Consistent demonstrated competency in equipment use including but not limited to: biomedical hemodynamic and physiologic monitoring systems, coronary and peripheral angiography, angioplasty and stenting, intravascular ultrasound, intracardiac echocardiography, doppler measurement, fractional flow reserve measurement, rotoblator, directional debulking, and laser atherectomy, cryoplasty, thrombectomy, intracardiac biopsy, direct gas exchange oxygen consumption measurement, percutaneous valvuloplasty, patent foramen ovale, patent ductus arteriosus, and atrial septal defect closure, intra-aortic balloon pump, left ventricular assistive devices, coil embolization, and neurological cooling. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success.