Fundamental Paper Education Occupational Competency

Workplace safety and health are crucial for young workers. This article explores the importance of foundational workplace safety and health knowledge and skills, particularly for young workers, and introduces a framework of core competencies.

Introduction

In the United States, the Occupational Safety and Health (OSH) Act of 1970 mandates employers to provide a safe and healthy workplace, free of recognized hazards. Despite significant improvements in occupational safety and health since the OSH Act's enactment, work-related injuries, illnesses, and fatalities remain a pressing public health concern. Every day, more than 12 workers die on the job. Moreover, employers reported over 3 million nonfatal injuries and illnesses to workers in private industry and 746,000 in state and local government in 2013. Workplace incidents cause physical, financial, and emotional hardship for businesses, workers, their families, and communities.

The Vulnerability of Young Workers

Younger workers (aged 15-24) are disproportionately affected by workplace injuries. For numerous developmental and environmental reasons, their nonfatal injury rate is approximately two times higher than that of workers age 25 or over. Given this high burden, occupational safety education and training for this vulnerable population is imperative. Many current frameworks for teaching work-readiness skills to the emerging workforce do not include the knowledge and abilities for safe and healthy work. The nature and organization of work are evolving, and young workers can expect to change jobs and employers many times during their working lives.

Factors Contributing to Higher Injury Rates

The inverse relationship between age and non-fatal work injuries is a consistent finding in occupational safety and health research. As new workers, adolescents are likely to be inexperienced and unfamiliar with required tasks. Adolescents’ unique characteristics, such as their size, sleep requirements, musculoskeletal and endocrinal development, and cognitive and emotional maturity, may predispose them to workplace injuries. Adolescent sensation seeking and risk-taking, especially with peers, are also contributing factors. Moreover, the absence of negative consequences when engaging in risky behavior may increase feelings of invulnerability.

The epidemiology of adolescent work-related injuries is less studied than that of adult workers. However, a substantial evidence base identifies individual factors, including minority status and socioeconomic status, and work-based risk factors, such as the fast pace of work, inadequate supervision and training, equipment use, working late, and working with cash and customers, that increase the risk for job-related injuries among adolescents. Lack of job-related knowledge, skills, and training, and lack of job control also contribute to heightened risk among younger workers, who might be less likely to recognize hazards, less likely to speak up regarding safety issues, and less aware of their legal rights as workers.

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Foundational Skills for Workplace Success

The terms “21st century skills,” “work-readiness skills,” “job-readiness skills,” and “employability skills” have become watchwords in education, business, and government. However, workplace safety and health are often missing from current frameworks to prepare the future American workforce. Young people frequently enter the labor force lacking even the most basic workplace safety and health knowledge and skills needed to be cognizant of the safety and health challenges and hazards they may face.

Foundational skills in the context of work are considered the fundamental, portable skills needed for training and workplace success. These skills, including reading for information, applied mathematics, problem-solving, critical thinking, managing personal and interpersonal relationships, and communication, are fundamental because they support more advanced skill development and are portable because they can be applied across a wide variety of occupations. Foundational skills for workplace safety and health are situated within the larger context of “work readiness” skills, which are generally thought of as “life skills” with a strong work focus. Life skills are abilities that allow individuals to adapt to the challenges of everyday life.

Active vs. Passive Strategies in Injury Prevention

Historically, there has been tension between injury prevention programs that use “active” (i.e., behavioral) strategies and those that use “passive” (i.e., structural) strategies. Active approaches are based on the premise that people can take an active role in protecting themselves, despite environmental hazards. These approaches have raised concerns about “blaming the victim” for their workplace injuries and illnesses. However, although structural interventions might appear straightforward, environmental changes require human adaptation. This view is consistent with social ecological models of behavioral influences, in which individual behavior models are situated within a larger context of intrapersonal, interpersonal, organizational, community, and public policy dimensions. The basic premise of social ecological models is that providing individuals with the skills and motivation to change behaviors cannot be effective if environments are not supportive of change.

Because safety has both personal and environmental dimensions, it is essentially an ecological concept. To reduce an individual’s risk of injury requires systematically addressing the factors that influence individual behavior and choices. Therefore, injury prevention efforts are most effective when they are situated within an ecological framework that considers both individual and sociocultural factors.

The NIOSH 8 Core Competencies

Foundational workplace safety and health skills are missing from most work readiness frameworks. The NIOSH 8 Core Competencies were developed to prepare young workers to be cognizant of workplace risks and controls, and to participate in promoting safe and healthy workplaces. The framework for the 8 Core Competencies is based on the Health Belief Model (HBM), one of the most widely used theories in health behavior research and practice. The HBM is frequently used as a theoretical underpinning for research on adolescent health promotion.

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The development of the NIOSH 8 Core Competencies was informed by results of prior, formative research and is based in part on activities included in precursor curricula developed by partners in Massachusetts and California. The NIOSH 8 Core Competencies were articulated based on the six key constructs of the HBM-perceived susceptibility; perceived severity; perceived benefits of taking action; perceived barriers to taking action; cues to action; and self-efficacy. A theoretical approach was used to allow for the linking of subsequent educational interventions using the NIOSH competencies with behavioral change and, ultimately, with positive health outcomes.

The NIOSH 8 Core Competencies are:

Recognize that, while work has benefits, all workers can be injured, become sick, or even be killed on the job.
Recognize how to prevent injury and illness.
Recognize that employers are responsible for, and workers have the right to, safe and healthy work.
Identify hazards at work, evaluate the risks, and predict how workers can be injured or made sick.
Identify emergencies at work and decide on the best ways to address them.
Understand the importance of safety procedures and rules.
Know how to locate information about workplace safety and health.
Know how to communicate effectively about workplace safety and health.

The 8 Core Competencies are not specific to any individual vocation or trade; rather, they apply to all occupations and industries and support job-specific skills gained through apprenticeships and career technical and vocational training programs, as well as on-the-job training. The competencies are not meant to preclude or replace any subsequent workplace safety and health training; rather, they form the basis for future job-specific safety and health learning.

The Health Belief Model is based on the premise that for any behavior change to succeed, individuals must: 1) feel threatened (perceived susceptibility and severity); 2) believe that change of a specific kind will result in a beneficial outcome at an acceptable cost (perceived benefit and barriers); and, 3) feel themselves competent (self-efficacious) to take the necessary action and to overcome perceived barriers.

Perceived Susceptibility

Perceived susceptibility refers to beliefs about the likelihood of experiencing a risk or getting a condition or disease. Recognizing that all workers can be injured, become sick, or even be killed on the job aligns with the perceived susceptibility construct of the HBM. Increasing perceptions of susceptibility to job-related injury among working youth may be one pathway for helping them recognize that, while work has benefits, young workers experience a higher rate of workplace injuries when compared to adults. Research on health behaviors in young people demonstrates that perceived susceptibility predicted positive change related to certain health behaviors.

Equity in Competency Education

Equity is both a central goal and fundamental value of competency education. Competency-based approaches are designed to promote equity by preventing students from falling behind or staying behind. In practice, however, poorly implemented competency-based programs could inadvertently increase inequity-in opportunities and in outcomes. Equity concerns in competency education are often examined through the lens of family income, exploring the effects and implications, as well as proposing potential mitigations.

The COPA Model: A Framework for Competency Outcomes

Carrie B. Dr. Lenburg developed the Competency Outcomes and Performance Assessment (COPA) Model, based on work with the New York Regents College Nursing Program and multiple other educational, service, and organizational entities and conducting research related to them. It is a holistic but focused model that requires the integration of practice-based outcomes, interactive learning methods, and performance assessment of competencies. The essential components are reviewed briefly below to illustrate one approach that is applicable in education and service environments.

The basic organizing framework for the COPA Model is simple but comprehensive. It requires the faculty, and/or others responsible for program (or course) development, to analyze and respond realistically and collaboratively to four essential questions:

What are the essential competencies and outcomes for contemporary practice?
How can those competencies be assessed to assure validity and reliability?
What are the most effective ways to learn those competencies?
How can the program be evaluated and improved to assure continued relevance and effectiveness?

Essential Competencies and Outcomes for Contemporary Practice

Answering the first question involves identifying the required competencies and wording them as practice-based competency outcomes rather than as traditional and obtuse objectives. Redirecting the focus to achieve actual competence for practice challenges leaders in the profession to come to consensus about the major competency categories and subskills essential for diverse segments of practice.

In the COPA Model, a constellation of eight core practice competencies are categories under which a flexible array of specific skills can be clustered for particular levels, types, or foci of practice. These core competency categories collectively define practice and are applicable universally in education and practice environments. Although many of them are required simultaneously in actual practice, they are discrete skills that can be adapted to fit specific settings, clients, employees, and types and levels of students and practitioners. These essential core competencies are: assessment and intervention, communication, critical thinking, teaching, human caring relationships, management, leadership, and knowledge integration skills. Essentially all specific subskills nurses perform can be listed under one of these competency categories.

This framework is attractive, in part, because of the universality of its competency classification and its applicability to education and practice in various circumstances and environments. Quite simply, these core competencies outline the array of abilities all nurses need to incorporate in fulfilling their roles, whether clinical, educational, administrative or otherwise; the related subskills and their implementation will vary with circumstances.

A major difficulty instructors have, regardless of setting, is changing from the traditional perspective of writing and using behavioral objectives to more contemporary competency outcomes as the blueprint for basic and advanced learning and practice of the discipline. Outcomes are the results to be attained, the end product, the focus of all related activities; they require learners to engage in and become competent in skills used in practice. Objectives, on the other hand, as commonly used, focus on ways of learning and directions for learning the content. Most often they do not reflect practice-related abilities for which the content is to be learned.

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