To the Editor.—We read the article, "Competence of Child Health Associates," by Machotka et al (Am J Dis Child 125:199-203) with interest. At present the medical profession is under pressure to assure the public that all those who are involved in the delivery of health care are competent (defining competency as having the necessary cognitive, psychomotor, and affective abilities to perform the tasks assigned to an individual within the health care delivery system).
To determine the cognitive competency of allied health professionals is, therefore, a highly desirable objective. However, it is essential that research intended to compare the knowledge of various groups of health professionals be as sound as that used in comparing the effectiveness of drugs or different diagnostic procedures. When the authors of the above paper state that their report "documents the extent, adequacy, and relevance of the child health associates' basic science training and knowledge of