme, classifying competencies for intimate partner violence according to educational program, baccalaureate versus master’s. The master’s education level moves beyond basic knowledge and skills to leadership competencies, such as developing, analyzing, and evaluating intimate partner violence programs.