Read below for information on:

C-Change aims to complement the work of other cancer organizations who are actively addressing the cancer specialist workforce shortage by helping to strengthen the basic cancer competency of the non-oncology workforce. The figure below illustrates the opportunity to improve access to health professionals with, at least, basic knowledge in cancer:

	Oncology Specialists	Total Professionals
Nurses	21,000 Oncology-certified	2,000,000 Registered Nurses
Social Workers	1,200 Association of Oncology Social Workers Members	320,000 Licensed Clinical Social Workers

Using the examples above, the Cancer Core Competency Initiative is the key to giving approximately 2,000,000 registered nurses some of the basic knowledge held by the 21,000 oncology-certified expert nurses. With greater awareness of cancer - cancer risk factors, prevention and early detection strategies, understanding of the needs of patients, survivors, and families, and knowledge of the cancer care system - health professionals will be better able to meet the needs of people at risk for or living with cancer and better leverage the expertise of cancer specialists.

Investment in a competency-based program directly contributes to solving the workforce crisis in the following practical ways:

• The intervention offers students and professionals a meaningful and relevant opportunity for professional growth and development - a key component to recruitment and retention efforts.
  
• Program development fosters collaboration among experts serving as faculty resulting in interdisciplinary practice.
  
• The host organization benefits from a stronger workforce and from an improved image in the surrounding community of patients and professionals. Such a program increases the skills of staff to appropriately handle the special needs of people at risk for and living with cancer.

The following section includes a set of standards and tools that were carefully developed by a national expert panel. The standards and tools are both flexible and useful and were validated with the participation of several pilot sites. We encourage you to utilize the following materials and tailor them to the needs of your organization.

Key Concepts of the Cancer Core Competency Initiative Competency Standards: By defining competency standards, C-Change has defined a set of standards that can be used to develop and implement goal-oriented education programs with the ability to measure achievements in the knowledge, skills, and attitudes of training and practicing health professionals. Tools: Competency-based education is an approach that involves logic model-driven curriculum development, participant-focused teaching methods, and measurement of participant improvement. The standards and tools to carry out a cancer competency building program are described below. Together, the standards and tools provide flexibility and utility in developing educational interventions to improve cancer competency. Flexibility Across Disciplines: The competency standards are flexible and can be applied in a wide array of professional disciplines including but not limited to medicine, nursing, social work, and public health. The competency standards can be utilized by varying levels of expertise including students and practicing professionals. Utility Across Work Settings: The competency tools are useful in a wide array of settings from clinical environments such as ambulatory care clinics, cancer centers, hospitals, comprehensive cancer coalitions, professional societies, and advocacy organizations, as well as academic training programs for any health professional.

This figure illustrates that the competency standards are useful in any setting and flexible in any discipline.

Standards for knowledge and skills, or "Competency Standards", are the basic building blocks for workforce development. Competency statements define the tasks or functions that a person should be able to do or perform. They can be written in a manner that describes minimal, moderate, or maximal levels of expertise.

Similarly, they can be interpreted within a particular profession's scope of practice or in the context of an individual's years of experience or current role and responsibilities. For example, the general competency "manage symptoms of the cancer patient" will be performed differently by:

• A physician, who may prescribe specific medications;
  
• An occupational therapist, who may assist a patient in developing new approaches to activities of daily living; and
  
• A psychologist facilitating an understanding of new limits in physical activity.

All of these disciplines play an important role in managing symptoms for a cancer patient, but the focus and expertise they bring to the bedside are quite different.

The table below illustrates the comprehensive content that is addressed by Cancer Competency standards. Again, each standard should be interpreted within the context of the professional discipline and scope of the professional practice.

A comprehensive list detailing the domains and examples can be found on the Competency Standards page.

Domain I: Continuum of Care
Topic Prevention and Behavioral Risks	Competency Standard Example Describe evidence-based early detection guidelines based upon risk factors
Screening and Early Detection	Explain the benefits and risks of screening tests
Treatment	Manage late and continuing effects of cancer and cancer treatment
Palliative and End-of-Life-Care	Refer patients to community palliative and end-of-life care and support resources
Domain II: Basic Cancer Science
Topic Incorporate General Cancer Knowledge into Professional Practice	Competency Standard Example Participate in professional cancer education opportunities
Describe the Biologic Attributes of Cancer Etiology	Explain the relationship between cancer and genetics
Reference the Cancer Epidemiology and Risk-factor Data for Individuals and Specific Communities	Apply epidemiologic principles of sensitivity and specificity to cancer screening recommendations
Discuss Complimentary and Alternative Therapies	Assess patient and family beliefs regarding complimentary and alternative therapies
Support Participation in Clinical Trials	Describe a clinical trial process beginning with informed consent
Adhere to the Data Collection Standards in Reporting Cancer Cases to Hospital, State, and National Tumor Surveillance Registries	Describe the role of tumor surveillance registries
Domain III: Collaboration and Communication
Topic Participate Within an Interdisciplinary Cancer Care Team	Competency Standard Example Define interdisciplinary care
Incorporate Psychosocial Communication Strategies in Conveying Cancer Information	Recognize the signs and symptoms of cancer related anxiety and depression
Incorporate Cross-Cultural Communication Strategies in Conveying Cancer Information	Define culture-specific beliefs and practices
Describe Common Ethical and Legal Issues in Cancer Care	Adhere to HIPAA policies, procedures, and regulations
Incorporate Communication Strategies that Encourage the Process of Grieving	Assist oncology team members with the coping strategies over the death of patients with cancer

The tools provided on this website include a methodical step-by-step process to the program development process and include easily adaptable logic models and validation templates. These rigorously tested tools were proven to be effective in the pilot phase of the C-Change Cancer Core Competency Initiative. Examples of the tools can be found in the "How-To" section.

The competency standards coupled with the tools will help to: