Advanced Practice for Biomedical Scientists in Histopathology Sarah May Deputy Chief Executive Institute of Biomedical Science

Institute Qualification Structure Advanced Specialist DiplomaDiploma of expert practiceextended practice Higher Specialist Diploma MSc Specialist Diploma Graduation + Registration Certificate of extended practice Certificate of biomedical practice

Eligibility Criteria Institute Fellow Minimum 5 years post registration experience Working in a CPA registered laboratory with Institute training approval Appropriate trainer or mentor

Cellular Pathology Exams Histological dissection (categories B&C) Immunocytochemistry Ultrastructural Pathology Ophthalmic pathology Non-gynaecological cytology Cervical cytology Breast and G.I dissection (D & E)

Advanced, Expert & Extended Practice Qualifications Cumulative Results - May 2008 QualificationFirst exam Total exams to date Total candidates Total successful Overall pass rate ASD cervical cytology DEP Non- gynae cyto DEP Histo disection DEP Immunocyt DEP Ultra struc path ??

Concerns about preparation for extended and advanced diplomas Choice of trainer/mentor Workload for trainer mentor Departmental support and opportunity to train/learn Lack of specialist courses

Responsibilities Trainer – structures and provides training – assesses knowledge and competence – verifies competence and completion of training Mentor – Provides professional support and guidance

Purpose of the Portfolio Evidence highly specialised skills and knowledge beyond the HSD/masters level – experiential learning Provide a framework and support for a programme of self-directed learning Indicate readiness to enter the final examination

Portfolio compilation Presented as a hard copy file Index or contents page –sections identified and labelled Introduction –brief description of training experience Evidence should be current, relevant and accompanied by a written commentary –indicate relevance of evidence to aims and learning outcomes stated in study guide or syllabus

Minimum requirements Case log Case reviews Case studies Formative assessments Audits Tutorials and training sessions General overview All must reflect the level of the qualification

Case Log Record of range of cases encountered Indication of workload Indication of specimen/sample repertoire No minimum number stated but should be sufficient to demonstrate competence has been achieved

Case/specimen reviews Undertaken with trainer Evidence level, scope and complexity of practice Demonstrate understanding of the implications of investigations for diagnosis and management Part of continuing audit

Case studies Approximately 500 – 1000 words Pre-analytical phase – presenting symptoms, medical history Analytical – how specimen handled, tests performed, differential diagnoses, previous results Post analytical – Possible outcomes, prognosis, any follow up treatment

Ongoing assessments A record of systematic periodic review of candidate performance Should demonstrate how candidate knowledge and skills have developed Should include evidence of reflection on practice

Audits Includes adverse incident/error log Horizontal and vertical audits Specific audits Demonstrate critical evaluation, reflection on practice and impact on patient care Reflect level of the qualification and experience of the individual

Tutorials and training sessions Questionnaires / written assessments Lectures and seminars Case/specimen reviews Presentations Pictures and printouts Journal clubs and local meetings Short courses

Additional information Training plan or schedule Standard Operating Procedures Departmental staff structure indicating role of the candidate within the department Demonstration of skills development Reflective learning records

Final Assessment Portfolio –2 assessors, 1 BMS and 1 pathologist –Pass or refer result Written examination –Paper 1 2 hours, short answers –Paper 2 2 hours, case studies OR optional mods

Portfolio Assessment –General overview –Workplace based assessment –Case review –Audit –Evidence of reflective learning –Case log –Case studies –Training logbook

Case Log 1.The log must reflect a variety of cases in order to assess candidates’ scope of professional practice 2.The log is clearly laid out and accessible 3.The mix of cases is in accordance with the modules or subjects in which the candidate claims experience

Formative assessments It is clear from the evidence presented that systematic and periodic review of the candidate’s performance throughout the training period has been undertaken It is evident from the details presented how the candidate’s practice has evolved over the course of the training period ( e.g. inclusion of assessments of competence)

Conclusions Understanding of the process still developing Biggest problems encountered by most experienced practitioners Standardisation of the examination system being undertaken Further qualification development based on demonstrated need

Next Steps Histological Dissection – specimen categories D and E –Breast and gastrointestinal pathology –Modular approach –Available 2010 or 11 –Gynaecological and skin pathology Modernising Scientific Careers