This study aimed to evaluate the psychometric properties of the TECO-D for students in Medical, Imaging, and Radiotherapy Radiology Techniques at Sapienza University of Rome. Conducted by the research group “Riabilitazione, Evidenza e Sviluppo” (R.E.S.), the study assessed internal consistency, cross-cultural validity, and discriminant validity. A total of 217 students participated, divided into four cohorts (first year: 76; second year: 67; third year: 62; undergraduates: 12). The TECO-D test comprised 92 multiple-choice questions across thirteen macro-areas and was administered via a digital platform managed by CINECA. Data analysis was performed using SPSS-23, following COSMIN standards. Internal consistency was assessed through Cronbach’s alpha (>0.70), cross-cultural validity using two-way ANOVA, and discriminant validity through the Area Under the Curve (AUC) from Receiver Operating Characteristic (ROC) analysis. The results demonstrated excellent internal consistency, confirming the reliability of the TECO-D. The cross-cultural validity analysis revealed a statistically significant improvement in scores across academic years, highlighting the test’s ability to assess competency acquisition. The AUC values showed a moderate ability to differentiate between competency levels: 0.89 (95% CI 0.81–0.88) for first year, 0.84 (95% CI 0.80–0.88) for second year, and 0.83 (95% CI 0.77–0.90) for third year students. These findings confirm that the TECO-D is a valid and reliable tool for assessing competencies in this degree program. Its ability to measure learning progression supports its use in monitoring educational outcomes and enhancing the quality of university training.