<![CDATA[Introduction: Healthcare facilities require competent health workers to ensure the proper management of hazardous and toxic materials (B3) waste. Training effectiveness is commonly evaluated by comparing pretest and posttest scores; however, achievement of a predefined mastery threshold as an indicator of competency readiness is less frequently analyzed in parallel with knowledge improvement. Methods: This quantitative evaluative study employed a one-group pretest-posttest design involving 206 participants selected through total sampling from the 2024 Healthcare Facility Waste Management Training at the UPTD Bapelkes of Lampung Province, Indonesia. The instrument consisted of 40 multiple-choice questions administered through the Plataran Sehat platform of the Ministry of Health of the Republic of Indonesia. Data were analyzed using the Wilcoxon Signed-Rank test, Mann-Whitney test, Kruskal-Wallis test followed by Dunn-Bonferroni post-hoc analysis, and Chi-Square/Fisher's Exact test. Statistical significance was set at α=0.05. Results: Knowledge scores increased significantly from 42.7±14.3 at pretest to 79.1±12.5 at posttest, with a mean gain score of 36.7±15.7 points (Z=−12.331; p<0.001). In the numerical analysis, only participants' district of origin was significantly associated with gain scores (H=22.181; p<0.001). Post-hoc analysis identified significant differences between Way Kanan and South Lampung (adjusted p=0.002) and between Tanggamus and South Lampung (adjusted p=0.002). In the categorical analysis, mastery status (posttest score ≥80) was significantly associated with profession (p<0.001), district of origin (p<0.001), age group (p=0.014), and workplace (p=0.025). The highest mastery rate was observed among Environmental Sanitation Workers (70.7%) and participants aged 20–29 years (72.3%). Discussion: The training significantly improved participants' knowledge overall; however, achievement of the mastery threshold varied according to professional background, age, workplace, and district of origin. These findings indicate that improvement in knowledge scores does not necessarily translate into uniform achievement of competency mastery. Conclusion: Healthcare facility waste management training was effective in significantly increasing participants' knowledge, but mastery achievement remained uneven across participant characteristics. Training organizers should consider conducting initial competency assessments and providing targeted mentoring, particularly for non-Environmental Sanitation Workers and senior participants.]]>
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