Advanced Practice for Biomedical Scientists in

Histopathology

Sarah MayDeputy Chief Executive

Institute of Biomedical Science

Institute Qualification StructureAdvanced Specialist Diploma

Diploma of Diploma of

expert practice extended practice

Higher Specialist Diploma

MScSpecialist 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 2008Qualification

First exam

Total exams to date

Total candidates

Total successful

Overall pass rate

ASD cervical cytology

2001 33 232 83 35.8

DEP Non- gynae cyto

2004 4 30 14 48

DEP Histo disection

2005 3 21 19 90

DEP Immunocyt

2006 2 5 4 80

DEP Ultra struc path

2008 0 3 ? ?

Concerns about preparation forextended 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 Log1. 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