Background- Competency based hand therapy is a critical component of evidence based practice and the maintenance of clinical standards. 
Problem- Few evidence based evaluation tools are available to assist in the training or evaluation of hand therapist competency. The complexity of conditions treated by hand therapists can range from low to high potential risk and requires a range of increasing complex technical and clinical reasoning skills, but this has not been mapped into competency evaluation tools. 
Intervention- A proposed tool - the RCCM (Risk Complexity & Competency Matrix) utilises an axis with a sliding scale of competency which starts from the base level of theoretical understanding and progresses through the stages of co-treatment and supervision to independence. On the other axis three levels of risk profile matching complexity of care need can be mapped. Methods to categorise competency levels, risk category and condition complexity will include peer review, reference to established risk matrices such as SAC coding, and questionnaires such as through survey monkey. 
Evaluation- This project is in its preliminary stage of development. Analysis of CHT peer evaluation of risk profiles will be undertaken, and the RCCM tool further refined. 
Recommendations- Peer reviewed and evidence based tools to map and evaluate progress in hand therapy competency are a key component of providing a quality therapy service. It is hoped that the development of the RCCM will assist in quality assurance activities.